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67 Cards in this Set

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Lorcet- generic name
acetaminophen and hydrocodone bitartrate
Lorcet- dosage forms
-Lorcet plus is 7.5 in 650
-Lorcet is 10 in 650
-also in 5 mg in 500 (lorcet HD) and 500 ASA (lorcet ASA)
Lorcet- indications/dosages
-for moderate to moderately severe pain
-one tablet q4-6h
-adjust dose for patient and pain severity
-tolerance can develop with continued use of HB and untoward effects are dose-related
-no more than 6 tab in 24h
Lorcet- pharmacology/PK
-acetaminophen produces analgesia in the CNS by inhibiting prostaglandin synthesis and in the PNS by inhibiting pain impulse generation
-HB produces analgesia by direct action on Central opioid receptors
Lorcet- Drug interactions
-other cns depressants/ alcohol
-increases MAOI and TCA
-anticholinergics may produce paralytic ileus
-hydeantoins and sulfinpyrazone use can increase risk of hepatotoxicity
Lorcet- Contraindications/precautions
-use with caution in pts with pulmonary disease, increased intracranial pressure, head injury, severe hepatic or renal disease, addison's disease, hypothyroidism, prostatic hypertrophy or urethral stricture, or in the presence of acute abdominal conditions
-preg C
Lorcet- Adverse Effects
Dizziness, Drowsiness, Constipation, Nausea, Vomitting
Lorcet- Pt Consult
-may cause drowsiness.
-avoid alcohol while taking this medication
-may take with milk or food to avoid GI upset
-Warning: may be habit forming
-store in a cool, dry place away from sunlight and children
-contact a physician if SE are severe or persistant
-if a dose is missed, skip it and return to normal dosing schedule
Lortab- generic name
acetaminophen and hydrocodone bitartrate
Lortab- Dosage Forms
-Lortab 2.5
-Lortab 5
-Lortab 7.5
-Lortab10/500
-Lortab elixer (5 ml is 2.5mg in 167 mg)
Lortab- Indications/dosages
-for the relief of moderate to moderately severe pain
-1-2 tab or 3 tsp q4-6h
-no more than 8 tab (6 of 10) q24h
Lortab- Pharmacology/ PK
-acetaminophen analgesia in the CNS by inhibiting prostagladin syn and in the PNS by inhibiting pain impulse generation
-HB analgesia is produced by activation of central opioid receptors
Lortab- Drug Interactions
-CNS depressants and alcohol
-increases TCA and MAOI
-anticholingerics cause paralytic ileus
-hydantoins and sulfinpyrazone increase hepatotoxicity risks
Lortab- contraindications/ precautions
-pulmonary disease, increased intracranial pressure, head injury, severe hepatic and renal disease, addison's disease, hypothyroidism, prostatic hypertrophy, urethral stricutre, acute abdominal condictions
-preg c
Lortab- Adverse Effects
Dizziness, Drowsiness, Nausea, Constipation, Vomitting
Lortab- Pt consult
-may cause drowsiness
-avoid alcohol
-may take with food or milk
-store in cool, dry, dark, away from children
-contact a physician if SE are persistant or severe
-skip a dose if missed
Vicoden- generic name
acetaminophen and hydrocodone bitartrate
Vicoden- dosage forms
-vicoden 50 in 500
-vicoden ES is 7.5 in 750
-Vicoden HP is 10 in 660
Vicoden- indications/ dosages
-relief of mod to moderately severe pain
-one tab q4-6h
no more than 8, 5 ES, 4 HP in 24 hours
-take with milk or food to avoid GI upset
-may cause drowsiness
Vicoden- Pharmacology/PK
-acetaminophen analgesia is produced in CNS by inhibiting prostaglandin synthesis and in the pns by inhibiting pain impulse generation
Lortab- Drug interactions
-CNS depressants and alcohol
-increase MAOI, TCA
-anticholinergics may cause paralytic ileus
-hydantoins and sulfinpyrazone may increase hepatotoxicity risk
Lortab- contraindication/precautions
pulmonary disease, increased intracranial pressure, head injury, severe heaptic or renal disease, addison's disease, hypothyroidism, prostatic hypertrophy, urethral stricture, acute abdominal conditions, ES contains NA metabisulfite so watch in sulfite allergy and asthmatics, preg C
Lortab- AE
Drowsy, Dizzy, Constipate, Nausea
Lortab- Pt Consult
-may cause drowsiness
-avoid alcohol
-take take with food or milk
-warning: may be habit forming
-store in a cool dry dark place away from kids
-contact a physician if SE are severe or persistant
-skip a missed dose
Levoxyl- generic name
levothyroxine sodium
levoxyl-other common brand name
synthroid
lecothroid
levoxyl- dosage forms
25 mcg- orange
50- white
75- purple
88-olive
100-yellow
112- rose
125- brown
137- blue
175- turqoise
200- pink
300- green
.1 mg= 64 mg thyroid
Levoxyl- indications
Replacement therapy for reduced or absent thyroid function
-0-1 yr: 9mcg/kg/day
1-5: 6
6-10: 4
11-20: 3
adult: 25-300 mcg/day
Levoxyl- pharmacology/ PK
-exact mechanism is unknown but is throught to be due to protein synthesis control resulting in (1) a regulation of growth and development, (2) an in crease in meatbolic rate, (3) inhibition of the secretino of thyrotopin by the pituitary, (4) various effects on lipid and carb metabolism.
-synthetic T4 is similar to that made by thyroid.
-99% is bound to proteins
Levoxyl- drug interactions
-may increase the effects of oral anticoagulants
-cholestyramine may decrease the absorption of levothyroxine
-may decrease the effectiveness of digitalis glycosides
levoxyl- contra and precautions
-contra in pts with diagnosed but untreated adrenal cortical insufficiency, untreated thyrotoxicosis, and in patients with acute MI
-cautioned in nursing moms, pts with cardiovascular disorders, hypopituitarism, diabetes, pts on oral anticoagulants
-preg a
levoxyl- AE
-overdose causes a hypermetalabotic state, fever, hypoglycemia, heart failure, fluid loss, tachycardia, anxiety, insomnia
levoxyl- Pt consult
-don't discontinue without talking to a physcian
-notify Dr if overdose occurs
-transient loss of hair in children can occur, but comes back
-store in a cool, dry, dark, out of reach place
-missed dose instructions
Synthroid- generic name
levothyroxine sodium
synthroid- common brand names
levoxyl
levothroid
synthroid- dosage forms
tablets (25 mcg orange, 50 white, 75 violet, 88 olive, 100 white, 112 rose, 125 brown, 175 lilac, 200 pink, 300 green)
injection (200 or 500 mcg per vial)
-.1 mg=65 thyroid
Synthroid- Indications and dosages
-replacement therapy for reduced or absent thyroid function
-0-1y:9
1-5:6
6-10:4
11-20: 3
adults (25-300/ day)
-myxedema coma or stupor: 200-500 IV on first day, 100-300 on 2nd day, 50-100 after that
Synthroid- pharmacology, pk
exact mech is unknown but is start to work due to protein syn control causing
-a regulation in growth and development
-an increase in metabolic rate
-inhibition of the secretion of thyrotoprin by pituitary
-various effects on lipid and carb metabolism

Synthetic T4 is similar to that produced by human thyroid and is 99% bound
Synthroid- Drug interactions
-may increase the effects of oral anticoagulants
-cholestyramine may decrease the absorption of levothyroxine
-may decrease the effectiveness of digitalis glycosides
synthroid- contra and precautions
-contra in diagnosed but uncorrected adrenal cortical insufficiency, untreated thyrotoxicosis, and in pts with acute mi
-caution in nursing moms, cardiovascular disease, hypopituitarism, diabetes, pts on anticoagulants
-perg a
synthroid- AE
-overdose (hypermetabolic state), fever, hypoglycemic, heart failure, fluid loss, tachycardia, anxiety, insomnia
synthroid- pt consult
-don't dc without talking to DR
-Notify DR is overdose occurs
-transient loss of hair in kids
-store in cool, dry, dark, out of reach place
-missed dose
Zestril- generic name
lisinopril
zestril-other brand names
prinivil
zestril- dosage forms
2.5 mg white
5 pink
10 pink
30 pink
40 yellow
zestril- indications/dosages
-treat hypertension (10 sid, adjust for bp, usually 20-40 sid, not controlled bp add diuretic and reduce dose)
-renal impairment dose (Cl cr 10-30, start with 5 mg, under 10 start with 2.5 mg)
-adjunctive therapy in the management of CHF in pts not responding to diuretic and digitialis: give 5 mg initiailly sid with D&D, under medical sup, esp with low bp, peak mean bp lowering is 6-8 hours post-dose, continue observation until bp is stable, reduce diuretic dose to help minimize hypovolemia which may contribute to hypotension, usual dose is 5-20 sid, with hyponatremia initial dose is 2.5
-tmt of hemodynamically stable pts within 24h of acute MI: 5 mg then 5 mg 24, 10 mg 48, and 10 sid for 6 wks; if bp uner 120 start at 2.5 mg
zestril-pharmacology/pk
-suppresions of renin-angiotension-aldosterone system
-competivetly inhibits ACE to decrease amount of Angiotension II (vasoconstrictor)
-a decrease in Angiotension II also means a decrease in aldosterone whin decrease sodium and water resorption and lowers plasma volume
-ACE is involved with the degradation of bradykinin, a vasodilator
-peak serum levels are at 7 hours
-t1/2-12 hours
-not bound
-not metabolized, excreted
zestril- drug interactions
-decreased effect with indomethacin
-capsaicin may increase risk of coughing
-higher risk of hypersenstivity reaction occurs with allopurinol
-decreases li concentration
-use with K supp may cause hyperkalemia
-may potentiate the action of oral antidiabetics and or insulin
zestril- contra and precautions
-conta in pts with angioedema related to ACE I
-caution in pts with impaired renal function
-risks of hyperkalemia with k supp, k sparing drugs, diabetes, impaired renal function
-hypoglycemia may occur when added to pts taking antidiabeteics/ insulin
-angioedema/severe hypotension--dc
-ACE I have been linked to cholestatic jaundice that leads to fulminant hepatic necrosis
-preg c
zestril- AE
dizzy, HA, fatigue, cough, diarrhea
zestril- pt consult
-may take without regard to meals
-don't dc unless told by DR
-acoid non-RX cough, cold, allergy meds unless directed
-avoid a salt sub with k
-store
-missed dose
-contact a Dr if SE are persistant, severe
-contact a DR if signs of swelling occur
Lasix- generic name
furosemide
Lasix- dosage forms
tablets (20, 40, 80 mg)
Oral solution(10mg/ml, 40 mg/5 ml)
injection (10 mg/ml)
Lasix- FDA indications/dosages
-edema-associated CHF, cirrhosis of liver, and renal disease:
>oral: initially 20-80 mg/day with increase of 20-40 mg increments q6-8h until desired diuresis occurs. MD is 20-600 mg/day sid or bid
>parenteral: 20-40 mg IM or IV over 2 min. Increase dose by 20 mg no sooner than 2 hours until desired diuresis occurs. This dose is MD given sid or bid
-treat hypertension oral: 40 mg bid then adjust
-acute pulmonary edema (iv only): 40 mg IV. may increase after one hour to 80 mg IV
Lasix-pharmacology/pk
-loop diuretic which inhibits resorption of Na and Cl in the proximal and distal tubules and in the LOOP.
-peak diuresis occurs within 1 hour and lasts for 6-8 hours
-bound: 91-99%
Lasix- Drug interactions
-auditory toxicity increases with cisplatin or aminosglycosides
-effects may be reduced by phenytoin and NSAIDS
-hypoalemia may potentiate digitalis-induced arrythmias
-additive hypokalemic effects may occur with other K-depleting drugs
Lasix- contras and precautions
-contra with anuria
-caution with hepatic coma, severe electrolyte depletion, hypersensitivity to sulfonamides, cirrhosis, gout, diabetes, corticosteriods, ACTH,
-excess diuresis is serious
-may exabeterate or activate systemic lupus eythematosus
-preg c
Lasix- AE
dizzy, othrostatic hypotension, dry mouth, hearing loss, nausea, vomiting, weakness, muscle cramps, paresthesia, anemia, photosensitivity, purura, rash, hyperglycemia
Lasix- pt consult
-may take with food or milk for Gi upset
-timing of dose is important bc of diuresis, take in am
-avoid overexposure to sun
-don't take any non-RX cough, cold, allergy meds
-may cause orthostatic hypotension
-storage
-missed dose
-contact doc regarding SE
Tenormin- generic name
atenolol
Tenormin- dosage forms
tablets (25, 50, 100 mg)
injection (5 mg/10 ml)
Tenormin- FDA indications/ dosages
-manage hypertension (oral): initially give 50 mg sid alone or w/ diurectic, MD is 50-100 mg sid
-angina pectoris (oral): 50-200 mg sid, start with 50 and titrate after 7d
-acute MI: infuse 5 mg over 5 minutes with another 10 min later, can dilute in dextrose or NaCl inj. If Iv doses are tolerated, initiate oral with 50 mg 10 min after last iv dose and 50 mg 12 hours later. give 100 sid or 50 bid for 7 days
-in severe renal impairment- see man. lit.
Tenormin- pharmacology/pk
-cardioselective B1 adrenergic receptor blocker which results in
> decrease heart rate and decreased output
> a decrease in bp
> inhibition of isoproterenol tachycardia
>a decerase of reflex orthostatic tachycardia

-does not cross bbb
-F=50%
-peak levels in 2-4 hours (oral)
-t 1/2 is 6-7 hours
-onset of action is 1 hour, lasts 24 hours
-excreted unchanged
Tenormin- drug interactions
-may decrease effects of Clonidine
-NSAIDS may decrease effects
-toxic effects may be increased with verapamil
-may increase toxic effects of lidocaine
-use with prazosin may increase postural hypotension
-ampicillin may decrease effects
Tenormin- contra and precautions
-contra with sinus bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure
-caution with bronchial asthma, CHF, diabetes mellitus, hyperthyroidism, and in pts with impaired renal function.
-use during preg and nursing may increase the risk of neonatal hypoglycemia and bradycardia
-preg c
Tenormin- AE
dizziness, fatigue, drowsiness, nausea, bradycardia, hypotension
tenormin- pt consult
-may take with food, milk for gi
-may cause drowsiness
-avoid abrupt dc of therapy
-pt with diabetes need to know that this can mask hypoglycemic symptoms
-storage
-missed dose
-talk to dr regarding se