New drug encounter #1 Flashcards
1
Q
Soolantra
Generic and indication
A
Ivermectin topical
Acne rosacea
2
Q
Nuvessa
A
Nuv - new vaginal gel
Metronidazole 1.3% vaginal gel
Bacterial vaginosis
3
Q
Edarbyclor
A
Azilsartan + chlothalidone
High blood pressure
Edarbyclor see in name
* arb = azilsartan
* clor = chlorthalidone
4
Q
Edarbi generic
A
Azilsartan
edARBi = arb
5
Q
Valtoco
A
Diazepam nasal spray
For seizures
6
Q
Nayzilam
A
Midazolam (versed) nasal spray
For seizures
- nayziLAM = midazoLAM
7
Q
Belsomra
A
Suvorexant
- Insomnia
8
Q
cytotec generic
A
misoprostol
9
Q
cytotec indications (2)
A
- cervical ripening
- labor induction
cervical ripening - a process of softening and opening the cervix before labor starts
* the cervix is stiff and closed through most of your pregnancy to hold baby inside uterus. But during labor, cervical dilation (widening) allows baby to pass through your birth canal
induction (n) - the act of bringing about something (especially at an early time)
* After a baseball player’s induction into the Hall of Fame, his name remains on the wall there for life. Induction is something that begins a process or a series of events.
10
Q
what side effects should you think with cytotec (2)
A
Cytotec is used for abortion, will cause muscle contraction and movements leading to DIARRHEA
I want an abortion, having this baby will be a HEADACHE
GI: abdominal pain and diarrhea (40%)
CNS: Headache
note: administer with meals to decrease risk of diarrhea
You will have less HEADACHE without the baby
11
Q
what should you avoid while taking cytotec?
A
Alcohol
note: cytotec causes a lot of GI irritation (diarrhea and abdominal pain), alcohol also causes GI irritation (makes it worse only)
- avoid magnesium - increase diarrhea
12
Q
can I take antacid before or after cytotec to minimize GI side effects?
A
Yes
Note: can take before or after cytotec
Avoid magnesium containing antacid may cause more diarrhea
tums
Avoid maalox
13
Q
How do I take cytotec PO
A
Take with food
- to minimize diarrhea
Note: cytotec cause a lot of diarrhea 40%
14
Q
galantamine brand name?
A
Razadyne (ER)
15
Q
galantamine indication (1)
A
Alzheimer DEMENTIA
16
Q
galantamine indication (1)
A
Alzheimer disease, mild-moderate dementia
17
Q
how to take galantamine
A
Increase acetylcholine (rest and digest) leading to INCREASE ACID secretion causing NVD
take with food
- most common side effects N, V, D
18
Q
galantamine side effects (2)
A
- Nause, Vomiting or Diarrhea (most commonly)
- HA or fatigue
19
Q
galantamine IR and ER dosing
A
galantamine IR - twice daily with food
galantamine ER - once daily with food
20
Q
generic for Zubsolv
A
buprenorphine & naloxone (SL tablet)
21
Q
Zubsolv indication
A
opioid dependence
22
Q
age limit for Zubslov
A
16 years or older
23
Q
difference between Zubsolv and Suboxone
A
Zubsolv dissolved more quicker than Suboxone, therefore, requires less mg
- more bioavailability
24
Q
zubsolv side effects 2
Think what zubsolv is
A
Zubsolv is for opioid dependence
* b/c I can’t get any opioid, it makes me not able to sleep and gives me headache
** all opioid cause GI symptoms: NVDC
- Headache (HA) and Insomnia (most commonly)
- GI: N, V, C or Diarrhea
25
Wegovy generic
Semaglutide
26
Wegovy indication
Weight loss
Wegovy
* W - weight loss
* W - once weekly injection
27
Wegovy side effects (2)
1. GI: N, V, D or Constipation. Abdominal pain
2. Dizziness or headache
28
Wegovy in relation to food?
Wegovy injection - With or without food
29
Saxenda generic name
Liraglutide
30
Saxenda indication
weight loss
Saxenda
* Sax = sexy
31
dosing frequency for saxenda
once daily
Victoza (liaglutide) - dose once daily
32
saxenda side effects (2)
1. GI: N, V, D, or Constipation. Abdominal pain.
2. Headache
33
saxenda administration in relation to food
saxenda - with or without food
34
Victoza generic name
liraglutide
35
2 brand names for liraglutide
1. victoza
2. saxenda
36
dosing frequency for victoza
once daily
37
Mounjaro generic name
Tirzepatide
38
Mounjaro indication
diabetes
39
dosing frequency for Mounjaro
once weekly
40
what makes Mounjaro unique
Dual action - GIP and GLP-1 agonist
1. activates glucose-dependent insulinotropic polypeptide (GIP)
2. GLP-1 receptor agonist - resulting in
* increase insulin secretion
* decrease glucagon secretion
* increase insulin sensitivity
* delay gastric emptying
Insulinotropic means = stimulate insulin release
41
Tirosint generic
levothyroxine (liquid gel capsule)
42
what makes tirosint possibly better than synthroid (3)
1. cleaner - less inactive inactive ingredients
* gelatin
* glycerin
* water
* thyroxine (T4)
2. better absorption
3. can take WOW food
43
what is NP thyroid
NP - natural product
* thyroid derive from pigs' thyroid gland - contains both T4 and T3
44
What is Armour thyroid
Pig thyroid extract (T4 and T3)
* same as NP thyroid
45
What is Synthroid?
man-made synthetic thyroid (T4 only)
SYNThroid = synthetic man made in lab
46
liothyronie brand name
Cytomel
47
what is liothyronine
synthetic T3 only
* T3 - is the active form (T4 is converted to T3)
T3 - triidothyronine
48
acamprosate brand name
campral
49
acamprosate indication
alcohol dependence
50
dosing for acamprosate
666 mg TID - WoW food
51
side effects of acamprosate 2
Think of
For alcohol abuse, alcohol cause GI symptoms (nausea) and without alcohol- you can’t sleep or relax (insomnia & anxiety)
1. GI: diarrhea
2. anxiety, insomnia,
52
what to monitor with acamprosate (1)
Kidney function
53
acamprosate simple moa
antagonize glutamate
* glutamate is an excitatory neurotransmitter (glutamate - animate)
54
how to start acamprosate
a period of abstinence is recommended before starting acamprosate
55
can you still drink alcohol while on acamprosate
relapsed is okay
* any reduction in drinking is desirable
continue treatment even with relapsed
56
how long does it take for acamprosate to work
about 1 week
57
dosing frequency for acamprosate
TID
58
action of GABA neurotransmitters
inhibitory
* makes you sleepy
* anxiolytic
59
semaglutide brand names (3)
1. rybelsus (PO)
2. Ozempic - once weekly for diabetes
3. Wegovy - once weekly for weight loss
60
semaglutide moa (simple)
glp-1 receptor agonists (mimics glp-1) - leading to insulin secretion
* glp-1 glucagon like peptides - increase insulin secretion
decrease glucagon, slow gastric emptying
reduce food intake
promotes beta-cell proliferation
61
rybelsus administration
exactly 30 minutes before first food, beverage or other oral meds
with no more than 4 oz of water
* wait less than 30 min to eat - may decrease absorption
* wait more than 30 min to eat - may increase absorption
** food decrease absorption
62
rybelsus missed dose
wait until next day for next dose
63
Wegovy generic
semaglutide
64
wegovy indication
weight loss
65
how many pens in wegovy box
4 pen
66
wegovy with or without food
wegovy injection - no regards to timing of food
67
wegoyv missed dose
if you have 48 hours before next dose, take it, then resume schedule
* you have 5 days to inject missed dose
68
ozempic generic
semaglutide
69
ozempic indication
diabetes
70
ozempic injection with or without food
ozempic - can be injected with or without food (no regard)
71
ozempic missed dose
if you have 48 hours until next dose, take it, then resume schedule
72
ozempic missed dose
if you have 48 hours until next dose, take it, then resume schedule
* you have 5 days to inject missed dose
73
semaglutide (ozempic, rybelsus, wegovy)
* 2 main side effects to remember
1. GI: N, V, D and decreased appetite = GI most common
2. CNS: HA, dizziness, or fatigue
* can decrease blood pressure and cause orthostatic hypotension
74
semaglutide (ozempic, rybelsus, wegovy)
* organs affected
1. gallbladder - may cause gallstone
2. decrease renal function
3. increase LFT (liver function)
4. Pancreatitis - pancreatic cancer
5. Hypotension
6. Hair loss
7. increase HR - if consistent increased in resting HR - stop medication
8. Thyroid cancer.
75
semaglutide may cause pancreatitis, signs and symtoms to report
persistent severe abdominal pain, sometimes radiating to the back
may or may not accompany by VOMITING
76
Can I shower with nicotine patch?
Yes
Bathing will not affect patch
77
Strattera generic
Atomoxetine
78
How do I take strattera
Take with or without food in the morning
79
Most common side effects (3) Strattera
Most common: NAusea
Dry mouth
Headache & insomnia
Decrease appetite
Strattera is a stimulant; stimulant will lead to wt loss by causing NAUSEA & DECREASE APPETITE and also cause DRY MOUTH
A stimulant also wires you brain causing INSOMNIA & HEADACHE
80
Can you open Strattera capsules?
No. Powder is an eye irritant
81
Mexiletine (Mexitil) indication
Arrhythmia (ventricular)
82
How do I take mexiletine?
Take with food - to prevent nausea
* can take with tums or antacid
83
What to monitor mexiletine?
Liver damage
* needs lab work
Think: liver toxicity, Nausea and dizziness
84
Mexiletine common side effects (3)
Think arrhythmia as “Fast “; cause Nausea and dizziness, tremors
Most common: NAUSEA (40%)
* take with food
Dizzy
Tremors, uncoordinated
85
Mexiletine moa
Blocks sodium channel in heart
* slows down abnormal electricity in heart
86
Azopt generic
Brinzolamide
87
Azopt drug class
Carbonic anhydrase inhibitor
Generic: brinzolamide
* think acetazolamide
88
How does Azopt work
Lower fluid in the eye to reduce pressure
89
Azopt dosing frequency
TID
90
Azopt common side effects 2
Blurry vision
Unusual or taste change
91
Azopt clinic warning
Sulfa allergy - avoid
92
Simbrinza generic
Brinzolamide & brimonidine
Brinzolamide (Azopt) - carbonic anhydrase inhibitor
Brimonidine (Alphagan P) - alpha agonist
* reduce intraocular fluid
Both REDUCE introcular fluid
93
Simbrinza dosing frequency
TID
94
Simbrinza common side effects 3
Blurry vision
Unusual taste or sour taste
Dry mouth
95
Simbrinza clinical warning
Sulfa allergy - avoid
* Brinzolamide is a sulfa
96
Alphagan P generic name
Brimonidine
97
Alphagan P (brimonidine) drug class
Alpha 2 agonist
* Alphagan = alpha 2 agonist
98
Brimonidine (Alphagan P) dosing
TID
99
Brimonidine (Alphagan P) common side effects 3
Eye drop causes eye irritation
1. Eye irritation: redness, itching, burning and may affect vision
DRY mouth
Tired (somnolence) - related to clonidine
100
Brimonidine (alphagan P)
Think of what oral med to help you remember this eye drop and it’s moa
Clonidine
101
What is Lumify and it’s indication
OTC brimonidine for red eye
* recommend for 5 years and older
102
Linzess generic
Linaclotide
103
Linzess indicated
Irritable bowel syndrome with constipation
IBS-C
Linzess = L for lazy bowel - constipation
104
Linzess moa
Agonist on GC-C receptors in gut
* increase intestinal fluid
* increase motility
* reduce intestinal pain
105
Linzess most common side effects 2
Think GI: diarrhea and abdominal pain
106
How to take linzess
30 minutes prior to 1st meal
* similar to Levoxyl
Capsules can be open and sprinkle onto applesauce or water and swallow whole without chewing
107
Can use a syringe to draw insulin from a humalog U-200 ?
No. The units will not be the same
108
What to do if I missed my trulicity dose?
Make sure there’s 72 hours before your next scheduled dose
You have the next 3 days to inject missed dose and resume normal schedule
109
Droxidopa indication
Low blood pressure, usually when standing
** orthostatic hypotension
110
Droxidopa dosing frequency
Three times a day, but not every 8 hours
** take last dose at least 3 hours before bedtime **
** do not take before bedtime - can cause high blood pressure while laying down (supine hypertension)
111
What is the most important thing to remember when taking droxidopa?
Do not take late right before bedtime, can cause high blood pressure while laying down leading to heart attack and stroke.
Take last dose at least 3 hours before going to sleep
Sleep with head elevated ***
112
Droxidopa simple moa
Droxidopa is class: alpha and beta agonist (think of it as an oral EpiPen)
converted to norepinephrine NE in the brain, increase NE level
NE is a vasoconstrictor - increase blood pressure and heart rate
Alpha agonist = Increase HR & BP
Beta agonist = lung dilation breathing easier
113
I can’t swallow droxidopa, can I open the capsules?
No. Capsule can’t be open.
114
What to monitor when taking droxidopa?
Monitor blood pressure
** if too high don’t lie down, stand up or sit until blood pressure returns to normal
Lying down will only cause blood pressure to go up
Monitor for pancreatitis
* upper stomach pain going to the back
115
Droxidopa common side effects 3
Headache
Dizzy
Nausea
116
How do I sleep when taking droxidopa
Sleep with head elevated
117
Rhopressa indication
Glaucoma (pressure in the eye)
118
Rhopressa generic
Netarsudil
119
Rhopressa dosing
Once daily in the evening
120
Rhopressa drug class and moa
Rhopressa is a ROCK
Rho Kinase Inhibitor- blocks enzyme called rho kinase
** increase outflow
* similar to xalatan
RhoPressa Rho kinase inhibitor **
121
Rhopressa storage
Can be stored at RT for 6 weeks or in frig
* like xalatan- can be store at RT 6 wks
122
Rhopressa missed dose
Skip until next dose at night
* dose once daily at night**
123
Rhopressa common side effects 3
Pink eye or Red eye
Deposit on cornea - reversible
Pain cause by eye drop
* red spot cause by broken blood vessels
124
Alfuzosin brand name
Uroxatral
125
Alfuzosin how to take
Once daily, anytime, with food ** for better absorption, do not take on empty stomach
Do not crush or chew, swallow whole
126
Alfuzosin indication and moa
For BPH enlarged prostate
Alpha 1 receptor blocker- relax muscles around prostate and bladder to make it easier to urinate
Does not shrink prostate
127
Alfuzosin how long does it take to work
4 weeks
128
Alfuzosin 3 clinical side effects
Floppy iris syndrome
* tell eye doctor before surgery
* may affect EYE
Priapism
* erection lasting longer than 4 hours
Orthostatic hypotension
129
Alfuzosin common side effects 3
Think:
Think: dizzy and HA d/t alpha blocker
Fatigue
130
Alfuzosin summary 3 things to remember
Alpha 1 blocker like flomax- relax muscles doesn’t shrink prostate
Take with food, better absorption, anytime of the day. Swallow whole
May cause orthostatic hypotension, priapism and floppy iris syndrome
* may cause dizziness
131
Calcitriol
How to take Calcitriol
Take in morning with Food
** remember, Calcitriol is a vitamin D and you know vitamin d is best absorb with food
132
What is calcitriol? What is use for? What patients population?
Calcitriol is the most active or potent vitamin d . Vitamin d is needed to stimulate intestinal calcium absorption
Calcitriol is used in predialysis or dialysis patients to increase calcium in the blood or patient with hypo parathyroidism
133
Clinical side effects Calcitriol
* what does it increase 3
Hypercalcemia
Hyper phosphatemia
Elevated creatinine level
134
Calcitriol common side effects 3
Think of:
GI: nausea vomiting or AP
Other: tire (somnolence)
Decrease appetite
135
3 things to do while on Calcitriol
Hint: which vitamin is affected by Calcitriol
Don’t take additional vitamin d supplement without doctor approval
Avoid magnesium (antacid) - can lead to high magnesium level causing breathing or heart problems
Keep calcium intake the same, do not increase intake
136
Methotrexate 2 indication
1. Rheumatoid arthritis
2. Psoriasis
137
What does methotrexate do for RA?
Methotrexate reduce pain, swelling and slows down joint damage and disease progression
** methotrexate is a DMARD
138
How does methotrexate work?
Methotrexate blocks DNA, RNA synthesis and new cell formulation
It disrupts the process of RA
139
Why do people take folic acid when on methotrexate?
Methotrexate decreases your body’s folic acid.
Folic acid supplement prevents side effects from methotrexate such as mouth sores
** do not take folic acid on the same day as methotrexate
140
Methotrexate and vaccines administration?
Avoid live vaccines- consult with doctor first
Live vaccines MMR and varicella
141
How long does it take for methotrexate to work?
3 to 6 weeks
142
How to take methotrexate
Best on empty stomach, but can take with food if nausea
143
More common side effects of methotrexate 4
** think**
Think: cell toxicity
Most common: mouth sores (stomatitis)
Next: GI NVD
Increase risk of infection
Sun sensitivity
Hair loss - remember chemo drug
144
How is methotrexate dose for RA
Once weekly with or without food
* take folic acid on off day
** make sure patient understand it is once weekly and not daily - can be fatal
145
Can I get pregnant and impregnate a women while on methotrexate? Or when?
No. Birth defects. Make sure to use a reliable birth control method
Women - do not get pregnant for 6 months after last dose
Men - wait for 3 months after last dose
** young adult - consult to use a reliable birth control **
146
Can methotrexate cause infertility
Yes. Decrease sperm counts, menstrual problem. These may not be reversible
147
System affected by methotrexate 4
1. Liver - monitor yellowing of the eye, dark urine
2. Lung - difficulty breathing, coughing
3. Kidney - report edema ankle
* NSAID should be avoid
4. Skin - mouth sores, Sun sensitivity
148
Methotrexate warning 8
* just for reading
Fetal harm - birth defects
* do not get pregnant
* women 6 months
* men wait 3 months
Allergic reaction - skin, tongue lip swelled
Increase infection risk
* report new fever
Gastrointestinal
* can cause ulceration - report bloody or black tarry stool
* mouth sores
* report severe abdomen pain
Hepatotoxic
Lung: report coughing breathing sx
Skin rash - Sun sensitivity
Kidney- report any changes in urine output more or less
149
Summary for methotrexate 4
Once weekly with or without food
Must not get pregnant or get a woman pregnant
A lot of warning- review all the warnings
Reduce inflammation, joint pain, slow down the process of RA
150
What is RA in simple term
The body’s own immune system attacking your joint, especially the joint cartilage or lining
* autoimmune disease *
151
Organs affected by semaglutide 7
This will related to its side effects
Pancreas - pancreatitis (report upper stomach pain going to the back)
Thyroid- risk for thyroid cancer (rat)
Gallbladder- gallstone
Kidney- decrease function output
Liver - report jaundice
Heart - increase HR & resting HR (report)
GI: n, v, d or decrease appetite (most common side effects)
152
Mexiletine 2 things to associate
Nausea- take with food, tums or antacid
Liver damage- jaundice, lab work
153
Calcitriol is used in hypoparathyroidism
What is hypoparathyroidism?
Low parathyroid hormones PTH
* low PTH causes low calcium and high phosphate in the blood
What is the main function of PTH?
* causes release of calcium from bone into blood stream
* cause absorption of calcium from food by intestines
* decrease calcium excretion (preserve calcium)
What is the role of calcium?
1. Build strong bone & teeth
2. Plays a role in clotting
3. Send nerves signal
4. Muscle contraction & relaxation
154
Is semaglutide liver toxicity?
Rybelsus
Ozempic
Wegovy
Yes. Monitor jaundice
155
Strattera
Drug class and moa explain
NERI = a NE reuptake inhibitor
* increase NE level in brain
This increase in NE = increase ATTENTION spam and FOCUS
Also Increase NE = reduce HYPERACTIVITY and IMPULSIVE behavior
156
Brimonidine
Drug class and moa simplify
Alpha 2 adrenergic agonist
Works 2 ways (alpha 2)
* decrease production of fluid
* increase fluid outflow
157
Midodrine
Drug class and moa simplify
Alpha agonist
Alpha agonist causes vasoconstriction - get increase blood pressure
