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New drug encounter #1 Flashcards

1
Q

Soolantra

Generic and indication

A

Ivermectin topical

Acne rosacea

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2
Q

Nuvessa

A

Nuv - new vaginal gel

Metronidazole 1.3% vaginal gel

Bacterial vaginosis

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3
Q

Edarbyclor

A

Azilsartan + chlothalidone

High blood pressure

Edarbyclor see in name
* arb = azilsartan
* clor = chlorthalidone

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4
Q

Edarbi generic

A

Azilsartan

edARBi = arb

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5
Q

Valtoco

A

Diazepam nasal spray

For seizures

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6
Q

Nayzilam

A

Midazolam (versed) nasal spray

For seizures

  • nayziLAM = midazoLAM
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7
Q

Belsomra

A

Suvorexant

  • Insomnia
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8
Q

cytotec generic

A

misoprostol

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9
Q

cytotec indications (2)

A
  1. cervical ripening
  2. labor induction

cervical ripening - a process of softening and opening the cervix before labor starts
* the cervix is stiff and closed through most of your pregnancy to hold baby inside uterus. But during labor, cervical dilation (widening) allows baby to pass through your birth canal

induction (n) - the act of bringing about something (especially at an early time)
* After a baseball player’s induction into the Hall of Fame, his name remains on the wall there for life. Induction is something that begins a process or a series of events.

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10
Q

what side effects should you think with cytotec (2)

A

Cytotec is used for abortion, will cause muscle contraction and movements leading to DIARRHEA

I want an abortion, having this baby will be a HEADACHE

GI: abdominal pain and diarrhea (40%)

CNS: Headache

note: administer with meals to decrease risk of diarrhea

You will have less HEADACHE without the baby

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11
Q

what should you avoid while taking cytotec?

A

Alcohol

note: cytotec causes a lot of GI irritation (diarrhea and abdominal pain), alcohol also causes GI irritation (makes it worse only)

  • avoid magnesium - increase diarrhea
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12
Q

can I take antacid before or after cytotec to minimize GI side effects?

A

Yes

Note: can take before or after cytotec
Avoid magnesium containing antacid may cause more diarrhea

tums

Avoid maalox

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13
Q

How do I take cytotec PO

A

Take with food

  • to minimize diarrhea

Note: cytotec cause a lot of diarrhea 40%

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14
Q

galantamine brand name?

A

Razadyne (ER)

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15
Q

galantamine indication (1)

A

Alzheimer DEMENTIA

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16
Q

galantamine indication (1)

A

Alzheimer disease, mild-moderate dementia

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17
Q

how to take galantamine

A

Increase acetylcholine (rest and digest) leading to INCREASE ACID secretion causing NVD

take with food

  • most common side effects N, V, D
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18
Q

galantamine side effects (2)

A
  1. Nause, Vomiting or Diarrhea (most commonly)
  2. HA or fatigue
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19
Q

galantamine IR and ER dosing

A

galantamine IR - twice daily with food

galantamine ER - once daily with food

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20
Q

generic for Zubsolv

A

buprenorphine & naloxone (SL tablet)

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21
Q

Zubsolv indication

A

opioid dependence

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22
Q

age limit for Zubslov

A

16 years or older

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23
Q

difference between Zubsolv and Suboxone

A

Zubsolv dissolved more quicker than Suboxone, therefore, requires less mg

  • more bioavailability
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24
Q

zubsolv side effects 2

Think what zubsolv is

A

Zubsolv is for opioid dependence
* b/c I can’t get any opioid, it makes me not able to sleep and gives me headache
** all opioid cause GI symptoms: NVDC

  1. Headache (HA) and Insomnia (most commonly)
  2. GI: N, V, C or Diarrhea
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25
Q

Wegovy generic

A

Semaglutide

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26
Q

Wegovy indication

A

Weight loss

Wegovy

  • W - weight loss
  • W - once weekly injection
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27
Q

Wegovy side effects (2)

A
  1. GI: N, V, D or Constipation. Abdominal pain
  2. Dizziness or headache
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28
Q

Wegovy in relation to food?

A

Wegovy injection - With or without food

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29
Q

Saxenda generic name

A

Liraglutide

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30
Q

Saxenda indication

A

weight loss

Saxenda
* Sax = sexy

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31
Q

dosing frequency for saxenda

A

once daily

Victoza (liaglutide) - dose once daily

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32
Q

saxenda side effects (2)

A
  1. GI: N, V, D, or Constipation. Abdominal pain.
  2. Headache
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33
Q

saxenda administration in relation to food

A

saxenda - with or without food

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34
Q

Victoza generic name

A

liraglutide

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35
Q

2 brand names for liraglutide

A
  1. victoza
  2. saxenda
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36
Q

dosing frequency for victoza

A

once daily

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37
Q

Mounjaro generic name

A

Tirzepatide

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38
Q

Mounjaro indication

A

diabetes

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39
Q

dosing frequency for Mounjaro

A

once weekly

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40
Q

what makes Mounjaro unique

A

Dual action - GIP and GLP-1 agonist

  1. activates glucose-dependent insulinotropic polypeptide (GIP)
  2. GLP-1 receptor agonist - resulting in
    * increase insulin secretion
    * decrease glucagon secretion
    * increase insulin sensitivity
    * delay gastric emptying

Insulinotropic means = stimulate insulin release

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41
Q

Tirosint generic

A

levothyroxine (liquid gel capsule)

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42
Q

what makes tirosint possibly better than synthroid (3)

A
  1. cleaner - less inactive inactive ingredients
    * gelatin
    * glycerin
    * water
    * thyroxine (T4)
  2. better absorption
  3. can take WOW food
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43
Q

what is NP thyroid

A

NP - natural product

  • thyroid derive from pigs’ thyroid gland - contains both T4 and T3
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44
Q

What is Armour thyroid

A

Pig thyroid extract (T4 and T3)

  • same as NP thyroid
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45
Q

What is Synthroid?

A

man-made synthetic thyroid (T4 only)

SYNThroid = synthetic man made in lab

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46
Q

liothyronie brand name

A

Cytomel

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47
Q

what is liothyronine

A

synthetic T3 only

  • T3 - is the active form (T4 is converted to T3)

T3 - triidothyronine

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48
Q

acamprosate brand name

A

campral

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49
Q

acamprosate indication

A

alcohol dependence

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50
Q

dosing for acamprosate

A

666 mg TID - WoW food

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51
Q

side effects of acamprosate 2

Think of

A

For alcohol abuse, alcohol cause GI symptoms (nausea) and without alcohol- you can’t sleep or relax (insomnia & anxiety)

  1. GI: diarrhea
  2. anxiety, insomnia,
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52
Q

what to monitor with acamprosate (1)

A

Kidney function

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53
Q

acamprosate simple moa

A

antagonize glutamate

  • glutamate is an excitatory neurotransmitter (glutamate - animate)
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54
Q

how to start acamprosate

A

a period of abstinence is recommended before starting acamprosate

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55
Q

can you still drink alcohol while on acamprosate

A

relapsed is okay

  • any reduction in drinking is desirable

continue treatment even with relapsed

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56
Q

how long does it take for acamprosate to work

A

about 1 week

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57
Q

dosing frequency for acamprosate

A

TID

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58
Q

action of GABA neurotransmitters

A

inhibitory

  • makes you sleepy
  • anxiolytic
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59
Q

semaglutide brand names (3)

A
  1. rybelsus (PO)
  2. Ozempic - once weekly for diabetes
  3. Wegovy - once weekly for weight loss
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60
Q

semaglutide moa (simple)

A

glp-1 receptor agonists (mimics glp-1) - leading to insulin secretion

  • glp-1 glucagon like peptides - increase insulin secretion
    decrease glucagon, slow gastric emptying
    reduce food intake
    promotes beta-cell proliferation
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61
Q

rybelsus administration

A

exactly 30 minutes before first food, beverage or other oral meds
with no more than 4 oz of water

  • wait less than 30 min to eat - may decrease absorption
  • wait more than 30 min to eat - may increase absorption

** food decrease absorption

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62
Q

rybelsus missed dose

A

wait until next day for next dose

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63
Q

Wegovy generic

A

semaglutide

64
Q

wegovy indication

A

weight loss

65
Q

how many pens in wegovy box

66
Q

wegovy with or without food

A

wegovy injection - no regards to timing of food

67
Q

wegoyv missed dose

A

if you have 48 hours before next dose, take it, then resume schedule

  • you have 5 days to inject missed dose
68
Q

ozempic generic

A

semaglutide

69
Q

ozempic indication

70
Q

ozempic injection with or without food

A

ozempic - can be injected with or without food (no regard)

71
Q

ozempic missed dose

A

if you have 48 hours until next dose, take it, then resume schedule

72
Q

ozempic missed dose

A

if you have 48 hours until next dose, take it, then resume schedule

  • you have 5 days to inject missed dose
73
Q

semaglutide (ozempic, rybelsus, wegovy)

  • 2 main side effects to remember
A
  1. GI: N, V, D and decreased appetite = GI most common
  2. CNS: HA, dizziness, or fatigue
  • can decrease blood pressure and cause orthostatic hypotension
74
Q

semaglutide (ozempic, rybelsus, wegovy)

  • organs affected
A
  1. gallbladder - may cause gallstone
  2. decrease renal function
  3. increase LFT (liver function)
  4. Pancreatitis - pancreatic cancer
  5. Hypotension
  6. Hair loss
  7. increase HR - if consistent increased in resting HR - stop medication
  8. Thyroid cancer.
75
Q

semaglutide may cause pancreatitis, signs and symtoms to report

A

persistent severe abdominal pain, sometimes radiating to the back

may or may not accompany by VOMITING

76
Q

Can I shower with nicotine patch?

A

Yes

Bathing will not affect patch

77
Q

Strattera generic

A

Atomoxetine

78
Q

How do I take strattera

A

Take with or without food in the morning

79
Q

Most common side effects (3) Strattera

A

Most common: NAusea

Dry mouth

Headache & insomnia

Decrease appetite

Strattera is a stimulant; stimulant will lead to wt loss by causing NAUSEA & DECREASE APPETITE and also cause DRY MOUTH

A stimulant also wires you brain causing INSOMNIA & HEADACHE

80
Q

Can you open Strattera capsules?

A

No. Powder is an eye irritant

81
Q

Mexiletine (Mexitil) indication

A

Arrhythmia (ventricular)

82
Q

How do I take mexiletine?

A

Take with food - to prevent nausea

  • can take with tums or antacid
83
Q

What to monitor mexiletine?

A

Liver damage

  • needs lab work

Think: liver toxicity, Nausea and dizziness

84
Q

Mexiletine common side effects (3)

A

Think arrhythmia as “Fast “; cause Nausea and dizziness, tremors

Most common: NAUSEA (40%)
* take with food

Dizzy

Tremors, uncoordinated

85
Q

Mexiletine moa

A

Blocks sodium channel in heart

  • slows down abnormal electricity in heart
86
Q

Azopt generic

A

Brinzolamide

87
Q

Azopt drug class

A

Carbonic anhydrase inhibitor

Generic: brinzolamide

  • think acetazolamide
88
Q

How does Azopt work

A

Lower fluid in the eye to reduce pressure

89
Q

Azopt dosing frequency

90
Q

Azopt common side effects 2

A

Blurry vision

Unusual or taste change

91
Q

Azopt clinic warning

A

Sulfa allergy - avoid

92
Q

Simbrinza generic

A

Brinzolamide & brimonidine

Brinzolamide (Azopt) - carbonic anhydrase inhibitor

Brimonidine (Alphagan P) - alpha agonist
* reduce intraocular fluid

Both REDUCE introcular fluid

93
Q

Simbrinza dosing frequency

94
Q

Simbrinza common side effects 3

A

Blurry vision

Unusual taste or sour taste

Dry mouth

95
Q

Simbrinza clinical warning

A

Sulfa allergy - avoid

  • Brinzolamide is a sulfa
96
Q

Alphagan P generic name

A

Brimonidine

97
Q

Alphagan P (brimonidine) drug class

A

Alpha 2 agonist

  • Alphagan = alpha 2 agonist
98
Q

Brimonidine (Alphagan P) dosing

99
Q

Brimonidine (Alphagan P) common side effects 3

A

Eye drop causes eye irritation

  1. Eye irritation: redness, itching, burning and may affect vision

DRY mouth

Tired (somnolence) - related to clonidine

100
Q

Brimonidine (alphagan P)

Think of what oral med to help you remember this eye drop and it’s moa

101
Q

What is Lumify and it’s indication

A

OTC brimonidine for red eye

  • recommend for 5 years and older
102
Q

Linzess generic

A

Linaclotide

103
Q

Linzess indicated

A

Irritable bowel syndrome with constipation

IBS-C

Linzess = L for lazy bowel - constipation

104
Q

Linzess moa

A

Agonist on GC-C receptors in gut

  • increase intestinal fluid
  • increase motility
  • reduce intestinal pain
105
Q

Linzess most common side effects 2

A

Think GI: diarrhea and abdominal pain

106
Q

How to take linzess

A

30 minutes prior to 1st meal

  • similar to Levoxyl

Capsules can be open and sprinkle onto applesauce or water and swallow whole without chewing

107
Q

Can use a syringe to draw insulin from a humalog U-200 ?

A

No. The units will not be the same

108
Q

What to do if I missed my trulicity dose?

A

Make sure there’s 72 hours before your next scheduled dose

You have the next 3 days to inject missed dose and resume normal schedule

109
Q

Droxidopa indication

A

Low blood pressure, usually when standing

** orthostatic hypotension

110
Q

Droxidopa dosing frequency

A

Three times a day, but not every 8 hours

** take last dose at least 3 hours before bedtime **

** do not take before bedtime - can cause high blood pressure while laying down (supine hypertension)

111
Q

What is the most important thing to remember when taking droxidopa?

A

Do not take late right before bedtime, can cause high blood pressure while laying down leading to heart attack and stroke.

Take last dose at least 3 hours before going to sleep

Sleep with head elevated ***

112
Q

Droxidopa simple moa

A

Droxidopa is class: alpha and beta agonist (think of it as an oral EpiPen)

converted to norepinephrine NE in the brain, increase NE level

NE is a vasoconstrictor - increase blood pressure and heart rate

Alpha agonist = Increase HR & BP

Beta agonist = lung dilation breathing easier

113
Q

I can’t swallow droxidopa, can I open the capsules?

A

No. Capsule can’t be open.

114
Q

What to monitor when taking droxidopa?

A

Monitor blood pressure

** if too high don’t lie down, stand up or sit until blood pressure returns to normal

Lying down will only cause blood pressure to go up

Monitor for pancreatitis
* upper stomach pain going to the back

115
Q

Droxidopa common side effects 3

A

Headache

Dizzy

Nausea

116
Q

How do I sleep when taking droxidopa

A

Sleep with head elevated

117
Q

Rhopressa indication

A

Glaucoma (pressure in the eye)

118
Q

Rhopressa generic

A

Netarsudil

119
Q

Rhopressa dosing

A

Once daily in the evening

120
Q

Rhopressa drug class and moa

A

Rhopressa is a ROCK

Rho Kinase Inhibitor- blocks enzyme called rho kinase
** increase outflow
* similar to xalatan

RhoPressa Rho kinase inhibitor **

121
Q

Rhopressa storage

A

Can be stored at RT for 6 weeks or in frig

  • like xalatan- can be store at RT 6 wks
122
Q

Rhopressa missed dose

A

Skip until next dose at night

  • dose once daily at night**
123
Q

Rhopressa common side effects 3

A

Pink eye or Red eye

Deposit on cornea - reversible

Pain cause by eye drop

  • red spot cause by broken blood vessels
124
Q

Alfuzosin brand name

125
Q

Alfuzosin how to take

A

Once daily, anytime, with food ** for better absorption, do not take on empty stomach

Do not crush or chew, swallow whole

126
Q

Alfuzosin indication and moa

A

For BPH enlarged prostate

Alpha 1 receptor blocker- relax muscles around prostate and bladder to make it easier to urinate

Does not shrink prostate

127
Q

Alfuzosin how long does it take to work

128
Q

Alfuzosin 3 clinical side effects

A

Floppy iris syndrome
* tell eye doctor before surgery
* may affect EYE

Priapism
* erection lasting longer than 4 hours

Orthostatic hypotension

129
Q

Alfuzosin common side effects 3

Think:

A

Think: dizzy and HA d/t alpha blocker

Fatigue

130
Q

Alfuzosin summary 3 things to remember

A

Alpha 1 blocker like flomax- relax muscles doesn’t shrink prostate

Take with food, better absorption, anytime of the day. Swallow whole

May cause orthostatic hypotension, priapism and floppy iris syndrome
* may cause dizziness

131
Q

Calcitriol

How to take Calcitriol

A

Take in morning with Food

** remember, Calcitriol is a vitamin D and you know vitamin d is best absorb with food

132
Q

What is calcitriol? What is use for? What patients population?

A

Calcitriol is the most active or potent vitamin d . Vitamin d is needed to stimulate intestinal calcium absorption

Calcitriol is used in predialysis or dialysis patients to increase calcium in the blood or patient with hypo parathyroidism

133
Q

Clinical side effects Calcitriol

  • what does it increase 3
A

Hypercalcemia

Hyper phosphatemia

Elevated creatinine level

134
Q

Calcitriol common side effects 3

Think of:

A

GI: nausea vomiting or AP

Other: tire (somnolence)

Decrease appetite

135
Q

3 things to do while on Calcitriol

Hint: which vitamin is affected by Calcitriol

A

Don’t take additional vitamin d supplement without doctor approval

Avoid magnesium (antacid) - can lead to high magnesium level causing breathing or heart problems

Keep calcium intake the same, do not increase intake

136
Q

Methotrexate 2 indication

A
  1. Rheumatoid arthritis
  2. Psoriasis
137
Q

What does methotrexate do for RA?

A

Methotrexate reduce pain, swelling and slows down joint damage and disease progression

** methotrexate is a DMARD

138
Q

How does methotrexate work?

A

Methotrexate blocks DNA, RNA synthesis and new cell formulation

It disrupts the process of RA

139
Q

Why do people take folic acid when on methotrexate?

A

Methotrexate decreases your body’s folic acid.

Folic acid supplement prevents side effects from methotrexate such as mouth sores

** do not take folic acid on the same day as methotrexate

140
Q

Methotrexate and vaccines administration?

A

Avoid live vaccines- consult with doctor first

Live vaccines MMR and varicella

141
Q

How long does it take for methotrexate to work?

A

3 to 6 weeks

142
Q

How to take methotrexate

A

Best on empty stomach, but can take with food if nausea

143
Q

More common side effects of methotrexate 4

** think**

A

Think: cell toxicity

Most common: mouth sores (stomatitis)

Next: GI NVD

Increase risk of infection

Sun sensitivity

Hair loss - remember chemo drug

144
Q

How is methotrexate dose for RA

A

Once weekly with or without food

  • take folic acid on off day

** make sure patient understand it is once weekly and not daily - can be fatal

145
Q

Can I get pregnant and impregnate a women while on methotrexate? Or when?

A

No. Birth defects. Make sure to use a reliable birth control method

Women - do not get pregnant for 6 months after last dose

Men - wait for 3 months after last dose

** young adult - consult to use a reliable birth control **

146
Q

Can methotrexate cause infertility

A

Yes. Decrease sperm counts, menstrual problem. These may not be reversible

147
Q

System affected by methotrexate 4

A
  1. Liver - monitor yellowing of the eye, dark urine
  2. Lung - difficulty breathing, coughing
  3. Kidney - report edema ankle
    * NSAID should be avoid
  4. Skin - mouth sores, Sun sensitivity
148
Q

Methotrexate warning 8

  • just for reading
A

Fetal harm - birth defects
* do not get pregnant
* women 6 months
* men wait 3 months

Allergic reaction - skin, tongue lip swelled

Increase infection risk
* report new fever

Gastrointestinal
* can cause ulceration - report bloody or black tarry stool
* mouth sores
* report severe abdomen pain

Hepatotoxic

Lung: report coughing breathing sx

Skin rash - Sun sensitivity

Kidney- report any changes in urine output more or less

149
Q

Summary for methotrexate 4

A

Once weekly with or without food

Must not get pregnant or get a woman pregnant

A lot of warning- review all the warnings

Reduce inflammation, joint pain, slow down the process of RA

150
Q

What is RA in simple term

A

The body’s own immune system attacking your joint, especially the joint cartilage or lining

  • autoimmune disease *
151
Q

Organs affected by semaglutide 7

This will related to its side effects

A

Pancreas - pancreatitis (report upper stomach pain going to the back)

Thyroid- risk for thyroid cancer (rat)

Gallbladder- gallstone

Kidney- decrease function output

Liver - report jaundice

Heart - increase HR & resting HR (report)

GI: n, v, d or decrease appetite (most common side effects)

152
Q

Mexiletine 2 things to associate

A

Nausea- take with food, tums or antacid

Liver damage- jaundice, lab work

153
Q

Calcitriol is used in hypoparathyroidism

What is hypoparathyroidism?

A

Low parathyroid hormones PTH
* low PTH causes low calcium and high phosphate in the blood

What is the main function of PTH?
* causes release of calcium from bone into blood stream
* cause absorption of calcium from food by intestines
* decrease calcium excretion (preserve calcium)

What is the role of calcium?
1. Build strong bone & teeth
2. Plays a role in clotting
3. Send nerves signal
4. Muscle contraction & relaxation

154
Q

Is semaglutide liver toxicity?

Rybelsus

Ozempic

Wegovy

A

Yes. Monitor jaundice

155
Q

Strattera

Drug class and moa explain

A

NERI = a NE reuptake inhibitor
* increase NE level in brain

This increase in NE = increase ATTENTION spam and FOCUS

Also Increase NE = reduce HYPERACTIVITY and IMPULSIVE behavior

156
Q

Brimonidine

Drug class and moa simplify

A

Alpha 2 adrenergic agonist

Works 2 ways (alpha 2)
* decrease production of fluid
* increase fluid outflow

157
Q

Midodrine

Drug class and moa simplify

A

Alpha agonist

Alpha agonist causes vasoconstriction - get increase blood pressure

Drug (13 decks)

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