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Signer 36th Flashcards

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1
Q

Abacavir, Dolutegravir, Lamivudine

A 
Triumeq 
I: HIV (Antiretroviral)
Monitor: LFT, CD4+ cell count 
DDI: CYP3A4 Inducer
CI: HLA-B*5701, liver
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2
Q

Acetaminophen + Codeine

A 
Tylenol #2, 3, 4, Capital
C - III Opioid Analgesic
One or two tablets q3-4h PRN
DI: CNS depression (avoid alcohol) 
SE: dizziness, drowsiness, constipation, N/V, excessive sweating 
Take with food to avoid GI upset
*habit forming
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3
Q

Acyclovir

A

Zovirax
HSV1, shingles

Herpes: 200mg PO q4 x 10days (total: 5 capsules)
Shingle: 800mg q4-5h (7-10days) within 72hrs of rash

Avoid sexual intercourse (HSV) + lesion

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4
Q

Albuterol Sulfate (inhalation)

A

Proventil, Ventolin, Proair
Bronchodilator Asthma, COPD
HFA Inhaler: 90mcg per spray
1-2 inhalations q4-6h PRN (2 inhalations QID)
Exercise: 2 inhalations 15min, prior to exercise

DDI: sympathomimetics (TCA, MAOI)
SE: N/V, nervousness, insomnia, tremor, tachycardia, palpitations (think of NE)
Shake before each inhalation, clean mouthpiece at least once a week

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5
Q

Albuterol Sulfate (oral)

A

Proventil
2-4mg TID - QID (max. 32mg/day)
SE: tremor, nervousness

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6
Q

Alendronate

A

Fosamax
Osteoporosis
10mg QD or 70mg QW
*Doses must be swallowed whole with plain water immediately upon arising (at least 30min. prior to breakfast). Not lie down for 30 min. after.
DDI: calcium and antacids may decrease absorption
SE: abdominal pain, constipation, diarrhea, flatulance, musculoskeletal pain

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7
Q

Alfuzosin Hydrochloride

A

Uroxatral
Benigh prostatic hyperplasia (BPH) - alpha 1 adrenergic receptor inhibitor
1 tablet QD with food, same meal QD
Monitor: BP
DDI: CYP3A4 inhibitor
SE: dizziness, H/A, hypotension,syncope
Take with food, at the same time, same day

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8
Q

Allopurinol

A

Zyloprim
Gout
200mg to 300mg per day
Gout attacks may increase during initiation of therapy, use colchicine or NSAID prophylactically, drink fluid to prevent precipitation of urates (kidney stones)
SE: drowsiness (avoid alcohol), diarrhea, nausea, vomiting, abdominal pain, rash

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9
Q

Alprazolam

A 
Xanax CIV
Antianxiety, panic disorders 
Benzodiazepines 
0.25mg - 0.5mg initially, given TID
Do NOT d/c abruptly - withdrawal symptoms
CI: CNS depressants, opioids (resp. depression, coma, death) - avoid alcohol 
SE: drowsiness, hypotension
Beer’s List
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10
Q

Amantadine HCl

A

Symmetrel
Parkinson’s Disease - increase DA
100mg PO BID
CI: anticholingeric increase SE: anticholingeric effects (Nausea, dizziness, insomnia, anxiety, dry mouth, dry nose)
Do not abruptly d/c - withdrawal (neuroleptic malignant syndrome - muscle rigidity, autonomic dysfunction, tachycardia)

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11
Q

Amiodarone (a mee ow dr own)

A

Cordarone, Pacerone, Nexterone
Antiarrhythmics - Class III (K channel blocker)
Maintenance dose is 400mg
Monitor: Liver, pulmonary function
DDI: increase effect of warfarin, phenytoin, digoxin, quinidine, procainamide, disopyramide. CYP 3A4 inibitors and inducers

Beer’s List

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12
Q

Amitriptyline (a muh trip tuh leen)

A

Elavil
TCA: Depression - inhibit reuptake of NE, Serotonin
40mg - 150mg at bedtime
CI: < 12 yo, MAOI, antidepressant increase suicidal thoughts and actions in children, adolescents, young adults
SE: tachycardia, dry mouth, N/V, H/A, urinary retention, drowsiness (T: thrombocytopenia, C: cardiac (arrhythmia, MI, stroke), A: Anticholinergic, S: seizures)

Beer’s List

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13
Q

Amlodipine

A 
Norvasc
CCB - HTN
2.5mg - 10mg QD
SE: peripheral edema, flushing, h/a, palpitation, reflex tachycardia, gingival hyperplasia
Safest in HF (lowering BP)
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14
Q

Amlopdipine Besylate + Benazepril HCl

A

Lotrel
Lowest dose of Amlodipine to avoid peripheral edema
CI: pregnancy, h/o angioedema, within 36 hr of Entresto
SE: cough, hyperkalemia, hypotension, renal impairment, bilateral renal artery stenosis (avoid)

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15
Q

Amoxicillin Trihydrate

A

Amoxil, Moxatag, Trimox
1st line: acute otitis media (Pediatric:90mg/kg/day)
DOC: infective endocarditis prophylaxis before dental procedure (2g PO x1, 30-60min before)
Gram negative (H. Influenza, E.coli, N. Gonorrhoeae) Gram positive (Adult: 250mg to 500mg q8hr or 500mg to 875mg q12hr
CI: severe renal impairment (CrCl < 30), beta lactam allergy
SE: seizure with accumulation, GI upset, diarrhea, rash (SJS/TEN)
Taken on empty stomach, complete full course of therapy, shake/keep suspension refrigerated (discard after 14 days)

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16
Q

Amoxicillin/Clavulanate Potassium

A 
Augmentin, Augmentin XR
500mg q8h or 875mg q12h
Taken at the start of a meal
CI: renal 
SE: seizure, diarrhea (C.diff)
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17
Q

Amphetamine/Dextroamphetamine

A

Adderall, Adderall XR
ADHD
C II - RX can NOT be refilled
Stimulant - block NE/DA
Dosed qAM, do NOT need to be tapered off
BW: misuse cause sudden death, serious CV event
CI: < 6yo
SE: resetleness, dizziness, insomnia, tremor, h/a, palpitation, tachycardia

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18
Q

Anastrozole

A

Arimidex
Block conversion of androgen to estrogen (Breast cancer - hormone based chemo) - Aromatase Inhibitor
Postmenopausal women - 1mg daily
*higher risk of osteoporosis, higher risk of CVD compared to SERM
SE: hot flashes/night sweats, arthralgia/myalgia

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19
Q

Apixaban

A

Eliquis
Anticoagulant - Oral Direct Factor Xa Inhibitor
Nonvslvular AFib (stroke prophylaxis): 5mg PO BID
2 of the following: > or equal to 80 yo, body weight < or equal to 60kg, or SCr > or equal to 1.5 - give 2.5mg BID
Treatment of DVT/PE: 10mg BID x 7 days, then 5mg BID
BW: pt receiving neuraxial anesthesia - risk of hematomas or paralysis
CI: active pathological bleeding, prosthetic heart valve
SE: bleeding
NO MONITORING OF EFFICACY
Antidote: andexanet alfa (Andexxa)

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20
Q

Aripiprazole

A

Abilify (Abilify Maintena - IM: monthly, Aristada - IM: q4-8wks)
Antipsychotic - second generation
SE: Akathisia (inability to sit still, restlessnesses), activating
CI: dementia related psychosis - suicidal thoughts
QT prolongation

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21
Q

Atenolol

A

Tenormin
Hypertension for pts with post-MI, stable ischemic heart disease, heart failure
25mg - 100mg QD
BW: do not d/c abruptly; taper down
W: worsen glycemia, mask hypoglycemic symtoms, caution with asthma, COPD, Raynaud’s
SE: bradycardia, fatigue, hypotension, dizziness, depression, impotence

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22
Q

Atomixerine HCl

A

Strattera
ADHD - Non stimulant (second line)
SNRI
Children > 70kg: target dose is 80mg qAM or qPM
BW: suicidal ideation risk
CI: MAOI within the past 14 days
SE: decreased appetite, insomnia, somnolence, dry mouth, hypertension, tachycardia (increased NE)

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23
Q

Atorvastatin

A

Lipitor
Hyperlipidemia
CI: pregnancy, lactating , liver disease
SE: HMG, photosensitivity
H: hepatic
M: muscle damage (myopathy, rhabdomyolysis)
higher risk with elderly, higher dose, used with fibrate (Gemfibrozil)
G: glucose

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24
Q

Azelastine HCl (nasal)

A

Astelin, Astepro
Antihistamine
Allergy
2 sprays per nostril BID: prime by pumping 4 times, no additional priming unless more than 3 days lapses between doses
SE: May cause drowsiness
Missed dose: skip, return to normal dosing schedule

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25
Azithromycin Dihydrate
Macrolide - atypical, CA-Resp. tract infection, chlamydia, gonorrhea Zithromax, Z-pak Z-pak: 500mg on day 1, then 250mg on days 2-5 Tri-pak: 500mg QD x 3 days CI: liver W: QT prolongation, hepatotoxicity SE: GI upset - take with food
26
Baclofen
``` Lioresal Muscle relaxant - GABA 10-20mg TID-QID SE: CNS depression - drowsiness (avoid alcohol) Contain PKU - disintegrating tablets ```
27
Benazepril HCl
``` Lotensin Antihypertensive - ACE Inhibitor Initial: 10mg QD CI: pregnancy, lactating, within 36 hra of Entresto SE: cough, angioedema, hyperkalemia ```
28
Benzonatate
Tessalon Antitussive 100mg TID PRN (>10 yo) SE: drowsiness, h/a, constipation, nausea, pruritus, nasal congestion, sensation of burning in the eyes
29
Benztropine Mesylate
Cogentin Anti-arkinson Agent - antihistamine/ anticholinergic 1mg - 4mg QD or BID PO or IV, CI: pregnant, BPH SE: anticholinergic, numbness of finger, depression, nervousness, CNS depression May take with food, avoid exposure to hot weather Beer’s List
30
Bictegravir, emtricitabine, and tenofovir alafenamide
Biktarvy 1st line HIV-1 - One pill/once daily SE: increase SCr, renal function, decrease bone mineral density CI: CrCl < 30 - do not start, st. john’s wort Test for hep B before treatment
31
Bimatoprost
Lumigan, Latisse Glaucoma agent (prostaglandin) - decrease IOP 1 drop in the affected eye or eyes QD in the evening SE: permanently change the pigmentstion and growth of the eyelashes/lids Lie down or tilt head backward and look up, drop solution inside lower lid, and make sure dropper does not come in comtact with eye or fingers. Wait at least 5 min. before instilling other preparation, remove contact lenses prior
32
Bisoprolol Fumarate with Hydrochlorothiazide (HCT)
Ziac Antihypertensive - beta 1 selective blocker, hct 1 tablet daily in the morning (increased diuresis) SE: fatigue, h/a, dizziness, diarrhea Take with food or milk if GI Upset, avoid abrupt withdrawal from therapy, mask hypoglycermic symptoms, avoid excessive exposure to sunlight.
33
Brimonidine Tartrate
Alphagen P Glaucoma agent - alpha 2 adrenergic agonist (reduction of production/increase output) 1 drop in the affected eyes three times daily (approx. 8 hrs apart) CI: MAOI SE: allergic conjunctivitis, conjunctival hyperemia, eye pruritis Monitor: IOP Lie down or tilt head backward and look up. Holding the dropper above the eye, drop solution inside lower eyelid, making sure the dropper does not come in contact with the eye or finger. Keep the eye open for at least 30 seconds, and apply pressure to the inside corner of eye for at least 1 min.
34
Budesonide (inhalation)
Pulmicort Inhaled corricosteroids (Antiasthmatic) - asthma, COPD 180mcg (children) or 360mg (adult) BID 1 - 4 inhalation BID SE: dysphonia (difficulty speaking), oral candidiasis (thrush), cough Rinse mouth with water and spit out after each use to prevent trush; can use spacer device Use on a regular basis. 1) twist off white cover 2) twist brown base to right and then left until click 3) inhale forcefully and deeply
35
Budesonide and Formoterol Fumarate Dihydrate (inhalation)
Symbicort COPD, asthma 2 inhalation twice daily Rinse mouth after each use Not intended to provide immediate releif of bronchospasm - use on a regular basis
36
Bumetanide
Bumex Diuretic - loop diuretic Warning - sulfa allergy SE: decrease Ca, K, Mg, Na, Cl, increase UA, TC, BG, HCO3, ototoxicity orthostatic hypotension, photosensitivity Monitoring: renal, fluid status, BP, electrolyte, audiology testing Equal dosing: furosemide (40) = torsemide (20) = bumetanide (1) = ethacrynic acid (50)
37
Buprenorphine with Naloxone
``` Suboxone C-III REMS Opioid dependence Partisl opioid agonist/antagonist Target dose - 16mg QD sublingual SE: drowsiness, CNS depressant, h/a, constipation, nausea, sweating Do not d/c abruptly ``` Habit forming
38
Bupropion
``` Wellbutrin, Forfivo XL, Zyban (REMS) - TCA Antidepressant IR - TID SR - BID XL - QD MAX: 450mg/day ``` DDI: MAOI, linezolid, IV methylene blue, other form of bupropion (renal accumulation - seizure) CI: seizure, h/o bulimia/anorexia SE: druy mouth, CNS stimulstion (insomnia, restlessness), tremor/seizure, weight loss Increase suiciadal thoughts and actions in children, adolescents, and young adults
39
Buspirone
Buspar Antianxiety 5HT1A, 5HT2 Start 7.5mh BID, Max 30mg BID CI: MAOI - Serotonin syndrome SE: dizziness, drowsiness, h/a, nausea, excitement No potential for abuse, tolerance, or physiological dependence
40
Butalbital, Acetaminophen, Caffeine
``` Fioricet Analgesic 1-2 tsbd/caps q4hr PRN (max: 6) X children < 12 SE: dizziness, drowsiness, lightheadedness May take with food to avoid GI upset ``` Habit forming Beers List
41
Calcitriol
Rocaltrol, Calcijex Vitamin D3 - hypocalcemia (liver and kidney) CI: hypercalcemia, vitamin D toxicity SE: N/V, diarrhea, hypercalcemia, hyperphosphatemia Monitoring: calcium, phosphorus, PTH Take with food or shortly after a meal to decrease GI upset
42
Calcium Acetate
``` Phoslo Phosphate binder - hyperphosphatemia ESRD: 2 capsules/tablets with each meal DDI: chelates - tetracycline, fluroquinolones CCI: hypercalcemia SE: nausea, vomiting, hypercalcemia ``` Take with food or meal Do not d/c without first consulting MD Do not take additional calcium supplements
43
Canaglifozin
``` Invokana DM - SGLT2 inhibitors proximal renal tubules - increase excretion of glucose 100mg QD prior to first meal eGFR <30: not recommended ``` CI: dialysis W: ketoacidosis, genital mycotic infections, urosepsis and pyelonephritis, necrotizing fasciitis of the perineum, hypotension, AKI (vol. depletion), increased risk of leg and foot amputation, risk of fracture SE: weight loss, inceased urination and thirst * reduction in HF and CKD progression
44
Carbamazepine
``` Tegretol, Tegretol XR, Carbatrol ER, Equetro ER Anticonvulsant- narrow spectrum Initial: 200mg BID Max: 1600mg/day Therapeutic range: 4-12mcg/ml ``` BW: serious skin reaction, HLA-B*1502, aplastic anemia, agranulocytosis CI: myelosuppression W: hyponatremia (SIADH), fetal harm SE: dizziness, drowsiness, N/V Monitoring: CBC (+platelet), electrolyte (Na) CYP3A4 Inducer and autoinducer Take with food/milk
45
Carbidopa with Levodopa
Sinemet, Sinemet CR, Rytary (ER), Duopa (enteral suspension) Antiparkinson - (precursor of DA, inhibits dopa decarboxylase enzyme) - prevents peripheral metabolism of levodopa IR: 25/100mg PO TID CI: non-selective MAOI within 14 days SE: nausea, dizziness, orthostasis, dyskinesia, hallucination, psychosis can cause brown, black, or dark discoloring of urine Coomb’s test: d/c (hemolysis risk) unusual sex urge, priapism ***70-100mg of carbidopa needed Long term - fluctuations in response and dyskinesia (involuntarily mvnt) Do not abruptly d/c
46
Carisoprodol
``` Soma Muscle relaxant Tablet: 250-350mg TID QHS SE: drowsiness, dizziness, h/a If missed dose, skip. DDI: additive with alcohol or CNS depressants ```
47
Carvedilol
Coreg, Coreg CR Antihypertensive - nonselective beta blocker 12.5mg BID CI: NYHA Class IV decompensated cardiac failure, asthma or COPD, AV Block, severe bradycardia SE: dizziness, diarrhea, bradycardia, hypotension, hyperglycemia, visual abnormalities Take with food to decease orthostasis Do not d/c abrutply
48
Cefdinir
Omnicef 3rd generation ceohalosporin PO CI: PCN allergy SE: Risk of seizure if accumulation (renal adjustment), GI upset, diarrhea, rash
49
Cefuroxime Axetil (oral)
Ceftin 2nd generation cephalosporin CI: pcn allergy SE: risk of seizure if accumulation occurs (renal dysfunction), GI upset, diarrhea, rash Complete full course of therapy unless otherwise directed
50
Celecoxib
Celebrex NSAID - lower risk for GI, increased risk for MI/stroke, renal Osteoarthiritis: 200mg QD or 100mg BID Rheumatoid: 100-200mg BID CI: sulfonamide allergy *highest COX-2 selectivity Avoid in pregnancy
51
Cephalexin
Keflex 1st generation cephalosporin PO: 250-500mg q6-12h CI: pcn allergy SE: seizure risk (accumulation), n/v, diarrhea, hives, itching, rash Take it on empty stomach with water Complete full course of therapy unless otherwise directed
52
Chlorhexidine Gluconate
Peridex, Periogard Treatment of gingivitis (oral rinse) - gram+/- BID oral rinsing for 30 seconds, morning and evening after brushing teeth SE: stain oral surface, change taste perception, increase calculus formation, minor irritation of oral mucosa Do not swallow, rinse with water following use Use after meals and after brushing teeth
53
Chlorthalidone
Hygroton Inhibit Na and Cl reabsorption Diuretic - adjunctive therapy in edema (HF) 50mg QD or 100mg Every other day HTN 25mg QD initially, increase to 50mg to 100mg per day CI: hypersensitivity to sulfonamide-derived drugs SE: decrease K, Mg, Na incresse Ca, UA, LDL, TG, BG photosensitivity, impotence, dizziness, rash Monitor: electrolyte, renal function Thiazide are not effective if CrCl < 30 Take early in the morning to avoid nocturia
54
Cilostazol
Pletal Platelet inhibitor 100mg BID Cyp3A4 inhibitor CI: congestive HF SE: h/c, diarrhea, abnormal stool, palpitation, dizziness Noticeable improvement may take up to 12 weeks to appear. Take on empty stomach, at least 30 min before or 2 hr after meals X grapejuice
55
Ciprofloxacin HCL
Cipro, Cipro XR 250mg - 750mg PO q12h CrCl 30-50: q12h CrCl < 30: q18-24h Bw: tendon inflammation and/or rupture, peripheral neuropathy, CNS effect: seizure, tremor, restlessness, confusion, hallucination, depression, paranoia, nightmares, insomnia, increased intracranial pressure Warning: QT prlongation, hypo/hyper-glycemia, psychiatric disturbance, avoid in children/pregnancy/lactation due to musculoskeletal toxicity, photosensitivity, hepatotoxicity SE: n/d, h/a, dizziness, serious skin reaction Cipro suspension: shake vigorously x 15 sec before each use, X through NG or other feeding tube Antacid and other polyvalent cation can chelate and inhibit quinolone absorption Lanthanum (Fosrenol) and sevelamer (Renvela, Renagel) - decrease concentration of quinolone Increase warfarin, SU, insulin [ ]
56
Ciprofloxacin (ophthalmic)
Ciloxan Solution: Use 1 - 2 drops into the conjunctival sac q2h while awake for 2 days and 1-2 drops q4h while awake for the next 5 days Ointment: 1/2 inch to conjunctival sac TID X 2 days, then BID for the next 5 days SE: burning or discomfort Wait at least 5 min before instilling other opthalmic preparation
57
Ciprofloxacin with Dexamethasone (otic) - otitis
CiproDex 4 drops instilled into the affected ear twice a day for 7 days Suspension: Shake/warmed in the hand SE: ear discomfort, pain, pruritus Complete full course of therapy unless other wise directed
58
Citalopram HBr
Celexa Antidepressant - SSRI Initial: 20mg QD and gradually increase to 40mg QD (MAX) The full effect may not be seen until 4 weeks Do not abruptly d/c DDI: MOAI, linezolid CI: increase suicidal thoughts and actions in children, adolescents, and young adults SE: nause, dry mouth, somnolence, insomnia, diarrhea, impotence, diaphoresis, weakness, dizziness, h/a Take it in the morning * QT prolongstion: do not exceed 20mg/day in elderly (>60yrs), liver disease * bleeding (additive risk) * SIADH/hyponatremia, fall risk
59
Clindamycin
``` Cleocin Gram + including CA MRSA and anaerobes No renal adjustments required ‘ BW: colitis (C.difficile) SE: N/V/D, rash, urticaria, increase LFTs ``` ``` Induction test (D-test) should be performed S. Aureus (S - clindamycin but R - erythromycin) flattened zone between the disk (positive D-test) indicates inducible clindamycin resistance and clindamycin should not be used ```
60
Clobetasol Propionate
Temovate Corticosteroid Short term treatment - gently rub in affected area BID for no more than 2 consecutive weeks SE: local burning and itching Do not use with occlusive dressings

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