Top Drugs Quiz 5 Flashcards
(29 cards)
Finasteride (Proscar)
Class: 5α-Reductase Inhibitor
Approved Indications: Benign prostatic hyperplasia, Male pattern alopecia
Contraindications: Hypersensitivity to finasteride, pregnancy, children
Common Adverse Rxns: Impotence, reduced libido
Efficacy MP: dec. residual urine vol., inc. urine flow for BPH; inc. hair growth for alopecia
Toxicity MP: PSA, BP, breast/prostate cancer development
Nitrofurantoin (Macrobid)
Class: Nitrofuran Antibiotic
Approved Indications: UTI treatment & prophylaxis
Contraindications: Hypersensitivity to nitrofurantoin, use in neonates or pregnant at 38-42 wks
Common Adverse Rxns: N/V, HA, discolored urine
Efficacy MP: Resolved infection within 2-3 d
Toxicity MP: Diarrhea, jaundice, unusual bruising/bleeding, blistering skin rash, or SOB. Signs of pulmonary rxn, numbness/tingling of extremities. With long-term use, CBC, LFTs, SCr
Simvastatin (Zocor)
Class: HMG-CoA Reductase Inhibitor
Approved Indications: Hyperlipidemia, 1 & 2 preventions of AS CVD, 2 prevention of CVD events, Familial hypercholesterolemia (homo)
Contraindications: Hypersensitivity to simvastatin, active liver disease, pregnancy and lactation
Common Adverse Rxns: None
Efficacy MP: Reduced cholesterol & triglycerides levels; inc. in HDL levels. Obtain baseline & fasting lipid panel 4-12 wk after start & every 3-12 mo thereafter
Toxicity MP: Obtain baseline LFTs, SCr, and BUN. Repeat LFTs if signs of hepatotoxicity. Consider CPK in pt w symptoms of myopathy
Buspirone (Buspar)
Class: Antianxiety Approved Indications: Anxiety Contraindications: Hypersensitivity Common Adverse Rxns: Dizziness Efficacy MP: Reduction of anxiety Toxicity MP: Signs and symptoms of withdrawal upon abrupt dose reduction or D/C
Celecoxib (Celebrex)
Class: Cyclooxygenase-2 Inhibitor
Approved Indications: OA, RA, Ankylosing spondylitis, Acute pain, primary dysmenorrhea
Contraindications: Asthma, urticaria, or allergic rxn following aspirin or NSAIDs; CABG surgery, treatment of perioperative pain, hypersensitivity to sulfonamides
Black Box: GI toxicity, cardiotoxicity, CABG
Common Adverse Rxns: HT, HA, GI distress, diarrhea
Efficacy MP: Dec. pain and improved motion
Toxicity MP: CBC, LFTs, SCr, fecal occult blood tests, BP, skin rash, black stools, swelling or weight gain, severe pain, jaundice, change in urination
Budesonide/formoterol (Symbicort)
Class: Inhaled Corticosteroid/Bronchodilator Combo
Approved Indications: Asthma & COPD
Contraindications: Hypersensitivity to budesonide or formoterol; primary treatment of status asthmaticus or acute episodes of asthma or COPD
Black Box: Asthma deaths; pediatrics, risk of hospitalized
Common Adverse Rxns: Upper respiratory tract infections
Efficacy MP: Monitor PFTs. Resolved asthma symptoms
Toxicity MP: Growth velocity in pediatric pt during prolonged therapy; alternative therapy/seek treatment if paradoxical bronchospasms occur
Clopidogrel (Plavix)
Class: Platelet Aggregation Inhibitor
Approved Indications: Acute ST segment elevation MI managed medically (without PCI) & non–ST segment elevation MI, Thrombosis prevention in AS vascular disease, following stroke, in peripheral arterial occlusive disease
Contraindications: Hypersensitivity to clopidogrel and active bleeding
Black Box: Reduced CYP2C19 fx
Common Adverse Rxns: HA
Efficacy MP: Prevention of thrombotic events
Toxicity MP: Signs/symptoms of bleeding, especially with concomitant anticoagulant therapy
Trazodone (Desyrel)
Class: Antidepressant
Approved Indications: Depression
Contraindications: Hypersensitivity, use of MAOI
Black Box: Suicidal ideation, not for use in children
Common Adverse Rxns: Dizziness, sedation, HA, N/V, somnolence, xerostomia
Efficacy MP: Improvement in depression
Toxicity MP: Worsen depression, suicidality, or unusual changes in behavior, especially at start of therapy or w dosage inc. or dec. Irregular HR in pt with cardiac disease and/or risk factors associated with QTc prolongation. Signs/symptoms of peripheral edema, inc. HR, liver damage; Monitor ECG, LFT, SCr, BUN, serum Na, & vitals
Levothyroxine (Synthroid)
Class: Thyroid Supplement
Approved Indications: Hypothyroidism, Thyroid-stimulating hormone suppression, pituitary
Contraindications: Hypersensitivity, nontoxic diffuse goiter/nodular thyroid disease, thyrotoxicosis, acute MI, treatment of obesity/weight loss, uncorrected adrenal insufficiency; may precipitate acute adrenal crisis
Black Box: Not for weight reduction
Efficacy MP: Serum TSH, T(3), & T(4) levels. Resolution of hypothyroidism, fatigue, edema, hair loss, cold intolerance, & lethargy
Toxicity MP: Monitor pt w preexisting CVD for exacerbation of symptoms
Zolpidem (Ambien)
Class: Nonbarbiturate Hypnotic. C-IV
Approved Indications: Insomnia, short-term treatment
Contraindications: Hypersensitivity, history of complex sleep behavior
Black Box: Risk of complex sleep behaviors (sleepwalking, sleep driving, etc)
Common Adverse Rxns: Dizziness, drowsiness, HA
Efficacy MP: Improved ability sleep through night. Inc. daytime alertness
Toxicity MP: Severe drowsiness, thoughts of suicide, allergic rxn, irregular respiratory rate, fast or irregular heartbeat
Carvedilol (Coreg)
Class: Class: α/β-Adrenergic Blocker
Approved Indications: HF, HT, Impaired LV fx post-MI
Contraindications: Hypersensitivity, bronchial asthma, severe sinus bradycardia, 2nd- or 3rd-degree AV block, sick sinus syndrome, overt HF, cardiogenic shock, severe hepatic impairment
Common Adverse Rxns: Cold extremities, dizziness, ED, fatigue, hypotension, weight gain
Efficacy MP: Dec. BP and HR, reduced chest pain, dec. # weekly angina attacks, reduced use of prophylactic nitroglycerin, improved signs/symptoms of HF
Toxicity MP: Signs/symptoms of HF, bronchospasm, inc./dec. blood glucose levels in diabetic patients, and hepatotoxicity
Levetiracetam (Keppra)
Class: Anticonvulsant
Approved Indications: Myoclonic seizure, Partial seizure, Tonic-clonic seizure, 1 generalized
Contraindications: Hypersensitivity
Common Adverse Rxns: Asthenia, fatigue, HA, somnolence, vomiting
Efficacy MP: Reduced freq. and severity of seizures
Toxicity MP: Emergence or worsening of depression, suicidal behavior or ideation, or unusual changes in behavior, WBC, LFTs
Atenolol (Tenormin)
Class: β-Adrenergic Blocker, Cardioselective
Approved Indications: Angina pectoris, chronic, HT
Contraindications: Hypersensitivity to atenolol, severe sinus bradycardia, 2- or 3-degree AV block, overt heart failure or cardiogenic shock
Black Box: Avoid abrupt withdrawal
Common Adverse Rxns: Bradyarrhythmias, cold extremities, dizziness, fatigue, hypotension, depression
Efficacy MP: Dec. BP, reduced chest pain, dec. # weekly angina attacks, reduced use of prophylactic nitroglycerin, improvement in signs/symptoms of HF
Toxicity MP: Signs/symptoms of heart failure, dec. HR; Monitor serum electrolytes and renal fx at baseline & periodically
Metformin (Glucophage)
Class: Biguanide, Hypoglycemic
Approved Indications: Diabetes mellitus, Type 2, Polycystic ovary syndrome
Contraindications: Hypersensitivity to metformin, contrast media, eGFR, metabolic acidosis
Black Box: Lactic acidosis
Common Adverse Rxns: Diarrhea, malabsorption, N/V, asthenia, flatulence
Efficacy MP: HbA1c <7%, monitored every 3-6 mo
Toxicity MP: Measure renal fx beyond SCr (measurement of eGFR) prior to start & annually thereafter, CBC at start & annually thereafter, B12 levels every 2-3 y; Severe skin rash, muscle weakness or pain, jaundice, unusual bruising or bleeding
Venlafaxine (Effexor)
Class: Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor
Approved Indications: Generalized anxiety disorder, Depression, Panic disorder, Social anxiety disorder
Contraindications: Hypersensitivity; MAOIs
Black Box: Suicidal ideation
Common Adverse Rxns: Dizziness, HA, insomnia, nausea, somnolence, xerostomia, weakness
Efficacy MP: Improved depression, anxiety, & panic
Toxicity MP: Worse depression, suicidality, or unusual changes in behavior, especially at start of therapy or w dosage inc./dec.; signs/symptoms of abnormal bleeding, serotonin syndrome, hyponatremia; Monitor BP, LFT, serum cholesterol levels, serum Na
Diltiazem (Cardizem)
Class: Calcium Channel Blocker
Approved Indications: HT, Angina, Atrial arrhythmia & paroxysmal supraventricular tachycardia
Contraindications: Hypersensitivity to diltiazem; hypotension; 2-/3-degree AV block, sick sinus syndrome
Common Adverse Rxns: Edema, HA
Efficacy MP: Dec. BP, dec. chest pain, dec. # angina attacks, reduced use of nitroglycerin
Toxicity MP: Signs/symptoms of HF, liver toxicity; low HR, exacerbations of angina pectoris or acute coronary insufficiency while tapering chronic therapy
Propranolol (Inderal)
Class: β-Adrenergic Blocker, Nonselective
Approved Indications: Angina pectoris, Cardiac dysrhythmia, HT, Migraine, prophylaxis
Contraindications: Hypersensitivity to propranolol; asthma; sinus bradycardia, AV block, sick sinus syndrome, cardiogenic shock
Black Box: Avoid abrupt withdrawal
Common Adverse Rxns: Hypotension
Efficacy MP: Dec. BP, chest pain, # angina attacks, nitroglycerin use, signs/symptoms of CHF, reduced tremors, freq. of migraines
Toxicity MP: Signs/symptoms of CHF, dec. HR, bronchospasm, inc. FPG, exacerbations of angina pectoris or acute coronary insufficiency; Monitor HR & BP
Donepezil (Aricept)
Class: Central Cholinesterase Inhibitor
Approved Indications: AD, dementia
Contraindications: Hypersensitivity to donepezil or piperidine derivatives
Common Adverse Rxns: Asthenia
Efficacy MP: Improvement in Alzheimer-type dementia; however, only slowed decline may be seen
Toxicity MP: Symptoms of active or occult GI bleeding
Amlodipine (Norvasc)
Class: Calcium Channel Blocker
Approved Indications: HT, stable & variant Angina
Contraindications: Hypersensitivity to amlodipine
Common Adverse Rxns: Peripheral & pulmonary edema
Efficacy MP: Dec. BP, reduced chest pain, dec. # weekly angina attacks, reduced use of prophylactic nitroglycerin, improved signs/symptoms of HF
Toxicity MP: Signs/symptoms of peripheral edema, inc. HR, LFTs
Hydroxyzine (Atarax)
Class: Antihistamine
Approved Indications: Anxiety, Pruritus, Sedation
Contraindications: Hypersensitivity to cetirizine or hydroxyzine
Efficacy MP: Improved symptoms for indication
Toxicity MP: Signs of severe CNS toxicity
Naproxen (Naprosyn)
Class: NSAID
Approved Indications: OA, RA, Gout, Fever, Pain
Contraindications: Hypersensitivity to naproxen & NSAIDs, aspirin or sulfonamides; asthma or allergic rxn, CABG surgery, treatment of perioperative pain
Black Box: Cardiovascular and GI risk; thrombotic events
Efficacy MP: Dec. pain & improved range of motion
Toxicity MP: Skin rash, black stools, chest pain, jaundice, change in urination; Monitor CBC, LFTs, SCr, fecal occult blood tests, BP (if pt has HT)
Lisdexamfetamine (Vyvanse)
Class: Amphetamine, CNS Stimulant. C-II
Approved Indications: ADHD, Binge eating disorder
Contraindications: Hypersensitivity/idiosyncrasy to sympathomimetic amines; MAOIs; symptomatic CVD or advanced AS; HT; hyperthyroidism; glaucoma; agitated states; history of drug abuse
Black Box: Risk of abuse, misuse, diversion
Common Adverse Rxns: Insomnia, irritability, loss of appetite, upper abdominal pain, xerostomia
Efficacy MP: Improvement of ADHD or in binge eating
Toxicity MP: Cardiac evaluation if known or suspected cardiac disease. BP and HR should be evaluated at baseline, follow-up at 1-3 mo & every 6-12 mo
Hydrochlorothiazide (Microzide)
Class: Thiazide Diuretic, Antihypertensive
Approved Indications: Edema, HT
Contraindications: Hypersensitivity to hydrochlorothiazide or sulfonamide, concomitant dofetilide therapy, or anuric pt
Common Adverse Rxns: Hypotension, dizziness, HA
Efficacy MP: Dec. BP, reduced edema
Toxicity MP: Dec. serum and urine electrolytes, dec. renal fx, inc. serum uric acid or blood glucose. Skin rash, jaundice, dec. urine output, or symptoms of gout
Lamotrigine (Lamictal)
Class: Phenyltriazine Anticonvulsant
Approved Indications: Bipolar I disorder, Partial seizure, tonic-clonic seizure, Lennox-Gastaut syndrome
Contraindications: Hypersensitivity
Black Box: Serious skin rxns
Common Adverse Rxns: Rash, ataxia, somnolence, HA, diplopia, rhinitis, N/V, insomnia
Efficacy MP: Seizure severity and freq. Dec. manic/depressive symptoms
Toxicity MP: SCr, LFTs
