Advanced Community Lab - Drugs 39 - 82

Front 1

Atacand

Back 1

Candesartan
ARB Antihypertensive

Hint 1

Side-effects include: hyperkalemia, hypotension, renal dysfunction and dizziness . Black box warning in pregnancy. D/I's NSAIDS, avoid salt substitutes, caution with K+ sparing diuretics. If serum creatinine inc over 30% from baseline, d/c ARB until normalizes. Avoid combination use with ACE and/or a direct renin inhibitor (aliskirin) b/c increased side-effect risk with no BP benefit

Front 2

Avapro

Back 2

Irbesartan
ARB Antihypertensive

Hint 2

Side-effects include: hyperkalemia, hypotension, renal dysfunction and dizziness . Black box warning in pregnancy. D/I's NSAIDS, avoid salt substitutes, caution with K+ sparing diuretics. If serum creatinine inc over 30% from baseline, d/c ARB until normalizes. Avoid combination use with ACE and/or a direct renin inhibitor (aliskirin) b/c increased side-effect risk with no BP benefit

Front 3

Micardis

Back 3

Telmisartan
ARB Antihypertensive

Hint 3

Avoid salt substitutes, do not open foil pkg until ready to use

Front 4

Exforge

Back 4

Amlodipine/Valsartan
ARB/Calcium channel blocker

Hint 4

Avoid salt substitutes

Front 5

Hyzaar

Back 5

Losartan/HCTZ
ARB/diuretic

Hint 5

Avoid salt substitutes, take in AM

Front 6

Inderal (LA)

Back 6

Propranolol
Beta Blocker - Nonselective

Hint 6

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly, LA and immed release are not mg per mg equivalent (likely need 30% more of the LA when converting from the immediate to the LA form)

Front 7

Coreg (CR)

Back 7

Carvedilol
Beta Blocker (+ alpha 1 blocker)

Hint 7

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly, CR and immed release are not mg per mg equivalent (liver 2d6 has greater opportunity to chew up so need higher once daily release), example Coreg CR 10mg = Coreg 3.125mg BID

Front 8

Normodyne or Trandate

Back 8

Labetalol
Beta Blocker (+ alpha 1 blocker)

Hint 8

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly

Front 9

Lopressor

Back 9

Metoprolol Tartrate
Beta Blocker -Selective

Hint 9

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly

Front 10

Tenormin

Back 10

Atenolol
Beta Blocker -Selective

Hint 10

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly. Limited evidenced based data

Front 11

Toprol XL

Back 11

Metoprolol Succinate
Beta Blocker -Selective

Hint 11

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly, XL and immed release are not mg per mg equivalent (200 succinate equal to 150 of tartrate)

Front 12

Bystolic

Back 12

Nebivolol
Beta blocker, Beta-1 selective

Hint 12

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly. No outcome data.

Front 13

Ziac

Back 13

Bisoprolol/HCTZ
Beta Blocker - Beta 1 selective/thiazide diuretic

Hint 13

May cause drowsiness, may mask hypoglycemia, do not discontinue therapy abruptly. Bisoprolol does have outcome data in heart failure at a target dose of 10mg QD

Front 14

Azor

Back 14

Amlodipine/Olmestartan
Calcium channel blocker/ARB

Hint 14

Refer to individual agents

Front 15

Caduet

Back 15

Amlodipine/Atorvastatin
Calcium channel blocker/HMG-CoA inhibitor

Hint 15

Refer to individual agents alone

Front 16

Norvasc

Back 16

Amlodipine
Dihydro Ca Channel Blocker

Hint 16

May cause drowsiness and peripheral edema not responsive to diuretic but is to ACE-I or ARB

Front 17

Lanoxin or Lanoxicap

Back 17

Digoxin
+ Inotropic/ -chronotrope

Hint 17

Narrow therapeutic index drug, avoid D/I's, Caution for signs/symptoms of digoxin toxicity (anorexia, nausea, fatigue, vision disturbances, bradycardia, arrthymias)

Front 18

Lotensin

Back 18

Benazepril
ACE Inhibitor (diuretic)

Hint 18

Risk of dry cough and angioedema, hyperkalemia (avoid salt substitutes), possible first dose hypotension especially in hypovolemia and CHF, renoprotective but may cause acute renal failure (monitor serum Cr and d/C if greater than 30% inc), Preg Cat X

Front 19

Zestril or Prinivil

Back 19

Lisinopril
ACE Inhibitor Antihypertensive

Hint 19

Risk of dry cough and angioedema, hyperkalemia (avoid salt substitutes), possible first dose hypotension especially in hypovolemia and CHF, renoprotective but may cause acute renal failure (monitor serum Cr and d/C if greater than 30% inc), Preg Cat X

Front 20

Mavik

Back 20

Trandolapril
ACE Inhibitor Antihypertensive

Hint 20

Risk of dry cough and angioedema, hyperkalemia (avoid salt substitutes), possible first dose hypotension especially in hypovolemia and CHF, renoprotective but may cause acute renal failure (monitor serum Cr and d/C if greater than 30% inc), Preg Cat X

Front 21

Accupril

Back 21

Quinapril
ACE Inhibitor Antihypertensive

Hint 21

Risk of dry cough and angioedema, hyperkalemia (avoid salt substitutes), possible first dose hypotension especially in hypovolemia and CHF, renoprotective but may cause acute renal failure (monitor serum Cr and d/C if greater than 30% inc), Preg Cat X

Front 22

Altace

Back 22

Ramipril
ACE Inhibitor Antihypertensive

Hint 22

Risk of dry cough and angioedema, hyperkalemia (avoid salt substitutes), possible first dose hypotension especially in hypovolemia and CHF, renoprotective but may cause acute renal failure (monitor serum Cr and d/C if greater than 30% inc), Preg Cat X

Front 23

Vasotec

Back 23

Enalapril Maleate
ACE Inhibitor Antihypertensive

Hint 23

Risk of dry cough and angioedema, hyperkalemia (avoid salt substitutes), possible first dose hypotension especially in hypovolemia and CHF, renoprotective but may cause acute renal failure (monitor serum Cr and d/C if greater than 30% inc), Preg Cat X

Front 24

Cardura (XL)

Back 24

Doxazosin Mesylate
Alpha 1 Blocker Antihypertensive, BPH

Hint 24

1st dose associated syncope, may cause orthostasis, dizziness

Front 25

Hytrin

Back 25

Terazosin
Alpha 1 Blocker Antihypertensive, BPH

Hint 25

1st dose associated syncope, may cause orthostasis, dizziness

Front 26

Catapres (TTS) or Nexiclon XR

Back 26

Clonidine
Alpha II agonist Antihypertensive

Hint 26

May cause drowsiness, do not discontinue therapy abruptly, TTS should rotate sites, skin rxns common, discard carefully

Front 27

Cordarone

Back 27

Amiodarone
Antiarrhythmic

Hint 27

Many D/I's possible. Take into acct. very long half-life (~40-50 days!), thyroid problems, Hypotension, bradycardia, QTc, Hepatic and Pulmonary damage possible; notify MD of any jaundice, dark urine, problems breathing.

Front 28

Coumadin

Back 28

Warfarin Sodium
Anticoagulent

Hint 28

Narrow Therapeutic Index drug, GI bleed risk, control Vitamin K intake, INR monitoring, dose adjustment…, D/I's -don't start or stop another med unless talk to MD or RPh first.

Front 29

Crestor

Back 29

Rosuvastatin
Antihyperlipidemic - HMG reductase inhibitor

Hint 29

Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider), can be taken any time of the day, Preg Cat X

Front 30

Lescol

Back 30

Fluvastatin
Antihyperlipidemic - HMG reductase inhibitor

Hint 30

Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider), best taken in evening, Preg Cat X. Lescol only statin that does not interact with gemfibrozil – Lopid as it is not altered by inhibition of glucuronidation

Front 31

Lipitor

Back 31

Atorvastatin
Antihyperlipidemic - HMG reductase inhibitor

Hint 31

Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider), can be taken any time of the day, Preg Cat X, minor 3A4 D/I

Front 32

Niaspan

Back 32

Niacin
Antihyperlipidemic

Hint 32

Take at bedtime with a low fat snack, ASA 325mg or NSAIDs may decrease flushing. No outcome data to date (AIM HIGH was not positive when added to simvastatin) and avoid using more than 2 grams per day because of hepatotoxicity risk

Front 33

Pravachol

Back 33

Pravastatin
Antihyperlipidemic - HMG reductase inhibitor

Hint 33

Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider), can be taken any time of the day, Preg Cat X

Front 34

Tricor

Back 34

Fenofibrate
Antihyperlipidemic

Hint 34

May increase effect of sulfonylurea, Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider)

Front 35

Trilipix

Back 35

Fenofibric acid
Antihyperlipidemic

Hint 35

May increase effect of sulfonylurea, Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider). No good outcome data (FIELD and ACCORD Lipid were not positive) safer to combine with a statin than gemfibrozil but not evidence based.

Front 36

Zocor

Back 36

Simvastatin
Antihyperlipidemic - HMG reductase inhibitor

Hint 36

Myalgias, Rhabdomyolysis caution, report muscle pain asap to provider, take at bedtime, major 3A4 D/I's, avoid large amt of grapefruit juice (>1qt/day)

Front 37

Lopid

Back 37

Gemfibrozil
Antihyperlipidemic

Hint 37

Decreased glucoronidation so increases effects of all statins except fluvastation, Should be taken 30 mins before breakfast and dinner, Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider), risk of cholelithiasis

Front 38

Vytorin

Back 38

Simvastatin/ezetimibe
Antihyperlipidemic - HMG reductase inhibitor and

Hint 38

No good outcome data with addition of ezetimibe to simvastatin. Myalgias, Rhabdomyolysis caution (report muscle pain, brown urine asap to provider), can be taken any time of the day, Preg Cat X, significant 3A4 D/I

Front 39

Altoprev

Back 39

Lovastatin ER
Antihyperlipidemic - HMG reductase inhibitor

Hint 39

Myalgias, Rhabdomyolysis caution, take at bedtime, 3A4 D/I's

Front 40

Mevacor

Back 40

Lovastatin
Antihyperlipidemic - HMG reductase inhibitor

Hint 40

Myalgias, Rhabdomyolysis caution, take at bedtime, 3A4 D/I's

Front 41

Lovaza

Back 41

omega-3 fatty acid
Antihyperlipidemic

Hint 41

Not evidence based. May cause fishy burp/taste, may cause inc risk of bleeds with coumadin, aspirin, clopidogrel or new alternatives.

Front 42

Benicar

Back 42

Olmesartan
ARB (diuretic) Antihypertensive

Hint 42

Side-effects include: hyperkalemia, hypotension, renal dysfunction and dizziness . Black box warning in pregnancy. D/I's NSAIDS, avoid salt substitutes, caution with K+ sparing diuretics. If serum creatinine inc over 30% from baseline, d/c ARB until normalizes. Avoid combination use with ACE and/or a direct renin inhibitor (aliskirin) b/c increased side-effect risk with no BP benefit

Front 43

Diovan

Back 43

Valsartan
ARB (diuretic) Antihypertensive

Hint 43

Side-effects include: hyperkalemia, hypotension, renal dysfunction and dizziness . Black box warning in pregnancy. D/I's NSAIDS, avoid salt substitutes, caution with K+ sparing diuretics. If serum creatinine inc over 30% from baseline, d/c ARB until normalizes. Avoid combination use with ACE and/or a direct renin inhibitor (aliskirin) b/c increased side-effect risk with no BP benefit

Front 44

Cozaar

Back 44

Losartan
ARB Antihypertensive

Hint 44

Side-effects include: hyperkalemia, hypotension, renal dysfunction and dizziness . Black box warning in pregnancy. D/I's NSAIDS, avoid salt substitutes, caution with K+ sparing diuretics. If serum creatinine inc over 30% from baseline, d/c ARB until normalizes. Avoid combination use with ACE and/or a direct renin inhibitor (aliskirin) b/c increased side-effect risk with no BP benefit