Extra Tips Flashcards
Weird long term metronidazole adr
Peripheral neuropathy
Hepatic encephalopathy
- lactulose
- Rifaxim
- Neomycin ( caution neuro tox)
- PO metronidazole
Lasix : spironolactone ratio
40:100
Weight and TCAs
Weight gain
Adjunctive antipsyches for depression
Abilify, symbyax, seroquel, brexpiprazole
Sodium oxybate reqs
REMs
Date rape drug
Narcolepsy with cataplexy
C3, xyrem
PAH tx
Positive Nitric oxide response
-CCB (no verapamil)
Negative: go to main drugs
PDE-5 inhibitor interactions
Cyp3A4 inhibitors!
Nitrates
Etoh!
Adempas info
Riociguat
PAH
REMs for pharmacy and Females
Monthly preganancy tests
Bosentan additional information
Male and female must enroll in REMs
I think more hepatotoxicity
Weird ADR of LTRAs
Neuropsychiatric events (mood and behavior )
Theophylline kinetics
Michaels-menton
Respimat
These are MDIs but don’t need to be shaken!
Exercise induced asthma
SABA
Albuterol Neb solution 0.083% vs 0.5%
0.5% must be diluted with 2.5 mL NS
Inhaler type of no suffix
MDI
Only DPI requiring priming
Flexhaler
Just before first use!
Ergots major interaction
CI with 3A4 inhibitors
Drugs to avoid if salicylate allergy
MESALAMINE, bismuth, sulfasalazine
MDIs that don’t need to be shaken
Respimat, Alvesco, Qvar redihaler, atrovent
CYP1A2 substrates
Caffeine, theophylline,
R-warfarin (less potent), fluvoxamine, olanzapine, clozapine
Minimum nicotine gum or lozenge to use
9 pc /day in first 6 wk
How to bupropion and Chantix work for smoking cessation
Both reduce cravings and withdrawal
Chantix is partial agonist and blocks reward affects associated with smoking
*no need to taper these
Is bupropion serotonergic?
Yes
Chantix adrs
Nausea (take with food and WATER), insomnia, seizures, headache, constipation, psychiatric effects
Possible rash/ SJS
Less know side effects of bupropion
Dry mouth
When to NEVER use cipro!
PNA!
MGL!!!
Can you use 1st gen antihistamines with MAOI?
Apparently not
Antihistamine in lactation
No first gen- use second gen
Fexofenadine info
Take with water NOT juice
-no al or mg products
Chem 7 fishbone
Na CL BUN
GLUCOSE
K CO2 scr
Vincristine extravasation
Warm compress
Menthol age req
Don’t use in children less than 2
Glaucoma drugs MOA
PG analogs: increase outflow Carbonic anhydrase: produc? BB; production Cholinergic: outflow Rho kinase: outflow Alpha agonists: both
Cholinergic effect on pupils
Constriction (mitosis)
Weird lamotrigine ADR
Hair loss
Give zinc or selenium
Levetiracetam ADR
Psychiatric reactions, rash, anemias
Renal dose < 80
AEDs causing hyperammonium
Topiramate and valproate
Topiramate max and renal dose
Max: 400/ d
50% for crcl < 70
Valproate vitamin supplementation
Carnitine for hyperammonium
Valproate DR to ER
Increase daily dose 8-20%
Carbamazepine level
4-12
AED IV: PO 1:1
Phenytoin, levetiracetam, lacosamide
When to stick with same manufacturer
AEDs, thyroid
PO acyclovir consideration
Take with water to avoid kidney stone
Acid base issues with diuretics and RASS inhibitors
Thiazides/loops: metabolic alkalosis
K+ sparing: metabolic acidosis
RASS: metabolic acidosis
Cardio selective beta blockers
AMEBBA
+ nebivolol (added Nitric oxide )
When are CCB CI
Acute MI (both DHP and Non-DHP)
If BB use only non-DHP CI
If HF both CI- if normal EF non-DHP ok
Clopidogrel dose
75 mg Qd
Preganancy BG goals
Fasting <95
Post prandial <120-140
Should diabetes patients get live vaccine
No
Urine albumin:scr ratio in kidney dx
> 30
Drugs that increase BG
Cough syrup, thiazide/loop diuretics, transplant, niacin, protease inhibitors, FQ, atypicals, statins, steroids
Azoles, beta-agonists, diazoxide, interferon alpha,
BB, FQ, and octreotide can increase and decrease
DM drugs with CV benefit
GLP-1: liraglutide, semaglutide, exenatide
SGLT-2: empagliflozin, canagliflozin
DM meds NOT to combine!
Insulin and SU/meglitinides
GLP-1 and DPP-4
Metformin and contrast dye timing
Stop at time of or before
Restart 48 hours after
Metformin + topiramate
Increase risk of metabolic acidosis
Metformin food?
Duh!
Older SU
Chlorpropamide, tolazamide, tolbutamide
*not used d/t hypoglycemia
Micronase vs microzide
Micronase: glyburide
Microzide: HCTZ
Can you use meglitinides or SU in T1DM?
No
TZDs less know risks
Risk of fractures
Ovulation- use BC
URTI
SGLT2 renal
Not recommended GFR<45
CI: GFR<30
Canagliflozin electrolyte
Hyperkalemia
SGLT2 less known risk
Keto acidosis!!
DPP-4 risks
- Acute pancreatitis
- HF (saxagliptan and alogliptan)
- hepatotoxicity (alogliptan)
- renal dose except linagliptan
Insulin dosing T2DM
Basal: 10 u/ day or 0.1-0.2 u/kg/d
Prandial: 4 u/d or 10% basal
GLP-1 renal dosing
Exenatide: don’t use with crcl<30
Victoza dose
0.6 mg QD x 1 week then 1.2 mg QD
Can increase to 1.8
Trulicity dose
Dulaglutide
0.75 mg Qwk
Can increase to 1.5 mg
Byetta and adlyxin unique properties
No risk of thyroid CA
Give with 60 min of meals (others no regard to meals)
Adlyxin
Lixisenatide
Start with green pen and use all doses before moving to burgundy pen
Pramlintide facts
T1 and T2 DM
Weight loss
Must give with food!
Insulin timing
Rapid: 15 mins before meal
Short: 30 mins before meal
Long: bedtime
Humulin U-500 syringe
Each marking=5 units
No conversions necessary
Insulins available without RX
Regular, NPH, 70/30’s
Can you mix LA insulins with other insulins?
No!
Humulin R and Novulin R
VS
Humulin 70/30 and novulin 70/30
R: regular
70/30: 70%NPH/30%regular
Starting basal bolus insulin reg for T1DM
0.5 u/kg/d
50% basal and 50% bolus (divide bolus by three)
Trulicity and adlyxin exp
14 D
Victoza, symlin, byetta exp
30 d
Drugs that can cause hypoglycemia
Belviq (lorcaserin), linezolid, pentamidine, beta blockers, FQ, octreotide, quinine
DKA v HHS
DKA: BG>250, ph<7.35, anion gap>12
HHS: BG>600, osmolarity>320,
Dehydrated, ph>7.3, bicarb >15
When to not use GLP-1
Gastroparesis
Slows gastric emptying
DM drugs avoid if crcl<30
Metformin, SGLT2, exenatide, glyburide
DM drugs hepatotoxicity
Alogliptan and TZDs
Which biologic DMARDS are anti-TNF
- Enbrel (enterecept)
- Humira (adalimumab)
- Simponi (golimumab)
- Remicade (infliximab)
- Cimzia (certolizumab)
Myxedema coma
Emergency of hypothyroidism
-IV levothyroxine
Liotrix
T3 + T4 (levothyroxine + liothyronine)
*thyrolar
Other levothyroxine interactions
BB decrease conversion of T4 to T4
Take bisphosphonates 30 minutes before levothyroxine
Major steroid ADRs
- Hyperglycemia
- Hypertension
- Glaucoma
- Psychiatric
*decreased BMD, fluid retention, increased appetite/wt gain
Prednisone and prednisolone relationship
Prednisone is a prodrug of prednisolone
Preferred initial tx of RA
MTX
MTX major ADR
Hepatotoxicity, myelosuppression, mucositis/bleed, pregnancy, pulmonary
*give folate to decrease ADRs-give NEXT day!
Immunocompromise
Sulfa drugs causing crystaluria
Sulfasalazine, bactrim
Does amiodarone prolong QTc
Yes—-dummy
Preferred sglt2s in HF
Dapagliflozin, empagliflozin
Which statin is renally dosed?
Rosuvastatin
Which non-bio DMARDs to avoid with biologics DMARDs?
Xeljanz (tofacitinib) and Olumiant (baricitinib)
Janus kinase inhibitors (JAK)
Biologic DMARD preganancy (TNF and Non-TNF)
Risk unknown- pregnancy registry
Unlike MTX and leflunamide- CI in pregnancy
Parenteral vs oral meds for MS
Parenteral: copaxone/glatopa (glatiramer acetate) and interferon beta, alemtuzumab (lemtrada), ocrevus, tysabri
Oral: teriflunamide (aubagio), gilenya (fingolamid), tecfidera (dinethyl funarate), simponimod (mayzent), cladrabine (mavenclad)
Which MS/ RA drug- no pregnancy x 2 yr- can do accelerated elimination
Leflunamide (arava)-RA
Teriflunamide (aubagio)- MS
Myasthenia gravis
Autoimmune- destroys ach receptors- muscle weakness
Tx: cholinesterase inhibitor
Cholinergics and asthma/COPD
Bad- bronchoconstriction
Lipophilic and hydrophobic ABX
Hydro: beta-lactams, aminoglycosides, daptomycin, gylcopeptides, polymyxins
*BAD GP
LIPo: macrolide, rifampin, linezolid, quinolones, tetracyclines
Hydrophilic v lipophilic ABX properties
Hydro: renal elimination, not active against atypical, small VD, NOT 1:1
Doripenem do not use
PNA
Moxifloxacin unique coverage
Anaerobes- GI infxns
No UTI!!
Erythromycin unique effect
Promotility
-GI upset
Daptomycin drug interaction
Statins- myopathy/rhabdo
Tigecycline does not cover
3 P’s
Pseudomonas, proteus, providencia
Metro and etoh separation
3 days
Which enterococcus does synercid not cover
Faecalis
What does no beta lactam cover?
Atypicals
Ribaverin v abacavir ADR
Ribaverin: hemolysis and pregnancy
Abacavir: hypersensitivity
*double check!
Genetic alleles for rash
5801- allopurinol
1502- anticonvulsants
5701- abacavir
Metoprolol iv:po
1:2.5
PPI ok in G-tube
Lansoprazole
Vilazodone food?
With food!
Which drugs (other than antipsyches) worsen PD?
Alzheimer’s meds
Which anticonvulsants cause weight loss?
Lamotrigine, keppra, Zonisamide, topiramate
Tx bordetella (whooping cough)
Zpack, clarithromycin, or bactrim
Is clindamycin renally dosed?
No
Do cipro and levo cover anerobes?
Don’t this so, use moxifloxacin or add metro
UTI ppx
> 3 /yr
- bactrim SS QD or DS after sex
- nitro 50 QD
Bactrim and nitro pregnancy
Avoid both in 1st trimester
-avoid nitro in third trimester
Bicillin LA or CR for syphilis
LA
- don’t sub!
Metronidazole pregnancy
CI in first trimester except for trichomoniasis
Tick illnesses
Typhus, ehrlichiosis, tularemia,
Lyme, Ricky mountain
Almost always doxy.
Gent/tobra for tularemia
Diflucan renal adjustment
<50 decrease by 50%
Voriconazole / posaconazole renal impairment
Oral preferred bc IV vehicle (SBECD) accumulates
<50
Zygomycetes
Posa or isavu NOT vori
Which antifungal requires a filter
Isavuconazole
What is famciclovir a prodrug of
Penciclovir (denavir)
Acyclovir infusion time
At least 1 hour (prevent kidney damage)
Shingles and tx
Cluster, fluid filled blisters in band
- tx best within 72 hrs
- tx duration: 7 d
- acy 800 Po 5x/d
- Val 1g tid
- fam 500 tid
Are cidofovir, ganciclovir and Valganciclovir hazardous
Yes
Valcyte and cytovene suspension storage
Fridge
Amo/ amp rash with EBV
Not an allergy!
-FYI no tx for ebv
Immunosuppressed definition
20 mg prednisone equivalent or 2 mg/kg/d x 14 days!
Does reglan require medguide
Yes
Which antihistamine is a metabolite of hydroxyzine?
Cetirizine
Hormones breast cancer
Both estrogens and progesterone can cause- I think
Hormones uterine cancer
Estrogen increases risk
Progesterone decreases risk
When can you use cephalosporin in PCN allergy
Acute otitis media: use second or third gen cephalosporin
What is not considered a sulfa allergy?
Sulfite and sulfate do NOT cross react with sulfonamides
Michaelis menton drugs
Phenytoin, theophylline, voriconazole
HLA-1502 drugs
Carbamazepine, oxcarbazepine, phenytoin, fosphenytoin
*test all ASIAN patients before starting CARBAMAZEPINE *
Plavix gene- don’t use
Cyp2c19 *2 or *3
Poor metabolizes
Genetic: avoid codeine
Cyp2D6 ultra rapid metabolizer
Genes to decrease warfarin dose
Cyp2c9 *2 or *3
VKORC1 G> A
Azathioprine gene
Low or absent TPMT increases risk of myelosuppression
Which drug requires genetic testing in all patient?
Abacavir!! 5701
Carb- asians
Cetuximab (kras)
Trasruzumab (her-2)
Azathioprine (TPMT)
How long is phenytoin IV bag stable for ?
4 hours
FQ QTc
Moxi>levo>cipro
FQ most potent inhibitor
Cipro
Hepatotoxic supplements
Black cohosh, kava
Anxiety herbals
Valerian, passionflower, kava, chamomile, st, johns
Cold sore herbal
l-lysine
Dementia herbal
Ginkgo, vitamin E
Depression herbal
SAMe, St. John, valerian
Diabetes herbal
Alpha lipoic, cinnamon, chromium
Cholesterol herbals
Ref yeast rice, garlic, omega 3, plant sterol, fibers
Energy/wt loss herbal
Bitter orange, caffeine, guarana, green tea powder
HF herbal
Hawthorn, coQ10, omertà 3
HTN herbal
Omega 3, l-arginine, coQ10, garlic
Inflammation herbal
Flax seed, turmeric, omega 3
Liver dx herbal
Milk thistle
Motion sickness herbal
Ginger, peppermint
Soy
Osteoporosis and menopause herbal
Nutrient depletion
- MTX
- PPI
- Folate
2. Magnesium, B12
NAc dose
Po: 140 mg/kg x1, 70 mg/kg q4 x17 h
IV: 150 mg/kg over 60 min, 50 mg/kg over 4g, 100 mg/kg over 16h
Physostigmine
Acetylcholinesterase inhibitor- reverses anticholinergic OD
- BB OD
2. CCB OD
- Glucagon
2. IV calcium
Metal OD
Dimercaprol, penicillamine, succimer
Pralidoxime
Acetylcholinesterase inhibitor OD (neostigmine, pyridostigmine)
Fomepizole
Ethylene glycol, antifreeze, methanol toxicity
Sodium bicarb heart effect
Use if widened QRS
Levocarbitine
Use for valproate or topiramate induced hyperammonium
Crofab
Snake bites
Which diuretics are sulfa drugs
Loops and thiazides
Corticosteroids potassium
Hypokalemia
Do clonidine and precedex decrease HR?
Yes
Cyp2D6 inhibitors
Fluoxetine, paroxetine, fluvoxamine,
Ciprofloxacin, , amiodarone
FQ separation from chelators
*give FQ…
Cipro: 2h before, 6h after
Levo: 2h before, 2h after
Moxi: 4h before, 8h after
Doxy: 1-2 before, 4-6 after
*minocycline is fine
Serotonergic drugs
Lithium, buspirone, amphetamines, fent/meth/tram/tapentadol, lorcaserin, reglan, triptans, St. John, mirtazapine, trazodone , dectromethorphan, DHE
Ototoxicity
Cisplatin
Amg,salicylates, ASA, loops, vanc
Agranulocytosis meds
PTU, methimazole, procainamide, clozapine, carbamazepine, bactrim, isoniazid
Procainamide level
4-10
Napa-15-25
Combine: 10-30
Hazardous drugs USP
800
Copaxone (glatiramer) room temp exp
30 d
Cymzia room temp exp
7 d
Simponi room temp exp
30 d
Abalopartide (tymlos) and teriparatide (forteo) storage and exp
- 30 d room temp
2. Fridge at all times
IV MTX color
Yellow
Licorice
Increase BP, decrease k
Thiazide and loop adr
Photosensitivity and rash
BG, TG, chol, uric acid
Met alkalosis
Spironolactone pregnancy
No!
BB less know ADRs
Fluid retention, dyslipidemia and wt gain, depression
When are fibrinolytics contraindicated?
Pregnancy, HTN
Lipid effects for lupus meds
Fish oil: decrease TG, inc LDL
Niacin: decrease TG/LDL inc HDL
Fibrates: decrease TG, inc LDL
Bile acid: decrease LDL, inc TG
Riboflavin
B2
Does ASA require medguide
No, don’t think so
NSAID safe with lithium
Sulindac
ASA separation from Motrin
Take ASA 1h before or 8h after
Dig + milnacipran
Increase dig
Triptans
Stroke, HTN, paresthesias, seratonin syndrome, chest sensation
How soon must you take cochicine for acute gout attack
Within 36 hours
Colchicine timing
- start within 36h
- restart ppx in 12h
- no repeat tx dose for 3 d
Can lesinurad be used without XOI
No
Uricosuric (lesinurad and probenecid) counseling point
Hydration!!
Pegloticase (krystexxa) major ADR
Hypersensitivity rxn
Premeditate
G6PD
*don’t combine with other four agents
When can you use rectal steroids?
For UC only! Not chrones
Which meds are NOT helpful for motion sickness
Reglan, 5HT3 blockers
Use cyclizine, dimenhydrinate, or meclizine…or Benadryl. Or scop
Dramamine v Dramamine all day less drowsy
- Dimenhydrinate
2. Meclizine
If you miss a dose of POP how long must you use back up?
Use for 48 h if 3 h late
Why is estrogen given with progesterone
Protects from endometrial cancer in women with uterus!
nothing about menopause- unlike AIs (given post menopause or if no uterus)
What types of cancer do estrogens cause
Endometrial (if no progesterone), breast, ovarian, liver
Medroxyprogesterone IM ADRs
Decreases BDM, weight gain!!
When to avoid patch birth control
> 198 pounds
Technivie or viekira pak plus ethinyl estradiol
CI! Liver toxicity!!
Protease inhibitors /ritonavir plus birth control
Use backup! Decrease it somehow! Even though they’re inhibitors
How long to use backup if 2 missed COC? POP (3h late)
7 days
48h
How long can vaginal ring fall out for
3h, if >3h backup required
Nuvaring exp at room temp
4 months
Annovera
Reusable vaginal ring (up to a year)
Paragard
Copper IUD
-fun fact: also works as EC if placed within 5 days
Other than day limit, when else may ella be better than plan B
Overweight: >165 pounds
When should you treat asymptomatic bacturia
Pregnancy!
Drugs that cause osteoporosis
Anticonvulsants, aromatase inhibitors, medroxyprogesterone, GnRH agonists, lithium, PPIs, steroids, thyroid hormones, loop diuretics, TZDs, SSRIs, heparin
What do aromatase inhibitors do? What are they for?
Breast cancer treatment/ppx. They prevent conversion or other hormones to estrogen!
Post menopausal!
Tamoxifen bone effect
Increased BMD- (unlike AIs)
Osteoporosis ppx vs tx
Ppx: bisphosphonates (except IV ibandronate), raloxifene, duavee
Tx: bisphosphonates, denosumab, PTH analogs, (teriparatide),, calcitonin
Bisphosphonates or v IV
Oral: alendronate (daily/weekly), risendronate (daily/weekly/monthly) or ibandronate (monthly!!)
IV: zolendronate (reclast)- 5 yearly
Zometa (hyerpK) - 4 mg
Ibandronate Q3 months!
*boniva is monthly if oral and quarterly if IV
Bisphosphonates ADRs
Osteonecrosis of jaw (check vit D and calcium lvls before), GI!!!, esophagitis/erosions, hypocalcemia, atypical femur fractures, heartburn/dyspepsia, separate from divalent cations/antacids, renal
*IV- no esophagitis or GI but does have acute phase rxn
Teriparatide (forteo) and tymlos (abaliparatide) safety considerations
Max 2 years! (Osteosarcoma)
hyPERcalcemia
Estrogen cancer risks
Endometrial AND breast!
Testosterone ADRs
Clotting risk, prostate growth (don’t give if BPH), baldness, acne, gynecomastia, liver toxicity
Who can take flibanserin (addyi)
Premenopausal only!
Testosterone and BPH
Test increases prostate growth
-5- alpha reductase inhibitors prevents formation of test (may cause ED though )
Fosrenol adr
And sevelemer
Lanthanum
N/V/D, constipation- chew thoroughly!!
Sevelemer- same and can also decrease cholesterol
Chelation!
Bupropion enzymes
2D6 inhibitor
Which MAOi doesn’t require no tyramine rich food
Selegiline patch (emsam)
Antipsych potency trick
Low: thioridozine (mellaril) and chlirpromazine (Thorazine)
Mid: loxapine (loxitane/adasuve) abd perphenazine
*all others are high!
Fast acting INj antipsyches
Haldol, fluphenazine, zyprexa, ziprasidone
Smoking and Antiopsyces
Reduces olanzapine and clozapine
Antipsyches with ODT
Abilify, fazaclo, risperdal M-tab, zydis
*asenapine is SL
Risperdal oral solution
Cannot mix with cola or tea
Bipolar drugs ok in pregnancy
Lamotrigine, lurasidone
Lithium risk neurotoxicity (other drugs)
Verapamil, diltiazem, phenytoin, carbamazepine
Kapvay- don’t get confused…
ER, NOT IR
BZD differences
Diazepam: lipophillic- fast onset and long half life
Alprazolam: fast onset
Etoh: diazepam, Ativan, chlordiazepoxide
Less known effect if Z-drugs
Pins and needles
Less known effect if Z-drugs
Pins and needles
Less known effect if Z-drugs
Pins and needles
What other drugs can help narcolepsy
Solriamfetol (sunosi)
Amphetamines/stimulants
Hep C DAA major issue
Interactions- watch for 3A4 inducers
No monotherapy Hep c
Ribaverin!!
Daclatasvir, sofosbuvir
Crcl to reduce NRTIs
<50 Except TAF (vemlidy) <15
Octreotide adrs
Hypo/hyperglycemia, bradycardia, cholethiasis/biliary sludge
Selegiline adr
Activating
Measles
Koplik spots (small white ) in mouth,maculopapular rash, fever , malaise , cough, rhinitis, conjunctivitis
Mumps
Swollen and tender salivary glands under ears
HA, Fever, fatigue, loss of appetite
Rubella
Fine pink rash that begins on face and spreads to rest of body
Polio
Nerve damage, weakness and cognitive issues later in life
Fever, sore throat, fatigue , nausea, HA, abd pain
Pertussis
Whooping cough
TDAP
Rotavirus
Diarrhea , fever, vomiting
Chicken pox
Itchy rash, crops of sores that turn to blisters then burst then form crusts
Anticoagulation monitoring
IVs (argat, bival, UFH): aPTT
SubQ: (Fonda, LMWH): anti-XA
Most things: Hgb/hct, plt, scr
Orals: no efficacy monitoring
Doacs: LFTs
Amlodipine + statin
Simvastatin max: 20/d
Lovastatin max: 20-40/ d
Additional fintate interaction
Increase effects of SU and warf
Zetia, statins, colchicine
Niacin other tox
Bleeding, increase INR, N/V/D
Liver, BG, UA, flushing
Women age: for taking tymlos forteo
At least 5 yr post-menopausal
PPI equal doses
20: omeprazole, esomeprazole
Raber
40: pantop
30 lanso, dexlan
P ovale
Dandruff yeast
Diltiazem and verapamil iv to po
NOT 1:1
GpIIBIIIA and Tpa adr and CI
CI: hx recent stroke
ADR: hypotension
GpIIbIIIA: throbocytopenia
Azithromycin and clarithromycin food
Azithromycin ER susp- empty stomach
Clarithromycin XL- with food!
Vanco max concentration and rate
Conc: 5mg/ml
Rate: 15 mg/ min
Hydralazine v nitrates
Hydralazine: arterial dilator (afterload)
Nitrates: venous dilator (preload)
Heparin weird adr
Osteoporosis
*less with LMWH
Only fibrinolytic allowed for stroke
Alteplase
4.5 hr symptom onset
1 hr of hospital arrival
0.9 mg/kg (max 90 mg)
Tpa BP req
Start: <185/110
Keep: <180/105
When is anti-Xa lvl obtain for lmwh
4 hours post dose! (6h for aPTT)
Extremes body wt, pregnancy, extremes age, renal insufficiency
(3h if for fondaparinux)
DOAC ok to double up for missed dose
BID dosing if Xarelto
Xarelto food
With evening meal! If > 15 mg
Edoxaban limitatjkn
After 5-10d parenteral AC (same with dabigatran)
Crcl <50: 30 mg
Vit k ADR
Anaphylaxis
Dilute in 50 mL
ER iron
Not initially!!
Iron OD tx
Desferal (deferoxamine )
Schillings
Pernicious anemia
When is glipizide taken
30 mins before meals
Other SU with breakfast
Sglt2 other adrs
Increased LDL, fractures
DPP-4 less know adr
Arthralgia (joint pain)
Heart failure (esp saxa and alo) URTIs
Nafcillin
Vesicant- use cold packs
Bismuth + tetracycline
Chelation
Which drugs falsely increase PT/INR
Dapto!, televancin, oritavancin, dalbavancin
Which suspension should not be shaken?
Linezolid
Shingles tx
Tx within 72 h and rx for 7 days
Acy 800 5x
Val 1g tid
Fam 500 tid
Phenazopyridine
Hemolysis if G6PD deficiency
Take with water or food
Phenazopyridine
Hemolysis if G6PD deficiency
Take with water or food
Peak flow meter
Morning before using inhalers
- compare to personal best
- record highest value