MS Contin

VS

oxycontin

MS contin is morphine sulfate

oxycontin is oxycodone

meperidine

side effect and monitoring

CNS effect

seizures

Reduced renal function

duragesic patch

avoid fever over 102.5

application of heat to the patch

cyp3a4

not for opioid naieve

COPD watch out for this drug

one opioid for at least a week

non dyhydropyradine

AZOLE

PI 

macrolide exept azith

amio

nefazodone (serotonin RE/INH)

aprepitant

camphorate tincture  of opium aka (paregoric)

CII in california?CIII Fed

DTO is Deoderized tincture opium

do not substitute paregoric for Tincture, it contains more alcohol

weekly for non oncologic tx

daily for oncologic tx (trexall)

antineoplastic 

green urine

mix up with MTX

Humira and Enbrel

what allergies to look for prior to dispense

latex

fridge, leave to room temp before dispense

foradil- formoteral

spiriva- tiotropium

Lansoprazole power is use for what 

ruote of administration

Diastat Acudial

how to use it

pharmacist must dial before dispense

come in 10 and 20mg rectal syringe

two syringe in each pack

once dial and lock (green band will apear visable)

Dose TID to QID

antineoplastics

chloramphenical

lindane

metronidazole

phenytoin

tamoxifen

PTU

androgen and Antiandrogen

isotret

misoprotal

drug with special handling conern due to

pregnancy

avodart

propecia

topical testosterone

cellcept(mycophenalate)

valcyte (valgancyclovir)

efudex (topical fluorouracil)

coal tar

quinidine

TCA

avoid anticonvulsant (use these: gabapentin,levetirazetam,tiagabine,valproate)

or 

use OC with at least 50mcg 

rifampin: back up 1 month after DC of Rif

Back up is optional for Antibiotics

Ritonavir and st John (backup)

metronidazole

omnicef suspension if refridge

biaxin suspension if refridge

60mg of morphine/day for at least 1 week

30 mg of oxycodone dialy for 1 week

8 mg of oral hydromorephone

be careful when initial dose is 25mcg/hr

take 6 days for fentanyl to be affective

flush in toilet

12.5

25

50

75

100

so by 25

buccal tabs

100 mcg

200

400

600

800

* use for breakthrough repeat after 30min

Fentanyl 

and the different formulations

abstral: sub tab

actiq: logzenge

fentora: buccal tab

onsolis: buccal film

both IV

venofer is newer and much less anaphalaxis

serum creatinine

potassium

isosorbide 

remember:

dosing for frequency for isosorbide 

mono vs dinitrate

MONO:monoket,ismo: QD, BID (7hr apart)

*Imdur is extend release:QD

Dinitrate: TID:Isordil (7am,12,5)

or (BID 7 am,noon)

*ER: Dilatrate-SR QD or BID

chorthalidone more hypokalemia

chorthalidone longer duration of action

similiar peak and overall blodd level

not time it takes to get there

bystolic is 

comparable to 

nebivolol

coreg for HF

pt on 6.25 BID will need 20/day

12.5 BID will need 40/day

* avoid alcohol within 2 hours of coreg, drug release faster

what is BIDIL 

what is the benefit

dose

enhance nitrate free

dinitrate with hydralazine

20mg dinitreat/37.5 hydralazine (1 to 2 tab TID)

lupus becuase of hydralazine

NItrate: avoid viagra, lavitra

spironalactone

dose side effect

initial 25mg/day

maintanance 50/day

hyperkalemia (hospital death)

lescol: fluvastatin

Pravachol: pravastatin

qt prolongation

* avoid poten cyp 3a4 with QT

nitrostat

- call 911 if dont get pain relief in 5 min after just one dose

oxycodone level increase when dose with

decrease level when dose with

increase level: 3a4 inhibitor

decrease: when dose with inducers

fentanyl

when methadone is dose with cyp 3a4 

what alternative to choose

morphine

codeine

hydromorphone

tapentadol (nucynta)

twinject

adrenaclick

epipen auto injectors

*some may be prescribed two doses, use second dose 5-10 minutes later if still experience breathing issues

angioedemia

bronchospasm

anaphylaxis

rash

byetta

januvia

junamet

* extanatide & sitagliptan

abdominal pain call doctor

* same with onglyza(saxaglipton)

Venofer is 

dilute in 

iron sucrose

NS

asenapine 

*sublingual

Loading: 15-20mg/kg PO or IV 

maintanance dose: 4-7 mg/kg

*get trough 30 min before the next dose

* 90% albumin bound

*level 10-20

* increaes 50-100mg each time

lower heart rate

fainting

WellbutrinSR vs Wellbutrin XL 

dosing

IR: TID ( 75 & 100mg)

SR: 150 BID (100,150,200)

XL: 300 QD (150,300)

*no LA 

*zyban is SR (150)

1. right patient

2. right drug

3. right dose

4. right time

5. right route

keppra vs keflex

both available in 

what dose tablets

Lorazepam

both come in with 1 mg

imdur: 30 mg

theodur 300mg

*both comes in a 250 and 500 tabs

* both approve for migraines

Depakot ER: extended release: QD

Depakote: Delayed release: BID-TID

ability is available 

in what confusing tablet dose

Omnicef 

usually dose is

QD-BID

cefdinir

* may be mistake with keflex

when question given solution

consider 

hypoglycemics

opiats and narcotics

anticoagulant

hydroxyurea

Methotrexate

meformin

watch out for 

HCL and XR

850, 1000 is HCL

750 is XR

*both has 500

OTC tylenol

tylenol extra-strength: 500mg

Regular strength: 325

Extended-release strength: 650

kids 4-23 months

10-15 mg/kg q4-6 hours (5 doses/day)

needle choice for 

IM injection

SQ injection

SQ insulin

IM: 1"-1.5" adults 5/8 to 1.25 Kids

*Guage 18-25

SQ: 5/8" (zostavax)

insulin: SQ 3/16 teens, 5/16 adult

*  23-27 guage

cocaine

codeine (slingle ingreadient)

Fantanyl

hydromorephone

meperidine

methyphenidate

nabilone(cesamet)-chemo induce(emetic)

opium tincture

oxycodone

morphine

C2 partial fill

the remainder of the drug must be DISPENCE within

72 hours

* not furnish

Scheldule 2

can technician pull CII ?

can they count?

can they write it in the log book?

is backcount require?

yes

yes/pharmacist must double count

yes

NO

no, they are the opposite effect, makes you hyper

require for opioid CII

date and amount of drug received docummentds

save for two years

when CII is expired 

what form is used to complete and destruction of expired drugs

DEA 106 (theft of loss)

DEA 41(breakage, spilled)

* i dont know, pharmacist letter says form 106

refuse to dispense, it your responsibility to dispense or not

if you suspect, you have to right not to dispense

call the police

contact state board

fill out 106

Report to DEA (fax or phone)

prescription as for 

methyphenadate

and alprazelam

one the same visit

dont fill

contradiction

abusers wants uppder and downer at the same time

the following drugs given together with constant refills 

suggest

hydrocodone

soma

benzo

* together these drugs suggest abuse

avoid nitrate

20 mg TID

bismuth subsalicylate instead of 

aluminum and magnesium hydroxide

flovent diskus

Serevent diskus 

is good for how long after opening of packag

e-prescribing

barcode

cpoe

why rather than who

*why,how,when,what happen

device use to deliver lantus or apidra

use for 3ml prefilled cartridge

patient dials amount to be injected

* mistake when try to dial upside down

20mcg/day

but pen said 750/3ml

if you have 

solution and gel eye drop

dose which one first

solution first, then gel

* give five minutes in between

a prescription for metoprolol is given without salt identify what do you do

same for amoxicillin

Same for buproprion

levoxyl & synthroid

* NOT Levothroid

can tiazac generic be substituted for cardizem CD or Dilacor XR?

but can not be substituted

10 and over

tessalon

cough suppressant

clonidine is indicated for 

dose

children over 6 in adhd

dose 

.1,.2,.3

* doubling dose can be fatal in children

* Dose BID

diphenhydramine

* six strips at one time can be dangerous

methyl salicilate

* 1 table spoon is like 90 baby aspirin strength

iron supplement

penatal vitamins

infant: 80/.8

children: 160/5

* infant concentration is three folds of children if both taken at 5 ml

no limits on number of RX

* total day of supply can not exceed 90 days

ex: three 30s or 9 10 days supply

if suboxone and subutex is dispense for pain

only DEA is require

* for opioid tx require X and DEA

if your pharmacy is close 

what must you to the form DEA 222

you Enter:name of produce and quanity (FED)

customer enter: name,address,date adn time,sign

* can be done by electronic

if customer cannot fill information to the psuedophedrine log themself 

you can

24 hours

* phone or fax is the best way

* use form 106

Effexor XR and venlafaxine ER 

are both brand

give with food

both taken daily

* venlafaxin ER contain 225 mg

* other 37.5,75,150

* TEVA gernic is approve for XR

*venlafaxin ER only "authroized generics"

* allergice to codeine,morphine,oxycodone

with sedation: taking with benzo

repiratory depression: with methadone

arrythmias: amio,eryth,quinidine

sedation: SSRI

* watch out for strong inhibitors

Avinza

kadian 

MS contin

oxycontin 

are usually dose?

qd or BID

* if dose q8h or more, calll doc

when you see patient on fent drip or PCA

double check to see if there are additional 

IV or PO drugs ordered

morphine oral liquid comes in 

what strength

20mg/5 ml

10mg/5

20mg/ml

1mg/ml

2mg/ml

10mg/ml

eydrop sig code

AD

AS

AU

OD

OS

OU

AD: right ear

AS: left ear

AU: both ear

OD: right eye

OS: left eye

OU: both eye

Otic

non sterile

azasite

xalatan

alkaine (keep in fridge once dispense)

opthaine (keep in fridge once dispense)

blephamide

(prednisolon and sulfacetamide)

eye drops

dexamethasone

eye drops

prednisolone

eye drop

ear drop

(cipro and hydrocortisone)

neomycin and hydrocortisone

ear drop

cortisporin

( non TC)

hydocortison,neomycin,polymyxin B

ear drop

* both suspension and solution

if not include suspension or solution, call doctor

blue kit: when take with VPA: lower dose

green: carb,pheny,pheno,primidon,rifam, higher dose

orange: not on any of these meds

* hydrobromide VS HCL of wellbutrin

174 for 150 HCL

348 for 300

522 for 450

may self prescribe, but not controlled

if famiy member: must be in context of physcian/patient relationship (meaning must have appropriate record keeping)

add first,third,fifth

add second,fouth,sixth, (SUMX2)

all both togetther, last digit match with the last digit of DEA Number

new prescription for fentanyl for new patient

with three orders of fentanyl

dated for each month ( with when to filled date)

is this appropriate

* total must be 90 days supply

*med is new and not maintanance ( if maintance then appropriate, dose is subjected to change)

active ingredient for "Claritin Eye" and 

Zyrtec Itchy Eye drop

ketofitifen

* same as Zaditor and Allaway

NaphCon A

OPhtcon A

and vision A

VS

zaditor

allaway

sudafed is pseudoephedrine

but 

sudafed sinus advance has

calcium

* separate by 48 hours

Fosfomycin: urine VRE

Daptomycin: Blood,bone,heart

Linezolid: saem as dapto coverage

Synercid: faecium, but not faecalis

Tigecycline: skin and intraabdominal

Dtap: children through age 6

Tdap: for adolescent and adults

*Adecel (11-64) and Boostrix(10-18)

*TD q10 years

morphine,hydromorphone,meperidine

IV to PO

not equivalence

dantin: macrocystals

Macrobid: macrocrystals& monohydrate

macrobid 100mg BID

macrodantin 50 qid

Vancomycin

oto & nephro

trough 5-20

monitor: trough before the 4th dose

dose q8-12

ABW

500mg/30minutes

pneumovax: 23

prevnar 13: 15 month-5 years