-
Ditroptan
- Oxybutynin - antimuscarinic
- Also available as a patch and gel
- 5 mg PO BID to TID
- Patch is dosed 3.9 mg daily applied 2x/week
- SE: dry mouth, constipation, dry eyes/blurred vision, urinary retention, drowsiness (especially with oxybutynin and tolterodine)
-
Oxytrol
- Oxybutynin patch
- Changed twice weekly, apply on abdomen, hips or buttocks, causes less dry mouth and constipation than oral form
-
Gelnique
Oxybutynin topical
-
Detrol
- Tolterodine IR 1-2 mg PO BID
- Tolterodine ER 2-4 mg PO daily
-
Sanctura
- Trospium
- 20 mg BID or 60 mg XR daily, take on empty stomach
-
Vesicare
- Solifenacin
- 5 to 10 mg PO daily
-
Enablex
- Darifenacin
- 7.5 to 15 mg PO daily
- May cause most constipation
-
Toviaz
- Fesoterodine
- 4-8 mg PO daily
-
Myrbetriq
- Mirabegron - activates beta 3 receptors which increases bladder capacity
- SE: HTN, nasopharyngitis, UTI, HA
- 25-50 mg daily
- Reduce dose with reduced CrCl
-
Opthalmic Beta Blockers Effects
Nonselective, reduce aqueous humor production
-
Timoptic and Timoptic XE
- Timolol opth is QD or BID
- Timolol XE is a gel used QD
-
-
-
OptiPranolol
Metipranolol
-
Betoptic, Betoptic S
Betaxolol
-
Prostaglandin Analogs Effects
Increase aquoues outflow
-
Travatan Z
- Travoprost - prostaglandin analog
- Travatan X doesn't contain benzalkonium chloride but has different preservative
-
Lumigan
Bimatoprost - prostaglandin analog
-
Latisse
Bimotoprost opth indicated for eyelash hypotrichosis
-
Xalatan
- Latanoprost - prostaglandin analog
- Keep unopened bottles in fridge
-
Zioptan
- Tafluprost - comes in foil pouches of 10 single use containers
- Keep refrigerated
-
Miotics Effects
Increase aqueous outflow
-
Isopto, Miostat
Carbachol - miotic
-
Isopto Carpine
Pilocarpine - miotic
-
Carbonic Anhydrase inhibitor Effect
Reduce aqueoue humor production
-
Diomax
- Acetazolamide
- 250 to 500 mg oral 1-4x daily
-
-
-
Cosopt
Dorzolamide/Timolol
-
Adrenergics opth effect
Increase aqueoue outflow and decrease production
-
Iopidine
- Apraclonidine TID
- Adrenergic
-
Alphagan P
- Brimonidine TID
- Adrenergic
-
-
Combigan
Brimonidine + Timolol
-
Alpha blocker ocular SE
Floppy iris syndrome causing difficulty in cataract surgery
-
Amiodarone ocular SE
Corneal deposits, optic neuropathy
-
Bisphosphonates ocular SE
Ocular inflammation
-
Digoxin ocular SE
Yellow/green vision, blurriness, halos
-
Ethambutol ocular SE
Optic neuropathy especially with chronic use
-
Linezolid ocular SE
Optic neuropathy, especially with chronic use
-
Plaquenil ocular SE
retinopathy
-
Isoniazid ocular SE
Optic neuritis
-
Isotretinoin ocular SE
decrease in night vision which may be permanent, dry eyes/irritation
-
Quinolones ocular SE
Retinal detachment
-
Viagra ocular SE
greenish tinge around objects, possible permanent vision loss in one or both eyes, also hearing loss
-
Tamoxifen ocular SE
corneal changes, decreased color perception
-
Telithromycin ocular SE
blurry vision, diplopia
-
VFEND ocular SE
abnormal vision, color vision change, photophobia
-
Zaditor, Alaway
Ketotifen
-
Naphcon, Opcon, Visine
Naphazoline/pheniramine
-
Xyzal opth
Levocetirizine
-
-
-
Alomide
Lodoxamine - mast cell stabilizer
-
Alocril
Nedocromil - mast cell stabilizer
-
Alamast
Pemirolast - mast cell stabilizer
-
Optivar
Azelastine-mast cell stabilizer and antihistamine
-
Elestat
Epinastine - mast cell stabilizer and antihstamine
-
Patanol
Olopatadine - antihistamine and mast cell stabilizer
-
-
-
Restasis
- Cyclosporine Emulsion Eye Drops
- 1 drop to each eye BID
- Open one pack per use
-
Azasite
Azithromycin opth - stored in refrigerator, 14 days at room temp
-
Vigamox
Moxifloxacin opth
-
Besivance
Besifloxacin opth
-
Antiobiotic/steroid opth
Tobramycin/dexamethasone
-
Ciloxan
Ciprofloxacin opth
-
-
Garamycin
Gentamicin opth
-
-
Polytrim
trimethoprim/polymyxin
-
-
-
Neosporin
Neomycin, bacitracin, polymyxin
-
Auralgan
Antipyrine and benzocaine otic
-
A/B Otic
Antipyrine and benzocaine otic
-
Americaine Otic
Benzocaine otic
-
Cipro HC
Ciprofloxacin and hydrocortisone
-
Ciprodex
Ciprofloxacin and dexamethasone
-
FLoxin
Ciprofloxacin Otic
-
Cortisporin-TC
Neomycin and hydrocortisone
-
Debrox
Carbamide peroxide
-
Cerumenex
Triethanolamine
-
Anticonvulsants Pregnancy D category (6)
- (Carbamazepine, clonazepam, phenobarbital, phenytoin, topiramate, and valproate)
- Valproate has highest risk of fetal harm
- All other AEDs are pregnancy category C
-
AEDs that are strong inducers (7)
Carbamazepine, oxcarbazepine, primidone, phenobarbital, phenytoin, and topiramate
-
Anticonvulsants with modest weight loss (3)
Topiramate, Zonisamide, levetiracetam
-
Klonopin for Seizures
- Clonazepam - enhanced activity of GABA
- Available: tablet, ODT
- 0.5 BID to TID
- Max 20/day
- Somnolence, dizziness/ataxia, drooling, cognitive impairment, depression, mood changes, physiological dependence, tolerance
-
Onfi for Seizures
- Clobazam
- Available: tablet
- less than 30 kg 5 daily, max 10
- more than 30 kg 10 daily max 20
-
Tegretol for Seizures
- Carbamazepine - fast NA channel blocker
- Inital 200 mg BID, daily if XR
- Max 1600 mg/day
- Therapeutic range: 4-12 mcg/ml
- Available: capsule, tablet, suspension
- BBW: serious skin reactions, test for HLAB1502, fatal blood cell abnormalities
- SE: N/V, dizzy, drowsy, rare - serious skin reactions, hepatotoxicity, SIADH, vit D and Ca deficiency
-
-
-
Equetro
Carbamazepine for bipolar
-
Zarontin
- Ethosuximide - T type calcium channel blocker
- Initial 250 mg BID
- Max 1500 mg/day
- DOC for absence
- Available: capsule, solution
-
Luminal
- Phenobarbital - enhances GABA mediated chloride influx CIV
- Available: tablet, solution, injection
- Initial 1-3 mg/kg/day
- Max 300 mg/day
- Therapeutic range 20-40 mcg/ml in adults, 15 to 30 mcg/ml in children
- SE: Major sedation, cognitive impairment, dizziness/ataxia, dependence, tolerance
-
Mysoline
Primidone - prodrug of phenobarbital
-
Dilantin
- Phenytoin - fast sodium channel blocker
- Michalis Mentin kinetics
- If albumin is low, the true phentoin levels will be higher than it appears
- Enteral feedings may decrease phenytoin absorption, must separate
- IV to oral: 1 to 1
- SE: chronic therapy - gingival hyperplasia, lupus-like syndrome, connective tissue disorder, hirsutis,, peripheral neuropathies, vit D and cal deficiency
- Toxic sx: ataxia/slurred speech, nystagmus, blurred vision, diplopia, lethary, HA, drowsiness
- SErious adverse affects: skin reaction, purple glove syndrome
- See menumonic
- Mix injection in NS only, max infusion rate 50 mg/min
- Available: capsules, tablts, suspensions, injections
- Initial 100 mg TID
- Max 600 mg/day
-
Fospheytoin
- Pro-drug of phenytoin IV or IM
- I mg PE = 1 mg PHT
- Max 150 mg PE/min
- Can mix in NS or D5W
-
Depakote
- Divaloproex - T type calcium channel blocker an fast sodium channel blocker
- Sodium valproate and valproic acid in a 1:1 ratio
- Depakote - delayed release tablet
- Depakote ER - ext release tablet
- Depakote Sprinkle
- Can increase lamotrigine levels
- See valproic acid for SE
-
Depakene
Valproic acid - capsules, solution
-
Stavzor
- Valproic Acid
- Delayed release capsules
-
Depacon
- Valproic acid IV
- Initial 125 to 250 mg BID
- Max 60 mg/k/day
- Range 50 to 100 mcg/ml
- If albumin is low, true valproate level may be higher
- BBW: hepatic failure, teratogen neural tube defects, pancreatitis
- SE: GI, ab painm dizziness, asthenia, alopecia (treat with selenium and zinc), somnolence, tremor, weight gain, polysystic ovary syndrome, thrombocytopenia, vit D an cal deficiency
-
Lamictal
- Lamotrigine - inhibits release of glutamate and aspartate
- Dosing: slow taper, being with 25 mg/day x 2 weeks, then 50 mg/day x 2 weeks, increase by 50 mg every 1 to 2 weeks, may have to titrate deifferently based on co-meds (carbamazepine, phenytoin, valproate, phenobarbital, primidone)
- BBW: serious skin reactions
- SE: N, sleepy, dizzy, diplobia, blurred vision, ataxia, rash, increased risk of aseptic meningitis
- Available: tablet
-
Keppra
- Levetiracetam
- Max 3000 daily
-
Trileptal
- Oxcarbazepine
- Hyponatremia, more common with oxcarbazepine
- Max 2400 mg daily
- Carbazepine: oxcarb dose conversion: 1.2-1.5x carbamazepine dose
-
Lyrica
- Pregabalin
- CV
- Initial 75 mg BID
- Max 450 mg/day
- Decrease dose if CrCl less than 60
-
Neurontin
- Gabapentin
- Max 3600 mg/day
- Decrease dose if interval less than 60
-
Topamax
- Topiramate
- Decrease dose if CrCl less tha 70
- Rare side effects: oligohydrosis, hyperthemia, nephrolithiasis (kidney stones)
-
Zonegran
- Zonisamide
- Initiall 100 daily, max 400 daily
- Don't use if CrCl less than 50
- Rare SE: oligohydrosis, nephrolithiasis, serious skin reactions
- Don't use if allergic to sulfonamides
-
Potiga
- Ezogabine
- Initial 100 mg TID
- Max 1200 daily
-
Felbatol
- Felbamate
- Initial 1200 mg daily divded TID to QID and reduce concomitant AED dose by one-third
- BBW: hepatic failure and aplastic anemia
-
Vimpat
- Lacosamide CV
- Initial 50 mg BID
- max 400 daily
- Decrease if CrCl less than 30
- Prolongs PR interval, get ECG before therapy starts
-
Banzel
- Rufinamide
- Initial 200 to 400 mg BID
- Max 3200 mg daily
- QT shortening
-
Gabitril
- Tiagabine
- Initial 4 mg daily
- Max 56 mg daily
-
Sabril
- Vigabatrin
- Intial 500 mg BID
- Max 3000 mg daily
- ONly available through SHARE progrma
- BBW: can cause permanent vision loss
-
Fycompa
- Perampanel
- Initial 2 mg QHS
- Max 12 mg/day
-
Interferons for MS (3)
- Have antiviral and antiproliferative effects
- Avonex, Rebif, and Betaseron or Extavia
- SE: flu like reactions, injection site reactions, depression/suicide
-
Avonex
- Interferon beta-1a
- 30 mcg weekly
- Powder for reconstitution, pre-filled syringes and pens - refrigerate
-
Rebif
- Interferon beta-1a
- SC: 22 mcg or 44 mcg three times weekly
- Pre-filled syringes--refrigerate
-
Betaseron
- Interferon beta 1b
- SC: 0.25 mg every other day
- Power (for reconstitution) store at room temperature
-
Extavia
- Interferon beta 1b
- SC: 0.25 mg every other day
- Power (for reconstitution) store at room temperature
-
Copaxone
- Glatiramer aceate - immune modulator
- 20 mg SC daily, single use syringe, referigerate
- INjection site reactions vasodilation, rash dyspnea, etc.
-
Tysabri
- Natalizumab - recombinant humanized monoclonal antibody
- 300 mg IV given over 1 hour every 4 weeks
- Can cause progressive mutifocal leukoencephalopathy
-
Gilenya
- Fingolimod - oral immune modulator
- 0.5 mg capsule daily with or without food
- SE: decrease in heart rate, mascular edema, increase in infections, decrease in pulmonary function tests, increase in LFTs
-
Aubagio
- Teriflunomide - prymidine synthesis inhibitor
- Active metabolite of lefluonmide
- 7 mg or 14 mg daily
- BBW: severe liver tox and teratogenicity
-
Ampyra
- Dalfampridine - K channel blocker, may increase nerve signal conduction
- 10 mg BID Ext Rel tablets
|
|