NAPLEX Counseling Points Flashcards
Quinolones Can Cause: (6 things)
- CNS effects (includes seizures)
- Hypo/Hyper Glycemia
- Peripheral Neuropathy
- Photosensitivity
- QT prolongation
- Tendon inflammation (or rupture)
Can Quinolones be used in pregnancy?
No, avoid also in breastfeeding and in children
Macrocodes Can Cause: (2 things)
GI Upset
QT prolongation
Should pregnant patients take tetracycline?
No, avoid in pregnancy, breastfeeding, and children < 8 y
How should you take oral doxycycline ?
full glass of water and remain upright for 30 minutes after to avoid GI irritation
Can Bactrim be used in pregnancy?
No, do not use in pregnancy or breastfeeding.
Bactrim side effects: (2)
photosensitivity
crystals in urine (full glass of water)
How long should you avoid alcohol after taking Metronidazole?
3 days
Metronidazole can cause (2 side effects)
Nausea
Metallic taste in the mouth
What can you do to decrease Nausea in Nitrofurantoin?
Take with food
Nitrofurantoin can cause (2 side effects)
Nausea
Discolored urine (brown - harmless)
What do you counsel on with Mupirocin Nasal Ointment?
1/2 ointment from the tube into 1 nostril and repeat on the other. press down on both nostrils at the same time. Do this multiple times for one minute.
- Wash hands after use
- Can cause burning and itching in the nose
Azole Antifungals can cause? (2 points)
Liver damage
&
Prolong QT (except isavuconazonium)
All have many DDI
What is unique about Cresemba (Isavuconazonium)?
does not prolong QTc
How should you take itraconazole tablets/capsules?
With food
How should you take itraconazole solution?
on an empty stomach
What do both itraconazole and ketoconazole need for best absorption?
ACIDIC environment! need to space out PPI’s by at least 2 hours.
How do you best take Posaconazole (Noxafil)?
take the tablets with food
take the suspension: full meal or a liquid nutritional supplement
When is it best to take voriconazole (Vfend0
best on an empty stomach, at least one hour before or after meals.
Store reconstituted suspension at room temperature
Voriconazole can cause (2 side effects)
photosensitivity and vision changes
What should patients know about the effects of Terbinafine?
can take several months after finishing treatment to see the full benefit. (takes time for new healthy nails to grow in place of the infected ones)
When can a patient start Oseltamivir (tamiflu) and what can it cause?
Should start within two days of symptom onset.
CAN cause delirium
When should a patient start acyclovir and valacyclovir?
within 24 hours of symptom onset
What is an important thing to tell patients about acyclovir topical cream?
Can cause temporary burning or stinging
Lactic Acidosis can occur in all (HIV Class)
NRTIs (ZDS <3 LATTE)
Abacavir requires ?
HLAB 5701 Allele (increased risk of hypersensitivity reaction)
A patient comes in with darkened spots on their hands and the soles of their feet. What HIV medication is most likely causing this?
Emtricitabine (Emtriva)
TDF and TAF can cause (2 things)
Kidney Impairment
Low Bone Density/Fracture risk
All INSTI’s interact with this type of medication and requires spacing?
Antacids! take 2 hours before or 6 hours after
(-tegravir BRED)
All NNRTIs Can cause (2 things)
Rash/ Severe
Hepatotoxicity
(-vir- , REDDEN)
Efavirenz, an NNRTI, should be taken at what time of day?
Night and on an empty stomach to decrease side effects (CNS)
- Depression and psychosis, confusion, abnormal dreams (should all improve within 2 -4 weeks )
All Protease inhibitors should be taken with food EXCEPT:
Fosamprenavir po SOL
When looking at a patient with HIV’s labs you see they have both elevated glucose and TG. You have also noticed some body fat redistribution. WHAT HIV Class could be causing this?
Protease Inhibitors (-navir)
If a patient is taking RITONAVIR with Atazanavir or Darunavir what should they do?
Make sure to take them at the SAME TIME
Atazanavir can cause: (2 things)
Hyperbilirubinemia and is CI with acid suppressing medications
If a patient has an allergy to X darunavir, fosamprenavir, and tipranvir should be used with caution:
Sulfa
What fruit should be avoided in all Statins?
Grapefruit due to its effects on CYP3A4 (increased levels)
Ezetimibe can cause (2 things)
Muscle damage and liver damage
What kind of administration/storage/SE can PCSK9 inhibitors cause?
Admin: SUBQ (thigh, abdomen, upper arm)
Store: in fridge, allow to warm up to room temp before injecting. Can be kept at room temp for 30 days
Can cause: injection site reactions, Allergic Rxn
What are 3 important points for Bile acid sequestrants (admin, se x 2)
take at meal time with plenty of fluids
can cause constipation
reduces ADEK vitamin absorption
Fibrates can cause (2 things)
Pancreatitis
Cholelithiasis (gallstones)
A patient is experiencing flushing while taking niacin. How can we help them?
Take ASA 325 or Ibuprofen 200 30 - 60 minutes before the dose.
Avoid spicy foods and hot liquids.
Thiazides, BB, and Clonidine can cause:
Sexual Dysfunction
A patient comes in with gingival hyperplasia. What class of medication may have caused this?
CCB (non DHP>DHP)
Nitroglycerin products have a known DDI with?
PDE5- inhibitors (increases hypotension )
A patient tells you that when they take their SL Nitrostat they get a slight burning and tingling feeling.
They ask you if this needs to occur to know that it is working?
No, this feeling is not a sign of how the medication is working
What counseling should be given to patient taking home a Nitro spray?
DO NOT SHAKE. spray onto or under the tongue. do NOT inhale the spray and try not to swallow too quickly afterward.
A patient asks you what they should no when applying nitrobid ointment:
measure with the dose card.
it can stain your clothing
