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Hospital Drugs
| Question | Answer |
|---|---|
| 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 |
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estherjlee89
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