EOR pharm part 2 Flashcards
Dosage forms of Tylenol with codeine
Tablet
PO suspension
Average daily dosages of Tylenol with codeine
Cough: 1/2t-1t every 4-6 hours
Pain: 1-2t every 4-6 hours
Common indications of Tylenol with codeine
Relief of mild-to-moderate pain
MOA of Tylenol with codeine
Acetaminophen: Although not fully elucidated, believed to inhibit the synthesis of prostaglandins in the central nervous system and peripherally block pain impulse generation; produces antipyresis from inhibition of hypothalamic heat-regulating center.
Codeine: Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; causes cough suppression by direct central action in the medulla; produces generalized CNS depression
Common adverse effects of Tylenol with codeine
Hepatotoxicity Steven Johnson syndrome Constipation Dizziness/drowsiness HA Lightheadedness
Renal or hepatic dose adjustments of Tylenol with codeine
Hepatic: use with caution may cause hepatotoxicity
BBW for Tylenol with codeine
Hepatotoxicity and ultra-rapid metabolism of codeine to morphine
Clinically sig drug interactions of Tylenol with codein
EtOH
Major counseling points of Tylenol with codeine
Do not use any other product including OTC with APAP
Avoid alcohol
Do not exceed 3-4gm/day of APAP
Monitoring parameters of Tylenol with codeine
Pain control
Constipation
Abuse
Misuse
Dosage forms of risperidone
Tablets, Orally disintegrating tabletsRISPERDAL® M-TAB® Orally Disintegrating Tablets 0.5 mg, 1 mg, 2 mg, 3mg, 4mg,
Powder for injection
Oral solution
Average daily dosages of risperidone
Oral: 1mg BID on day 1, 2mg BID on day 2, 3mg BID on day 3, then titrate on a weekly basis. Max dose: 16mg
Injection: 25mg IM every 2 weeks
Common indications of risperidone
Bipolar mania Bipolar I maintenance Schizophrenia PTSD Tourette's syndrome Agitation
MOA of risperidone
Dopamine (D2) and serotonin (5HT2) antagonism
Common adverse effects of risperidone
EPS Tachycardia Priapism Rash Somnolence Agitation/anxiety
Renal or hepatic dose adjustments for risperidone
Renal and hepatic adjustments recommended
BBW in risperidone
Increased mortality in elderly pts with dementia-related psychosis
Drug interactions with risperidone
Fluoxetine, carbamazepine, and clozapine may increase risperidone
Major counseling points of risperidone
May cause fainting during initial doses
May impair judgement
Avoid EtOH
Avoid excessive exposure to sunlight and heat during therapy
Monitoring parameters of risperidone
Decrease S/sx of bipolar, schizophrenia, PTSD, and Tourettes
Dosage forms of quetiapine
Tablets (25mg, 50mg, 100mg, 200mg, 300mg, 400mg)
Tablets, extended-release, XR (50mg, 150mg, 200mg, 300mg, 400mg)
Average daily dosages of quetiapine
Maintenance dose should be between 300 and 400 mg daily, given in two to three doses or one extended-release tablet; Max 800 mg per day
Common indications for quetiapine
Tx of schizophrenia
Tx of depressive episodes associated with bipolar d/o
Tx of MDD
PTSD
MOA of quetiapine
Combination of dopamine type 2 (D2) and serotonin type 2 (5-HT2) antagonism
Common adverse effects of quetiapine
Somnolence Dizziness Constipation Postural hypotension Dry mouth Dyspepsia
Renal or hepatic dosage adjustments for quetiapine
Hepatic impairment- initiate 25mg/day then step up daily in increments of 25-50mg/day
BBW of quetiapine
Increased mortality in elderly patients with dementia-related psychosis.
Increased suicidal thoughts and behavior
Clinically sig drug interactions with quetiapine
May have additive sedative effects with other CNS depressants. \
Oral clearance is increased with phenytoin and thioridazine.
Chronic use with NSAIDS increases risk of GI bleed
Major counseling points of quetiapine
Caution when rising from a prone position.
May cause drowsiness- use caution when performing tasks that require alertness. May be taken without regards to food.
Seroquel XR should be swallowed whole and not crushed, divided, or chewed.
Monitoring parameters of quetiapine
Decrease in shizophrenic/bipolar/depressive episodes
Unusual changes in mood
Suicidality
Dosage forms of metronidazole
IV: 500mg/100ml Capsule: 375mg Tablet: 250, 500mg Cream: 0.75% Gel: 0.75, 1% Lotion: 0.75% Vaginal Gel: 0.75%
Average daily dosages of metronidazole
250-1000 mg/day
Common indications of metronidazole
Various infections
MOA of metronidazole
Metronidazole inhibits anaerobic bacterial DNA synthesis leading to bacterial death
Common adverse effects of metronidazole
Vaginitis Abdominal discomfort Diarrhea Nausea Taste disturbance
BBW of metronidazole
Carcinogenic
Drug interactions of metronidazole
When taken with zipasidone QT prolongation may be seen
Major counseling points of metronidazole
NO EtOH
Monitoring parameters of metronidazole
Improvement in S/sx of infection
WBC
Dosage forms of fluconazole
Tabs
PO suspension
Injectable solution
Average daily dosages of fluconazole
100-800 mg daily (depending on indication)
Common indications of fluconazole
Treatment of candidiasis (esophageal, oropharyngeal, peritoneal, urinary tract, vaginal)
Systemic candida infections (eg, candidemia, disseminated candidiasis, and pneumonia); Cryptococcal meningitis
Antifungal prophylaxis in allogeneic bone marrow transplant recipients
MOA of fluconazole
Interferes with fungal cytochrome P450 activity (lanosterol 14-α-demethylase), decreasing ergosterol synthesis (principal sterol in fungal cell membrane) and inhibiting cell membrane formation
Common adverse effects of fluconazole
HAs Dizziness Abd pain Vomiting Rash/pruritis Increase in AST/ALT
Renal or hepatic dose adjustments of fluconazole
Renal- If CrCl is <50: administer 50% of recommended dose
Clinically sig drug interactions of fluconazole
Fluconazole is a 34, 2C9 and 2C19 inhibitor (may increase INR in patients on warfarin)
Major counseling points of fluconazole
Take with or without food
If you are passing brown or dark-colored urine, have pale stools, or feel more tired than usual or skin/sclera turning yellow immediately contact your physician
If you develop a serious rash contact your physician
The liquid suspension should not be refrigerated.
