Week 3 & 4

Question 1

Lamotrigine (Lamictal) ADRs

Answer 1

Common: dizziness, N/V, insomnia, Rash, Ataxia

Serious: SJS, anemia, leukopenia, skin shit, weird thoughts

Question 2

Lamotrigine (Lamictal) Counseling and Keys

Answer 2

Low and slow (25mg), D/C if rash develops (more common in kiddos)
Antiepileptic of choice in pregos
Valproic acid increases serum levels
Phenytoin decreases serum levels

Question 3

Phenytoin (Dilantin) ADRs

Answer 3

Common: hair growth, coarsening of facial features, gingival hyperplasia, hyperglycemia

Serious: Hepatotoxicity, hypotension, bradycardia, dysrhythmias

Question 4

Phenytoin (Dilantin) Counseling and Keys

Answer 4

Watch for Nystagmus (first indicator of toxicity)
Highly protein-bound
Good oral hygiene important (gingival hyperplasia)
albumin levels and renal function can influence serum level

Question 5

Methadone (Methadose) ADRs

Answer 5

Common: Constipation, Nausea, Drowsiness/sedation

Serious: QT prolongation, Arrhythmia, Respiratory Depression

Question 6

Methadone (Methadose) Counseling and Keys

Answer 6

Methadone & SSRIs can increase serotonin syndrome
Use w/ caution with 3A4 inhibitors due to respiratory depression risks
Careful initiation, slow titrate (No more than every 3 to 4 days and 10mg/day)

Question 7

Azithromycin (Zithromax) ADRs

Answer 7

Common: N/V/D

Serious: QT, Hypersensitivity Reactions

Question 8

Azithromycin (Zithromax) Counseling or Key Points

Answer 8

Better gram (-) than other macrolides
better atypical coverage than clarithro
few 3A4 interactions than clarithro
Longer t1/2 than claithro
QT prolongation ESPECIALLY with other agents

Question 9

Omeprazole (Prilosec) ADRs

Answer 9

common: Nausea, Diarrhea, HA, Gas

Serious; Kidney damage, SJS, Bone fractures, Lupus

Question 10

Omeprazole (Prilosec) Counseling and Key points

Answer 10

duration of use >14 days consulted with a doctor
If unintentional weight loss or dysphagia call doc
take 30-60min before first meal of day
Can see rebound acid hypersecretion (must taper)
DDIs for drugs requiring acid environment: HepC/HIV drugs, Azoles, Oral Chemo, Transplant meds

Question 11

Ranitidine (Zantac) ADRs

Answer 11

HA, ab pain or constipation (generally well tolerated)

Serious: EXTREMELY RARE bradyarrthymia or thrombocytopenia

Question 12

Raniditine (Zantac) Counseling and Key points

Answer 12

may say tachyphylaxis with higher doses
(300 –> 150) Cut dose in half if renal function <50ml/min
DDIs for drugs requiring acid environment: HepC/HIV drugs, Azoles, Oral Chemo, Transplant meds

Question 13

Nitroglycerin (Nitrostat) ADRs

Answer 13

common: Dizziness, light headedness, HA, flushing

Severe: Inc Intracranial Pressure, Severe HA

Question 14

Nitroglycerin (Nitrostat) Counseling and Keys

Answer 14

Tolerance develops over time
limited to 3 doses, call 911 with the second dose
DO NOT USE with PDE5 inhibitors

Question 15

Sildenafil (Viagra/Revatio) ADRs

Answer 15

common: HA, Flushing, Visual disturbances

Serious: Priapism, Retinal Hemorrhage, hearing loss

Question 16

Sildenafil (Viagra/Revatio) Counseling and Keys

Answer 16

Use an hour prior to sexual intercourse
may see blue-green color distortion
Three times dosing is for pulmonary arterial hypertension
half life is about 4 hours
No NItrates!!!