Key Drugs Flashcards
Therapeutic Drug Ranges
Carbamazepine
Ch. 4 Labs Values & Drug Monitoring (page 82)
4 - 12 mcg/mL
Therapeutic Drug Ranges
Digoxin
Ch. 4 Labs Values & Drug Monitoring (page 82)
AFib: 0.8 - 2 ng/mL
HF: 0.5 - 0.9 ng/mL
Therapeutic Drug Ranges
Lithium
Ch. 4 Labs Values & Drug Monitoring (page 82)
0.6 - 1.2 mEq/mL (up to 1.5 mEq/mL for acute symptoms)
drawn as a trough
0.6 - 1.2 mEq/mL (up to 1.5 mEq/mL for acute symptoms)
drawn as a trough
Phenytoin/Fosphenytoin: 10 - 20 mcg/mL; if albumin is low, correct serum level
Free Phenytoin: 1 - 2.5 mcg/mL
Therapeutic Drug Ranges
Gentamicin & Tobramycin (traditional dosing)
Ch. 4 Labs Values & Drug Monitoring (page 82)
Peak: 5 - 10 mcg/mL
Trough: <2 mcg/mL
Therapeutic Drug Ranges
Procainamide
NAPA (procainamide active metabolite)
Combined
Ch. 4 Labs Values & Drug Monitoring (page 82)
Procainamide: 4 - 10 mcg/mL
NAPA: 15 - 25 mcg/mL
Combined: 10 - 30 mcg/mL
Therapeutic Drug Ranges
Theophylline
Ch. 4 Labs Values & Drug Monitoring (page 82)
5 - 15 mcg/mL
Therapeutic Drug Ranges
Valproic Acid
Ch. 4 Labs Values & Drug Monitoring (page 82)
50 - 100 mcg/mL (up to 150 mcg/mL in some patients); if albumin low, correct serum level
Therapeutic Drug Ranges
Vancomycin*
Ch. 4 Labs Values & Drug Monitoring (page 82)
Trough: 15 - 20 mcg/mL for most serious infections (pneumonia, endocarditis, osteomyelitis, meningitis and bacteremia)
Trough: 10 - 15 mcg/mL for others
AUC can be used to monitor vancomycin
Therapeutic Drug Ranges
Warfarin
Ch. 4 Labs Values & Drug Monitoring (page 82)
Goal INR: 2 - 3 for most indications
Higher range (2.5 - 3.5) for high-risk indications, like mechanical mitral valves
What drugs have an issue with leaching, absorption, with PVC containers?
Ch. 7 Intravenous Medication Principles (page 108)
Lorazepam Amiodarone Tacrolimus Taxanes* Insulin Nitroglycerin
Leach Absorbs To Take In Nutrients
What drugs can ONLY be mixed with saline (no dextrose)?
Ch. 7 Intravenous Medication Principles (page 108)
Ampicillin Daptomycin (Cubicin) Infliximab (Remicade) Ampicillin/Sulbactam (Unasyn) Caspofungin (Cancidas) Ertapenem (Invanz) Phenytoin (Dilantin)
A DIAbetic Can’t Eat Pie
What drugs can ONLY be mixed with dextrose (not saline)?
Ch. 7 Intravenous Medication Principles (page 108)
Oxaliplatin
Bactrim (smx/tmp)
Amphotericin B (all)
Synercid (quinupristin/dalfopristin)
Old Bats Avoid Salt
What drugs require the filters to be drawn up?
Ch. 7 Intravenous Medication Principles (page 110)
Golimumab (Simponi)
Amiodarone
Lorazepam
Phenytoin
Lipids - 1.2 micron
Amphotericin B (lipid formulations)
Taxanes “except docetaxel”
GAL PLAT
What drugs should NOT be refrigerated?
Ch. 7 Intravenous Medication Principles (page 110)
Dexmedetomidine (Precedex) Sulfamethoxazole/Trimethoprim (Bactrim) Phenytoin - crystallizes Furosemide - crystallizes Metronidazole Moxifloxacin (Avelox) Enoxaparin (Lovenox)
Dear Sweet Pharmacist Freezing Makes Me Edgy!
What drugs need to be protected from light during administration?
Ch. 7 Intravenous Medication Principles (page 111)
Phytonadione (vitamin K, Mephyton) Epoprostenol (Flolan) Nitroprusside (Nitropress) Micafungin (Mycamine) Doxycycline
Protect Every Necessary Med from Daylight
What are the class(es) of drugs on the Hazardous NIOSH List?
Ch. 15 Compounding: Basics I (page 239)
Antineoplastic Drugs (Chemotherapeutics)
Non-Antineoplastic Drugs
What are the Non-Antineoplastic Hazardous Drugs on the NIOSH List?
Ch. 15 Compounding: Basics I (page 239)
Abortifacient (Mifepristone, Misoprostol)
ABX (Chloramphenicol)
Anticoag (Warfarin)
Antifungals (Fluconazole, Voriconazole)
Antiretrovirals (Abacavir, Entecavir, Zidovudine)
Antivirals (Cidofovir, Ganciclovir, Valganciclovir)
Acne (Isotretinoin)
Arrhythmia (Dronedarone)
Autoimmune Conditions (Acitretin, Azathioprine, Leflunomide, Fingolimod, Teriflunomide)
BPH (Dutasteride, Finasteride)
Bisphosphonates (Pamidronate, Zoledronic Acid)
Chemoprotectant (Dexrazoxane Cardiac)
Depression (Paroxetine)
Diabetes (Exenatide, Liraglutide)
Dyslipidemia (Lomitapide
Seizures/Epilepsy (Clobazam, Clonazepam, Carbamazepine, Oxcarbazepine, Eslicarbazepine, Divalproex, Fosphenytoin, Phenytoin, Topiramate, Vigabatrin, Zonisamide)
Gout (Colchicine)
Heart Failure (Ivabradine, Spironolactone)
Hepatitis (Ribavirin)
Hormonal Agents (Androgens, Estrogens, Oxytocin, dinoprostone, Progesterones, SERD/SERMs, Ulipristal)
Hyperthyroidism (Methimazole, Propylthiouracil)
Insomnia (Temazepam, Triazolam)
Iron Overload (Deferiprone)
Migraine (Dihydroergotamine)
Parkinson’s Disease (Apomorphine, Rasagiline)
Pulmonary Arterial Hypertension (Ambrisentan, Bosentan, Macitentan, Riociguat)
Schizophrenia (Ziprasidone)
Transplant (Cyclosporine, Mycophenolate, Tacrolimus, Sirolimus)
What drugs are most commonly associated with photosensitivity?
Ch. 77 Drug Allergies & Adverse Drug Reactions (page 958)
Amiodarone Diuretics (thiazides and loops) Methotrexate PO/topical retinoids Quinolones St. John's wort Sulfa abx Tacrolimus Tetracyclines Voriconazole
What drugs are commonly associated with thrombotic thrombocytopenic purpura (TTP)?
Ch. 77 Drug Allergies & Adverse Drug Reactions (page 958)
PO P2Y12 Inhibitors (Clopidogrel)
Sulfamethoxazole
What drugs are commonly associated with severe skin reactions?
Ch. 77 Drug Allergies & Adverse Drug Reactions (page 959)
Abacavir Allopurinol Carbamazepine Ethosuximide Lamotrigine Modafinil Nevirapine Penicillins Phenytoin Sulfamethoxazole
Name the Live Vaccines.
Ch. 20 Immunizations (page 320)
MMR Intranasal influenza Cholera Rotavirus Oral Typhoid Varicella Yellow Fever
MICRO-VY
Name the Inactivated and Live Vaccines needed for travel.
Ch. 21 Travelers (page 338)
------Inactivated Vaccines------ Hepatitis A (Havrix, VAQTA) Hepatitis B (Energix-B, Recombivax HB) Hepatitis A/B (Twinrix) Japanese encephalitis (Ixiaro) Meningococcus (Menveo, Menactra) Polio (IPOL) Typhoid-IM (Typhim Vi)
—–Live Vaccines——
Cholera - PO (Vaxchora)
Typhoid - PO (Vivotif)
Yellow Fever - SC (YF-VAX)
What drugs or conditions can cause weight gain?
Ch. 57 Weight Loss (page 754)
---Drugs--- Antipsychotics (clozapine, olanzapine, risperidone, quetiapine) Diabetes drugs (insulin, meglitinides, sulfonylureas, thiazolidinediones) Divalproex/valproic acid Gabapentin, pregabalin Lithium Mirtazapine Steroids TCAs (amitriptyline, nortriptyline)
—-Conditions—-
Hypothyroidism
What drugs or conditions can cause weight loss?
Ch. 57 Weight Loss (page 754)
----Drugs---- ADHD Drugs (amphetamine, methylphenidate) Bupropion GLP-1 agonist (exenatide, liraglutide) Pramlintide Roflumilast SGLT2 inhibitors (canagliflozin, empagliflozin) Topiramate
—-Conditions—-
Hyperthyroidism
Celiac Disease
Inflammatory Bowel Disease
What drugs increase uric acid?
Ch. 60 Gout (page 789)
Aspirin, lower doses
Calcineurin inhibitors (tacrolimus and cyclosporine)
Diuretics (loops and thiazides)
Niacin
Pyrazinamide
Select chemotherapy (with tumor lysis syndrome)
Select pancreatic enzyme products
What drugs/drug class(es) can cause or worsen depression?
Ch. 63 Depression (page 842)
ADHD (atomoxetine - Strattera)
Analgesics (indomethacin)
Antiretrovirals “NNRTIs” (efavirenz in Atripla & rilpivirine in Complera, Odefsey)
Cardiovascular “Beta-blockers” (propranolol)
Hormones (Hormonal contraceptives & Anabolic Steroids)
Antidepressants
Benzodiazepines
Systemic Steroids
Interferons
Varenicline
Ethanol
What medications/illicit drugs can cause psychotic symptoms?
Ch. 64 Schizophrenia/Epilepsy (page 854)
——Medications——-
Anticholinergics (centrally-acting, high doses)
Dextromethorphan
Dopamine or dopamine agonists (Requip, Mirapex, Sinemet)
Interferons
Stimulants
Systemic Steroids –> lack of sleep - ICU psychosis
----Illicit Substances---- Bath salts (synthetic cathinones, MDPV) Cannabis Cocaine (esp. crack cocaine) Lysergic acid diethylamide (LSD, hallucinogens) Methamphetamine, ice, crystal Phencyclidine (PCP)
What drugs can cause anxiety?
Ch. 67 Anxiety Disorders (page 872)
Albuterol (if used frequently or incorrectly)
Antipsychotics (Abilify, Haldol)
Bupropion
Caffeine, in high doses
Decongestants (PSE)
Illicit drugs (cocaine, LSD, methamphetamine)
Levothyroxine (if therapeutic OD occurs)
Steroids
Stimulants (amphetamine, methylphenidate)
Theophylline
What drugs can worsen insomnia?
Ch. 68 Sleep Disorders (page 877)
Acetylcholinesterase inhibitors (donepezil) Alcohol Antiretrovirals (emtricitabine, INSTIs) Aripiprazole Atomoxetine Bupropion Caffeine Decongestants (PSE) Diuretics (due to nocturia) Fluoxetine, if taken late in the day (AM dosing - activating) Steroids Stimulants (methylphenidate, phentermine) Varenicline
What Dopamine blocking drugs can worsen Parkinson Disease?
Ch. 69 Parkinson Disease (page 885)
Phenothiazines (prochlorperazine) used for psychosis, nausea, agitation
Butyrophenones (haloperidol, droperidol) used for psychosis and behavior disorders or nausea
First & Second Generation Antipsychotics (risperidone “at high doses,” paliperidone); lowest risk with quetiapine
Metoclopramide, a renally-cleared drug that can accumulate in elderly patients
What drugs can worsen dementia?
Ch. 70 Alzheimer’s Disease (page 891)
Antiemetics (promethazine)
Antihistamines (diphenhydramine, doxylamine)
Antipsychotics (chlorpromazine, aripiprazole)
Barbiturates (phenobarbital, butalbital)
Benzodiazepines (alprazolam, clonazepam)
Central anticholinergics (benztropine)
Peripheral anticholinergics (incontinence & IBS drugs)
Skeletal muscle relaxants (baclofen)
Other CNS depressants (opioids, sedative hypnotics)
What drugs can lower the seizure threshold?
Ch. 71 Seizures/Epilepsy (page 896)
Bupropion Clozapine Theophylline Varenicline Carbapenems (esp. imipenem) Lithium* Meperidine* Penicillin* Quinolones* Tramadol*
High doses and renal impairment increase risk
What drugs can worsen GERD symptoms?
Ch. 72 GERD & PUD (page 913)
Aspirin/NSAIDs Bisphosphonates Dabigatran Estrogen products Fish Oil products Iron supplements Nicotine replacement therapy Steroids Tetracyclines
What drugs can cause constipation?
Ch. 73 Constipation & Diarrhea (page 922)
Antacids (Al- and Ca- containing) Antidiarrheals Clonidine Colesevelam Drugs with anticholinergic effects: --Antihistamines (diphenhydramine) --Antispasmodics (baclofen) --Phenothiazines (prochlorperazine) --TCAs (amitriptyline) --Urge Incontinence drugs (oxybutynin) Iron Non-DHP CCB (Verapamil) Opioids Sucralfate (contains an Al- complex)
What drugs can cause diarrhea?
Ch. 73 Constipation & Diarrhea (page 928)
Acetylcholinesterase inhibitors (donepezil)
Antacids (Mg+ containing)
Antibiotics (esp. broad-spectrum drugs), diarrhea may be infectious –> C. diff (most associated with Clindamycin)
Antidiabetics (metformin, GLP-1 agonists)
Antineoplastics (irinotecan, capecitabine, 5-FU, MTX, TKIs)
Colchicine
Drugs used for constipation (laxatives)
Misoprostol
Mycophenolate
Prokinetic drugs (metoclopramide, cisapride)
Protease Inhibitors (esp. nelfinavir)
Quinidine
Roflumilast
What drugs do NOT require renal dose adjustments?
Ch. 22 Infectious Diseases I: Background & ABX Class (page 373)
Antistaphylococcal penicillins (dicloxacillin, nafcillin) Ceftriaxone Clindamycin Doxycycline Macrolides (azithromycin & erythromycin only) Metronidazole Moxifloxacin Linezolid
What drugs can increase blood pressure?
Ch. 28 Hypertension (page 445)
Amphetamine and ADHD drugs Cocaine Decongestants (PSE, PE) Erythropoiesis-stimulating agents Immunosuppressants (cyclosporine) NSAIDs Systemic Steroids
Name the IV Hypertension Medications.
Ch. 28 Hypertension (page 457)
Chlorothiazide Clevidipine Diltiazem Enalapril Esmolol Hydralazine Labetalol Metoprolol tartrate Nicardipine Nitroglycerin* Nitroprusside* Propranolol Verapamil
*vasodilators
What drugs can cause or worsen heart failure?
Ch. 31 Chronic Heart Failure (page 474)
-Dipeptidyl peptidase 4 inhibitors (alogliptin, saxagliptin)
Immunosuppressants (TNF inhibitors - adalimumab, etanercept) and interferons
-Nondihydropyridine CCBs (diltiazem & verapamil “in systolic HF”)
-Antiarrhythmics (Class I agents - quinidine, flecainide [dronedarone]) & (Amiodarone and dofetilide are preferred in patients with HF)
-Thiazolidinediones (increase risk of edema)
-Itraconazole
-Oncology drugs (Anthracyclines “doxorubicin, daunorubicin”)
-NSAIDs (all including celecoxib)
What drug classes can increase or prolong the QT interval?
Ch. 32 Arrhythmias (page 490)
- Antiarrhythmics (Class I and Ia) and Class III
- Antibiotics (Quinolones and Macrolides)
- Azole Antifungals (all except isavuconazonium)
- Antidepressants (TCAs - amitriptyline, clomipramine, doxepin; SSRIs - citalopram, escitalopram; sertraline is preferred in cardiac pts; SNRIs - mirtazapine & trazodone)
- Antiemetic drugs (5-HT3 receptor antagonists, droperidol & phenothiazines)
- Antipsychotics “most” (chlorpromazine, clozapine, haloperidol, olanzapine, paliperidone, quetiapine, risperidone, thioridazine, ziprasidone)
- Other drugs (donepezil, fingolimod, methadone, tacrolimus)
What drugs can cause hemolytic anemia?
Ch. 35 Anemia (page 531)
Cephalosporins Dapsone* Isoniazid Levodopa Methyldopa Methylene blue* Nitrofurantoin* Pegloticase* Penicillins Primaquine* Quinidine Quinine Rasburicase* Rifampin Sulfonamides*
Avoid in G6PD deficiency
What are the key vaccines in Sickle Cell Disease?
Ch. 36 Sickle Cell Anemia (page 533)
-----Routine Childhood Series----- Haemophilus influenzae type B (Hib) Pneumococcal conjugate (PCV13, PCV20 Prevnar)
—–Additional Vaccines for Functional Asplenia——
Meningococcal conjugate series plus routine boosters
Meningococcal serogroup B (Bexsero, Trumenba)*
Pneumococcal polysaccharide (PPSV23,Pneumovax 23)**
Pneumococcal conjugate (PCV13,20,Prevnar) x 1 in any patient ≥ 6 yoa, if never received as a part of routine childhood series
- at age ≥ 10 yrs
- *at age ≥ 2 yrs, booster 5 years later and at age ≥ 65 yrs
What drugs can increase intraocular pressure (IOP)?
Ch. 38 Common Conditions of the Eyes and Ears (page 549)
- Anticholinergics (oxybutynin, tolterodine, benztropine, trihexyphenidyl, TCAs)
- Cough, cold & motion sickness medications (antihistamines, scopolamine)
- Chronic steroids, esp eye drops such as prednisolone (Pred Forte)
- Topiramate (Topamax)
What common drugs are known to cause vision changes or damage?
Ch. 38 Common Conditions of the Eyes and Ears (page 553)
- Retinal changes/retinopathy (Chloroquine, hydroxychloroquine)
- Optic neuropathy (amiodarone “plus corneal deposits,” ethambutol, linezolid)
- IFIS; causes difficulty in cataract surgery (alpha-blockers “tamsulosin”)
- Color discrimination (Digoxin “w/ toxicity” - yellow/green vision; PDE-5 (sildenafil) - greenish tinge around objects; Voriconazole - color vision changes)
- Vision loss/abnormal vision (Digoxin “w/ toxicity” - blurry, halos; PDE-5 - vision loss in one or both eyes “can be permanent;” Isotretinoin - decr. night vision “can be permanent,” dry eyes, irritation; topiramate - visual field defects; Vigabatrin - permanent vision loss “high risk;” voriconazole - abnormal vision, photophobia)
What drugs can cause pulmonary arterial hypertension (PAH)?
Ch. 40 Pulmonary Arterial Hypertension (page 573)
Cocaine
SSRI use during pregnancy increase risk of persistent pulmonary hypertension of a newborn (PPHN)
Weight Loss drugs (diethylpropion, lorcaserin, phendimetrazine, phentermine)
Methamphetamines/amphetamines
What drugs affect blood glucose by increasing it?
Ch. 44 Diabetes (page 631)
Beta-blockers* Thiazide & Loop Diuretics Tacrolimus Cyclosporine Protease Inhibitors Quinolones* Antipsychotics (olanzapine, quetiapine) Statins Steroids (systemic) Cough syrups Niacin
*can cause hypo/hyperglycemia
What drugs affect blood glucose by decreasing it?
Ch. 44 Diabetes (page 631)
Beta-blockers*
Quinolones*
Tramadol
*can cause hypo/hyperglycemia
What drugs and conditions can cause hypothyroidism?
Ch. 45 Thyroid Disorders (page 636)
Interferons* Tyrosine kinase inhibitors (sunitinib) Amiodarone* Lithium Carbamazepine
Condition: Hashimoto’s Disease
*can also cause hyperthyroidism
What drugs can cause drug-induced lupus erythematosus (DILE)?
Ch. 46 Systemic Steroids & Autoimmune Conditions (page 652)
Methimazole Propylthiouracil Methyldopa Minocycline Procainamide Hydralazine (alone, and in BiDil) Anti-TNF agents Terbinafine Isoniazid Quinidine
My Pretty Malar Marking Probably Has A TransIent Quality
What drug/drug classes are teratogenic (danger in pregnancy)?
Ch. 48 Drugs Use In Pregnancy & Lactation (page 679)
- Acne (Isotretinoin, topical retinoids)
- Antibiotics* (FQs, tetracyclines)
- Anticoag (Warfarin)
- Dyslipidemia, HF & HTN (Statins, RAAS inhibitors “ACEs, ARBs, ARNI”)
- Hormones (estradiol, progesterone ‘including megestrol,’ raloxifene, Duavee, testosterone, contraceptives)
- Migraine (dihydroergotamine, ergotamine)
- Hydroxyurea
- Lithium
- MTX
- Misoprostol
- NSAIDs
- Paroxetine
- Ribavirin
- Thalidomide
- Topiramate
- Weight Loss Drugs
- Valproic Acid/Divalproex
What drug/drug classes can cause erectile dysfunction?
Ch. 50 Sexual Dysfunction (page 698)
- Alcohol
- Antidepressants (SSRIs/SNRIs)
- Antihypertensives (b-blockers, clonidine, thiazides)
- Antipsychotics (1st gen - chlorpromazine; Prolactin-raising 2nd gen - risperidone, paliperidone)
- BPH medications (finasteride, dutasteride, & silodosin)
What drugs can worsen BPH?
Ch. 51 Benign Prostatic Hyperplasia (page 702)
-Centrally-acting anticholinergics (benztropine)
-Anticholinergic classes
==Antihistamines (diphenhydramine)
==Decongestants (PSE, PE)
==Phenothiazines (prochlorperazine)
==TCAs (amitriptyline)
-Caffeine
-Diuretics
-SNRIs
-Testosterone products
What drugs can cause CKD?
Ch. 18 Renal Disease (page 294)
Aminoglycosides Amphotericin B Cisplatin Cyclosporine Loop diuretics NSAIDs Polymyxins Radiographic contrast dye Tacrolimus Vancomycin
What drug/drug classes require a decrease dose or increase interval in CKD?
Ch. 18 Renal Disease (page 296)
- Anti-infectives (AMG ↑ dosing interval primarily; Beta-lactams abx ‘except antistaphylococcal PCNs & ceftriaxone;’ fluconazole; FQs ‘except moxi;’ vancomycin)
- Cardiovascular drugs (LMWH - enoxaparin; AFib = rivaroxaban, apixaban, dabigatran)
- GERD drugs (H2RAs, metoclopramide)
- Bisphosphonates
- Lithium
What drugs are contraindicated in CKD?
Ch. 18 Renal Disease (page 296)
—–CrCl < 60 mL/min—–
Nitrofurantoin
—–CrCl < 50 mL/min——
Tenofovir disoproxil fumarate containing products (Atripla, Complera, Delstrigo, Stribild, Symfi, Symfi Lo)
Voriconazole IV (vesicant)
—–CrCl < 30 mL/min——
Tenofovir alafenamide containing products (Biktarvy, Descovy, Genvoya, Odefsey, Symtuza)
NSAIDs
Dabigatran & Rivaroxaban (DVT/PE)
—–GFR , 30 mL/min/1.73 m^2——-
SGLT2i
Metformin
Meperidine
What drugs raise potassium levels?
Ch. 18 Renal Disease (page 300)
ACEis Aldosterone receptor antagonists ARBs ARNI Canagliflozin Drospirenone-containing COCs Potassium-containing IV fluids (including TPNs) SMX/TMP Transplant drugs (cyclosporine, everolimus, tacrolimus)
What drugs have a Boxed Warning for liver damage?
Ch. 19 Liver Disease & Hepatitis (page 311)
APAP (high doses, acute or chronic) Amiodarone Isoniazid Ketoconazole (PO) MTX Nefazodone NNRTs (esp. nevirapine) NRTIs Propylthiouracil Tipranavir Valproic Acid
