Signer 36th Flashcards
Abacavir, Dolutegravir, Lamivudine
Triumeq I: HIV (Antiretroviral) Monitor: LFT, CD4+ cell count DDI: CYP3A4 Inducer CI: HLA-B*5701, liver
Acetaminophen + Codeine
Tylenol #2, 3, 4, Capital C - III Opioid Analgesic One or two tablets q3-4h PRN DI: CNS depression (avoid alcohol) SE: dizziness, drowsiness, constipation, N/V, excessive sweating Take with food to avoid GI upset *habit forming
Acyclovir
Zovirax
HSV1, shingles
Herpes: 200mg PO q4 x 10days (total: 5 capsules)
Shingle: 800mg q4-5h (7-10days) within 72hrs of rash
Avoid sexual intercourse (HSV) + lesion
Albuterol Sulfate (inhalation)
Proventil, Ventolin, Proair
Bronchodilator Asthma, COPD
HFA Inhaler: 90mcg per spray
1-2 inhalations q4-6h PRN (2 inhalations QID)
Exercise: 2 inhalations 15min, prior to exercise
DDI: sympathomimetics (TCA, MAOI)
SE: N/V, nervousness, insomnia, tremor, tachycardia, palpitations (think of NE)
Shake before each inhalation, clean mouthpiece at least once a week
Albuterol Sulfate (oral)
Proventil
2-4mg TID - QID (max. 32mg/day)
SE: tremor, nervousness
Alendronate
Fosamax
Osteoporosis
10mg QD or 70mg QW
*Doses must be swallowed whole with plain water immediately upon arising (at least 30min. prior to breakfast). Not lie down for 30 min. after.
DDI: calcium and antacids may decrease absorption
SE: abdominal pain, constipation, diarrhea, flatulance, musculoskeletal pain
Alfuzosin Hydrochloride
Uroxatral
Benigh prostatic hyperplasia (BPH) - alpha 1 adrenergic receptor inhibitor
1 tablet QD with food, same meal QD
Monitor: BP
DDI: CYP3A4 inhibitor
SE: dizziness, H/A, hypotension,syncope
Take with food, at the same time, same day
Allopurinol
Zyloprim
Gout
200mg to 300mg per day
Gout attacks may increase during initiation of therapy, use colchicine or NSAID prophylactically, drink fluid to prevent precipitation of urates (kidney stones)
SE: drowsiness (avoid alcohol), diarrhea, nausea, vomiting, abdominal pain, rash
Alprazolam
Xanax CIV Antianxiety, panic disorders Benzodiazepines 0.25mg - 0.5mg initially, given TID Do NOT d/c abruptly - withdrawal symptoms CI: CNS depressants, opioids (resp. depression, coma, death) - avoid alcohol SE: drowsiness, hypotension Beer’s List
Amantadine HCl
Symmetrel
Parkinson’s Disease - increase DA
100mg PO BID
CI: anticholingeric increase SE: anticholingeric effects (Nausea, dizziness, insomnia, anxiety, dry mouth, dry nose)
Do not abruptly d/c - withdrawal (neuroleptic malignant syndrome - muscle rigidity, autonomic dysfunction, tachycardia)
Amiodarone (a mee ow dr own)
Cordarone, Pacerone, Nexterone
Antiarrhythmics - Class III (K channel blocker)
Maintenance dose is 400mg
Monitor: Liver, pulmonary function
DDI: increase effect of warfarin, phenytoin, digoxin, quinidine, procainamide, disopyramide. CYP 3A4 inibitors and inducers
Beer’s List
Amitriptyline (a muh trip tuh leen)
Elavil
TCA: Depression - inhibit reuptake of NE, Serotonin
40mg - 150mg at bedtime
CI: < 12 yo, MAOI, antidepressant increase suicidal thoughts and actions in children, adolescents, young adults
SE: tachycardia, dry mouth, N/V, H/A, urinary retention, drowsiness (T: thrombocytopenia, C: cardiac (arrhythmia, MI, stroke), A: Anticholinergic, S: seizures)
Beer’s List
Amlodipine
Norvasc CCB - HTN 2.5mg - 10mg QD SE: peripheral edema, flushing, h/a, palpitation, reflex tachycardia, gingival hyperplasia Safest in HF (lowering BP)
Amlopdipine Besylate + Benazepril HCl
Lotrel
Lowest dose of Amlodipine to avoid peripheral edema
CI: pregnancy, h/o angioedema, within 36 hr of Entresto
SE: cough, hyperkalemia, hypotension, renal impairment, bilateral renal artery stenosis (avoid)
Amoxicillin Trihydrate
Amoxil, Moxatag, Trimox
1st line: acute otitis media (Pediatric:90mg/kg/day)
DOC: infective endocarditis prophylaxis before dental procedure (2g PO x1, 30-60min before)
Gram negative (H. Influenza, E.coli, N. Gonorrhoeae) Gram positive (Adult: 250mg to 500mg q8hr or 500mg to 875mg q12hr
CI: severe renal impairment (CrCl < 30), beta lactam allergy
SE: seizure with accumulation, GI upset, diarrhea, rash (SJS/TEN)
Taken on empty stomach, complete full course of therapy, shake/keep suspension refrigerated (discard after 14 days)
Amoxicillin/Clavulanate Potassium
Augmentin, Augmentin XR 500mg q8h or 875mg q12h Taken at the start of a meal CI: renal SE: seizure, diarrhea (C.diff)
Amphetamine/Dextroamphetamine
Adderall, Adderall XR
ADHD
C II - RX can NOT be refilled
Stimulant - block NE/DA
Dosed qAM, do NOT need to be tapered off
BW: misuse cause sudden death, serious CV event
CI: < 6yo
SE: resetleness, dizziness, insomnia, tremor, h/a, palpitation, tachycardia
Anastrozole
Arimidex
Block conversion of androgen to estrogen (Breast cancer - hormone based chemo) - Aromatase Inhibitor
Postmenopausal women - 1mg daily
*higher risk of osteoporosis, higher risk of CVD compared to SERM
SE: hot flashes/night sweats, arthralgia/myalgia
Apixaban
Eliquis
Anticoagulant - Oral Direct Factor Xa Inhibitor
Nonvslvular AFib (stroke prophylaxis): 5mg PO BID
2 of the following: > or equal to 80 yo, body weight < or equal to 60kg, or SCr > or equal to 1.5 - give 2.5mg BID
Treatment of DVT/PE: 10mg BID x 7 days, then 5mg BID
BW: pt receiving neuraxial anesthesia - risk of hematomas or paralysis
CI: active pathological bleeding, prosthetic heart valve
SE: bleeding
NO MONITORING OF EFFICACY
Antidote: andexanet alfa (Andexxa)
Aripiprazole
Abilify (Abilify Maintena - IM: monthly, Aristada - IM: q4-8wks)
Antipsychotic - second generation
SE: Akathisia (inability to sit still, restlessnesses), activating
CI: dementia related psychosis - suicidal thoughts
QT prolongation
Atenolol
Tenormin
Hypertension for pts with post-MI, stable ischemic heart disease, heart failure
25mg - 100mg QD
BW: do not d/c abruptly; taper down
W: worsen glycemia, mask hypoglycemic symtoms, caution with asthma, COPD, Raynaud’s
SE: bradycardia, fatigue, hypotension, dizziness, depression, impotence
Atomixerine HCl
Strattera
ADHD - Non stimulant (second line)
SNRI
Children > 70kg: target dose is 80mg qAM or qPM
BW: suicidal ideation risk
CI: MAOI within the past 14 days
SE: decreased appetite, insomnia, somnolence, dry mouth, hypertension, tachycardia (increased NE)
Atorvastatin
Lipitor
Hyperlipidemia
CI: pregnancy, lactating , liver disease
SE: HMG, photosensitivity
H: hepatic
M: muscle damage (myopathy, rhabdomyolysis)
higher risk with elderly, higher dose, used with fibrate (Gemfibrozil)
G: glucose
Azelastine HCl (nasal)
Astelin, Astepro
Antihistamine
Allergy
2 sprays per nostril BID: prime by pumping 4 times, no additional priming unless more than 3 days lapses between doses
SE: May cause drowsiness
Missed dose: skip, return to normal dosing schedule
Azithromycin Dihydrate
Macrolide - atypical, CA-Resp. tract infection, chlamydia, gonorrhea
Zithromax, Z-pak
Z-pak: 500mg on day 1, then 250mg on days 2-5
Tri-pak: 500mg QD x 3 days
CI: liver
W: QT prolongation, hepatotoxicity
SE: GI upset - take with food
Baclofen
Lioresal Muscle relaxant - GABA 10-20mg TID-QID SE: CNS depression - drowsiness (avoid alcohol) Contain PKU - disintegrating tablets
Benazepril HCl
Lotensin Antihypertensive - ACE Inhibitor Initial: 10mg QD CI: pregnancy, lactating, within 36 hra of Entresto SE: cough, angioedema, hyperkalemia
Benzonatate
Tessalon
Antitussive
100mg TID PRN (>10 yo)
SE: drowsiness, h/a, constipation, nausea, pruritus, nasal congestion, sensation of burning in the eyes
Benztropine Mesylate
Cogentin
Anti-arkinson Agent - antihistamine/ anticholinergic
1mg - 4mg QD or BID PO or IV,
CI: pregnant, BPH
SE: anticholinergic, numbness of finger, depression, nervousness, CNS depression
May take with food, avoid exposure to hot weather
Beer’s List
Bictegravir, emtricitabine, and tenofovir alafenamide
Biktarvy
1st line
HIV-1 - One pill/once daily
SE: increase SCr, renal function, decrease bone mineral density
CI: CrCl < 30 - do not start, st. john’s wort
Test for hep B before treatment
Bimatoprost
Lumigan, Latisse
Glaucoma agent (prostaglandin) - decrease IOP
1 drop in the affected eye or eyes QD in the evening
SE: permanently change the pigmentstion and growth of the eyelashes/lids
Lie down or tilt head backward and look up, drop solution inside lower lid, and make sure dropper does not come in comtact with eye or fingers. Wait at least 5 min. before instilling other preparation, remove contact lenses prior
Bisoprolol Fumarate with Hydrochlorothiazide (HCT)
Ziac
Antihypertensive - beta 1 selective blocker, hct
1 tablet daily in the morning (increased diuresis)
SE: fatigue, h/a, dizziness, diarrhea
Take with food or milk if GI Upset, avoid abrupt withdrawal from therapy, mask hypoglycermic symptoms, avoid excessive exposure to sunlight.
Brimonidine Tartrate
Alphagen P
Glaucoma agent - alpha 2 adrenergic agonist (reduction of production/increase output)
1 drop in the affected eyes three times daily (approx. 8 hrs apart)
CI: MAOI
SE: allergic conjunctivitis, conjunctival hyperemia, eye pruritis
Monitor: IOP
Lie down or tilt head backward and look up. Holding the dropper above the eye, drop solution inside lower eyelid, making sure the dropper does not come in contact with the eye or finger. Keep the eye open for at least 30 seconds, and apply pressure to the inside corner of eye for at least 1 min.
Budesonide (inhalation)
Pulmicort
Inhaled corricosteroids (Antiasthmatic) - asthma, COPD
180mcg (children) or 360mg (adult) BID
1 - 4 inhalation BID
SE: dysphonia (difficulty speaking), oral candidiasis (thrush), cough
Rinse mouth with water and spit out after each use to prevent trush; can use spacer device
Use on a regular basis.
1) twist off white cover
2) twist brown base to right and then left until click
3) inhale forcefully and deeply
Budesonide and Formoterol Fumarate Dihydrate (inhalation)
Symbicort
COPD, asthma
2 inhalation twice daily
Rinse mouth after each use
Not intended to provide immediate releif of bronchospasm - use on a regular basis
Bumetanide
Bumex
Diuretic - loop diuretic
Warning - sulfa allergy
SE: decrease Ca, K, Mg, Na, Cl, increase UA, TC, BG, HCO3, ototoxicity orthostatic hypotension, photosensitivity
Monitoring: renal, fluid status, BP, electrolyte, audiology testing
Equal dosing: furosemide (40) = torsemide (20) = bumetanide (1) = ethacrynic acid (50)
Buprenorphine with Naloxone
Suboxone C-III REMS Opioid dependence Partisl opioid agonist/antagonist Target dose - 16mg QD sublingual SE: drowsiness, CNS depressant, h/a, constipation, nausea, sweating Do not d/c abruptly
Habit forming
Bupropion
Wellbutrin, Forfivo XL, Zyban (REMS) - TCA Antidepressant IR - TID SR - BID XL - QD MAX: 450mg/day
DDI: MAOI, linezolid, IV methylene blue, other form of bupropion (renal accumulation - seizure)
CI: seizure, h/o bulimia/anorexia
SE: druy mouth, CNS stimulstion (insomnia, restlessness), tremor/seizure, weight loss
Increase suiciadal thoughts and actions in children, adolescents, and young adults
Buspirone
Buspar
Antianxiety
5HT1A, 5HT2
Start 7.5mh BID, Max 30mg BID
CI: MAOI - Serotonin syndrome
SE: dizziness, drowsiness, h/a, nausea, excitement
No potential for abuse, tolerance, or physiological dependence
Butalbital, Acetaminophen, Caffeine
Fioricet Analgesic 1-2 tsbd/caps q4hr PRN (max: 6) X children < 12 SE: dizziness, drowsiness, lightheadedness May take with food to avoid GI upset
Habit forming
Beers List
Calcitriol
Rocaltrol, Calcijex
Vitamin D3 - hypocalcemia (liver and kidney)
CI: hypercalcemia, vitamin D toxicity
SE: N/V, diarrhea, hypercalcemia, hyperphosphatemia
Monitoring: calcium, phosphorus, PTH
Take with food or shortly after a meal to decrease GI upset
Calcium Acetate
Phoslo Phosphate binder - hyperphosphatemia ESRD: 2 capsules/tablets with each meal DDI: chelates - tetracycline, fluroquinolones CCI: hypercalcemia SE: nausea, vomiting, hypercalcemia
Take with food or meal
Do not d/c without first consulting MD
Do not take additional calcium supplements
Canaglifozin
Invokana DM - SGLT2 inhibitors proximal renal tubules - increase excretion of glucose 100mg QD prior to first meal eGFR <30: not recommended
CI: dialysis
W: ketoacidosis, genital mycotic infections, urosepsis and pyelonephritis, necrotizing fasciitis of the perineum, hypotension, AKI (vol. depletion), increased risk of leg and foot amputation, risk of fracture
SE: weight loss, inceased urination and thirst
- reduction in HF and CKD progression
Carbamazepine
Tegretol, Tegretol XR, Carbatrol ER, Equetro ER Anticonvulsant- narrow spectrum Initial: 200mg BID Max: 1600mg/day Therapeutic range: 4-12mcg/ml
BW: serious skin reaction, HLA-B*1502, aplastic anemia, agranulocytosis
CI: myelosuppression
W: hyponatremia (SIADH), fetal harm
SE: dizziness, drowsiness, N/V
Monitoring: CBC (+platelet), electrolyte (Na)
CYP3A4 Inducer and autoinducer
Take with food/milk
Carbidopa with Levodopa
Sinemet, Sinemet CR, Rytary (ER), Duopa (enteral suspension)
Antiparkinson - (precursor of DA, inhibits dopa decarboxylase enzyme) - prevents peripheral metabolism of levodopa
IR: 25/100mg PO TID
CI: non-selective MAOI within 14 days
SE: nausea, dizziness, orthostasis, dyskinesia, hallucination, psychosis
can cause brown, black, or dark discoloring of urine
Coomb’s test: d/c (hemolysis risk)
unusual sex urge, priapism
***70-100mg of carbidopa needed
Long term - fluctuations in response and dyskinesia (involuntarily mvnt)
Do not abruptly d/c
Carisoprodol
Soma Muscle relaxant Tablet: 250-350mg TID QHS SE: drowsiness, dizziness, h/a If missed dose, skip. DDI: additive with alcohol or CNS depressants
Carvedilol
Coreg, Coreg CR
Antihypertensive - nonselective beta blocker
12.5mg BID
CI: NYHA Class IV decompensated cardiac failure, asthma or COPD, AV Block, severe bradycardia
SE: dizziness, diarrhea, bradycardia, hypotension, hyperglycemia, visual abnormalities
Take with food to decease orthostasis
Do not d/c abrutply
Cefdinir
Omnicef
3rd generation ceohalosporin PO
CI: PCN allergy
SE: Risk of seizure if accumulation (renal adjustment), GI upset, diarrhea, rash
Cefuroxime Axetil (oral)
Ceftin
2nd generation cephalosporin
CI: pcn allergy
SE: risk of seizure if accumulation occurs (renal dysfunction), GI upset, diarrhea, rash
Complete full course of therapy unless otherwise directed
Celecoxib
Celebrex
NSAID - lower risk for GI, increased risk for MI/stroke, renal
Osteoarthiritis: 200mg QD or 100mg BID
Rheumatoid: 100-200mg BID
CI: sulfonamide allergy
*highest COX-2 selectivity
Avoid in pregnancy
Cephalexin
Keflex
1st generation cephalosporin
PO: 250-500mg q6-12h
CI: pcn allergy
SE: seizure risk (accumulation), n/v, diarrhea, hives, itching, rash
Take it on empty stomach with water
Complete full course of therapy unless otherwise directed
Chlorhexidine Gluconate
Peridex, Periogard
Treatment of gingivitis (oral rinse) - gram+/-
BID oral rinsing for 30 seconds, morning and evening after brushing teeth
SE: stain oral surface, change taste perception, increase calculus formation, minor irritation of oral mucosa
Do not swallow, rinse with water following use
Use after meals and after brushing teeth
Chlorthalidone
Hygroton
Inhibit Na and Cl reabsorption
Diuretic - adjunctive therapy in edema (HF)
50mg QD or 100mg Every other day
HTN
25mg QD initially, increase to 50mg to 100mg per day
CI: hypersensitivity to sulfonamide-derived drugs
SE: decrease K, Mg, Na
incresse Ca, UA, LDL, TG, BG
photosensitivity, impotence, dizziness, rash
Monitor: electrolyte, renal function
Thiazide are not effective if CrCl < 30
Take early in the morning to avoid nocturia
Cilostazol
Pletal
Platelet inhibitor
100mg BID
Cyp3A4 inhibitor
CI: congestive HF
SE: h/c, diarrhea, abnormal stool, palpitation, dizziness
Noticeable improvement may take up to 12 weeks to appear.
Take on empty stomach, at least 30 min before or 2 hr after meals
X grapejuice
Ciprofloxacin HCL
Cipro, Cipro XR
250mg - 750mg PO q12h
CrCl 30-50: q12h
CrCl < 30: q18-24h
Bw: tendon inflammation and/or rupture, peripheral neuropathy, CNS effect: seizure, tremor, restlessness, confusion, hallucination, depression, paranoia, nightmares, insomnia, increased intracranial pressure
Warning: QT prlongation, hypo/hyper-glycemia, psychiatric disturbance, avoid in children/pregnancy/lactation due to musculoskeletal toxicity, photosensitivity, hepatotoxicity
SE: n/d, h/a, dizziness, serious skin reaction
Cipro suspension: shake vigorously x 15 sec before each use, X through NG or other feeding tube
Antacid and other polyvalent cation can chelate and inhibit quinolone absorption
Lanthanum (Fosrenol) and sevelamer (Renvela, Renagel) - decrease concentration of quinolone
Increase warfarin, SU, insulin [ ]
Ciprofloxacin (ophthalmic)
Ciloxan
Solution: Use 1 - 2 drops into the conjunctival sac q2h while awake for 2 days and 1-2 drops q4h while awake for the next 5 days
Ointment: 1/2 inch to conjunctival sac TID X 2 days, then BID for the next 5 days
SE: burning or discomfort
Wait at least 5 min before instilling other opthalmic preparation
Ciprofloxacin with Dexamethasone (otic) - otitis
CiproDex
4 drops instilled into the affected ear twice a day for 7 days
Suspension: Shake/warmed in the hand
SE: ear discomfort, pain, pruritus
Complete full course of therapy unless other wise directed
Citalopram HBr
Celexa
Antidepressant - SSRI
Initial: 20mg QD and gradually increase to 40mg QD (MAX)
The full effect may not be seen until 4 weeks
Do not abruptly d/c
DDI: MOAI, linezolid
CI: increase suicidal thoughts and actions in children, adolescents, and young adults
SE: nause, dry mouth, somnolence, insomnia, diarrhea, impotence, diaphoresis, weakness, dizziness, h/a
Take it in the morning
- QT prolongstion: do not exceed 20mg/day in elderly (>60yrs), liver disease
- bleeding (additive risk)
- SIADH/hyponatremia, fall risk
Clindamycin
Cleocin Gram + including CA MRSA and anaerobes No renal adjustments required ‘ BW: colitis (C.difficile) SE: N/V/D, rash, urticaria, increase LFTs
Induction test (D-test) should be performed S. Aureus (S - clindamycin but R - erythromycin) flattened zone between the disk (positive D-test) indicates inducible clindamycin resistance and clindamycin should not be used
Clobetasol Propionate
Temovate
Corticosteroid
Short term treatment - gently rub in affected area BID for no more than 2 consecutive weeks
SE: local burning and itching
Do not use with occlusive dressings
