Final Medication List Counseling Tips and Important Info Flashcards
doxycycline (monohydrate or hyclate)
-sun-sensitivity
-take with food to prevent upset stomach
-do not take food, vitamins, or medications containing Ca2+, Fe2+, Mg2+, or Zn2+ within 2 hours before or after doxycycline
-may decrease effectiveness of oral contraceptives; use additional form of birth control during and 1 week after last dose
amoxicillin
-may decrease effectiveness of oral contraceptives; use additional form of birth control during and 1 week after last dose
-contraindicated if penicillin allergy
cephalexin
-do not take vitamins or medications containing Zn2+ for at least 3 hours after cephalexin
-contraindicated if cephalosporin allergy
-caution if penicillin allergy
azithromycin
-do not take with Al2+ or Mg2+ containing antacids
-QTc prolongation occurs rarely (possible interactions with different medications)
-contraindicated if macrolide allergy
ciprofloxacin
-QTc prolongation occurs rarely (possible interactions with different medications)
-do not take food or medications containing Ca2+ or Fe2+ within 2 hours before or after ciprofloxacin
-sun-sensitivity
-may increase caffeine sensitivty
-contraindicated if fluoroquinolone allergy
sulfamethoxazole/trimethoprim (SMZ-TMP)
-sun-sensitivity
-take with at least 8 oz of water
-contraindicated if sulfa allergy
nitrofurantoin
-orange or brown urine is expected
-do not take food or medications containing Mg2+ within 2 hours before or after nitrofurantoin
-take with food/milk to increase absorption
metronidazole
-contraindicated with alcohol during therapy and 3 days after last dose
-metallic taste in mouth
-headache
fluconazole
-QTc prolongation occurs rarely (possible interactions with different medications)
-report new skin rash to prescriber
valacyclovir
-headache
-does not prevent disease transmission (avoid sex when sores are present)
-drink lots of fluids to prevent accumulation in kidneys
general counseling tips for anti-infective therapy
-generally 5-14 days of therapy
-finish entire therapy even if you feel better
-if symptoms have not resolved, contact prescriber
-most effective when taken at regularly scheduled intervals
-upset stomach, nausea, abdominal pain, diarrhea
-itching, rash, swelling, or difficulty breathing may indicate an allergic reaction (if so, discontinue and contact prescriber)
female contraception, anxiety, and muscle spasms
-water retention
-upset stomach/nausea
-headache
-if contraceptive not started on day 1 of menses, use additional non-drug form of contraception for first week of therapy
-take at same time each day for maximum effectiveness
-some anti-convulsants may decrease effectiveness of hormonal contraceptives and/or increase chance of seizures
-none of these medications protect against HIV/AIDS/STDs
non-FDA uses of female contraception
-regulation of menstrual cycle
-lessen menstrual flow
-reduce painful menses
missed doses of female contraception
take as soon as possible or with next day’s dose
products containing ethinyl estradiol
increased cardiovascular risk (not recommended for > 35 years old, smoker, or history of stroke/blood clots)
ethinyl estradiol/drospirenone
drospirenone lessens water retention/weight gain side effects of estrogen
ethinyl estradiol/norelgestromin
-same side effects as oral contraceptives but more common
-adhesive may cause skin rash/rotate sites
-do not cut patch
-apply to butt, upper torso, stomach, or upper arm
ethinyl estradiol/etonogestrel
-if it falls out, rinse with cool water and reinsert within 3 hours
-do not remove for intercourse
-not contraceptive barrier
medroxyprogesterone
-nervousness
-administration by healthcare professional
-do not use for more than 2 years due to potential bone loss
-spotting or absent menses
levonorgestrel (OTC)
-same side effects as oral contraceptives but more common
-fatigue
-no interaction with antibiotics
-will not terminate existing pregnancy
clonazepam
-drowsiness
-fatigue
-ataxia
-behavioral problems
alprazolam
-confusion
-drowsiness (excessive with alcohol)
-do not stop drug suddenly if taking routinely
cyclobenazprine
-dry mouth (xerostomia)
-dizziness
-drowsiness
loratadine (OTC)
headache
diphenhydramine (OTC)
-drowsiness (intensifies with alcohol)
-paradoxical hyperactivity in children
-dry mouth
fluticasone (OTC)
-gently shake before each use
-may take several days for full effect
-headache
-sore throat
montelukast
-do not use for acute asthma attack
-headache
-take dose in evening to enhance airway efficacy (airways are more relaxed)
albuterol sulfate
-shake well
-increased heart rate
budesonide and formoterol
-shake well
-rinse out mouth after each use to prevent oral thrush
bezonatate
-drowsiness
-do not chew (numbing and choking)
dextromethorphan (OTC)
-shake well
-potential for abuse (hallucinogen in high dose)
guaifenesin (OTC)
-drink lots of water to thin mucus
-nausea
pseudoephedrine (BTC)
-increased heart rate
-jitters
-insomnia
amphetamine/dextroamphetamine (CII)
-take in morning due to insomnia
-weight loss from decreased appetite
-increased heart rate
-dry mouth
-headache
methylphenidate (CII)
-take in morning due to insomnia
-weight loss from decreased appetite
-increased heart rate
-dry mouth
-headache
escitalopram
-headache
-insomnia or drowsiness
-sexual dysfunction
venlafaxine
-headache
-insomnia or drowsiness
-dry mouth
-take with food if upset stomach
fluoxetine
-sexual dysfunction
-anorexia
-diarrhea
-asthenia
duloxetine
-insomnia or drowsiness
-take with food if upset stomach
sertraline
-headache
-insomnia > drowsiness
-take with food if upset stomach
-sexual dysfunction
amitriptyline
-drowsiness
-weight gain
-constipation
trazodone
-drowsiness
-take with food to increase absorption
bupropion
-insomnia
-begin 1 week before patient intends to quit smoking
antidepressants
-report signs/symptoms of worsening depression, behavior changes, and increase in suicidal thoughts to healthcare provider immediately
-may need to taper up/down when using high doses (do not adjust doses without consulting prescriber first)
-may take 2-6 weeks to see therapeutic effect
-avoid alcohol (intensifies side effects)
aspirin, acetylsalicylic acid (ASA) (OTC)
-stomach upset (possible bleed/ulceration)
-take with food/milk
-take with water
-do not give to children less than 18 years old due to risk of Reyes’ Syndrome
-ringing in ears with high dose
ibuprofen (OTC), naproxen sodium (OTC), meloxicam
-stomach upset (possible bleed/ulceration)
-take with food or milk
-avoid if history of heart problems
methylprednisolone
-finish entire course
-take with food or milk to avoid stomach upset
-take earlier in day to avoid insomnia
hydrocortisone (OTC)
localized burning
acetaminophen (APAP) (OTC)
-APAP in many oTC and Rx combination products
-do not use for hangovers (liver toxicity)
tramadol (CIV)
-constipation
-drowsiness
-dizziness
hydrocodone/APAP (CII)
-stomach upset
-constipation
-drowsiness
-consider other APAP counseling tips
oxycodone (CII)
-stomach upset
-constipation
-drowsiness
-do not rush or chew CR tablets
olanzapine
-drowsiness
-weight gain
-increased blood sugar and/or cholesterol
-movement disorders
-decreased sex drive
quetiapine
-drowsiness
-weight gain
-increased blood pressure and/or tachycardia
-increased appetite
-dizziness
aripiprazole
-drowsiness or insomnia
-weight gain
-movement disorders
topiramate
-dizziness/drowsiness
-numbness/tingling
-memory impairment
-weight loss (decreased appetite from nausea)
pregabalin (CV)
-drowsiness/dizziness
-headache
-blurred vision
-weight gain
gabapentin
-drowsiness/dizziness
-uncoordinated muscle movements
lamotrigine
-drowsiness/dizziness
-uncoordinated muscle movements
-headache
-blurred/double vision
divalproex sodium
-drowsiness/dizziness
-tremors
-muscle weakness
-upset stomach (take with food)
zolpidem (CIV)
-take within 20 minutes of bedtime
-get > 8 hours of rest (may cause next day drowsiness)
-risk of abnormal sleep behaviors
temazepam (CIV)
-take right before bed
-get > 8 hours of rest (may cause next day drowsiness)
-headache
antipsychotic, anti-epileptic, hypnotic
-avoid alcohol (intensifies side effects)
-do not adjust doses or discontinue without consulting healthcare provider
promethazine
-drowsiness
-dizziness
-avoid alcohol due to enhanced drowsiness
-sun-sensitivity
ondansetron
-fatigue
-headache
-constipation or diarrhea
omeprazole (OTC)
-works in 1 day, up to 4 days for full effect
-take > 1 hour before food
-separate from antacids by 2 hours
famotidine (OTC)
-works in 1 hour, up to 1 day for full effect
-can be taken with antacids
magnesium hydroxide, aluminum hydroxide, simethicone (OTC)
-shake well
-works within minutes
-many drug-drug interactions
-constipation from aluminum
-diarrhea from magnesium and simethicone
calcium carbonate (OTC)
-constipation
-chew before swallowing
-do not use > 2 weeks for indigestion
docusate sodium (OTC)
-works in 1-3 days
-take with water
-diarrhea and cramps
polyethylene glycol (PEG) (OTC)
-laxative works in 1-3 days
-do not take laxative longer than 1 week without doctor approval
-colonoscopy prep works in 1 hour
-diarrhea, cramps, bloating
bisacodyl (OTC)
-oral dose works in 8 hours
-suppository works within 15-60 minutes
-do not take longer than 1 week without doctor approval
-diarrhea and cramps
loperamide (OTC)
-drowsiness
-if diarrhea not improved in 2 days, call doctor (dehydration risk)
omega-3 fatty acids
-burping and taste disturbances
-swallow whole; do not open
-refrigerate to reduce taste and smell
fenofibrate
-increased liver enzymes
-discontinue if gallstones form
-photosensitivity
atorvastatin and rosuvastatin
-increased liver enzymes
-report unusual muscle pain, tenderness, weakness, or dark urine
-avoid grapefruit juice
-contraindicated in pregnancy
-diarrhea
ezetimibe
-increased liver enzymes
-diarrhea
insulin lispro (rapid-acting) and insulin glargine (long-acting)
-low blood sugar
-refrigerate unopened vials
-discard after 28 days if at room temperature
-let syringe reach room temperature before injection (could be painful)
-rotate injection sites
metformin
-diarrhea, nausea, abdominal pain
-take with food
-titrate dose up weekly (reduces stomach upset and diarrhea)
-long-term use can cause vitamin B-12 deficiency
dapagliflozin
-UTI
-increased urine output
-decreased blood pressure
liraglutide
-low blood sugar
-rotate injection sites
-diarrhea
-nausea
-headache
clopidogrel
-avoid NSAIDs unless instructed (bleeding risk)
-seek medical attention for unusual or prolonged bleeding or bruising
-avoid abrupt discontinuation
warfarin
-same as clopidogrel
-keep dietary vitamin K and alcohol consumption consistent
-many drug interactions
-take missed dose ASAP, but do not double dose in same day
rivaroxaban
-seek medical attention for unusual or prolonged bleeding or bruising
-gastroenteritis
-vomiting
-cough (pediatric patients)
furosemide
-sun-sensitivity
-decreased electrolytes (Ca2+, K2+, Mg2+)
-dizziness upon standing
-avoid taking at bedtime (increases urination)
spironolactone
-gynecomastia
-increased serum potassium
-diarrhea
-irregular menses
hydrochlorothiazide (HCTZ)
-sun-sensitivity
-dizziness upon standing
-avoid taking at bedtime (increases urination)
lisinopril
-avoid during pregnancy
-dizziness
-dry cough
-headache
-increases serum potassium
losartan
-avoid during pregnancy
-dizziness
-headache
-increases serum potassium
amlodipine
-leg swelling
-headache
metoprolol tartrate and metoprolol succinate
-dizziness
-fatigue (goes away within 7 days)
-take with food (better absorption)
-lowers heart rate
-do not discontinue abruptly (increased cardiovascular risk)
diuretics and antihypertensives
hypotension
levothyroxine
-take with water at least 30 minutes before breakfast
-take same way everyday
-take > 4 hours from antacids and iron
-may take several weeks to see symptoms improve
tamsulosin
-take 30 minutes after same meal each day
-orthostatic hypotension
-headache
-dizziness
tolterodine
-constipation
-dry mouth
-headache
donepezil
-nausea
-diarrhea
-risk of stomach bleed with NSAIDs
-prolonged QT interval
alendronate
-take 30 minutes before breakfast
-ensure adequate calcium and vitamin D intake
-take with 8 oz of water and remain upright for 30 minutes
-report heartburn or bone pain to physician
allopurinol
-report rash to prescriber
-nausea and/or diarrhea
-gout attacks may be more frequent in early therapy
oseltamivir
-nausea/vomiting
-headache
-does not replace influenza vaccine
-must initiate within 48 hours of onset of symptoms
ferrous sulfate (OTC)
-best absorbed on empty stomach (can take with food)
-separate 2 hours before or after other medications
-black stools
-constipation
sumatriptan
-tingling and dizziness
-avoid if history of cardiovascular disease
-overuse (more than 10 days per month) may worsen or increase frequency of headaches
tadalafil
-do not take more than once daily
-avoid alcohol due to risk of low blood pressure
-avoid grapefruit juice or lower dose/frequency of tadalafil use
-headache and flushing
-report sudden loss of hearing or vision and discontinue use
