PUP Final: Counseling Tips and Important Info Flashcards
doxycycline monohydrate or hyclate forms
Sun-sensitivity: use sunscreens, avoid tanning beds
Take with food to prevent stomach upset
Do not take food, vitamins, or medication containing
Ca++, Fe++, Mg++, or Zn++ within 2 hrs before or 2 hrs after doxycycline
Though unlikely, may decrease effectiveness of oral
contraceptives (OC); use additional form of birth control
(BC) during and 1 wk after last dose
Amoxicilin
Though unlikely, may decrease effectiveness of OC; use
additional form of BC during and 1 wk after last dose
Contraindicated if penicillin allergy
Cephalexin
Do not take vitamins or medication containing Zn++ for at least 3 hrs after cephalexin
Contraindicated if cephalosporin allergy
Caution if penicillin allergy
azithromycin
Do not take with an Al++ or Mg++ containing antacid
QTc prolongation occurs rarely, but possible interaction
with many different medications
Contraindicated if macrolide allergy
ciprofloxacin
QTc prolongation occurs rarely, but possible interaction
with many different medications
Do not take food or medications containing Ca++, Fe++
within 2 hrs before or 2 hrs after ciprofloxacin
Sun-sensitivity: use sunscreens, avoid tanning beds
May increase caffeine sensitivity
Contraindicated if fluoroquinolone allergy
sulfamethoxazole/trimethoprim
Sun-sensitivity: use sunscreens, avoid tanning beds
Take with at least 8 oz. water
Contraindicated if sulfa allergy
Nitrofurantoin
Orange or brown urine is expected and not cause for
concern
Do not take food or medications containing Mg++ within 2 hrs before or 2 hrs after nitrofurantoin
Take with food/milk to ↑ absorption
Metronidazole
Contraindicated: Alcohol use during therapy and for 3 days following last dose
Metallic taste in mouth
Headache common adverse effect
Fluconazole
QTc prolongation occurs rarely, but possible interaction
with many different medications
Report any new skin rash to the prescriber
Valacyclovir
Headache common adverse effect
Does not prevent disease transmission [avoid sex when
sores are present]
Drink lots of fluids to prevent accumulation in kidneys
ethinyl estradiol products
Miss a dose: take as soon as possible or within next days’ dose (miss Monday, take 2 on Tuesday. If you miss 2 or more days, refer to package directions)
If OC not started day 1 of menses, use additional non-drug form of contraception first week of therapy
Take same time each day for maximum effectiveness
Some anti-convulsants (divalproex, lamotrigine) may decrease effectiveness of hormonal contraceptives and/or increase chance of seizures
None of the medications on this list protect against HIV/AIDS/STDs
Increased Cardiovascular Risk (DVT, PE, MI). Not recommended for those over 35 years old, smoker or history of stroke/blood clots
Ethinyl estradiol/norgestromin
Same side effect profile as oral contraceptives but more common
Adhesive my cause skin rash/rotate sites
Do not cut patch
Apply to butt, upper torso, stomach, upper arm
ethinyl estradiol/etonogestrel
If it falls out, rinse with cool water and re-insert within 3 hours
Don’t remove for intercourse
Ring is drug delivery device, not a barrier
medroxyprogesterone
Nervousness
Administration by healthcare professional
Don’t use more than 2 years due to potential bone loss
Spotting or absent menses may result
levonorgestrel
Same side effects as oral contraceptives but more common
Fatigue
No evidence of interaction with antibiotics
Will not terminate existing pregnancy
clonazapam
Drowsiness
Fatigue
Ataxia
Behavioral Problems
alprazolam
Confusion
Drowsiness
Excessive drowsiness with alcohol - avoid
Do not stop drug suddenly if taking routinely
cyclobenzaprine
Dry Mouth (aka xerostomia)
Dizziness
Drowsiness
loratadine
headache
diphenhydramine
drowsiness
alcohol intensifies drowsiness
paradoxical hyperactivity in children
dry mouth
fluticasone
gently shake before each use
may take several days for full effect
headache
sore throat
montelukast
don’t use for an acute asthma attack
headache
take dose in the evening to enhance efficacy: airways are more relaxed
albuterol sulfate
shake well
increased heart rate
budesonide and formoterol
Shake Well
Rinse out mouth after each use to prevent oral thrush
benzonatate
Drowsiness
Do not chew (numbing and choking)
dextromethorphan
shake well
potential for abuse - hallucinogen in high dose
guaifenesin
drinks lots of water to thin mucus
nausea
pseudoephrine
increased heart rate
jitters
insomnia
amphetamine/dextroamphetamine
take in the am due to insomnia
weight loss from decreased appetite
increases heart rate
dry mouth
headache
methylphenidate
take in the am due to insomnia
weight loss from decreased appetite
increases heart rate
dry mouth
headache
escitalopram
headache
insomnia or drowsiness
sexual dysfunction
venlafaxine
headache
insomnia or drowsiness
dry mouth
take with food if upset stomach
fluoxetine
sexual dysfunciton
anorexia
diarrhea
asthenia (lack of energy)
duloxetine
insomnia or drowsiness
take with food if upset stomach
sertraline
headache
insomnia > drowsiness
take with food if upset stomach
sexual dysfunction
amitriptyline
weight gain
constipation
trazodone
drowsiness
take with food to increase absorption
bupropion
insomnia
begin one week before patient intends to quit smoking
ASA
stomach upset - possible bleed/ulceration
take with food/milk
take with water
do not give to children <18 yo due to risk of reye’s syndrome
ringing in ears with high dose
ibuprofen, naproxen sodium, meloxicam
stomach upset (possible bleed/ulceration)
take with food/milk
avoid if history of heart problems
methylprednisolone
finish entire course
take with food or milk to avoid stomach upset
take earlier in the day to avoid insomnia
hydrocortisone
localized burning
acetaminophen
APAP in many OTC and Rx combo products
do not treat hangovers with APAP due to liver toxicity
tramadol
constipation
drowsiness
dizziness
hydrocodone/apap
stomach upset
constipation
drowsiness
consider other apap counseling tips
oxycodone
stomach upset
constipation
drowsiness
do not crush or chew CR tablets
olanzapine
drowsiness
weight gain
increase blood sugar and/or cholesterol
movement disorders (muscle restlessness, stiffness, spasms)
decreased sex drive
quetiapine
drowsiness
weight gain
increased BP, tachycardia
increased appetite
dizziness
aripiprazole
drowsiness or insomnia
weight gain
movement disorders
topiramate
dizziness/drowsiness
numbness/tingling
memory impairment
weight loss due to decreased appetite from nausea
pregabalin
drowsiness/dizziness
headache
blurred vision
weight gain
gabapentin
drowsiness/dizziness
uncoordinated muscle movements
lamotrigine
drowsiness/dizziness
uncoordinated muscle movements
headache
blurred/double vision
divalproex sodium
drowsiness/dizziness
tremor
muscle weakness
upset stomach, may take with food
zolpidem
take within 20 minutes of bedtime
get >8 hours of rest, may cause next day drowsiness
risk of abnormal sleep behaviors
temazepam
take drug right before you get into bed
get > 8 hours of rest, may cause next day drowsiness
headache
promethazine
drowsiness
dizziness
avoid alcohol due to enhanced drowsiness
sun sensitivity
ondansetron
fatigue
headache
constipation or diarrhea
omeprazole
works in one day, up to four days for full effect
food delays absorption so take > 1 hour before food
separate from antacids by 2 hours
famotidine
works in one hour, up to 1 day for full effect
can be taken with antacids
magnesium hydroxide, aluminum hydroxide, simethicone
shake well
works within minutes
many drug-drug interactions
constipation from aluminum
diarrhea from magnesium and simethicone
calcium carbonate
constipation
chew before swallowing
do not use > 2 weeks for indigestion
docusate sodium
works in 1-3 days
take with water
diarrhea, cramps
polyethylene glycol
laxative works 1-3 days
do not take laxative longer than 1 week without MD approval
colon prep works in 1 hour
diarrhea, cramps, bloating
bisacodyl
oral dose works in 8 hours
suppository works within 15 to 60 minutes
do not take longer than 1 week without md approval
diarrhea, cramps
loperamide
drowsiness
if diarrhea not improved in 2 days, call md due to dehydration risk
omega-3-fatty acids
burping and taste disturbances
swallow whole; do not open
refrigerate to reduce taste and smell
fenofibrate
increased liver enzymes
discontinue if gallstones form
photosensitivity
statins
increased liver enzymes
report unusual muscle pain, tenderness, weakness, or dark urine –> rhabdomyolysis
avoid grapefruit juice (increased drug concentration)
contraindicated in pregnancy
diarrhea
ezetimibe
increased liver enzymes
diarrhea
insulin
low blood sugar (sweating, nausea, dizziness)
refrigerate unopened vials
discard after 28 days if at room temperature
let syringe reach room temp prior to injection to avoid painful injection
rotate injection sites
metformin
diarrhea, nausea, abdominal pain
take with food
titrate dose up weekly (to reduce upset stomach, diarrhea)
long term use can cause vitamin b-12 deficiency
dapagliflozin
urinary tract infection
increased urine output
decreased blood pressure
liraglutide
low blood sugar (sweating, nausea, dizziness)
rotate injection sites
diarrhea
nausea
headache
clopidogrel
avoid nsaids unless instructed due to increased bleeding risk
seek medical attention for unusual or prolonged bleeding or bruising
avoid abrupt discontinuation
warfarin
avoid nsaids unless instructed due to increased bleeding risk
seek medical attention for unusual or prolonged bleeding or bruising
avoid abrupt discontinuation
keep dietary K and alcohol consumption consistent
many drug interactions; discuss new meds with RPh
take missed dose asap, but don’t double dose same day
rivaroxaban
seek medical attention for unusual or prolonged bleeding or bruising
gastroenteritis
vomiting
cough (pediatric patients)
furosemide
sun sensitivity
decreased electrolytes
dizziness upon standing
avoid taking at bedtime - increases urination
spironolactone
gynecomastia
increased serum potassium
diarrhea
irregular menses
hydrochlorothiazide
sun sensitivity
dizziness upon standing
avoid taking at bedtime - increases urination
lisinopril
avoid during pregnancy
dizziness
dry cough
headache
increases serum potassium
losartan
avoid during pregnancy
dizziness
headache
increases serum potassium
amlodipine
leg swelling (edema)
headache
metoprolol
dizziness
fatigue (goes away within 7 days)
take with food (better absorption)
lowers heart rate
do not discontinue medication abruptly –> increased cardiovascular risk
levothyroxine
take with water at least 30 minutes before breakfast to increase absorption
take the same way every day
take >4 hours apart from antacids
may take several weeks to see symptoms improve
tamsulosin
take 30 minutes after the same meal each day to increase absorption
orthostatic hypotension
headache
dizziness
tolterodine
constipation
dry mouth
headache
donepezil
nausea
diarrhea
risk of stomach bleed with nsaids
prolonged qt interval
alendronate
take 30 min before breakfast to increase absorption
ensure adequate calcium and vitamin d intake
take with 8 ox of water and remain upright for 30 min
report heartburn or bone pain to physician
allopurinol
report rash to prescriber if it occurs
may cause nausea and/or diarrhea
gout attacks may be more frequent in early therapy
oseltamivir
nausea/vomiting
headache
does not replace flu vaccine
must initiate within 48 hours of onset of symptoms
ferrous sulfate
best absorbed on empty stomach but take with food if stomach upset occurs
separate 2 hours before or after other medications
black stools
constipation common
sumatriptan
tingling, dizziness common
avoid if history of cardiovascular disease
overuse (more than 10 days per month) may worsen or increase frequency of headaches
tadalafil
do not take more than one daily
avoid alcohol due to risk of low blood pressure
avoid grapefruit juice or lower dose/frequency of tadalafil use
headache and flushing
report sudden loss of hearing or vision and discontinue use
