Top 14 Drugs FYIs

Question 1

Pregnancy Cat B

Avoid doses > 3250 mg daily

Answer 1

Acetaminophen

Question 2

Comes in combination w/ Benazepril, Atorvastatin, Olmesartan, Telmisartan, & Valsartan

Use w/ caution in CHF

Peripheral edema may take 2-3 weeks to develop

Titrate slowly in those w/ severe hepatic impairment due to extensive liver metabolism

Answer 2

Amlodipine

Question 3

Contraindications: bleeding GI ulcers, hemophilia, hemorrhoids, lactating mothers, nasal polyps associated with asthma, sarcoidosis, thrombocytopenia, ulcerative colitis

Avoid using in pediatric pts due to increased incidence of Reyes syndrome

May worsen CHF in pts due to increased Na & H2O retention due to prostaglandin inhibition

Answer 3

Aspirin

Question 4

May cause elevations in LFTs

Risk of myopathy increased by coadministration of HIV protease inhibitors or azole antifungals

Answer 4

Atorvastatin

Question 5

May have symptoms of hypoglycemia masked by beta blockers (except sweating)
Monitor blood glucose 2-4 times per day
Alcohol may cause disulfiram reaction
Often add-on in therapy with metformin if A1c goals are not met

Answer 5

Glyburide

Question 6

Full hypotensive effect may require 2-3 weeks

Avoid alcohol and using NSAIDs

Answer 6

Hydrochlorothiazide

Question 7

Use with caution in renal dysfunction

NSAIDs associated with increased risk of CV thrombotic events

Answer 7

Ibuprofen

Question 8

Not approaved in children younger than age of 18. Oral and IV dosing is interchangeable. Increased risk of tendon rupture in >60yr

Answer 8

Levofloxacin

Question 9

ACEI induced cough

Answer 9

Lisinopril

Question 10

Does not cause hypoglycemia, need good renal function measured by GFR, not SCr anymore

Answer 10

Metformin

Question 11

Avoid concomitant use of CCBs as use may significantly affect heart rate rhythm

Answer 11

Metoprolol succinate

Question 12

Avoid concomitant use of CCBs as use may significantly affect heart rate rhythm

Answer 12

Metoprolol tartrate

Question 13

AVOID during pregnancy
Report sxs of muscle pain/weakness
Take in the evening
CYP3A4 drug interactions: limit to 20mg w/ amiodarone, amlodipine, ranolazine, limit to 10mg w/ verapamil, diltiazem, dronedarone
Do not initiate 80mg - restricted to pts who received that dose chronically for at least 12 months w/o evidence of muscle toxicity

Answer 13

Simvastatin