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Hospital Drugs

QuestionAnswer
Lortab Hydrocodone w/ APAP Mod-Mod severe pain 1-2 tab Q4-6 hr PRN Max of 8tab/day (6tab is lortab 10) Onset < 30min C-3
Vicoprofen Hydrocodone w/ Ibuprofen Acute pain 1 tab Q4-6 hr PRN Max of 5 tab/day Not for arthritis C-3
MS contin Morphine sulfate Mod-severe pain Individualized (Q8-12 hr) Do not crush Centrally acting on opiate receptors CI : respiratory depression, paralytic ileus
OxyContin Oxycodone Mod-severe pain Individualized (Q12 hr) centrally acting on opiate receptors CI: respiratory depression, paralytic ileus Do not crush
Percocet Oxycodone w/ APAP Mod-mod severe pain 1-2 tab Q4-6 hr PRN Max is 1g/APAP/dose
Duragesic Fentanyl transdermal Chronic pain Q72 Hr Start no higher than 25 mcg/hr is naive Apply to normal dry skin on upper torso Rotate application site Careful disposal
Demerol Meperidine Mod-mod severe pain 50-150 mg PO Q 3-4 hr PRN Active metabolite (normeperidine) can cause seizures CI: MAOI Avoid in elderly or renal impairment
Ultram Tramadol Mod-mod severe pain 50-100 mg Q4-6 hr PRN Max is 8 tab (400mg) Renal adjustment and active metabolite (caution in h/o seizure) Intx : CNS depressant, TCA, SSRI Food will slow absorption but its OK for WF Causes drowsiness
Nucynta Tapentadol mod-severe pain Caution in significant asthma, respiratory depression, paralytic ileus, 14 days of MAOI
Dilaudid Hydromorphone Management of mod-severe pain in opioid-tolerant patients CI: acute/severe asthma, severe respiratory depression
Fentanyl IV Pain management in PCA
Toradol Ketorolac Mod/severe acute pain NMT 5 days due to risk of GI bleed. Limit 40mg/day CI: PUD, Advanced renal impairment, bleeding, NSAID co-administration Precaution: HTN, CHF, Elderly
Soma Carisoprolol Acute musculoskeletal conditions Centrally acting Caution in lover or renal dysfxn, elderly
Phenergan Promethazine For Nausea: Q4-6hr PRN Anticholinergic CI in <2y/o bc respiratory depression
Flexeril Cyclobenzaprine Skeletal muscle spasm 15-30mg/day TID dosing Use only 3 weeks DI: CNS depressant CI: CHF, arrhythmias, acute MI Precaution: Urinary retention, NA Glaucoma
Reglan Metoclopramide Diabetic Gastroparesis (NMT 8 wk) Symptomatic GERD 5-10mg QID (30min AC&HS) Inhibit dopamine receptor to stimulate motility of upper GI tract CI: GI obstruction, epilepsy, drugs causing EPS (levodopa) AE: risk of tardive dyskinesia
Zofran Ondansetron 5HT3 antagonist 8mgBID if Chemo-induced NV with 1st dose 30 min before chemo 16mg pre-anesthesia for Post op NV ADR: HA, fatigue, constipation
Compazine Prochlorperazine Severe NV 5-10mg T-QID (tab) 10mg Q12hr or 15mgAM (spansule cap) DI: CNS Depressant CI: <2y/o or <20lb Cau cause EPS
Carafate Sucralfate Duodenal ulcer 1g QID (1 hour AC and HS) Avoid antacid Precaution in renal dysfxn b/c aluminum accumulation DI: Dig, wafarin, Phenytoin, theophylline, Levothy, quinolone, tetracycline ADR: constipation/indigestion
Dexilant Dexlansoprazole Erosive esophagitis - 60mg QD
Aciphex Rabeprazole Erosive esophagitis - 20mg QD H.pylori - 20mg + Amoxil 1g + Clarithromycin 500mg BID AE: HA
Nexium Esomeprazole Erosive esophagitis - 20-40 mg QD H.pylori - 40mg + Amoxil 1g + Clarithromycin 500mg BID DI: Diazepam Take 60 min before food
Prevacid Lansoprazole Erosive esophagitis - 30mg QD H.pylori - 30mg + Amoxil 1g + Clarithromycin 500mg BID Food decrease absorption so empty stomach ADR: HA, diarrhea, abdominal pain
Prilosec Omeprazole Erosive esophagitis - 20mg QD H.pylori - 20mg + Amoxil 1g + Clarithromycin 500mg BID DI: Phenytoin, Diazepam, Warfarin Take prior to meal
Protonix Pantoprozole Erosive esophagitia 40mg QD (available IV) DI: GI pH effects AE: HA, diarrhea
Asacol Mesalamine Tx and maintenance of ulcerative colitis (Crohn) 2 tab TID (adult) CI: ASA allergy Do not crush b/c DR
Pentasa Mesalamine Tx and maintenance of ulcerative colitis (Crohn) 1000mg QIDx8 weeks(adult) CI: ASA allergy
Lomotil Diphenoxylate Hydrochloride/Atropine Sulfate QID until diarrhea controlled, then QD-BID Bind to gut opiate receptor DI: Haldol - tardive dyskinesia DC if no response in 48 hr
Miralax Polyethylene Glycol 3350 1tbsp - 17g. QD in soda/water Used <2weeks Osmotic agent High doses causes diarrhea
CoLyte Polyethylene Glycol
Colace Docusate (OTC) Stool softener
Lactulose Hepatic Encephalopathy 30-45 ml T-QID NOT PRN, its scheduled!
Peridex Chlorhexidine Gluconate 15 mL oral rinse SWISH AND SPIT for 30 seconds twice daily (morning and evening) after toothbrushing
Deltasone Prednisone Short-term tx of respiratory inflammation 5-60mg CI: systemic fungal infection ADR: Upset stomach, NV, Fluid retention, hypokalemia, behavior disturbances, PUD, Osteoporosis/Cushing (long-term) Take with food/milk Do not abruptly DC
Medrol Methyl-Prednisolone Short-term tx of respiratory inflammation 4-48mg CI: systemic fungal infection ADR: Upset stomach, NV, Fluid retention, hypokalemia, behavior disturbances, PUD, Osteoporosis/Cushing (long-term) Take WF/milk Do not abruptly DC
Epogen Procrit Epoeitn Alfa Anemia 50-100units/kg SQ Not recommended for use in Iron Deficiency anemia, sickle cell, autoimmune hemolytic anemia/ active bleeding
Methotrexate (MTX) Rheumatoid arthritis 7.5mg weekly or 2.5mg Q12 hr x 3 doses Inhibits dihydrofolic acid reductase DI: No NSAID w/ high dose CI: pregnancy Maintain hydration
Plaquenil Hydroxychloroquine Malaria, SLE, RA 200mg
Imuran Azathioprine Kidney transplant rejection, RA, Crohn, Ulcerative colitis
Penicillin G Sodium Empty stomach AE: NV, Diarrhea, hives/rash empty stomach Intx: Oral contraceptives, Probenecid Drink plenty of fluid
Ampicillin Aminopenicillins Extended activity against gram (-) Q6H
Ticarcillin Carboxypenicillins good for P.aeruginosa 3g IV Q4hr Administer aminoglycosides separately with Ticar
Augmentin Amoxicillin/Clavulanate Take at start of meal empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid
Unasyn Ampicillin/Sulbactam 1.5-3g IV Q6hr No coverage of pseudonas bc ampicillin (200mg/kg/day) Covers anaerobes
Timentin Ticarcillin/Clavulanate 3.1g IV Q4-6hr Covers anaerobes
Zosyn Piperacillin/Tazobactam 3.375g IV Q6hr Covers anaerobes 4.5g IV Q6h in combo with Aminoglycoside for suspected pseudomonal infections
Ancef Cefazolin (1st gen) Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea 1-2g IV Q8h First generation
Keflex Cephalexin (1st gen) Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea
Ceftin Cefuroxime (2nd gen) Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea
Cefoxitin 2nd gen Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea
Cefzil Cefprozil (2nd gen) Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea
Cefotaxime 3rd gen Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea Enhanced gram (-) coverage, no pseudomonas coverage
Rocephin Ceftriazone Meningitis Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea
Omnicef Cefdinir (3rd gen) Avoid antacid/vitamin/Fe within 2 hour Empty stomach Intx: Oral contraceptives, Probenecid ADE: Red discoloration of stool, Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea
Maxipine Cefepime (4th gen) 1-2g IV Q12hr Pseudomonas coverage Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea
Teflaro Ceftarolin (5th gen) Empty stomach Intx: Oral contraceptives, Probenecid ADE: Nausea, Diarrhea, Rash Drink plenty of fluid Report persistent diarrhea 600 mg IV Q12hr Skin infection : 5-14 days CAP - 5-7 days Not active against Gram (-)
Erythromycin Inhibits 50S Intx: Digoxin,Theophyline,Warfarin, Carbamazepine, Lova & Simvastatin, Triazolam ADE: GI Take WF CYP 450 inhibition
Zithromax Azithromycin Inhibits 50S Avoid antacid Long t1/2 - QD dosing Intx: Digoxin,Theophyline,Warfarin ADE: GI
Biaxin Clarithromycin Inhibits 50S Intx: Digoxin,Theophyline,Warfarin, Carbamazepine, Lova & Simvastatin, Triazolam ADE: GI Take XL WF CYP 450 inhibition non-linear kinetic - longer t1/2 with higher doses
Flagyl Metronidazole Trichomoniasis Sexual partner require therapy Intx: Warfarin AE: GI SE, metallic taste, seizure risk Take WF/milk Avoid alcohol during and 24 hr after (severe vomiting)
Vibramycin Doxycycline Covers atypical bacteria Prefer empty stomach or food PRN (NO DAIRY) No antacid/Iron within 2 hours Intx: OC, antacid Precaution in <8y/o bc tooth discoloration
Bactrim Sulfamethoxazole/Trimethoprim Empty stomach with ample H2O Intx: warfarin AE: rash, diarrhea, photosensitivity
Rifampin Inhibit RNA polymerase Tx N.meningitis, H.flu, S.aureus, TB CYP450 inducer orange discoloration of secretions
Gentamicin Aminoglycosides Inhibit bacterial proteitn synthesis Bactericidal, concentration dependent ADE: Renal tubular necrosis, ear damage Max 3-5mg/kg/day
Tobramycin Aminoglycosides Inhibit bacterial proteitn synthesis Bactericidal, concentration dependent ADE: Renal tubular necrosis, ear damage Max 3-5mg/kg/day
Vancocin Vancomycin Cdiff or MRSA ADR: nephrotoxicity, ototoxicity, red man syndrome oral has negligible absorption
Cipro Ciprofloxacin CI: children, pregnant Precaution: seizure disorder, risk of tendon rupture Intx: Warfarin, theophylline, antacid, FE, Sucralfate ADR: Nausea, diarrhea, HA, photosensitivity NOT broad spectrum FQ/respiratory FQ
Levaquin Levofloxacin CI: children, pregnant Precaution: seizure disorder, risk of tendon rupture Intx: Warfarin, theophylline, antacid, FE, Sucralfate ADR: Nausea, diarrhea, HA, photosensitivity Inhibits DNA gyrase and topoisomerase
Avelox Moxifloxacin CI: children, pregnant Precaution: seizure disorder, risk of tendon rupture Intx: Warfarin, theophylline, antacid, FE, Sucralfate ADR: Nausea, diarrhea, HA, photosensitivity Risk of QT prolongation
Primaxin Imipenem/Cilastatin Carbapenems Inhibit cell wall synthesis ADE: seizures, drug fever 500 mg Q6hr
Merrem Meropenem Imipenem/Cilastatin Carbapenems Inhibit cell wall synthesis ADE: seizures, drug fever 1g Q8hr
Aztreonam Monobactam Bind to transpeptidase and PBP to inhibit cell wall synthesis Gram (-) coverage only ADE: rash, diarrhea 1-2 g IV Q6-8hr Safer in PCN allergic patients
Synercid Quinupristin/Dalfopristin Act on bacterial ribosomes to inhibit protein synthesis covers VRE, MRSA 7.5mg/kg IV Q8012 hr 3A4 inhibitor
Zyvox Linezolid Act on ribosomes to inhibit translocation Covers: VRE, MRSA, CAP ADE: myelosuppression 600mg IV Q12 hr May cause serotonin syndrom if used with SSRI
Cubicin Daptomycin Cyclic lipopeptide Rapid depolarization of bacterial membrane resulting in cell death Cover: VRE, MRSA ADR: increase LFT and CPK 4mg/kg IV Q24hr
Ketek Telithromycin bind to 50s effective against erythromycin resistant strains BBW: myasthenia gravis
Diflucan Fluconazole Candidiasis CYP450 metabolized Intx: Warfarin Monitor LFT AE: Nausea, dizziness
Amphotericin B Pre-meditate w/ NSAID or APAP + Benadryl or Hydrocortisone Test dose recommended
Cancidas Caspofungin Inhibit synthesise of beta d glucan (cell wall of fungi) covers Aspergillus IV infusion over 1 hour
Zovirax Acyclovir Herpes infection Ample H2O Renal elimination CI/P: renal disease, dehydration Oral AE: N/V
Foscarnet Tx of CMV, acyclovir-resistant HSV DoC for esophagitis
Cidofovir Cytomegaloviral infection (CMV)
Potassium Hypokalemia or w/ K-depleting diuretics (Zaroxolyn, Lasix, Demadex, Bumex)
Lanoxin Digoxin CHF/afib 0.125-0.5mg DI: Diuretic, BAS, Amiodaron, Quinidine, Propafenone, Cyclosporine, Verapamil CI: VFib AE: Anorexia, NV, Gynecomastia, blurred vision, HA, bradycardia Avoid OTC cough, antacid, laxative
Cordarone Amiodarone Ventricular Arrhthmias T1/2 >50 days CI: Sinus node dysfxn ADE: Thyroid, pulmonary, ocular, photosensitivity Importance of routin lab! Intx: warfarin, digoxin
Multaq Dronedarone Less thyroid and pulmonary toxicity compared to amiodarone
Pradaxa Dabigatran Direct thrombin Inhibitor 150mg BID
Effient Prasugrel More reliable than Plavix
Plavix Clopidogrel Inhibit ADP platelet receptors 75mg QD
Brilinta Ticagrelor Used w/ ASA (NMT >100mg/day) May increase risk of bleeding Risk of CV events increased upon DC Caution in hyperuricemia (gout)
Lovenox Enoxaparin DVT prophylaxis/tx Start warfarin on the same day and continue lovenox until INR>2 1mg/kg/Q12hr
Imdur Isosorbide Mononitrate Angina Prophylaxis QAM ADE: HA! Don't crush, can split scored tablets but swallow whole
Nitrostat Nitro-Dur (patch) Nitroglycerin STAT-Q3 tab/15 min PRN Sit down before taking Store in original amber vial
Aldactone Spironolactone Edema, HTN Potassium-sparing DI: ACEI, other K sparing, Potassium CI: Anuria/renal insufficiency AE: Gynecomastia, nausea, hyperK
Inspra Eplerenone CHF, HTN Binds to mineralcorticoid receptor and blocsk Aldosterone binding
Zaroxolyn Metolazone 2nd agent for enhanced diuresis DI: Diuretic, BAS, amiodarone, quinidine, propafenone, cyclosporine, verapamit K-wasting
Lasix Furosemide CHF Electrolyte wasting Inhibit absorption in distal tubule and ascending loop
Demadex Torsemide CHF, HTN Electrolyte wasting
Bumex Bumetanide CHF Loop Diuretic No adj for PO to IV Electrolyte wasting
Lamictal Lamotrigine Adjunct in seizure disorders DI: phenytoin, carbamaz, phenobarb, valproate ADR: serious rash and dizzy
Dilantin Phenytoin DI: amiodarone, cimetidine, fluconazole, carbamaze, sucralfate, valproic, APAP, OC, theophyline Precaution in impaired liver fxn ADR: gingivial hyperplasia Take WF Toxicity: rash, slurred speech, confusion
Trileptal Oxcarbazepine Partial seizures use IR on ESRD and if <30ml/min use half of dose Associated with agranulocytosis, angioedema, rash
Depakote/ER Divalproex Seizure/Mania CI: hepatic disease Take WF or milk to avoid GI upset Cap can be sprinkled
Topamax Topiramate Seizure adj therapy Weak carbonic anhydrase inhibitor P: kidney stones ADE: fatigue, wt loss/anorexia Excreted in urine unchanged DI: CNS depressant, metformin, phenytoin, carbamazepine
Keppra Levetiracetam Seizure Dose adj. for renal dysfxn no DI May cause hostility and nervousness Do not stop abruptly, taper over time
Lyrica Pregablin Neuropathic pain structually similar to GABA but doesn't act like GABA CNS Depressant Avoid alcohol May cause drowsiness, peripheral edema
Neurontin Gabapentin neuropathic pain Renally excreted DI: Antacid May cause drowsiness
Phenobarbital EIADH CNS Depressant Half live averages 80-120 hours
Tegretol/ER Carbamazepine Tx of seizure Macrolide may increase serum levels CI: Bone marrow depression Look for rash Take WF EIADH
Zonegran Zonisamide For partial seizures Not recommended if <50ml/min Watch out for rash CI: hypersensativity to sulfonamides
Lithonate/Lithotabs Lithium carbonate Renal elimination DI: NSAID, ACEI, Thiazide (incraese serum concentration) CI: renal/CV disease, dehydration or sodium depletion ADE: tremor, nausea, thirst Avoid dehydration Toxicity: extreme polyuria
Created by: estherjlee89
 

 



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