Rotation 3 pharm quiz part 2 Flashcards
Dosage forms of trazodone
Tablets: 50 mg, 100 mg, 150 mg, 300 mg
Average daily dosages of trazodone
150-400 mg daily
Common indications for trazodone
Depression
Insomnia
MOA of trazodone
Inhibits serotonin uptake in the brain
Common AE of trazodone
Drowsiness Dry mouth Hypotension Dizziness Fatigue Confusion Nightmares
BBW of trazodone
Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults with MDD or other psychiatric d/os
Clinically sig drug interactions
EtOH 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
Major counseling points of trazodone
Take with food to enhance absorption
May cause drowsiness- use caution when operating machinery/driving
Avoid EtOH while taking this medication
Stop taking this drug and seek immediate 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 for trazodone
Improvement of sleep/mood
Unusual mood changes or suicidal thought
Dosage forms of Bactrim
Tablets: 400 mg/80 mg, 800 mg/160 mg
Suspension: 200 mg/40 mg/5 mL
Infusion: 400 mg/80 mg/5 mL
Average daily dosages of Bactrim?
800 mg/160 mg every 12 hrs x 10-14 days
Common indications of Bactrim
Susceptible infections
MOA of Bactrim
Trimethoprim blocks production of tetrahydrofolic acid by inhibiting dihydrofolate reductase
Sulfamethoxazole inhibits bacterial synthesis of dihydrofolic acid by competitively antagonizing PABA
Common AEs of Bactrim
Increased sensitivity to sunlight, diarrhea, rash, GI upset, increased potassium
Renal or hepatic dose adjustments of Bactrim
CrCl 15-30 mL/min: administer 50% recommended dose
CrCl <15 mL/min: use not recommended
Clinically significant drug interactions with Bactrim
May increase effects of cyclosporine
May increase serum levels of phenytoin
May increase effects of oral anticoagulants and sulfonylureas
Major counseling points of Bactrim
Preferably taken on an empty stomach one hour before or two hours after meals with a full glass of water
Complete full course of therapy unless otherwise directed
Avoid prolonged exposure to sunlight
Shake suspension well before using
Store in a cool dry place away from kids and sunlight
If a dose is missed, take it ASAP
Monitoring parameters of Bactrim
Improvement of S/Sx of infection, WBC
Dosage forms of Plavix
Tablets: 75 mg, 300 mg
Average daily dosages of Plavix
75 mg
Common indications of Plavix
Reduction of atherosclerotic events in pt with h/o stroke, MI, established peripheral artery disease, or acute coronary syndrome
MOA of Plavix
Converted to active metabolite via CYP2C19, which irreversibly modifies platelet receptors, selectively inhibiting binding of ADP to the platelet receptors, thereby inhibiting platelet aggregation
Common AEs of Plavix
CP HA Flu-like sx Arthralgia Dizziness GI bleed
BBW for Plavix
Diminished effectiveness in poor CYP2C19 metabolizers
Clinically sig drug interactions with Plavix
Predisposition of occult blood loss with NSAIDs
May interfere with metabolism of CYP2C9 substrates
Omeprazole and esomeprazole may decrease effects of clopidogrel
Major counseling points of Plavix
Contact physician if you notice any sign of infection
Can be taken with or without food
Do not take PPIs with this
Bleeding time will be increased while taking this
Tell physicians and dentists about therapy prior to surgery
Take only as prescribed
Store in cool dry place away from kids and sunlight
If dose is missed, take it ASAP
If it is closer to the time of the next dose, skip the missed dose and return to nl dosing schedule- do not double doses
Monitoring parameters of Plavix
Bruising/bleeding
Common indications of PPIs
Duodenal/gastric ulcer Erosive esophagitis GERD H. pylori infection Heartburn (hypersecretory conditions)
MOA of PPIs
Supresses H+/K ATPase (proton pump) at the gastric parietal cells decreasing production of acid
Common AEs of PPIs
Cough
Constipation
Rash
Dizziness
Clinically sig drug interactions of PPIs
Increase gastric pH
Inhibits activation of clopidogrel
Increases levels of diazepam, phenytoin, and warfarin
Major counseling points of PPIs
Take 30 mins prior to a meal
Contents of capsule may be added to applesauce for administration
Monitoring parameters of PPIs
Improvement in GI sx
Mg if used long term
Common indications of H2 blockers
Short-term tx of active duodenal ulcer, GERD, erosive esophagitis, gastritis
MOA of H2 blockers
Competitively and reversibly inhibits histamine at H2 receptors on gastric cells
Common AEs of H2 blockers
Abd pain
Constipation
Diarrhea
HA
Clinically sig drug interactions of H2 blockers
May decrease warfarin clearance
Major counseling points of H2 blockers
May be taken with food if GI upset occurs
Prolonged tx greater than or equal to 2 yrs may lead to vitamin B12 malabsorption
Monitoring parameters of H2 blockers
Improvement in GI S/sx
Common indications for alpha blockers
HTN
BPH
MOA of alpha blockers
HTN: Competitively inhibits postsynaptic alpha-adrenergic receptors which results in vasodilation of veins and arterioles and a decrease in total peripheral resistance and blood pressure
BPH: Competitively inhibtis postsynaptic alpha-adrenergic receptors in prostatic stromal and bladder neck tissues. This reduces the sympathetic tone-induced urethral stricture causing BPH sx
Common AEs of alpha blockers
Dizziness
Fatigue
Orthostatic hypotension
HA
Renal or hepatic dose adjustments for alpha blockers
Use with caution in mild-to-moderate hepatic dysfunction
Do not use with severe impairment
Clinically sig drug interactions with alpha blockers
PDE-5 inhibitors
Major counseling points of alpha blockers
May cause sudden drop in BP so watch for dizziness, light-headed, etc
Check BP when sitting or lying down
When awaking at night get up slowly
Do not drive until you feel the effectiveness of the medication
Avoid drinking alcohol if medications causes dizziness and increase nighttime urination if taken close to bedtime
Contact physician if you are taking cold/allergy meds and if painful erection occurs
Monitoring parameters of alpha blockers
Decrease in BP
Urinary retention
