Exam 3 (Drugs 101 - 150) Flashcards
Insulin Aspart
Novolog
Insulin is the primary hormone responsible for carrying out proper glucose utilization in metabolic processes
Insulin Aspart, Insulin Lispro, Insulin Detemir
Hypoglycemic reactions are not uncommon in diabetics and may be caused by excessive insulin dose or when glucose absorption is decreased due to fasting, diarrhea, or vomiting
Insulin Aspart, Insulin Lispro, Insulin Detemir
May cause lipodystrophy at the injection site
Insulin Aspart, Insulin Lispro, Insulin Detemir
Administer 5 - 10 minutes before eating
Insulin Aspart
Estrogens (conjugated)
Premarin
A mixture of naturally occurring estrogens derived from pregnant mares’ urine
Premarin
CI in patients with known or suspected cancer of the breast except in selected patients being treated for metastatic disease. Do not use in patients with known or suspected estrogen-dependent neoplasia, known or suspected pregnancy, undiagnosed genital bleeding, or in pts with thrombophlebitis, thrombosis, or thromboembolic disorders
Premarin, Estradiol (topical)
Estrogens have been reported to increase the risk of endometrial carcinoma and to increase the risk of cardiovascular events including MI, stroke, pulmonary emboli, and DVT in postmenopausal women. Because of these risks, estrogens should be prescribed at the lowest effective dose and for the shortest duration consistent with treatment goals
Premarin
AE’s include rash, acne, alopecia, hirsutism, abnormal menstrual BLEEDING, edema, changes in weight, cholestatic JAUNDICE, changes in cervical erosion and cervical secretions, mental depression, pyrexia, insomnia, nausea, and somnolence
Premarin
Report any severe side effects to your physician including pains in the legs, coughing blood, abnormal vaginal bleeding, skin yellowing, and abdominal pain
Premarin
Read patient information sheet carefully
Premarin
Hydroxyzine Pamoate (antianxiety)
Vistaril
Antagonizes the H1 receptors in the subcortical region of the CNS. Primary skeletal muscle relaxation, bronchodilator activity, and antihistaminic and analgesic activity have been demonstrated
Hydroxyzine Pamoate
May potentiate the effects of opioids and barbiturates, dosage requirements may be necessary
Hydroxyzine Pamoate
Sedating drugs may cause confusion and over sedation in the elderly; elderly patients should be started on a lower dose
Hydroxyzine Pamoate
The most common AE’s are dry mouth and drowsiness. Drowsiness is usually transitory in nature and may disappear after a few days of treatment
Hydroxyzine Pamoate
Tizanidine HCl
Zanaflex
Agonist at alpha-2 adrenergic receptor sites and presumably reduces spasticity by increasing presynaptic inhibition of motor neurons. Does not affect skeletal muscle fibers or the neuromuscular junction with minimal effects on monosynaptic spinal reflexes
Tizanidine
Structurally similar to clonidine but with much lower effects on blood pressure
Tizanidine
Tablet and capsule formulations are bioequivalent when given in the fasted state, but not when given with food. When given with food, the plasma concentrations of the tablet form are increased and the plasma concentration of the capsule form are decreased
Tizanidine
Oral contraceptives decrease this drug’s clearance
Tizanidine
Occasional cases of liver injury have been reported during therapy. Monitor liver enzymes before and during treatment (baseline, 1, 3, 6 months) and stop therapy if liver function tests > 3x ULN. Animal studies have shown dose-related retinal degeneration & corneal opacities
Tizanidine
More frequent AE’s include dry mouth, drowsiness, asthenia, bradycardia, hypotension, and dizziness. Less frequent include constipation, ABNORMAL LIVER FUNCTION TESTS, BLURRED VISION, rhinitis, nervousness, vomiting, speech disorder, and pharyngitis
Tizanidine
Methylphenidate HCl
Ritalin (SR, LA), Methylin, Metadate
Presumably activates the brain stem arousal system and cortex to produce its stimulant effect
Methylphenidate
May produce hypertensive crisis when used with MAOI’s
Methylphenidate
CI in patients with anxiety, tension, or agitation, in patients with glaucoma or motor tics, and in patients with a family history or diagnosis of Tourette’s syndrome
Methylphenidate
Should not be used in children < 6 yo
Methylphenidate
Take last dose early in the evening to avoid insomnia. LA capsules may be swallowed whole or the contents sprinkled over soft food and ingested without chewing
Methylphenidate
Ciprofloxacin HCl
Cipro (XR)
A fluoroquinolone antibiotic which prevents the synthesis of bacterial DNA by interfering with the enzyme DNA gyrase. Has a wide range of activity against gram-negative and gram-positive bacteria.
Ciprofloxacin
Antacids and iron salts decrease bioavailability. Probenecid increases serum levels by decreasing exertion. NSAID’s may lower seizure thresholds and predispose patients to convulsive seizures when taking this drug.
Ciprofloxacin
Do not use in children, adolescents, or pregnant women due to permanent lesions in weight-bearing joints. Do not use in patients receiving theophylline. Patients should be well hydrated to avoid crystalluria.
Ciprofloxacin
Quinolones have been shown to cause ruptures of the shoulder, hand, and Achilles tendons.
Ciprofloxacin
Most common AE’s are nausea, RASH, diarrhea, sun sensitivity, and dizziness
Ciprofloxacin
Drink a full glass of water after each dose. May be taken without regards to meals, although it is preferable to take dose two hours following a meal. Do not take antacids during therapy.
Ciprofloxacin
Suspension may be stored at room temperature or in the refrigerator and is stable for 14 days after reconstitution. Shake vigorously for 15 seconds before each dose
Ciprofloxacin
Do not take antacids or products containing calcium, zinc, or iron at the same time as this drug. This drug can be taken 2 hours before or 6 hours after these products
Ciprofloxacin
Lansoprazole
Prevacid
Inhibits the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell. This enzyme system is involved in the movement and production of gastric acid.
Lansoprazole
Ezetimibe
Zetia
Lipid-lowering compound that selectively inhibits the intestinal absorption of cholesterol and is related to phytosterols. Appears to act at the brush border of the small intestine to inhibit cholesterol absorption thereby decreasing the delivery of cholesterol to the liver
Ezetimibe
AE’s include myalgia, increased CPK, elevations in liver transaminases, hepatitis, thrombocytopenia, urticaria, arthralgia, and myopathy/rhabdo
Ezetimibe
Do not take within 2 hours before or 4 hours after the administration of a bile acid sequestrant (cholestyramine)
Ezetimibe
Propranolol HCl
Inderal (LA), Innopran XL
Causes non-selective blockage of beta-adrenergic receptors resulting in 1) a decreased HR, 2) a decrease in systolic and diastolic BP, 3) an inhibition of isoproterenol tachycardia, and 4) a decrease of reflex tachycardia
Propranolol
Toxic effects may be increased with concurrent use of VERAPAMIL
Propranolol
CI in patients with cardiogenic shock, bronchial asthma, sinus bradycardia, greater than 1st degree heart block, and CHF, unless secondary to tachyarrhythmia treatable with propranolol
Propranolol
Patients with diabetes need to be aware that this agent can cause masking of hypoglycemic symptoms
Propranolol
Fentanyl (transdermal)
Duragesic
An opioid analgesic, therefore analgesia is produced centrally via action on the central opiate receptors. Interacts predominantly with the mu-opioid receptor.
Fentanyl
Patches should be applied to non-irritated and non-irradiated skin on a flat surface of the upper torso. Do not apply to extremities below the knee or elbow. Hair at the application site should be clipped (not shaved) prior to system application.
Fentanyl
Patches should be applied immediately upon removal from the sealed package. The transdermal system should be pressed firmly in place with the palm of the hand for 10 - 20 seconds. Each patch may be worn continuously for 72 hours.
Fentanyl
Used systems should be folded so that the adhesive side of the system adheres to itself and then flushed down the toilet immediately upon removal. Do not cut or puncture systems
Fentanyl
Nystatin (topical)
Nystop
An antimycotic polyene antibiotic obtained from Streptomyces noursei. MOA is that it binds to sterols in the cell membrane of susceptible Candida species, changing the permeability of the cell membrane. Fungicidal and fungistatic against many fungi. It is not absorbed from intact skin or mucous membranes
Nystatin
Cream, ointment, and powder preparations are not to be used in ophthalmic, intravaginal, oral or systemic infections
Nystatin
Do not use in or around the eyes - not for opthalmic use
Nystatin
Doxycycline Hyclate
Vibramycin & Vibra-Tabs
Tetracycline antibiotic which prevents bacterial protein synthesis by competitively binding to the 30S ribosomal subunit. Bacteriostatic at normal dosage ranges.
Doxycycline
May impair the action of bactericidal antibiotics. May impair the systemic absorption of oral contraceptives. Absorption may be impaired by aluminum, bismuth, calcium, magnesium, zinc, iron salts, and urinary alkalinizers
Doxycycline
Use with precaution in children < 8 yo (during tooth development). Cases of C. diff associated diarrhea have occurred during treatment
Doxycycline
Preferably taken on an empty stomach - one hour before or two hours after meals - with a full glass of water. Taken at intervals, preferably around the clock. Avoid prolonged exposure to the sunlight.
Doxycycline
Insulin Lispro
Humalog
Administer 15 minutes before eating
Insulin Lispro
Carbidopa with Levodopa
Sinemet (CR)
Levodopa crosses the BBB and is converted into dopamine in the basal ganglia. A large portion of levodopa is converted to dopamine in extracerebral tissue. Dopamine does not cross the BBB. Carbidopa inhibits the dopa-decarboxylase in extracerebral tissue, thereby increasing the levels of levodopa available to the CNS and decreases the side effects (nausea) seen from high levels of peripheral dopamine.
Carbidopa with levodopa
Hydantoins and pyridoxine (vitamin B6) may decrease effectiveness. Hypertensive crisis may occur if given with MAOI’s.
Carbidopa with levodopa
CI in patients with narrow-angle glaucoma, in patients with a suspicious, undiagnosed skin lesion or a history of melanomas, and in patients currently taking MAOI’s
Carbidopa with levodopa
D/C levodopa therapy at least 8 hours before initiation of Sinemet therapy
Carbidopa with levodopa
AE’s include DYSTONIC or involuntary movements, depression, dementia, and nausea
Carbidopa with levodopa
_____ CR may be given whole or in half tablets but should not be crushed or chewed
Carbidopa with levodopa
Avoid vitamin B6 (pyridoxine) products
Carbidopa with levodopa
Valsartan
Diovan
Blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues (ARB)
Valsartan
NSAID’s, including COX-2 inhibitors, may decrease effects and increase risk of renal function deterioration
Valsartan
Use with caution in volume or salt-depleted patients due to excessive hypotension
Valsartan
Famotidine
Pepcid
Competitively inhibits histamine at the H2 receptors, including receptors on gastric cells. Inhibits basal, nocturnal, and food stimulated gastric secretion.
Famotidine
Shake suspension well and discard unused portion after 30 days
Famotidine
Antacids may be given concomitantly to relieve acute pain
Famotidine
Sitagliptin Phosphate
Januvia
Inhibits the dipeptidyl-peptidase-4 (DPP-4) enzyme - this enzyme is responsible for deactivating the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)
Sitagliptin
The use of this drug with drugs that may cause hypoglycemic reactions (including sulfonylureas & insulin) has not been adequately studied and these combinations should be avoided.
Sitagliptin
Most common AE is nasopharyngitis (5%)
Sitagliptin
May be taken without regard to meals. Quarterly HbA1c testing should be performed
Sitagliptin
Eszopiclone
Lunesta
A pyrrolopyrazine of the cyclopyrrolone class (structurally unrelated to benzodiazepines). Thought to act at GABA-receptor complexes at binding sites located near or coupled to BZD receptors
Eszopiclone
Additive CNS depressant effect is seen when this drug is given with CNS depressants, including alcohol.
Eszopiclone
Sleep disturbances may be a sign of a physical and/or psychiatric disorder. The failure of insomnia to remit after 10 days of treatment may indicate the presence of a primary physical and/or psychiatric illness.
Eszopiclone
Most common AE’s (>10%) are drowsiness, HA, and an unpleasant taste sensation. Less common AE’s (< 5%) include dry mouth, anxiety, depression, dysmenorrhea, gynecomastia, and infection
Eszopiclone
Preferably taken on an empty stomach. High fat meals delay onset of action. Take immediately before bedtime. A rapid decrease or abrupt D/C of therapy may precipitate withdrawal symptoms
Eszopiclone
Temazepam
Restoril
Facilitates the inhibitory neurotransmitter action of GABA, which mediates both pre- and post-synaptic inhibition in all regions of the CNS
Temazepam
Insomnia may be a sign of an underlying psychiatric disorder. Reevaluate therapy if insomnia fails to remit after 10 days of treatment
Temazepam
This medication is not intended to be used for longer than 10 consecutive days
Temazepam
Verapamil HCl
Isoptin, Calan, Verelen
Calcium-channel blocker which inhibits the movement (influx) of calcium ions across specific cellular membranes (slow channels) resulting in 1) dilation of coronary arteries and arterioles resulting in a decreased vascular resistance, 2) coronary spasm inhibition, 3) lowering of arterial BP, 4) slowing of SA and AV conduction, and 5) prolongation of AV node ERP & FRP
Verapamil
Therapeutic and toxic effects of BETA-BLOCKERS and prazosin may be increased when used with this drug.
Verapamil
CI in patients with severe left ventricular dysfunction hypotension, cardiogenic shock, sick sinus syndrome, and 2nd or 3rd degree AV block
Verapamil
AE’s include hypotension, peripheral edema, dizziness, HA, constipation, and nausea
Verapamil
Take each dose on an empty stomach at least one hour before or two hours after a meal. Do not D/C therapy without first consulting a physician
Verapamil
Chlorpheniramine with Hydrocodone
Tussionex
A narcotic which depresses the cough reflex center in the medulla oblongata & an H1 antihistamine receptor antagonist which possesses anticholinergic activity
Chlorpheniramine with Hydrocodone
Use with extra caution postoperatively and in patients with pulmonary disease, obstructive bowel disease, increased intracranial pressure, or head injury
Chlorpheniramine with Hydrocodone
Enalapril Maleate
Vasotec
Undergoes hydrolysis after absorption to form the active metabolite enalaprilat
Enalapril
Competitively inhibits angiotensin-converting enzyme (ACEI)
Enalapril
Capsaicin may increase the incidence of coughing. Diuretics (especially potassium-sparing diuretics) and potassium supplements may increase hyperkalemia
Enalapril
Avoid nonprescription cough, cold, and allergy medications unless otherwise directed
Enalapril
Solifenacin Succinate
Vesicare
A competitive muscarinic receptor antagonist
Solifenacin
CI in patients with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma and in patients who are at risk for these conditions
Solifenacin
AE’s are usually mild and transient and include (in order of occurrence): dry mouth, constipation, blurred vision, UTI, dyspepsia, nausea, abdominal pain, dizziness, fatigue, and dry eyes
Solifenacin
Avoid prolonged exposure to hot weather
Solifenacin
Estradiol (topical)
Vivelle-Dot
Estrogens promote growth and development of the vagina, uterus, and fallopian tubes, and enlargement of the breasts. They are also involved in the process of menstruation. Estradiol is the more potent of the estrogens with estrone and estriol being less potent. Transdermal applied estradiol avoids the first-pass metabolism of orally administered estradiol to estrone
Estradiol (topical)
Irritation of application site, EDEMA, THROMBOEMBOLIC disorders, breast tenderness, disturbances in menstruation, and depression
Estradiol (topical)
Discuss the uses and dangers of estrogen therapy (package insert)
Estradiol (topical)
Closely follow the cyclic administration. Water will not affect system. Do not use scissors to remove protective pouch. Avoid application sites that are oily, damaged, irritated, or wet. Do not apply to the waistline, since tight clothing may rub system off.
Estradiol (topical)
Pramipexole Dihydrochloride (antiparkinson agent)
Mirapex
A nonergot dopamine receptor agonist with a higher affinity to D3 dopamine receptors than D2 or D1 receptors. Principle site of action for the treatment of Parkinson’s disease appears to be in the striatum and substantial nigra
Pramipexole
Orthostatic hypotension is common during dose escalations. Careful dose titrations minimize the clinical effect of the orthostatic hypotension. May potentiate the dopaminergic side effects (dyskinesia) of levodopa therefore requiring a lowering of the levodopa dose. Some patients have reported suddenly falling asleep during activities of daily living, even after one year therapy
Pramipexole
AE’s found in early Parkinson’s disease include dizziness (25%), somnolence (22%), asthenia (14%), etc. AE’s found in advanced Parkinson’s disease include orthostatic hypotension (53%), dyskinesia (47%), insomnia (27%), dizziness (26%), etc.
Pramipexole
Patients should be informed that hallucinations may occur during therapy. Report any changes in vision. Report any new or increased intense urges (gambling, sexual, other). May cause orthostatic hypotension.
Pramipexole
Carbamazepine
Tegretol (XR), Carbatrol ER, Equetrol ER
Appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation.
Carbamazepine
CI in patients hypersensitive to tricyclic compounds and in patients with bone marrow suppression. Patients of Asian descent should be tested for HLA-B*1502 bc these patients have a much higher risk of developing serious skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis
Carbamazepine
Rare reports of aplastic anemia, agranulocytosis, and Stevens-Johnson syndrome have been reported. Contact a physician immediately if fever, sore throat, mouth ulcers, bruising, or skin rash occurs.
Carbamazepine
Taken with food or milk. Drink a full glass of water following administration of chewable tablets
Carbamazepine
Phenytoin Sodium (extended)
Dilantin Kapseals
Increases the extrusion of sodium ions from neurons and cardiac myocytes. This produces a stabilization of the excitable membrane to repetitive stimuli. The primary site of action appears to be the motor cortex
Phenytoin
MANY drug interactions. D/C use if rash develops
Phenytoin
AE’s include nystagmus, ATAXIA, SLURRED SPEECH, MENTAL CONFUSION, N/V, RASH, hirsutism, gingival hyperplasia, constipation, dizziness, drowsiness
Phenytoin
Take with food to enhance absorption and to reduce GI upset. Practice good oral hygiene to help prevent gingival hyperplasia. Diabetic patients should monitor blood glucose levels closely. Do not D/C therapy without first consulting a physician.
Phenytoin
Levalbuterol HCl
Xopenex
A sympathomimetic which stimulates adenyl cyclase, the enzyme which catalyzes the formation of cAMP from ATP. This formation causes relaxation of bronchial, uterine, and vascular smooth muscle through stimulation of beta-2 adrenergic receptors
Levalbuterol
Solution for inhalation can produce paradoxical bronchospasm, which can be life-threatening
Levalbuterol
AE’s listed in approximate order of frequency: dizziness, pharyngitis, and rhinitis
Levalbuterol
Do not take more frequently than recommended. Vials are distributed in foil pouches in groups of 12. Once a foil pouch is opened, the vials inside should be used within 2 weeks. After opening the foil, keep the vials inside the pouch until ready to use. Solution in the vial should be colorless.
Levalbuterol
Shake canister well before each inhalation. Prime with 4 sprays before first use and if not used for 3 days. Clean mouthpiece at least once a week by removing the canister, running warm water through it for 30 seconds, and letting it air dry thoroughly.
Levalbuterol
Cephalexin Monohydrate
Keflex
A first generation cephalosporin which inhibits bacterial cell wall synthesis via acylation of the transpeptidase enzyme.
Cephalexin
CI in patients hypersensitive to PCNs/cephalosporins. Estimated incidence of cross-sensitivity is 5 - 16%. Cases of pseudomembranous colitis have occurred during treatment.
Cephalexin
AE’s include N/V, DIARRHEA, HIVES, ITCHING, and RASH
Cephalexin
Preferably taken on an empty stomach (one hour before or two hours after meals) with a full glass of water. Take at even intervals, preferably around the clock. Keep suspension refrigerated
Cephalexin
Desvenlafaxine
Pristiq
A potent inhibitor of neuronal serotonin and norepinephrine reuptake
Desvenlafaxine
ANTIDEPRESSANTS INCREASE SUICIDAL THOUGHTS AND ACTIONS IN SOME CHILDREN, ADOLESCENTS, AND YOUNG ADULTS. Should not be used within 14 days of D/C MAOI therapy. Wait at least one week after stopping this drug to initiate an MAOI
Desvenlafaxine
Use cautiously in patients with a history of seizures. Not indicated for use in pediatric patients.
Desvenlafaxine
Most common AE’s include nausea, dry mouth, anorexia, constipation, drowsiness, insomnia, dizziness, sweating, erectile dysfunction, and decreased libido
Desvenlafaxine
Continued therapy of up to 2 weeks may be needed to show noticeable improvement
Desvenlafaxine
Do not abruptly stop therapy before consulting a physician. Matrix tablet shell may be found intact in the stool.
Desvenlafaxine
Mometasone Furoate Monohydrate (intranasal)
Nasonex
Adrenocorticoid that binds to certain receptor proteins found in the cytoplasm of sensitive cells to form a steroid-receptor complex. The steroid-receptor complex enters the nucleus of the cell where it reacts with chromatin, or DNA. The steroid (or possibly the receptor) then uses stored information to stimulate or inhibit the transcription of mRNA.
Nasonex, Triamcinolone acetonide (topical), Fluticasone propionate (inhalation)
Use with caution in patients with tuberculous infections of the respiratory tract, untreated fungal, bacterial, or systemic viral infections, ocular herpes simplex, or unhealed wounds of the nasal mucosa
Nasonex, Triamcinolone acetonide (except for nasal part)
AE’s include HA (26%), viral infection (14%), pharyngitis (12%), epistaxis (11%), cough (7%), upper respiratory tract infection (6%), dysmenorrhea, muscle pain, and sinusitis (5%)
Nasonex
Shake bottle well before each use. Therapeutic effects are not seen at once, benefits are usually seen in a few days but may take as long as three weeks. If no improvement is evident by that time, use should be D/C. Clear nasal passages of secretions prior to use. Oral decongestants may be used if needed.
Nasonex
Ziprasidone HCl (antipsychotic)
Geodon
Exact MOA unknown, but thought to act by antagonism of dopamine D2 and serotonin 5-HT2 receptors. Also has been shown to be an antagonist at histamine H1 and alpha-1-adrenergic receptors
Ziprasidone
Should not be used with other drugs that prolong the QTc interval including dofetilide, sotalol, quinidine, other Class Ia and III antiarrhythmics, FQ’s, etc
Ziprasidone
CI IN PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS. CI in patients with a known history of QT prolongation, with recent MI, with uncompensated HF, & in pts currently taking a drug which prolongs the QTc interval
Ziprasidone
Rare cases of Neuroleptic Malignant Syndrome (NMS) have occurred in patients taking antipsychotic medications. Rare cases of leukopenia/neutropenia and agranulocytosis have been reported in patients taking antipsychotic agents
Ziprasidone
Most common AE’s include: drowsiness, nausea, constipation, dyspepsia, dizziness, akathisia, cold symptoms, EPS, diarrhea, rhinitis, asthenia, dry mouth, dystonia, and non-allergic rash
Ziprasidone
This drug can cause serious heart arrhythmias. Take with food to help its absorption. Do not D/C abruptly. May take several weeks to see symptom improvement. Use appropriate precautions against heat exposure and dehydration
Ziprasidone
Niacin (ER)
Niaspan
AKA nicotinic acid; functions in the body after conversion to nicotinamide adenine dinucleotide (NAD). Lowers cholesterol by a mechanism unrelated to its actions as a vitamin. Increases lipoprotein lipase activity, decreases lipolysis in adipose tissue, and decreases esterification of triglycerides in the liver
Niacin
Bile acid sequestrants will decrease absorption; a minimum of 4 hours should elapse between administration of these drugs. Rare cases of rhabdomyolysis have occurred in patients taking niacin with HMG-CoA reductase inhibitors.
Niacin
CI in patients with significant or unexplained hepatic dysfunction, active PUD, or arterial bleeding.
Niacin
Most frequent AE’s include flushing (88%), pruritis (6%), and rash (5%)
Niacin
Take at bedtime with a low-fat snack. Taking on an empty stomach is not recommended
Niacin
Flushing is a common AE and usually subsides after a few weeks of therapy. Aspirin or NSAIDs taken shortly before bedtime may minimize flushing. Avoid alcohol around the same time as this drug to avoid flushing reactions
Niacin
Fluconazole
Diflucan
A highly selective inhibitor of fungal cytochrome P450 sterol C-14 alpha-demethylation. Mammalian cell demethylation is much less sensitive to fluconazole inhibition
Fluconazole
No evidence of cross hypersensitivity between this drug and other azole antifungal agents
Fluconazole
Nausea, HA, abdominal pain, diarrhea, dizziness, dyspepsia, and taste perversion are common AE’s
Fluconazole
Gemfibrozil
Lopid
Decreases serum triglycerides and VLDL-cholesterol and increases HDL-cholesterol. Reduction of triglycerides is due to an inhibition of peripheral lipolysis and reduction of hepatic extraction of free fatty acids.
Gemfibrozil
Coadministration with LOVASTATIN may cause severe myopathy or rhabdomyolysis
Gemfibrozil
CI in patients with hepatic or severe renal dysfunction and preexisting gallbladder disease. May cause cholelithiasis
Gemfibrozil
AE’s include dyspepsia (19.6%), abdominal pain (9.8%), diarrhea (7.2%), nausea (2.5%), and fatigue (3.8%)
Gemfibrozil
Lithium Carbonate
Lithonate, Lithotabs, Lithobid
Exact MOA in the treatment of mania is unknown. Mood stabilizing effect may be due to an antagonism of the release of NE and dopamine from nerve terminals or from increasing the reuptake and inactivation of catecholamines. Does NOT inhibit the release of serotonin
Lithium carbonate
CI in patients with significant renal or CV disease, severe debilitation, dehydration, or sodium depletion. Use with caution in patients taking diuretics or ACEI’s
Lithium carbonate
Adequate sodium and fluid (2500 - 3500 mL) intake should be maintained. This drug has a narrow therapeutic index
Lithium carbonate
AE’s include hand tremor, nausea, and mild thirst during initial therapy. Toxicity is manifested by DIARRHEA, VOMITING, DROWSINESS, muscular weakness & lack of coordination followed by BLURRED VISION, TINNITUS, and extreme polyuria
Lithium carbonate
Effects may not be seen at once - may take 1 - 2 weeks before optimum effect is seen. Maintain your normal diet and have a fluid intake of 2 - 3 quarts a day during therapy. Avoid overexposure to heat and sweating during therapy.
Lithium carbonate
Triamcinolone Acetonide (topical)
Kenalog
AE’s include local burning, itching, and skin atrophy. AE’s occur more frequently when an occlusive dressing is used
Triamcinolone acetonide
Doxazosin Mesylate
Cardura (XL)
Selective antagonist of postsynaptic alpha-1 adrenergic receptors. This action results in dilation of arterioles and veins which leads to decreased peripheral resistance and decreased BP. Diastolic BP is affected more than systolic BP.
Doxazosin
Caution should be used when given with other antihypertensive agents to avoid the possibility of significant hypotension
Doxazosin
To decrease the risk or syncope at the initiation of therapy, all patients should be started with 1 mg tablets given at bedtime
Doxazosin
Take XL form in the morning with breakfast. The insoluble shell of the XL tablet may be noticed in the stool
Doxazosin
Take first dose of IR tablets at bedtime to avoid fainting - advise patients to rise slowly from a sitting or lying position
Doxazosin
Avoid activities that require alertness for 12 hours following initial dose or dosing increases
Doxazosin
Fluticasone propionate (inhalation)
Flovent
CI in primary treatment of status asthmaticus. Use caution in patients who are being transferred from systemic corticosteroids to Flovent bc deaths due to adrenal insufficiency have occurred during and after transfer to aerosolized steroids. Not to be regarded as a bronchodilator and should not be given for rapid relief of bronchospasm
Fluticasone propionate (inhalation)
Not intended to provide immediate relief of bronchospasm. To receive the full benefits of therapy, use on a regular basis. Although benefits can be seen after 2 days of treatment, up to 4 weeks may be needed to observe benefits.
Fluticasone propionate (inhalation)
Follow instructions for technique: shake inhaler, breathe out fully, breathe medicine in deeply and slowly, hold breath as long as possible, breathe out gently, wait 1 min between puffs and repeat, rinse mouth after use, clean the inhaler at least once a day with warm water.
Fluticasone propionate (inhalation)
Olmesartan Medoxomil
Benicar
A prodrug that is hydrolyzed to olmesartan during absorption from the GI tract. Works as an ARB
Olmesartan
Most common AE seen during therapy is dizziness (3%).
Olmesartan
Butalbital, APAP, & Caffeine
Fioricet
APAP produces analgesia by inhibiting prostaglandin synthesis in the CNS and through a peripheral action of blocking pain impulse generation. Butalbital produces sensory cortex depression through inhibition of conduction in the reticular formation at the level of the thalamus. Caffeine produces CNS stimulation by inhibition of phosphodiesterase which increases the accumulation of cAMP.
Fioricet
CI in patients with porphyria
Fioricet
Amoxicillin with Clavulanate Potassium
Augmentin (XR)
Amoxicillin is a bacteriocidal antibiotic which inhibits bacterial cell wall synthesis via acylation of a transpeptidase enzyme. Clavulanic acid binds competitively to the active sites of beta-lactamase enzymes, thereby protecting PCNs and cephalosporins from destruction
Augmentin
Since both Augmentin 250 and 500 tablets contain 125 mg clavulanic acid, two Augmentin 250 tablets do not equal one 500 tablet.
Augmentin
Preferably taken at the start of a meal to enhance absorption and decrease GI upset. Take at even intervals, preferably around the clock. Follow chewable tablets with a full glass of water. Keep suspension refrigerated, discard after 10 days.
Augmentin
APAP with Codeine
Tylenol w/codeine, Phenaphen w/codeine
APAP produces analgesia by inhibiting prostaglandin synthesis in the CNS and through a peripheral action by blocking pain impulse generation. Codeine phosphate produces analgesia centrally via action on the central opiate receptors
APAP with codeine
Use with caution in patients with increased ICP, head injury, severe hepatic or renal impairment, Addison’s disease, hypothyroidism, prostatic hypertrophy or urethral stricture, and in the presence of acute abdominal conditions
APAP with codeine
Insulin Detemir
Levemir
Unopened vials should be stored in the refrigerator. Do not freeze. Can be kept at room temperature for 42 days
Insulin Detemir
Valsartan with HCTZ
Diovan-HCT
Valsartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues (ARB). HCTZ inhibits the reabsorption of sodium and chloride at the distal renal tubule
Valsartan with HCTZ
CI in patients with anuria or who are hypersensitive to sulfonamide-derived drugs.
Valsartan with HCTZ, Losartan with HCTZ
Oxcarbazepine
Trileptal
May produce its antiseizure activity by blockade of voltage-sensitive sodium channels, resulting in stabilization of hyper excited neural membranes, inhibition of repetitive neuronal firing, and diminution of propagation of synaptic impulses
Oxcarbazepine
Approximately 25 - 30% of patients who have hypersensitivity to carbamazepine will have similar reactions to this drug
Oxcarbazepine
Clinically significant hyponatremia can occur with this drug
Oxcarbazepine
Most common AE’s are dizziness, somnolence, diplopia, fatigue, N/V, ataxia, abnormal vision, abdominal pain, tremor, dyspepsia, and abnormal gait
Oxcarbazepine
Ondansetron HCl
Zofran
A selective 5-HT3 receptor antagonist. Serotonin 5-HT3 receptors can be found peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone of the area postrema
Ondansetron
Not a drug that stimulates gastric or intestinal peristalsis (should not be used instead of nasogastric suction). Chewable tablets contain phenylalanine; use caution in phenylketonurics
Ondansetron
AE’s include HA (25%), fatigue (10%), and constipation (8%)
Ondansetron
Do not remove chewable tablets from the blister until just prior to use. Do not try to push the tablet through the foil, peel the blister apart to remove.
Ondansetron
Ezetimibe with Simvastatin
Vytorin
A class of lipid-lowering compounds that selectively inhibits the intestinal absorption of cholesterol and related phytosterols.
Ezetimibe with Simvastatin
CI in patients with active liver disease or unexplained persistent elevations of serum transaminases. May cause optic nerve degeneration
Ezetimibe with Simvastatin
Avoid grapefruit and grapefruit juice when taking this medication. Avoid overexposure to sunlight due to possibility of photosensitivity
Ezetimibe with Simvastatin
Losartan Potassium with HCTZ
Hyzaar
This drug and its principal active metabolite block the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues. The second part of this drug inhibits the reabsorption of sodium and chloride at the distal renal tubule
Losartan with HCTZ
Most common AE’s are upper respiratory infection, dizziness, cough, and back pain
Losartan with HCTZ
Budesonide & Formoterol Fumarate Dihydrate
Symbicort
A LABA and a corticosteroid combination
Budesonide/Formoterol
Budesonide is a potent anti-inflammatory corticosteroid that shows inhibitory activities against multiple cell types (mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (histamine, eicosanoids, leukotrienes, cytokines).
Formoterol is a long-acting selective beta-2 adrenergic agonist which acts locally in the lung as a bronchodilator.
Symbicort
CI in primary treatment of status asthmaticus
Symbicort
LONG-ACTING BETA-2 AGONISTS INCREASE THE RISK OF ASTHMA-RELATED DEATH
Symbicort
Secondary fungal infections of the oral cavity may occur and may require antifungal treatment
Symbicort
Rinse mouth after each use
Symbicort
To receive full benefits of therapy, use on a regular basis. Although benefits can be seen after 2 days of treatment, up to 4 weeks may be needed to observe benefits.
Symbicort
