IDEALS YEAR 2 Flashcards
AE Amoxicillin/Clavunalate
Common (>10%): Nausea, diarrhea
Less common (1-10%): skin rash, vomiting, mycosis (fungal infection), candidiasis
Tell doctor: severe allergic reactins (SJS), dark urine, bruising or bleeding
Amoxicillin/Clavulanate Contraindication
-Prolonged result in fungal infection
-Phenylalanine
-less efficient when near to labor (pregnant)
Ciprofloxacin (Cipro)
AE
Common (>10%): muscle pain, tooth discoloration in infants
Less common: diarrhea, N/V, headache, dizziness
Rare but serious:
-Tendon rupture
-QTc prolongation
-SJS
-renal failure
-peripheral neuropathy
-neutropenia
Ciprofloxacin
DI
-Diabetic agents
-Corticosteroids
-Warfarin
-Aluminium, calcium, magnesium
Ciprofloxacin
Counsel
-Photosensitivity (use sunscreen)
-Chelation (space 2h before or 6h after taking the drug)
-Tendon rupture
-QTc prolongation
Doxycycline AE
Common (>10%):
Esophageal injury (sit up straight and take w/ water
Skin hyperpigmentationon
Tooth discoloration in children
Less common: N/V, diarrhea
Doxycycline DI
-Antacids
-Digoxin (for heart failure)
-Penicillin
Doxycycline Counsel
-Complete full course
-Take with water, sit up straight
-Space antacids or supplements
-Expect improvement after 2-3d
-Photosensitivity (use sunscreen)
-discontinue in case of skin erythema (redness)
Azithromycin AE
Zithromax, Z-pak
Common (>10%): Diarrhea, N/V
Less common:
-Headache,
-elevated liver enzymes
-flatulence
-abdominal pain
Rare: SJS, QTc prolongation
Azithromycin DI
Zithromax, Z-pak
-Statins!!!
-antiarrhythmics, drugs causing QTc prolongation
-Digoxin
-Warfarin
Azithromycin Counsel
Zithromax, Z-pak
-Complete full treatment
-w/ or w/o food -> suspension w/o food
-Expect improvement after 2-3 days
CLARITHROMYCIN: Biaxin
AE
-Taste disturbance
Less common: Headache, diarrhea, nausea, vomiting, rash
Rare: QTc prolongation, SJS, LFT’s
hallucination, nephrotoxicity
CLARITHROMYCIN: Biaxin
DI
-SSRI
-Warfarin
-QTc causing drugs
-Digoxin
CLARITHROMYCIN: Biaxin
Counsel
-Take full course
-Improvement after 2-3 days
Cephalexin (Keflex)
AE
Common: Nausea
Less common: Vomiting
Rare: SJS, anemia, neutropenia, seizure
Cephalexin (Keflex)
DI
-Cholestyramine (for Cholesterol)
-Metformin
-Multivitamins
-Vaccine (cholera, typhoid)
Cephalexin (Keflex)
Counsel
-Complete full treatment
-tell the doctor if a rash develops
-Suspension: shake well, expires after short after reconstitution, don’t mix with food
Trimethoprim/sulfamethoxazole
Bactrim, Septra
AE
Common: diarrhea, nausea
Less common: skin rash, urticaria (hives)
Rare: SJS, hypoglycemia, hyperkalemia
Trimethoprim/sulfamethoxazole
Bactrim, Septra
DI
-Antiarrhythmics (Amiodarone)
-Methotrexate (for arthritis, psoriasis, cancer)
Trimethoprim/sulfamethoxazole
Bactrim, Septra
Counsel
-Complete full course
-Improvement after 2-3 days
-Photosensitivity (use sunscreen)
-drink plenty of water during therapy (kidney complications)
-tell the doctor: severe diarrhea or dark urine, heavy skin rash or allergic reaction, bruising or bleeding
Albuterol (ProAir HFA)
AE
Common: Nausea, pharyngitis, rhinitis, upper respiratory infection, tremor, nervousness
Less common: Angina, tachycardia, hypokalemia, insomnia, cough, headache
Albuterol (ProAir HFA)
DI
-sympathomimetics (epinephrine, norepinephrine)
-non-selective ß-blocker (Carvedilol, propranolol, labetalol)
-Diuretics (chlorthalidone, furosemide)
-Digoxin
-MAOI and TCA
Albuterol (ProAir HFA)
Counseling
-Shake well, Prime
-Inhaler technique
-Rinse mouth with water and spit
Tiotropium (Spiriva)
AE
Common: Xerostomia (dry mouth), upper respiratory infection
Less common: Constipation Pharyngitis (sore throat), Sinusitis, Constipation
Tiotropium (Spiriva) LAMA
DDI
-Other anticholinergics
-Donepezil, Bupropion
Tiotropium (Spiriva)
Counsel
-not for rescue (it is long-acting)
-can increase HR
-Inhaler technique
-Rinse mouth with water and spit
-urinary retention, dry mouth, constipation
-for Handihaler: inhale the capsule twice (do not swallow)
Breo Ellipta
(Fluticasone and Vilanterol)
ICS and LABA
ADE
less common:
-extrasystoles (irregular heartbeat), hypertension,
-candidiasis, headache, change in voice
sinusitis (runny nose), allergic rhinitis (stuffy nose), sore throat
Breo Ellipta
(Fluticasone and Vilanterol)
ICS and LABA
DI
-beta-blocler (non-selective)
-loop diuretics
-TCA
Breo Ellipta
(Fluticasone and Vilanterol)
ICS and LABA
Counsel
-not for rescue (shortness of breath)
-Inhaler technique
-rinse and spit
Flovent Diskus (Fluticasone)
AE
Common: Pharyngeal candidiasis (oral thrush)
Less common: Epistaxis
Rare: severe allergic reaction, glaucoma
Flovent Diskus (Fluticasone)
DDI
CYP3A4 inhibitor: ritonavir, clarithromycin, erythromycin, ketoconazole, grapefruit
Flovent Diskus (Fluticasone)
Counsel
-don’t stop abruptly (adrenal insufficiency)
-rinse and spit
-Inhaler technique
Paxlovid (Nirmatrelvir and Ritonavir)
AE
Bradycardia, hypertension
headache, nausea
Paxlovid (Nirmatrelvir and Ritonavir)
DI
contains Ritonavir: CYP3A4 inhibitor
-Glucosteroids
Oseltamivir (Tamiflue)
AE
N/V, diarrhea, headache
Oseltamivir (Tamiflu)
DI
Influenza vaccine
(interferes with vaccine effectiveness)
Oseltamivir (Tamiflu)
Counsel
-take with food to prevent GI irritation
-take missed ASAP, skip if more than 2h
-finish full treatment
-improvement after 2-3 days
Prednisone (Deltasone)
AE
Common: GI upset
Less common: HTN, impaired skin healing, pulmonary tuberculosis, depression, euphoria
Prednisone (Deltasone)
DI
-Antacids
-CYP inhibitor: ritonavir, clarithromycin, erythromycin, ketoconazole, grapefruit
-CYP inducer: rifampin, phenytoin, carbamazepine, phenobarbitone
-Warfarin
-FQ
Prednisone (Deltasone)
Counsel
-take with food to help with GI upset
-take in the morning to prevent insomnia
-don’t stop abruptly
-diabetic? monitor for hyperglycemia
Metoprolol succinate (Lopressor and Toprol XL)
AE
Common: Dizziness, fatigue, hypotension
Less common: Arthralgia (joint stiffness), bronchospasm, dyspnea, vomiting
Metoprolol succinate (Lopressor and Toprol XL)
DI
-Alpha-blockers: Doxazosin, terazosin, tamsulsin)
-Fentanyl
-amiodarone, dronedarone (antiarrhythmic)
-antidiabetic
-Calcium channel blocker (amlodipine, felodipine)
-Clonidine (alpha2 agonist, for HTN)
-CYP inhibitor: ritonavir, erythromycin, clarithromycin, ketoconazole, grapefruit
-NSAIDs
Metoprolol succinate (Lopressor and Toprol XL)
Counsel
-take on an empty stomach
-dont stop abruptly
-follow your blood sugar, it masks low blood sugar (bc it slows the heart rate, HR is high with low blood sugar)
-tell the doctor when hypotension occurs
Metformin ER Glucophage
AE
Common: diarrhea, N/V, malabsorption, flatulence
Less common: Headache, indigestion, weight loss
Metformin ER Glucophage
DI
-contrast media (Acetrizoic)
-Beta-blocker
-Cationic drugs
-Cephalexin
-FQ
-MAOI
Metformin ER Glucophage
Counsel
-take with meal and water
-avoid alcohol due to lactic acidosis
DDI with diabetic drugs
Ciprofloxacin
Cephalexin
Metoprolol
DDI beta-blocker (non-selective)
Albuterol
Breo Ellipta
Metformin
DDI with Anti-cholesterol
Cephalexin and Cholestyramine
Azithromycin and statins
DDI with Antacids
Ciprofloxacin
Doxycycline
Prednisone
DDI with Warfarin
Ciprofloxacin
Azithromycin
Clarithromycin
Prednisone
DDI with TCA or SSRI
Albuterol
Breo Ellipta
Clarithromycin with SSRI
DDI with FQ
Metformin
Prednisone
DDI with CYP inhibitor
Flovent Diskus
Prednisone (CYP inhibitor + inducer)
Paxlovid
Metoprolol
