Pharmacology Flashcards
ABX against acne or skin rashes
Doxycycline
(Good against MRSA)
Family: Tetracyclines
Dose: 100mg BID for 5 - 14 days
No dose adjustment in kidney impairment, but needed if dialysis present.
SE:
- Bone growth retardation and dental malformation - do not give to pediatric population.
Photosensitivity - use sunscreen
- Skin hyperpigmentation
Mupirocin Ointment
Topical ointment to treat skin IFX, MRSA
Topical for 5 - 7 days.
Use to treat folliculitis, impetigo or secondary skin infections.
Keflex
Cephalexin
1st Gen Cephalosporin (also Cefaxolin)
Activity against Gram positive (staph and strep) and gram negatives
- Treat Cellulitis, abscesses (staph and strep)
- Treat Strep throat
- Treat UTI (Gram neg E Coli, Proteus, Klebsiella)
- Used for surgical prophylaxis
Dose:
250 mg to 1 g every 6 hours
or
500 mg every 12 hours (maximum: 4 g/day).
Safe in pregnancy
Bactrim
Trimethroprim-Sulfamethoxazole
AKA co-trimazole
Activity against gram-positive and gram-negative bacteria
Activity against MRSA
SE: Nausea, Vomiting, skin rash
CI: Sulfa Allergy
Dose:
- single-strength tablet contains trimethoprim 80 mg and sulfamethoxazole 400 mg.
- double-strength tablet contains trimethoprim 160 mg and sulfamethoxazole 800 mg.
1 to 2 double-strength tablets every 12 to 24 hours. Note: Serum creatinine and potassium concentrations should be monitored in outpatients receiving high-dose therapy (>5 mg/kg/day trimethoprim component])
Augmentin
Amoxicillin-Clavulanate
Coverage: Gram-positive, gram-negative and beta-lactamase
Oral dose: 500 mg every 8 to 12 hours or 875 mg every 12 hours; Extended release: 2 g every 12 hours
Use: bite wound infection, otitis media, COPD exacerbation, tooth issues, acute bacterial rhinosinusitis, diabetic foot infection.
Lipitor
Atorvastatin
- Atorvastatin 40-80 mg is considered high dose statin
- Atorvastatin 10-20 mg is considered moderate intensity statin.
SE:
- muscle pain or fatigue => stop med and check Creatine kinase.
Crestor
Rosuvastatin
- Rosuvastatin 20-40 considered high intensity
- Rosuvastatin 5-10 considered moderate intensity.
Assess response in 1-3 months
Reevaluate dose Q3-12 months
Severe muscle symptoms or fatigue: Promptly discontinue use; evaluate CPK, creatinine, and urinalysis for myoglobinuria
Levothyroxine
synthetic thyroxine (T4).
Brand names: Ermeza; Euthyrox; Levoxyl; Synthroid; Thyquidity; Tirosint; Tirosint-SOL; Unithroid
The average full replacement dose of T4 in adults is approximately 1.6 mcg/kg body weight per day.
- If TSH is above the reference range, the dose of T4 can be increased by 12 to 25 mcg/day in older patients, or it can be increased by a higher dose in younger patients based on the degree to which the initial dose increased free T4 concentrations and reduced TSH concentrations.
- Average maintenance dose is ~1.6 mcg/kg/day; range of required doses is wide and varies from 50 to ≥200 mcg/day (Ref). Maintenance doses >300 mcg/day are rarely required; in patients who require high doses (eg, >2 mcg/kg/day), consider missed doses, malabsorption, and/or drug interactions.
- If the TSH is slightly elevated (eg, 5 to 10 mU/L), a small increase of 12 to 25 mcg/day is usually sufficient.
- If the TSH is ≥10 mU/L, a larger dose increase (eg, 25 to 50 mcg/day) is usually necessary.
Because of the seven-day half-life of levothyroxine, another method of changing the dose without the need for a new prescription is to recommend increasing the dose by 15 percent by adding one tablet a week. For example, if a patient is taking 100 mcg/d (1 tablet a day), if they were to take 8 tablets a week (eg, 1 tablet a day for 6 days and 2 tablets on 1 day), this is equivalent to 114 mcg a day ([(100 x 8)/7 = 114]).
- Re-evaluate measuring serum TSH in four to six weeks.
-prolonged half-life, levothyroxine steady-state concentrations are not achieved until ~6 weeks after therapy is initiated or dosage adjustment.
Pepcid
Famotidine
Anti-histamine H2 blocker
When to stop warfarin preoperatively
Stop 5 days before
Restart w/in 24 hrs if not bleeding occurs.
Magnesium oxide
Doesn’t really change magnesium level (better IV)
SE: Can cause diarrhea, which is good for pts with constipation.
Magnesium replacement
2g IV will raise magnesium 0.2
Potassium replacement
10 mEq will raise it 0.08, for simplicity round up to .10
So 10mEq to raise it 0.10
Iron dose
Oral: 325 mg every other day because it raises hepcidin and decreases absorption if given daily plus causes constipation.
