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Dispensing Exam 3 > Transdermals and related drugs > Flashcards

Transdermals and related drugs Flashcards

1
Q

rate of diffusion through the skin?

A

Flux

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2
Q

Adhesive matrix?

A

drug is evenly distributed, can be cut in half, contains a release liner, and drug is released from the adhesive

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3
Q

Reservoir matrix?

A

cannot be cut in half because the drug would leak, adhesive on both sides, has a rate controlling membrane, and reservoir filled with drug formulation

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4
Q

Nitroglycerin indications:

A

vasodilators indicated for prevention of angina pectoris

will not relieve acute attack

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5
Q

Nitroglycerin side effects:

A

headache due to vasodilation

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6
Q

2 nitroglycerin Trades?

A

Minitran and Nitro-Dur

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7
Q

Minitran details?

A 
nitroglycerin
•	0.1 mg/hr
•	qday
•	Adhesive matrix
•	Minimize tolerance by wearing for 12 hours → remove for 12 hours
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8
Q

Nitro-Dur details?

A

nitroglycerin
• qday
• Adhesive matrix
• Minimize tolerance by wearing for 12 hours → remove for 12 hours

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9
Q

Ranexa generic?

A

ranolazine

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10
Q

ranolazine Trade and details?

A

Ranexa
vasodilator (not relieve acute attack)
• 500 and 1000 mg TABLET
• BID

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11
Q

Estrogen hormone for hormone replacement therapy?

A

estradiol

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12
Q

hot flash order of events?

A

• Loss of ovarian estrogen secretion after menopause → instability of thermoregulation → hot flash

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13
Q

inflammation of the vagina due to thinning/shrinking of tissues

A

atrophic vaginitis

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14
Q

painful intercourse

A

dyspareunia

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15
Q

2 BBW for estradiol?

A
  • BBW: increases risk of CVD and dementia in post-menopausal women
  • BBW: increase risk of endometrial cancer in pre-menopausal women
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16
Q

estradiol indications?

A

• Indicated for vasomotor symptoms, vaginal atrophy, and osteoporosis (exception: Menostar)

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17
Q

5 Trades for estradiol transdermal products?

A

Climara, Vivelle-Dot, Alora, Minivelle, Menostar

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18
Q

Climara details?

A

estradiol
• qweek
• 0.025, 0.0375, 0.05, 0.06, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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19
Q

Vivelle-Dot details?

A

estradiol
• twice weekly
• 0.025, 0.0375, 0.05, 0.06, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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20
Q

Alora details?

A

estradiol
• twice weekly
• 0.025, 0.05, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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21
Q

Minivelle details?

A

estradiol
• twice weekly
• 0.0375, 0.05, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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22
Q

Menostar details?

A 
estradiol
•	qweek
•	0.014 mg/24 hours
•	Only indicated for osteoporosis
•	Adhesive matrix
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23
Q

estradiol (only) other products - 6

even eating dicks feels very eerie

A

Estrasorb, Evamist, Divigel, Femring, Vagifem, Estrace

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24
Q

Estrasorb details?

A

estradiol
• 2 packets qAM
• Topical emulsion
• 0.05 mg/2 packets: one packet each leg for 3 minutes, excess on buttocks
• Indicated for VM
• Alcohol USP is used as a P.A.E.
• Contains soybean oil; do not take if allergic to peanuts

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25
Q

Evamist details?

A 
estradiol
•	1 spray qday
•	0.021 mg/spray transdermal spray
•	Indicated for VM
•	Spray on inside of arm
•	Alcohol USP and octisalate are the percutaneous absorption enhancers
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26
Q

Divigel details?

A

estradiol
• qday
• 0.1% topical gel: 0.25, 0.5, 1 g packets of gel
• Indicated for VM
• Apply one packet to upper thigh
• Alcohol USP is used as a percutaneous absorption enhancer

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27
Q

Femring details?

A 
estradiol
•	q3months
•	Vaginal ring
•	0.05 and 0.1 mg/24 hours
•	Indicated for VM and VA
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28
Q

Vagifem details?

A 
estradiol
•	10 mcg vaginal tablet
•	Indicated for VA
•	Initial: 1 tablet qday x 2 weeks
•	Maintenance: 1 tablet twice weekly
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29
Q

Estrace details?

A 
estradiol
•	0.1 mg/g vaginal cream
•	Indicated for VA
•	Initial: qday x 2 weeks → after 2 weeks use ½ dose qday x 2 weeks
•	Maintenance: 1-3x/week
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30
Q

conjugated equine estrogens Trade?

A

Premarin Vaginal Cream

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31
Q

Premarin Vaginal Cream generic and details?

A

conjugated equine estrogens
• BIW 0.625mg/g vaginal cream
• Indicated for VA
• derived from pregnant horse urine

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32
Q

Climara Pro generic and details?

A

estradiol, levonorgestrel
• Qweek
• Adhesive matrix
• Indicated for VM and O

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33
Q

estradiol, levonorgestrel Trade?

A

Climara Pro

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34
Q

estradiol norethindrone Trades?

A

CombiPatch and Activella

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35
Q

CombiPatch details?

A 
estradiol, norethindrone
•	Twice weekly
•	Adhesive matrix
•	Indicated for VM and VA
•	Refrigerate in the pharmacy
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36
Q

Activella details?

A 
estradiol, norethindrone
•	qday
•	0.5 mg/0.1 mg tablet
•	1 mg/0.5 mg tablet
•	Indicated for VM, VA, and O
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37
Q

Ortho Evra generic and details?

A 
ethinyl estradiol, norelgestromin
•	qweek
•	Adhesive matrix
•	Indicated for contraception
•	Apply 1 patch qweek x 3 weeks → patch-free for 1 week → repeat
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38
Q

ethinyl estradiol, norelgestromin Trade?

A

Ortho Evra

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39
Q

Testosterone produced by men?

A

5mg/day

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40
Q

synthetic derivatives of testosterone?

A

anabolic steroids

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41
Q

anabolic steroid legislation?

A

Anabolic Steroids Control Act- makes all CIII drugs

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42
Q

decreased activity of the gonads → insufficient secretion of testosterone → no libido ?

A 
male hypogonadism
(Libido - sex drive)
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43
Q

testosterone drug BBW:

A

secondary exposure in women and children can cause virilization → wash hands after use

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44
Q

testosterone drug interactions:

A

testosterone decreases anticoagulant and insulin requirements

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45
Q

testosterone Trades? (5)

Adam always tries fornication annually

A

Androderm, AndroGel, Testim, Fortesta, Axiron

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46
Q

Androderm details?

A 
testosterone
•	qday
•	2 mg/24 hours and 4 mg/24 hours
•	*****Reservoir patch
•	Contains alcohol USP
•	Do not use the same site more than once per week → irritation
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47
Q

AndroGel details?

A

testosterone
• Qday
• Single dose packet: 2.5 g, 5 g = 25 mg, 50 mg testosterone → 2.5 mg, 5 mg absorbed via the shoulder
• Metered dose pump: 1% (1 pump=12.5 mg x 4 pumps) = 50 mg → 5 mg absorbed via the shoulder, 1.62% (1 pump=20 mg x 2 pumps) = 40 mg testosterone → 4 mg absorbed via the shoulder

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48
Q

Testim details?

A

testosterone
• qday
• 5 g single dose packets = 50 mg testosterone → 5 mg absorbed

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49
Q

Fortesta details?

A

testosterone
• qday
• Metered dose pump
• 2 pumps applied to each thigh to minimize secondary exposure
• 1 pump = 10 mg testosterone x 4 pumps = 40 mg → absorb 4 mg

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50
Q

Axiron details?

A 
testosterone
•	qday
•	Topical solution
•	Metered dose pump: 1 pump = 30 mg testosterone x 2 pumps (1 under each arm) = 60 mg → 6 mg absorbed
•	Contains alcohol USP
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51
Q

clonidine Trades?

A

Catapres TTS and Kapvay

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52
Q

Catapres TTS details?

A 
clonidine
•	qweek
•	0.1, 0.2, 0.3 mg/24 hours
•	Reservoir system
•	Indicated for hypertension
•	Transdermal Therapeutic System
•	Optional adhesive overlay to keep patch on
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53
Q

Kapvay details?

A

clonidine
• BID (maintenance)
• 0.1 mg and 0.2 mg ER tablet
• Indicated for ADHD

54
Q

Fentanyl Trades?

A

Duragesic, Actiq, Onsolis, Fentora, Abstral, Lazanda

55
Q

Duragesic details

A 
fentanyl
•	q72h
•	12.5, 25, 50, 75, 100 mcg/hr
•	***Reservoir system
•	Indicated for chronic pain (12 hour onset)
•	Contains alcohol USP
•	Fold over on itself to discard
56
Q

Actiq details

A 
fentanyl
•	q4h
•	Transmucosal lozenge on a stick
•	Rub on side of cheek for 15 minutes
•	Hold under hot water to dissolve
57
Q

Onsolis details?

A 
fentanyl
•	q2h
•	Transmucosal buccal film
•	Applied to the inside of the cheek
•	Flush down toilet to discard
58
Q

Fentora details?

A

fentanyl
• q4h
• Buccal tablet
• Flush down toilet to discard

59
Q

Abstral details?

A

fentanyl
• q2h
• Sublingual tablet
• Flush down toilet to discard

60
Q

Lazanda details?

A 
fentanyl
•	q2h
•	Nasal spray
•	1 spray in 1 nostril
•	Spray extra into provided pouch → place in child resistant container → discard
61
Q

First transdermal system?

A

scopolamine

62
Q

scopolamine indications?

A

prevention of nausea and vomiting

63
Q

2 directions for scopolamine?

A
  • Motion sickness: place behind ear 4 hours before needed; may leave on 3 days
  • Surgery: apply patch the evening before surgery
64
Q

directions for after application of scopolamine?

A
  • Wash hands thoroughly after applying or removing because it may cause mydriasis
  • Most common side effect is dry mouth and drowsiness
65
Q

scopolamine Trade and details?

A

Transderm-Scop
• 5 mcg/hr
• Anticholinergic agent
• Adhesive matrix

66
Q

lidocaine Trade?

67
Q

Lidoderm details?

A 
lidocaine
•	qday -5%
•	Adhesive matrix without a P.A.E. 
•	Local anesthetic
•	Indicated for pain associated PHN
•	Apply up to 3 patches/day at the same time; put one on for 12 hours, then remove for 12 hours
68
Q

gabapentin Trade?

69
Q

Neurontin generic and details?

A

gabapentin

• Indicated for PHN and partial seizures

70
Q

pregabalin Trade?

71
Q

Lyrica generic and details?

A

pregabalin

• Indicated for PHN, partial seizures, DPN, and fibromyalgia

72
Q

Chicken pox vaccine?

A

Varivax - varicella vaccine

for children and adults

73
Q

shingles vaccine?

A

Zostavax - zoster vaccine

prevents reactivation of the varicella virus, must be 50+ years old

74
Q

Anticholinergic indication, symptoms, and side effects:

A

can be used for overactive bladder
• Symptoms: urinary incontinence, urgency, and frequency
• Side effects: xerostomia, constipation, sedation, mydriasis, and hyperthermia

75
Q

Trades of oxybutynin?

A

Oxytrol, Ditropan, Ditropan XL, Gelnique

anticholinergics

76
Q

Oxytrol details?

A

oxybutynin (anticholinergic)
• Twice weekly
• 3.9 mg/24 hours transdermal
• Adhesive matrix

77
Q

Ditropan details?

A

oxybutynin (anticholinergic)
IR tablet
ER tablet - Ditropan XL

78
Q

Gelnique details?

A

oxybutynin (anticholinergic)
• qday
• 10% topical gel
• Individually wrapped packets of gel → applied to abdomen
• Contains percutaneous absorption enhancer

79
Q

tolterodine Trade?

A

Detrol, Detrol LA

anticholinergic

80
Q

Detrol generic?

A

tolterodine IR - tablet
Detrol LA - tolteridone ER - CAPSULE
anticholinergic

81
Q

trospium Trade?

A

Sanctura, Sanctura XR

anticholinergic

82
Q

Sanctura generic and details?

A

trospium IR tablet - empty stomach
Sanctura XR - tropsium ER capsule - empty stomach
anticholinergic

83
Q

darifenacin Trade?

A

Enablex

anticholinergic

84
Q

Enablex generic?

A

darifenacin

anticholinergic

85
Q

solifenacin Trade?

A

Vesicare

anticholinergic

86
Q

Vesicare generic?

A

solifenacin

anticholinergic

87
Q

Toviaz generic?

A

fesoterodine

anticholinergic

88
Q

fesoterodine Trade?

A

Toviaz

anticholinergic

89
Q

mirabegron Trade?

90
Q

Myrbetriq generic and details?

A

mirabegron
• relaxes bladder smooth muscle
• Beta-3 agonist
• NOT anticholinergic

91
Q

methylphenidate Trade?

92
Q

Daytrana generic and details?

A 
methylphenidate
•	qday
•	10, 15, 20, 30 mg/9 hours
•	Adhesive matrix
•	Indicated for ADHD
•	Wear on hip 2 hours before needed, then take off 9 hours later
•	CII
93
Q

selegiline Trades?

A

Emsam, Eldepryl, Zelapar

94
Q

Emsam generic and details?

A 
selegiline
•	qday
•	6, 9, 12 mg/24 hours
•	Adhesive matrix
•	MAOI antidepressant
•	Indicated for depression
•	Be careful with tyramine if taking 9 mg or 12 mg; avoid pseudoephedrine and phenylephrine
95
Q

Eldepryl generic and details?

A

selegiline (MAOI)
• Capsule
• Antiparkinson’s agent

96
Q

Zelapar generic and details?

A

selegiline (MAOI)
• ODT
• Antiparkinson’s agent

97
Q

granisetron Trade?

A

Sancuso

antiemetic

98
Q

Sancuso generic and details?

A

granisetron
• qweek
• 3.1 mg/24 hours - Adhesive matrix
• Antiemetic - Indicated for N/V patients receiving chemotherapy for 5 straight days; works in the CTZ
• Apply on upper arm 24 hours before first treatment → take off 24 hours after last treatment
• May cause phototoxic reaction:avoid sun exposure for 10 days after removal

99
Q

Aloxi generic?

A

palonosetron

antiemetic

100
Q

palonosetron Trade?

A

Aloxi

antiemetic

101
Q

Anzemet generic?

A

dolasetron

antiemetic

102
Q

dolasetron Trade?

A

Anzemet

antiemetic

103
Q

Zofran generic?

A

ondansetron

104
Q

ondansetron Trade?

105
Q

Emend generic?

A

aprepitant

antiemetic

106
Q

aprepitant Trade?

A

Emend

antiemetic

107
Q

Cholinesterase Inhibitors indication?

A

Alzheimer’s Disease
inhibit cholinesterase → increase ACh levels in the brain
o Side effect: N/V if dose is too high

108
Q

rivastigmine Trade?

A

Exelon Patch

cholinesterase inhibitor

109
Q

Exelon generic and details?

A 
rivastigmine
•	qday
•	4.6, 9.5 mg/24 hours
•	Adhesive matrix
•	4.6 mg x 1 month, then increase to 9.5 mg as maintenance dose
•	Apply patch in the middle of the back
110
Q

Aricept generic?

A

donepezil

cholinesterase inhibitor

111
Q

Razadyne generic?

A

galantamine

cholinesterase inhibitor

112
Q

donepezil Trade?

A

Aricept

cholinesterase inhibitor

113
Q

galantamine Trade?

A

Razadyne

cholinesterase inhibitor

114
Q

buprenorphine Trades?

A

Butrans and Buprenex

+ non-trade sublingual tab

115
Q

Butrans details?

A

buprenorphine
• qweek
• 5, 10, 20 mcg/hour
• Adhesive matrix
• Opioid analgesic
• Once patch is removed do not use the same skin for 3 weeks
• 10 and 20 mcg/hour are used in opioid intolerant patients

116
Q

Buprenex details?

A

parenteral buprenorphine

opioid analgesic

117
Q

oral buprenorphine

A

opiod analgesic
• Sublingual tablet
• Indicated for addiction

118
Q

diclofenac epolamine Trade?

A

Flector Patch

119
Q

Flector generic and details?

A 
diclofenac epolamine (patch)
•	BID
•	1.3% adhesive matrix
•	NSAID → inhibits cyclooxygenase-2
•	Indicated for strains (stretched muscle) and sprains (stretched ligament)
•	Do not use if allergic to aspirin
120
Q

smoking cessation generics?

A

buproprion, varenicline, nicotine

121
Q

buproprion Trade?

A

Zyban

smoking cessation

122
Q

Zyban generic and details?

A

buproprion
• 150 mg tablet
• Take 1 tablet x 3 days, then BID x 12 weeks
• Aminoketone antidepressant
• Indicated only for smoking cessation
• Start 1 week before trying to quit to give drug a chance to reach therapeutic levels
• Rx only

123
Q

varenicline Trade?

A

Chantix

smoking cessation

124
Q

Chantix generic and details?

strength, dosing, class, MOA, side effects, BBW

A

varenicline
• 0.5 mg and 1 mg tablet
• Take 0.5 mg qday x 3 days, then 0.5 mg BID x 4 days, then 1 mg BID x 12 weeks
• Nicotine receptor agonist
• Varenicline binds to its receptor and produces nicotine-like effects and inhibits nicotine
• Side effects: N/V (take with food to help), vivid dreams, violent behavior
• BBW: 1. may cause neuropsychiatric events. 2. Do not use in patients with depression, BD, or schizophrenia
• Rx only

125
Q

nicotine Trades?

A

Nicorette, Nicorette DS, Nicotrol Inhaler, Nicoderm CQ, + no-trade lozenges

126
Q

Nicorette dosing details?

A

nicotine
• 2 mg nicotine gum; 30 maximum pieces a day
• DS: 4 mg nicotine gum; 20 maximum pieces a day
• Patients smoking >25 cigarettes a day should start with 4 mg

127
Q

Nicorette delivery details?

A
  • Contains a sugar free base to allow systemic delivery; absorbed via buccal mucosa in alkaline saliva → avoid swallowing and beverages that make saliva acidic
  • Tempted to smoke → chew 1 piece until peppery taste/tingling is perceived → place between cheek and gum until taste is gone → repeat for ~30 minutes
128
Q

nicotine lozenges details?

A
  • 2 mg and 4 mg nicotine lozenge (OTC)
  • Dose depends on “time to first cigarette”; needs alkaline saliva
  • 4 mg: within 30 minutes of waking up
  • 2 mg: after 30 minutes of waking up
  • Take 1 lozenge q1-2h x 6 weeks, then q2-4h x 3 weeks, then q4-8h x 3 weeks
129
Q

Nicotrol details?

A

nicotine inhaler
• 4 mg cartridge; max dose/day = 16 cartridges
• Contains enough nicotine for 20 minutes of active puffing
• Transmucosal so do not inhale into lungs
• Rx only

130
Q

Nicoderm strengths and application instructions?

A
  • qday
  • 7 mg, 14 mg, 21 mg/hr adhesive matrix
  • Apply to area on upper part of arm → remove after 24 hours (do not reuse this site for 7 days) and apply new patch to different site → fold patch in half to discard
131
Q

Nicoderm dosing instructions?

A
  • Dosing is based on how many cigarettes/day smoked
  • > 10 cigarettes: 21 mg – 6 weeks, 14 mg and 7 mg– 2 weeks
  • <10 cigarettes: 14 mg – 6 weeks, 7 mg – 2 weeks

Dispensing Exam 3 (4 decks)

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