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Dispensing Exam 3 > Transdermals and related drugs > Flashcards

Transdermals and related drugs Flashcards

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1
Q

rate of diffusion through the skin?

A

Flux

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2
Q

Adhesive matrix?

A

drug is evenly distributed, can be cut in half, contains a release liner, and drug is released from the adhesive

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3
Q

Reservoir matrix?

A

cannot be cut in half because the drug would leak, adhesive on both sides, has a rate controlling membrane, and reservoir filled with drug formulation

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4
Q

Nitroglycerin indications:

A

vasodilators indicated for prevention of angina pectoris

will not relieve acute attack

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5
Q

Nitroglycerin side effects:

A

headache due to vasodilation

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6
Q

2 nitroglycerin Trades?

A

Minitran and Nitro-Dur

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7
Q

Minitran details?

A 
nitroglycerin
•	0.1 mg/hr
•	qday
•	Adhesive matrix
•	Minimize tolerance by wearing for 12 hours → remove for 12 hours
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8
Q

Nitro-Dur details?

A

nitroglycerin
• qday
• Adhesive matrix
• Minimize tolerance by wearing for 12 hours → remove for 12 hours

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9
Q

Ranexa generic?

A

ranolazine

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10
Q

ranolazine Trade and details?

A

Ranexa
vasodilator (not relieve acute attack)
• 500 and 1000 mg TABLET
• BID

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11
Q

Estrogen hormone for hormone replacement therapy?

A

estradiol

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12
Q

hot flash order of events?

A

• Loss of ovarian estrogen secretion after menopause → instability of thermoregulation → hot flash

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13
Q

inflammation of the vagina due to thinning/shrinking of tissues

A

atrophic vaginitis

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14
Q

painful intercourse

A

dyspareunia

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15
Q

2 BBW for estradiol?

A
  • BBW: increases risk of CVD and dementia in post-menopausal women
  • BBW: increase risk of endometrial cancer in pre-menopausal women
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16
Q

estradiol indications?

A

• Indicated for vasomotor symptoms, vaginal atrophy, and osteoporosis (exception: Menostar)

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17
Q

5 Trades for estradiol transdermal products?

A

Climara, Vivelle-Dot, Alora, Minivelle, Menostar

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18
Q

Climara details?

A

estradiol
• qweek
• 0.025, 0.0375, 0.05, 0.06, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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19
Q

Vivelle-Dot details?

A

estradiol
• twice weekly
• 0.025, 0.0375, 0.05, 0.06, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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20
Q

Alora details?

A

estradiol
• twice weekly
• 0.025, 0.05, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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21
Q

Minivelle details?

A

estradiol
• twice weekly
• 0.0375, 0.05, 0.075, 0.1 mg/24 hours
• Adhesive matrix

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22
Q

Menostar details?

A 
estradiol
•	qweek
•	0.014 mg/24 hours
•	Only indicated for osteoporosis
•	Adhesive matrix
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23
Q

estradiol (only) other products - 6

even eating dicks feels very eerie

A

Estrasorb, Evamist, Divigel, Femring, Vagifem, Estrace

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24
Q

Estrasorb details?

A

estradiol
• 2 packets qAM
• Topical emulsion
• 0.05 mg/2 packets: one packet each leg for 3 minutes, excess on buttocks
• Indicated for VM
• Alcohol USP is used as a P.A.E.
• Contains soybean oil; do not take if allergic to peanuts

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25
Evamist details?
``` estradiol • 1 spray qday • 0.021 mg/spray transdermal spray • Indicated for VM • Spray on inside of arm • Alcohol USP and octisalate are the percutaneous absorption enhancers ```
26
Divigel details?
estradiol • qday • 0.1% topical gel: 0.25, 0.5, 1 g packets of gel • Indicated for VM • Apply one packet to upper thigh • Alcohol USP is used as a percutaneous absorption enhancer
27
Femring details?
``` estradiol • q3months • Vaginal ring • 0.05 and 0.1 mg/24 hours • Indicated for VM and VA ```
28
Vagifem details?
``` estradiol • 10 mcg vaginal tablet • Indicated for VA • Initial: 1 tablet qday x 2 weeks • Maintenance: 1 tablet twice weekly ```
29
Estrace details?
``` estradiol • 0.1 mg/g vaginal cream • Indicated for VA • Initial: qday x 2 weeks → after 2 weeks use ½ dose qday x 2 weeks • Maintenance: 1-3x/week ```
30
conjugated equine estrogens Trade?
Premarin Vaginal Cream
31
Premarin Vaginal Cream generic and details?
conjugated equine estrogens • BIW 0.625mg/g vaginal cream • Indicated for VA • derived from pregnant horse urine
32
Climara Pro generic and details?
estradiol, levonorgestrel • Qweek • Adhesive matrix • Indicated for VM and O
33
estradiol, levonorgestrel Trade?
Climara Pro
34
estradiol norethindrone Trades?
CombiPatch and Activella
35
CombiPatch details?
``` estradiol, norethindrone • Twice weekly • Adhesive matrix • Indicated for VM and VA • Refrigerate in the pharmacy ```
36
Activella details?
``` estradiol, norethindrone • qday • 0.5 mg/0.1 mg tablet • 1 mg/0.5 mg tablet • Indicated for VM, VA, and O ```
37
Ortho Evra generic and details?
``` ethinyl estradiol, norelgestromin • qweek • Adhesive matrix • Indicated for contraception • Apply 1 patch qweek x 3 weeks → patch-free for 1 week → repeat ```
38
ethinyl estradiol, norelgestromin Trade?
Ortho Evra
39
Testosterone produced by men?
5mg/day
40
synthetic derivatives of testosterone?
anabolic steroids
41
anabolic steroid legislation?
Anabolic Steroids Control Act- makes all CIII drugs
42
decreased activity of the gonads → insufficient secretion of testosterone → no libido ?
``` male hypogonadism (Libido - sex drive) ```
43
testosterone drug BBW:
secondary exposure in women and children can cause virilization → wash hands after use
44
testosterone drug interactions:
testosterone decreases anticoagulant and insulin requirements
45
testosterone Trades? (5) | Adam always tries fornication annually
Androderm, AndroGel, Testim, Fortesta, Axiron
46
Androderm details?
``` testosterone • qday • 2 mg/24 hours and 4 mg/24 hours • *****Reservoir patch • Contains alcohol USP • Do not use the same site more than once per week → irritation ```
47
AndroGel details?
testosterone • Qday • Single dose packet: 2.5 g, 5 g = 25 mg, 50 mg testosterone → 2.5 mg, 5 mg absorbed via the shoulder • Metered dose pump: 1% (1 pump=12.5 mg x 4 pumps) = 50 mg → 5 mg absorbed via the shoulder, 1.62% (1 pump=20 mg x 2 pumps) = 40 mg testosterone → 4 mg absorbed via the shoulder
48
Testim details?
testosterone • qday • 5 g single dose packets = 50 mg testosterone → 5 mg absorbed
49
Fortesta details?
testosterone • qday • Metered dose pump • 2 pumps applied to each thigh to minimize secondary exposure • 1 pump = 10 mg testosterone x 4 pumps = 40 mg → absorb 4 mg
50
Axiron details?
``` testosterone • qday • Topical solution • Metered dose pump: 1 pump = 30 mg testosterone x 2 pumps (1 under each arm) = 60 mg → 6 mg absorbed • Contains alcohol USP ```
51
clonidine Trades?
Catapres TTS and Kapvay
52
Catapres TTS details?
``` clonidine • qweek • 0.1, 0.2, 0.3 mg/24 hours • Reservoir system • Indicated for hypertension • Transdermal Therapeutic System • Optional adhesive overlay to keep patch on ```
53
Kapvay details?
clonidine • BID (maintenance) • 0.1 mg and 0.2 mg ER tablet • Indicated for ADHD
54
Fentanyl Trades?
Duragesic, Actiq, Onsolis, Fentora, Abstral, Lazanda
55
Duragesic details
``` fentanyl • q72h • 12.5, 25, 50, 75, 100 mcg/hr • ***Reservoir system • Indicated for chronic pain (12 hour onset) • Contains alcohol USP • Fold over on itself to discard ```
56
Actiq details
``` fentanyl • q4h • Transmucosal lozenge on a stick • Rub on side of cheek for 15 minutes • Hold under hot water to dissolve ```
57
Onsolis details?
``` fentanyl • q2h • Transmucosal buccal film • Applied to the inside of the cheek • Flush down toilet to discard ```
58
Fentora details?
fentanyl • q4h • Buccal tablet • Flush down toilet to discard
59
Abstral details?
fentanyl • q2h • Sublingual tablet • Flush down toilet to discard
60
Lazanda details?
``` fentanyl • q2h • Nasal spray • 1 spray in 1 nostril • Spray extra into provided pouch → place in child resistant container → discard ```
61
First transdermal system?
scopolamine
62
scopolamine indications?
prevention of nausea and vomiting
63
2 directions for scopolamine?
* Motion sickness: place behind ear 4 hours before needed; may leave on 3 days * Surgery: apply patch the evening before surgery
64
directions for after application of scopolamine?
* Wash hands thoroughly after applying or removing because it may cause mydriasis * Most common side effect is dry mouth and drowsiness
65
scopolamine Trade and details?
Transderm-Scop • 5 mcg/hr • Anticholinergic agent • Adhesive matrix
66
lidocaine Trade?
Lidoderm
67
Lidoderm details?
``` lidocaine • qday -5% • Adhesive matrix without a P.A.E. • Local anesthetic • Indicated for pain associated PHN • Apply up to 3 patches/day at the same time; put one on for 12 hours, then remove for 12 hours ```
68
gabapentin Trade?
Neurontin
69
Neurontin generic and details?
gabapentin | • Indicated for PHN and partial seizures
70
pregabalin Trade?
Lyrica
71
Lyrica generic and details?
pregabalin | • Indicated for PHN, partial seizures, DPN, and fibromyalgia
72
Chicken pox vaccine?
Varivax - varicella vaccine | for children and adults
73
shingles vaccine?
Zostavax - zoster vaccine | prevents reactivation of the varicella virus, must be 50+ years old
74
Anticholinergic indication, symptoms, and side effects:
can be used for overactive bladder • Symptoms: urinary incontinence, urgency, and frequency • Side effects: xerostomia, constipation, sedation, mydriasis, and hyperthermia
75
Trades of oxybutynin?
Oxytrol, Ditropan, Ditropan XL, Gelnique | anticholinergics
76
Oxytrol details?
oxybutynin (anticholinergic) • Twice weekly • 3.9 mg/24 hours transdermal • Adhesive matrix
77
Ditropan details?
oxybutynin (anticholinergic) IR tablet ER tablet - Ditropan XL
78
Gelnique details?
oxybutynin (anticholinergic) • qday • 10% topical gel • Individually wrapped packets of gel → applied to abdomen • Contains percutaneous absorption enhancer
79
tolterodine Trade?
Detrol, Detrol LA | anticholinergic
80
Detrol generic?
tolterodine IR - tablet Detrol LA - tolteridone ER - CAPSULE anticholinergic
81
trospium Trade?
Sanctura, Sanctura XR | anticholinergic
82
Sanctura generic and details?
trospium IR tablet - empty stomach Sanctura XR - tropsium ER capsule - empty stomach anticholinergic
83
darifenacin Trade?
Enablex | anticholinergic
84
Enablex generic?
darifenacin | anticholinergic
85
solifenacin Trade?
Vesicare | anticholinergic
86
Vesicare generic?
solifenacin | anticholinergic
87
Toviaz generic?
fesoterodine | anticholinergic
88
fesoterodine Trade?
Toviaz | anticholinergic
89
mirabegron Trade?
Myrbetriq
90
Myrbetriq generic and details?
mirabegron • relaxes bladder smooth muscle • Beta-3 agonist • NOT anticholinergic
91
methylphenidate Trade?
Daytrana
92
Daytrana generic and details?
``` methylphenidate • qday • 10, 15, 20, 30 mg/9 hours • Adhesive matrix • Indicated for ADHD • Wear on hip 2 hours before needed, then take off 9 hours later • CII ```
93
selegiline Trades?
Emsam, Eldepryl, Zelapar
94
Emsam generic and details?
``` selegiline • qday • 6, 9, 12 mg/24 hours • Adhesive matrix • MAOI antidepressant • Indicated for depression • Be careful with tyramine if taking 9 mg or 12 mg; avoid pseudoephedrine and phenylephrine ```
95
Eldepryl generic and details?
selegiline (MAOI) • Capsule • Antiparkinson’s agent
96
Zelapar generic and details?
selegiline (MAOI) • ODT • Antiparkinson’s agent
97
granisetron Trade?
Sancuso | antiemetic
98
Sancuso generic and details?
granisetron • qweek • 3.1 mg/24 hours - Adhesive matrix • Antiemetic - Indicated for N/V patients receiving chemotherapy for 5 straight days; works in the CTZ • Apply on upper arm 24 hours before first treatment → take off 24 hours after last treatment • May cause phototoxic reaction:avoid sun exposure for 10 days after removal
99
Aloxi generic?
palonosetron | antiemetic
100
palonosetron Trade?
Aloxi | antiemetic
101
Anzemet generic?
dolasetron | antiemetic
102
dolasetron Trade?
Anzemet | antiemetic
103
Zofran generic?
ondansetron
104
ondansetron Trade?
Zofran
105
Emend generic?
aprepitant | antiemetic
106
aprepitant Trade?
Emend | antiemetic
107
Cholinesterase Inhibitors indication?
Alzheimer's Disease inhibit cholinesterase → increase ACh levels in the brain o Side effect: N/V if dose is too high
108
rivastigmine Trade?
Exelon Patch | cholinesterase inhibitor
109
Exelon generic and details?
``` rivastigmine • qday • 4.6, 9.5 mg/24 hours • Adhesive matrix • 4.6 mg x 1 month, then increase to 9.5 mg as maintenance dose • Apply patch in the middle of the back ```
110
Aricept generic?
donepezil | cholinesterase inhibitor
111
Razadyne generic?
galantamine | cholinesterase inhibitor
112
donepezil Trade?
Aricept | cholinesterase inhibitor
113
galantamine Trade?
Razadyne | cholinesterase inhibitor
114
buprenorphine Trades?
Butrans and Buprenex | + non-trade sublingual tab
115
Butrans details?
buprenorphine • qweek • 5, 10, 20 mcg/hour • Adhesive matrix • Opioid analgesic • Once patch is removed do not use the same skin for 3 weeks • 10 and 20 mcg/hour are used in opioid intolerant patients
116
Buprenex details?
parenteral buprenorphine | opioid analgesic
117
oral buprenorphine
opiod analgesic • Sublingual tablet • Indicated for addiction
118
diclofenac epolamine Trade?
Flector Patch
119
Flector generic and details?
``` diclofenac epolamine (patch) • BID • 1.3% adhesive matrix • NSAID → inhibits cyclooxygenase-2 • Indicated for strains (stretched muscle) and sprains (stretched ligament) • Do not use if allergic to aspirin ```
120
smoking cessation generics?
buproprion, varenicline, nicotine
121
buproprion Trade?
Zyban | smoking cessation
122
Zyban generic and details?
buproprion • 150 mg tablet • Take 1 tablet x 3 days, then BID x 12 weeks • Aminoketone antidepressant • Indicated only for smoking cessation • Start 1 week before trying to quit to give drug a chance to reach therapeutic levels • Rx only
123
varenicline Trade?
Chantix | smoking cessation
124
Chantix generic and details? | strength, dosing, class, MOA, side effects, BBW
varenicline • 0.5 mg and 1 mg tablet • Take 0.5 mg qday x 3 days, then 0.5 mg BID x 4 days, then 1 mg BID x 12 weeks • Nicotine receptor agonist • Varenicline binds to its receptor and produces nicotine-like effects and inhibits nicotine • Side effects: N/V (take with food to help), vivid dreams, violent behavior • BBW: 1. may cause neuropsychiatric events. 2. Do not use in patients with depression, BD, or schizophrenia • Rx only
125
nicotine Trades?
Nicorette, Nicorette DS, Nicotrol Inhaler, Nicoderm CQ, + no-trade lozenges
126
Nicorette dosing details?
nicotine • 2 mg nicotine gum; 30 maximum pieces a day • DS: 4 mg nicotine gum; 20 maximum pieces a day • Patients smoking >25 cigarettes a day should start with 4 mg
127
Nicorette delivery details?
* Contains a sugar free base to allow systemic delivery; absorbed via buccal mucosa in alkaline saliva → avoid swallowing and beverages that make saliva acidic * Tempted to smoke → chew 1 piece until peppery taste/tingling is perceived → place between cheek and gum until taste is gone → repeat for ~30 minutes
128
nicotine lozenges details?
* 2 mg and 4 mg nicotine lozenge (OTC) * Dose depends on “time to first cigarette”; needs alkaline saliva * 4 mg: within 30 minutes of waking up * 2 mg: after 30 minutes of waking up * Take 1 lozenge q1-2h x 6 weeks, then q2-4h x 3 weeks, then q4-8h x 3 weeks
129
Nicotrol details?
nicotine inhaler • 4 mg cartridge; max dose/day = 16 cartridges • Contains enough nicotine for 20 minutes of active puffing • Transmucosal so do not inhale into lungs • Rx only
130
Nicoderm strengths and application instructions?
* qday * 7 mg, 14 mg, 21 mg/hr adhesive matrix * Apply to area on upper part of arm → remove after 24 hours (do not reuse this site for 7 days) and apply new patch to different site → fold patch in half to discard
131
Nicoderm dosing instructions?
* Dosing is based on how many cigarettes/day smoked * >10 cigarettes: 21 mg – 6 weeks, 14 mg and 7 mg– 2 weeks * <10 cigarettes: 14 mg – 6 weeks, 7 mg – 2 weeks

Dispensing Exam 3 (4 decks)

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