Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
177 Cards in this Set
- Front
- Back
|
Thyroid Hormones - General
|
Thyroid hormones are indicated as replacement or supplemental therapy in hypothyroidism. Hypothyroidism is defined as deficit activity of the thyroid gland.
Thyroid gland hormones: T4 and T3 |
|
|
synthetic T4
|
levothyroxine
|
|
|
synthetic T3
|
liothyronine
|
|
|
Thyroid Hormones - Patient Counseling
|
Patients should take these on an empty stomach because food decreases absorption.
|
|
|
Thyroid Hormones - Black Box Warning
|
Ineffective and potentially toxic in weight reduction.
(other problems: Hypertension and tachycardia occurs with increased doses) |
|
|
Diabetes - General
|
Diabetes mellitus is a disorder of carbohydrate metabolism in which blood glucose is abnormally high (hyperglycemia) because the body doesn’t produce and/or adequately use insulin. Insulin is the principle hormone required for glucose utilization in normal metabolic processes.
Type 1 was formerly referred to as insulin dependent diabetes mellitus. Type 1 patients must use insulin because the pancreas does not produce insulin. (can NOT control) Type 2 was formerly referred to as non-insulin dependent diabetes. Type 2 is caused by: 1. body does not produce enough insulin 2. insulin resistance (insulin is not utilized by tissue) Treatment of Type 2 diabetes should consist of diet, exercise, and weight reduction (type 2 diabetes CAN be prevented by lifestyle). Patients whose hyperglycemia cannot be controlled by these measures are candidates for oral antidiabetic agents. Some Type 2 diabetes patients require low doses of insulin. |
|
|
Humulin R and Novolin R
|
regular insulin
short-acing onset= 30 minutes duration= 8 hours OTC |
|
|
Humulin NPH and Novolin NPH
|
isophane insulin
NPH= Neutral Protamine Hagedorn (protamine extends duration of action) intermediate-acting onset= 1 hour duration= 24 hours OTC |
|
|
Humulin 70/30 and Novolin 70/30
|
70% NPH insulin and 30% regular insulin
Rx only |
|
|
Humalog
|
insulin lispro
manufactured by substituting one of insulin’s amino acid proline with lysine on the insulin B chain rapid-acting onset= 15 minutes duration= 3 hours |
|
|
insulin lispro
|
Humalog
|
|
|
Novolog
|
insulin aspart
rapid-acting |
|
|
insulin aspart
|
Novolog
|
|
|
Apidra
|
insulin glulisine
rapid-acting |
|
|
insulin glulisine
|
Apidra
|
|
|
Lantus
|
insulin glargine
long-acting onset= 1 hour duration= 24 hours dosing interval= once daily |
|
|
insulin glargine
|
Lantus
|
|
|
Levemir
|
insulin detemir
long-acting |
|
|
insulin detemir
|
Levemir
|
|
|
Incretin Mimetic - General
|
Incretin hormones are released in the intestine in response to a meal (glucose). If you don’t eat, then no incretin hormones are released. Incretin hormones stimulate insulin release from the pancreas.
Incretin mimetics imitate (mimics) the effects of incretin hormones-- stimulates insulin release from pancreas. -Byetta |
|
|
Byetta
|
exenatide
5 mcg and 10 mcg subcutaneous injection administered 1 hour before breakfast & supper Dosing Interval= BID Must be refrigerated. Patient may store at room temperature for 30 days. Usually used in combination with oral diabetics. Only used for Type 2 Diabetics |
|
|
exenatide
|
Byetta
|
|
|
Dipeptidyl peptidase-4 inhibitor (DPP-4)
|
DPP-4 is an enzyme that metabolizes the incretin hormones. Inhibiting the enzyme prolongs the effect of incretin hormones and stimulates more insulin secretion.
-Januvia |
|
|
Januvia
|
sitagliptin
25 mg, 50 mg, and 100 mg tablet Dosing Interval= once daily |
|
|
sitagliptin
|
Januvia
|
|
|
Sulfonylureas
|
Increase tissue sensitivity to insulin and stimulate insulin release from the pancreas.
-glipizide -glimepiride -glyburide |
|
|
Glucotrol XL
|
glipizide
2.5 mg, 5 mg, 10 mg extended release tablet Dosing Interval= once daily |
|
|
glipizide
|
Glucotrol XL
|
|
|
Amaryl
|
glimepiride
2 mg and 4 mg tablet Dosing Interval= once daily |
|
|
glimepiride
|
Amaryl
|
|
|
Glynase PresTab
|
glyburide
3 mg and 6 mg tablet Dosing Interval= once OR twice daily PresTab= unusual shaped tablet |
|
|
glyburide
|
Glynase PresTab
|
|
|
Thiazolidinediones
|
Increase tissue sensitivity to insulin.
-Actos -Avandia |
|
|
Actos
|
pioglitazone
15 mg, 30 mg, and 45 mg tablet Dosing Interval= once daily |
|
|
pioglitazone
|
Actos
|
|
|
Avandia
|
rosiglitazone
2 mg, 4 mg, and 8 mg tablet Dosing Interval= once OR twice daily |
|
|
rosiglitazone
|
Avandia
|
|
|
Biguanides
|
Increase tissue sensitivity to insulin.
-metformin |
|
|
Glucophage
|
metformin
500 mg, 850 mg, and 1000 mg tablet Dosing Interval= once OR twice daily |
|
|
metformin
|
Glucophage
Glucophage XR Fortamet Glumetza |
|
|
Glucophage XR
|
metformin
500 mg and 750 mg extended release tablet Dosing Interval= once daily |
|
|
Fortamet
|
metformin
500 mg and 1000 mg extended release tablet Dosing Interval= once daily |
|
|
Glumetza
|
metformin
500 mg extended release tablet Dosing Interval= once daily |
|
|
Avandamet
|
rosiglitazone, metformin
Increases tissue sensitivity to insulin (helps with resistance) 2/500 mg, 2/100 mg, 4/500 mg, 4/1000 mg tablet Dosing Interval= BID |
|
|
rosiglitazone, metformin
|
Avandamet
|
|
|
ActoPlus Met
|
pioglitazone, metformin
Increases tissue sensitivity to insulin (helps with resistance) 15/500 mg and 15/850 mg tablet Dosing Interval= BID |
|
|
pioglitazone, metformin
|
ActoPlus Met
|
|
|
Metaglip
|
glipizide, metformin
Stimulates insulin secretion (glipizide) and increases tissue sensitivity to insulin (metformin). 2.5/250 mg, 2.5/500mg, and 5/500 mg tablet Dosing Interval= once OR twice daily |
|
|
glipizide, metformin
|
Metaglip
|
|
|
Glucovance
|
glyburide, metformin
Stimulates insulin secretion (glyburide) and increases tissue sensitivity to insulin (metformin). 1.25/250 mg, 2.5/500 mg, and 5/500 mg tablet Dosing Interval= once OR twice daily |
|
|
glyburide, metformin
|
Glucovance
|
|
|
Menopause
|
ovarian function decreases and less estrogen is being produced
|
|
|
Decreased estrogen levels are associated with:
|
1. Vasomotor Symptoms (hot flashes associated with sleep disturbances and excessive sweating)
2. Increased risk of osteoporosis |
|
|
Estrogen Indications
|
Hormone Replacement Therapy (HRT) for treatment of vasomotor symptoms and for prevention of osteoporosis because they reduce bone resorption.
|
|
|
Estrogen Black Box Warning
|
1. Use with caution in patients with heart disease.
· Estrogen increases the risk of heart attack and stroke. 2. Increased risk of dementia in post-menopausal women. |
|
|
Premarin
|
conjugated estrogens
Indicated for vasomotor symptoms and osteoporosis prevention. Conjugated estrogens are purified from the urine of pregnant mares. tablet Dosing Interval= once daily Premarin Vaginal Cream § Indicated for post-menopausal atrophy of vagina § Dosing interval is variable |
|
|
conjugated estrogens
|
Premarin
|
|
|
Vivelle-Dot
|
estradiol
Indicated for vasomotor symptoms and osteoporosis prevention. transdermal system (apply to hip/abdomen) Release Rates: § 0.025 mg/24 hr § 0.0375 mg/24 hr § 0.05 mg/24 hr § 0.075 mg/24 hr § 0.1 mg/24 hr Dosing Interval= twice weekly |
|
|
Femring
|
estradiol
Indicated for vasomotor symptoms vaginal ring Dosing Interval= every 3 months Release Rates: § 0.05 mg/24 hr § 0.1 mg/24 hr |
|
|
Vagifem
|
estradiol
Indicated for vaginal atrophy associated with menopause. 25 mcg vaginal tablet Dosing Interval= twice weekly |
|
|
estradiol
|
Vivelle-Dot
Femring Vagifem |
|
|
Activella
|
estradiol, norethindrone
Indicated for vasomotor symptoms. Norethindrone is a progestin (clinical term for synthetic progesterone= progestin) tablet § 0.5 mg estrogen/ 0.1 mg norethindrone § 1 mg estrogen/ 0.5 mg norethindrone Dosing Interval= once daily |
|
|
estradiol, norethindrone
|
Activella
|
|
|
Mechanism of Action of Contraceptives
|
1. Suppress ovulation
2. Alter cervical mucous to decrease sperm penetration 3. Induce changes to uterus which decrease chance of egg implantation |
|
|
Black Box Warning for Oral Contraceptives
|
Increased risk of cardiovascular side effects in women who smoke.
|
|
|
Aviane
|
ethinyl estradiol, levonorgestrel
|
|
|
Trivora
|
ethinyl estradiol, levonorgestrel
|
|
|
Levora
|
ethinyl estradiol, levonorgestrel
|
|
|
ethinyl estradiol, levonorgestrel
|
Aviane
Trivora Levora |
|
|
Kariva
|
ethinyl estradiol, desogestrel
|
|
|
Apri
|
ethinyl estradiol, desogestrel
|
|
|
ethinyl estradiol, desogestrel
|
Kariva
Apri |
|
|
Trinessa
|
ethinyl estradiol, norgestimate
|
|
|
Ortho Tri-Cyclen
|
ethinyl estradiol, norgestimate
Also indicated for acne in females > 15 years old. |
|
|
ethinyl estradiol, norgestimate
|
Trinessa
Ortho Tri-Cyclen Tri-Sprintec |
|
|
Tri-Sprintec
|
ethinyl estradiol, norgestimate
|
|
|
Yasmin
|
ethinyl estradiol, drospirenone
|
|
|
Yaz
|
ethinyl estradiol, drospirenone
Other indications: a. Acne in females > 15 years old b. Premenstrual Dysphoric Disorder (PMDD) |
|
|
ethinyl estradiol, drospirenone
|
Yasmin
Yaz |
|
|
SSRIs indicated for PMDD
|
1. Zoloft (sertraline)
2. Paxil (paroxetine hydrochloride) |
|
|
Necon
|
ethinyl estradiol, norethindrone
|
|
|
Estrostep
|
ethinyl estradiol, norethindrone
Also indicated for acne in females > 15 years old |
|
|
ethinyl estradiol, norethindrone
|
Necon
Estrostep |
|
|
Low-Ogestrel
|
ethinyl estradiol, norgestrel
|
|
|
ethinyl estradiol, norgestrel
|
Low-Ogestrel
|
|
|
Ortho Evra
|
ethinyl estradiol, norelgestromin
transdermal system Dosing Interval= apply one patch once weekly for 3 weeks then have a patch free week |
|
|
ethinyl estradiol, norelgestromin
|
Ortho Evra
|
|
|
NuvaRing
|
ethinyl estradiol, etonogestrel
vaginal ring Dosing Interval= once monthly; wear continuously for 3 weeks, then remove for 1 week, then repeat Must be refrigerated in pharmacy |
|
|
ethinyl estradiol, etonogestrel
|
NuvaRing
|
|
|
Antihyperlipidemics Indication
|
Hyperlipidemia (clinical term for elevated serum cholesterol)
Hyperlipidemia is a major risk factor for Coronary Heart Disease (CHD). |
|
|
HMG-CoA Reductase Inhibitors Adverse Effects
|
rhabdomyolysis
Disintegration or dissolution of muscle tissue Can lead to renal failure Incidence is approximately 1% Increased risk in patients that drink a lot of grapefruit juice § Grapefruit juice inhibits the CYP450 system § Inhibition leads to reduced statin metabolism, which increases blood level of statin, thus increasing risk for rhabdomyolysis Pregnancy Category X Avoid in pregnant women Cholesterol is important in fetal development |
|
|
HMG-CoA Reductase Inhibitors Dosing Interval
|
once daily
In general, take at bedtime because cholesterol synthesis occurs during the night. |
|
|
Lipitor
|
atorvastatin
tablet |
|
|
atorvastatin
|
Lipitor
|
|
|
Crestor
|
rosuvastatin
tablet |
|
|
rosuvastatin
|
Crestor
|
|
|
Lescol XL
|
fluvastatin
extended release tablet Dosing Interval= once daily |
|
|
fluvastatin
|
Lescol XL
|
|
|
Lescol
|
fluvastatin
capsule Dosing Interval= twice daily |
|
|
Zocor
|
simvastatin
tablet |
|
|
simvastatin
|
Zocor
|
|
|
Pravachol
|
pravastatin
tablet |
|
|
pravastatin
|
Pravachol
|
|
|
Fibric Acid Derivatives Indication
|
hypertriglyceridemia
|
|
|
Fibric Acid Derivatives Adverse Effects
|
Not to be used in patients taking a statin because there is an increased risk of rhabdomyolysis. Increases incidence to 5%.
|
|
|
Tricor
|
fenofibrate
48 mg and 145 mg tablet Dosing Interval= once daily |
|
|
Triglide
|
fenofibrate
50 mg and 160 mg tablet Dosing Interval= once daily |
|
|
Lofibra
|
fenofibrate
54 mg and 160 mg tablet 67 mg, 134 mg, and 200 mg capsule Dosing Interval= once daily |
|
|
fenofibrate
|
Tricor
Triglide Lofibra |
|
|
Lopid
|
gemfibrozil
600 mg tablet Dosing Interval= twice daily |
|
|
gemfibrozil
|
Lopid
|
|
|
Zetia
|
ezetimibe
Inhibits cholesterol absorption in intestines 10 mg tablet Dosing Interval= once daily |
|
|
ezetimibe
|
Zetia
|
|
|
Vytorin
|
ezetimibe, simvastatin
10/10 mg, 10/20 mg, 10/40 mg, and 10/80 mg tablet Dosing Interval= once daily |
|
|
ezetimibe, simvastatin
|
Vytorin
|
|
|
Lovaza
|
omega-3 fatty acids
Unknown mechanism of action Indication= hypertriglyceridemia 1 gram capsule (higher concentration that OTC omega-3 fatty acid products) Dose= 4 grams (4 capsules) once daily OR 2 grams (2 capsules) twice daily |
|
|
omega-3 fatty acids
|
Lovaza
|
|
|
Niaspan
|
niacin
Unknown mechanism of action 500 mg, 750 mg, and 1000 mg extended release tablet Dosing Interval= once daily Adverse Effect= causes flushing due to vasodilation caused by prostaglandins § Can minimize flushing by taking 325 mg aspirin or 200 mg ibuprofen 30 minutes before niacin (aspiring and ibuprofen reduce prostaglandin synthesis) § Also avoid hot drinks (which can increase vasodilation and flushing) |
|
|
niacin
|
Niaspan
|
|
|
Bisphosphonate Indication and MOA
|
Osteoporosis is a decrease in bone density caused by bone resorption. Resorption means loss of a substance. Bone resorption is when Calcium moves from the bone into the blood.
Normally the bone is continually remodeled by a balance between osteoblasts and osteoclasts. Osteoblasts – building cells; reform bone Osteoclasts – cells that cause bone resorption Osteoclasts always function, but as you get older osteoblast’s function decreases. Bisphosphonates become part of the bone structure making it more resistant to resorption so that calcium stays in the bone. |
|
|
Fosamax
|
alendronate
70 mg tablet 70 mg/75 mL oral solution Dosing Interval= once weekly |
|
|
alendronate
|
Fosamax
|
|
|
Fosamax Plus D
|
alendronate, cholecalciferol
70 mg alendronate/ 70 mcg cholecalciferol (70 mcg = 2800 units Vitamin D) 70 mg alendronate/ 140 mcg cholecalciferol (140 mcg = 5600 units Vitamin D) Dosing Interval= once weekly Vitamin D is required for calcium absorption. Vitamin D deficiency leads to increase in osteoclast production, which leads to increased resorption. |
|
|
alendronate, cholecalciferol
|
Fosamax Plus D
|
|
|
Actonel
|
risedronate
35 mg tablet; Dosing Interval= once weekly 75 mg tablet; Dosing Interval= 1 tab qd X 2 days once a month 150 mg tablet; Dosing Interval= once monthly |
|
|
risedronate
|
Actonel
|
|
|
Actonel With Calcium
|
risedronate, calcium carbonate
1 package with 28 tablets 4 tablets of Actonel 35 mg; Dosing Interval= once weekly 24 tablets of calcium carbonate 1250 mg; Dosing Interval= 1 qd for remaining 6 days of week |
|
|
risedronate, calcium carbonate
|
Actonel With Calcium
|
|
|
Boniva
|
ibandronate
150 mg tablet Dosing Interval= once monthly |
|
|
ibandronate
|
Boniva
|
|
|
Imitrex
|
sumatriptan
Tablet § 25 mg, 50 mg, 100 mg § Maximum daily dose= 200 mg § Taken 1 tab at onset of headache. May repeat every 2 hours up to max daily dose of 200 mg. Injection § 8 mg/mL and 12 mg/mL § Inject 0.5 mL (4 or 6 mg) at onset of headache. May repeat once in one hour. § Maximum daily dose= 2 injections (8 or 12 mg) Nasal Spray § 20 mg/spray § Maximum daily dose= 40 mg § Use 1 spray at onset of headache. May use another spray in 2 hours. (max= 2 sprays/24 hrs) § Unit dose (use spray then throw away) |
|
|
sumatriptan
|
Imitrex
|
|
|
Relpax
|
eletriptan
20 mg and 40 mg tablet Maximum daily dose= 80 mg Take 1 tablet at onset of headache. May repeat every 2 hours up to maximum daily dose of 80 mg. |
|
|
eletriptan
|
Relpax
|
|
|
Zomig
|
zolmitriptan
Tablet § 2.5 mg and 5 mg § Maximum daily dose= 10 mg § Take 1 tablet at onset of headache. May repeat every 2 hours up to max daily dose of 10 mg. Orally disintegrating tablet: Zomig-ZMT § 2.5 mg and 5 mg § Maximum daily dose= 10 mg § Take 1 tablet at onset of headache. May repeat every 2 hours up to max daily dose of 10 mg. Nasal Spray § 5 mg/spray § Maximum daily dose= 10 mg § Use 1 spray at onset of headache. May use another spray in 2 hours. (max= 2 sprays/24 hrs) |
|
|
zolmitriptan
|
Zomig
|
|
|
Maxalt
|
rizatriptan
Tablet § 5 mg and 10 mg § Maximum daily dose= 30 mg § Take 1 tablet at onset of headache. May repeat every 2 hours up to max daily dose of 30 mg. Orally disintegrating tablet: Maxalt-MLT § 5 mg and 10 mg § Maximum daily dose= 30 mg § Take 1 tablet at onset of headache. May repeat every 2 hours up to max daily dose of 30 mg. |
|
|
rizatriptan
|
Maxalt
|
|
|
Prostaglandins in Glaucoma
|
Increase aqueous humor outflow from eye which reduces intraocular pressure
|
|
|
Antiglaucomal Agents Adverse Effects
|
can turn eye color brown after several months of use
|
|
|
Xalatan
|
latanoprost
Store in refrigerator in pharmacy. Patient may store at room temp. for 6 weeks. |
|
|
latanoprost
|
Xalatan
|
|
|
Lumigan
|
bimatoprost
|
|
|
bimatoprost
|
Lumigan
|
|
|
Travatan
|
travoprost
|
|
|
travoprost
|
Travatan-Z
|
|
|
Travatan-Z
|
travoprost
Does NOT contain the preservative benzalkonium chloride. The preservative can be irritating to the eye. Instead Travatan-Z contains a buffer agent that is easier on the eye and is not irritating. |
|
|
Carbonic Anhydrase Inhibitors
|
Decreases production of aqueous humor.
Carbonic anhydrase is an enzyme necessary for aqueous humor formation, so inhibiting the enzyme causes less aqueous humor to be formed. |
|
|
Azopt
|
brinzolamide
Ophthalmic suspension; so “Shake Well” Dosing Interval= TID |
|
|
brinzolamide
|
Azopt
|
|
|
dorzolamide
|
Ophthalmic solution
Dosing Interval= TID |
|
|
Beta-Blocking Agents
|
Reduce aqueous humor production
|
|
|
Betoptic-S
|
betaxolol
S= ophthalmic suspension Dosing Interval= twice daily |
|
|
betaxolol
|
Betoptic-S
|
|
|
Timoptic
|
timolol
Opthalmic solution Dosing Interval= twice daily |
|
|
timolol
|
Timoptic (XE)
|
|
|
Timoptic-XE
|
timolol
Ophthalmic solution After instilled, it forms a gel on the surface of the eye, giving it a longer duration of action. Dosing Interval= once daily |
|
|
Cosopt
|
dorzolamide, timolol
Combination Product Both products reduce aqueous humor production. Dosing Interval= twice daily |
|
|
dorzolamide, timolol
|
Cosopt
|
|
|
Alphagan-P
|
brimonidine
Reduces aqueous humor production AND increases aqueous humor outflow. Ophthalmic solution. Dosing Interval= TID P= purite (trade name preservative) |
|
|
brimonidine
|
Alphagan-P
|
|
|
Chantix
|
varenicline
0.5 mg and 1 mg tablet Dose= 0.5 mg qd X 3 days, 0.5 mg BID X 4 days, 1 mg BID thereafter for 12 weeks After 12 weeks the patient is reevaluated § If patient has stopped, then they take it for an additional 12 weeks to prevent relapse. § If patient has not stopped, then figure out why the patient can’t quit. Then take it for an additional 12 weeks (hopefully they can quit this time). Adverse effects § Insomnia § Abnormal Dreams |
|
|
varenicline
|
Chantix
|
|
|
Cholinesterase Inhibitors Indications
|
Alzheimer’s disease.
Alzheimer’s is a deficiency of acetylcholine in the brain. Acetylcholine is necessary for nerve impulses in the synapse. Cholinesterase is an enzyme that metabolizes acetylcholine. So inhibiting cholinesterase increases the concentration of acetylcholine. These agents proved improvement for about 6 months. |
|
|
Aricept
|
donepezil
5 mg and 10 mg tablet 5 mg and 10 mg orally disintegrating tablet: Aricept ODT Dosing Interval= once daily |
|
|
donepezil
|
Aricept
|
|
|
Exelon
|
rivastigmine
|
|
|
rivastigmine
|
Exelon
|
|
|
Razadyne
|
galantamine
|
|
|
galantamine
|
Razadyne
|
|
|
Arimidex
|
anastrozole
Indication= breast cancer Antineoplastic class= aromatase inhibitor Aromatase is an enzyme necessary for estrogen synthesis. Inhibiting the enzyme will decrease estrogen levels. 1 mg tablet Dosing Interval= once daily Counsel patient to take Calcium and Vitamin D to prevent osteoporosis. |
|
|
anastrozole
|
Arimidex
|
|
|
NSAID uses
|
analgesic, antipyretic (reduces fever), and anti-inflammatory.
NSAIDs reduce prostaglandin formation. Prostaglandin is an inflammatory mediatory. |
|
|
NSAID adverse effects
|
dysmenorrhea (painful menses)
|
|
|
NSAID Black Box Warnings
|
1. Increased risk of cardiovascular events (such as MI)
2. Increased risk of ulcer formation - Can minimize by taking NSAID with food |
|
|
Celebrex
|
celecoxib
100 mg, 200 mg, and 400 mg capsule Dosing Interval= once to twice daily |
|
|
celecoxib
|
Celebrex
|
