Dispensing; Exam 2 (Patient Counseling)

Front 1

ACE Inhibitors

Back 1

1. Persistent cough may develop (nonproductive, starts 1 week or so after initial dose, about 5% incidence, more common in women, cough goes away about 1 week after discontinuing)
2. Do not use in pregnancy (this is a BBW, drugs that affect renin-angiotensin system can cause birth defects in the 1st trimester, can cause renal failure in 2nd and 3rd trimesters)
3. Avoid salt substitutes (they are potassium based, ACE inhibitors tend to raise potassium levels, could lead to hyperkalemia)
4. Captopril and moexipril need to be taken on an empty stomach (food decreases absorption, this also applies to Capozide and Uniretic)

Front 2

Angiotensin II Receptor Antagonists

Back 2

1. Do not use in pregnancy (this is a BBW, they affect the renin-angiotensin system).
2. Avoid salt substitutes (they are potassium based and tend to raise potassium levels, which could lead to hyperkalemia)

Front 3

Renin Inhibitors

Back 3

1. Do not use in pregnancy (this is a BBW, these affect the renin-angiotensin system)
2. Take on an empty stomach
3. Persistent cough may develop

Front 4

Inhaled Corticosteroid

Back 4

1. Rinse mouth with water after use (to avoid thrush, do it 15-20 minutes after work)

Front 5

Antiarrhythmic

Back 5

1. May cause unusual heartbeat (all can cuase new or worsening arrhythmias called proarrhythmic effects)

Front 6

Amiodarone

Back 6

1. May cause breathing problems and visual disturbances

Front 7

Coumadin

Back 7

1. Avoid changing diet (large intake of Vitamin K would need higher Coumadin dose)

Front 8

Bile Acid Sequestrants

Back 8

1. May cause constipation
2. Take with plenty of water (Questran, Prevalite, and Colestid are all powders and Welchol is a large tablet)
3. May interfere with absorption of other drugs (bind to other medications, patients need to take other drugs 1 hour before or 4 hours after)

Front 9

HMG-CoA Reductase Inhibitors

Back 9

1. May cause muscle pain, weakness, or dark urine

Front 10

Lovastatin

Back 10

1. Take with food

Front 11

Alpha-1 Adrenergic Blockers

Back 11

1. May cause syncope with 1st few doses (fainting, this could also happen with a dose increase, they cause a drop in blood pressure, patients need to be laying down)

Front 12

Cytoxan

Back 12

1. Drink plenty of water (it cause hemorrhagic cystitis)

Front 13

Methotrexate

Back 13

1. May cause fever or sore throat

Front 14

Benzodiazepine

Back 14

1. May cause drowsiness (somnolence)
2. Avoid alcohol
3. Do not discontinue therapy abruptly

Front 15

Beta Blockers

Back 15

1. Do not discontinue suddenly (could cause a dangerous increase in blood pressure)
2. Take sotalol on an empty stomach.

Front 16

Digoxin

Back 16

1. May cause nausea, vomiting, and vision problems (signs of digoxin toxicity, patients see colored halos around things)

Front 17

Loop and Thiazide Diuretic

Back 17

1. May cause muscle cramps, unusual tiredness, or weakness (symptoms of hypokalemia, normal serum potassium levels are 3.5-5 mEq)
2. May cause photosensitivity
3. Take early in the morning (avoid nocturia – excessive urination at night)

Front 18

Potassium Sparing Diuretic

Back 18

1. Hyperkalemia may occur (have blood checked)(this is a BBW)
2. Avoid salt substitutes
3. Take early in the morning

Front 19

Hydantoin (oral)

Back 19

1. Use good dental care (can cause gingival hyperplasia, gums swell and grow, could cover teeth; brush and floss; the highest incidence is in children)
2. Avoid alcohol (lowers blood level of phenytoin)
3. Do not discontinue therapy abruptly (can trigger status epilepticus)
4. Decrease the effectiveness of oral contraceptives

Front 20

MAO Inhibitors

Back 20

1. Avoid cheese, certain types of fish, sausage, alcohol, caffeine, chocolate, and some fruits (bananas and raisins). (These contain tyramine, which can lead to a hypertensive crisis because tyramine is structurally related to Epi and NE).
2. Avoid OTC nasal decongestants (they are sympathomimetics and add to the increase of Epi and NE; this can lead to a hypertensive crisis)

Front 21

MUSE

Back 21

1. Urinate prior to inserting (residual urine will help dissolve)

Front 22

Viagra/Levitra

Back 22

1. Take 1 hour prior to sexual activity (1 tablet every 24 hours max)
2. Take on an empty stomach (food decreases absorption by 50%)

Front 23

Cialis

Back 23

1. Take without regard to meals

Front 24

NSAID

Back 24

1. Take with food

Front 25

Ophthalmic NSAID

Back 25

1. Will cause burning on administration

Front 26

Antabuse

Back 26

1. Do not drink alcoholic beverages

Front 27

Metronidazole

Back 27

1. Do not drink alcoholic beverages (10% chance of disulfiram reaction)

Front 28

Isotretinoin

Back 28

1. Contraindicated in pregnancy
2. Take with food (increases blood levels)
3. Causes phototoxicity

Front 29

Nitroglycerin

Back 29

1. Avoid alcohol (causes hypotension and headache)

Front 30

Antiretroviral

Back 30

1. Take exactly as directed, do not skip doses (this increases the chance of drug resistance)