| Term 
 
        |   Counseling points on clopidogrel (Plavix): Anti-platelet, Thienopyridine   |  | Definition 
 
        | 
Take w/or w/out mealsDo not use Plavix if you are allergic to clopidogrel, or if you have any active bleeding such as a stomach ulcer or bleeding in the brain (such as from a head injury). If you have any of these other conditions, you may need a dose adjustment or special tests:
A bleeding or blood clotting disorder, such as TTP (thrombocytopenic purpura) or hemophilia;a history of stroke, including TIA ("mini-stroke");a stomach ulcer or ulcerative colitis; orkidney disease. FDA pregnancy category B. Plavix is not expected to be harmful to an unborn baby.    |  | 
        |  | 
        
        | Term 
 
        | gabapentin (Neurontin): Anticonvulsant, GABA Analog |  | Definition 
 
        |   
   It may take 2-3 weeks to achieve desired results. Do not stop medication abruptly, may lead to increased seizure activity. 
Avoid alcohol. Maintain adequate hydration, unless instructed to restrict fluid intake. 
You may experience drowsiness, lightheadedness, impaired coordination, dizziness, blurred vision, nausea, vomiting, anorexia, constipation, diarrhea, postural hypotension, or decreased sexual function or libido (reversible).Report persistent CNS effects (nervousness, restlessness, insomnia, anxiety, excitation, headache, sedation, seizures, mania, abnormal thinking); suicide ideation or depression; rash or skin irritation; muscle cramping, tremors, or change in gait; chest pain or palpitations; change in urinary pattern; or worsening of condition.   |  | 
        |  | 
        
        | Term 
 
        | Is gabapentin cleared hepatically? |  | Definition 
 
        | a.Renal impairment:  dosage adjust w/ CrCl b.Hepatic:  not hepatically metabolized
 |  | 
        |  | 
        
        | Term 
 
        | Nitrofurantoin (Macrodantin, Macorbid)- Antibacterial (UTI) |  | Definition 
 
        | Dosage: capsule DI: Mag salts decrease effectiveness
 CI: Anuria, oliguria, dec ren fxn, G6PD deficiency, peripheral neuropathy, pulmonary, C. diff
 AE: N/V/D, HA, flatulence, chills, fever, cough
 |  | 
        |  | 
        
        | Term 
 
        | Sulfameth/Trimeth (Bactrim, Septra)- Sulfonamide ABX |  | Definition 
 
        | FDA: Infxn, PCP ppx, traveler's diarrhea 
Dosage: Tablets, Suspension, IV infusion
DI: dec. effs of cyclosporine, and incr.procainamide, hydration salts,& effects of anticoag & sulfonylureas
CI: <2mo old, preg, megalobastic anemic
SE: N/V/D, RASH, HIVES
PE: EMPTY STOMACH 1-2hr b4&post meal w/full h2o; avoid LIGHT |  | 
        |  | 
        
        | Term 
 
        | Amoxicillin (Amoxil, Trimox)-PCN ABX Trt Infection |  | Definition 
 
        | Dosage: Tabs, Chew, Cap., Susp.
DI: ORC, probenecid dec. Renal excretion
CI: allergy to PCN & CS, C.dif, Pseu. colitis
ADR: N/V/D, RASH, hives, itch 
PE: EMPTY STOMACH 1-2H  pre or post meals w/full h2o |  | 
        |  | 
        
        | Term 
 
        | Amoxicillin w/ Clavulonate -Augmentin (XR) PCN ABX; TRT INFECTION |  | Definition 
 
        | Dosage: Tabs, Chew, Susp
DI: ORC, probenicid dec renal excretion
CI: Allergy,renal, pseudo col, C. diff
ADR: N/V/D , hives, itch
PE: TAKE START OF MEAL to INC ABSORB & dec GI; Take at even intervals, chew tabs with full h2o, refrig susp 10d |  | 
        |  | 
        
        | Term 
 
        | Azithromycin (Zmax,Zithromax - Macrolide ABX; TRT Infection |  | Definition 
 
        | Dosage: Tabs, packets, susp, injection
DI: ANTACIDS=SLOW AB, FOOD WILL DEC ABSORP, Nelfinavir inc [Zmax] 
CI: Allergy to macrolides/ketolides, impr hepatic, pseudo colitis, C.diff, compl PNA, gonorrhea, syphillis
PE:TNR food, NO Antacids w/ 1hr
ADR: N/V/D, abd pain 
PE: TAKE EMPTY STOMACH 1-2h pre or post meal w/full h2o; take even intervals; refridge soln |  | 
        |  | 
        
        | Term 
 
        | Clindamycin (Cleocin) ABX; TRT Infection |  | Definition 
 
        | Dosage: Caps, Grans
DI: inc theophylline & carbamezepine
CI: pseudo col, elderly, GI disease, not cross BBB
ADR: abd pain, N/V/D, PURITIS,vaginitis, muscle pain (diff from other ABX)
PE: D/C if severe diarrhea, rash, muscle pain--> con PCP; w/full h2o, TNR food |  | 
        |  | 
        
        | Term 
 
        | Cefdinir (Omnicef) CS ABX; TRT Infection |  | Definition 
 
        | Dosage: Cap, Grans
DI: Al, Mg, ANTACIDS & Fe supp dec probenecid inc[Omnicef]
CI: Hypersen, renal fxn, pseudo col, C.diff
ADR: N/D (16%), vaginal moniliasis aka yeast infxn, HA ab pain
PE: DON'T take with ANTACIDS or Fe supps w/in 2H of dose; Susp good for 10D |  | 
        |  | 
        
        | Term 
 
        | Cephalein (Keflex) CS ABX; Trt Infection |  | Definition 
 
        | Dosage: Tab, Cap, Susp
DI: ORC, probenecid [inc]; False pos labs (UA, direct coombs) 
ADR: Allergy; Pseu col
SE: N/V/D, ITCHING, RASH, HIVES 
PE: EMPTY STOMACHE w/full h2o, take even intervals, Refridge 14days *vs Cefdinir (Omnicef 10d)* |  | 
        |  | 
        
        | Term 
 
        | Ciprofloxacin (Cipro XR) FQ ABX; TRT Infection |  | Definition 
 
        | Dosage: Tab, Susp, Inject
DI: ANTACIDS & FE salts [dec]; probenecid inc [ABX] bc dec renal; NSAID dec Seizure threshold, inc [theophylline]
CI: Allergy, QTc prolongation HOKalemia, antiarrhythmias (quinidine, procainamide, amdiodarione, sotalol), CNS disorders,  TENDON REPTURE, not for <18yo
SE: RASH, PHOTO, N/V/D, Dz
PE: AVOID SUN, d/c if rash, w/full h2o, TNR food (pref 2h after meal); NO ANTACIDS, Ca, Zn, Fe; Susp RT or fridge 14D |  | 
        |  | 
        
        | Term 
 
        | Moxifloxacin (Avelox) FQ ABX; TRT Infection |  | Definition 
 
        | Dosage: Tab, Inject DI: ANTACIDS, WARFARIN, Sucralfate, FE, NSAIDs dec seizure threshold, theophylline
 CI: QTc, allergy, HOkalemia, antiarrhythmias, CNS disorders, TENDON RUPTURE, not for <18yo
 SE: N/D; Dz
 PE: PHOTO, D/C if rash or TENDON RUPTURE, w/full h2o, TNR food, don't take ANTACIDS, FE, Zn, Ca, cause Dz, lightheaded
 |  | 
        |  | 
        
        | Term 
 
        | Fluconazole (Diflucan)Antifungal; Trt Infection, Tinea Infxn, Seborrheic Derm, Dandruff |  | Definition 
 
        | Dose: Tab, Sus, Inj DI: WARFARIN, phenytoin, midazolam, cyclosporin, tolbutamide, glyburide, glipizide, Rifampin
 CI: allergy, LFTs, QTc prolongation (rare), proarrhythmias
 SE: N/D, HA, ab pain, Dz, dyspepsia, taste
 PE: contact PCP if Rash
 |  | 
        |  | 
        
        | Term 
 
        | Metronidazole Flagyl (ER); Antiprotozoal, Antibacterial; TRT Amebiasis, Trichomoniasis infection |  | Definition 
 
        | Dosage: Tab, Cap, Inject
DI: Inc WARFARIN effects, dec Barbiturates, Disulfiram-->confused state; EtoH cause disulfiram-like rxn 
CI: Allergy, Trichomoniasis in 1st trimester of preg, CNS dx, severe hep impair, DON'T REFridge IV Soln
SE: SEIZURES, PER NEUROPATHY, anorexia, N/V/D, ab cramp, HA, dysuria, metallic taste |  | 
        |  | 
        
        | Term 
 
        | Nystatin topical (Nystop) Antifungal; Trt Candidiasis, cutaneous or mucocutaneous mycotic infxn (binds to sterols in cell membrane of candida species)*won't absorb through skin or mucous membrane* |  | Definition 
 
        | Dosage: Powder, cream, Ointment 
DI: None Known 
CI: PregC, not to be used in intravaginal, oral or systemic infxn
ADR: Rare (itching, rash, & pain on application)
PE: Don't use on eyes |  | 
        |  | 
        
        | Term 
 
        | Doxycycline (Vibramycin, Vibra-tabs) Tetracycline (Syphyllis, Gonorhea, Chlamydia, Malaria, PPx) |  | Definition 
 
        | Dosage: Tabs, Caps, Susp, Syrup, Inject
DI: ORC, inc [Digoxin], dec [alum, bismuth, Ca, Mg, Zn, Fe]
CI: Hypersensitivity, tooth dev in children <8yo, renal fxn, C.diff 
ADR: Dz, vertigo, N/V/D, PHOTO, DISCOLORS forming teeth, sore/dark tongue , cramps, burning stomach
PE: Empty stomach w/full glass h2o; TWF if GI upset, PHOTO |  | 
        |  | 
        
        | Term 
 
        | Minocycline (Minocin) Tetracycline (syphyllis, Gonorrhea, Chlamydia, Malaria, PPx) |  | Definition 
 
        | Dosage: Tabs, Caps, Sus, Syrup, Inject DI: ORC inc [dig], dec [metals]
 CI: Allergy, Dz, Vertigo, N/V/D, discolor teeth, SORE/DARK TONGUE, cramps, burning stomach, PHOTO rare
 PE: EMPTY STOMACH w/full h2o, TWF if GI, even interval, NO ANTACIDS
 |  | 
        |  | 
        
        | Term 
 
        | Valacyclovir (Valtex) Antiviral; Trt Genital Herpes, Cold Sore |  | Definition 
 
        | Dosage: Tab DI: Inc [Probenecid]
 CI: Allergy, dose dec in renal, precip of drug in dehydrated pts
 SE: N/V, HA, abd pain
 PE: Avoid sex with vis lesions, Valtrex doesn't kill latent virus & no cure, Take plenty of fluids
 |  | 
        |  | 
        
        | Term 
 
        | Budesonide (Pulmicort) ihalation; Anti-asthmatic (adrenocorticoid); Maintenance tx of asthma |  | Definition 
 
        | Dosage: Susp for inhalation MDI DI: incr[budesonide] by Ketoconazole
 CI: caution xfer pts from sys corticosteriods to Pulmicort (adrenal insufficiency), NOT FOR RAPID RELIEF, oral fungal infxn, HPA response
 SE: HA, asthenia, pain, dyspepsia, N, oral candid, cough, resp infxn, rhinitis, sinusitis
 PE: Avoid eyes, Use ST bronchodilators before Pulmicort, RINSE MOUTH after use, red mark = 20 dose left, avoid exp to chxpox or measiles, Tubohaler not with Spacer
 |  | 
        |  | 
        
        | Term 
 
        | Fluticasone Propionate (Flovent)Anti-asthmatic (adrenocorticoid); Trt Maint Asthma |  | Definition 
 
        | Dosage: MDI DI: Additive eff w/systemic corticosteroids
 CI: Adrenal insuff during steroid conversion, NOT for RAPID RELIEF of bronchospasm, oral fungal infxn, HPA Response
 ADR: Pharyngitis, nasal congestion, URI
 PE: avoid eyes, use other Bronchodilators minutes b4 Pulmicort
 |  | 
        |  | 
        
        | Term 
 
        | Fluticasone Propionate w/ Salmeterol (Advair); Antiasthmatic (adrenocorticoid & inc CAMP); Main tx of Asthma COPD **long-acting beta2-adrenergic receptor agonist (LAB2A)** |  | Definition 
 
        | Dosage: DISKUS HFA DI: Additive effect w/ systemic corticosteriod, sympathomimetics, TCAs, MAOIs inc tox B dec eff of Salmeterol
 CI: adrenal insuff during steroid conversion, not for RAPID relief, oral fungal infxn, HPA fxn, CV disorders, HN, hypthyroidism, DM
 SE: URI, Pharyngitis, HA, N/V, sinusitis, bronchitis, cough, RASH, AGIOEDEMA (ACEI causes this too)
 PE: Avoid eyes, Not for rapid relief, Proper use of diskus and HFA devices
 |  | 
        |  | 
        
        | Term 
 
        | Montelukast (Singulair)- Antiasthmatic (Leukotriene inhibitor); Trt Chronic Asthma, Seasonal Allergies/rhinitis |  | Definition 
 
        | Dosage: Tabs, Grans DI: dec [probenecid], inc [pxclitaxel, rosiglitazone, repaglinide] via 2C8
 CI: Not for acute attacks, NOT for monotherapy for exercise induced asthma. Rare Eosin.
 SE: HA (18%), flu, cough, ab pain, dyspepsi, Dz (rare), aggressive behavior, abn dreams, depression, suicidal thinking
 PE: Take regularly for asthma; chew tabs contain phenylalanine, can be mix w/spoon of soft food
 |  | 
        |  | 
        
        | Term 
 
        | Raloxifene (Evista)-Osteoporosis in post-menopause |  | Definition 
 
        | Dosage: 60 mg Tab DI: dec[cholestyramine], Prot Bind. w/diazepam, clofibrate, indometh, naproxen, IBU, diazoxide
 CI: Peg, DVT, PE, retinal vein thrombosis
 ADR: Hot flashes, leg cramps, wt gain, per edema, sinusitis, rash, sweating
 PE: TNR Food, D/C 72 hrs b4 and during prolonged periods of immob.; Take Ca + Vit.D
 |  | 
        |  | 
        
        | Term 
 
        | Alendronate(Fosamax) Osteoporosis-Osteoclast Inhibitor --Osteo in men and women & Pagets disease |  | Definition 
 
        | Dosage: 70 mg Qwk, 10 mg Qday, soln, Fosamax D DI: dec [Ca]&[ANTACIDS], ASA inc GI effects
 CI: Esophageal abn, HOCalcemia, renal disease
 SE: Ab pain, C/D, flatulence, musculoskeletal pain, upper GI irrit (rare)
 PE:Take w 6-8ox of plan h2o upon awakening, DO NOT LIE DOWN FOR 30 min after taking and not until first food of day consumed; report GI distress, swallow whole, no oral meds w/in 30 min of taking fosamax
 |  | 
        |  | 
        
        | Term 
 
        | Ibandronate (Boniva) Osteoporosis (antiesorption) Tx/prevent in POSTmenopausal women |  | Definition 
 
        | Dosage: Tabs (150mg Q month); Inject (3mg IV Q 3 Month) DI: dec absorpt w/Ca & ATACIDS
 CI: HOCa, allergy, renal impairment, JAW OSTEONECROSIS
 ADR: DYSPEPSIA, D, bronchitis, PNA, UTI
 PE: Take @ least 60 min b4 1st food/drink of day; take upright position - no lie down for 60 min after (swallow whole); don't take supp @ same time
 |  | 
        |  | 
        
        | Term 
 
        | Esomeprazole (Nexium) PPI -GERD, Ulcers, H. pylori, Zollinger-Ellison |  | Definition 
 
        | Dosage: Cap, Gran, Inject DI: inc [diazepam]; changes for drugs sen to pH (keto, dig, cyanocobal., ampicillin, Fe, dec [atazanivir], inc[variconazole]
 CI: Gastric carcinio tumors w/long term use; Toxic Epidermal necrolysis; SJ, erythema multiforme
 SE: HA, N/C/D, gas, ab pain, DRY MOUTH
 PE: take 60 min b4 eating; ANTACIDs TAKE SAME TIME OK; Capsule content add to 1 Tbsp of applesauce, swallow imm (no chew) + glass of h20; mix gransw/15mL water, stir, set it for 2-3min, take orally; Take w/in 30min of mix
 |  | 
        |  | 
        
        | Term 
 
        | Lansoprazole (Prevacid) PPI -GERD, Ulcers, H. pylori, Zollinger-Ellison |  | Definition 
 
        | Dosage: Caps XR, Tabs (ODT "Solutab"), Gran, Powder for injection DI: take 30 min b4 sucralfate; drugs aff by pH(keto, amp, Fe, dig, theophylline dose titration)
 CI: Allergy
 ADR: N/N/D, ab pain,HA
 PE: TAKE On EMPTY Stomach,swallow cap whole or empty into soft food swallow w/out chew; mix gran in 30ml water, stir, drink immed.
 |  | 
        |  | 
        
        | Term 
 
        | Omeprazole (Prilosec) PPI-GERD, Ulcers, H. pylori, Zollinger-Ellison |  | Definition 
 
        | Dosage: Cap DI: inc [diazepam, phynytoin,WARFARIN]; maybe cyclosporine, disulfiram, BZD; drug aff by pH (ketoconazole, digoxin, cyanocabalamine, ampicillin, Fe, inc [voriconazole]
 CI: Gastric Carcinoid tumors w/long term use
 ADR: Cough, C, Rash, Dz, back pain (rare)
 PE: Take 30 min B4 eating, ANTACIDs take same time OK, capsule content added to 1Tbsp of applesauce, swallow imm + h2o, don't chew or crash capsule contents
 |  | 
        |  | 
        
        | Term 
 
        | Pantoprazole (Protinix)-PPI - GERD, erosive esophageal, Zollinger Ellison (not the same as Esomep, Lanso, or Omep) |  | Definition 
 
        | Dosage: Tab, Granules for oral susp, Injection (powder) DI: bc Panto inc pH-drugs affected by co-admin(ketoconazole, amp, Fe salts)
 CI: Allergy (preg class B)
 PE: TNR food, swallow whole, Grans mixed with applesauce or apple juice --swallow immed; take ANTACIDs same time
 |  | 
        |  | 
        
        | Term 
 
        | Ranitidine (Zantac)-H2 blocker (Antagonist)-Anti-ulcer |  | Definition 
 
        | Dosage: Tab, EFFERdose, Syrup (pepermint flav), Injection (NOT powder for recon.)
DI: inc[WARFARIN, nifedipine, TCAs], inc absorp of triazolam
CI: Imp renal & hepatic fxn, reversible hepatitis, EFFERdose tabs contain phenylalanine 
ADR: HA, Dz, N/C, abd pain 
PE: May take w/food/milk if GI upset; don't freeze syrup; must dissolve EFFERtabs in h2o |  | 
        |  | 
        
        | Term 
 
        | Famotidine (Pepcid) - H2 blocker (antagonist)- Anti-Ulcer |  | Definition 
 
        | Dosage: Tab, ODT, Powder for oral Susp, Injection 
DI: inc [WARFARIN]
CI: Allergy, impaired renal fxn
ADR:HA, Dz, C, D, irrit @ inject site
PE:  ANTACIDs may take same time,Shake susp, discard after 30 |  | 
        |  | 
        
        | Term 
 
        | Metformin Glucophage (XR)-biguanine-antidiabetic |  | Definition 
 
        | Dosage: Tabs
DI: inc [Metformin]with Lasix, cimetidine, nifedipine, EtOH may inc lactate metab
CI:imp renal& hep fxn, not for use during iodinated radiologic study, DON'T use in METABOLIC acidosis/DKA
ADR: dec Vit.B12 absorpt,LACTIC ACIDOSIS, N/V/D, flat, anorexia, bloating, metallic taste, Gi effects dec once dose stable; lact.acid. z/sx hypervent, myalgia, maliase, somnolence
PE: TWF, avoid EtOH, keep well hydrated, cont PCP lact acid s/sx |  | 
        |  | 
        
        | Term 
 
        | Amaryl=dec BG DM II Glucotrol (XL)=Tx DM
 Micronase, Diabeta =Tx DM
 |  | Definition 
 
        | A-Glimeperide G-Glipizide
 M-Glyburide
 |  | 
        |  | 
        
        | Term 
 
        | Glimeperide (Amaryl)-Beta cell stimulant- Tx DM II |  | Definition 
 
        | Dosage: Tab Di: 2C9 possible interxn (miconazole, phenytoin, diclofenac, IBU, naproxen, mefenamic acid)
 CI: pts w/DKA, inc CV mortality
 ADR: Dz,asthenia,HA,N
 PE: TWF, avoid EtOH, PCP if s/sx of DKA, keep well hydrated
 |  | 
        |  | 
        
        | Term 
 
        | Glipizide-Glucotrol (XL)-Sunfonylurea-Tx DM |  | Definition 
 
        | Dosage: Tabs DI: inc eff by Dicumarol chloramphenicol, EtOH, MAOI, phenylbutazone, Salicylates, sulfinpyrazone, sulfonamides, dec effect by Diazoxide, rifampin, thaizides
 CI: not for DM TYPE I (juvenile), unstable/compl DM  as monotherapy, Sulfa allergy, DKA, renal/hep impair, thyroid fxn, burns, infxn, trauma
 ADR: N, pruritis/itch/Urticaria, mild HOglycemic rxns
 PE: Take 30 min b4 meals; avoid excessive EtOH
 |  | 
        |  | 
        
        | Term 
 
        | Glyburide (Micronase, Diabeta)-Beta cell stimulant - Tx DM |  | Definition 
 
        | Dosage: Tabs DI: Not for juven, unstable/complic DM as monotherapy, sulfa allergy, DKA, renal/hep impair, thyroid dysfxn, burns, infxn, truama
 CI: N, HB, pruritis/Urticaria, mild HOglycemia rxn
 PE: take 30min b4 meals; avoid EtOH
 |  | 
        |  | 
        
        | Term 
 
        | Pioglitazone (Actos)-thiazolidinedione dec insulin resistance- Adjunct Tx DM II improve glycemic QC |  | Definition 
 
        | Dosage: Tab DI: ORC; inc [Actos] by ketocon, itracon, gemfibrazil, dec [Actos] by rifampin
 CI: NYHA Class III or IV HF, exacerbtae CHF, need insulin to work, DON'T USE IN TYPE I DM to trt DKA, hep dysfxn
 ADR: URI (13%), HA, Sinusitis, myalgia, tooth disorder, aggrev of DM, pharygitis
 PE: TNR Food, Quarterly HgbA1C
 |  | 
        |  | 
        
        | Term 
 
        | Sitagliptan (Januvia)-inhibits DDP4(inc insulin & dec glucagon)- Tx DM II *or adjunct ther to diet & Exercise |  | Definition 
 
        | Dosage: Tabs DI: may inc digoxin
 CI: Allergy, renal insuff(dose adjust), concom use w/sulfonylureas or insulin =HOglycemia, pregclass B)
 ADR: Nasopharygitis (5%)
 PE:TNR Food; Quarterly HgbA1C
 |  | 
        |  | 
        
        | Term 
 
        | Insulin Aspart - Novolog (Short Acting) Insulin Glargine - Lantus (Long Acting)
 Insluin Lispro - Humalog (SA)
 Insulin - Humulin (Intermediate)
 |  | Definition 
 
        | Insulin Aspart - Novolog -Type I or II Insulin Glargine- Lantus -Type I or II
 Insulin Lispro - Humulog- Type I or II
 Insulin - Humulin - Type I or II
 |  | 
        |  | 
        
        | Term 
 
        | Insulin Aspart (Novolog)rDNA origin - SA-Meal time Insulin analog |  | Definition 
 
        | Dosage: SQ injection 100 units per mL; (mix 70/30)-30% insulin aspart sln 70% insulin aspart protamine susp DI: these drug dec HOgly eff of insulin (corticosteriods, diltiazem, dobutamine, epinephrine, ORC, thiazide diuretics), thyroid, tobacco smoke; inc HOgly eff (EtOH, anabolic steroid, nonsel BB, clofibrate, MOAI, salicylates, tetracyclines etc.)
 CI: HOgly, DON't MIX W/ LANTUS (mess up timing)
 ADR: HOglyc, allergy (redness, swelling, itching @inject site); LIPOdystrophy at injection site
 PE: admin 5-10 min b4 eating, store in fridge; consult provider if change syringe brand or dose
 |  | 
        |  | 
        
        | Term 
 
        | Miscellaneous information about insulin |  | Definition 
 
        | NPH insulin (or neutral protamine Hagedorn) (also known as Humulin N, Novolin N, Novolin NPH, NPH Lletin II, and isophane insulin), is an intermediate-acting insulin given to help control the blood sugar level of those with diabetes. NPH was created in 1936 when Nordisk formulated "isophane" porcine insulin by adding neutral protamine to regular insulin. 
 This is a suspension of crystalline zinc insulin combined with the positively charged polypeptide, protamine. When injected subcutaneously, it has an intermediate duration of action, meaning longer than that of regular insulin, and shorter than ultralente, glargine or detemir.
 |  | 
        |  | 
        
        | Term 
 
        | Insulin glargine (Lantus)-Long acting-Tx DM I & II |  | Definition 
 
        | Dosage: SQ injection HS DI: dec insulin eff insulin by corticosteriods, diltiazen, dobutamine, epi, ORC, THZ diuretic, thryoid, tobacco smoke; inc effect of insulin: EtOH, anabolic steroid, non selec BB, clofibrate, fenfluramine, guanethidine, MAOIs, phenybutazone, salicylates, sulfinpyrazone, tetracyclines--> LIKE all insulins in top 200 2011
 CI: Not for IV use
 SE: HOgly, allergy, lipodystrophy at injection site
 PE: Give 15min b4 eating, con PCP during illness, STORE in fridge
 |  | 
        |  | 
        
        | Term 
 
        | Insulin (Humulin)-Intermediate Acting-aka NPH-Tx DM I & II |  | Definition 
 
        | Dosage: SQ injection as R (also comes in U-500), NPH, Humulin 70/30, 50/50 DI: dec insulin eff insulin by corticosteriods, diltiazen, dobutamine, epi, ORC, THZ diuretic, thryoid, tobacco smoke; inc effect of insulin: EtOH, anabolic steroid, non selec BB, clofibrate, fenfluramine, guanethidine, MAOIs, phenybutazone, salicylates, sulfinpyrazone, tetracyclines--> LIKE all insulins in top 200 2011
 CI: HOglycemia
 ADR: HOglycemia, allergy, lipodystrophy at injection site
 PE: Follow general insulin counseling card
 |  | 
        |  | 
        
        | Term 
 
        | General Insulin Counseling |  | Definition 
 
        | 1. Follow prescribed diet carefully 2. Don't change brand of syringe, or dose w/consult
 3. Don't change order of mixing
 4. Continually monitor BG
 5. S/Sx of HOglycemia (sweating, tremor, blurred vision, weakness, hunger, and confusion)
 6. Trt with rule of 15s (take 15 grams of glucose and check BG in 15 minutes)
 |  | 
        |  | 
        
        | Term 
 
        | General Patient Education on MDI |  | Definition 
 
        | •Shake the MDI canister to mix med & propellant. •Holding the MDI upright, exhale (breathe out empty lungs). Open your mouth and hold the MDI about an inch away from your lips or put lips around it.
 •Begin to breathe in while press down on the canister and cont to breathe in slowly and completely.
 •Hold breath for up to 10 secs to allow the medicine to reach deep into your lungs.
 •Slowly breathe out.
 |  | 
        |  | 
        
        | Term 
 
        | General Patient Education for DPI |  | Definition 
 
        | •Place teeth on mouthpiece seal w/lips around it-tongue not block mouthpiece. •several different types of DPI’s diff ways to load med -->
 oAdvair DISKUS®, Plumicort Turbuhaler® ,Spiriva Handihaler®
 •Breathe in quickly and deeply through your mouth activating flow of med.
 •Take mouth off of the mouthpiece hold breath for up to 10 seconds and exhale.
 •Slowly breathe out.
 |  | 
        |  | 
        
        | Term 
 
        | Insulin Lispro (Humalog)-LA-Tx DM I & II |  | Definition 
 
        | Dosage: SQ inject (75/25), (50/50) DI: DI: dec insulin eff insulin by corticosteriods, diltiazen, dobutamine, epi, ORC, THZ diuretic, thryoid, tobacco smoke; inc effect of insulin: EtOH, anabolic steroid, non selec BB, clofibrate, fenfluramine, guanethidine, MAOIs, phenybutazone, salicylates, sulfinpyrazone, tetracyclines--> LIKE all insulins in top 200 2011
 CI: HOglycemia
 ADR: HOglycemia, allergy at inj site, lipodystrophy at inj site
 PE: Give 15min B4 eating, pcp if any illness, store in refridge
 |  | 
        |  | 
        
        | Term 
 
        | General Insulin Storage info |  | Definition 
 
        | Generally - unopened refridge; opened=RT; Never freeze *Once insulin has been opened and the seal has been punctured, use or discard insulin within 28 days.
 *Insulin that is mixed with another insulin (both drawn into a syringe) should be used immediately.
 *Mixing use ASAP
 |  | 
        |  | 
        
        | Term 
 
        | Amitriptyline(Elavil)-Antidepressant TCA-Tx Depression |  | Definition 
 
        | Dosage: Tab
DI: inc axn dicumarol, dec eff clonidine & guanethidine, inc tox fluoxetine, in eff of direct acting sympathos, Tox w/MOAIs, INC DROWSINESS w/EtOH & other CNS depres, inc [Elavil] w/ cimetidine
CI: MOAI w/in 14 days, NO preg category estab, imp hep, angle-closure glaucoma, Urinary reten, CV dx, inc IOP, hyperthyroidism
ADR: TACHYCARDIA, DRY MOUTH, blurred vision, N/V/C, Dz, weakness, HA, Urine reten, WT GAIN, Drowsiness
PE: no D/C, Drowsiness, no EtOH |  | 
        |  | 
        
        | Term 
 
        | Bupropion - Wellbutrin (SR,XL)-Anti-Depressant-Tx DEPRESSION,SAD |  | Definition 
 
        | Dosage: Tab DI: Tox inc w/MOAIs & L-dopa, EtOH may dec seizure threshold
 CI: Seizure dx, eating dx, MOAIs, can inc suicidal ideation in Kids/teens, psychomotor disturb, mania, psychosis, hallucin.
 ADR: Dz, C, wt loss, DRY MOUTH, insomnia, sweating, agitation, TREMOR, dec sexual fxn
 PE: Take XR Am avoid insomnia, no double dose if missed, NO OTC w/o consult,no EtOH
 |  | 
        |  | 
        
        | Term 
 
        | Citalopram (Celexa)-SSRI-Tx Depression |  | Definition 
 
        | Dosage: Tab, Soln DI: co-admin w/MOAIs, cimetidine inc conc, co-admin w/ASA or NSAID risk upper GI bleed
 CI: w/in 14 day MAOIs, ANTIDEP INCR SUICIDAL IDEATION IN CHILDREN/TEENS, HOnatremia, hepat dx,no D/C (bc irrrit, dysphoric mood, agitation, Dz, anxiety, confusion, insomnia, HA, preg C
 ADR: N(21%), DRY MOUTH (20%), SOMNOLENCE(18%), ejac & impotence
 PE: impair cog & motor perform, no D/C, no EtOH
 |  | 
        |  | 
        
        | Term 
 
        | Duloxetine(Cymbalta)-potent inhib of serotonin & Norepi reuptake,slight dopamine-Antidepressant-Tx MDD, DM neuropathy, GAD |  | Definition 
 
        | Dosage: Caps DI: MAOIs, inc[Cymbalta] inhib CYP1A2 (fluvoxamine, FQ)& 2D6 (paroxetine, fluoxetine, quinidine), Cymbalta may inc level of (TCA, phenothaizines, profenone, flecainide)
 CI: SUICIDE kids/teens, pt taking MOAIs taking unQC narrow angle gluacoma, hep dysfxn, EtOH, seizures, may inc BP & activate hypomania
 ADR: Nausea (20%)/V/C/D, DRY Mouth, C,D, Dz, Insomnia, dec appetite, fatigue, drowsy, sweating, blurred vision, erectile dysfxn
 PE: May take up to 4 wks to work, DROWSINESS, no EtOH, NO D/C
 |  | 
        |  | 
        
        | Term 
 
        | Escitalopram (Lexapro)-SSRI-Tx Depression |  | Definition 
 
        | Dosage: Tab, Oral soln DI: MOAIs co-admin=rxn like Neuroepileptic Malig syndomr (NMS),inc by cimetidine, NSAID/ASA in risk of GI bleed
 CI: MOAI w/in 14D, Suicide in kids/teens, reversible HOnatremia, liver dx
 ADR: N(15%)/D, Dz, Somnolence, insomna, ejac disorder, inc sweating, dizzy, impotence
 PE: Cog/motor impair, no EtOH, pcp b4 taking OTCs, no D/C
 |  | 
        |  | 
        
        | Term 
 
        | Fluoxetine (Prozac)-SSRI-Tx Depression, OCD, bulimia, panic dx |  | Definition 
 
        | Dosage: Tabs, Caps, Liquid DI: MAOIs wait 14d to take Prozac after D/C, wt 5 wks after D/C prozac to start MAOI, inc [thioridazine]a schizo drug-wt 5 wks post d/c prozac to take, inc [TCA, BZD, phenytion, CBZ, tryptophan & sumatriptan, +ASA/NSAID inc GI bleeds
 CI: MOAIs, suicide kids/teens, RASH, hep dx, not for <7yo, pregclass C
 ADR: N/D, insomnia, anorexia, HA, sweating, asthenia, dec labido, ab ejac & fatigue
 PE: Drowsiness, no EtOH, consult b4 OTCs, pcp if HIVES
 |  | 
        |  | 
        
        | Term 
 
        | Mirtazapine (Remeron)-Antidepressant(a2,5HT,H1)-Tx Depression |  | Definition 
 
        | Dosage: Tabs, ODTs
DI: additive eff w/CNS depress, MAOIs, NSAID/ASA inc GI Bleed risk
CI: suicide kids/teens, Agranulocytosis, D/C s/sx of sore throat, fever, stomatitis, infxn dec WBC, warning of abrupt D/C 
ADR: DROWSINESS (54%), DRY MOUTH (25%), C (13%),inc appetite(17%), wt gain (12%), Dz, flu syndrome, abn dreams
PE: Drowsiness, no EtOH, no D/C |  | 
        |  | 
        
        | Term 
 
        | Paroxetine-Paxil (CR), Pexeva-SSRI-Tx Depression, OCD, Panic Dx, Social Anxiety Disorder, CR-premenstrual dyphoric dx |  | Definition 
 
        | Dosage: Tabs, Oral Susp
DI: MOAIs, con changes w/phenytoin, phenobarb, cimetidine, may displace WARFARIN from prot bind, inc [procyclidine], 2D6 substrate may have variable eff, NSAID/ASA inc GI bleed
CI: Preg,MAOIs (14d rule),Suicide kids/teen, dec dose in elderly, renal/hep impair,caution in mainia-seizure, HoNa s/sx edema-excess thirst, no D/C
ADR: Somnolence,N/V/C/D, insomnia, sex dysfxn,sweating, tremor, abd pain, wt loss, gas  
PE: Drowsiness, PCP if inc edema/ex thirst, avoid EtOH, up 2 wks to work, consult b4 OTC use, no D/C, ONLY 1QDay |  | 
        |  | 
        
        | Term 
 
        | Sertraline(Zoloft)-SSRI-Tx Depression, OCD, Panic Disorder, Post traumatic Stress Disorder(PTSD), PMDD |  | Definition 
 
        | Dosage: Tabs, Oral concentrates DI: MAOIs(14d rule), in[pimozide], may displace prot bound drugs (WARFARIN, DIGOXIN],inc [diazepam,tolbutamide], variable eff w/3A3/4 substrates, NSAID/ASA inc GI bleed risk
 CI: MAOI, suicide ideation, D/C
 ADR:N/D, dyspepsia, tremor, Dz, insomnia, sweating, DRY MOUTH, male sex dysfxn (ejac delay)
 PE: Oral conc. dosage dilute in 4 ox h2o, ginger ale, lemon(-ade)/lime soda,OJ only ; take imm after mix; avoid EtOH, DROWSINESS, no D/C
 |  | 
        |  | 
        
        | Term 
 
        | Trazodone (Desyrel)-SSRI-Tx Depression |  | Definition 
 
        | Dosage: Tabs
DI:EtOH & other CNS depr=inc DROWSINESS; inc eff of pheny, GFJ inc con, in con by 3A4 inhib (ketocon, ritonavir, indinavir)
CI: Recent MI,CV, arrhythmias, PRIAPSM, no <18yo, slower/greater absorp given w/FOOD
ADR:Drowsy, PRIAPSM,dry mouth, HOTN, Dz, confusion, fatigue, HA, N/V
PE: TWF enhance absorp, DROWSINESSno EtOH |  | 
        |  | 
        
        | Term 
 
        | Venlafaxine-Effexor(XR)- SNRI(Serot & norep reuptake inhib)-Tx Depression, GAD |  | Definition 
 
        | Dosage: Tab, Cap DI: MAOIs, *other CNS Dep (EtOH, antihist..); NSAID/ASA risk of GI bleed
 CI: MAOI (14D rule); D/C Effexor 2wk b4 start MAOI, suicide ideation, HTN, mania, seizures, renal impr
 ADR: N/C, DRY MOUTH, anorexia, DROWSY, insomnia, Dz, Nervousness, abn Ejaculation & dec labido, sweaty, yawning
 PE: avoid EtOH; consult for OTCs
 |  | 
        |  | 
        
        | Term 
 
        | Alprazolam CIV-Xanax (XR)-anxiety BZD-Tx Anxiety, Panic Disorder |  | Definition 
 
        | Dosage: Tabs, ODT, Soln DI: CNS depression inc w/other CNS depressants
 CI: HTN, Narr-angle-glauc, caut w/primary HTN, psychosis, impaired rena/hep fx, withdrawal sx
 ADR: Drowsiness, HOTN
 PE: DROWSINESS, avoid EtOH, consult for OTCs
 |  | 
        |  | 
        
        | Term 
 
        | Diazepam CIV (Valium)-BZD-Tx Anxiety |  | Definition 
 
        | Dosage: Tabs, ODT, Soln
DI: CNS Depress in with other CNS dep
CI: HTN, unTx N angle gluac, prim depress,Preg, ren/hep impr
ADR: DROWSY, ataxi, fatigue
PE: Oral Conc must be diluted b4 use, Cuation DROWSINESS, no EtOH, may be habit forming |  | 
        |  | 
        
        | Term 
 
        | Lorazepam CIV (Ativan)-Ativan-BZD-Tx Anxiety, insomnia from anxiety, pre-anesthetic, sedation, epilepsy |  | Definition 
 
        | Dosage: Tabs, Soln, Inject
DI: Inc CNS Depress, inc con w/probenacid by 50%
CI: HTN, n angle gluac, caut w/primary depr, psychosis, renal/hepatic impr
ADR: Drowsy, Dz, unsteadiness weakness
PE: caut w/drowsiness, avoid EtOH, habit-forming |  | 
        |  | 
        
        | Term 
 
        | Buspirone (Buspar)-ST Tx Anxiety; MOA unknown |  | Definition 
 
        | Dosage: Tri-scored Tabs
DI: +MOAIs = HTN; GFJ inc [plamsm]
CI: mod-sev ren/hep fxn; Buspirone binds to dopamine recept --poss dystonia, parkinsonism, tardive dyskenesia during therapy, Preg B, caut w/lactation
ADR: TACHYCARDIA, Rash, HA, fatigue, sweating, mus pain, dream disturb, Dz, Drowsy, nerv, insomnia, mood alter, dep, DRY Mouth, N/C/D, nasal congest, blur vis, tinnitis,sore throat*unique than other antidep* 
PE: DROWSINESS, DZ, report involun move of tongue or facial muscles, chang in motor restles, avoid GFJ |  | 
        |  | 
        
        | Term 
 
        | Aripiprazole (Abilify)-MOA: unknown (~? 5-HT1A&2A and Dopamine D2 receptor)-Tx Anti-PSYCHOTIC (Schizo, BiPolar, acute mania |  | Definition 
 
        | Dosage: Tabs, ODT, Oral inj
DI: [dec]by 3A4 (CBZ), [inc] by 3A4 inhib (quinidine, fluoxetine, paroxetine)
Ci: Hypersen, dementia, related PSYCHOSIS, NMS S/sx hyperpyrexia, muscl rigid, alt mental status, autonomic instab (irr HR, BP, Diaphoresis, cardia arrh), *CV dx, seizures, aspiration PNA
ADR: TARDIVE DYSKENESIA, HA, ANXIETY, insomnia, asthenia, N/V, lighthead.,DROWSY, blurr vision
PE: DROWSY,avoid EtOH, HEAT EXP/Dehydration-bc hyperpyrexia, store oral sln in fridge |  | 
        |  | 
        
        | Term 
 
        | Which drugs cause the highest level of DROWSINESS/Somnolence? |  | Definition 
 
        | Vicoden (Lortab, Norco, Lorcet),Alprazolam, Citalopram (som 20%), CLONAZEPAM (50 & 30% ataxia), Escitalopram (som 6%), Gabapentin (som 19% & 17% Dz), Lorazepam, Quetiapine fumerate -Seroquel som 18% & 10% Dz), ~Topiramate, Divalproex-Depakote (som 17%), Lamotrigine-Lamixtal-som14%), Diazepam, eszopiclone Lunesta >10% Drowsyness, Fluoxetine |  | 
        |  | 
        
        | Term 
 
        | Buproprion (Wellbutrin-SR or XL)-Antidepressant-Tx Depression, Seasonal Affective Disorder "SAD" |  | Definition 
 
        | Dosage: Tab
DI: Tox inc w/MAOI & L-dopa, EtOH may lower seizure threshold 
CI: Seizure dx, eating dx, current MAOI therapy, can inc suicidal thoughts/axns in kids/teens, psychomotor disturb, psychosis, hallucinations
ADR:Dz,C,wt loss, Dry mouth, insomnia,sweating, agitation, TREMOR, dec sex fxn |  | 
        |  | 
        
        | Term 
 
        | Lithium Carbonate (Lithonate, Lithotabs, Lithobid)-Antipsychotic-Tx Manic episodes |  | Definition 
 
        | Dosage: Caps, Tabs, Oral Sln
DI: CBZ = neurotox, Iodides = HOthyroidism, [inc]w/NSAIDs, ACEI, thiazides, [dec]urinary alkalizers, Haloperidol-variable tox eff
CI: cx renal failure, CV dx, devere debilitation, dehydration, Na depletion, *diuretics, ACEIs, preg/lact, Na deplet cause lith tox --maintain Na & fluids, NARROW TI DRUG
ADR: Tox-->DIARRHEA, VOMITING, DROWSINESS, BLURRED VISION, TINNITIS, hand tremor, nausea, mild thirst ~initial therapy, extreme polyuria, muscular wkness, lack of coordin +blurred vision
PE: Closely follow dose, eff takes 1-2wks b4 opt eff, take 2-3 quarts daily during therapy, avoid exposure to *HEAT |  | 
        |  | 
        
        | Term 
 
        | Why is heat exposure a problem with people on Lithium? Tx= Bipolar aka Manic depression
 |  | Definition 
 
        | Heat Exhaustion and Lithium
According to the U.S. Centers for Disease Control and Prevention, heat exhaustion is a milder form of heat-related illness to heat stroke, caused by excessive water and salt loss.
Along with the other side effects mentioned above, lithium can cause dehydration, a symptom of heat exhaustion. Lithium in itself does not cause heat exhaustion but exacerbates the symptoms of it. |  | 
        |  | 
        
        | Term 
 
        | Quetiapine-Seroquel (XR)-ATYPICAL Anti-psychotic-Tx Schizo, Bipolar DEPRESSIVE episodes & Manic episodes **multiple NT antagonist [D1,D2,H1, a1, a2, 5HT(1a,2)] |  | Definition 
 
        | Dosage: Tabs
DI: Additive effects w/CNS dep, [dec] or inc oral clear. w/pheny & thioridazine 
CI: DEMENTIA RELATED PSYCHOSIS PTS, MAY INC SUICIDE IDEATION in KIDS/TEENS, Neuroleptic Malignant Synd (NMS), hyperpyrexia, mus rigid, alt mental stat, auton. instab, Tardive dys (TD)--gen for antipsychotic drugs --if TD d/c warranted, orth HOTN *@initiation, CATARACTs may dev during therapy (lens exam 1st 6 month), seizures, dysphagia, hypothyroidism, hx of Breast can, HperGLy (DKA-coma/death), pregC/lact
ADR: somnolence (18%), Dz(10%), C(9%), post HOTN (7%), DRY MOUTH (7%), dyspepsia (6%), 1%(Hypertonia, flu syn, anorexia, palpitation, pharygitis, rhinitis, cough, dyspnea, peripheral edema, sweating, & Leukopen)
PE: Post HOTN (*from prone pos*initial dosing), DROWSINESS/SOMN., TNR FOOD |  | 
        |  | 
        
        | Term 
 
        | Risperidone (Risperdal)-ATYPICAL Anti-Psychotic- Tx Schizo, BiPolar manic episodes or mixed episodes , AUTISTIC IRRITABILITY  only Tx bipolar MANIC ep. |  | Definition 
 
        | Dosage: Tabs, oral soln, Inject
DI: inc eff of L-DOPA, [dec] by CBZ, [inc] by fluoxetine, clozapine
CI: DEMENTIA RELATED PSYCHOSIS, fatal complex --NMS(s=musc rigid, hyperpyrexia, auto instab--if so D/C); May lengthen QT interval & prod orth HOTN, *bradycardiac pts, elect imbalancek, CV dx, hx seizures, HyperGly coma/death, pregC
ADR: EXTRAPYRAMIDAL SYMP, Tachycardia, insomnia, agitation, anxiety, somnolence, N/C/V, dyspepsia, rhinitis, dry skin, RASH.
PE: Fainting occur w/init dose, impair judgement *cars & machinery, no EtOH, TWF or milk if GI, Soln okay w/OJ, Coffee, & LOW FAT MILK, Risperdal M-tabs take asp after open, open w/dry hands, Avoid exp SUN & HEAT during therapy, consult b4 OTC |  | 
        |  | 
        
        | Term 
 
        | Divalpoex Sodium- Depakote (ER)-Seizures (petit mal,complex abs, or complex partial seizures); Acute mania or mixed episodes ass w/BiPolar, & Migraine PPx |  | Definition 
 
        | Dosage: Tabs, sprinkle Caps *all enteric coated 
DI: Prot binding w/ASA, CBZ, dicumerol, dec ren clear of phenobarb, alter levels of pheny, clonaz may cause abs of seizures 
CI:Cx/hx hep dx (+valproic a. =fatal), pancreat s/sx; ab pain, plt dysfxn, suicidal ideation, PREGClass D, N/V
ADR: N(31%)/D(12%)/V(11%),Somnolence (17%),asthenia-wkness(20%) ab pain, TREMOR, WT GAIN & inc app(8%,6%), back pain, ALOPECIA (7%), dyspepsia (13%), Dz (12%)
PE: no D/C, DROWSINESS, no EtOH, TWF or Milk if GI, Cap sprinkle swall whole or add to 1Tsp soft food |  | 
        |  | 
        
        | Term 
 
        | Donepezil HCl (Aricept) - Reversible Acetyl Cholinesterase Inhibitor, Tx mild-sev DEMETNIA of Alzheimer's type-*96% PB; metab 2D6 & 3A4 |  | Definition 
 
        | Dosage: Tabs, Tab ODT (Aricept -ODT), Oral Sln-->QHS
DI: Unknown regarding CYP intxns; min metab of terbinafine & cisapride; poss [inc]w/CBZ, pheny, phenobarb, rifampin, dexameth; [dec] keto or quin
CI: Hypersen to Donepezil or piperidine deriv, D/C b4 anesthesia, VAGOTONIC effects oh heart, may inc GI acid:.*in sick sinus syn, *asthma/COPD, PregC
ADR: N/V/D, muscle cramps, fatigue, anorexia
SE: TNR FOOD, HS b4 bed |  | 
        |  | 
        
        | Term 
 
        | Pregabalin (Lyrica) - Anticonvulsant/Antineuralgic -Tx Dm neuropathic pain, postherpetic neuralgia, adjunct adult partial onset seizure, fibromyalgia |  | Definition 
 
        | Dosage: Caps DI: add CNS dep= dec cogn & motor fxn, per edema when given w/thiazolidinedione a-DM agents
 CI: Hypersen, when D/C taper over 1 wk, per edema, rare myop/rhabdo, AED gen cautions
 ADR: Common --(Dz, Somnolence/Drowsiness, Dry mouth), others (ataxia, confusion, asthenia, abn thought, blurred vs, wt gain, per edem
 PE: Caution w/ drowsiness, no EtOH, no D/C, report unex musc pain, tenderness, wkness, fever, malaise, TNR food
 |  | 
        |  | 
        
        | Term 
 
        | Carbamazepine (Tregretol, Tegretol XR, Carbatrol ER, Equetrol ER)-Seizures Refractory  to other Anticonvul. & Trigeminal neuralgia; MOA (blockage of potentiation) |  | Definition 
 
        | Dosage: Tabs, ODT, Chewable Tabs, Caps (Equetrol, Carbatrol), Susp
DI: Dec eff of ORC, Valproic acic, pancuronium; Cimetidine, isoniazide, diltiazen, fluoxetine, propoxyphene, primidone, verapmil, danazol, or MACROLIDED may [inc]; dec[doxycycline &haloperidol]; Tox w/Li, GFJ [inc]
CI: Hypersen to TCA or CBZ in pts w/BMS, *preg/lact, MOAIs (14d rule),IOP, CV, ren/hep, hx hemo rxn, asplas/agran, pcp if s/sx(fever, sore throat, mouth ulcer, easy bruising, Asians HLA-B*1502-skin compl-SJS, AED generals
ADR: Common (Dz,unsteady, N/V, DROWSINESS); rare aplast/agran, SJS :.report fever, sore throat, mouth ulcers, bruising, skin rash to provider or pharmD
PE: TWF or milk+ full glass h2o 240mL with Chew tabs, DROWSINESS, no EtOH, Shake susp |  | 
        |  | 
        
        | Term 
 
        | What are the drugs that are used to Tx Seizures alone? |  | Definition 
 
        | -Levetiracetam (Keppra)ok for KIDS & **no known DI** 
-Phenytoin (Dilantin, Kapseals)*lots of DI-Clonazepam-CIV-Klonopin-Tx Lennox Gastaut Syndrome (peptit mal variant), akinetic & myoclonic seizures, & pats w/absence seizures (petit mal) failed respond to succinimides *KIDS & ADULTS |  | 
        |  | 
        
        | Term 
 
        | Which seizure medications have additional indications? |  | Definition 
 
        | Pregabalin (Lyrica)-AE+Antineuralgic+Post Herpetic neuralgia+Fibromyalgia 
Carbamezapine(Tegratol XR, Carbatrol ER, Equetrol ER)-AE+Trigeminal Neuralgia (shock like face pain)Gabapentin (Neurontin)- AE+postherpetic neuralgia 
Topiramate (Topamax)-AE+Migraine PPx Lamotrigine (Lamictal)-AE+BiPolar 
Divalproex (Depakote,ER)-AE+antipsycho (tx seizure, bipolar mania, migrain PPx) |  | 
        |  | 
        
        | Term 
 
        | Which antiepileptic drugs (AED) aka Anti-convulsants have ODT dosage forms? |  | Definition 
 
        | Clonazepam (Klonopin) & Lamotragine (Lamictal) |  | 
        |  | 
        
        | Term 
 
        | Levetiracetam (Keppra)-Anticonvulsant-Tx Seizures (OK children) |  | Definition 
 
        | Dosage: Tabs, Caps, Susp
DI: No Known clin sig DI exist
CI: Hypersen, dec dose in renal, D/C slowly red trig seizure, exc breast milk *prgc/lact
ADR: common (Somnolence, asthenia, infxn, Dz); Hostility & nervousness
PE: DZ or DROWSINESS, **no D/C** |  | 
        |  | 
        
        | Term 
 
        | Gabapentin (Neurontin)-Anti-epileptic-Tx Seizures, postherpetic neuralgi |  | Definition 
 
        | Dosage: Tabs, Cap, Oral sln
DI: ANTACIDS dec bioavail when co-admin
CI: ped<12yo not estab, *renal
ADR: Somnolence (19%), Dz (17%), ataxia (12%), fatigue (11%), nystagmus -invol eye move(8%), tremor (7%), diplopia(6%),bluvision(4%), rhinitis
PE:DROWSINESS, no EtOH, no D/C taper/1wk |  | 
        |  | 
        
        | Term 
 
        | Topiramate (Topamax)-Anti-epileptic-Tx Seizures, Migraine PPx |  | Definition 
 
        | Dosage: Tabs, Sprinkle Caps (also in Depakote) DI: Add CNS depress w/ EtOH or CNS dep, inc metab of estrogens, inc [metformin], *wk CA inhib avoid use w/other CAI, [dec]w/pheny & CBZ, [inc]HCTZ, co-admin w/Valproic acid=hyperammonemia
 CI: HOChloremic, non-anion gap Metab acidosis (dec in Bicarb), acute myopia ass w/ 2nd an clos gluacoma, eye pain=withdraw gradually of Topa., PregC., Carbonic ANhy IN = possible kidney stones
 ADR: common dose dep(Dz, nervousness,diff w/concen, confusion, diff concen, depres, anorexia, wt dec); dose indep (somnolence, dz, atax, speech diff, psycho, slow, abnorm vision, diff w/mem, paresth & diplopia)
 PE: TNR Food, DROWSINESS, no EtOH, PCP if pain,blurr vision, keep hydrated reduce risk of kidney stones, Sprinkle 1 Tsp of soft food & Swallowed ASAP, not chewed
 |  | 
        |  | 
        
        | Term 
 
        | Clonazepam (Klonipin CIV)-BZD-Antiepileptic-Tz Lennox Gastaut Syndrome |  | Definition 
 
        | Dosage: ODT, Tabs
DI: Additive eff w/CNS dep & EtOH
CI: Hypersen, liver dx, <60 m/5yo, nangle clos gluac,unTx open-angle gluc, man inc granmal seiz & suicideal ideation, no D/C, inc salivation :.*w/chronic resp dx
ADR:DROWSINESS(50%), ataxia (30%), and fatigue
PE: DROWSINESS, no EtOH, WARNING: MAY BE HABIT FORMING; no D/c |  | 
        |  | 
        
        | Term 
 
        | Phenytoin (Dilantin, Kapseals-ER version)-Tx Tonic-Clonic Seizures & Psychomotor Seizures during or post surgery *also used in peds; MOA: Sodium extrusion from neurons/myocytes |  | Definition 
 
        | Dosage: Caps, Inject
DI: [Inc] w/AMIODARONE, CHLORAMPHENICAL, CIMETIDINE, DISULFURAM, ISONIAZID, ORAL ANTICOAGS, SULFONAMIDES, FLUCONAZOLE, TRIMETHOPRIM, phenacemide phenybutazone;[dec]w/ diazoxide, folic acid, RIFAMPIN, SUCRALFATE & theophyllines; ANTINEOPLASTIC may dec axn; dec [CBZ]; inc axn by valproic acid; Hepatox w/APAP, inc metab of corticosteriods, DISOPYMIDE, doxycycline, metyrapone, mexiletine, quinidine, and THEOPHYLLINE. Dec axn of cyclosporine, levodopa, ORC, & nondepol muscle relaxants. Inc serum levels of primidone. Serous HOTN w/dopamine infusion |  | 
        |  |