Pharmacy foundations Flashcards
Common CYP inhibitors
G ❤️ PACMAN
Grapefruit
Protease inhibitors
Azole antifungals
Cyclosporine, Cobicistat
Macrolides (not azithromycin)
Amiodarone (and dronedarone)
Non-DHP CCBs
Common CYP inducers
PS PORCS
Phenytoin
Smoking
Phenobarbital
Oxcarbazepine
Rifampin (+ rifabutin, rifapentine)
Carbamazepine
St. Johns Wort
Tyramine-rich food
aged cheese, air-dried meats, sauerkraut
Drugs with additive ototoxicity
Aminoglycosides
Cisplatin
Loop diuretics (Esp rapid IV admin)
Salicylates
Vancomycin
Drugs that are nephrotoxic
Anti-infectives: aminoglycosides, amp B, polymyxins, vanco
Cisplatin
CNIs
Loops
NSAIDs
Contrast dye
Drugs that cause immune-mediated hemolytic anemia (positive Coombs test)
PCNs & cephalosporins
Isoniazid
Levodopa
Methyldopa
Quinidine
Quinine
Rifampin
Sulfonamides
Drugs that increase uric acid
Diuretics
Niacin
Low dose aspirin
Pyrazinamide
Cyclosporine, Tacrolimus
Pancreatic enzyme products
Chemotherapy (d/t TLS)
Drugs to be careful of with TPMT (Thiopurine S-methyltransferase) deficiency
Azathioprine
Mercaptopurine
Low doses
Carbamazepine: therapeutic range
4-12 mcg/mL
Digoxin: therapeutic range
0.8–2 ng/mL (AF)
0.5-0.9 ng/mL (HF)
Gentamicin (traditional dosing): therapeutic range
Peak: 5-10 mcg/mL
Trough: < 2 mcg/mL
Lithium: therapeutic range
0.6–1.2 mEq/L (up to 1.5 mEq/L for acute symptoms)
Phenytoin/Fosphenytoin: therapeutic range
Total: 10-20 mcg/mL
Free: 1-2.5 mcg/mL
Procainamide: therapeutic range
4-10 mcg/mL
NAPA (active metabolite): 15–25 mcg/mL
Combined: 10-30 mcg/mL
Theophylline: therapeutic range
5-15 mcg/mL
Tobramycin (traditional dosing): therapeutic range
Peak: 5-10 mcg/mL
Trough: < 2 mcg/mL
Valproic acid:therapeutic range
50-100 mcg/mL (up to 150 mcg/mL in some patients)
Vancomycin therapeutic range
Trough: 15-20 mcg/mL for most serious infections
Trough: 10-15 mcg/mL for less serious (e.g. SSTIs)
Orange book (FDA)
List of approved drugs that can be interchanged with generics
Pink book (CDC)
information on epidemiology & vaccine-preventable diseases
Red Book, Pharmacy
Drug pricing information
Pink sheet (pharma Intelligence)
News report on regulatory, legislative, legal & business developments
Purple book (FDA)
List of biological drug products, including biosimilars
Red Book (AAP)
Summaries of pediatric ID, antimicrobial treatment & vaccinations
Yellow Book (CDC)
Info on health risks of international travel, required vaccinations & ppx medications
Green Book (FDA)
Information on approved animal drug products
Phenylalanine C/I
phenylketouria (PKU)
Flector (diclofenac patch): admin site & frequency
BID to affected areas
Daytrana (Methylphenidate): admin site & frequency
2 hours prior to school on the hip
Exelon (Rivastigmine patch): admin site & frequency
Chest, back, upper arm BUT NOT flanks. Once daily
Androderm (Testosterone patch): admin site & frequency
NOT on scrotum, nightly
Lidoderm: admin site & frequency
1-3 patches PRN, on for 12 hours, off for 12 hours to affected areas
Nitroglycerin patch: frequency
on for 12-14 hours, off for 10-12 hours (daily)
Duragesic (Fentanyl patch): admin site & frequency
Chest, back, upper arms. Q72H
Transderm Scop (Scopolamine): admin site & frequency
Q72H PRN behind the ear
Alora, Vivelle-Dot (Estradiol): admin site & frequency
Twice weekly
Ville-dot: lower abdomen or buttock
Oxytrol (Oxybutinin patch): admin site & frequency
Twice weekly on abdomen, hip or buttock
Adlarity (donepezil patch): frequency
weekly
Catapres-TTS: frequency + pearls
Weekly
Contains metal
Comes with its own adhesive
Climara (estradiol) patch frequency
Weekly
Xulane (norelgestromin / ethinyl estradiol): admin site & frequency
Weekly on back, abdomen, arm or buttock
Patches that contain metal & need to be removed prior to MRI
CAN’T
Catapres-TTS
Anderoderm
Neupro(rotigotine)
Transderm Scop
Patches that should be flushed after use
Daytrana
Duragesic
Butrans
Butrans & duragesic can only be covered with Bioclusive or Tegaderm
Promethazine warning
Can cause severe tissue injury
Intra-arterial or SC routes should not used.* IM route preferred. *DO not use in < 2 yrs
Drugs that have issues with leaching/adsorption/absorption issues with PVC containers
LATTIN
Lorazepam
Amiodarone
Taxanes (NOT Abraxane)
Tacrolimus
Insulin
Nitroglycerin
Drugs that can only be reconstituted in saline (NO dextrose)
Antimicrobials: Ampicillin, Ampicillin/Sulbactam
Daptomycin (Cubicin), Caspofungin (Cancidas), Ertapenem (Invanz)
Infliximab (Remicade)
Phenytoin (Dilantin)
Drugs that can only be reconstituted in dextrose (NO saline)
Oxaliplatin
Bactrim
Amphotericin B
Synercid (Quinopristin/Dalfopristin)
NEVER mix calcium with the following
Ceftriaxone LR contains calcium
Phosphate
Filter sizes
Most: 0.22 micron
Lipids: 1.2 micron
Drugs with filter requirements
Golimumab
Amphotericin B (lipid formulations)
Lipids
Isavuconazonium
Phenytoin for continuous infusion, not IV push
Amiodarone
Taxanes
Mannitol ≥ 20%
Parenteral nutrition: 1.2 micron
Drugs that CANNOT be refrigerated
Antimicrobials: Bactrim, Metronidazole, Moxifloxacin
Dexmedetomidine (Precedex)
Phenytoin (Dilantin)
Furosemide (Lasix)
Enoxaparin (Lovenox)
Drugs to protect from light
PENMD
Phytonadione (Vit. K)
Epoprostenol
Nitroprussde BLUE = cyanide = DONT use
Micafungin
Doxycycline
Lovenox Dosing
VTE ppx: 40mg SC daily or 30mg SC BID (If CrCl <30, then 30mg SC daily)
VTE treatment: 1mg/kg SC Q12H or 1.5mg/kg daily (If CrCl < 30, then 1 mg/kg/day)
