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Top 200 Drug Details Flashcards

1
Q

Zolpidem moa

A

Binds to GABA-A receptor, specifically alpha-1 subunit, an agonist

  • this receptor is meant for GABA NT
  • GABA NT is the body’s inhibitory NT, producing a calming effect, reduce anxiety stress and fear

Zolpidem works like GABA NT

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2
Q

Zolpidem

How to take it?

A

Take right before bedtime on Empty Stomach

  • for faster onset
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3
Q

Zolpidem common side effects 2

A

Drowsy, dizzy and next day somnolence (extremely tire)
* caution driving

Diarrhea

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4
Q

Zolpidem how do I take it?

A

Take on empty stomach, for faster onset

  • do not take if you had alcohol that evening
  • need 7 to 8 hours of sleep time, or do not take
  • do not take if you wake up middle of night
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5
Q

Zolpidem

Why is women dose lower than men?

A

Women’s ability to clear zolpidem is lower than men

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6
Q

What is the difference between ambien IR and Ambien ER?

A

Ambien IR - fast acting, help you to fall asleep

Ambien ER - has 2 layers: a fast acting and extended release layer
* IR layer - helps you fall asleep
* ER layer - helps maintain sleep

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7
Q

Who should not take zolpidem?

A

Patient who had complex sleep while taking zolpidem

Complex sleep behavior
* sleep walking and sleep driving
* cooking while not fully awake

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8
Q

Zolpidem warnings 4

A

Morning sedation- somnolence

Abnormal thinking and behavior changes, and decrease inhibition
* more outgoing
* more aggressive

Depression; suicidal thoughts

Liver toxicity

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9
Q

Can I take zolpidem if I drink alcohol that evening?

A

No

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10
Q

If I forgot to take zolpidem and woke up middle of night, can I take it?

A

No

Need at least 7 to 8 hours of sleep time after taking zolpidem

Will cause sedation next day

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11
Q

Can zolpidem affect my behaviors?

A

Yes.

Zolpidem can cause behavioral change
* more aggressive
* more outgoing

Can cause depression and suicidal thoughts

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12
Q

Zolpidem vs zolpidem ER

A

Zolpidem ER has two layer

An IR layer to help fall asleep

An ER layer to help maintain sleep

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13
Q

Zolpidem consultation 5

A
  1. For insomnia, take right before bedtime on empty sleep
  2. May cause next day sedation, drowsy and dizzy
  3. May cause diarrhea
  4. Report abnormal sleep behavior such as sleep walking, sleep driving or performing activity while not fully awake
  5. Do not take zolpidem if you have alcohol that evening
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14
Q

Amoxicillin

Drug class & types of infection

A

Penicillin

Good for
* ENT (ear, nose &throat) infections
* lower respiratory tract infection

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15
Q

Amoxicillin max dose

A

45 mg/kg per day

  • last dispense 12 years old 4000 mg per day
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16
Q

Amoxicillin common side effects 2

A

Think GI: NVD

Rash

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17
Q

Amoxicillin plus birth control

A

Amoxicillin can decrease effectiveness of birth control

  • use back up method
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18
Q

Amoxicillin moa

A

Binds to penicillin binding protein - prevent cell wall formation

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19
Q

How do bacteria develop resistance to amoxicillin

A

Bacteria produce beta-lactamase; an enzyme that cleaves the beta-lactam ring

Makes amoxicillin ineffective

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20
Q

Amoxicillin

Monitor and report

A

Watery and bloody diarrhea
* can occur even 2 months after antibiotics had been stop

Diarrhea can occur anytime during treatment, but should stop once treatment is completed

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21
Q

Augmentin

Amoxicillin & clavulanate k

Explain each component

A

Amoxicillin- a penicillin derived from ampicillin

Clavulanate K - a beta lactamase inhibitor

  • beta lactamase is produced by bacteria to cleave the beta lactam ring and render it ineffective
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22
Q

Augmentin treats what type of infection

A

ENT infection

Skin infection

Lower respiratory tract infection

UTI

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23
Q

Augmentin common side effects 2

A

GI: nausea and diarrhea

Skin rash

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24
Q

Penicillin VK

Types of infection

A

Upper respiratory tract infection

Pneumonia

Skin infection

Pharyngitis

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25
Q

Penicillin VK

How to take?

A

Take with or without food
* best absorb on empty stomach

Penicillin VK - potassium salt makes it acid resistant in stomach acid

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26
Q

Penicillin VK side effects

A

Nausea
Vomiting
Diarrhea

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27
Q

Ampicillin

Drug class

What does it treat differently?

A

Ampicillin is a penicillin

Treats
1. Gonorrhea - STD that can cause infection of mouth, throat and rectum

  1. Meningitis
  2. Respiratory tract (same as other penicillin)
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28
Q

How to take ampicillin

A

Take on empty stomach with full glass of water

1 hour before or 2 hours after meal for BEST absorption

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29
Q

Dicloxicillin

Drug class and how it is different

A

Dicloxicillin is a penicillinase resistant penicillin

  • resistant to beta lactamase
  • also acid resistant
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30
Q

How to take dicloxacillin

A

Take on empty stomach
* penicillin absorb best on empty stomach

Take with full glass of water
* can cause throat irritation & ulceration
* do not lay down for 30 minutes
* do not take while laying down

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31
Q

Metformin moa

A

Works 3 different ways to help diabetes

  1. Decrease liver glucose production
  2. Decrease intestinal glucose absorption
  3. Increase insulin sensitivity in peripheral (muscle)
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32
Q

Can metformin cause hypoglycemia

A

No.

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33
Q

Metformin warnings 3

A
  1. Lactic acidosis- a buildup of lactic acid in blood
    ** unusual tiredness, weakness, muscle cramp or pain
    ** a feeling of being well
  2. Alcohol intake- limit; excessive alcohol intake can increase risk of lactic acidosis
  3. Vitamin B12 deficiency d/t decrease absorption
    ** rarely lead to anemia
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34
Q

Metformin side effects 3

A

Main: diarrhea

Nausea vomiting

Gas or bloating

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35
Q

Metformin consultation 4

A

Take with Food for diabetes

Most common side effects: diarrhea
* may cause nausea, vomiting or gas and bloating

Limit alcohol intake- can increase risk of lactic acidosis

Report unusual tiredness, muscle pain or cramping or muscle weakness
*report if you are just not feeling well

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36
Q

Metformin

Max dose and effective dose

A

Max: 2550 mg per day

Dose less than 1500 mg not clinical effective

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37
Q

Can metformin be use in pregnancy?

A

Yes.

  • insulin is still first line agent
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38
Q

Furosemide

Consultation Tips

A

Take with Food in morning for water retention & HBP

May cause: frequent urination, dizziness and nausea

Makes you more sensitive to sunlight

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39
Q

Furosemide

Drug class

Moa

A

Potent LOOP diuretic
* inhibit absorption of Na & Cl

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40
Q

Furosemide

Loop diuretic warnings

A

Tinnitus and hearing loss (rare)

Hypokalemia (low potassium)

Orthostatic Hypotension OSH

Diabetes- may increase glucose levels

Decrease uric acid excretion- leading to hyperuricemia and gout

Sun sensitivity

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41
Q

Furosemide

Common side effects 3

A
  1. Frequent urination
  2. Dizziness & headache
  3. Nausea
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42
Q

Chlothalidone consultation tips

A
  1. Take in morning with Food
  2. Cause frequent urination & dizziness
  3. Alcohol increase risk for dizziness
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43
Q

Chlothalidone

Drug class and moa

A

Loop diuretic
* long duration (48 to 72 hours)

Low toxicity

Inhibit absorption of Na and Cl

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44
Q

Chlothalidone warnings 3

A
  1. Hypokalemia
  2. Hyperuricemia - gout
  3. Decrease magnesium
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45
Q

Symptoms of Hypokalemia 5

A
  1. Excess thirst
  2. Tired, drowsy
  3. Muscle cramps & pain
  4. Nausea vomiting
  5. Increase HR
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46
Q

Bumetanide

Drug class

Unique?

A

Potent loop diuretic

What makes it different?
* rapid onset and short duration

  • blocks absorption of Cl more than Na

*** chlothalidone is long duration

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47
Q

Bumetanide side effects 3

A
  1. Muscle cramps
  2. Dizzy
  3. Headache & nausea
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48
Q

How to take Bumetanide

A

Take with or without Food

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49
Q

Bumetanide warnings 4

A
  1. Dehydration
  2. Hypokalemia
  3. Ototoxicity (very rare)
  4. Sulfa allergy
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50
Q

Hydrochlorothiazide

Drug class and moa

A

Thiazide diuretic

Blocks absorption of Na and Cl in distal tubules

** this additional Na is exchanged for K
Can lead to Hypokalemia

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51
Q

Hydrochlorothiazide indication

A

Hypertension

  • volume depletion returns to normal long term treatment
  • vascular resistant decrease remain
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52
Q

How to take hydrochlorothiazide

A

Take with or without food

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53
Q

Contraindication to hydrochlorothiazide

A

Sulfa allergy

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54
Q

Hydrochlorothiazide

Side effects

A

OSH dizziness

Feel weak in general

Sun sensitivity

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55
Q

Hydrochlorothiazide and uric acid

A

HCTZ decrease excretion of uric acid leading to hyperuricemia

  • may cause gout
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56
Q

Hydrochlorothiazide warnings 2

A
  1. Acute myopia (nearsightedness) or glaucoma
    ** report any changes in vision or eye pain
  2. Can increase glucose level - monitor sugar level
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57
Q

Indapamide

Brand & drug class

Indication

A

Lozol - a thiazide diuretic
* inhibit distal tubules reabsorption of Na

For hypertension and edema

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58
Q

How to take indapamide

A

Take with or without food

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59
Q

Indapamide

Common side effects 4

A

Nausea abdominal pain

Fatigue; muscle weakness

Dizzy OSH

Sun sensitivity

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60
Q

Metolazone

Brand & drug class

Indication

A

Zaroxolyn

Thiazide-like diuretic
* inhibit Na reabsorption

For edema and hypertension

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61
Q

How to take metolazone

A

Take with or without food

** seems all thiazide diuretic can be taken this way

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62
Q

Metolazone common side effects 3

A

Mostly well tolerated

  1. Nausea
  2. Dizzy OSH
  3. Increase HR

** watch for sulfa allergy

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63
Q

2 electrolytes affected by Metolazone

A

Decrease Magnesium level

Increase calcium level

** decrease Na level

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64
Q

Are zaroxolyn and mykrox interchangeable?

A

No, both are Metolazone

Mykrox is rapid dissolve and rapidly bioavailability

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65
Q

Myrbetriq (mirabegron)

Drug class and indication

A

Urinary antispasmodic

For overactive bladder OAB

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66
Q

How to take Myrbetiq

A

Take once daily with or without food

Do not crush or chew swallow whole

  • missed dose: have 12 hours to take missed dose
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67
Q

Myrbetiq moa

A

Stimulate B3 adrenergic receptor- relax smooth muscle

  • relax detrusor muscle during storage phase of the urinary bladder fill-void cycle by activating of B3-AR
  • increase bladder storage capacity **

** activate fight or flight response; no time for peeing or pooping

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68
Q

Are Myrbetiq and Myrbetiq granules interchangeable?

A

No not interchangeable on a mg to mg basis

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69
Q

Myrbetiq common side effects 5

A
  1. Increase BP & HR (Fight or flight)
    * beta3-AR agonist
  2. UTI - increase
  3. Nasopharyngitis (sneezing, stuffy nose, sore throat, coughing)
  4. Headache
  • Nausea and constipation (F&F)
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70
Q

What is nasopharyngitis?

A

Pain or swelling of nose and throat

Sx: sneezing, coughing, stuffy nose and sore throat

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71
Q

Myrbetiq warnings 3

A
  1. Increase BP
  2. Urinary retention in patients with urinary obstruction or patient taking antimuscarinic
  3. Angioedema - swelling of face or tongue
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72
Q

Myrbetiq consultation tips 5

A
  1. Take once daily with or without food, swallow whole do not crush or chew
  2. For overactive bladder, helps bladder relax
  3. May increase BP or HR need to monitor and inform your doctor
  4. Monitor for angioedema - swelling of face or tongue
  5. Most common SE: increase risk for UTI, sinus irritation (sneezing coughing), headache and constipation
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73
Q

Vesicare (solifenacin)

Drug class

A

Antimuscarinic for OAB

  • relaxes bladder smooth muscle
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74
Q

How to take vesicare

A

Once daily with or without food

  • swallow whole do not crush or chew
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75
Q

Vesicare warnings 4

A
  1. Glaucoma- monitor for vision changes or pain
  2. Angioedema- swelling of face or tongue
  3. QT prolongation
  4. Heat stroke - decrease body’s ability to sweat
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76
Q

Vesicare side effects

A

Think: dry mouth and constipation

Increase UTI

Drowsy, blurred vision

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77
Q

Vesicare consultation tips

A

Once daily with or without food for OAB

Most CSE: dry mouth & CSTP

May cause drowsiness and blurry vision
* caution with driving
* alcohol can make these side effects worse

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78
Q

Moujaro has duel mechanism; mimics GIP and GLP-1

What is GIP and GLP-1?

A

Both are hormones produced in the gut in response to eating food

Both reduce appetite and cause release of insulin

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79
Q

Bepotastine “bed-po-tastine”

Bepreve

Class & moa

A

Antihistamine; mast cell stabilizer

  • inhibit histamine release from mast cell
  • stops your body from reacting to allergens that can irritate the eye
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80
Q

Bepotastine

Bepreve
* common side effects

A

Think: unpleasant taste in mouth

Other side effects:
* eye irritation
* headache
* nasopharyngitis (common cold symptoms)

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81
Q

Bepotastine (bepreve)

Dosing frequency

A

Twice daily

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82
Q

Atorvastatin

Moa simplify

A

Inhibit HMG-CoA reductase
* enzyme responsible for making cholesterol

Stops liver production of cholesterol

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83
Q

Atorvastatin indication 2

A
  1. Cholesterol
  2. Reduce risk of stroke, heart attack or angina, & revascular surgery
    * stabilize plaque but will not clean arteries; prevent new plaques buildup
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84
Q

Atorvastatin contraindication 1

A

Pregnancy and lactation

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85
Q

Atorvastatin warnings 2

A
  1. Myopathy & Rhabdomyolosis
    * report unexplained and or persistent muscle pain, tenderness weakness especially accompanied fever & fatigue
  2. Liver toxicity: increase LFT
    * report dark urine, jaundice, right upper abdominal discomfort
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86
Q

Atorvastatin 2 most common side effects

And others

A

Think: nasopharyngitis
* nose irritation and sore throat

Joint pain

Others: diarrhea

Increase UTI

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87
Q

How to take atorvastatin

A

Take with or without food; do not crush or chew

Take anytime

Avoid grapefruit

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88
Q

Atorvastatin

How much grapefruit to limit?

A

Less than 1 liter

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89
Q

Atorvastatin alcohol limit

A

Limit alcohol to 2 glass or less

  • atorvastatin can cause liver toxicity and alcohol can increase risk of liver toxicity
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90
Q

Atorvastatin patients consultation 3

A

Monitor for muscle pain and weakness especially with fever

Monitor for liver toxicity: dark urine, jaundice or abdominal pain

Use effective birth control
* contraindication in pregnancy & lactation

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91
Q

Simvastatin indication 2

A
  1. High cholesterol
  2. Reduce risk of stroke, heart attack or revascularization procedure in high risk patients
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92
Q

How to take simvastatin?

A

Take in EVENING with or without food
* avoid grapefruit

Compare to atorvastatin:
* atorvastatin can be taken anytime

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93
Q

Simvastatin side effects

  • most common
  • other
A

Most common: increase upper respiratory infection (bronchitis) and HEADACHE

Other: GI symptoms Nausea, constipation, abdominal pain

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94
Q

Simvastatin contraindication 2

A
  1. Use with CYP3A4 inhibitor
    * azole antifungal
    * azithromycin
  2. Use with cyclosporine and gemfibrozil

Gemfibrozil can cause rhabdo

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95
Q

Simvastatin warnings 2

A
  1. Myopathy and rhabdo
  2. Liver toxicity increased LFT
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96
Q

Is it recommended to use Simvastatin and gemfibrozil?

A

No. Contraindication

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97
Q

Simvastatin plus (verapamil, diltiazem, Multaq)

  • what does to not exceed
A

Simvastatin 10 mg

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98
Q

Simvastatin plus (amiodarone, amlodipine, ranolazine)

What dose not to exceed?

A

Simvastatin 20 mg max

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99
Q

Omeprazole

Indication and age limit

A
  1. Ulcer
  2. GERD
  3. H Pylori adjunct

** can be use in patients > 1 year old

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100
Q

Omeprazole

Common side effects 3

A

HEADACHE and ABDOMINAL pain

Others: NVD

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101
Q

How to take omeprazole?

A

Take 30 minutes before meal

  • antacid can be take at same time
  • swallow whole, do not crush or chew
  • capsule can be open and sprinkle onto applesauce, swallow whole without chewing
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102
Q

Omeprazole consultation tips 5

A
  1. Decrease acid in stomach
  2. Take 30 minutes before food, swallow whole
  3. Most CSE: headache, abdominal pain
    * may cause NVD
    * if you have watery diarrhea with fever, contact your doctor
  4. Decrease absorption of vitamin and mineral: B12 and magnesium
  5. Report any rash, especially on face or if you have joint pain
    * omeprazole can cause LUPUS
    * and gets worse in Sun
  6. Report decrease urine output or blood in urine
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103
Q

Can omeprazole cause kidney problem?

A

Yes. Report if you notice decreased urine production or blood in urine

  • acute tubulointerstitial nephritis **
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104
Q

Can omeprazole cause diarrhea?

A

Yes. Can cause C. Dif

Report watery diarrhea, stomach pain especially with fever that does not go away

105
Q

Omeprazole warnings 5

A
  1. Kidney problem
    * report decrease urine or blood in urine
  2. C. Dif associated DIARRHEA
  3. Increase BONE fracture
    * for patient on it longer than 1 year
  4. Skin rash reaction - LUPUS
    * report rash on cheeks and worsen with Sun
    * report joint pain
  5. Decrease Vit B12 and magnesium
106
Q

Omeprazole

2 drug interactions listed under warnings

A
  1. Plavix - avoid taking at same time
  2. MTX - increase mtx level
107
Q

Explain plavix and omeprazole interaction

A

Decrease plavix effectiveness

  • decrease conversation of plavix to its active metabolite
108
Q

Difference between esomeprazole and omeprazole?

A

Omeprazole contains both omeprazole isomers

Esomeprazole maybe more effective in acid suppression

109
Q

Famotidine

Moa and indication 2

A

Histamine2 receptor antagonist
* H2-RA

  1. Ulcer
  2. GERD
110
Q

How to take famotidine

A

Take with or without food

  • can be given with antacid
111
Q

Famotidine common side effects

A

HEADACHE and Dizziness

Other: constipation or diarrhea

112
Q

What does concomitant mean

A

Take at same time

113
Q

Famotidine warnings 2

A
  1. CNS adverse reaction in elderly and patient with decreased renal function
    ** confusion, hallucination
  2. QT prolongation
    * report palpitations, fainting or dizziness
114
Q

Famotidine and tizanidine drug interaction

A

Increase Tizanidine level - can cause hypertension, low HR, excessive drowsy

115
Q

Can tizanidine cause QT prolongation?

A

Yes

Report symptoms: palpitations, fainting and dizziness

116
Q

Metoprolol

How to take metoprolol

A

Take with food or immediately after food

117
Q

Metoprolol indication 3

A
  1. Hypertension
  2. Angina (chest pain)
  3. MI
118
Q

Is metoprolol beta1 selective

A

Yes.

Metoprolol is cardioselective B1

119
Q

Metoprolol common side effects

A

TIRED and Dizzy

Diarrhea 5%

Decrease HR (monitor)
SHB (report)

120
Q

Metoprolol patient information 4

A
  1. Take with or immediately after meal
  2. Avoid driving until you know how medication affects you
  3. Report if you experienced any SHB
  4. Before any surgery- inform doctor
121
Q

Metoprolol warnings 5

A
  1. Beta blocker may precipitate HF
    * decrease heart contractility
  2. Do not abruptly DC
    * can cause CP, MI, ven arrhythmia
  3. Bradycardia- monitor HR
  4. May exacerbate asthma
    * use lowest effective dose
  5. Blocks symptom of hypoglycemia
    * tachycardia
    * patient will still have dizziness & sweating
122
Q

Atenolol indication 3

A
  1. HBP
  2. Angina
  3. Acute MI - once patient is stable
123
Q

How does beta blockers help Angina and Acute MI

A

Beta blockers reduce oxygen requirements of HEART

124
Q

How to take atenolol

A

Take with or without food

  • food does decrease bioavailability
  • OJ decreased more

To make it easier, tell patient to take with food
** same as metoprolol **

125
Q

Atenolol common side effects

A
  1. TIRED and Dizzy

Nausea or diarrhea

Decrease HR (monitor)

126
Q

Atenolol consultation 4

A
  1. Take with or without food
    * take with food to make it easier to remember
  2. Can make you feel tired or dizzy: caution driving
  3. Report low HR and SHB
  4. Do not stop abruptly
127
Q

Atenolol warnings 8

A
  1. HF patient- may precipitate or worsen Heart failure
  2. May cause HF in patients without a hx of cardiac failure
    * due to long term depression of myocardium
  3. Do not dc abruptly
  4. Concomitant use with calcium channel blocker (verapamil & diltiazem)
  5. Asthma patients
  6. Diabetes
    * may block symptoms of hypoglycemia TACHYCARDIA
  7. Major surgery
    * anesthesia causes HR to slow down
  8. Pregnant and Lactation - AVOID
128
Q

Anesthesia and beta blockers interaction

  • major surgery
A

Anesthesia reduces amount of oxygen deliver to heart

This cause HR to slow down

Beta blockers also slow down HR

129
Q

Buspirone indication

130
Q

Buspirone moa

A

Moa: unknown

Thought to have affinity for serotonin and dopamine

** Anxiety med not chemically or pharmacologically related to benzodiazepines, barbiturates or other sedative hypnotic drugs **

131
Q

Buspirone warnings 2

A
  1. Caution with driving - may cause DD
  2. Alcohol - avoid taking at same time
132
Q

Buspirone patients inflammation 4

A
  1. Do not drive until affect of med is known
    * may cause dizziness drowsy
  2. Can take with or without food
    *** be consistent **
  3. Avoid large amounts of grapefruit juice
133
Q

Carvedilol

2 indication

A
  1. Hypertension
  2. Chronic HEART FAILURE
134
Q

Carvedilol moa

A

Alpha-1 and Beta-1 and Beta-2 receptor antagonist

135
Q

How to take carvedilol

A

Take with food to decrease dizziness

  • slows rate of absorption to decrease OSH*
136
Q

Carbidopa patients information 4

A
  1. Take with Food to decrease dizziness
  2. Do not stop abruptly
  3. May cause dizziness or make you feel TIRED - avoid driving until you know affect of medication
  4. For patient with heart failure: report sx of worsening HF such as weight gain or SHB
137
Q

Carvedilol warnings 5

A
  1. Do not stop abruptly
  2. Bradycardia, hypotension, worsening HF, Fluid retention can occur
  3. Chronic bronchitis and emphysema patients: avoid beta blocker
  4. Diabetic: may masked symptoms of hypoglycemia (tachycardia)
  5. Rare decrease renal function
    * especially in pt with low BP, previous MI, and underlying kidney problem
138
Q

Bystolic generic name

139
Q

Is bystolic beta selective

A

Bystolic is beta1 selective at dose less than 10 mg

140
Q

Bystolic (nebivolol) indication

A

HBP - to reduce risk of stroke and MI

141
Q

How to take Bystolic (nebivolol)

A

Take with or without food

** metoprolol is take with food or immediately after meal

142
Q

Bystolic (nebivolol) common side effects 2

A

FATIGUE

Headache and Dizziness

143
Q

What makes Bystolic different than other beta blockers?

A

Bystolic = BI = 2 moa

Exerts Nitric oxide vasodilation and Beta blockade

144
Q

Bystolic warnings 4

*** same as other beta blockers **

A
  1. Do not abruptly stop
    * can cause acute exacerbation of coronary artery disease
  2. Diabetic: masked hypoglycemia symptom (tachycardia)
  3. Asthmatic: may cause worsening or bronchospasm
  4. Surgery: anesthesia also cause decrease HR (additive affect)
145
Q

Bystolic consultation tips 3

A
  1. For BPH, can take with or without food
  2. May cause dizziness, headache and tired: caution with driving
  3. Report shortness of breath
146
Q

Labetalol Moa

A

Blocks alpha 1 and non selective beta 1 and beta 2 blockers

** same as Coreg **

In addition to beta blocker of HEART, labetalol also cause peripheral vasodilation

Alpha 1 blockade: result in OSH dizziness

147
Q

How to take labetalol

A

Take with or without food

** but, be consistent **

Food increase bioavailability

148
Q

Labetolol indication

A

HYPERTENSION

** safe and used in PREGNANCY ***
Different than other beta blockers

149
Q

Labetalol patient information 3

A
  1. Do not stop abruptly
  2. Report worsening of HF (SHB)
  3. Report liver toxicity (jaundice, abdominal pain)
150
Q

Labetalol common side effects 3

A

DIZZINESS - due to alpha blocker

Fatigue - same as other beta blockers

** Nausea - different

151
Q

Labetalol warnings 5

What is different about labetalol in the warnings

A
  1. HEPATIC injury
    ** different
    ** report jaundice, right upper abdominal pain, dark urine, persistent nausea and anorexia
  2. Can worsen HF
    * report fluid retention and SHB
  3. Do not stop abruptly
  4. Asthma: can cause bronchospasm
  5. Diabetic: masked tachycardia
152
Q

What is intrinsic sympathomimetic ISA activity?

A

Refers to beta blockers that are actually weak AGONIST of one or more beta adrenergic subtype

153
Q

What makes labetalol different than other beta blockers?

A
  1. Used in PREGNANCY
  2. Has alpha 1, beta 1 and beta 2 blockers
    ** same as Coreg **
154
Q

Propranolol

Moa

A

Non-Selective beta blocker

155
Q

Propranolol indications 5

A
  1. Hypertension
  2. Angina
  3. Atrial fibrillation
  4. MI
  5. Migraine prophylaxis
156
Q

Propranolol common side effects

A

FATIGUE and DIZZY

Constipation

Impotence

Alopecia

157
Q

How to take propranolol regular tablet and propranolol ER

A

Propranolol tablets: take BEFORE meals

Propranolol ER (Inderal LA)
** take with or without food, consistent
** take at night at 10 pm

158
Q

Propranolol warnings 6

  • which warnings is different compared to other beta blockers
A

** skin reaction and hypersensitivity
SJS, anaphylaxis

Beta blocker: do not stop abruptly

May precipitate more severe HF

Asthma: may cause bronchospasm

Surgery: anesthesia also decrease HR

Diabetic: masked symptoms of hypoglycemia tachycardia

159
Q

How does phenazopyridine work

A

Moa unknown

Cause a local analgesic effect on the mucosa of the urinary tract

160
Q

How long should you take phenazopyridine

A

Do not take more than 2 days

161
Q

Phenazopyridine pt information 3

A

Take with food to decrease nausea

May change urine color: red orange

Do not take more than 2 days

162
Q

Phenazopyridine common side effects 3

A

NAUSEA - take with food

Change in urine or fece color
* orange red

Headache

163
Q

Hydroxychloroquine indication 3

A

Rheumatoid arthritis RA

Malaria, treatment and prevention

lupus

164
Q

Hydroxychloroquine dosing in RA

A

Once daily with Food

165
Q

Hydroxychloroquine common side effects

A

GI: NAUSEA VOMITING DIARRHEA and AP

166
Q

Hydroxychloroquine warnings 8

A
  1. Heart arrhythmia reported
  2. Eye deposit: regular eye exam and report any vision change
  3. Skin reaction: SJS, report any blister
  4. Muscle and nerve damage: report muscle weakness
  5. Worsening psoriasis: avoid in patient with psoriasis
  6. Renal toxicity
  7. Suicidal thoughts: report behavior change
  8. Hypoglycemia
167
Q

How to take hydroxychloroquine

A

Take WITH FOOD air milk

Do not crush or divide

168
Q

Ondansetron indication

169
Q

Ondansetron common side effects 3

A

HEADACHE and FATIGUE

diarrhea or constipation

170
Q

Ondansetron moa

A

5-HT3 receptor antagonist
* in the stomach and CNS

Works in the stomach to block the signals to the brain that cause NV

Serotonin release stimulates nausea and vomiting

** maybe that is why SSRI has NV side effects **

171
Q

How does it take for ondansetron to work?

A

30 minutes

172
Q

Ondansetron warnings 4

A
  1. Hypersensitivity or allergic rxn
    * anaphylaxis, bronchospasm
  2. QT prolongation
    * avoid drugs causing QT prolongation
  3. Serotonin syndrome
  4. Chest pain or tightness
173
Q

Symptoms of QT prolongation 2

A
  1. Change in heart rate
  2. Feeling of lightheaded or fainting
174
Q

Symptoms of anaphylaxis rxn or hypersensitivity 3

A
  1. Fever or chills
  2. RASH
  3. Breathing problem
175
Q

Pantoprazole

Indication

176
Q

Pantoprazole common side effects 2

A

HEADACHE

DIARRHEA and abdominal pain

177
Q

How to take pantoprazole

A

Pantoprazole can be taken with or without food

** other PPI: take 30 minutes prior to meal

178
Q

Can I take pantoprazole and antacid together?

179
Q

Pantoprazole warnings 7

A
  1. Gastric malignancy
    * response does not preclude presence of gastric malignancy
  2. Kidney inflammation
    * report decrease urine, blood in urine
    * nausea and anorexia
  3. C Dif diarrhea
  4. Bone fracture: usually with long term
  5. Severe skin reaction: blister, SJS
  6. Cutaneous lupus: worsen or new onset
  7. Decrease B12, decrease magnesium
    * low magnesium leads to low calcium and low potassium
180
Q

MTX plus PPI interaction

A

Increase MTX level: can be toxicity

181
Q

Lansoprazole indication 3

A

Ulcer

H Pylori

GERD

182
Q

How to take lansoprazole

A

Take 30 minutes before food

183
Q

Lansoprazole interaction with Sucralfate and antacid

A

Antacid + Lansoprazole = okay

Sucralfate + Lansoprazole = separate by 30 minutes

184
Q

Lansoprazole can be open and sprinkle into ____ or mix with ___ juice?

A

Can be mix with soft food
1. Applesauce
2. Cottage cheese
3. Yogurt

Can mix with juice
1. Apple juice
2. Orange juice
3. Tomato juice

185
Q

Lansoprazole common side effects 3

A

ABDOMINAL PAIN and HEADACHE

Diarrhea

186
Q

Do not take lansoprazole if taking rilpivirine

  • contraindication

Name 2 drugs that you see have rilpivirine

A

Think HIV medications

  1. Complera
  2. Odefsey
187
Q

Pantoprazole warnings 8

A
  1. Gastric malignancy
  2. Kidney inflammation
  3. C. Dif
  4. Bone fracture
  5. Severe skin rash
  6. Lupus: new onset or worsening
  7. Decrease B12, decrease Magnesium
  8. Increase MTX level
188
Q

Cefdinir (Omnicef) indication 5

A
  1. CAP
  2. BRonchitis
  3. Sinus, tonsil, pharyngitis
  4. EAR infection (pediatric)
  5. Skin infection
189
Q

Cefdinir moa

A

Binds to penicillin binding protein (PBP), inhibit cell wall synthesis

** is stable in the presence of some, but not all, beta lactamase enzyme

190
Q

How do I take cefdinir?

A

Can be taken with or without food

But avoid antacid and iron at same time, decrease absorption

191
Q

Cefdinir warnings 2

A
  1. Cross-sensitivity with patients allergic to penicillin
    ** 10%
  2. C Dif
192
Q

I’m allergic to penicillin, what is the cross-sensitivity reaction percentage?

A

10%

Both are still beta lactam antibiotics

193
Q

Cefdinir common side 2

A

DIARRHEA 15%

Nausea

194
Q

Cefdinir + antacid interaction

A

Space 2 hours

195
Q

Cefdinir + iron supplement

A

Avoid, space by 2 hours

196
Q

Cefdinir patient consultation 4

A
  1. For infection: may feel better after a couple of day, but make sure to complete treatment
  2. Take with or without food
  3. Do not take with antacid or iron, space 2 hours
  4. Diarrhea is a common side effects
    * should stop once treatment is done, but if diarrhea becomes watery and bloody, with or without fever, report to doctor
197
Q

Cephalexin indications 5

A
  1. Respiratory tract infections
  2. Ear infection
  3. Skin infection
  4. Bone infection
  5. Genitourinary tract infections
198
Q

Cephalexin common side effects 3

A

NVD and AP

Dyspepsia

199
Q

Cephalexin and metformin interaction

A

Cephalexin can increase metformin level

200
Q

Cephalexin warnings 3

A
  1. Allergic reaction
  2. C. Dif
  3. Seizure potential
    * use lower dose in renal impairment
201
Q

What is dyspepsia

A

Upper abdominal discomfort

Describe as burning sensation, bloating or gas, nausea

Feeling full too quickly

202
Q

Cefpodoxime brand name

203
Q

Cefpodoxime indication 4

A

Bronchitis

CAP

UTI

Ear, Nose and Throat infections

204
Q

Cefpodoxime common side effect

A

DIARRHEA

NVD

205
Q

How to take Cefpodoxime and why

A

Take with FOOD to increase absorption

206
Q

Cefpodoxime warnings 2

A
  1. Cross sensitivity reaction
  2. C Dif
207
Q

Cefuroxime brand name

208
Q

Cefuroxime indication 5

** what indication is different

A
  1. ENT infection
  2. Bronchitis
  3. Skin infection
  4. UTI
  5. Gonorrhea ** 1000 mg one dose
209
Q

Cefuroxime dosing frequency

A

Every 12 hours

210
Q

Cefuroxime common side effects 2

A

NVD

Increase LFT

211
Q

Cefuroxime warnings

** same as others

A
  1. Cross sensitivity 10%
  2. C Dif
212
Q

Can you interchange Cefuroxime tablet and oral suspension?

A

No.

Cefuroxime tablets and suspension are not interchangeable on a mg to mg basis

213
Q

How do I take Cefuroxime?

A

Can be taken with or without food

Food is more tolerable

** food does increase bioavailability but no clinical significance

214
Q

Why you should not crush Cefuroxime tablets

A

Has a strong persistent bitter taste

Not recommended to crush but contact MD to change to oral suspension

215
Q

Drug interaction with Cefuroxime

A

Drugs that decrease gastric acidity
* will decrease Cefuroxime bioavailability

Antacid: take Cefuroxime 1 hour before or 2 hours after antacid

H2RA (famotidine) and PPI should be avoided

216
Q

Sucralfate indication 1

217
Q

Sucralfate moa

A

Forms a protective layer at site of ulcer

218
Q

Sucralfate common side effect 1

A

Constipation

219
Q

How to take Sucralfate

A

Take on empty stomach 1 hour before or 2 hours after meal

  • separate 2 hours from other meds
  • antacid + Sucralfate- separate by 30 minutes
220
Q

What is hctz use for (2)?

A

Blood pressure

Edema

221
Q

Hctz drug class

A

“Thiazide “ diuretic

222
Q

HCTZ moa

A

Inhibit sodium chloride cotransporter in renal distal convoluted tubule

  • inhibit reabsorption of Na
  • water will follow Na
223
Q

How to take HCTZ

A

With or without food

224
Q

2 risks of using hctz

A

Increase risk of gout - increase uric acid level

Can increase glucose levels
* especially diabetes

225
Q

HCTZ side effects 3

A

Dizzy

Muscles cramps

Sun sensitivity

Other includes
HA and fatigue

226
Q

Electrolytes affected by HCTZ

A

Decrease in: potassium, chloride, sodium and magnesium

Increase in: calcium, uric acid, blood glucose and lipid

227
Q

2 to remember with HCTZ

A

Decrease potassium and increase uric acid (gout risk)

Dizziness

228
Q

Explain doxazosin + sildenafil interactions

A

Decrease blood pressure

  • only if approved by doctor

Doxazosin - vasodilation

Sildenafil - vasodilation

229
Q

Doxazosin moa

A

Alpa1 blockers- relaxes smooth muscles of bladder and prostate

Also relaxes peripheral smooth muscles = vasodilation
* cause OSH

230
Q

Doxazosin indicated 2

A
  1. BPH
    * see AZO
  2. HBP
231
Q

Doxazosin common se 3

A

Dizzy

Fatigue (tired)

Headache

** all related to alpha1 blockers

This asshole (doc azo) doc gave me headache, feel tired and Dizzy

232
Q

Doxazosin serious SE 2

A

Priapism

  • erection longer than 4 hours

OSH

233
Q

Doxazosin tips 4

A

Can be taken morning or night with or without food

Dizzy Tired - caution driving

OSH - standup slowly risk of falling

First time taking- do not drive for next 24 hours

234
Q

How to take doxazosin

A

Take with or without food anytime of the day morning or night

235
Q

First time taking doxazosin, what to warn patients

A

Do not drive for next 24 hours

236
Q

Cardura XL indicates and how to take it

A

Only indicated for BPH
* not high blood pressure

Take in morning

237
Q

Alfuzosin brand name

238
Q

Alfuzosin indicated

239
Q

Alfuzosin dosing

A

Once daily

240
Q

Alfuzosin side effects 2

A

Dizzy and Headache

  • all related to alpha blocker and vasodilation
241
Q

Alfuzosin moa

A

Alpha1 blocker - relaxes smooth muscle of bladder and prostate

242
Q

How to take Alfuzosin

  • compared with tamsulosin
A

Alfuzosin MUST be taken WITH FOOD
* for better absorption

Tamsulosin is taken 30 minutes after same meal each day

243
Q

Alfuzosin pharmacist tips 3

A

Must be taken with food

Cause dizziness and headaches OSH

Caution in patient with moderate to severe LIVER problems

244
Q

Alfuzosin and liver problems?

A

Caution use of Alfuzosin in patients with liver disease

245
Q

How long does it take Alfuzosin to work?

A

Couple days to months

246
Q

Alfuzosin risks 5

A

OSH

Drug interactions
* with Biaxin HIV medications

Liver problems

QT prolongation- heart problems

Priapism

247
Q

Does tamsulosin have lots of drug interactions

248
Q

Tamsulosin what is it for and how to take it

A

BPH

Take once daily 30 minutes after same meal each day, swallowing whole

249
Q

Tamsulosin moa

A

Alpha 1 blocker

Relaxes smooth muscle of bladder and prostate - making urination easier

More specific for alpha receptors of bladder and prostate

250
Q

Tamsulosin serious SE 3

A

Rash, hives - due to sulfa allergy

OSH - alpha 1 blocker vasodilation

Priapism - vasodilation

251
Q

Tamsulosin common SE 3

A

Headache and dizziness

Stuffy nose

Sexual side effects: abnormal ejaculation, decrease sex drive, priapism

252
Q

Tamsulosin pharmacist’s tip 3

A

Take 30 minutes after same meal each day - to decrease dizziness

Alcohol can worsen side effects Dizziness and decrease BP

Dizziness, decreased BP - caution when standing or driving

253
Q

Alcohol and tamsulosin

A

Alcohol increases risk of side effects dizziness and decreased BP

254
Q

Terazosin

Drug class and moa

A

Alpha 1 blocker

Relax smooth muscle of bladder and prostate, also peripheral blood vessels - this causes OSH

255
Q

Terazosin

Indication 3

A

BPH

PTSD

Decrease BP - not first choice

256
Q

Terazosin consultation tips 2

A

Take WOW, best at night to avoid side effects

Can cause HA and Dizziness
- careful with driving
- alcohol can worsen side effects
- stand slowly from a sitting position

257
Q

Terazosin common side effect 1

A

CNS: HA, dizzy and fatigue

258
Q

Terazosin risk or serious SE

Drug (13 decks)

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