Prescription Drug Slide Deck Flashcards
General points for antihypertensives
Lifestyle modifications (ask what the provider told them) ie weight, moderate alcohol, reduce sodium, smoking cessation, diet (DASH)
Encourage home BP monitoring
Common side effect: dizziness
Beta-blocker key points and side effects
Monitor HR (can slow) Do not discontinue abruptly Side effects: exercise intolerance, sexual dysfunction, fatigue/depression, dizziness
Calcium channel blockers key points and side effects
Monitor HR
Side effects: edema, fatigue, constipation (mostly verapamil and diltiazem)
Diuretics key points and side effects
Monitor electrolytes (K+) - some are potassium sparing and some are potassium wasting Side effects: urination, photosensitivity, possible rash
Ace inhibitors key points and side effects
Monitor electrolytes
First dose hypotension is worse if dehydrated
Side effects: cough (delayed onset), dizziness, angioedema (rare)
ARB key points and side effects
Monitor electrolytes
First dose hypotension is worse if dehydrated
Side effects: dizziness, angioedema (rare)
HMG-CoA reductase inhibitors key points and side effects
Take in the evening for best effects (simva, lova)
Avoid grapefruit juice (simva, lova, atorva)
Lifestyle modifications
Ensure they have follow up labs in 1-3 months
Side effects: nausea/dyspepsia, myalgia (call Dr if no cause), can increase levels of enzymes in LFTs
Warfarin key points and side effects
Consistent diet Avoid NSAIDs Let a provider know before you start taking a new drug or supplement Food interactions Keep all INR appointments INR too high leads to bleeds INR too low leads to clots
Clopidogrel key points and side effects
Avoid use with omeprazole - decreases effectiveness
Side effects: (usually well tolerated), increased risk of bleed, rash, pruritus
Metformin key points and side effects
Monitor A1C and renal function (BG monitoring not necessary)
Lifestyle modifications
Unlikely to cause hypoglycemia
Take with food
Side effects: nausea, vomiting, flatulence, diarrhea
Insulins key points and side effects
Monitor BG at home
Explain what to do if low BG
Proper pen/vial technique and storage
Side effects: hypoglycemia, weight gain
Muscle relaxants key points and side effects
Avoid other CNS depressants
Avoid abrupt withdrawal if taking scheduled
Side effects less severe with tizanidine than cylcobenzaprine and are less prevalent if used PRN rather than scheduled
Side effects: dry mouth, hypotension, dizziness, sedation
Opioids key points and side effects
Abuse/dependence
Avoid other CNS depressants
APAP max dosing
Side effects: sedation, constipation, risk of abuse
General points for antidepressants
Do not discontinue abruptly
Can increase suicide ideation (reference med guide)
Takes 4-6 weeks to see full effects
Most are sedating (except bupropion and fluoxetine)
May cause sexual dysfunction (except buproprion)
Best to start on a weekend when you can evaluate how it will effect you
SSRI key points and side effects
Titrate to minimize side effects
Can increase bleed risk with anticoagulants
Side effects (pretty well tolerated): nausea, headache, restlessness
Venlafaxine key points and side effects
Titrate to minimize side effects
Can increase bleed risk with anticoagulants
Side effects: insomnia, loss of appetite, constipation
Buproprion key points and side effects
Minimal sexual dysfunction
Contraindicated in seizure disorders
Side effects: dry mouth, insomnia/agitation, weight loss, headache, tachycardia
Benzodiazepines key points and side effects
Avoid other CNS depressants
Taper off slowly if taking scheduled (not a concern with PRN use)
Side effects: somnolence/dizziness, abuse/withdrawal, anterograde amnesia
Zolpidem key points and side effects
Take immediately before bedtime
Potential for dependence
Plan for a full night of sleep
Side effects: daytime somnolence, dizziness, parasomnias (not common but get a lot of press)
ADHD medications key points and side effects
Monitor BP and HR (and height and weight for kids)
Potential for dependency/abuse (keep in a safe place and don’t let other people take it)
Side effects: nausea, loss of appetite, insomnia/irritability, headache
Gabapentin key points and side effects
Several indications
Caution with other CNS depressants
Side effects: drowsiness/sedation, dizziness, fatigue, ataxia, fuzzy headed/confused
Albuterol key points and side effects
Inhalation technique
For rescue
If using >2x/week reevaluate maintenance
Side effects (generally transient): headache, tachycardia, tremor/shakiness, lightheadedness
Flovent/Advair key points and side effects
Rinse mouth out after every use
Use every day to control
Inhalation technique
Side effects: thrush, URI, cough/hoarseness, headache
Tiotropium/Combivent key points and side effects
Inhalation technique
Side effects: dry mouth, cough/hoarseness, bitter taste, URI
Prednisone key points and side effects
Used for asthma, allergic reactions, and RA
Take early in the day
Often a tapering dose
The side effects in the medication guide are with long term use (shouldn’t experience many with short term use)
Side effects: insomnia/agitation, fluid retention, increased appetite, can increase BP and BG at high doses
Triamcinolone key points and side effects
Apply sparingly
No occlusive dressing unless Dr told them to
Typically no more than 10-14 days (used for a little bit, stop, restart if flares back up)
Side effects: skin atrophy, burning and contact dermatitis uncommon
General points for antibiotics
Take exactly how prescribed
Finish the whole course even if you’re feeling better
May cause nausea/mild diarrhea - can take with food (except dairy with some)
Predispose to yeast infection
Double-check allergies
May interfere with oral contraceptives - not a lot of strong evidence but better safe than sorry
C. diff infection risk due to wiping out gut flora
Beta-lactam key points
Beware of PCN allergy
Advise to take Augmentin with food
Diarrhea is more common with Augmentin
Ciprofloxacin key points and side effects
Avoid taking with antacids, multivitamins, and dairy products
Side effects: tendonopathy, photosensitivity, peripheral neuropathy, QT prolongation (only counsel if they’re at higher risk)
Doxycycline key points and side effects
Not for use in
Clindamycin key points and side effects
Risk of C. diff (don’t use an OTC antidiarrheal)
Take full course if no problems
Side effects: nausea, vomiting, diarrhea
Azithromycin key points and side effects
With or without food
Do not take with antacids
Side effects: GI upset, QT prolongation
Septra/Bactrim key points and side effects
Take with plenty of water to avoid crystallization in kidney
Possible sulfa antibiotic allergy
Side effects: photosensitivity, rash
GoLytely key points and side effects
Read packet from the prescriber and follow their instructions, not the ones on the bottle
Do not plan to leave your house
Don’t mix with or drink any dark colors
Only good for 48hr after adding water
Side effects: diarrhea, nausea, increased thirst
Latanoprost key points and side effects
Administration technique
Side effects: mild irritation, blurred vision, eyelash growth, iris color change
Ophthamic antibiotics key points and side effects
Administration technique
Side effects: mild irritation, blurred vision
OC key points and side effects
Take every day
See insert on what to do if you miss a pill
Start on the first day of the menstrual cycle or use ‘quick start’ method
No smoking
Side effects: breast tenderness, breakthrough bleeding/spotting, reported weight gain (not a lot of evidence), headache/migraine, increased clot risk
Antiviral key points and side effects
Works best at the first sign of an outbreak
Increased fluid intake
Can take with or without food
Side effects: malaise, headache, nausea, vomiting, diarrhea
Alendronate key points and side effects
Take on an empty stomach with a full glass of water and avoid lying down for 30 minutes
Take calcium and vitamin D supplements
Side effects: nausea, vomiting, heartburn, RARE: atypical femur fracture, osteonecrosis of jaw
Levothyroxine key points and side effects
Consistency is key**
Take on an empty stomach
Monitor TSH
No side effects if dosage is correct (euthyroid)
Side effects if dose is too high: tachycardia, sweating, weight loss
Tamsulosin key points and side effects
Monitor BP
Side effects: dizziness, orthostatic hypotension, fatigue, headache
Phosphodiesterase 5 inhibitor key points and side effects
Take 30-60 minutes prior to sexual activity
Contraindicated if taking nitrates
Limit to 1 dose per day
Side effects (generally well tolerated): headache, flushing, color vision change, dyspepsia, priapism
Epinephrine key points
Tell patient to get comfortable with the technique
Still need to seek medical attention if you use it
Always keep on hand and check expiration date
