-
Actigall
- Gallstone-Solubilizing Agent: Urosdiol
- reduces cholesterol content of bile, emulsifies bile salts
- used for small, non calcified stones (see on US but not x-ray)
-
Allylamines
- Lamisil
- new class on antifungals
- also Butenafine, Terbinafine
-
Amikacin
- Aminoglycoside
- broadest spectrum
- least vulnerable to inactivation by bacterial enzymes
- reserved for when other things really dont work
- SE: nephrotoxic, ototoxic
-
Amoxicillin
- Broad Spectrum: Aminopenicillin
- Tx: H. Pylori, Otitis media
- best in neutral pH
- better absorbed & fewer SE than ampicillin
- PO only
-
Ampicillin
- Broad Spectrum: Aminopenicillin
- Primarily IV, can be PO
- generally not tolerated very well
-
Amphogel, Alternagel
- Antacid: Aluminum Hydroxide
- use in pts w renal failure
- Can also bring down phos levels - binds w PO4
- avoid in HTN, FH - has high Na+
- SE: constipation, inc CO2 production
-
Amphotericin B
- Antifungal
- Tx: systemic mycoses
- Broad spectrum, resistance is rare
- highly toxic, difficult for pt - binds to ergosterol in cell membrane, humans have sterols in membrane also
- fungicidal or fungistatic depending on conc
- no PO, IV - 6-8 weeks, may be up to 3-4 months to finish
- dont know how its excreted, stays in body for long time
- SE: phlebitis, fever, chills, rigors (demerol or Dantrolene), N, HA, nephrotoxic in all (BUN & Creat up), hypokalemia (related to kidney)
- SE start 1-3 hours after, pretreat w Tylenol/Aspirin and Benadryl
- Interactions: nephrotoxic meds, Flucytosine (synergistic, can be used to lower dose of Ampho B)
- rotate site, infuse slowly, alternate day dosing
-
Antivert
- Anticholinergic/Antihistamine: Meclizine
- Tx: Motion Sickness
- SE: Sedation, anticholinergic effects
-
Augmentin
- Amoxicillin + Clavulanic Acid (Beta-Lactam Inhibitor)
- PO
- more diarrhea than just amoxicillin
-
Azithromycin
- Macrolide Antibiotic: Zithromax, Z-pack
- very specific dosing
- take w or w/o food, not w antacids
- newer - stronger, longer-half life = may be done taking before everything clears up
- Tx: mycobacterium avium complex prophylaxis
-
Aztreonam
- Monobactam Antibiotic
- Tx: gram neg aerobes only, very specific use, may need ID consult
- can give w PCN allergy
- affects cell wall but not beta-lactamase sensitive
-
Azulfadine
- 5-aminosalicylic acid derivate: Sulfasalazine
- Tx: IBD
- suppresses inflammation
- SE: from Sulfa (photosensitivity, dec granulocytes, N, rash), less if given as enema
- Contraindications: sulfa or aspirin allergy
-
Bismuth
- pepto Bismol
- treatment of H. Pylori
- antimicrobial agents that is local in GI tract
- diarrhea, turns tongue and stool black
-
Carafate
- Sucralfate: Mucosal Protectant
- aluminum salt & sulfated sucrose
- acts locally like a BandAid, take PO and goes to place
- Does not neutralize or reduce acid
- SE: Constipation and reduced absorption of meds absorbed in stomach
-
Cardura
- Alpha1 Adrenergic Blocker: doxazosin
- Tx: BPH
- relax smooth muscle in prostate capsule, prostatic urethra and bladder neck
- SE: dec BP, especially if on bp med, nitro, viagra
- lifelong
-
Castor Oil
- stimulant laxative
- works in small intestine
- PO
- not really used any more except sometime in emergencies to clear bowel before surgery
-
Cefazolin
- Cephalosporin Antibiotic - 1st Gen
- Affects cell wall
-
Ceftazadime
- Cephalosporin Antibiotic - 3rd Gen
- Affects cell wall
-
Ceftriaxone
- Cephalosporin Antibiotic - 3rd Gen
- Affects cell wall
-
Chlorampenicol
- Broad spectrum, also kills normal flora
- IV only
- SE: bone marrow suppression, Gray syndrome, Aplastic anemia
- only used if safer agent not avail
- Grey syndrome: in newborns bc kidney and liver are immature, trouble clearing med - CV collapse and even death
- can cross into placenta and breast milk
-
Cinobac
- Cinoxacin
- Urinary Tract Antiseptic
-
Cipro
- Fluoroquinolone: Ciprofloxacin
- broad spectrum, inhibits DNA gyrase
- Tx: anthrax, UTI, prostatitis, pneumonia...
- SE: GI, CNS (HA), tendon rupture, suprainrection (ex candida)
- Drug and food interactions in PO only: Al and MG antacids, Fe and Zinc salts, dairy, Sucralfate
-
Citrucel
- Bulk Forming Laxative: methylcellulose
- also used in tx of diarrhea, absorbs fecal water
-
Clarithromycin
- Macrolide Antibiotic: Biaxin
- Tx: H. Pylori, Mycobacterium avium Complex prophylaxis
- distortion of taste, nausea, diarrhea
- extended release must be taken w meal
- newer - stronger, longer half-life = may be done taking before everything is cleared up
-
Clindamycin
- Lincosamide Antibiotic
- Tx: anaerobic infections outside CNS, acne
- IV, PO, topical (vaginal)
- SE: Pseudomembranous Colitis, rapid admin can cause EKG changes and hypotension
- PO - take w full glass of H2O
-
Colace
- Surfactant Laxative: Docusate
- stool softner
- facilitates addition of fat & water over a few days
- prophylactic
- give w full glass of water, important to drink enough
-
Compazine
- Anti-emetic/Dopamine Antagonist: Prochloroperazine
- Phenothiazine
- EPS and sleepy due to dopamine blockade at chemoreceptor site(cant drive home)
- very cheap but bad SE
- PO, IM, IV, suppository
- make sure they have call bell bc EPS will scare them
-
Cytotec
- Misoprostol: Antisecretory agent
- synthetic form of prostaglandin
- Tx: prevention of NSAID induced Gastric ulcers (not duodenal)
- Promotes secretion of bicarb, mucus and blood flow and reduces secretion of acid
- SE: Diarrhea, abd pain, utrine contractions, spotting & dysmenorrhea (Category X)
-
Dapsone
- Antimycobacterial
- Tx: Leprosy
- SE: GI, HA, rash, usually well tolerated tho
- blocks synthesis of folic acid
- Bactericidal, related to sulfonamides
- used in combo w rifampin & clofazimine
-
Dicloxacillin
- PCNase resistant
- narrow spectrum
- MRSA resistant
-
Doxycycline
- Long Acting Tetracycline Antibiotic: Vibramycin
- Tx: Lyme, Chlamydia, Malaria prophylaxis
- longer half-life, better absorbed than tetracycline, can take w meal
-
Dramamine
- Anticholinergic/Antihistamine: Dimenhydrinate
- Tx: Motion Sickness
- Decs neural stimulation on neural pathway btwn inner ear and VC
- SE: anticholinergic effects
-
Dulcolax
- Stimulant & Irritant Laxative: Bisacodyl
- suppositories work in 15-60 mins
-
Erythromycin
- Macrolide Antibiotic
- Tx: Better in Gram +, gastroparesis (separate effect)
- PO, IV, topical (eye ointment)
- alternate for PCN allergy
- SE: Gi upset (common), Suprainfection, QT prolongation (rare)
- Food generally decs absorption
-
Ethambutol
- Antimycobacterial
- Tx: TB, active Mycobacterium avium
- bacteristatic
- SE: optic neuritis, allergy, hyperuricemia, GI discomfort
-
Flomax
- Alpha1 Adrenergic Blocker: tamsulosin
- Tx: BPH
- relax smooth muscle in prostate capsule, prostatic urethra and bladder neck
- SE: dec BP less likely bc selective to prostate
-
Flutamide
- Androgen Receptor Blocker: Eulexin
- Tx: Prostate CA
- blocks testosterone, really only works for ~2 yrs
- SE: gynecomastia, N/V/D, liver toxicity
- combined w surgical or chem castration
-
Folic Acid
- Water Sol
- Deficiency: megaloblastic anemia, neural tube defects
- No neurologic effect
- common in alcoholics
- excess really doesnt cause a problem
-
Furadantin
- Nitrofurantoin
- Urinary Tract Antiseptic
-
Gentamicin
- Aminoglycoside Antibiotic
- Tx: serious gram - aerobic infections
- not effective on anaerobic
- can b used in empiric tx, but mostly specific tx
- IM or intrathecal, PO (only for GI)
- SE: neprotoxic, ototoxic, neuromuscular blockade (not common) - high peaks not dangerous, just high trough - monitor peak and trough
- can be given daily (better, only draw trough) or 2-3 smaller doses (both)
- serum levels vary greatly btwn pts, not just on ht/wt
- Caution: using other nepro- or ototoxic meds
- used in combo w PCN bc it breaks down cell wall but dont run through same IC
-
Glycerine
- suppository laxative
- gentle, safe in infants and children
- just softens stool, no stimulant effect
- helps re-establish bowel patterns after abuse
-
GoLYTELY
- polyethylene Glycol-Electrolyte Solutions
- isometric w body fluids: no fluid or electrolyte loss
- Use: diagnostic procedure prep
- drink 4L in 2-3 hours
- safe in pts w dehydration
- yellow, Gatorade like color
-
Griseofulvin
- Tx: dermatophytic infections
- deposited in keratin precursor cells, newly formed keratin is resistant to fungal infections
- 3-8 weeks for skin
- 2-3 months for palms
- up to 1 yr+ for nails
-
-
Imipenem
- Carbapenem Antibiotic
- IM or IV only
- admin w Cilastin to inc urine excretion
- PCN allergy cross sensitivity
- affects cell wall
-
Immodium
- Antidiarrheal: Loperamide
- Tx: gastroenteritis (acute or chronic diarrhea)
- chem related to opioids but cant get high - dont need atropine so less SE
- Slows motility
-
Imuran
- Immunomodulator: Azathioprine
- Tx: refractory IBD
- onset may be up to 6 months
- SE: pancreatitis, bone marrow suppression, can be hepato- and nephrotoxic
- monitor CBC
-
INH
- Isoniazid, Laniazid
- Antituberculis/Antimycobacterial
- primary agent, bactericidal
- SE: peripheral neuropathy (Vit B6), hepatotoxic, optic neuritis, anemia
-
Iron
- Ferrous Sulfate
- Deficiency: microcystic, hypochromic anemia (pale, tired, SOB, weakness)
- Can be caused by chronic blood loss, pregnancy, also in infancy & early childhood
- SE: GI (N/V, constipation, dark/green stool), Anaphylaxis w parenteral(usually do small skin test)
- children at greatest risk of toxicity
- better absorption btwn meals but food decs GI irritation, Vit C promotes absorption
- can stain teeth
-
Ivermectin
- Stromectol
- Tx: mites and lice
- causes paralysis, disrupts nerve and muscle function
- single dose, off label
- still need to use comb to remove eggs
-
Ketoconazole
- Tx: systemic and superficial mycoses, less severe
- less toxic, but less effective than Ampho B
- Broad Spectrum, fungistatic & Fungicidal
- inhibits synthesis of ergosterol
- SE: N/V, hepatotoxic, effects sex hormone
- Interactions: meds that inc gastric pH, inhibit cytochrome P450 enzymes, rifampin
-
Lactulose
- synthetic disaccharide of galactose & fructose
- metabolized: by bacteria into acids & CO2, draws H2O into stool
- tx: hepatic encephalopathy - acid draws ammonia in
- cant b digested and is poorly absorbed
- soft formed stool in 1-3 days
- SE: cramping and flatulence
-
Lamodil
- Antidiarrheal: Diphenoxylate HCL w Atropine
- opioid w atropine to deter abuse, can get morphine like high if you take alot, but very bad SE
- Schedule V
- SE: anticholinergic effects, opioid effects (CNS depression, constipation)
- Drug interaction: MAOIs
- Contraindications: infectious diarrhea, obstructed jaundice, under 2 years
-
Lotronex
- IBS: Alosetron
- for women only
- Risk management program: Fatal GI effects (obstructions, ischemia, perforations)
- reduces urgency and freq of BMs
-
Lupron
- Leuprolide
- Gonadotropin-Releasing Hormone Agonist
- suppresses testosterone prod
- SE: hot flashes, impotence, loss of libido, osteoporosis in men
- chemical castration
-
Maalox
- Antacid
- combination of aluminum (constipating) and magnesium (diarrhea) to balance out
-
Malathion
- Ovide
- Organophosphate cholinesterase inhibitor
- 0.5%lotion
- Tx: lice and their ova
- apply to hair, let air dry
- flammable - high alcohol content
- still need to use comb to remove eggs
-
Mandelamine
- Methenamine
- Urinary Tract Antiseptic
-
Marinol
- Antiemetic/Cannabinoid: Dronabinol
- Tx: N/V associated w chemo, appetite stimulant in AIDS, dementia
- SE: dissociation, dysphoria
- Caution: in cardiac pts - can drop bp and have palpations
- Schedule III
- Slow onset of action
-
Mesalamine
- 5-aminosalicylic acid derivate: Asacol or Pentasa
- Tx: IBD
- similar to sulfasalazine but w/o sulfa part, so less SE
- Contraindication: aspirin allergy
-
Metamucil
- Bulk Forming Laxative: Psyllium
- Unlabeled use: cholesterol lowering agent
-
Methylprednisolone
- Corticosteroid
- Tx: IBD
- PO, IV
-
Metronidazole
- Antiprotozoal: Flagyl, Metizol, Protostat
- Tx: H. Pylori, Pseudomembranous Colitis, intestinal amebiasis, giardiasis, T. vaginalis
- Broad spectrum, high resistance
- Pro drug - need anaerobic enviro (our cells are aerobicc)
- SE: N/V, HA, dry mouth, metallic taste, stomatitis, diarrhea, insomnia, vertigo, weakness, darkening of urine
- Interactions: disulfiram, inhibits inactivation of warfarin, incs levels of Phenytoin, lithium, fluorouricil, Cyclosporin, Tacrolimus, binds w Cholesyramine (2 hours btwn), drugs that effect CYP3A4
- Caution: in renal pts, dont use in 1st tri, caution after, dont use in CNS pts
-
Milk of Magnesia
- Antacid: Magnesium Hydroxide
- Osmotic Laxative
- generally more for constipation
- SE: diarrhea, substantial fluid and electrolyte loss
- Caution in pts w renal failure & HF, can inc mag level
- Avoid w undiagnosed abd pain
- Incs effect of sulfonylureas, quinidine & dicumarol
-
Mineral Oil
- Emollient or Lubricant laxative
- excessive oral admin decs absorption of fat sol vits
- poorly absorbed
- not really used much anymore, was used in "healthy" chips
-
Nafcillin
- PCNase resistant
- narrow spectrum
- MRSA resistant
-
NegGram
- Nalidixic acid
- Urinary Tract Antiseptic
-
Neomycin
- Aminoglycoside
- highest risk for toxicity
- PO, topically, NOT IV
- Tx: suppress bowel flore before surgery
-
Nystatin
- polyene antibiotic
- Tx: candidiasis only
- PO (pill or suspension) & topical (powder)
-
Orlistat
- Lipase Inhibitor: Xenical
- Tx: obesity
- reduces absorption of dietary fats
- must be obese (BMI 30) or overwt (27) w related health problems/CV risk factors
- Contraindications: malabsorption syndrome, cholestasis, caution w kidney stones, delayed bladder emptying
- SE: oily fecal incontinence, dec absorption of fat sol vitamins
-
Oxacillin
- PCNase resistant
- narrow spectrum
- MRSA resistant
-
Pancrelipase
- lipase, protease & amylse
- enteric coated - dont cut or crush
- Contraindications: hypersensitivities to porcine proteins, acute or chronic flares (will be NPO)
- give w a meal or snack
- Pancreatin - same action and indication but less conc
- monitor albumin, prealbumin, pancreatic enzymes
-
PCN G
- Forms: Potassium PCN, Procaine PCN, Benzathine PCN - salts dissociate to release PCN G
- Dont give PO, only K can be given IV
- Distribution: inflammation incs penetration into CSF, joints and eye
- not metabolized, so make sure no kidney problems
- SE: allergy, pain at site, neurotoxicity w high blood levels, hyperkalemia w lg Iv doses
- Interactions: Aminoglycosides inactivated when they are mixed - separate admin!
-
PCN V
- PCN VK, Pen-Vee K
- PO only - usually w meal to reduce GI SE
- Tx: dental work/issues, strep...
-
Pepcid
- Famotidine: H2 Receptor antagonist
- does not inhibit hepat drug metabolizing enzymes
- Same uses and SE as Zantac
-
Pepto Bismol
- Bismuth Subsalicylate
- Antidiarrheal
- antimicrobial effects in GI, reduces inflammation, soothes bowel, ins H2O absorption
- SE: discoloration of tongue and stool
- Contraindications: aspirin allergy, kids (Reye's), IBD (bursting)
-
Lindane
- Kwell, G-well
- Tx: scabies, lice, pruritis (min effect)
- causes seizure in parasite, can in pt too, esp if hx of seizure
- SE: eye and mucus membrane irritation, seizure
- Contraindication: Seizure d/o, elderly, less than 110 lbs
- Caution: open sores, psoriasis, atopic dermatitis
-
Permethrin
- Nix, Elimite, Acticin
- 1% liquid
- Tx: scabies and lice
- causes paralysis of insect
- SE: not many - itching/burning
- for scabies: apply to entire body (massage in), leave overnight, shower in morning
- For lice: wash hair before, apply, leave 10 days, can retreat in 7
- resistance in 5%
-
Phenergan
- Anti-emetic/Dopamine Antagonist: Promethazine
- Phenothiazine
- EPS and sleepy due to dopamine blockade at chemoreceptor site(cant drive home)
- very cheap but bad SE
- PO, IM, IV, suppository
- make sure they have call bell bc EPS will scare them
- Phenergan extravassation - necrosis,
- death, finger and hand amputation – need to be very careful giving IV, some hospitals have pulled it, - if giving dilute it w NSS, only use a very good site, stay to watch it go in
-
Piperacillin
- Extended Spectrum: Antipseudomonal PCN
- IV
- PCNase sensitive
-
-
Prilosec
- omeprazole - PPI
- Tx: GERD, PUD, Zollinger-Ellison, Dyspepsia
- newer and more effective in dec gastric acid than H2 blockers
-
Proscar
- 5-alpha-reductase inhibitor: Finasteride
- Tx: urinary symptoms of BPH
- inc effect w inc enlargement
- decs prostate size
- SE: gynecomastia, dec libido, dec ejaculate volume
- effects begin in 6-12 mo
- indefinite tx, prostate will re-enlarge
- monitor PSA, should go down
- preg X = cant donate blood for certain period
-
Pyrazinamide
- Antimycobacterial
- Tx: TB
- Bactericidal
- SE: hepatotoxic, photosensitivity
-
Reglan
- antiemetic/prokinetic agent: metoclopromide
- Tx: N/V related to gastroparesis, GERD, psot-op, chemo
- sensitizes tissue to acetylcholine, incs peristalsis & gastric emptying, Dopamine antagonist
- SE: CNS depression, EPS, Diarrhea
-
Rifampin
- Antimycobacterial: Rifadin
- Tx: TB, Leprosy, H flu, Legionella
- SE: hepatitis, body fluid discoloration (red), optic neuritis
- Interactions: cytochrome P450 meds (coumadin, contraceptives, HIV meds - incs metab
- consult eye dr about contacts bc body fluids
-
Scopolamine
- Anticholinergic/Muscarinic Antagonist
- Tx: Motion Sickness
- SE: dry mouth, blurred vision, drowsiness (anticholinergic effects)
- patch and pill
- dec neural stimulation on pathway btwn inner ear and vomiting center
-
Senokot
- Stimulant Laxative: Anthraquinones
- herbal source
- change in urine color to dark yellow
- red/brown pill
-
Sodium Bicarbonate
- Antacid
- not an agent of choice
- can make body pH rise
- avoid Na+ load in pts w hx of HTN & HF
-
Synercid
- Streptgramin Antibiotic: Quinupristin/Dalfopristin (always come together in set ratio)
- Tx: MRSA, VRE - require ID approval
- Caution: pts w dec hepat func - monitor liver enzymes, bilirubin
- Interactions: saline, heparin (flush line w D5W)
- metabolized by liver
- monitor for thrombophlebitis (flush line regularly)
-
Tagamet
- Cimetidine
- PO, IM, IV
- H2 Receptor Antagonist
- treatment of PUD, GERD, Zollinger-Ellison Syndrome, Dyspepsia, prevention of aspiration pneumonitis
- Blocks Histamine (messenger) at receptor site, histamine causes inc gastric acid prod. from parietal cells
- Dont really use any more bc bad SE: antiandrogenic confusion (esp in elderly), inhibits hepatic drug metabolizing
- Dont take w Antacids
-
Terazosin
- Alpha1 Adrenergic Blocker: Hytrin
- Tx: BPH
- relax smooth muscle in prostate capsule, prostatic urethra and bladder neck
- SE: dec BP, especially if on bp med, nitro, viagra
- lifelong
-
Tetracycline
- Tx: H. Pylori, acne
- SE: stains teeth, photosensitivity, GI irritation, suprainfection
- PO, topical
- Contraindicated: pregnancy, breastfeeding, under 8
- Take on empty stomach, space 2 hours from Ca, Fe, MG-form non-absorbable compounds)
-
Thiamin
- Vit B1 - Water Sol
- Deficiency: Wernicke-Korsakoff syndrome (CNS effects), common in alcoholics
- Wernicke-Korsakoff requires IV replacement
-
Ticarcillin
- Extended Spectrum: Antipseudomonal PCN
- IV
- PCNase sensitive
-
Timentin
- Ticaricillin + Clavulanic acid (Beta-Lactamase Inhibitor)
- IV
-
Tobramycin
- Aminoglycoside
- same interactions and SE as gentamicin
-
Trimethroprim
- Suppresses synthesis of DNA, RNA, and protein (more sensitive to bacterial cells)
- Bactericidal or Bacteriosatic
- SE: rash, itching, GI upset, but generally well tolerated
- not recommended druing preg (exacerbates folate deficiency)
-
TMP-SMZ
- Trimethoprim-Sulfamethoxazole: Bactrim, Cotrim, Spetra (comes pre-mixed 1:5)
- Tx: broad spectrum of Gram - and +, UTI, otitis media, bronchitis, pneumonia-PCP, Shigellosis, community MRSA
- Action: inhibits production of nucleic acids and proteins
- very effective and low resistance bc working at 2 points of protein synthesis process
- PO or IV, well distributed
- SE: N/V, rash, sulfonamide reactions, sulfa allergy, GI upset (common)
- dose based on TMP component
- Interactions: Coumadin, Phenytoin, Sulfonylureas (intensifies)
-
TUMS
- Antacid: Calcium Carbonate
- SE: acid rebound, constipation, eructation due to inc CO2 production
-
Unasyn
- Ampicillin + Sulbactam (Beta-Lactamase Inhibitor)
- IV
-
Vancomycin
- Tx: MRSA, pseudomembranous colitis, gram + infections
- Safe in PCN allergy
- SE: redman/neck syndrome, ototoxic, nephrotoxic
- monitor peak, trough, and infusion time
- IV, PO (only for GI) - cant be IM
- Redman: flushed, anxious - directly related to infusion time
-
Viagra
- Sildenafil
- PDE5 inhibitor
- also Cialis, Levitra (prolongs QT)
- Tx: ED
- Selective inhibition
- PRN! 1/day, works for whole day
- SE: hypotension, Priapism, MI, Sudden death, HA, flushing, dyspepsia, nonartereic ischemic optic neuropathy
- augments effects of nitric oxide resulting in inc blood flow
- most insurance wont cover
- Interactions: nitrates, alpha1 antagonists, hepatic pathway, high fat foods delay absorption
- make sure they're able to tolerate activity
-
Vit A
- Fat Sol
- Deficiency: night blindness
- Toxicity: birth defects, liver injury, bone related D/Os
- Teratogenic:
- From: anything that is orange, fish, meats, dairy
-
Vit B6
- Pyridoxine - Water Soluble
- Deficiency: peripheral neuritis - common in alchohilcs and pts on INH
- Interactions: interferes w Levodopa
-
Vit B12
- Cyanocobalamin - Water Sol
- Deficiency: Megaloblastic anemia, parasthesias that can progress to permanent neurologic changes
- Generally from impaired absorption (lack of intrinsic factor), also from celiac and gastric surgery
- May require life long monthly IM
-
Vit D
- Fat Sol
- Deficiency: rickets/osteomalacia
- Toxicity: hypercalcemia
- From: sun, fortified foods, not many foods naturally have it
- incs Ca absorption
-
Vit E
- Fat sol
- Deficiency: neurologic effects - rare, except malabsorption syndromes
- Toxicity: risk of bleeding at very high doses
-
Vit C
- Water Sol
- Deficiency: Scurvy - bone and tooth development, bleeding from gums, loose teeth
- From: citrus fruits
- involved in production of collagen
-
Vit K
- Fat Sol
- Deficiency: bleeding tendency
- Toxicity: its not really stores so its hard to reach toxic levels
- Uses: in neonates, warfarin OD
- PO, IV (risk of hypersensitivity)
- causes blood clotting, Coumadin blocks it
- From: green leafy veggies, synthesized by bacteria in GI
-
Zantac
- Ranitidine - H2 Receptor Antagonist
- more powerful than tagamet w fewer SE and drug interactions: no antiandrogenic effects, doesnt cross BBB, weak inhibitor of hepat drug metab enzymes
- antacids can dec absorption
- Uses: GERD, PUD, Zollinger-Ellison, Dyspepsia
-
Zofran
- 5-HT3 receptor antagonist: ondansetron
- very good, not just for Ca tx
- comes PO, IV and dissolving tab
-
Zosyn
- Piperacillin + Tazobactam (Beta-Lactamase Inhibitor)
- IV
-
Zyvox
- Oxazolidinone Antibiotic: Linezolid
- Tx: MRSA and VRE - require ID approval, $5,000 bottle of wine
- SE: Myelosuppression, N/V, Diarrhea, headache
- Interactions: MAOI and Sympathomimetics (HTN crisis), SSRI (serotonin syndrome
- IV or PO
-
Proton Pump Inhibitors
- Prevacid, Protonix, Nexium, Aciphex
- 1st 3 can be IV, all others PO
- -prazole
- Nexium metabolizes slower than Prilosec
- prevent production of acid itself
- take ac and 2 hours pc, do not crush/chew, needs to reach duodenum
- 4-8 weeks recommended use to promote healing bc dec acid can lead to inc gastrin (neg feedback), can cause Ca
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