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Which nonpharmacologic alternative have shown to be efficacious in the treatment of nausea?
Ginger
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Which vitamin does green tea contain and must therefore be cautious in patient under warfarin therapy?
Vitamin K
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What is a significant side effect of licorice?
Hypokalemia because licorice is a mineralocorticoid analog.
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What is the marketed indication for saw palmetto?
For BPH. It does not interfere with PSA test.
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The American Heart Association recommends AGAINST the use of which nonpharmacologic alternative for treatment and prevention of hyperlipidemia, or for breast, endometrial, or prostate cancer?
Soy
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What side effects have been associated with using Yohimbe?
There have been reports of seizures and deaths since it causes CNS stimulation and HTN.
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Why is IV codeine contraindicated in children?
IV use in children is contraindicated since it can promote excessive histamine release and cardiovascular problems.
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What is the approved use foor oral transmucosal delivery of Fentanyl?
For breakthrough cancer pain
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What cautions must be taken with using Meperidine?
1. May cause seizures, particularly in patients with renal problems, the elderly, or those taking MAO inhibitors, or in anyone taking a high dose.
2. May cause serotonin syndrome when used concurrently with SSRIs, SNRIs, or MAOIs.
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What side effect is seen with high doses of methadone?
Torsade de Pointe
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What kind of drug interactions does Methadone have the potential of having or making?
P450 Inducers significantly reduce serum methadone levels (and methadone itself is a P450 inducer)
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What are the contraindications associated with Propoxyphene?
Propoxyphene is an opioid used for mild to moderate pain.
-->It is contraindicated with renal failure and the elderly because of a significantly increased risk for seizure, CNS disturbance, and QRS prolongation.
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Which nonpharmacologic alternative is marketed for use to treat postmenopausal vasomotor symptoms and for the pain of oral aphthous ulcers?
Licorice
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What is the specific indication for oral Buprenorphine?
Oral buprenorphine is called Subutex and is used for treatment of opioid dependence.
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What are the ADRs associated with Pentazocine?
Pentazocine is an opioid agonist-antagonist with ADRs including:
1. Hallucinations
2. Seizures
3. Disorientation
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What is Suboxone?
Suboxone is the tradename for the combination of Subutex (buprenorphine) and Naloxone for treatement of opioid dependence.
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Which drugs belong to the class, Selective Serotonin Reuptake Inhibitors?
1. Citalopram
2. Escitalopram
3. Fluoxetine
4. Fluvoxamine
5. Paroxetine
6. Sertraline
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Which medications are classified as Tricyclic Amines?
1. Amitriptyline- affects serotonin
2. Amoxapine
3. Clomipramine - affects serotonin
4. Doxepine
5. Imipramine - affects both serotonin and norepinephrine
6. Maprotiline
7. Nortiptyline
8. Protriptyline
9. Trimipramine
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Patients on MAO inhibitors should avoid foods that contain what?
Tyramine.
--> No ingestion of wine, beer, cheese, liver, grapes, avocados, sauerkraut, processed meats, chocolate, soy products
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What is Bupropion?
It is a dopamine reuptake inhibitor and a nicotinic antagonist.
--> Contraindicated in seizure disorder, eating disorders.
--> ADRs: Seizures
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What is Mirtazapine?
An antidepressant that works by stimulating norepinephrine and serotonin release, and inhibits serotonin reuptake.
--> ADRs: drowsiness, increased appetite/weight gain, agranulocytosis
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What should you monitor for in patients placed on Serotonin-Norepinephrine Reuptake Inhibitors?
Monitor for the emergence of anxiety, panic attacks, insomnia, and irritability.
1. Desvenlafaxine - therapeutic dose can be started on day one of therapy, without starting an initial ramp-up dose first
2. Duloxetine
3. Venlafaxine
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