-
When to schedule meds with antacids?
One hour before or two hours after
-
Antacids decrease absorption of which drugs
- sucralfate
- digoxin
- ketoconazole
- tetracycline
- quinolone abx
-
Population in need of high vitamin usage:
- rapid body growth
- pregnant/breastfeeding
- malnoursihed
- debilitated
-
How and when to admin H2 blockers?
- With meals
- bedtime dose
- rapid IV (<2min)= cardiac dysrthy, hypotension
-
Prevpac contains?
- Lansoprazole (PPI) (1)
- amoxicillin (2)
- clarithromycin (1)
- BID morning, evening
-
With prevpac, observe for?
- anaphylaxis, rash, or serum sickness like rxn
- signs of suprainfxn (candidiasis, c.diff)
- chk fecal occult, H/H
-
Antacids that contain __ cause diarrhea
- Mg
- caution use in pt with ostomy, hemorrhoid, ulcerative colitis, diverticulitis
-
Antacids that contain___ cause constipation
- Al, Ca
- caution use in pt w/ hx of constipation, hemorrhoid
-
When to admin cholestryamine?
- Before meals
- Incr fluids: 2500mL
- Admin other drugs 1 hour before or 4-6 hours after
- Sprinkle powder on liquid/semiliquid
-
Cholestryamine DDI
- HMG CoA reductase inhib
- decreases warfarin (chk INR)
- digoxin
- corticosteroids
- decreases absorption of propranolol, thiazide diuretics
-
Lovastatin Adverse effects
- rhabdomyolysis
- myopathy
- acute kidney failure
- CATEGORY X
-
Lovastatin DDI
- Grapefruit
- antacids dec. statin
- incr digoxin
- horme contraceptive
-
Lovastatin--Monitor for
- LFT
- dc if transaminase 3xs normal
- myositis
-
When is Lovastatin taken?
taken without regard to meals but must be taken consistently
-
When to admin omeprazole?
- immed. before meals, preferrably morning
- with antacid to decrease GI distress
-
Omeprazole DDI
Increases warfarin, inc INR
-
Sucralfate DDI
- decreases warfarin
- digoxin
- theophylline
Do NOT use with antacid, H2blocker, PPI
-
How to admin sucralfate?
- with water 1 hour before meal and at bedtime
- taken on empty stomach
via NG=bezoar
-
Sucralfate--monitor for
- constipation/diarrhea
- used in caution for pt w/ renal failure
-
Cimetidine DDI
- Inc warfarine
- amodarone
- CCB
- theophylline
-
Cimetidine SE
- constipation
- confusion
- dry mouth
- problem in older pt w/ renal insuff
- breast swelling/pain
- Rare: neutropenia, tachycardia, agranulocytosis
-
Misoprostol indications
- prevention of NSAID induced gastric ulcer
- off label: chronic constipation, early pregnancy termination
-
Misoprostol SE
- Pregnancy Category X
- Black Box warning
- stomach distress, diarrhea
-
Misoprostol ok with antacids except for
Mg containing antacids (diarrhea)
-
When to admin misoprostol?
With or after meals
-
Gemfibrozil DDI
- Hmg CoA increases rhabdomyolysis
- incr anticoag effect w/ warfarin
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