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
2
Q
Zolpidem
How to take it?
A
Take right before bedtime on Empty Stomach
- for faster onset
3
Q
Zolpidem common side effects 2
A
Drowsy, dizzy and next day somnolence (extremely tire)
* caution driving
Diarrhea
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
5
Q
Zolpidem
Why is women dose lower than men?
A
Women’s ability to clear zolpidem is lower than men
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
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
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
9
Q
Can I take zolpidem if I drink alcohol that evening?
A
No
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
11
Q
Can zolpidem affect my behaviors?
A
Yes.
Zolpidem can cause behavioral change
* more aggressive
* more outgoing
Can cause depression and suicidal thoughts
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
13
Q
Zolpidem consultation 5
A
- For insomnia, take right before bedtime on empty sleep
- May cause next day sedation, drowsy and dizzy
- May cause diarrhea
- Report abnormal sleep behavior such as sleep walking, sleep driving or performing activity while not fully awake
- Do not take zolpidem if you have alcohol that evening
14
Q
Amoxicillin
Drug class & types of infection
A
Penicillin
Good for
* ENT (ear, nose &throat) infections
* lower respiratory tract infection
15
Q
Amoxicillin max dose
A
45 mg/kg per day
- last dispense 12 years old 4000 mg per day
16
Q
Amoxicillin common side effects 2
A
Think GI: NVD
Rash
17
Q
Amoxicillin plus birth control
A
Amoxicillin can decrease effectiveness of birth control
- use back up method
18
Q
Amoxicillin moa
A
Binds to penicillin binding protein - prevent cell wall formation
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
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
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
22
Q
Augmentin treats what type of infection
A
ENT infection
Skin infection
Lower respiratory tract infection
UTI
23
Q
Augmentin common side effects 2
A
GI: nausea and diarrhea
Skin rash
24
Q
Penicillin VK
Types of infection
A
Upper respiratory tract infection
Pneumonia
Skin infection
Pharyngitis
25
Penicillin VK
How to take?
Take with or without food
* best absorb on empty stomach
Penicillin VK - potassium salt makes it acid resistant in stomach acid
26
Penicillin VK side effects
Nausea
Vomiting
Diarrhea
27
Ampicillin
Drug class
What does it treat differently?
Ampicillin is a penicillin
Treats
1. Gonorrhea - STD that can cause infection of mouth, throat and rectum
2. Meningitis
3. Respiratory tract (same as other penicillin)
28
How to take ampicillin
Take on empty stomach with full glass of water
1 hour before or 2 hours after meal for BEST absorption
29
Dicloxicillin
Drug class and how it is different
Dicloxicillin is a penicillinase resistant penicillin
* resistant to beta lactamase
* also acid resistant
30
How to take dicloxacillin
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
31
Metformin moa
Works 3 different ways to help diabetes
1. Decrease liver glucose production
2. Decrease intestinal glucose absorption
3. Increase insulin sensitivity in peripheral (muscle)
32
Can metformin cause hypoglycemia
No.
33
Metformin warnings 3
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
34
Metformin side effects 3
Main: diarrhea
Nausea vomiting
Gas or bloating
35
Metformin consultation 4
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
36
Metformin
Max dose and effective dose
Max: 2550 mg per day
Dose less than 1500 mg not clinical effective
37
Can metformin be use in pregnancy?
Yes.
* insulin is still first line agent
38
Furosemide
Consultation Tips
Take with Food in morning for water retention & HBP
May cause: frequent urination, dizziness and nausea
Makes you more sensitive to sunlight
39
Furosemide
Drug class
Moa
Potent LOOP diuretic
* inhibit absorption of Na & Cl
40
Furosemide
Loop diuretic warnings
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
41
Furosemide
Common side effects 3
1. Frequent urination
2. Dizziness & headache
3. Nausea
42
Chlothalidone consultation tips
1. Take in morning with Food
2. Cause frequent urination & dizziness
3. Alcohol increase risk for dizziness
43
Chlothalidone
Drug class and moa
Loop diuretic
* long duration (48 to 72 hours)
Low toxicity
Inhibit absorption of Na and Cl
44
Chlothalidone warnings 3
1. Hypokalemia
2. Hyperuricemia - gout
3. Decrease magnesium
45
Symptoms of Hypokalemia 5
1. Excess thirst
2. Tired, drowsy
3. Muscle cramps & pain
4. Nausea vomiting
5. Increase HR
46
Bumetanide
Drug class
Unique?
Potent loop diuretic
What makes it different?
* rapid onset and short duration
* blocks absorption of Cl more than Na
*** chlothalidone is long duration
47
Bumetanide side effects 3
1. Muscle cramps
2. Dizzy
3. Headache & nausea
48
How to take Bumetanide
Take with or without Food
49
Bumetanide warnings 4
1. Dehydration
2. Hypokalemia
3. Ototoxicity (very rare)
4. Sulfa allergy
50
Hydrochlorothiazide
Drug class and moa
Thiazide diuretic
Blocks absorption of Na and Cl in distal tubules
** this additional Na is exchanged for K
Can lead to Hypokalemia
51
Hydrochlorothiazide indication
Hypertension
* volume depletion returns to normal long term treatment
* vascular resistant decrease remain
52
How to take hydrochlorothiazide
Take with or without food
53
Contraindication to hydrochlorothiazide
Sulfa allergy
54
Hydrochlorothiazide
Side effects
OSH dizziness
Feel weak in general
Sun sensitivity
55
Hydrochlorothiazide and uric acid
HCTZ decrease excretion of uric acid leading to hyperuricemia
* may cause gout
56
Hydrochlorothiazide warnings 2
1. Acute myopia (nearsightedness) or glaucoma
** report any changes in vision or eye pain
2. Can increase glucose level - monitor sugar level
57
Indapamide
Brand & drug class
Indication
Lozol - a thiazide diuretic
* inhibit distal tubules reabsorption of Na
For hypertension and edema
58
How to take indapamide
Take with or without food
59
Indapamide
Common side effects 4
Nausea abdominal pain
Fatigue; muscle weakness
Dizzy OSH
Sun sensitivity
60
Metolazone
Brand & drug class
Indication
Zaroxolyn
Thiazide-like diuretic
* inhibit Na reabsorption
For edema and hypertension
61
How to take metolazone
Take with or without food
** seems all thiazide diuretic can be taken this way
62
Metolazone common side effects 3
Mostly well tolerated
1. Nausea
2. Dizzy OSH
3. Increase HR
** watch for sulfa allergy
63
2 electrolytes affected by Metolazone
Decrease Magnesium level
Increase calcium level
** decrease Na level
64
Are zaroxolyn and mykrox interchangeable?
No, both are Metolazone
Mykrox is rapid dissolve and rapidly bioavailability
65
Myrbetriq (mirabegron)
Drug class and indication
Urinary antispasmodic
For overactive bladder OAB
66
How to take Myrbetiq
Take once daily with or without food
Do not crush or chew swallow whole
* missed dose: have 12 hours to take missed dose
67
Myrbetiq moa
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
68
Are Myrbetiq and Myrbetiq granules interchangeable?
No not interchangeable on a mg to mg basis
69
Myrbetiq common side effects 5
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)
70
What is nasopharyngitis?
Pain or swelling of nose and throat
Sx: sneezing, coughing, stuffy nose and sore throat
71
Myrbetiq warnings 3
1. Increase BP
2. Urinary retention in patients with urinary obstruction or patient taking antimuscarinic
3. Angioedema - swelling of face or tongue
72
Myrbetiq consultation tips 5
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
73
Vesicare (solifenacin)
Drug class
Antimuscarinic for OAB
* relaxes bladder smooth muscle
74
How to take vesicare
Once daily with or without food
* swallow whole do not crush or chew
75
Vesicare warnings 4
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
76
Vesicare side effects
Think: dry mouth and constipation
Increase UTI
Drowsy, blurred vision
77
Vesicare consultation tips
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
78
Moujaro has duel mechanism; mimics GIP and GLP-1
What is GIP and GLP-1?
Both are hormones produced in the gut in response to eating food
Both reduce appetite and cause release of insulin
79
Bepotastine “bed-po-tastine”
Bepreve
Class & moa
Antihistamine; mast cell stabilizer
* inhibit histamine release from mast cell
* stops your body from reacting to allergens that can irritate the eye
80
Bepotastine
Bepreve
* common side effects
Think: unpleasant taste in mouth
Other side effects:
* eye irritation
* headache
* nasopharyngitis (common cold symptoms)
81
Bepotastine (bepreve)
Dosing frequency
Twice daily
82
Atorvastatin
Moa simplify
Inhibit HMG-CoA reductase
* enzyme responsible for making cholesterol
Stops liver production of cholesterol
83
Atorvastatin indication 2
1. Cholesterol
2. Reduce risk of stroke, heart attack or angina, & revascular surgery
* stabilize plaque but will not clean arteries; prevent new plaques buildup
84
Atorvastatin contraindication 1
Pregnancy and lactation
85
Atorvastatin warnings 2
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
86
Atorvastatin 2 most common side effects
And others
Think: nasopharyngitis
* nose irritation and sore throat
Joint pain
Others: diarrhea
Increase UTI
87
How to take atorvastatin
Take with or without food; do not crush or chew
Take anytime
Avoid grapefruit
88
Atorvastatin
How much grapefruit to limit?
Less than 1 liter
89
Atorvastatin alcohol limit
Limit alcohol to 2 glass or less
* atorvastatin can cause liver toxicity and alcohol can increase risk of liver toxicity
90
Atorvastatin patients consultation 3
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
91
Simvastatin indication 2
1. High cholesterol
2. Reduce risk of stroke, heart attack or revascularization procedure in high risk patients
92
How to take simvastatin?
Take in EVENING with or without food
* avoid grapefruit
Compare to atorvastatin:
* atorvastatin can be taken anytime
93
Simvastatin side effects
* most common
* other
Most common: increase upper respiratory infection (bronchitis) and HEADACHE
Other: GI symptoms Nausea, constipation, abdominal pain
94
Simvastatin contraindication 2
1. Use with CYP3A4 inhibitor
* azole antifungal
* azithromycin
2. Use with cyclosporine and gemfibrozil
Gemfibrozil can cause rhabdo
95
Simvastatin warnings 2
1. Myopathy and rhabdo
2. Liver toxicity increased LFT
96
Is it recommended to use Simvastatin and gemfibrozil?
No. Contraindication
97
Simvastatin plus (verapamil, diltiazem, Multaq)
* what does to not exceed
Simvastatin 10 mg
98
Simvastatin plus (amiodarone, amlodipine, ranolazine)
What dose not to exceed?
Simvastatin 20 mg max
99
Omeprazole
Indication and age limit
1. Ulcer
2. GERD
3. H Pylori adjunct
** can be use in patients > 1 year old
100
Omeprazole
Common side effects 3
HEADACHE and ABDOMINAL pain
Others: NVD
101
How to take omeprazole?
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
102
Omeprazole consultation tips 5
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
103
Can omeprazole cause kidney problem?
Yes. Report if you notice decreased urine production or blood in urine
* acute tubulointerstitial nephritis **
104
Can omeprazole cause diarrhea?
Yes. Can cause C. Dif
Report watery diarrhea, stomach pain especially with fever that does not go away
105
Omeprazole warnings 5
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
Omeprazole
2 drug interactions listed under warnings
1. Plavix - avoid taking at same time
2. MTX - increase mtx level
107
Explain plavix and omeprazole interaction
Decrease plavix effectiveness
* decrease conversation of plavix to its active metabolite
108
Difference between esomeprazole and omeprazole?
Omeprazole contains both omeprazole isomers
Esomeprazole maybe more effective in acid suppression
109
Famotidine
Moa and indication 2
Histamine2 receptor antagonist
* H2-RA
1. Ulcer
2. GERD
110
How to take famotidine
Take with or without food
* can be given with antacid
111
Famotidine common side effects
HEADACHE and Dizziness
Other: constipation or diarrhea
112
What does concomitant mean
Take at same time
113
Famotidine warnings 2
1. CNS adverse reaction in elderly and patient with decreased renal function
** confusion, hallucination
2. QT prolongation
* report palpitations, fainting or dizziness
114
Famotidine and tizanidine drug interaction
Increase Tizanidine level - can cause hypertension, low HR, excessive drowsy
115
Can tizanidine cause QT prolongation?
Yes
Report symptoms: palpitations, fainting and dizziness
116
Metoprolol
How to take metoprolol
Take with food or immediately after food
117
Metoprolol indication 3
1. Hypertension
2. Angina (chest pain)
3. MI
118
Is metoprolol beta1 selective
Yes.
Metoprolol is cardioselective B1
119
Metoprolol common side effects
TIRED and Dizzy
Diarrhea 5%
Decrease HR (monitor)
SHB (report)
120
Metoprolol patient information 4
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
Metoprolol warnings 5
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
Atenolol indication 3
1. HBP
2. Angina
3. Acute MI - once patient is stable
123
How does beta blockers help Angina and Acute MI
Beta blockers reduce oxygen requirements of HEART
124
How to take atenolol
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
Atenolol common side effects
1. TIRED and Dizzy
Nausea or diarrhea
Decrease HR (monitor)
126
Atenolol consultation 4
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
Atenolol warnings 8
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
Anesthesia and beta blockers interaction
* major surgery
Anesthesia reduces amount of oxygen deliver to heart
This cause HR to slow down
Beta blockers also slow down HR
129
Buspirone indication
Anxiety
130
Buspirone moa
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
Buspirone warnings 2
1. Caution with driving - may cause DD
2. Alcohol - avoid taking at same time
132
Buspirone patients inflammation 4
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
Carvedilol
2 indication
1. Hypertension
2. Chronic HEART FAILURE
134
Carvedilol moa
Alpha-1 and Beta-1 and Beta-2 receptor antagonist
135
How to take carvedilol
Take with food to decrease dizziness
* slows rate of absorption to decrease OSH*
136
Carbidopa patients information 4
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
Carvedilol warnings 5
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
Bystolic generic name
Nebivolol
139
Is bystolic beta selective
Bystolic is beta1 selective at dose less than 10 mg
140
Bystolic (nebivolol) indication
HBP - to reduce risk of stroke and MI
141
How to take Bystolic (nebivolol)
Take with or without food
** metoprolol is take with food or immediately after meal
142
Bystolic (nebivolol) common side effects 2
FATIGUE
Headache and Dizziness
143
What makes Bystolic different than other beta blockers?
Bystolic = BI = 2 moa
Exerts Nitric oxide vasodilation and Beta blockade
144
Bystolic warnings 4
*** same as other beta blockers **
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
Bystolic consultation tips 3
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
Labetalol Moa
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
How to take labetalol
Take with or without food
*** but, be consistent ***
Food increase bioavailability
148
Labetolol indication
HYPERTENSION
**** safe and used in PREGNANCY ***
Different than other beta blockers
149
Labetalol patient information 3
1. Do not stop abruptly
2. Report worsening of HF (SHB)
3. Report liver toxicity (jaundice, abdominal pain)
150
Labetalol common side effects 3
DIZZINESS - due to alpha blocker
Fatigue - same as other beta blockers
** Nausea - different
151
Labetalol warnings 5
What is different about labetalol in the warnings
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
What is intrinsic sympathomimetic ISA activity?
Refers to beta blockers that are actually weak AGONIST of one or more beta adrenergic subtype
153
What makes labetalol different than other beta blockers?
1. Used in PREGNANCY
2. Has alpha 1, beta 1 and beta 2 blockers
** same as Coreg **
154
Propranolol
Moa
Non-Selective beta blocker
155
Propranolol indications 5
1. Hypertension
2. Angina
3. Atrial fibrillation
4. MI
5. Migraine prophylaxis
156
Propranolol common side effects
FATIGUE and DIZZY
Constipation
Impotence
Alopecia
157
How to take propranolol regular tablet and propranolol ER
Propranolol tablets: take BEFORE meals
Propranolol ER (Inderal LA)
** take with or without food, consistent
** take at night at 10 pm
158
Propranolol warnings 6
* which warnings is different compared to other beta blockers
** 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
How does phenazopyridine work
Moa unknown
Cause a local analgesic effect on the mucosa of the urinary tract
160
How long should you take phenazopyridine
Do not take more than 2 days
161
Phenazopyridine pt information 3
Take with food to decrease nausea
May change urine color: red orange
Do not take more than 2 days
162
Phenazopyridine common side effects 3
NAUSEA - take with food
Change in urine or fece color
* orange red
Headache
163
Hydroxychloroquine indication 3
Rheumatoid arthritis RA
Malaria, treatment and prevention
lupus
164
Hydroxychloroquine dosing in RA
Once daily with Food
165
Hydroxychloroquine common side effects
GI: NAUSEA VOMITING DIARRHEA and AP
166
Hydroxychloroquine warnings 8
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
How to take hydroxychloroquine
Take WITH FOOD air milk
Do not crush or divide
168
Ondansetron indication
NAUSEA
169
Ondansetron common side effects 3
HEADACHE and FATIGUE
diarrhea or constipation
170
Ondansetron moa
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
How does it take for ondansetron to work?
30 minutes
172
Ondansetron warnings 4
1. Hypersensitivity or allergic rxn
* anaphylaxis, bronchospasm
2. QT prolongation
* avoid drugs causing QT prolongation
3. Serotonin syndrome
4. Chest pain or tightness
173
Symptoms of QT prolongation 2
1. Change in heart rate
2. Feeling of lightheaded or fainting
174
Symptoms of anaphylaxis rxn or hypersensitivity 3
1. Fever or chills
2. RASH
3. Breathing problem
175
Pantoprazole
Indication
GERD
176
Pantoprazole common side effects 2
HEADACHE
DIARRHEA and abdominal pain
177
How to take pantoprazole
Pantoprazole can be taken with or without food
** other PPI: take 30 minutes prior to meal
178
Can I take pantoprazole and antacid together?
Yes
179
Pantoprazole warnings 7
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
MTX plus PPI interaction
Increase MTX level: can be toxicity
181
Lansoprazole indication 3
Ulcer
H Pylori
GERD
182
How to take lansoprazole
Take 30 minutes before food
183
Lansoprazole interaction with Sucralfate and antacid
Antacid + Lansoprazole = okay
Sucralfate + Lansoprazole = separate by 30 minutes
184
Lansoprazole can be open and sprinkle into ____ or mix with ___ juice?
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
Lansoprazole common side effects 3
ABDOMINAL PAIN and HEADACHE
Diarrhea
186
Do not take lansoprazole if taking rilpivirine
* contraindication
Name 2 drugs that you see have rilpivirine
Think HIV medications
1. Complera
2. Odefsey
187
Pantoprazole warnings 8
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
Cefdinir (Omnicef) indication 5
1. CAP
2. BRonchitis
3. Sinus, tonsil, pharyngitis
4. EAR infection (pediatric)
5. Skin infection
189
Cefdinir moa
Binds to penicillin binding protein (PBP), inhibit cell wall synthesis
** is stable in the presence of some, but not all, beta lactamase enzyme
190
How do I take cefdinir?
Can be taken with or without food
But avoid antacid and iron at same time, decrease absorption
191
Cefdinir warnings 2
1. Cross-sensitivity with patients allergic to penicillin
** 10%
2. C Dif
192
I’m allergic to penicillin, what is the cross-sensitivity reaction percentage?
10%
Both are still beta lactam antibiotics
193
Cefdinir common side 2
DIARRHEA 15%
Nausea
194
Cefdinir + antacid interaction
Space 2 hours
195
Cefdinir + iron supplement
Avoid, space by 2 hours
196
Cefdinir patient consultation 4
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
Cephalexin indications 5
1. Respiratory tract infections
2. Ear infection
3. Skin infection
4. Bone infection
5. Genitourinary tract infections
198
Cephalexin common side effects 3
NVD and AP
Dyspepsia
199
Cephalexin and metformin interaction
Cephalexin can increase metformin level
200
Cephalexin warnings 3
1. Allergic reaction
2. C. Dif
3. Seizure potential
* use lower dose in renal impairment
201
What is dyspepsia
Upper abdominal discomfort
Describe as burning sensation, bloating or gas, nausea
Feeling full too quickly
202
Cefpodoxime brand name
Vantin
203
Cefpodoxime indication 4
Bronchitis
CAP
UTI
Ear, Nose and Throat infections
204
Cefpodoxime common side effect
DIARRHEA
NVD
205
How to take Cefpodoxime and why
Take with FOOD to increase absorption
206
Cefpodoxime warnings 2
1. Cross sensitivity reaction
2. C Dif
207
Cefuroxime brand name
Ceftin
208
Cefuroxime indication 5
** what indication is different
1. ENT infection
2. Bronchitis
3. Skin infection
4. UTI
5. Gonorrhea **** 1000 mg one dose
209
Cefuroxime dosing frequency
Every 12 hours
210
Cefuroxime common side effects 2
NVD
Increase LFT
211
Cefuroxime warnings
** same as others
1. Cross sensitivity 10%
2. C Dif
212
Can you interchange Cefuroxime tablet and oral suspension?
No.
Cefuroxime tablets and suspension are not interchangeable on a mg to mg basis
213
How do I take Cefuroxime?
Can be taken with or without food
Food is more tolerable
** food does increase bioavailability but no clinical significance
214
Why you should not crush Cefuroxime tablets
Has a strong persistent bitter taste
Not recommended to crush but contact MD to change to oral suspension
215
Drug interaction with Cefuroxime
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
Sucralfate indication 1
Ulcer
217
Sucralfate moa
Forms a protective layer at site of ulcer
218
Sucralfate common side effect 1
Constipation
219
How to take Sucralfate
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
What is hctz use for (2)?
Blood pressure
Edema
221
Hctz drug class
“Thiazide “ diuretic
222
HCTZ moa
Inhibit sodium chloride cotransporter in renal distal convoluted tubule
* inhibit reabsorption of Na
* water will follow Na
223
How to take HCTZ
With or without food
224
2 risks of using hctz
Increase risk of gout - increase uric acid level
Can increase glucose levels
* especially diabetes
225
HCTZ side effects 3
Dizzy
Muscles cramps
Sun sensitivity
Other includes
HA and fatigue
226
Electrolytes affected by HCTZ
Decrease in: potassium, chloride, sodium and magnesium
Increase in: calcium, uric acid, blood glucose and lipid
227
2 to remember with HCTZ
Decrease potassium and increase uric acid (gout risk)
Dizziness
228
Explain doxazosin + sildenafil interactions
Decrease blood pressure
* only if approved by doctor
Doxazosin - vasodilation
Sildenafil - vasodilation
229
Doxazosin moa
Alpa1 blockers- relaxes smooth muscles of bladder and prostate
Also relaxes peripheral smooth muscles = vasodilation
* cause OSH
230
Doxazosin indicated 2
1. BPH
* see AZO
2. HBP
231
Doxazosin common se 3
Dizzy
Fatigue (tired)
Headache
** all related to alpha1 blockers
This asshole (doc azo) doc gave me headache, feel tired and Dizzy
232
Doxazosin serious SE 2
Priapism
* erection longer than 4 hours
OSH
233
Doxazosin tips 4
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
How to take doxazosin
Take with or without food anytime of the day morning or night
235
First time taking doxazosin, what to warn patients
Do not drive for next 24 hours
236
Cardura XL indicates and how to take it
Only indicated for BPH
* not high blood pressure
Take in morning
237
Alfuzosin brand name
Uroxatral
238
Alfuzosin indicated
BPH only
239
Alfuzosin dosing
Once daily
240
Alfuzosin side effects 2
Dizzy and Headache
* all related to alpha blocker and vasodilation
241
Alfuzosin moa
Alpha1 blocker - relaxes smooth muscle of bladder and prostate
242
How to take Alfuzosin
* compared with tamsulosin
Alfuzosin MUST be taken WITH FOOD
* for better absorption
Tamsulosin is taken 30 minutes after same meal each day
243
Alfuzosin pharmacist tips 3
Must be taken with food
Cause dizziness and headaches OSH
Caution in patient with moderate to severe LIVER problems
244
Alfuzosin and liver problems?
Caution use of Alfuzosin in patients with liver disease
245
How long does it take Alfuzosin to work?
Couple days to months
246
Alfuzosin risks 5
OSH
Drug interactions
* with Biaxin HIV medications
Liver problems
QT prolongation- heart problems
Priapism
247
Does tamsulosin have lots of drug interactions
Yes
248
Tamsulosin what is it for and how to take it
BPH
Take once daily 30 minutes after same meal each day, swallowing whole
249
Tamsulosin moa
Alpha 1 blocker
Relaxes smooth muscle of bladder and prostate - making urination easier
More specific for alpha receptors of bladder and prostate
250
Tamsulosin serious SE 3
Rash, hives - due to sulfa allergy
OSH - alpha 1 blocker vasodilation
Priapism - vasodilation
251
Tamsulosin common SE 3
Headache and dizziness
Stuffy nose
Sexual side effects: abnormal ejaculation, decrease sex drive, priapism
252
Tamsulosin pharmacist’s tip 3
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
Alcohol and tamsulosin
Alcohol increases risk of side effects dizziness and decreased BP
254
Terazosin
Drug class and moa
Alpha 1 blocker
Relax smooth muscle of bladder and prostate, also peripheral blood vessels - this causes OSH
255
Terazosin
Indication 3
BPH
PTSD
Decrease BP - not first choice
256
Terazosin consultation tips 2
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
Terazosin common side effect 1
CNS: HA, dizzy and fatigue
258
Terazosin risk or serious SE
Priapism
