Pharmacy Practice V Exam 2 Drug Cards

Front 1

glimepiride/Amaryl

Back 1

T2DM; 1-8 mg QD; titrate q 1-2 wks; , 24hr dur but no active metabolite; take w/ breakfast or 1st meal; good in elderly; may break up dose; insulin secretagogue

Front 2

glipizide/Glucotrol, XL

Back 2

T2DM; 2.5-40 mg div 1-2, >15 mg=bid; food delays abs, take 30 min before; XL: 2.5-20 mg; food inc abs, take w/ 1st meal; titrate either q 1-2 wks; insulin secretagogue

Front 3

glyburide/Diabeta, Micronase

Back 3

T2DM; 1.5-20 mg div 1-2 doses, >10 mg=bid; titrate q 1-2 wks, cheap, 30 min before or w/ food; 24 hr dur; renal excretion; active metab; caution renal/liver dx; insulin secretagogue

Front 4

repaglinide/Prandin

Back 4

T2DM; 0.5-4 mg tid; titrate weekly; 15 min ā meal; max dose 16 mg/24 hr; use mono or combo; skip if miss meal; good for irregular eaters; insulin secretagogue

Front 5

nateglinide/Starlix

Back 5

T2DM; 60-120 mg tid; titrate weekly; 15 min ā meal; max dose 16 mg/24 hr; use mono or combo; skip if miss meal; good for irregular eaters; insulin secretagogue

Front 6

acarbose/Precose

Back 6

T2DM; 25-100 mg tid; titrate q 4-8 wks; 15 min before meal; max dose done by weight; individualized, mono or combo; CI:IBD; prec: LFT q 3 mos then yearly; AE: farts (74%), D; no hypogly if mono; take w/ 1st bite of meal; impacts post prandial BG; α glucosidase inhibitor

Front 7

pioglitazone/Actos

Back 7

T2DM; 15-45 mg QD; titrate q 3 mos; use mono, combo, insulin adj; regardless of meals; bladder CA risk; no REMS; less CV risk; TZD

Front 8

rosiglitazone/Avandia

Back 8

T2DM; 4-8 mg div 1-2 doses; titrate q 3 mos; restricted access; use in existing tx or unable to control w/ other agents; risk MI, don't use w/ insulin, nitrates; MD & pharmacy registration required; TZD

Front 9

metformin/Glucophage, XR, Glumetza (ER)

Back 9

1000-2550 div 2-3 doses, start 500 QD, titrate 500 q wk or 850 qo wk, w/ food; XR: 500-2000 w/ evening meal; ER: 1000-2000 w/ evening meal; all: 1st line T2DM; oral agent w/o renal dx; renal elim; CI: Scr limits, liver dx; prec: metab acidosis, hypoperfusion (CHF); AE: NVD, flatulence, anorexia (transient); DC ā contrast dye, no EtOH, XR shell in stool; start low; biguanide

Front 10

metformin+glipizide/Metaglip

Back 10

T2DM; max 20/2000 mg q 24hr div 2; titrate q 2 wks; take w/ food; biguanide & insulin secretagogue

Front 11

metformin+glyburide/Glucovance

Back 11

T2DM; max 20/2000 mg q 24 hr div 2; titrate q 2 wks; take w/ food; biguanide & insulin secretagogue

Front 12

metformin+pioglitazone/Actos plus Met

Back 12

T2DM; max 45/2550 mg q 24 hr div 2; w/ food; biguanide & TZD

Front 13

metformin+rosiglitazone/Avandamet

Back 13

T2DM; max 8/2000 mg q 24 hr div 2; restricted access/ w/ food; biguanide & TZD

Front 14

sitagliptin/Januvia

Back 14

T2DM; 100 mg QD; dose adj CrCl <50; post market: pancreatitis, hypersens (dermatologic, angioedema) med guide; DPP4 inhibitor

Front 15

saxagliptin/Onglyza

Back 15

T2DM; 2.5-5 mg QD; dose adj CrCl <50 or w/ strong 3A4 inhibitors; 3A4 substrate, active metab; baseline renal fx, monitor elderly pts, limit 2.5 mg if on 3A4 inhib; DPP4 inhib

Front 16

linagliptin/Tradjenta

Back 16

T2DM; 5 mg QD; no renal adj; nonrenal elim; mild inhib of 3A4; p glyco p substrate; DPP4 inhib

Front 17

pramlintide/Symlin

Back 17

T1DM/T2DM; T1: 15 mcg SQ up to 60; T2: 60 mcg up to 120; prior to major meals; dec meal time insulin dose; must be on bolus insulin; CI: gastro paresis; hypoglyc unawareness; AE: nausea; counsel: SQ immed prior to major meals (30 g carb); do not mix w/ insulin or inject near insulin inj site, N will dec after several days at same dose; contact MD for persist N, hypoglyc; amylin mimetic

Front 18

exenatide/Byetta

Back 18

T2DM; 5-10 mg SQ bid; before morn & evening meals; adjunct to orals; monitor for pancreatitis; AE: NVD; skip if no meals; give SQ w/i 60 min; premeal; N subsides over time, contact MD if persists; incretin mimetic

Front 19

liraglutide/Victoza

Back 19

T2DM; 0.6 mg SQ daily x 1 wk, then 1.2 mg QD; same q day, max 1.8 mg QD; CI hx medullary thyroid CA (black box); dec insulin secretagog; check pancreatitis; give at same time QD, monitor diff swallow, hoarseness, change throat; incretin mimetic

Front 20

insulin glulisine/Apidra

Back 20

DM; 0-15 min ā meal; rapid; vials, pens, clear

Front 21

insulin aspart/Novolog

Back 21

DM; 0-15 min ā meal; rapid; vials, pens, clear

Front 22

insulin lispro/Humalog

Back 22

DM; 0-15 min ā meal; rapid; vials, pens, clear

Front 23

regular human insulin/Humulin R

Back 23

DM; 30 min ā meal; fast acting; clear; can mix w/ N

Front 24

isophane insulin suspension/Humulin N

Back 24

DM; div 1-2; intermediate acting; cloudy; can mix w/ R, cloudy, biphasic peak

Front 25

regular insulin + isophane susp/Humulin 70/30, 50/50

Back 25

DM; div 2, 30 min ā AM/PM meal; cloudy, biphasic peak

Front 26

insulin aspart + protamine susp/Novolog mix 70/30

Back 26

DM; div 2, 0-15 min; ā AM/PM meal; cloudy, biphasic peak

Front 27

insulin lispro + protamine susp/Humalog mix 75/25, 50/50

Back 27

DM; div 2, 0-15 min; ā AM/PM meal; cloudy, biphasic peak

Front 28

insulin glargine/Lantus

Back 28

DM; QD, evening or HS; vials, pens; dec by 20% if Δ from NPH bid; basal, clear only SQ; do not dilute or mix

Front 29

insulin detemir/Levemir

Back 29

DM; div 1-2; can transfer from another basal on per unit basis; vial, pen, basal, clear; SQ only; PM/HS or q 12 hr; do not mix or dilute

Front 30

insulin degludec

Back 30

DM; approval pending; phase 3 trials; ultra long acting (basal); use w/ rapid acting

Front 31

naproxen sodium/Anaprox, DS

Back 31

mild, mod pain, up to 1650 mg div 3-4; DS: arthritis, 550-1100 mg div 2; OTC available-Aleve; 275, 550 mg tabs; acute not chronic pain; peak 1-2 hr

Front 32

naproxen base/Naprosyn, EC-Naprosyn

Back 32

pain; upto 1250 mg div 3-4; EC: arthritis, 500-1000 mg div 2; 250, 375, 500 avail, peak 2-4 hr; EC: 375, 500, peak 4-6 hr; EC has less GI SE, do not crush

Front 33

ibuprofen/Motrin

Back 33

mild/mod pain: 1600-2400 mg div 3-4 400, 600, 800 avail, OTC avail; arthritis: 1200-3200 mg div 3-4, 800 QID max; t1/2 2 hrs; QID for max relief

Front 34

oxaprozin/Daypro

Back 34

arthritis; 600-1800 mg div 1-2; 600 mg cap; can have QD dosing; longest acting propionic acid

Front 35

Etodolac/Lodine, XL

Back 35

arthritis; 600-1800 mg div 1-2; 200, 300, 400, 500 avail peak 1 hr; XL: 400, 500, 600, peak 6 hrs, do not crush, can sprinkle; tab, cap; potential enors

Front 36

diclofenac/Voltaren, XR

Back 36

arthritis; up to 200 mg div 2-4, 25, 50, 75; XR: 100-200 mg div 1-2, 100 mg SR tab; oral, opthalmic 0.1% soln; rapid abs, short t1/2 for parent compd; short acting, multiple daily doses XR

Front 37

sulindac/Clinoril

Back 37

arthritis; 300-400 mg div 2; 150, 200 mg; prodrug, dec dose liver dx; no sulfa allergy issue; metab to sulfide metabolite, active; t1/2 16 hrs; inactive comp, renally excreted

Front 38

piroxicam/Feldene

Back 38

arthritis; up to 20 mg QD; 10, 20 mg cap; can use 10 bid if GI upset; long t1/2; QD dosing; 50 hr; higher GI toxicity

Front 39

indomethacin/Indocin, Indomethacin CR

Back 39

arthritis; up to 200 mg div 2-3, 25-50 mg cap, 50 mg supp, 25 mg/5 ml oral susp; CR: up to 150 mg div 1-2; 75 mg SR cap; higher GI SE, take w/ food, milk, antacids

Front 40

ketorolac/Toradol

Back 40

mod/sev acute pain no more than 5 days total div 3-4, IM/IV ⇒ PO; CI: pentoxifylline, probenecid, severe renal imp, vol depletion; prolonged t1/2 in renal dx, elderly; IV for post op pain control higher renal, GI toxicity

Front 41

nabumetone/Relafen

Back 41

arthritis; 500-2000 mg div 1-2 doses; 500, 750 mg; t1/2 24 hr; prodrug; dec dose in liver dx; active metab renally cleared, dec if CrCl < 50; acetic acid class; 6 MNA: metab

Front 42

celecoxib/Celebrex

Back 42

acute pain; OA: 200 mg div 1-2; RA: 200-400 mg div 2; 100, 200, 400 mg cap; 2C9 substrate; 2D6 inhibitor; t1/2 11 hr; CI: sulfa allergy; int: warfarin (bleed), 2C9 inhib will inc celebrex [ ]; potential to inc [ ] of 2D6 substrates (antidepressants)

Front 43

meloxicam/Mobic

Back 43

arthritis; 7.5-15 mg QD; 7.5, 15 mg; t1/2: 15-20 hrs; can div bid

Front 44

salsalate/Disalcid

Back 44

arthritis, minor pain; up to 3000 mg div 3; 500, 750 mg; inhib prostaglandin synth; no effect on plts; 2 salicylates fused together, insol in acidic pH ⇒ small intestine; acts like EC

Front 45

diclofenac + misoprostol/Arthrotec

Back 45

arthritis + risk of ulcer; up to 200 mg/800 mcg div 2-4; prefer div 3; 50 mg/200 mcg, 75 mg/200 mcg; bid if GI upset; AE: GI (more than diclofenac mono); preg cat X do preg test w/i wks prior to start; take w/ food or milk

Front 46

methotrexate/methotrexate

Back 46

RA malignancy (daily), sev psoriasis; wkly: 7.5 mg x 1 day or 2.5 mg bid x 3 doses; 2.5 mg tab, 25 mg/ ml inj, max 15 mg/wk; black box: bone marrow depression; hepatotox (2 X N), dec Cl w/ renal dx; leukopenia; prelim + GI toxcity; int: avoid NSAIDS during high dose tx; preg cat X; AE: NVD, stomatitis, photosens; consult: maintain hydration, follow up labs, give folic acid 5 mg/wk if recommended by MD - will dec toxicity, not effect

Front 47

cyclobenzaprine/Flexeril

Back 47

musculoskel cond; 15-30 mg div 3; 5, 10 mg tab; max 60 mg/day; short term 3 wks; CI/prec: CHF, arrhythmia/heart condition abn; acute MI, anticholinergic prec; AE: drowsiness, dizzy, dry mouth fatigue

Front 48

methocaramol/Robaxin

Back 48

musculoskel cond; 3-4 g div 4; 500, 750 mg; AE: drowsy, dizzy, N

Front 49

orphenadrine/Norflex

Back 49

musculoskel cond; 200 mg div 2 (ER); 100 mg SR tab, 30 mg/ ml inj; long acting bid dosing; CI: conditions aggravated by anticholin - BPH, bladder dx, NAG; AE: drowsy, dizzy, dry mouth, fatigue; do not cruch, chew

Front 50

metaxalone/Skelaxin

Back 50

musculoskel cond; up to 3200 mg div 3-4; 800 mg tab; high risk, Beer's list; CI: renal, liver dx; AE: drowsy, dizzy, N

Front 51

carisoprodol/Soma

Back 51

musculoskel cond; up to 1400 mg div 4; 250, 350 mg tab abuse potential; 2C19 metab to active meprobamate; AE: drowsy, N, physical, dep dt metabolite

Front 52

tizandine/Zanaflex

Back 52

spasticity; 12-36 mg div; 2,4,6 mg cap, 2,4 mg tab; α 2 agonist, 1A2 substrate; CI: cipro, fluvoxamine; prec: hypoTN dt to α 2 effects, liver injury - baseline LFT's; AE: dry mouth, drowsy, bradycardia, hypoTN, dizzy, abn LFT's blurred vision; consult: food or milk if GI upset

Front 53

lioresal/Baclofen

Back 53

spasticity, can use in MS; 15-80 mg div 3-4 doses; start 5 mg tid; 10, 20 mg tab, intrathecal soln; titrate 15 mg q 3 days; int: CNS depressants; CI: do not DC abruptly; halluc, seizures; consult: AE, adherence, no EtOH

Front 54

rabeprazole/Aciphex

Back 54

eros esoph: 20 mg QD, 8 wk initial tx, daily maint; h pylori: 20 mg + 1 g amox + 500 mg clarith bid x 14 days; antacids ok

Front 55

esomeprazole/Nexium

Back 55

eros esoph: 20-40 mg QD; 4-8 wk initial, 20 mg QD maint; h pylori: 40 mg QD + amox + clarith bid x 14 days; 60 min ā food, antacids ok

Front 56

lansoprazole/Prevacid

Back 56

eros esoph: 30 mg QD; 8 wk initial, 15 mg QD maint; h pylori: 30 mg + amox + clarith BID x 14 days; NG tube admin in apple juice - pellets, break apart; food dec abs take on empty stomach

Front 57

omeprazole/Prilosec

Back 57

eros esoph: 20 mg QD; 4-8 wk initial, 20 mg QD maint; h pylori: 20 mg + amox + clarith bid x 14 days; high doses in hypersecretory dx; p450 interactions; 3A4: warfarin, plavix; take prior to eating; antacids ok; 1st PPI

Front 58

pantoprazole/Protonix

Back 58

eros esoph: 40 mg QD; 8 wk initial, 40 mg QD maint; IV avail, regardless of meals; antacids ok

Front 59

dexlansoprazole/Dexilant

Back 59

eros esoph: 60 mg QD, 8 wk initial, 30 mg QD maint; 30, 60 mg; abs peaks 1-2 hr, 4-5 hr; 2C19, 3A4 metab; regardless of meals; swallow whole or sprinkle on applesauce; newest

Front 60

famotidine/Pepcid

Back 60

duod ulcer: 20 mg bid or 40 mg QHS, 20 mg QHS maint; GERD: 20-40 mg bid 6-12 wks initial, 20 QHS maint; safest w/ warfarin, interacts but no prob; AE: HA; antacids ok

Front 61

cimetidine/Tagamet

Back 61

eros esoph: 400 mg QID; prevent upper GIB - IV infusion; 12 wk initial; p450; int: many, benzos, carbamazepine, BB (propranolol, metoprolol) labetalol, phenytoin, theophylline, warfarin; take w/ food, antacids 2 hrs after

Front 62

ranitidine/Zantac

Back 62

duod ulcer: 150 mg bid, 150 mg QHS; eros esoph: 150 mg QID, 150 mg bid maint; oral, IV, effer dose; dissolve effer tab granules + drink

Front 63

sucralfate/carafate

Back 63

duod ulcer, stress ulcer; 1 g QID ac+HS; 4-8 wk initial, 1 g bid maint; minimal systemic abs; caution: renal dysfx; int dt dec abs of other drugs - dig, warfarin, phenytoin, theoph, levothyrox, quinolon, tetracyc, antacids; AE: constipation, indigestion; take on empty stomach 1 hr ā meal, at HS; avoid antacids before/after, will coat stomach

Front 64

misoprostol/Cytotec

Back 64

dec NSAID induced gastric ulcer; 200 mcg QID; QID most effective; preg cat X; PGE1 analog; AE: d, abd pain, take w/ meal & at HS

Front 65

mesalamine/Asacol

Back 65

UC tx, maint; 400 mg tab, 2 tabs tid; acute tx 6 wks, delay release tab; CI: aspirin allergy; antiinflam properties; AE: abd pain, dyspepsia, constipation, do not crush

Front 66

balsalzide/Colazal

Back 66

UC tx 750 mg cap, 3 caps tid; acute tx 8-12 wks; AE: HA, abd pain; reg release; Δ to mesalamine in colon; CI: ASA allergy; can sprinkle on applesauce; acute tx 8-12 wks

Front 67

olsalazine/Dipentum

Back 67

UC maint; 250 mg caps, 2 caps bid; reg release; Δ to mesalamine in colon; CI: ASA allergy, take w/ food; AE: abd pain, dyspepsia, constipation

Front 68

sulfasalazine/azulfidine

Back 68

UC tx, maint; 2000-4000 mg div 3 initial tx, 2000 mg div 3 div 3 maint; 500 mg, EN 500 mg (delay release); AE: anorexia, HA, N; take at even intervals after meals w/ ample fluids

Front 69

dicyclomine/Bentyl

Back 69

fx/IBS; 20-40 mg tid-qid; 30 min ā meal; anticholinergic; drowsy, no EtOH

Front 70

hyoscyamine/Levsin, Levbid

Back 70

IBS; -sin: 0.125 mg, 1-2 q 4 hr prn, empty stomach ā meals or prn, max 12 tab per day, tab, SL tab; -bid: 0.375 mg, 1-2 q 12 hr SR bid; can use together; additive anticholin, int w/ antacids; AE: anticholin; empty stomach, no antacids, no EtOH

Front 71

chlordiazepoxide + clidinium/Librax

Back 71

IBS; 1-2 tid-qid; before meals/food +/- at HS; controlled, smooth muscle relaxant; antispasmodic, anticholin; int: 3A4, CNS dep; AE: anticholin; avoid abrupt withdrawal after long term use (benzo)

Front 72

prochlorperazine/Compazine

Back 72

sev N/V; 5-10 mg tid-qid; 5-10 mg tab; syrup, inj, supp; int: CNS dep; CI/prec: CNS dep, , < 2 yo, < 20 lbs; movement disorders w/ large or long doses; AE: drowsy, dizzy, blurry vision, CPS, no EtOH

Front 73

granisetron/Kytril

Back 73

post OP, chemo, N/V 1 mg tid; premed w/ 1st dose up to 60 min ā chemo; 5HT seratonin, antagonist; HA, fatigue, constipation; counsel pre/post med

Front 74

ondansetron/Zofran

Back 74

chemo NV: 8 mg bid 30 min ā chemo; post op NV: 16 mg preanesthesia; 4, 8, 24 mg tab; pre/post med

Front 75

metoclopramide/Reglan

Back 75

diabgastropar: 5-10 mg QID, 30 min ac, HS 2-8 wks trial; GERD + motility dx, chemo NV prev: 5-15 mg up to QID; 30 min ac, HS; CI: GI obstruction, other meds w/ EPS; black box tardive dyskinesia w/ > 12 wks use; AE: drowsy, fatigue, movement disorder; tab syr, inj

Front 76

trimethobenzamide/Tigan

Back 76

Sev NV 300 mg tid-qid; cap, soln, IM inj; caution: CNS dep; drowsy, dizzy, EPS; alt to compazine in pt central acting antiemetic; no EtOH

Front 77

atropine, hyoscyamine, scopolamine, phenobarbital/Donnatal

Back 77

GI, antispasmotic, IBS, enterocolitis; 1-2 tid-qid, max 8 tab/day; caut: anticholin-glaucoma, GI obs, sev UC, liver/renal dx, elderly; AE: antichol; antimuscarinic combo

Front 78

diphenoxylate + atropine/Lomotil

Back 78

D; 2 tabs or tsp qid initially then QD - BID; short term use; DC if no response in 48 hr; CI: pseudomembranous colitis (any motility dx) antichol

Front 79

polyethylene glycol (PEG 3350)/Miralax

Back 79

Constipation; 1 scoop, heap tbsp in 8 oz liq QD; use H2O, juice, soda, tea, coffee; may take 48-96 hr for effect; CI: bowel obs, V/abd pain, dist; AE: bloating, cramps, farts, D, osmotic lax, chill

Front 80

PEG + electrolyte soln/Colyte

Back 80

bowel cleanse prior to GI procedure; 8 oz of reconstit soln q 10 min tol clear or 4 L consumed, add H2O shake well, chill, no food food 3-4 hr ā; follow MD direction of wk to start, early afternoon, PM; meds 1 hr before no abs; drink quickly; no food, drink after finish prep

Front 81

docusate Na, Ca/Docusate

Back 81

constipation; Na: 50-100 mg bid or 250 mg QD; Ca: 240 mg QD; w/ full glass H2O; 24-72 hr for effect; surfactant, facil mix fat/H2O in stool; not w/ mineral oil, systemic abs; better for prevention; drink ample fluids, inc fiber

Front 82

lactulose/Chronulac

Back 82

constipation: 15-30 mL QD; portal sys enceph: 30-45 mL tid-QID; 24-48 hr for effect; metab to lactic + acidic acid ⇒ dec pH in intestine, inc BM; avoid antacids; AE: gas abd discomfort; mix w/ fruit juice; milk, H2O; dec ammonia abs, inc elim

Front 83

chlorhexidine gluconate/Peridex

Back 83

oral hygiene rinse; 1/2 oz for 30 sec bid after brush teeth; spit, don't swallow; avoid other rinses, food, H2O after; disrupts bacterial cell wall memb; AE: local initiation, taste Δ, stain oral surface