Cardiac

dobutamine

dobutrex

: vasopressor used for decreased cardiac out put and heart failure

beta-1 agonist

do not give with beta blockers or atomoxetine

ADRS: premature ventrciular contractions, angina, dyspnea, nervousness, and HTN

Cardiac

Epinephrine

Adrenaline

: catecholamine used as a cardiac stimulant and as a bronchodilator in cases of anaphylactic shock

potent non-selective adrenergic at both alpha and beta receptors- increases blood pressure

Do not give with MAOI's, alpha and beta blockers, or atomoxetine

ADRS- nervousness, excitability, n/v, diaphoresis, cardiac arrythmias

cardiac

Norepinephrine

Levophed

: vasocpressor used for the treatment of acute HoTN and septic shock- increases blood pressure

do not give with MAOI's, alpha and beta agonists, or atomoxetine

side effecrts: same as adrenaline

Cardiac

Phenylephrine

Neo-synephrine

: vasopressor used in the treatment of paroxsymal supraventricular tachycardia

-reduces heart rate

Do not give with MAOI's, bromocriptine, alpha and beta blockers

ADRS- HTN, angina, reflex sinus bradycardia, increased risk for heart failure

Cardiac

Alteplase

Activase

: thrombolytic agent used in MI and acute ischemic stroke

-plasminogen activator

Do not give with NSAIDS, anticoagulants, cephalosporins, and Nitroglycerin

ADRS- bleeding, arrhythmias, and angioedema

Cardiac

Amiodarone

Cordarone

: class III antiarrhythmic

- delays repolarization and increases the action potential duration

IV  no longer than 3 weeks

inhibits CYP 1A2, 2C9, 2D6, and p-GP

ADRS: pulomonary, GI, rare fatal hepatotoxicity, hematological effects

Cardiac

Bumetanide

Bumex

: diuretic used for edema associated with CHF, cirrhosis, and renal DX

-loop diuretic

Do not give with glucocorticoids (hypokalemia), lithium, and salicylates

ADRS: muscle cramps, HoTN, hypokalemia, hyponatremia, rare renal failure

Cardiac

Enoxaparin

Lovenox

LMWH- DVT and STEMI

Do not giev with anticoagulants, cephalosporins, NSAIDS or protamine ( protomaine reverses effects)

ADRS: bleeding, anemia, fever, peripheral edema

Cardiac

Heparin Sodium

Heparin

anticoagulant

do not give with anticoagulants, cephalosporins, NSAIDS or protamine

ADRS- bleeding, thrombocytopenia, hyperkalemia, and osteoporosis in long term

Cardiac

Esmolol

Brevibloc

Class II antiarrthymic: HTN and supraventricular arrhythmias

blocks sympathetic stimulation by beta 1 receptors in the heart

Do not give with- digoxin, diltiazem, or verapamil

ADRS: HoTN, sinus bradycardia, AV block

Cardiac

Milrinone

Primacor

: ainotropic/vasodilator agent for CHF

improves diastolic function and myocardial contractility

no significant interactions reported

ADRS: HoTN, ventricular arrhythmias, torsades

Cardiac

Vitamin K

phytonadione

Aquamephyton

: synthetic vitamin K- hypoprothrombenemia due to vitamin K deficiency

promotes liver clotting factors

do not give with warfarin or other anticoagulant TX

ADRS: Hsx rxns and injection site rxn

Penn/ Ceph

Amp/Sul

Unasyn

amp- beta lactam

sul- beta lactamase inhibitor

max- 4gram

do not give with A/G, methotrexate, BC

ADRS- N/V/D, ab pain, hsx rxn

Ceph/Penn

Penn-G

Pfizerpen

beta-lactam

do not give with A/G, metotrexate or BC

ADRs: N/V/D, ab pain and hsx rxn

Ceph/Penn

Pip/Taz

Zosyn

beta lactam with beta lactamase inhibitor

Crcl- 20

above- 3.375 gram over 30 min q12hr

below- 3.375 g over 4 hours Q8 hrs

do not give with A/G, methotrexate, or BC

ADRs: N/V/D, ab pain and hsx rxn

Ceph/Penn

Tic/Clav

Timentin

beta lactam with competitive inhibitor of beta lactamase

do not give with A/g, methotrexate, or bc

ADR's- N/V/D, ab paina nd hsx rxn

ceph/penn

Cefazolin sodium

Ancef

cephalosporins- cell lysis

MDD- 12 grams

do not give with chloramphenicol- inhibits

ADRs- H/A, hsx rxns, neutropenia, interstitial nephritis

1st gen: gram + (lil gram -)

maxipime

cell lysis- cephalosporin

do not give with chloramphenicol

ADRS: H/A, hsx rxn, netropenia, and interstital nephritis

4 generation

clarforan

cell lysis

do not give with chloramphenicol

H/A, hsx rxn, netropenia, and interstitial nephritis

3rd generation

Fortaz; Tazidime

cell lysis

do not give with chloramphenicol

h/A, hsx rxn, neutropenia, and interstital nephritis

Rocephin

cell lysis

1-2 g Q 24 hours

2 grams Q 12 hours for meningitis

do not give with chloramphenicol

H/A, hsx rxn, neutropenia, interstitial nephritis

3rd generation

cefuroxime

sodium

Zinacef

cell lysis

do not give with chloramphenicol

H/A, hsx rxn, neutropenia, and interstitial nephritis

2 generation

Garamycin

A/G

bind to 30 s and make non-functional proteins

Traditional : 3-6 mg/kg/day in 2-3 divided doses

HDODA: 5-7 mg/kg/day

levels drwan 8-12 hours after first dose

Dose for renal impairment

Do not give with acyclovir, AMP B, cidofovir, cisplatin, or loop diuretics

nephro and oto- toxicity

A/G

Nebcin

Tradtional and HDODA

dose for renal adjustment

do not give with acyclovir, amp B, cidofovir, cisplatin, or loop diuretics

nephro and oto - toxicity

Vancocin

MRSA

glycopeptide abx

alterates celll wall and RNA synthesis

infuse over atleast 1 hour

doses adjusted based on vanco trough level

dosed for renal impairment

Do not give with A/G, cidofovir, anesthetics (anaphylaxsis), and metformin (lactic acidosis)

Oto and nephro toxicity, red man syndrome and neutropenia

oral formulation is not systemically absorbed

Erythrocin

macrolide- bacterostatic

binds to 50 s

MDD- 4 grams

dose reduction for renal failure

inhibitor of 3A4 and p-GP

ADRS: acute generalized exanthematous pustulosis, diarrhea, ab pain and jaundice

Primaxin

imipenem- abx

cilastain- inhibitor of DHP=1

binds to penn. binding proteins

Higher dose in CF patients and dose reduction in renal impairment

Do not give with probenacid( prolonged levels), valproic acid (decreased levels) or theophylline (seizures)

ADRS- n/v/d, psuedomembranous colitis, seizures

Zyvox

ventilator associated pneumonia- MRSA

MRSA

vancomycin resistance enterococcus faecium

oxazolidinone abx- interferes with transolation and is a reversible non-selective MAOI

Do not give with MAOI (HTN crisis), beta agonists, tyramine foods, or caffeine

ADRS- N/V/D, lactic acidosis, HTN, thrombocytopenia

Fungizone

polyene antifungal- binds to sterols

MDD 1.5 g

dosing differs for formulation

do not give with A/G, cidofovir, loop or thiazide diuretics- hypokalemia

ADRs- nephrotoxicity, electrolyte loss, anaphylaxsis, anemia

liposomal formulation- false high serum phosphate concentrations

Cancidas

echinocandin antifungal

70 mg loading dose

50 mg QD over 1 hour

Do not give with cyclosporin (increases), carbamazepine, dexamethason, or phenytoin (decreases)

ADRS: fever, infusion rxns, elevated hepatic enzymes, pulmonary edema

Duragesic; Actiq; sublimaze

persistant to moderate pain requiring continuous opioid analgesics

mu receptor agonist

Do not give with 3A4 metabolized drugs- azole antifungals, phenytoin, erythormycin, or amiodarone (HoTN), or NO (resp. depression)

ADRS- risk of abuse, chest pain, arrythmias, syncope, chest wall rigidity

Dilaudid

mod- severe pain

mu agonist

do not give with barbituates- increases CNS depression or MAOI's- coma and death

ADRs- constiptaion, bradycardia, resp. depression, palpitation, dizzy and drowsy

4-7 times more potent that morphine

Demerol

active metabolite- normeperidine- may accumulate and precipitate twitches and tremors or seizures- not first line choice for pain management

mu agonist

Do not give with subutramine (serotonin sydrome) or phenytoin ( decreased effects)

ADRS: constipation, flushing, bradycardia, resp. depression, palpitation, phlebitis

mu agonist

dose dependent on condition

do not give with other CNS depressants

ADRS: constipation, bradycarida, resp. dep, flushing, vasodilation, confusion, dizzy, drowsy, hallucinations, H/A, and withdrawal

Narcan

- indicated for the complete or partial reversal of opioid overdose

narcotic antagonist- competes for the mu receptor but produces no effect

short half life- repetition may be needed

C/I- none to date

ADRS: nausea, vomiting, sweating, tachycardia, increased BP- all from reversal of opioid effects

Versed

prespective sedation or anti-anxiety or general anesthesia

short acting Benzo

reversible inhibition of GABA receptor

Do not give with CNS depressants or 3A4 drugs- cimetidine, erythromycin, diltiazem, ketoconazole

ADRs: H/A, admin irritation, nausea, vomiting, over sedation, and drowsy

Toradil

short term pain- under 5 days

NSAID

ADRs- peptic ulcers, GI bleed, hsx, HTN, palpitations, syncope

Decadron

: RA, adrenal gland disorders, resp. dx, autoimmune Dx, GI DX, dermatologic conditions and allergic conditions

anti-inflammatory- also breaks down skeletal muscle, fat, bone, and suppresses immune system- inhibits leukocyte migration to site of inflammation

Do not give with barbituates- decreases

B.C and ketoconazole, macrolides- increases

Digoxin- digoxin toxicity

ADRS: HPA axis supression, insomnia, delayed hsx, osteoporosis, cataracts, glaucoma, glucose intolerence, weight gain, hypokalemia, altered mood, peptic ulcers, GI bleed, infection suseptibility

Solu-cortef

many DX states dealing with inflammation

same as decadron- indication, MOA, what to stay away from, and ADRS

xylocaine

local or regional anethesia and acute management of cardiac arrythmias

prevent generation and conduction or nerve impulses

do not give with sedatives

Adrs- myocardial depression, HoTN, N/V/D, tinnitus, blurred vision

Diprivan

anasthesia- induces and maintains

sedation- monitored and ICU

IV hypnotic/sedative that works rapidly

mechanical ventilation is needed for continuous IV

Do not give with CNS depressants

Adrs- resp dep, HoTN, movement effects, vomiting, apnea

Inapsine

:reduce the incidence of N and V

antagonist of apomorphine- a dopaminergic agonist to produce the antiemetic effect

cardio should be monitored

Do not give with agents that prolong QT intervals: antiarryhthmics, CCB's, antidepressants

or parenteral analgesics- fentantyl- HTN

BBW: QT prolongation and torsades

ADRS- palpitations, HoTN, tachcardia

C/I- QTc > 440 msec

Zofran

N/V- chemo and radiation

selective serotonin antagonist- vagal nerve, GI, CTZ

do not give with riframpin- decrease

or serotonin drugs- serotonin syndrome

Compazine

- control severe N/V

schizophrenia and non-psychotic anxiety

MOA- unknown

MDD: 40 mg/day

do not give with p450 pathway, thiazide diuretics (HoTN), or merperidine (excessive sedation)

ADRs: cardiac arrest, HoTN, ECG changes, dizzy, drowsy, dyskinesia, extrapyrimidal sx, insomnia, dry mouth, and constiptation

Procrit; Epogen

Anemia

stimulates erythropoeis by syimulating bone marrow turnover

want: Hg rance 10-12 g/dl

none to date- interactions

ADRs- immunogenicity, HTN, seizure, thrombotic evetns, allergic rxns

Humulin R, novolin R

DM 1 and 2- not controlled by diet and exercise

hyperkalemia and severe ketoacidosis

Lowers blood glucose

hyperkalemia- shift in K cells lowering serum potassium

Avoid drugs: increases hyerglycemic affect- ACE, BB, alcohol, fibrates and that decrease hypoglycemic affect- albuertol, phenytoin, and BC

ADRs: hypoglycemia, hypokalemia, injection site reaction

INFeD; DexFerrum

iron deficiency when PO is N/A

D/C oral iron before start- test before give- dosage based off individual patient and chart or calculated

Avoid: chloramphenicol- increases iron

BBW- anaphylaxsis, arrythmias, cyanosis, and CV effects

requires a test dose to be given before adminsitration to prevent anaphylaxsis

used to replace magnesium deficiencies such as acute hypomanesiumia

ADr's- flushing, sweating, HoTN, hypothermia, as a result of magnesum intoxication

need to monitor levels

Pitocin

for the initiation or improvement of uterine contractions

acts on smooth muscle of the uterus to stimulate contractions

ADRs: cardiac arrythmias, N/V, hypertensive episodes, pelvic hematoma, postpartum hemorrhage

used for metabolic acidosis, urinary alkalinization, severe diarrhea

increases plasma bicarbonate and buffers excess hydrogen ion concentration to raise blood pH to reverse acidosis

individually monitored and dosed

ADRs- cellulitis with tissue necrosis, local pain and irritation