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Merrill CIs & ADRs
| Question | Answer |
|---|---|
| Plavix - clopidogrel | CI: pathologic bleedig, (PUD - peptic ulcer disease, intercranial hemorrhage), lactation, PREG = B ADR: **BLEEDING, **THROMBOTIC THROMBOCYTOPENIC PURPURA, abd pain, ND, dyspesia, gastritis, pruritis - itchy-tingly, purpura, rash |
| Nexium - esomeprazole | CI: hypersensitivity ADR: HA, abd pain, constipation, ND, dry mouth, flatulence, PREG = B |
| Norvasc - amlodipine | CI: hypersensitivity, ADR: *HA, *peripheral edema, dizzy, low BP, ^HR, gingival hyperplasia, flushing PREG = C |
| Adivair - fluticasone + salmeterol PREG = C | CI: fluticasone - acute asthma attack/status asthmaticus (inhaln); active untreated infections, salmeterol - acute relief of bronchiospasm, CV disease, ADR: *low wound heal, *HA, NVD, nervous, palpatations, oropharyngeal fungal infec, trimbling, cramps |
| Remicade - infleximab | CI: allergic to murine - mouse protiens, HF - (class 3/4), concurrent use of anakinra, active infections, PREG = B ADR: **INFECTIONS (reactivate TB), **MALIGNANCY,*fatigue, *HA, *abd pain,*N, D, rash, anemia,laryngitis, HTN, |
| Effexor - venlafaxine PREG = C | CI: concurrent MAOI - monoamine oxidase inhibitor therapy, ADR: **SEIZURES, SUICIDAL THOUGHTS, ^ in peds. *abnormal dreams, *anxiety, *dizzy, *HA, *insomnia, *nervousness, *weakness, *visual disturbances, *abd pain, *altered taste, *anorexia, *"urniary" |
| Risperdal - risperidone PREG = C | CI: H/O seizures, suicidal tendency, dementia related psychosis, ADR: **NMS - neuroleptic malignant syndrome, *aggressive behavior, *extrapyramidal reactions, **HA, *insomnia, *sedation, *visual disturbances, *dysmenorrhea/menorrhagia, *dyskinesia |
| Diovan - valsartan PREG = C 1st tri, D 2nd & 3rd tri | CI: pregnancy/lactation ADR: *dizzy, fatigue, HA, low BP, edema, ^LFTs, ^ K, abd pain, ND, ^ serum creatinine, arthralgia (joint), back pain, |
| Enbrel - etanercept PREG = B | CI: sepsis, active infection, lactation, concurrent use of cyclophosphamide or anakinra, ADR: 88CNS, **DEMYELINATING DISORDERS, **SEIZURES, **PANCYTOPENIA, *HA, **INFECTIONS (renew TB & HEP), **MALIGNANCY, **ANAPHYLAXIS, optic neuritis, pharyngitis, |
| Lipitor - atorvastatin PREG = X | CI: liver disease, pregnancy/lactation, ADR: **RHABDOMYOLYSIS - skeletal muscle destructon accumulates in renal tubes, myalgia, abd cramps, "bowels" HA, dypepsia, flatulence |
| Herceptin - trastuzumab PREG = B | CI: Pre existing pulmonary/cardiac dysfunction, hypersensitivity to trastuzumab or Chinese hamster ovary cell products, ADR: **CARDIOTOXICITY, **HYPERSENSITIVE REACTIONS, ^HR, *abd pain, *anorexia, * NVD, *rash, *back/bone pain, arthralgia, neuropathy, |
| Cozaar - losartan PREG = C 1st tri, D 2nd & 3rd tri | CI: pregnancy/lactation ADR: **ANGIOEDEMA - tissue swelling, weakness, CP - chest pain, edema, low BP, *diarrhea, hypoglycemia, ^wt, anemia, bach pain, myalgia, |
| Lovenox - enoxaparin PREG = B Peds safety not established | CI: allergic - heparin, pork products, or benzyl alcohol, active bleeding, thrombocytopenia related to previous therapy, spinal or epideral anesthesia, ADR: **BLEEDING, thrombocytopenia, pain at injection site, ^LFTs, |
| Niaspan (not in book) niacin - vitamin B3 PREG = C | CI: heart disease, kidney disease, sever low BP, peptic ulcer, ADR: facical neck swelling, NVD, gout, ^blood sugar, petic ulcers |
| Seroquel - quetiapine PREG = C | CI: bone marrow supression, demintia related psychoses, severe CNS - central nervous system depression, severe hepatic impairment, blood dyscrasias, coma, ADR: *dizzy, cognitive impairment, EPS, postural hypotension, leukopenia, tartive dyskinesia, |
| Singular - montelukast PREG = B | CI: acute attacks of asthma, PKU chew tabs w/aspartame, ADR: fatigue, HA, weakness, otitis, sinitis, cough, rrhinorhea, abd pain, ND, dyspepsia, |
| Fosamax - alendronate PREG = C | CI: esophageal disease, unable stand/sit for > 30 min., risk of asparation, hypocalcemia, severe renal insufficiency (CRCL <35ml/min. ADR: HA, abd pain, musculoskeletal pain, constipation, dyspepsia, dysphagia, esophagitis, osteonecrosis (jaw), NVD, |
| Protonix - pantoprazole PREG = B | CI: hypersensitivity ADR: HA, abd pain, NVD, rash, flatulence, ^LFTs, |
| Prevacid - lansoprazole PREG = B | CI: severe hepatic impairment, ADR: *dizzy, *HA, *NVD, abd pain, rash |
| Avandia - rosiglitazone PREG = C | CI: jaundice from previous therapy, active liver disease, ADR: **LACTIC ACIDOSIS, HF, edema, macular (retinal) edema, urticaria - hives, wt fractures, total ^cholesterol, anemia |
| Procrit - erythropoietin epoetin- alfa PREG = C | CI: allergic - albumin or mammilian cell derivatives ADR: **SEIZURES, **ARYTHMIAS, **HF, **MI, **STROKE, **THROMBIC EVENTS, **MORTALITY, * HA, *cough, *dyspenia, *edema, *^BP, CP - chest pain, *abd pain, *NVD, *arthralgia, *rash, pruitus - itching, fever |
| EPS | extrapyramidal symptoms - degenerative nervous system diseases - tremors, dystonia - involuntary muscle movements, chorea - involuntary dancing - writhing, e.g.(Parkinson's) |
| Mevalotin - pravachol Preg - X cholesterol | CI: liver disease, pregnancy/lactation, ADR: **Rhabdomyolysis, myalgia, HA, abd cramps, "bowels", dyspepsia, flatulence, ^LFTs, nausea, rash |
| Zocor - simvastatin Preg = X cholesterol | CI: liver disease, pregnancy/lactation ADR; **Rhabdomyolysis, myalgia, abd cramps, "bowels", dyspepsia, flatulence, ^ LFTs, nausea, rash |
| Epogen - epoeitin alfa Preg = C anemia | CI: allergic - albumin or mammalian cell products, uncontrooled HTN, ADR: **Arrhythmias, **HF, **MI, **stroke, **thrombic events, **tumor growth, **mortality, arthralgia, edema |
| Lexapro - escitalopram Preg = C depression | CI: MAOI or pimazide therapy, suicidal, Peds may have ^ effect (suicidal) ADR: suicidal, *HA, *insomnia, *dry mouth, ND, ^appetite, ED, lower libido, ^ sweating |
| Biaxin - clarithromycin Preg = C respiratory tract infections | CI: allergic - macrolides or ketolides, use of pimozide or ergot derivatives, AVOID during preg. unless no alternative, ADR: **Pseudomembranous colitis, SJS - Steve Johnson symdrom, NVD, HA, rash, pruritis |
| Aricept - donepizel Preg = C dementia - Alzheimer's | CI: lactation ADR: *HA, *ND, abnormal dreams, depression, dizzy, drowsy, insomnia, polyuria, ecchymoses, lower HR, ^BP, anorexia, muscle cramps |
| Proscar - finasteride Preg = X BPH - begnin prostatic hyperplasia, male pattern baldness | CI: women, PEDS ADR: impotency, lower libido |
| Avastin - bevacizumab Preg = C metastatic colorectal CA, - lung | CI: 1st 28 days after surgery, recent hemoptysis, other serious bleeding, ADR: **Thromboembolic events, **stroke, **TIA, **MI, **VTE, **GI perferation, **bleeding, ** wound dehiscence - surgical wound, impaired wound healing, fistulas nonGI, neutropenia, |
| Actos - pioglitazone Preg = C NIDDM - noninsulin dependent Diabetes Mellitus | CI: accute liver disease or ALT, IDDM; moderate to sever HF, hepatic imparement, ADR: edema, hepatitis, ^LFTs, fractures (women) arm, hand, foot, |
| Ambien - zolpidem Preg = C insomnia | CI: sleep apnea, previous abuce habits, ADR: abnormal thinking, anxiety, depression, behavior changes, physical/psychological dependence, sleep driving, ^BP, NVD, rash, hallucinations, day/drowsy, dizzy, |
| Zyrtec - cetirizine Preg = B seasonal/perinial allergies, chronic uriticara "hives", rhinitis, | CI: allergic - cetirizine or hydrozine, lactaion, CrCl < 11ml/min (not on dialysis) ADR: insomnia, pharyngitis, dry mouth, dizzy, drowsy, NVD, fatigue |
| Glucophage - metformin Preg = B type 2 DM | CI: metabolic acidosis, renal dysfunction, radiology w/IV iodinated contrast, HF ADR: **lactic acidosis, *abd bloating, *NVD, *lower BG - blood glucose, metallic taste, lower vit. B12 levels |
| Avapro - irbesartan Preg = c 1st tri, D 2nd & 3rd tri HTN | CI: pregnancy/lactation ADR: **Angioedema - hive under skin -life threat,^ K+, lower BP, ^HR, dyspepsia, ^ serum creatinine,(SCr), dizzy, fatigue |
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