Law Review GENERAL Clinical Flashcards
Rivabirin and pregnancy? how long after can a patient get pregnant?
contraindicated in pregnancy , even a guy who is taking hep C cant have sex with a girl cuz she might have a baby with defects
-must wait 6 months after stopping therapy
Rivabirin and the kidney
Contraindicated at ClCR less than 50
Pegasys to generic
peginterferon 2g
What happens when a patient gets anemia or neutropenia with hepatitis C treatment?
doctor can prescribe epoetin for anemia
or filgastrim for neutropenia (neupogen)
Entecavir Brand
FOOD?
Baraclude
NO FOOD
peginterferon + rivabirin Brand
Rebetron
interferons and medguides
always dispense
Boceprivir/teleprivir
- indication
- MOA
- frequency
- pregnancy
Hepatitis C
protease inihibitors
-every 7 to 9 hours around the clock
-need negative pregnancy test before initial refill and before each refill
-must use two non hormonal contraceptives
NRTI class side effects
-lactic acidosis: muscle weakness, feet , cant move arms
-Headache fatigue, nausea, diarrhea
-skin rash
ALL possible
Epivir to Generic
Epivir HBV to generic
lamivudine for HIV
epivir HBV has a lower dose that is indicated for hepatitis
what meds cover bacteroides fragilis
tigecycline metronidazole Amp sulbactam cefoxitin, cefotetan ertapenem
nitrofurantoin
- indication
- Se
- Serious side effect
- renal adjustment
only for cystitis NOT systemic symptoms of UTI since does not reach good systemic concentraiton
- causes yellow brown urine that sotpes when you DC
- can cause serious lung problems
- CI at ClCR less than 60
biaxin to generic
MOA/Class
SE
DDI
clarithromycin
macrolide inhibiting 50 s
GI abmnormalities
3A4 inhibitor
amphotericin B
- compatibility
- why use the lipid formulation
- pregnancy
- side effects
ONLY D5W
- use lipid formulations to decrease infusion reactions and decrease nephrotoxicity
- pregnancy category B
- SE nephrotoxicity and electrolyte imbalances
what do you give to someone who has Cdiff but it it refractory to vancomycin and metronidazole?
Fidaxomicin
main rifampin side effects
hepatotoxicity and red orange urine
treatment for cytomegalovirus
cidofovir
valgancyclovir
foscarnet
clindamycin brand
spectrum
Cleocin
Covers gram + strept/staph but not enterococcus, gram + anaerobes
gram - anaerobes
daptomycin
- type of killing
- concentration or time dependent
- renal
- SE
- compatibility
- bacteriocidal
- concentration dependent
- Adjust renally
- myopathy of adem… (?)
- NS only
antibiotics with SLE - like side effects?
isoniazid
microdantin versus macrobid frequency
100 QID
100 BID
sinusitis doxycyline dose
100mg twice daily for 7-14 days
Does voriconazole cover aspergilis?
Yes
oseltamivir dose
75mg po twice daily for 5 days ( within the first 2 days of symptoms)
malaria prevention
main schedule
take the PO meds before and after traveling to an infected region
mefloquine dosing
2 weeks before travel and 4 weeks after travel
vivotif berna storage
fridge NOT freezer
primaquine
- indication
- test
- pregancy
- dose timing
for p vivax
make sure patient gets tested for G6PD deficiency
pregnancy X
take 1-2 days before travel and 7 days after travel
How is typhoid fever transmitted ? how is it prevented?
infected feces of people
make sure you eat safe food and water, wash hands
take the vaccine before traveling
Diamox generic
- allergies
- side effects
- other recommendations
acetazolamide
CI in sulfa allergy
-photosensitivity
-remain well hydrated
possible side effects of valacyclovir
well tolerated but …
nausea and headache
common blood condition with Rivabirin?
within 1-2 weeks of starting, can cause hemolytic anemia
epivir dosing for hepatitis B vs HIV
HIV 300 po QD
HBV 100 po QD
Daytrana to generic where to place can you swim in it frequency indication
methylphenidate patch
place on right hip on even days, left hip on odd days
yes can swim and bathe in it , make sure to hold patch in place for at least 30 seconds
place it once a day
it is for ADHD
Recommended criteria for starting ADHD medications
MUST have inattention and symptoms of hyperactivity/impulsivity
symptoms must impair the person it at least 2 settings : home, work, school
can patients take ADHD meds at night to decrease appetite suppression?
not a good idea! stimulants can lead to insomnia
which medications can be flushed down the toilet?
duragesic- fentanyl nucynta opana- oxymorphone oxycontin butrans diastat- diazepam avinza - morphine sulfate Onsolis- fentanyl
Provigil to generic
- indication
- scheduled status
- main adverse effects
modafinil
narcolepsy
CIV
severe rash
Med guides and when to give them
- stimulants?
- atomoxetine
- provigil
give med guides for new prescriptions and for each refill
- Yes for all stimulants because of psychiatric and heart problems
- yes for atomoxetine because of risk of suicidal thoughts for children and teens, heart probles
- yest but for sever rash
what to monitor in patients ADHD meds? when ?
Monitor Blood pressure & heart rate every month
height and weight every month or less often
ADHD symptoms and mood every month
ritalin to generic
methylphenidate
what is the starting dose of concerta?
concerta generic
18 m g once a day
methylphenidate ER
methylphenidate
stimulant side effects
usual schedule
-SE seeing, hearing non-real stuff, paranoia –> report
has an abuse potential
report chest pain, SOB or fainign
-usual schedule is start at low dose and increase dose with time
Nardil to generic
MOA
phenelzine
monoamine oxidase inhibitor
drug of choice for acute otitis media
dose
organism
amoxicillin 90mg/kg per day divided every 8 or 12 h
streptococcus pneumoniae
moxatag to generic
- indication
- how to take
- kidney function
ER amoxicillin for pharyngitis by streptococcus pyogenes
- take within an hour of finishing a meal
- not for patient that has ClCr less than 30
treatment of giardiasis
diarrheal illness by a parasite
metronidazole po 250-500 TID or QID
Ceftin generic
cefuroxime
Extended dosing
gentamicin
tobramycin
amikacin
4 to 7 mg / kg/ dose
15mg/kg amikacin
penicillins and seizures
penicillins lower seizure threshold if they accumulate especially in renal impairment
Ketek generic
Telithromycin
minute time to infuse vancomycin
over two hours minimum
rifampin and urine
rifampin and food
orange red discoloration of body secretions
NO food! decreases absorption
treatment for syphillis based on duration of infection
penicillin G benzathine 2.4 million units x 1 for 3 weeks if unknown duration
if infection less than a year, just require one dose!
quinopristin-dalfopristing and VRE
IV covers only VRE faecium not faecalis. Also covers MRSA IV
ethambutol main side effects
optic neuritis and decrease in visual acuity
nitrofurantoin
- role in treatment
- when not to use
- serious toxicity
- food
for uncomplicated cystitis
NOT for less than 60 CL cr, not for systemic or complicated cystitis
pulmonary toxicity if used long term
take with food to increase absorption
Phenazopyridine
- indication
- OTC?
- max day use
- Food ? why?
to relieve pain from a UTI
yes OTC AZo and generics
maximum 2 day use because by then the antibiotics should be working by then so pain should be gone. If not gone, contact doctor cuz infection is not cured
-with food and 8 oz water because can cause stomach upset
vancomycin concentration dependent or time dependent?
time dependent
Drug of choice for ESBL bacteria
carbapenems
fidaxomicin
- indication
- effectiveness
clostridium dificille
as effective as vancomycin but less recurrence rates
zyban , Sexual dysfunction?
NO
adderall generic
dextroamphetamine / amphetamine
amphetamine toxicity treatment
if high blood pressure use BB
if super energetic give a sedative like lorazepam
if psychotic give an antipsychotic
what is the OROS system ?
what ADHD med takes advantage of this ?
Age limit?
- the outer layer dissolved right away for quick delivery but the inner layer is extended release
- concerta requires once daily dosing 18mg QAM
- 6 to 12 yo
indication for dronedarone
maintaining sinus rhythm in recurrent Afib ad paroxismal Afib
max use of afrin - oxymetazline (days)
why?
3 days
cuz of risk of rebound congestion and rhinits medicamentosa
triamcinolone for allergic rhinitis
Nasacort AQ
Razadyne
Galantamine
Beclomethasone for allergic rhinitis brand?
which is for asthma?
Q Nasl and Beconase AQ for allergic rhinitis
Q Var for asthma
fluticasone for allergic rhinitis brands
Flonase
Veramyst
mometasone for asthma vs for allergies
Asmanex
Nasonex
percent of elemental iron in
- ferrous fumarate
- ferrous sulfate
- ferrous sulfate exsiccated
- 33 %
- 20%
- 30%
how long to taker iron for iron deficiency anemia
3 to 6 months after RBC, iron stores and other labs are normalized
what is the main indication for dabigatran
reduce the risk of stroke and blood clots in patients with non-valvular atrial fibrillation AKA: if you have irregular heart rhythm and not a prostesthetic valve, mitral valve repair or disease of mitral valve
Black box warning of dronaderone and WHY
class IV (4) heart failure and permanent heart failure , worse outcomes in these populations
where to inject aranesp?
where to inject darbopoetin?
- abdomen (not 2 inches around belly button)
- front of middle thighs
- outer area of buttox
formulations of allergic rhinitis are? why?
oral tablets , eyedrops: itchy eyes, oral solution: pediatrics, nasal spray for nasal symptoms
class 3 antiarrhythmics
sotalol
amiodarone
what test to do to send a patient home on clindamycin if pt has MRSA
D-t est for resistance of MRSA to clindamycin
Intuniv to generic
- MOA
- indication
- DDI
- food?
- SEs
Guanfancine ER
- central alpha 2 adrenegic receptor agonist
- ADHD
- 34a substrate
- no high fat food
- somnolence, bradycardia, GI pain, nausea
drug of choice for perioperative prophylaxis
- first or second generation cephalosporins
2 if allergic: vancomycin
endocarditis prophylaxis drug of choice and second line
- 2 grams amoxicillin 30-60 minutes before dental procedure
- clindamycin 600mg po 1 hours before procedure if Beta lactam allergy
amphotericin B
- potassium
- magnesium
- blood pressure
- other side effects
decreases
decreases
decreases
chills and rigors, nephrotoxic
Nizoral A-D to generic
ketoconazole 1%
telithromycin main side effects
acute hepatic failure
visual problems
QTprolongation
rifaximin
- indication
- DDIs
treatment for Traveler’s diarrhea from non invasive ecoli
typhoid vaccine
- route
- storage
- when to get vaccinated
4 capsules or IM injections
refrigerated
1 to 2 weeks before travel
vivotif generic
and dosing
typhoid vaccine
1 capsule 1 hour before a meal with cold, luke warm water
pediarix to generic
hepatitis b and DTAP and Polio vaccine
name of the tetanus booster
how frequent to take it
Td
every ten years
children Dtap schedule
DT is for children who cant tolerated the pertussis vaccine start at 15- 18 months 2 years lold 4 years old 4-6 years old 6 years old
a total of 5 doses
who should use Tdap and who should be using TD
Tdap is to prevent a tetanus infection after a cut or a burn, also for people who have not gotten a dose previously
Td should be used if Tdap is not available
-a person who already got Tdap (a dose)
-or a person 65 years or older
MCV 4 vs MPSV4
- route
- age range
MCV 4 is given IM to patients 2 - 55 yo
MPSV4 is SC and 55 or older
which vaccine brands contain just hepatits B vaccine
engerix B
recombivax B
can you use acetaminophen during a vaccine
not before or after , but a while later is cool for mild pain or fever
in DTaP what do the captial versus the lower case letters mean
lower case d or p means a lower dose of diptheria or pertussi versus a capital D . The “a” means acellular
which vaccines go in the freezer and require reconstitution?
MMRV = Proquad
Zostavax
Varivax
Herpes zoster vaccine brand what temperature to store how quick to use vaccine route what needle
Zostavax
keep at -15 degrees celsius
use within 30 min of reconstitution or discard
SC with a 5/8” needle
three main symptoms of tetanus
muscle rigidity
painful muscle spasms
high fever
who should get the hpv vaccine
women 11 to 12 yo up to age 26
men up to age 21
where are the following injected polio Tdap/Td TPV Pnuemovax Hep A/B MCV 4 flu shot HPV
polio: SC or IM Td /Tdap IM TPV SC or IM Pneumovax SC or IM HepA/B : IM MCV 4 IM flu shot IM HPV IM
Flublok
- age range and indication
- how is it different from the normal flu vaccine
for 18 to 49 years old
can be used in egg allergies cuz not made in chickens, made with recombinant DNA techniques
Comvax to generic
Hepatitis B and Hemaphilus influenza
side effects of pegintron and indication
peginterferon plus rivabirin for hepatitis C
NV and loss of appetite
feeling of having the flu for 1 to 2 days after injections
fee low, worried, anxious
vision changes , hair
rash
IF SOB go to the doctor
sandostatin to generic
indication and MOA
ocreotide for variceal bleeding in portal hypertension
vasoconstriction of splanchnic vessels
itraconazole tabs vs oral solution FOOD
Tabs or capsules should be after a meal because they require acid
oral solution should be on an empty stomach
in gentamicin and tobramycin dosing
what dosing parameter affects the peak versus the trough
peak: Mg of the dose
trought: dosing frequency
one cephalosporin with anaerobic coverage
cefotetan
clindamycin renal adjustment
NO
moxifloxacin renal adjustment
NO
VFEND
sun?
voriconazole
yes photosensitivity
antibiotics with IV to PO 1 to 1 conversion
quinolones tetracycline smx tmp linezolid rifampin metronidazole
lyme disease treatment
doxycycline
alternative amoxicillin
what can be used for VRE
Tigacyl : tigecyline
Cubicin: daptomicin
Zyvox : linezolid
levofloxacin tablets versus oral solution
food?
tablets are with or without food
but the oral solution is NO food
risk factor to get tendonitis for fluoroquinolones
greater than 60 years old
transplant history
corticosteroid use
ceftaroline coverage
really good gram positive coverage including MRSA and VRE
gram negative coverage is just like ceftriaxone
oral candidiasis dosing for fluconazole IV
fluconazole IV 200mg IV qd for 7- 14 days
what is tuloremia? treatment ?
infection by francicella tularensis after getting bitten by animals or other ways like breathing stuff
gentamicin / tobramycin 5mg/kg/ day divided every 8 hours for 7 to 14 days
antibiotics that cover atypicals
Fluoroquinolones
doxycycline
azithromycin
Y site administaration of Ceftriaxone: with what is it to be avoided
Calcium containing solutions use cefotaxime instead
which cephalosporin has disulfuram like reaction with alcohol
cefotetan
can patients use condoms /diaphragms / have sex when suing antifungal vaginal suppositories
NO because damage to the condom or diaphragm,
only sanitary napkins not tampons are ok
rifaximin
indication
ddis
for travelers diarrhea from non invasive ecoli or for overt hepatic encephalopathy
doest not get absorbed systemically so not strong heaptic enzyme induction
first line treatment for status epilipticus
lorazepam or diazepam
side effects of depakote , generic
divalproex sodium
GI upset, nausea
weight gain
hair loss and thinnning
can phenytoid cause SJS / TEN
YES if toxic levels occurs
Phenytoid needs to be separate 2 hours from tube feedings (AKA needs to be separated from meals)
what diluent to use for phenytoin ONLY
normal saline
topamax pregnancy category
pregancy D due to risk of cleft palate
when to discontinue seizure treatment
if zero seizures within the last 2 to 4 years
if seizure from head injury , needs to be if zero seizures in 6 to 12 months can discontinue
main indication for ethosuximide
absence seizures
felbatol to generic
- indication
- Black box warning
felbamate for seizures
can cause hepatic failure, aplastic anemia
valproate / valproic acid to brand
divalproex age limit
-brand dose
-main side effects
depakene
Depakote ER 125 to 150 BID
can cause liver damage
oxcarbazine DDIs biggest risk normal side effects cross reactivity to carbamazepine sensitivity
CYP inducer
SJS
dizzy , sleepy, tired , nausea
yes can cross react
starting dose of topamax for seizures
MAx dose
25mg BID
200mg BID
primodone belongs to which drug class
barbiturate
what is the biggest warning for anticonvulsants
increased risk of suicidal ideation
lamotrigine starting dose
DDI with VPA
25 mg daily for 2 weeks
VPA will increase lamotrigine level
long term treatment with phenytoin , what are the side effects
how to treat two of them
causes hirsutism and gingival hyperplasia SLE Hepatitis macrocytic anemia: give folic acid osteoporosis: give calcium and vitamin D
Keppra to generic
lamictal to generic
levotiracetam
lamotrigine
WTF is oligohydrosis?
which anticonvulsants leand to oligohydrosis
who does it primarily affect
decreased sweating
topiramate/ zonisamide
children
main indication for levitiracetam
first line for partial or generalized tonic clonic seizures
if a patient got a rash with carbamazepine can they use oxcarbazine?
its not recommended cuz rish rash still there
max infusion rate of phenytoin
50mg per min
main toxicity from phenytoin overdose
ataxia : lack of coordination walking like you are drunk
fosphenytoin
- formulation
- advantage
- how long to work
injection IM with NS or D5W
thought to controll seizures faster cuz causes less hypdation than phenytoin
take 15 to 30 minutes to work so not really faster
what is gabapentin FDA approved for
epilepsy and restless leg syndrome
also for post herpetic neuralgia
carbamazepine testing
if asian descent HLA B1502
BBW for valproate or divalproex
hepatic failure
pancreatitis
teratogenicity
Gabitril to generic
tiagabine
Hydrea
Droxia
to generic
hydroxyurea
MOA of hydroxyurea with sickle cell disease
increases hemoglobin which blocks RBC sickling action
exjade administration
drop- stir - drinkk tab must be dissolved
use OJ, AJ, H20
stir till even and then drink
how is dabigatran cleared?
renally
how is enoxaparin cleared
renally
high potassium leads to what
muscle weakness bradycardia chest pain arrythmias paresthesias
ACE inhibitors and kidney dysfunction
start if no contrainidications at stage 3 ClCR 30-59
kidney disease stages
stage 1 is 120 or greater stage 2 is 60- 119 stage 3 is 30- 59 stage 4 is 15- 29 stage 5 is less than 15
act FAST
face is droopy
arms don’t raise the same way
speech is slurred
time - actu quickly
indication of nimodipine
only route of administration
for subarachnoid hemorrage
only PO max 21 days
BBW for IV (DO NOT USE IV)
what is the maximum dose of alteplase
90 mg
three approved regimens to prevents ischemic stroke
- ASA
- Clopidogrel
- ASA + dipyridamole
phenytoin level in blood target
IM injection ?
10 to 20
AVOID
number one reason patients get strokes
cuz they have hypertension and dont take their medicines regularly
side effects of hydroxyurea
leukopenia and neutropenia
HA dizziness
hyper-pigmentation of nail or skin
dose of folic acid for children
0.1mg to 0.4mg per day in 1 to 10 YO, can do 1mg a day, max 5mg a day
hydroxyurea and pregnancy
use gloves when handling if pregnant and wash hands afterwards cuz this is category D
why use deferasirox over deferoxamine
it Is PO vs the other is an injection . So it is better tolerated
it is less time consuming to administer
buspar versus wellbutrin in terms of 3a4
buspirone is substrate of 3a4 while buproprion is not
lithium and elderly patients
caution!
nuvigil to generic
MOA
inidication
armodafinil
not known
narcolepsy
tagamet to generic
cimetidine
drug of choice if asthmatic and pregnant
budesonide plus albuterol
budesonide = pulmicort, flexhaler or respule
budesonide is also the drug of choice for infants with asthma but only the respules
bacterial vaginosis and pregnancy treatment
DOC is clyndamycin PO and 2nd line is metronidazole PO
topical metronidazole and Clindamycin are not indicated in pregancy
pregnancy and macrolides
azithromycin and erythromycin are category B, Clarithromycin is category C
the folic acid name as a vitaimin name
vitamin B9
do prenatal vitamins contain enough calcium for pregnancy?
no ! 200mg is not enough you need at least 1000mg
chlor-trimeton
chlorpheniramine
what to treat motion sickness, nausea in pregnancy
vitamin B6 which is pyridxime, you can also use an antihistamine
trichomoniasis , metronidazole treatment dose?
pregnancy?
2G x 1 OR 500 BID x 7 OR 250 tid x 7 –ALL ok, even for pregnacy
Higher doses means higher side effects
pregnancy and chlamydia
zithromax can be used at 1g x 1, but if also going to treat gonorrhea can use 2g x 1
- Can also use amoxil
- clarythromycin is not safe in pregnancy
pregnancy and hyperthyroidism
can use PTU and methimazole but PTU is in the first trimester, then methemazole in 2nd and third trimester
which anticonvulsants also can be used for migraine prophylaxis
topamax
depakote- divalproex
drugs that increase the risk of seizures
demerol - meperidine
Ultram- tramadol
primaxin - imipenem/cylastin
zyban - bupoprion
what need to supplement with carbamazepine?
biggest concern with CBZ
vitamin and folate levels
scared of SJS or TEN
clindamycin renal dose adjustment
none MO-FO!
vitamin D3
vitamin D2
why use doxercalciferol?
why use paricalcitol?
cholecalciferol = rocaltrol= calcitione
ergocalciferol
they decrease changes of hypercalcemia
phosolo generic
calcium acetate
at what Clearance createnine to avoid alendronate
less than 35
tadalafil and severe renal impairment
less than 30 for prn use 5mg every 72 hours max
less than 30 for chronic daily treatment : DO NOT USE
meperidine is cleared how?
renally and end metabolite is cleared renally too, so its metabolite can accumulate
how is tigecycline cleared
50 % bile and 30 % urine
how is metoclopramide cleared
renally
pregabalin cleared
renally
why do renal disease patients get problems with bones
increased phosphate levels leads to increased pth excretion which leads to breakdown of bone. Solution is to decrease phosphate intake
rivaroxaban cleared?
renal cleared?
how is voriconazole cleared
renally
bicitra to generic
indication
cytra-z
SEs
sodium citrate/citric acid
for chronic metabolic acidosis
cytra z i s the same
SE are diarrhea
xarelto to generic
DDIs
Rivaroxaban
3A4 substrate
buspar DDI
cyp 3a4 substrate
biaxin to generic
class
clarithromycin
macrolide inhibition of 50s ribosome
what is the DDI of valproate with lamotrigine?
can you still give them together?
VPA inhibits metabolism of lamotrigine which increases the risk of rash
the lamictal dose titration can be used but need to use even lower doses
demadex to generic
torsemide
theophylline with respect to 3a4
subtrate
dyazide to generic
MOA
triamterene and hydrochlorothiazide
inihitbs the sodium in the distal convoluted tubule, leading to decreased H2o and increased potassium retention
inspra to generic
eplerenone
MOA of tetracyclines
inhibit the 30s subunit of ribosome leading to decreased protein synthesis
QT prolongation of
- antibiotics
- TCA
- opoids
Quinolones and macrolides
amytryptiline
methadone
can a patient on an MAOI take pseudophed?
alprazolam?
no pseudofed or analagos
yes alprazolam
Grepefruit juice and transplant medications
Do not use due to tacrolimus/cyclosporine DDI
common PGP substrates
cyclosporine/ TAC
dabigatran (pradaxa) /rivaroxaban (xarelto)
which statin has least DDI risk
pravastatin
meds that cause hearing damage
salicylate vancomycin tobramycin and gentamycin ethacrynic acid bumethanide
neoral to generic
cyclosporine
symptoms of serotonin syndrome
tremor, agitation, confusion, hallucination
tachycardia, sweating
diarrhea
muscle rigidity, shivering
sustiva to generic
atripla to generic
emtriva to generic
efavirenz
efavirenz with tenofovir and emtricitabine
emtricitiabine
kaletra to generic
food?
lopinavir and ritonavir
oral soluation must be with food but the tabs doesnt matter
one preferred regimen for pregnant woman with HIV
ZDV/3TC + Lopinavir/RTV
prophylaxis for toxoplasma in HIV, CD4 count
pneumocystitis CD4 count to start prophylaxis
less than 200
pregnancy category of efavirenz ?
D
treatment for mycobacterium avium complex (MAC) opportunistic infection
azithromycin 1200 mg po every week
epzicom to generic
ABC/3TC (abacavir/ lamivudine)
Ziagen to generic
- Bbw
- test
- class
abacavir
hypersensitivity if
positive for HLAB5701
NRTI
class side effects of protease inhibitors
fat redistribution
dyslipidemia
insulin resistance
tacrolimus
- monitoring
- DDIs
- MOA
monitor trough levels
cyp 3A4 substrate and pgp substrate
calceneurin inhibitor
cyclosporine to brands common side effects monitoring ddis MOA
Neoral (caps and tabs), Sandimmune increase in blood glucose, nephrotoxicity, qt prolongation trough levels 3a4 and pgp substrate calcineurin inhibitors
renal transplant
blood pressure goal
less than 130 /80 (check JNC 8)
belatacept bbw
post translplant lyphoproliferative disorder: lyphocytes grow out of control
only for EPV negative patients only
what can cyclosporine solution be diluted with
apple juice or orange juice
mycophenolate to brand pregnancy category food interaction frequency common side effects
CellCept (mofetil) Myfortic (delayed release)
D fetal harm
empty stomach / separate from multivitamins /questra/
give every 12 hours exactly
diarrhea
How are these transmitted
- dengue
- African sleeping sickness
- Japanese encephalopathy
- malaria
- yellow fever
All through mosquito bites except African sickness
Xenical should be separated from what ?
Separate from ADEK vitamins , take at different times of the day
Lorcaserin to brand
Pregnancy
MOA
Phase IV trials
Belviq
Category x
Serotonin receptor agonist
Monitor cardiovascular effects using lorcaserin
Most common side effects of orlistat
Flatulence with discharge
Fatty stool
Xenical to generic
Orlistat
Weight loss guidelines recommendation to have bariatric surgery
Yes if the Bmi is great than 40 or greater than 35 with obesity related conditions
Lorcaserin side effects
Headache and dizziness Fatigue Dry mouth Constipation Risk of hypoglycemia if diabetic
Qsymia to generic
Contraindication
Scheduled?
Phetermine and topiramate
Contraindicated in pregancy, lactation, MAOI within14 days, hyperpathyroidosis
Scheduled IV
Lorcaserin
Indication
Dose
DDI with serotonergic agents
Weight loss
Patients with bmi must be obese or overweight with at least one weight related condition
10mg bid
Increased risk of serotonin syndrome
What kind of environment is required for atazanavir absorption
Acidic required
Post exposure prophylaxis for HIV
Tenofovir emtricitabine to raltegravir for 4 weeks
