Weeks 5 & 6 Flashcards
Ritonavir (Norvir) ADRs
common: N/V/D, hyperTG and HyperLD, glucose intolerance
Severe: SJS, Pancreatitis, Hepatotoxicity
Ritonavir (Norvir) Counseling and Keys
Major 3A4 inhibition (CI w/ simvastatin and Amiodarone)
not used as single agent for HIV-1 infections
Tablets have greater peak serum concentrations
Tacrolimus (prograf) ADRs
Common: Alopecia, peripheral edema, GI stuff, thrombocytopenia, HA, Insomnia, paresthesia
Severe: Hypertension, Hyperglycemia, Diabetes, SJS Electrolyte imbalances
Tacrolimus (prograf) Counseling and keys
Super narrow therapeutic index (draw levels 30min before next dose)
Take w/ food to dec GI side effects
No NSAIDs
Major 3A4 metabolism
Carbidopa/Levodopa (sinemet) ADRs
Common: N/V, appetite dec, dizziness, dystonia and dyskinesia, Vivid dreams/nightmares
Serious: Depression, Axiety, Hallucination, Personality changes, uncontrollable intense urges, MI, melanoma etc
Carbidopa/Levodopa (sinemet) Counseling Keys
The Car(bidopa) gets the Levodopa where its needed (breaks down AADC and reduces GI side effects) High risks of long term side effects such as dyskinesia "wearing off" phenomenon switching between mobility and immobility. Can increase frequency, switch to ER or add Mirapex for additional efficacy
Pramipexole (Mirapex) ADRs
Common: Dizziness, nausea, dyskinesia, orthostatic hypotension, spontaneous somnolece
Serious: Heart failure, Psychotic disorder and malignant melanoma
Ibuprofen (Advil/Motrin) ADRs
Common: Nausea, Heartburn, gas
Serious: GI bleeding, Kidney damage
Ibuprofen (Advil/Motrin) Counseling and Keys
COX non-selective DO not use in CABG increases risk of heart failure hospitalization Take with food not within 30min of ASA Careful with other nephrotoxins
Lithium (Lithobid) ADRs
Common: Acne, Hyperparathyroidism, Hypothyroidism, weight increases, Nausea, Gastritis, Tremors
Serious:
short term -muscle weakness, polyuria, confusion, hand tremors
Long term - hypothyroidism, weight gain, renal toxcity
Lithium (Lithobid) Counseling and Keys
Narrow therapeutic index
- linear kinetics (double dose = double levels)
Drug interactions with nephrotoxins
DO not take with ACEs/ARBs, DIuretics, NSAIDs or non-DHP CCBs
Empaglifozin (Jardiance) ADRs
Common: Hypotension, Diuresis, UTIS
Serious: DKA, hypoglycemia, AKI, ESRD
Empaglifozin (Jardiance) Counseling and Keys
Efficacy dependent on renal function (CI if <30)
Has both cardiovascular and weight loss benefits
Should be taken in morning (w/ or w/o food)
drink 1-2 extra glasses water
Watch out for genital mycotic infections
Olanzapine (Zyprexa) ADRs
Common: Weight gain, sedation, orthostatic hypotension, EPS
Serious: Altered Cardiac conduction, Positive symptoms of schizophrenia, reduction of manic episodes in bipolar disorder
Olanzapine (Zyprexa) Counseling and Keys
Effects both 5HT2 and Dopamine antagonism
Anticholinergic like effects
Take in the evening (Risk of drowsiness)
Metabolic side effects (weight gain/diabetes)
No alcohol or other CNS depressant
