-
What to monitor w. Imuran?
- Azathioprin
- s/e thrombocytopenia
- neutorpenia
- livertoxicity
- so,check CBC, LFT...and what els?
-
Zanaplex?
- Daclizumab ( transpant drug )-immunosupprssant
- for prophylaxis of acute renal transplant rejection
-
Prempro* what combination?
- Conjujgated estrogens/ Medroxyprogesterone
- 1po QD
-
Dyseryl
- Trazodone
- antidepression ( max 400mg / day )
- * for Insomnia
- 25-100 mg/ HS ( max 200 mg/day )
- s.e priaprism
-
Compare Singular & Accolate
both in same class: AntileukienCysLT1
- Singulair ( Montelukast ) QD in the evening
- Accolate( Zirfirlukast ) BID emptystomach ( Inhibitor )
-
compare Vitravene & Vitrasert?
- Vitravene ( Inject to the eye like IV) q MONTH
- VitraSERT ( implant ( insert a small bullet into the eye) ->q 6 M
-
what is NL of ANC?
Absolute Neutrophile Count ( Bands + Seg ) x WBC
- 1,500 - 8,000 cell/ mm3 ( 1.5-8 ) considering normal
- But for Clozeril need to have ANC > 2 , and WBC 3.5 to fill.
-
which drugs can cause Fanconi syndrom?
- Tenofovir- Viread
- Cidofovir-Vistide
- Tetracycline- Sumycin, Acromycin
-
Two Bio terorism that NO Cure?
Smallpox & Ebola only supportive care ( NO CURE)!
-
DOC tx Anthrax?
- Cipro 500 mg po BID x 60 days
- or
- Doxycycline
-
SLS is ?
emulsifing agent
-
Olive oil use in?
Calamine lotion
-
Zosyn?
- Piperacillin/tazobactam
- tx pseudomonas
-
Bezamycin gel for acne?
- After mixing w. alcohol must keep in Fridge 2-8 C ( 36-46 F )
- Write EXP for 3 month after mixing!
- - only use " water base cosmetic " only ( Not oil base )
-
Fomepizole ( Antizole ) if antidote for ?
Methanot/ antifreeze
-
Barbiturate antidote?
Sodium Bicarbonate IV
-
Amphetamine overdose?
give NH4Cl ( acidify urine )
-
What form DOESN'T nitroglyceline come in?
- No oral solution
- No suppostory
-
What happen if ab.ruptly stop taking prednisone?
Addisonian crisis --> no steroid in the body at all!
-
-
DynaCirc?
Isradipine ( CCB )
-
Bicarb
- HCO3 ( -1)
- NaHCO3 -Sodiumbicarb
-
Flow Rate?
- Volumme/ Time
- ml/min, or ml--> gtt/min
-
know Acohol USP?
95% Alcohol USP
-
check digoxin level in ?
1 week d/ t long haft live ( 5 t/2)
-
which drug CI if BP< 90?
- Morphine
- Nesiritide- Natrecor s.e hypotension
-
Lovenox MoA?
Xa*
- Pradoxa- Dabigatran
- MoA: Factor II ( 2)
-
Pradaxa
75, 150 mg capsule
exp; 4 months
- Dabigatran --> Crcl
- Crcl >30 , give 150 mg BID po
- Crcl < 30-15, give 75 mg BID
-
for DVT usually tx w. anticoagulants for ?
6-9 months unless there multi risk factor ex. protein C/ or protien S may req. lifetime anti coagulants
-
t-PA?
reconstituted amust be used w. 8 hr*
vs r-PA( Reteplase ) use w/n 4 hr*
Streptokinase use w/n 8 hr* Don't shake vial!-( Antigen)
- Alteplase - Activase ( t-PA )
- thrombolytic class ( all IV )
-
Herbal Inc. INR?
- Horse chestnut,
- Feverfew - Migrain
- Drug:
- Valproic acid ( Inhibitor )
- Methimazole, Propylthioruacil ( tx hyperthyroid drugs )
Note: Chloroquine & hydroxychlorquine -> inc. throombocytopenia*
-
Arixtra ( LMWH) SC*
" Factor Xa Inhibitor" same as "Xarelto-Rivaroxaban "
- Fondaparinux
- on the Shelves ( RT)
- 2.5 mg SC QD
- CI; Crcl<30
- Monitor : CBC & Kidney
- No antidot " can give factor 7 "
-
Normiflo ( LMWH)
Ardeparin SC q 12 like Lovenox
- vs Fragmin- Dalteparin ( SC QD*)
- Fondaparinux SC QD 2.5 mg*
-
Campral?
- Acamprosate 333mg tab
- for: maintenance Alcohol abstinence
- dose: 2 (333) mg tab po TID
- Adv: Not cause disulfiram reaction w/ alcohol
-
Viroptic ( eye drop in FRIDGE)
- trifluridine
- tx viral infection
-
Vasopressin ?
- it's Antidiuretic Hormone ( ADH ) -> It inc. water absorption in kidney.
- So, there is a drug wrk as Antagonist of Vasopressin
- " Vaprisol - Conivaptan" is Vasopressin Receptor Antagonist"
- tx: hyponatremea in envolemic & hypervolemic ,hyponatremia in hospital pt-->IV
- It inc. Urine output and restore Na+
-
Regradex?
- for Diabetes Ulcer wound
- Keep in Fridge.
-
Risperdal
- Risperdone
- Oral solution,
- IV,
- ODT
- Tab
-
Alinia?
- Nitazoxamide
- tx diarrhea in Aids pt
- 500 mg tab BID x 3 days
-
Ask dose how to take Selegiline?
( parkinson dz )
- Eldepryl ( tab 1,25 & 5 mg tab )
- Zelapar ( ODT tab )
- Emsam ( patch but for depression only )
- Dose Selegiline BID ( AM & Lunch time )*
-
-
SE of warfarin?
- must know technical term all kind of bleeding:
- ecchymosis-blood under skin
- hematuria-blood in urine
- melena-black stiool
- epistaxis- nose bleed
- hemoptysis- cough up blood
- hematemesis- vomit blood
- hemorrahgic stroke-intracerebral bleeding
- puple toe syndrome*
- alopecia
-
How long to stop these drugs b/4 surgery?
- Stop 5 days b/4 surgery
- Plavix- Clopidogrel
- Coumadin
- Brilinta-Ticagrelor
- Exception w. Pradaxa-Dabigatran ( adjust dose w renal)
- Stop drug 1-2 days if good kidney crcl >= 50
- stope 3-5 day if Crcl <50
- Nsaids : stop drug 7 days b/4 surgery
-
Reopro
GP IIB/3A Antagonist
Must use Fillter & Do not shake!
- Abciximab ( TEA & AIR )=ATE TEA IV
- uniqe ; -only one that NO DOSE adjust in renal dz*
- - it's antigenic*
- use adjuct w/ heparin when "percutanous coronary intervention=PCI" is schedule w/n 24 hrs.
- Dose* 0.25 mg/kg IV bolus admins 10-60 mins b/4 start PCI then follow by 0.125 mcg /kg/min for 12 hr
-
What s/e of " Thienopyridine class Inh--> ADP of P2Y12 receptor"
Neutropenia & Thrombocytopenia --> check CBC
-
Prodrug
Plavix
Codien
Tamoxifen-Novaldex
- DI w. Those enz. Inhibitor* ingeneral
- Plavix CI Nexium, Prilosec--> Rec. H2 blocker( except;cimetidne )
- Tamoxifen CI w. SSRI inh ex Prozac,paxil--> Rec. Effexor-Venlafaxine in this case.
-
LD of plavix?
LD of Effient?
- LD plavix- clopidogrel--> 300mg Po, then d/c w. 75 mgQD
- LD effient- Prasugrel --> 60 mg, then d/c w. 10 mg QD
-
which drug use for " Cardiac exercise testing fo r people who cant' walk on treadmill"
- Persantine-Dipyridamole
- s/e Fertility impairment,hepatic
- Hypotensioin
-
Stents have 2 typs
- 1. Bare metal - must be on Plavix ( min 1-12 months)
- 2. Drug- Eluting stent -> must be on Plavix at least 1 year!*
-
NTG MOA
use in Angina, MI
Hypertensive Emergency
- MoA
- dec. preload Vein & After load ( high dose)
- S.E H/A, dizziness Orthostatic hypotension
- ( take SL NTG sitting down )
-
if does't have NTG SL what to use instead?
- Amy Nitreate ( X)
- crudh the capsule and snipp under nose
- it's flamable, HA
-
Isodil
TID ( 7 am, N. 5pm)
Isosorbide Dinitrate
-
NiCARdipine
most specific CCB , so only use in Angina
- Cardene
- 20-40 mg IR po. TID
-
Bepridil
- Vascor
- CCB use in Agina
- s.e Torsades
-
-
-
Nitrolingual pump spray
spray under the tongue
- must prime 5 time at the fist time
- don't shake!
- if never been use >= 6 wks , must pime 1 x before use
-
If pt allergic to Morphine give?
- Meperidine ( Demerol )
- 50-150 mg IM, SC. PO * q 3-4 hr
-
avoid morphine if SBP?
less than 90
-
what CI w. Morphine & NTG?
Note: must know that NTG vasodilate on ALL vascular ( coronary artery, peripheral and venous )
- SBP < 90
- severe Bradycardia ( Pulse < 50 ) NL 60-100
- PDE -5 inh Viagra-Sildalaphil w/n 24 hr , Cialis-Tadalaphil-36hr
- Note: extream tachycardia DO not use NTG*
-
BB use in MI?
PAM
- Propanolon
- Atenolol
- Metoprolol
-
the only LMWH that FDA appv for MI & unstable angina is?
Lovenox - Enoxaparin Wrk on factor Xa*
-
Enalaprilat ( VAsotec ) ACEI IV, what the dose?
IV dose ;1.25-5 mg q 6 hr
-
CI W/ ACEI in MI?
- SBP < 100*
- pregnancy
- Bilateral renal artery stenosis
- renal failure
- angioedema
-
what is tx of " STEMI"?
ST evaleate MI
- Fibrinolytic therapy- thrombolytic agents
- PCI
( percutaneous coronary intervention)--> Stent
-
why give LD of plavix b/4 perform PCI?
- give LD plavix 300mg TAB. at least 6 hr BEFORE PCI* perform! will reduce the risk of MI or strok prior to PCI by 38% use in hospital
- After PCI 24 hr after pt should on Plavix 75 mg QD >= 1 year.
-
LDL goal ? in Cardio Artery disease
- DM alone 100
- CAD alone 100 ( Angina )
- * DM +CAD = 70
- But high risk CAD ex MI & unstable Angina--> 70*
-
rare but seroius s/e of plavix is?
- TTP ( trhombotic thrombocytopenia purpura )
- bleeding
- diarrhea
-
0.9% NaCl has how many Na mEq in 1 liter?
154 mEq / Liter
-
Voprisol?
- Conivaptan IV
- use for Hypo.natremia in SIADH
-
when to check thyroid level after give the drug?
( SIX ) 6 weeks
-
what cause Hyper thyroidism?
- grave's dz
- sign: Exothalmus* eye pop out -irriversible
-
what cause Hypothyroidism?
Hashimoto both autoimmune dz ( most wowen )
-
what test for Siphylis?
RPR*= VDRL
-
*Zanaflex?
alpha 2 adrenergic Agonist--> like " Clonidine"*
- Tizanidine ->Zanaflex= Clonidine
- 2,4 mg tab
- Dose 4 mg q6-8 prn
- tx muscle spascitic d/t MS, spinalcord injury
-
First pass effect?
- PO med is absorbed from GI tract ->hepatic Portal vein-> Liver-> systemic circulation
- Note: IV, Patch, suppository are bypass first pass effect! ( basically, all the drug don't go thrugh mouth-> GI will bypass first pass effect.
- ---------------------------
- Drug metabolize by phase1 ( Oxidation,reduction,hydrolysis ) try to make drug more polar
- Phase 2: Conjugation pathway ( Glucoronidation most common--> very polar --> help elimination drug from the body.
-
Periodex, Periogard?
- Chlorhexidine 0.12%
- 15 ml gargle for 30 secs BID* and spit out. Do not eat & drink any things couples hr after
-
Lactolose*?
- use in encephalophathy to get rid of Ammonia ( NH4)
- MOA: Osmotic laxative ( increse stool water content, and trapping NH4 ions)
-
Cephalosporin come in IV & IM only are those popular!?
5 drugs
- Cefotetan-Cefotan
- Cefuroxime-Ceftin, Zinacef
- 3 gen:
- Fortaz-CefTAZidiem
- Rocephin- Ceftriaxone
- 4gen;
- Cefepime-Maxipime
-
Cepharosporin only come in IV?
- 1gen;-->Ancef-Cefazolin ( surgery prophylaxis )
- 2gen: Cefoxitin-Mefoxin
- 3 gen: CefoTAXxime- Claforan
-
Macular degeneration
Maculoregenesis?
- " damage of retina" in DM pt
- DOC give vitamin for eye " Lutein"
-
" Pernicious Anemia"
Pt will need to get B12 by IM inj 1000 unit per month
IM ; 20-23 gauge and 1-3 inches
is autoimmune dz. which thier own body attack GASTRIC Cell in stomach, so B12 can NOT form a complex w. intrinsic factor in order to get absorb--> "Pernicious Anemia vit b12 difficiency--> Magaloblastic or Macrocytic anemia ( could be either Folic acid or B12 )
-
Eosinophil
- Allergy *& Asthma
- Parasite
- Xolair - Omalizumab SC* q2-4 wks ( 1-2 x a month) in MD office must check IgE first
- MoA it's IgG monoclonal antibody that inh IgE binding to the IgE receptor on mast cell.
-
Amy & Lipase test for?
- Pancreatitis
- Which drug cause pancreatitis
- hiv, vaproic acid
-
Fordaril?
- Formoterol
- at pharmacy keep in Fridge, after dipense to pt keep at RT for 4 months.
- Symbicort 3months ( 90 days) after open foils!
-
What are 2 drugs " long acting beta 2 Agonist come in Nebulizer!"?
- Brovana* -argormoterol ( Fridge , or up to 6wks at RT)
- Perforomist - Formoterol (Never mix to other drug)
- tx; COPD related to bronchoconstriction
-
which first PO for COPD?
- Dali.resp ( think respiratory --COPD)
- MOA: Phosphodiesterase 4 ( PDE4 inhibitor) compare to Viagra PDE-5 inhibitor
- Daliresp-Roflumilast 500 mcg po QD w/wo food
- s.e Wight loss
- it's substate so caution w. enz Inh & ind
- CI w. liver impairment!
-
* if pt has MILK allergy ( do not give drug that have lactose ,most dry powder inhaltion)?
5 DPI that have lactose?
- think " Spiriva-PAAF" have lactose CI w/ milk allergy!
- Spiriva- Tiotropium ( anti cholinergic QD)
- Pulmicort Flexhaler- Budesonide
- Asmanex- Mometasone
- Advair Diskus ( 1 puff BID ) Fluticasone/salmeterol
- Foradil-Fometerol
-
Xoponex -Levalbuterol
DeoNeb --> Nebulizer from of Combivent ( Albuterol / Ipratopium) QID
- both ok only 1 wks after out of foil
- but 2 wk if keep it in foil
-
Vomax
Albuterol ( tab ) in Fridge!
-
" Churg Strauuss syndrom" is s/e of what drug?
- Zafirlukast - Accolate! ( inhibitor )
- BID eat later - empty stomach
-
Xopenex
( HFA, Neb )
- HFA > 4 yo ( 2 puff q4-6 hr )
- Neb > 6 yo (1 neb q 6-8 hr )
-
Advair Diskus vs
Advair HFA?
- Diskus-less dose & less age
- Advair Diskus > 4 y/o --> 1 puff BID
- VS
- Advair HFA ( harder bc hand& mouth coordinator )
- so HFA--> 12 y.o --> 2 PUff BID*
-
Albuterol forma available?
4 forms
- Tab -Volmax - in fridge( 2 & 4 mg )
- Tab ER- Vospire ER ( 4&8 mg )
- MDI -> HFA
- Neb-> inhale solution Xopenex
-
Fosrenol*?
- Lanthanum ( Lantanum carbonate) tab 500,750,1000 mg
- PO4 scavenger
- for reduce serum phoshphate in ESRD
- "chew or crush tablet completely-DO NOT swallow whole" take with meals ( or right after meals )
-
what are use for Preterm Labor?
- Makena*-Hydroxyprogesterone IM* once a week form 16th to the 37th wks of pregnancy
- Mgso4
- Indomethacin
- Nifedipine
-
Asmanex twisthaler, can start how old?
( Nasonex & Elocon topical--> Mometasone )
- Mom use in her kid as 4 y/o*
- 1-2 puff q PM ( QD)
-
For-Bud--> Symbicort Turbuhaler --> DPI*(formetorol/Budisonide )
opposit of
- Dulera ( For-Mom--> M*DI )
- Formetorol/ Mometasone
- Both > 12 y.o
-
B2 Agonist moa?
Increase in " cyclic AMP which acts on CA to produce smooth muscle relaxation"
-
Antichlolinergic moa?
Inhibiting C-GMP
-
Febuxostat
40,80 mg tab
- Urolic
- Xanthine oxidase inh ( like Alloporinol )
- start at 40 mg,may inc. to 80 mg po QD
- tx; Chronic gout
-
general rule to " taper drug"
- apply to all drugs:
- 1. decrease the dose
- 2. take it QOD
- do it over a couple weeks
-
Metformin IR-> BID
ER--> w . evening meal
However if TID for " Polycystic ovary syndrom"
-
Don't give Avandia w. Insulin--> Inc. CHF & weight gain
- Don't' give Symlin-Pramlintide ( 1&2) w. class alpha -glucosidase -> Miglitol-Glyset
- -> Acarbose-Precose
-
compare b/w Requip & Aricept?
- Requip- Ropinirole --> tx; parkinson
- vs
- Aricept-Donepazil --> Alzheimer
-
Zolinza
- Vorinostat
- only Histone Inhibitor
- tx: Lymphoma cancer
-
Zanocar ( Alkylating agent-> G1 phase)
- Streptozocin
- tx pancreatic cancer
- cause type 1 DM
-
which chemo drug can cause Feritlity ?
women dont' touch!
- Melphalan - Alkeran
- Mustaragen-Mechlorethamine
- Hexalen- Altretamine CI w. MAOI drugs
- Note: all are Alkerlating agents
-
Matulane
- Procarbazine--> MAOI
- avoid Alcohol cause disulfiram like reaction
-
Treanda
- Bendamustine
- IV & protected from light
- cause " tumor lysis syndrom"
- reconstitute w. sterile water! --> then mix w. 0.9% Nacl
- Colorless- pale yellow
- stable in fridge 24 hr ( onlyl 3 hr in RT)
-
Adriamyacin, Doxil -liposomal
( antibiotic --cin , except Mitoxantrone--blue)
- Doxorubicin ( Life time dose < 550, vs Dauna--> 900 )
- give Zinecard- Dexrazoxane ( Iron chelator) protect agaist cardiotoxicity
- S.E
- everythings --red
- give Cold for extravasation
- cat D* never give to pregnancy
-
Taxol
Plant alkaloid -> G2 phase
- Paclitaxol
- Non PVC
- s.e hypersensitivity--> need premedicate* w.
- 1. steroid 8 mg Bid x 3-5 days ( start 1 day b.4 chemo)
- 2. anti emetic
- 3. benadryl
- it has alcohol & caster oil in it-> watch for DI w. alcohol w. flagyl and NMTT side chain
- * need inline filter d/t hypersensitivity 0.22 micron
-
Gleevec
tyorsine kinase Inh
- substrate & 3A4 inhibitor
- No grapfuite juice*
- Inc. bleeding DI w. warfarin
- Only one in this class take w. Food
- Fluid retention & edema
- Monitor: CBC, LFT, and Weight gain d/t fluid retention!
-
Trastuzumab* is a DOC for?
Herceptin doc for "HER2-positive breast cancer"
-
Megace
- Megestrol--> thromboembolism
- It's Progestin--> estrogen
- weight gain
- tx/ advance breast cancer, endometrial cancer
- - also used for stimulate appetite--> like Marinol
-
Atevia
- new ER form of Residornate ( Actonel )
- 35 mg / wk just like Actonel
- every things still the same except " take after breakfast" w/ 4 oz of plain water ( vs Actonel w. 8 oz of water & empty stomach)
-
Bactroban
- Mupirocin ( cream / oint )
- 1. Inpetigo -> TID 3-5 days
- 2. Nasal MRSA colonizaton eradication
- ointment * BIDx 5 days ( in practice give x 30 days )
-
Mycolog II for what?
- Nystatin/ triamcinolone
- BID
- tx; TAPE Burn & Diaper rash
-
Vusion
Miconazole+ Xinc oxide
-
Koapectate, or Pepto- Bismol ?
- Bismuth subsalicylate ( BSS)
- tx ; 2 tab q 30 min* up to 8 doeses
- prevention: 2 tab QID upto 3 wks
-
Dificid
Fidoxamycin 200 mg BID x 10 days has lower recurrencr rate but more expensive
-
Moxatag
- Amoxicillin 775 mg ER QD
- strep throat
-
Augmentin ES--> 600 mg/ 5 ml suspension*
- Augmentin XR --> 1000 mg
- form: tab, chewable tab, suspension
- Both ES & ER --> BID* W. food
-
Gonnorhrea tx
- Ceftriaxone IV,IM* 250 mg IM once ( Rocephine)
- or 2 gm Azithromycin PO
- Or Suprex*- CeFIXime PO, Supension ( alternate for rochephine )
-
ZMAX?
Azithromycin Suspenson--> 2 gm in 60 ml single dose -EMPTY stomach --> ZMAX*
-
Bactrim
- inc. K
- CI crcl< 15
- watch for DI with Tekturna , ACEI
-
CefTAZidime & Cefepime cover?
- Ceptaz, Fortaz* & Maxipime cover pseudomonas
- both IM & IV
-
what are doc for pancreatitis infection?
- Carbapenem* most board spec trum. ( inc. seizure)
- 1. Primaxin - imi penem/ cilastatin
- 2 Merrem - Mero. pene,
- 3. Invanz- Erta.penem
- 4. Doribax- Doripenem
-
Ciprofloxaxin ( Cipro )
Ear?
Eye?
- Ciprodex-> Ear
- 4 gtt BID x 7 days
- Ciloxan* -> Eye
- Oint & Solution both 0.3%
- Ciloxan Ointment-> apply 0.5 ribbon TIDx first 2 days, then 0.5 ribbon BID next 5 days ( total 7 days )
- Ciloxan solution--> 1-2 gtt q2hr x 2 days while awake, then 1-2 gtt q 4 hr for next 5 days ( 7 days )
-
Gatifloxacin only for eye drop?
- Zymar - gatifloxacin
- 0.3% solution
- direction like Ciloxan 0.3% solution
- Note : only Besivance - Besifloxacin is Suspension* the rest are solution for ATX eye drop
- Ofcourse: CiproDEX-> for EAR only it's Suspension d/t dexamethosasone in it. so SHAke well.
-
Ofloxacin 2generation - floxin what form?
Po. Eye & Ear drops
-
Periostat?
- Doxycycline 20 mg for Periodontitis
- Note:
- Doxycycline-Adoxa, Vibramycin,Orecea 40mg qAM
-
Tetramycin
- Sumycin
- 250-500 mg QID EMPTY STOMACH*
- Note: BID only for Acne
-
Minocin, Dyancin, Solodyn-only one w. food
Minoccycline
-
what drug that if see Crystal can warm up?
- Manitol*
- Flagyl- Metronidazole
- Acyclovir IV
- Phenytoin
-
Do NOT put in Fridge!
- Biaxin- Clarithromycin suspension
- Cleocin- Clindamycin
- Omnicef- Cefdinir
- Vfend- Variconazole
-
see " Amphojel"* careful not Ampho B
It's AlOH antacid!- AmphoJEL*
-
Abelcet,
Ambisome
Amphotec
lipid form Ampho B--> to protect kidney!
-
pretreat w. AmphoB?
- Tylenol
- Benadryl
- Steroid
- " only have chill--> Meperidine- Demerol*
-
Oravig?
Don't crush/chew/ swallow
- Miconazole buccal tablet > 16 y.o
- tx Oropharyngeal cnadidiasis
- 50 mg buccal tab QD in AM x 14 days
- CI allergy to Milk protien
-
Tamiflu
- Oseltamivir
- for prevention up to 42 days*
- 75 mg QD* x 10 day up to 42 days!
tx-> 75 mg BID x 5 days
-
Foscarnet what special about it?
- Foscavir
- tx CMV in Aids
- * supply in glass bottle/ IVbag, but need to dilute w. D5w b/4 use--> after dilute MUST transfrer to PVC container
- ( After dilute must put in PVC container! )
-
* what to monitor w. Interferon?
- 4 things;
- TSH
- CBC
- LFT
- Electrolyte
- #1 s.e Flu like symtoms , all cause Depression
-
* Tyzeka what for?
- Tyzeka- > Telbivudine ( NRTI )
- tx Heb B
- sx Lactic acidosis & irregular heart beat
- dose: 600 mg QD for >= 16 yo.
-
waht is Lactinex & VSL-3?
( others are Culturelle , Acidophilus
- Probiotic -> keep in Fridge
- must tell pt to SEPARATE from ATX by 2 hr to prevent ATX killing the probiotic oraganism.
Note: only Florastor 2 caps BID => at RT bc it for FUNGI!
-
Lariam?
- Mefloquine
- malaria prophylaxis
- 1 wk b/4 departure,then 4 wks after return
-
-
Plaquenil?
( Plaq in the eye, take W: FOOD )
- Hydroxychloroquine
- IL-1 inhibitor ( Akina-Kinarat )
- s.e plaque in the eye--> check eye & CBC q 3 months
-
Drugs have alchohol in it--> watch for DI?
don't give w. NMTT side chain & Flagyl
- Hiv drugs
- -Aptivus, Norvir, and Kaletra ( alc in capsules )
- Donnatal
- Nystatin
-
Fomivirsen?
- Vitravene
- tx; CMV virus-> blindness
- shot directly into the eye q 1 MONTH
- vs
- VitraSERT - Ganciclovir implant --> INSERT q 6 M
-
Egrifta
- Tesamorelin
- GRF growth h. releasing factor
- 2 mc SC QD for fat distrophy
-
-
Cuprimine
antidose of Copper
use in wilson dz
- D- Penicillamine ( need to titrate dose slowly = Sulfasulazine
- month 1- 250 mg QD
- month 2- 500 mg QD
- month 3 750 mg QD
- month 4 - 1,000mg QD
- Maintaneient dose : 750-1,000 mg QD*
- Note; however ,the dose of Azulfidine - Sulfasalazine in
- 500mg 1-2 x day w/ food starter
- then incrase to 1,000 mg BID
-
Tizanidine
- Zanaflex
- MOA* alpha 2 Agonist (just like clonidine )
- muscle relaxant class
- t 4 mg,
- c 2,4 6
- Only IR form*
-
what are the s/e of Parlodel?
- Bromocriptine
- s/e N/V, HA, hallucination and hypotension*
- ok to use in renal dz
-
REquip what special about it?
- tx parkinson
- Ropinirole po TID ( max 24 mg/day)
- it has the least hypotension , least accident of falling d/t least alpha block than other drugs in same class ( all parkinson meds cause hypotension inc.risk of fall.
- caution in liver dysfuntion, Ok in renal pt.
-
Apomorphine
- Apokyn
- bbw; hypotension* and loss of consciusness use in parkinson dz last stage ( it's SC*)
- s/e; QT prolong and Falling asleep during activityes of daily activity.
- Monitor Blood pressure
- use w. Tigan- Trimethobenzamide 3 days b/4 initiating Apokyn!
-
-
Sublimaze
( Sub IV/IM into skin)
Fentanyl IV*
-
-
-
-
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Cachexia
low weight , weakness d/t chronic dz
-
" Pt notice insulin clump, streak" what to do?
- Discard it and get a new vial!
- Clump/ Steak sign of insulin break down! Do not use it.
-
Neurontin max?
- Gabapentin
- Max 3600 mg/day
-
Keppra
- Levetriacetam
- max 3000mg/ day
-
Topamax max1600 mg
- Topiramate
- #1 rx for migrain prevention
- From: only Cap & Tab BID*
Vs Zonegran--> Zonisamine only 100mg cap QD*
-
Klonopin
- Clonazepam
- max 20 mg/day
- VS Diazepam max 90 mg.day
-
Horizant*
( Gabapentin ER tab ) w. food
- Gabapentin ( Neurontin)
- Indication only for " Restless leg syndrom"
also Lyrica ( C-V)
-
-
Tiagabine
- Gabitril
- s.e susden unexpected death! Must titrate dose by inc by 4 mg per week:
- Start wk 1: give 4 mg PO QD
- wk 2-> 8 mg BID
- wk3-> 12 mg TID
-
Couseling point for Topiramat?
- Don't break tab
- Drink plenty of Fluid to prevent Nephrolithiasis
- s/e Hyperthermia
- metabolic acidosis
-
Vimpat ( V-> IV & C- V ) cause Euphoria
IV, Po
- Lacosamide
- s/e * AV block
- tx; Seizure
- check EKG= ECG base line
-
Banzel
- Rufinamide
- tx; Seizure > = 4yo
- 400-800 mg Bid w. Food*
- Max 3200 mg
-
SaBril ( B-> Blidness )
- Vigabatrin ( V-> vision loss )
- last line fro complex partial seizure & infantile spasms
- Noly qualified MD can cprescribe and the drug ship directly to the Pt.
-
DHEA
- Testosterone hormone
- NEVER ever give with any type of Cancer/ BPH, prostate cancer.
-
which lipid drug appove for DM?
Welchol-Colesevelam ( dec. Alc 0.5% )
-
Niacin think "3H"?
- HyperUricemia- Gout*
- Hyperglycemia-DM pt*
- Hepatotoxicity
- Monitor
- 1. LFT
- 2. Lipid
- 3. Glucose - DM
- 4. Uric acid - Gout pt
-
s/e of Fibric acid class is
Lopid- Gemfibrozil- Big enz- Inhibitor!
Tricor- Finofibrate
Trilipix- Finofibrate
Atromid-S*- Clofibrate
- cholelithiasis / Nephrolithiasis
- CI
- renal
- liver
- gallbladder dz
-
Which 2 imp drugs need to take " 30 min b/4 meals"?
Glipizide- Glucotrol* QD*( IR- max 40 mg,/ XR-max 20 mg)
- Gemfibrozil- Lopid tx ; dec. TG, Inc. HDL
- 600mg BID* AM & PM
-
What need to know Lovaza?
- dec TG for Pt > 500
- Inc. bleeding
- > 18 yo
- s/e nausea , loose stool, heart burn
-
what #1 s/e of Buspar-Buspirone?
Dizziness
-
what #1 Chantix- Varenicline
Nausea ( not rec. to use w. nicotinine replacement )
-
what are opiod antagonist?
- Naloxan-Narcan
- Nalmefene - Revex
- Morphine Form:
- Tab,
- Elixir
- rectal suppository
- sc,iv,im
-
what is Vivitrol?
- Naltrexone ER - IM form*
- give ONCE a month IM* tx & prevent relapse after pt undergone detocification tx. --> help pt stay off opiods.
-
what is Ofirmev???
Acetaminophen IV* >= 2 yo
-
what is Amitiza*?
take W/ FOOD BID
- Lubiprostone
- tx; IBS- Constipation*
- 8 mcg BID w. meals only for WOmen > 18 yo
- 24 mcg* BID w. meals for both men & women
-
Zelnorm?
- Tegaserod
- tx IBS- Constipation relate to heart problem
- only use in life threthening case
-
Lotronex?
- Alosetron
- tx IBS- Dirarrhea* only one
- must have PPL sticker to dispense
- 0.5 mg BID
- DI w. Luvox- Fluvoxamine 1A2 inhibitor
-
Loperamide?
- Imodium
- Solution& 2mg tab
- start at 4mg then after loose stool may repeat
- OTC max 8 mg/day
- In pt: max 16 mg/day
-
what form of Oxybutynin?
- tabs, ER tabs
- Syrup*
- Patch TWICE weekly- Oxytrol* ( release per 24 hr )
- Gel ( gelnique 10% ) QD- Oxybutynin
-
Enablex
( Ena married w. Dari)
Dari.fenacin
-
VeSicare
( has to care bc she -> " Solo.life"
Solife.nacin
-
Toviaz
Fesoterodine ER tab*
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