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58 Cards in this Set

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Beta Blockers
Abrupt D/C may cause angina, MI, or Hypertensive emergency; need to taper over 2 wks
Digoxin
Improves symptoms, decreases hospitalization
no effect on mortality

*abrupt D/C may cause worsening HF

Adjust dose in pts with renal dysfunction
Cymbalta
Effects take up to a month
Don't stop abruptly
CI'd with MAOIs
increased suicidality in kids/teens
Requip
+/- Food
avoid getting up to fast when using (OrthoStatic HTN)
Tell MD if plan to start/stop smoking
Pamelor
Drowsiness
CI'd w/ MAOIs (wait 2 weeks after stopping MAOI)
CI'd after an MI
caution in CV pts, Glaucoma, SZ pts
Strattera
+/- Food
CI'd w/ MAOIs, and Narrow angle GLAUcoma
Caution w/ pts on Albuterol
Caution in HTN, CVD, & unrinary reTN
Prozac
CI'd w/ MAOIs
Drowsiness
Tell MD if rash/hives present
Dont abruptly DC
ASA or NSAIDs may cause GI Bleed
Desyrel
Take w/ Food
Drowsiness
No Grapefruit juice
hypOTN, N/V,
PRIAPISM may occur
Ativan
CI'd w Narrow angle GLAUCOMA
Caution w/ impaired Renal or Hep
Drowsiness/ HABIT forming
Xanax
CI'd w Narrow angle GLAUCOMA
Caution w/ impaired Renal or Hep
Drowsiness/ HABIT forming
Paxil
SE's usually MILD
CI'd w MAOIs
HypOnatremia
Drowsiness
up to 2 weeks to work
DONT abruptly DC
Tell MD if XS thirst, leg, foot hand swells
Aricept
+/-Food
Take in EVENING
Should DC b4 anesthesia
Topamax
+/- Food
May cause ACIDOSIS
Should Periodically measure Bicarb
Drowsiness
Keep HYDRATED to avoid Kidney Stones
DC gradually
Valium
Drowsiness
HABIT Forming
Avoid Grapefruit
CI'd in kids under 6 months
CI'd in open angle Glaucoma
CI'd in Renal/Hep pts
Effexor
CI'd w MAOIs
Caution w HTN pts (monitor pts BP)
AEs: taste perversion, TINNitus, MYDriasis, ABNORMAL ejaculation/orgasm
Amitriptylline
CI'd w MAOIs
Drowsiness
Tachycardia, Dry mouth, N/V
Caution in HEP pts
Caution in Glaucoma
DONT DC unless told
Neurontin
+/_ Food
Drowsiness
Dont DC abruptly (Taper over 1 week)
Namenda
Caution in Renal pts
+/-Food
AEs: Dizziness, HA, confusion, HTN
Daily doses >5mg should be given BID & increases shouldnt be made sooner than weekly
Depakote
DONT DC abruptly
Drowsiness
Food or MILK to avoid GI upset
CI'd in HEP pts
Life-threatening PANCREAtitis
Lexapro
CI'd w MAOIs
Dont abruptly DC
Caution in HEP pts
ASA or NSAIDs increase GI Bleed
Risperdal
May cause FAINTING in 1st doses
Caution w Diabetes pts
Avoid XS sunlight/heat
Food or Milk to avoid GI upset
Ambien
HABIT forming
Caution in Elderly, Debilitated pts
Long term AEs: Dry mouth, back pain, flu-like sx, palpitations Upper Resp, infxn
Thiazide diuretics
NOT effective (except Metolazone) when CrCl<30mL/min; use Loops
CI'd w/ Sulfa drugs
Have Ceiling doses (unlike Loops)
Potassium Sparing Diuretics
Weak anti-Hypertensives
Not used as Monotherapy
Often used w/ HTCZ to decrease hypOkalemia
CI'd in hYPERkalemia, CKD
ACE inhibitors
CI'd in Pregnancy, HYPERkalemia, BILATERAL Renal Artery Stenosis
Switch to ARB if cough intolerable
Captopril has SHORTest DOA
ARBs
Angiotensin II Receptor Blockers
Same CI's as ACEi
HYPERkalemia & RENAL insuff also likely w/ ACEi
Renin Inhibitors
ex. Aliskiren
Use w. Caution when CrCl<30mL/min

AVOID taking w/ FATTY food
DONT use w/ Cyclosporine
DHP Calcium Channel Blockers
No CIs
SEs: Reflex tachycardia, HA, Flushing, PERIPHERAL Edema, GINGIVAL HYPERplasia,
HF exacerbation (EXCEPT Amlodipine and Felodipine)
Non-DHP Calcium Channel Blockers
CI'd in
greater than 2nd degree heart block, SYSTOLIC HF
SEs: BRADYcardia/heartblock, CONSTIPATION, PERIPHERAL Edema, GINGIVAL Hyperplasia, HF exacerbation
Alpha Blockers
DONT use with PDE-5 inhibitors (CI'd) increased risk of hypOTN,

Should NOT be used as 1st line therapy
Central Alpha-2 Agonists
CI'd w/ Methyldopa (Liver Dz)
SEs: Sedation, ORTHOstatic HypOTN, Depression,
PERIPHERAL Edema, Dry Mouth
Patch applied WEEKly
Abrupt DC (esp w/ Bbs) may acuse MI or HTNsive emergency; TAPER over 2 weeks
Direct Vasodilators
ex. Hydralazine
CI'd in Acute MI, Aortic dissection
ORTHOstatic hypOTN,
Peripheral Edema,
Lupus-like Syndrome
used for Refractory HTN
Bile Acid Resins
CI'd in Complete Biliary Obstruction
Can be used in Liver Dz pts
Caution in pts w/ High TGs
Colesvelam has FEWER GI SEs and interactions
Niacin
also available OTC
Flushing/itching, Orthostatic hypOTN, Myopathy, HYPERuricemia, HYPERglycemia
Fibric Acid Derivatives
CI'd in Gallbladder Dz, HEP pts, severe RENAL fxn,( Adjust dose)
When adding to statin, Fenofibrate preferred
HMG Co-A Reductase inhibitors
CI'd in PREGNANCY, HEP dysfxn
Most effective drugs to lower LDL
Pravastatin NOT metabolised by CYP enzymes
Cholesterol absorption inhibitors
No CIs
Cyclosporine & fibrates may increase effects
Loop Diuretics
CI'd w. Sulfa drugs
Decrease sx; Effect on mortality unknown
Similar SEs to Thiazides...except
causes HypOCALcemia
Aldosterone Receptor blocker
CI'd in K>5mEq/L
CI'd in CrCl <30
CI'd w. strong CYP 3A4 inhibitors
SEs: HYPERkalemia, GYNOMASTIA, breast tenderness, HIRSUTISM, menstrual changes
Penicillin VK
250mg-500mg PO q6h
Adjust dose in RENAL pts
Take 1 hour BEFORE or 2 hrs AFTER meals
SEs: Hypersensitivity rxn, N/V/D,
INTERSTITIAL NEPHRITIS
Hemolytic anemia (after prolonged use)
Amoxil
250mg - 500mg PO q8h or
500mg-875mg PO q12h
can be used in 3-drug tx for H. pyolri
1 hour Before or 2 hours AFTER food
Augmentin
AminoPCN + Beta lactamase inhibitor
Adjust dose in RENAL pts
Good AEROBIC coverage
Novolog
Rapid acting insulin: 5-15mins
Peak: 30 -90mins
Duration: < 5hrs
HYPOglycemia (BG:<70mg/dL) is most COMMON SE
Should be given within 15 minutes from eating
Humalog
Rapid acting insulin: 5-15mins
Peak: 30 -90mins
Duration: < 5hrs
HYPOglycemia (BG:<70mg/dL) is most COMMON SE
Should be given within 15 minutes from eating
Humulin N
aka NPH (Neutral Protamine Hagedorn)
Short acting insulin
Onset: 2-4hrs
Peak: 4-10hrs
DOA: 10-16hrs
Lantus
Long Acting, Basal insulin
Onset: 2-4hrs
NO PEAK
DoA: 20-24hrs
Humalog Mix 75/25
Long Acting Insulin
Onset: 5 - 15mins
Dual Peaks
DoA: 10-16hrs
Humalog Mix 50/50
Long acting insulin
Onset:5-15mins
Dual peaks
DoA: 10-16hrs
Novolog Mix 70/30
Long acting insulin
70%insulin aspart protamine/ 30% aspart
Onset:5-15mins
Dual peaks
DoA: 10-16hrs
70/30 (OTC)
long acting insulin
70%NPH/ 30% Regular insulin
Onset30 - 60mins
Dual peaks
DoA: 10-16hrs
Fluticasone
glucocorticoid agonist
CI'd as primary tx for acute bronchospasm
SEs: Throat irritation, Oral candidiasis, Lower Resp infxn
HFA formulation
Most Potent Corticosteroid
44-440mcg BID
Budesonide
glucocorticoid agonist
CI'd as primary tx for acute bronchospasm
SEs: Throat irritation, Oral candidiasis, Lower Resp infxn
Respules are the ONLY nebulized corticosteroid
200-800mcg BID
Mometasone
glucocorticoid agonist
CI'd as primary tx for acute bronchospasm
SEs: Throat irritation, Oral candidiasis, Lower Resp infxn
220-440mcg/day
Salmeterol
Long acting Beta-2 Agonist
CI'd as acute bronchodilator
CI'd in Tachycardic pts
SEs: HA, HTN, dizziness, Chest pain
ONLY use in adjunct tx w. inhaled corticosteroids: may increase risk of DEATH
Diskus:50mcg/puff (max: 2 pufs/day)
Montelukast
Selective leukotriene antagonist
Approved as young as 1 yr olds
SE: CHURG STRAUSS syndrome (rare)
4-10mg/@ bedtime
Albuterol
Beta-2 receptor agonist
XS use can INCREASE risk of DEATH
Nebulizer compatible w. budesonide, cromolyn, ipatropium
INTERACTS w. noselective Bbs (decreases its efx)
CI'd in TACHYcardic pts
SEs (Dose Dependent)
Angina, A.fib, arrhythmias, Tremors
MDI: 90mcg/puff
Levalbuterol
Beta-2 receptor agonist
INTERACTS w. noselective Bbs (decreases its efx)
CI'd in tachycardic pts (Less cardiac efx)
Prime the inhaler by releasing 4 actuations prior to use
MDI: 45mcg/puff (2000puffs/canister)
ADVAIR
Fluticasone & Salmeterol
Dosages: 100/50, 200/50, 500/50
synergistic efex w. the combo
MAX dose: 1 puff BID