Pharm part 2 Flashcards
Common indications for Advair
Long-term maintenance tx of asthma, COPD
MOA of Advair
Fluticasone is a corticosteroid that has extremely potent vasoconstrictive and anti-inflammatory activity
Salmeterol relaxes bronchial smooth muscle by selective action on beta2-receptors with little effect on heart rate
Common adverse effects of Advair
Upper resp tract infection Pharyngitis HA Sinusitis Bronchitis Rash Angioedema
BBW of Advair
LABA such as salmeterol may increase risk of asthma-related death
Drug interactions of Advair
Corticosteroids Sympathomimetics TCA MAOI All of the above may increase toxicity BBs may decrease the effectiveness of salmeterol
Major counseling points of Advair
Avoid contact with eyes
Rinse mouth after use
Not intended for immediate relief of sx
Use on a regular basis for full effect
Monitoring for Advair
PFT
Proper technique/medication adherence
S/sx of asthma/COPD
Common indications for albuterol
Relief of bronchospasm with reversible obstructive airway dz
Prevention of exacerbations of bronchospasm
Prevention of exercise-induced bronchospasm
MOA of albuterol
Catalyzes the formation of cAMP which can cause relaxation of bronchial smooth muscle
Common adverse effects of albuterol
HTN
Tachycardia
Dizziness
Pharyngitis
Clinically sig drug interactions with albuterol
Monoamine oxidase inhibitors may increase the toxicity of this medication
Major counseling points for albuterol
Do not take more frequently than recommended
Shake the canister well before each inhalation
Clean mouthpiece at least once a week.
Monitoring for albuterol
Proper technique
FEV1
Peak flow
Improvement in resp sx
Common indications for oxycodone
Moderate to severe pain
MOA of oxycodone
Binds to opiate receptors int the CNS causing inhibition of ascending pain pathway
Common adverse effects of oxycodone
Constipation
Somnolence
Drowsiness
Dizziness
Renal or hepatic dose adjustments in oxycodone
Use with caution in hepatic impairment
BBW for oxycodone
Resp depression
Drug interactions with oxycodone
Other CNS depressants and alcohol enhance activity of oxycodone
Increased risk of CNS related side effects with benzodiazepines
Monitoring for oxycodone
Pain control
Abuse
Misuse
Constipation
MOA of alprazolam
Facilitates the inhibitory neurotransmitter action of GABA in pre- and post-synapse
Common adverse effects of alprazolam
Drowsiness
Xerostomia
Renal or hepatic dosage adjustments for alprazolam
Caution in advanced liver disease
Drug interactions with alprazolam
Taking other CNS depressants along with alprazolam can increase drowsiness and risk of respiratory depression
Major counselling for alprazolam
May cause drowsiness Avoid taking with alcohol May be habit-forming XR tablets should be swallowed whole This med should not be abruptly d/c-ed
Common indications of statins
HLD
Hypertriglyceridemia
Primary and secondary prevention of cardiovascular dz
MOA of statins
Inhibitor of HMG-CoA reductase
Results in an increase in the expression of LDL receptors on hepatocyte membranes and a stimulation of LDL catabolism
Also has an effect on total cholesterol and Apo-B, as well as a minor increase in HDL
Common adverse effects of statins
CP HA N/V/D Rash Myalgia
Renal or hepatic dosage adjustments in statins
Do not use in active liver dz, renal impairment adjust dose
Drug interactions with statins
Gemfibrozil, erythromycin or immunosuppressive coadministration will likely cause rhabdo or myopathy
Grapefruit juice
Counseling for statins
Contact doc if muscle pain or tenderness
Maintain low-fat diet
NSAIDs and Tylenol are not acceptable forms of pain relief for myalgia
Limit sun exposure due to photosensitivity
Limit alcohol intake
Common indications for montelukast
Prophylaxis and chronic tx of asthma in adults and children 2 yrs of age and older
Relief of seasonal rhinitis and perennial allergic rhinitis
Prevention of exercise-induced bronchoconstriction
MOA of montelukast
Selective leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor
Common adverse effects of montelukast
HA Influenza Cough Abd pain Dyspepsia Dizziness
Drug interactions with montelukast
Phenobarbital may increase metabolism
May decrease the metabolism of paclitaxel, rosiglitazone, and repaglinide
Counseling for montelukast
Indicated for chronic tx of asthma and should be taken regularly even when the pt is asymptomatic
Not intended to treat asthmatic attacks
Singulair granules can be given either directly in the mouth or mixed with a spoonful of soft food
Monitoring for montelukast
FEV1
Peak flow
Unusual changes in mood
Improvement of s/sx of asthma
Indications for meloxicam
OA
RA
MOA of meloxicam
Inhibits cyclooxygenase resulting in a decreased biosynthesis of prostaglandins
Adverse effects of meloxicam
Abd pain Diarrhea Dyspepsia Flatulence Nausea
Renal or hepatic dosage adjustments for meloxicam
Caution with sig renal and hepatic impairment
BBW for meloxicam
Use is contraindicated for tx of perioperative pain the setting of CABG
Associated with increased risk of adverse cardio thrombotic events (MI, stroke)
Increased risk of GI irritation, inflammation, ulceration, bleeding,a nd perforation
Drug interactions with meloxicam
Increased risk of bleed in pts taking warfarin and other NSAIDs
Chronic use with NSAIDs and SSRIs/SNRIs increases risk of GI bleeds
Counseling for meloxicam
Avoid alcohol and concomitant use of other NSAIDs
May require up to 2 wks to see noticeable improvement in arthritic conditions
Monitoring for meloxicam
Improvement in inflammation/pain
Common indications for trazodone
Depression
Insomnia
MOA of trazodone
Inhibits serotonin uptake in the brain
Adverse effects of trazodone
Drowsiness Dry mouth Hypotension Dizziness Fatigue Confusion Nightmares
BBW for trazodone
Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults with major depressive disorder or other psychiatric d/os
Drug interactions with trazodone
Alcohol and other CNS depressants may potentiate drowsiness
May increase effectiveness of phenytoin
Grapefruit juice may increase plasma levels
CYP3A4 inhibitors may decrease metabolism of trazodone
Chronic use with NSAIDs and SSRIs/SNRIs increases risk of GI bleeds
Counseling points of trazodone
Take with food to enhance absorption
May cause drowsiness- use caution when operating machinery/driving
Avoid alcohol while taking this medication
Stop taking this drug and seek medical attention in the event of prolonged penile erection
Store in cool dry place away from kids and sunlight
If dose is missed, skip it and return to nl dosing schedule
Monitoring parameters of trazodone
Improvement of sleep/mood
Unusual mood changes or suicidal thought
