151-175 Flashcards
(25 cards)
Liothyronine
Brand: Cytomel MOA: Active (T3) thyroid hormone Schedule: legend Dosing: 25mcg to 75mcg once daily Max: 100mcg/day Contraindication(s): Uncorrected adrenal insufficiency Untreated thyrotoxicosis BBW: • Weight reduction Key Points: Empty stomach; may or may not be first thing in the morning Sxs of hyperthyroidism if dosed too aggresively Chelates with numerous drugs, vitamins, and mineralsRemind patient to have labs checked if new rx or changing dose
Lisinopril
Brand: Zestril, Prinivil MOA: Inhibits angiotensin converting enzyme, preventing the coversion of angiotensin I to angiotensin II Schedule: legend Dosing: 5mg to 40 mg once daily Contraindication(s): Angioedema related to previous treatment with an ACE inhibitor Cocomitant use of aliskerin in patients with diabetes BBW: • Fetal toxicity Key Points: May cause dry cough Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting AngioedemaLightheadedness, dizziness, orthostasis, hypotension
Lisinopril and Hydrochlorothiazide
Brand: Zestoretic MOA: See individual agents Schedule: legend Dosing: See individual agents Max 80mg/50mg once daily Contraindication(s): Hypersensitivity to sulfonamide-derived drugs Angioedema related to previous treatment with an ACE inhibitor Cocomitant use of aliskerin in patients with diabetes Idiopathic or heredetary angioedema BBW: • Fetal toxicity Key Points: See Individual Agents
Losartan
Brand: Cozaar MOA: Antagonizes angiotensin receptors, blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II Schedule: legend Dosing: 50mg to 100mg once daily Contraindication(s): Cocomitant use of aliskerin in patients with diabetes BBW: • Fetal toxicity Key Points: Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting Lightheadedness, dizziness, orthostasis, hypotension
Losartan and Hydrochlorothiazide
Brand: Hyzaar MOA: See individual agents Schedule: legend Dosing: See individual agents Contraindication(s): Hypersensitivity to sulfonamide-derived drugs Cocomitant use of aliskerin in patients with diabetes anuria BBW: • Fetal toxicity Key Points: See Individual Agents
Medroxyprogesterone
Brand: Provera, Depo-Provera MOA: Inhibits secretion of pituitary gonadotropins, which prevents follicular maturation and ovulation and causes endometrial thinning Schedule: legend Dosing: 5mg to 10 mg PO once daily Depo-Provera: 150 mg IM every 3 months Contraindication(s): DVT or PE Active or history of thromboembolic disease breast cancer Pregnancy BBW: • Cardiovascular disorders (tablet) • Breast cancer (tablet) • Dementia (tablet) • Long-term use (injection) • Loss of bone mineral density (injection) • Patient education (subcutaneous injection) • Risk vs benefits (tablet) Key Points: amenorrhea Weight gain Headache
Metoprolol
Brand: Lopressor, Toprol MOA: Selectively blocks beta1-receptors Schedule: legend Dosing: IR: Angina, afib, HTN: 50mg to 100 mg BID Does not treat HF ER: Angina and HTN: 25mg to 100 mg once daily Afib: 50mg to 400 mg once daily HF: Initiate 12.5mg to 25mg once daily and titrate to target 200mg once daily Contraindication(s): Second or third degree heart block Sinus bradycardia Cardiogenic shock BBW: • Ischemic heart disease Key Points: Fatigue and Lethargy Bradycardia (or rebound tachycardia if stopped abruptly) ImpotenceSuccinate = long acting Tartrate = short acting
Metronidazole
Brand: Flagyl, MetroGel, MetroCream, MetroLotion MOA: Interacts with DNA to cause a loss of helical DNA structure and strand breakage resulting in inhibition of protein synthesis and cell death Schedule: legend Dosing: 500mg to 750mg BID to TID Trichomoniasis: 250mg q 8 hours x 7 days OR 1gm BID x 1 day OR 2gm once as a single dose Contraindication(s): First trimester of pregnancy Use of alcohol within 3 days use of disulfiram within the past 2 weeks BBW: • Carcinogenic (systemic) Key Points: Avoid alcohol Metallic taste Headache, Nausea
Minocycline
Brand: Minocin, Solodyn MOA: Inhibits protein synthesis by binding with the 30S ribosomal subunit Schedule: legend Dosing: Acne Vulgaris: 50mg to 100mg BID Infection: 200mg once daily x 1 dose, followed by 100mg BID Contraindication(s): Hypersensitivity BBW: • None Key Points: Photosensitivity Avoid < 8 years old Adequate fluid intake otherwise esophagitisdiarrhea (AAD & CDAD)
Moxifloxacin
Brand: Avelox, Moxeza, Vigamox MOA: Inhibits DNA-gyrase and promotes breakage of double-stranded DNA Schedule: legend Dosing: 400mg PO or IV once daily Contraindication(s): Hypersensitivity to other quinolones BBW: • Serious adverse reactions • Myasthenia gravis Key Points: May bind with certain cations. Avoid taking with certain multivitamins and minerals (calcium, aluminum, magnesium, etc.) QTC prolongation Dysglycemia, Diarrhea (AAD & CDAD)
Mupirocin
Brand: Bactroban MOA: Binds to bacterial isoleucyl transfer-RNA synthetase resulting in the inhibition of protein synthesis Schedule: legend Dosing: AAA topically TID Contraindication(s): Hypersensitivity BBW: • None Key Points: Localized burning or stinging sensation Rhinitis Respiratory congestion
Niacin
Brand: Niaspan MOA: Inhibits of release of free fatty acids from adipose tissue and increases lipoprotein lipase activity Schedule: legend Dosing: IR: 1.5g to 3g daily in two to three evenly divided doses (Max 6g/day) ER: 1g to 2g q HS (Max 2g/day) Contraindication(s): Active liver disease Active peptic ulcer Arterial hemorrhage BBW: • None Key Points: Flushing reaction Hepatic injury Can take with cold water or food to reduce flushingFlushing will get less severe with time
Nifedipine
Brand: Adalat, Procardia, Afeditab MOA: Acts on vascular smooth muscle to produce peripheral arterial vasodilation by inhibiting calcium ions from entering select voltage-sensitive areas of vascular smooth muscle Schedule: legend Dosing: IR: Angina only: 10mg to 20mg TID (Max 180mg/day) ER: HTN and angina: 30mg to 90mg once daily (Max 120mg/day) Contraindication(s): Use in patients with STEMI BBW: • None Key Points: Peripheral edema Flushing hypotensiongingival hyperplasia
Nitrofurantoin
Brand: Macrobid, Macrodantin MOA: Inactivates or alters bacterial ribosomal proteins leading to inhibition of protein synthesis, aerobic energy metabolism, DNA, RNA, and cell wall synthesis Schedule: legend Dosing: Macrobid: 100mg BID for 7 days Macrodantin: 50mg to 100mg q 6 hours Contraindication(s): Anuria, oliguria, or impairment of renal function (CrCl less than 60ml/min) History of cholestatic jaundice or hepatic dysfunction associated with prior use of nitrofurantoin BBW: • None Key Points: GI Upset Do not use with poor renal function Pulmonary fibrosis with long term use
Nitroglycerin
Brand: Nitrostat, Nitro-Bid, Nitro-Dur, Nitrolingual MOA: Activates cGMP leading to dephosphorylation of myosin light chains and smooth muscle relaxation Schedule: legend Dosing: Sublingual tablet: 0.3mg to 0.6mg q 5 minutes (Max 3 tablets within 15 mintues) PO tablet: 2.5mg to 6.5 mg TID or QID Contraindication(s): Concurrent use with phosphodiesterase inhibitors or riociguat BBW: • None Key Points: Place under tongue, do not swallow or chew Keep in original bottle - Replace routinely and check expiration date May use up to 3 doses q5 min. If no symptom relief after 1 dose, call 911.Used for chest pain, sit before taking dose, may cause dizziness
Norethindrone
Brand: Nor-QD, Camila, Heather, Errin MOA: Suppresses ovulation, thickens cervical mucus (which inhibits sperm penetration), alters follicle-stimulating hormone (FSH) and luteinizing hormone (LH) concentrations, slows the movement of ovum through the fallopian tubes, and alters the endometrium Schedule: legend Dosing: 1 tablet once daily at the same time each day Contraindication(s): Hepatic impairment or disease Breast Cancer - known, suspected, or history of Pregnancy Undiagnosed abdominal genital bleeding BBW: • None Key Points: Nausea and Vomting Increased risk of blood clots Weight Changes; Fluid RetentionSticter dosing parmeters than other BCs. Consider various factors that may decrease effectiveness (time of dose, abx, missed dose, time to onset, etc.)
Olmesartan
Brand: Benicar MOA: Antagonizes angiotensin receptors, blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II Schedule: legend Dosing: 20mg to 40mg once daily Contraindication(s): Concomitant use of aliskerin in patients with diabetes BBW: • Fetal toxicity Key Points: Certain lab tests (K+ and sCr) may be increased and should be checked within 1-2 weeks of starting Lightheadedness, dizziness, orthostasis, hypotension
Olmesartan and Hydrochlorothiazide
Brand: Benicar HCT MOA: See individual agents Schedule: legend Dosing: See Individual Agents Contraindication(s): Concomitant use of aliskerin in patients with diabetes Anuria BBW: • Fetal toxicity Key Points: See Individual Agents
Omega-3 fatty acids
Brand: Lovaza MOA: Reduction in hepatic production of VLDL and a reduction in the hepatic synthesis of triglycerides Schedule: legend Dosing: 2g BID or 4g once daily Contraindication(s): Hypersensitivity BBW: • None Key Points: Diarrhea Nausea/Dyspepsia Abdominal PainEnsure no seafood allergies
Omeprazole
Brand: Prilosec MOA: Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell Schedule: legend Dosing: 20mg to 40mg once daily Contraindication(s): Hypersensitivity to other PPIs BBW: • None Key Points: Headache Diarrhea Take 30 minutes before food.May diminish effect of clopidogrel
Ondansetron
Brand: Zofran, Zuplenz MOA: Selective 5-HT3-receptor antagonist Schedule: legend Dosing: 8mg to 16mg po 30min to 1 hour before therapy Contraindication(s): Hypersensitivity Use with apomorphine BBW: • None Key Points: Headache Malaise FatigueConstipation
Oseltamivir
Brand: Tamiflu MOA: Inhibits influenza virus neuraminidase Schedule: legend Dosing: Influenza prophylaxis: 75mg once daily Influenza treatment: 75mg BID Contraindication(s): Hypersensitivity BBW: • None Key Points: Headache Nausea/Vomiting Give within 48 hours of flu symptoms
Oxybutynin
Brand: Oxytrol, Ditropan MOA: Direct antispasmodic effect on smooth muscle and inhibits the action of acetylcholine Schedule: legend Dosing: ER: 5mg to 10mg po once daily (Max 30mg/day) Contraindication(s): Patients with or at risk for uncontrolled narrow-angle glaucoma, urinary retention, gastric retention, or conditions with severely decreased GI motility BBW: • None Key Points: Anticholinergic AE (dry mouth, sedation, constipation,e tc.) dizziness vision disturbance
Pantoprazole
Brand: Protonix MOA: Suppresses gastric acid secretion by inhibition of the H+/K+-ATPase in the gastric parietal cell Schedule: legend Dosing: 40mg once daily or BID Contraindication(s): Hypersensitivity to other PPIs BBW: • None Key Points: Headache Diarrhea Take 30 minutes before food.
