Losartan potassium/ Hydrochlorothiazide

Hyzaar®

BBW: Can cause fatal injury and death if used in 2nd & 3rd trimesters, D/C treatment if PRG detected

Uses: HTN, DN, prevent CVA in HTN and LVH

MOA: Angiotensin II receptor blocker, thiazide diuretic ↓ distal tubule Na reabsorption

Dose: 50 mg/12.5 mg PO QD, Max 100 mg/25 mg/day, ↓ in elderly/hepatic impair

Caution: C/D/D, ?/-, w/ NSAIDs, w/ K sparing diurectics, supl may cause ↑ K, w/ RAS, hepatic impair

CI: PRG, component sensitivity

Disp: Tabs 50/12.5, 100/12.5, 100/25 mg (Losartan/HCTZ)

SE: ↓ BP, ↑ K, ↑ urination, GI upset, facial/angioedema, dizziness, cough, weakness, ↓ renal function

Oxycodone HCl/APAP

Endocet®, Percocet®, Tylox®

Schedule: C-II

Uses: Mod-Severe Pain

MOA: Narcotic analgesic

Dose: 1-2 tabs/caps PO q4-6h PRN (acetaminophen max dose 4g/d)

Caution: C/D, M

CI: Allergy, paralytic ileus, resp depression

Disp: Tabs 2.5/325, 5/325, 7.5/325, 10/325

SE: ↓ BP, sedation, dizziness, GI upset, constipation

Dicyclomine HCl

Bentyl®

Uses: Functional IBS

MOA: Smooth-muscle relaxant

Dose: 20 mg PO QID, ↑ to 160 mg/d MAX or 20 mg IM q6h, 80 mg/d ÷ QID then ↑ to 160 mg/d, max 2 wk

Caution: B, -

CI: Infants < 6 months, NAG, MyG, severe UC, BOO, Gi obst, reflux esophagitis

Disp: Caps 10, 20 mg; Tabs 20 mg, Syrup 10 mg/5 mL; Inj 10 mg/mL

SE: Anticholinergic SEs may limit dose

Notes: Take 30-60 min AC; avoid EtOH, do not administer IV

Clarithromycin

Biaxin®, Biaxin® XL

Uses: Upper/lower resp tract, skin/skin structure infxns, H. pylori ifxns, & infxns caused by non-tuberculosis (atypical) Mycobacterium, prevention of MAC infxns in HIV-infxn

MOA: Macrolide antibiotic; ↓ protein synth. Spectrum: H. influenzae, M. catarrhalis, S. pneumoniae, M. pneumoniae, & H. pylori

Dose: 250-500 mg PO BID or 1000 mg (2x500mg XL tab)/d. Mycobacterium: 500 mg PO BID, ↓ w/ renal impair

Caution: C, ?, Antibiotic-associated colitis, rare QT prolongation & ventricular arrhythmias, including torsades de pointes

CI: Macrolide allergy; w/ ranitidine in pts w/ Hx of porphyria or CrCl <25 mL/min

Disp: Tabs 250, 500 mg; Susp 125, 250 mg/5 mL; XL tabs 500 mg

SE: ↑ QT interval, causes metallic taste, N/D, Abd pain, HA, rash

Notes: Multiple drug interactions, ↑ theophylline & carbamazepine levels, do not refrigerate susp 

Bisoprolol/Hydrochlorothiazide

Ziac®

Uses: HTN

MOA: Competitively blocks beta-adrenergic receptors, thiazide diuretic, ↓ distal tubule Na reabsorption

Dose: 2.5 mg/6.25 mg PO QD, Max 10 mg/6.25 mg/day (Bisoprolol/HCTZ)

Caution: C/D/D, +/-

CI: Component sensitivity, Sinus bradycardia, AV conduction adnormalities, uncompensated cardiac failure

Disp: Tabs 5, 10 mg

SE: Fatigue, lethargy, HA, ↓ HR, edema, CHF, ↑ urination

Notes: Not dialyzed

Glyburide/ Metformin HCl

Glucovance®

Uses: Type 2 DM

MOA: Sulfonylurea, ↑ pancreatic insulin release, Metformin, peripheral insulin sensitivity, ↓ hepatic glucose output/production, ↓ intestinal glucose absorption

Dose: 1st line (naive pts), 1.25/250 mg PO QD-BID, 2nd line, 2.5/500 mg or 5/500 mg BID (max 20/2000 mg); take w/ meals, slowly ↑ dose; hold before & 48 hrs after ionic contrast media

Caution: C, -

CI: SCr > 1.4 mg/dL in females or >1.5 mg/dL in males; hypoxemic conditions (sepsis, recent MI), alcoholism, metabolic acidosis, liver disease

Disp: Tabs 1.25/250 mg, 2.5/500 mg, 5/500 mg

SE: HA, hypoglycemia, lactic acidosis, anorexia, N/V, rash

Notes: Avoid EtOH, hold dose if NPO, monitor folate levels (megaloblastic anemia)

Nabumetone

Relafen®

BBW: May ↑ risk of CV events & GI bleeding, perforation, CI w/ post-op coronary artery bypass graft

Uses: *OA, RA,* pain

MOA: NSAID, ↓ prostaglandins

Dose: 1000-2000 mg/d ÷ QD-BID w/ food

Caution: C, -, Severe hepatic disease

CI: w/ peptic ulcer, NSAID sensitivity, after coronary artery bypass graft surgery

Disp: Tabs 500, 750 mg

SE: Dizziness, rash, GI upset, edema, peptic ulcer, ↑ BP

Hydroxychloroquine

Plaquenil®

BBW: Prescribers should be familiar w/ complete prescribing information before use

Uses: *Prophylaxis and treatment of malaria, SLE,* Rheumatoid arthritis

MOA: Binds DNA, interferes w/ parasitic vesicle functions, inhibits phospholipid metabolism, inhibits plasmodial erythrocyte stage; antirheumatic/immunosuppressive effects, inhibits rheumatoid factor, acute phase reactants, and many enzymes

Dose: Malaria Tx: 400 mg PO q24h x2; 800 mg PO x1, then 400 mg q6-8h later. Malaria Prophylaxis: 400 mg qwk, start 2 wks before and continue x6-8wks after exposure. RA: 200 mg PO BID; give w/ food or milk

Caution: C, -, Hepatic impair, Alcoholism, concurrent hepatotoxic agents, pediatric pts

CI: Component sensitivity, retinal or visual field changes, psoriasis, PRG

Disp: Tabs 200 mg

SE: Dizziness, ataxia, HA, abd pain, N/V/D, itching, wgt loss, photosens

Benztropine

Cogentin®

Uses: Parkinsonism, Drug-induced extrapyramidal disorders

MOA: Partially blocks striatal cholinergic receptors

Dose: Parkinsonism: Initial 0.5-1 mg PO/IM/IV qHS, ↑ q 5-6 d PRN by 0.5 mg, usual dose 1-2 mg, 6 mg/d max. Extrapyramidal: 1-4 mg PO/IM/IV q day-BID. Acute Dystonia: 1-2 mg IM/IV, then 1-2 mg PO BID

Caution: C, ?, w/ urinary symptoms, NAG, hot environments, CNS or mental disorders, other phenothiazines or TCA

CI: <3 y

Disp: Tabs 0.5, 1, 2 mg; Inj 1 mg/mL

SE: Anticholinergic (tachycardia, ileus, N/V, etc.), anhydrosis, heat stroke

Notes: Physostigmine 1-2 mg SQ/IV to reverse severe symptoms 

Ropinirole HCl

Requip®

Uses: Treatment of Parkinson disease, restless legs syndrome

MOA: Dopamine agonist

Dose: Initial 0.25 mg PO TID, weekly ↑ 0.25 mg/dose, to 3 mg max, max 4 mg for RLS

Caution: C, ?/-, Severe CV/renal/hepatic impair

CI: Component allergy

Disp: Tabs 0.25, 0.5, 1, 2, 3, 4, 5 mg

SE: Syncope, postural ↓ BP, N/V, HA, somnolence, dose-related hallucinations, dyskinesias, dizziness

Notes: D/C w/ 7-d taper