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Pharm Pract 4 drugs

drugs 51-119 with indications and dosing; HTN, CHF, and Resp

BrandGenericDosingComments
Inderal Propanolol HTN: 40 - 480 mg/d divided BID angina prophylaxis: 60 - 160 mg/d of LA! Migraine prophylaxis: 80-240 mg/d of LA! •PK: non-selective BB, lipophilic (cross BBB) •Forms: tab, SR cap, oral soln (used in prediatrics) •CI: asthma
Tenormin Atenolol HTN 25 - 100 mg/d •PK: relatively cardioselective (BAMA) does NOT cross BBB
Tenoretic Atenolol/Chlorthalidone 1 Tab daily for HTN CI: sulfonamide alergy
Lopressor Metoprolol Tartrate HTN, post-MI: 50 mg BID •Take w/ FOOD to ↑ absorption •PK: relatively cardioselective, crosses BBB
Toprol XL Metoprolol Succinate, angina prophylaxis angina prophylaxis 100 mg/d Max: 400 mg/d •PK: relatively cardioselective, cross BBB •©: CHF monitor for increasing sx (weight gain, SOB), take w/ FOOD to ↑ absorption, do NOT crush whole/halved tab
Metoprolol succinate, HTN HTN 50 - 100 mg/d
Atenolol, ang proph angina prophylaxis 50 - 200 mg/d
Metoprolol Succinate, CHF CHF (stable NYHA class II/III) 12.5 mg/d Goal: 150-200mg/day
Trandate/Normodyne labetolol HTN: 200mg bid •PK: *α1] blocker + non-selective BB •Injectable form available (eg. drip post surgery)
Zebeta bisoprolol HTN: 5mg daily •PK: relatively cardioselective •Not FDA-indicated for CHF, but it may be used
Ziac bisoprolol and hydrochlorothiazide HTN: 1 tablet daily •PK: relatively cardioselective/thiazide diuretic •CI: sulfonamide allergy •©: take in AM, photosensitivity
Coreg Carvedilol CHF: 25mg bid for <85kg 50mg bid for >85kg starting CHF dose is 3.125mg bid •PK: *α1] blocker + non-selective BB •©: take w/ FOOD to ↓ orthostatic hypotension (↓ absorption)
carvedilol HTN HTN:6.25-25mg bid starting@ 6.25bid
Accupril Quinapril HTN: 20-80mg/day •Lower dosage when using diuretics •Requires adjustment for renal dysfunction
Altace Ramipril HTN: 2.5-20mg/day •Lower dosage when using diuretics •Requires adjustment for renal dysfunction •©: caps can be used as sprinkles if needed
Ramipril other indications ↓ risk of MI, stroke, and death from CV causes; CHF post-MI ↓ risk of MI, stroke, and death from CV causes; CHF post-MI
Capoten Captopril HTN: 25mg tid!!! take 1 hour before meal •Requires adjustment for renal dysfunction •AE: taste disturbances
Lotensin Benazepril HTN: 10-80 mg/day •Lower dosage when using diuretics •Requires adjustment for renal dysfunction
Lotensin HCT Benazepril/HCTZ HTN: 1 tab/day •CI: sulfonamide allergy
Mavik Trandolapril HTN: 2-4mg daily •Requires adjustment for renal dysfunction or hepatic cirrhosis
Monopril Fosinopril CHF: 10-40mg daily •Lower dosage when using diuretics •NO renal adjustment!!! •Final target dose may not be lower, but still start tx at lower dose w/ renal compromise
Fosinopril, HTN HTN: 20-80mg daily *lower when using diuretics
Univasc moexipril HTN: 7.5-30mg daily •Reduce dose w/ decreased renal function •©: take on an EMPTY stomach 1 h AC
Vasotec enalpril CHF: 2.5-20mg bid •Lower dosage when using diuretics •Requires adjustment for renal dysfunction
Enalapril, HTN HTN:10-40mg/day IV use for HTN ONLY
Vaseretic Enalapril/HCTZ HTN: 1-2tabs/day Combo not indicated for initial tx of HTN
Zestril lisinopril CHF: 5-40mg/day •Lower dosage when using diuretics •Requires adjustment for renal dysfunction •Within 24 h of MI
lisinopril, HTN HTN: 5-40mg/day same as CHF dosing
Zestoretic Lisinopril/HCTZ HTN: 10/12.5-20/25 mg/day •CI: sulfonamide allergy •©: take in AM, photosensitivity NOT for initial
Atacand candesartan HTN/CHF: 8-32mg/day •Lower dosage when using diuretics/volume depleted •Adjust dose for moderate hepatic impairment
Avapro irbesartan HTN + diabetic nephropathy: 150-300mg/day •Lower dosage when using diuretics/volume depleted
Avalide Irbesartan/HCTZ HTN (not initial): 150/12.5-300/12.5mg daily •©: take in AM, photosensitivity
Cozaar Losartan HTN/diabetic nephropathy: 25-100mg/day •Lower dosage when using diuretics/volume depleted •Consider lower dosage w/ hepatic impairment
Hyzaar Losartan/HCTZ HTN: 50/12.5-100/25mg daily •©: take in AM, photosensitivity
Diovan Valsartan CHF: 40-160 bid!!! titrate to highest tolerated dose •Lower dosage when using diuretics/volume depleted •In the tx of HTN, the addition of a diuretic has a greater effect than dose increases beyond 80 mg
Diovan-HCT valsartan/HCTZ HTN: 1 tab daily •©: take in AM, photosensitivity
Diovan HTN dose Valsartan, HTN 80-320mg daily
Benicar olmesartan HTN: 20-40mg daily
Benicar-HCT olmesartan/HCTZ 1 tab daily •Substitute combination product for titrated component
Micardis Telmisartan HTN: 20-80mg/day goal: 80mg/day •If further BP control needed after 2-4 wks on 80 mg, add diuretic •Most BP lowering effect seen in 2 wks, full effect obtained in about 4 wks
Proventil HFA MDI albuterol bronchspas: 2 puffs q 4-6 h prn can use 2 puffs 15 minutes prior to exercise
Proventil inh sol albuterol, neb relief: 1.25-5mg neb tid-qid prn
Xopenex levalbuterol bronchspas: 2 puffs q 4-6 h prn •For acute exacerbation doses may intensify
xopenex inh solution levalbuterol, neb 1 vial neb tid prn; dose based on age 3 avail strengths (.31, .63, and 1.25 per 3mL) ;use w/in 2 weeks of opening foil
Maxair/autoinhaler pirbuterol bronchspas: 2 puffs q 4-6 h prn •Maxair Autohaler is breath-activated (not good for children) •©: admin technique depends on dosage form, aerosol- shake well •EIB: 15 min prior
Serevent diskus salmeterol maint: 1 inh q 12 h dry powder inhaler long-term control •For long-term control use with corticosteroid •CI: now for acute tx of asthma •©: use on schedule as directed •EIB: 30-60 min prior
Foradil Formoterol maint: 12mcg cap q 12 h long control w/corticosteroid •For long-term control use with corticosteroid •EIB: 15 min prior (Fast Foradil vs. Slow Serevent) •For use in children > 5 yo
Azmacort triamcinolone chronic asthma tx: bid-tid individual dose has a builtin spacer shake well
Flovent MDI fluticasone chronic asthma tx: bid individual dose, f 3 strengths-44.110.220 •AE: HA, pharyngitis •©: aerosol- shake well
pulmicort Budesonide chronic asthma tx: bid individual dose, b inhaler or neb sol •Turbuhaler – dry powder •Respules (inhalation suspension) for nebulizer (unique form) •©: turbuhaler, flexihaler – NOT for use w/ a spacer
Advair Fluticasone/Salmeterol chronic asthma tx: 1 inh bid 100/50, 250/50, 500/50 •250/50 mcg strength specified for chronic tx of COPD w/ bronchitis •CI/PC: as w/ corticosteroid + sympathomimetic precautions
Advair, COPD fluticasone/salmeterol for COPD w/bronchitis COPD w/bronchitis: 1 inh bid 250/50 specified for this ind. no strength has immed relief
Symbicort Budesonide/formoterol chronic tx asthma: 2 inhalations bid (4 total inh) •2 strengths available (80/4.5, 160/4.5) •BBox Warning: anything w/ LABA should NOT be used as acute tx
Intal Cromolyn chronic asthma tx: 2 puffs qid!!! 15min-1 hour prior to EIB •AE: cough, sore throat •©: may take up to 4 wks for effect
Theophylline theophylline asthma/COPD: individual doses serum concentration monitoring necessary •IX: MANY- quinolones (fluoroquinolone, etc), macrolides (erythromycin, etc) •AE: GI, CNS •©: do NOT crush tab
ipratroprium atrovent? ipratropium maint: 2 puffs/1 neb vial tid-qid •AE: oral dosage forms- dry mouth, cough, HA; nasal dosage forms- dryness, epistaxis, irritation, HA •©: SCHEDULED use for COPD (not prn), shake well
Spiriva Tiotropium COPD only! 1 18mcg cap daily repeat inh of cap •AE: dry mouth, constipation •©: do NOT swallow cap, keep in original packaging until use
Duoneb ipratroprium/albuterol neb COPD: 1 vial neb qid!!! •Can use 2 additional doses if need per day
Combivent ipratroprium/albuterol MDI COPD: 2 puffs qid •IC: COPD on bronchodilator w/ evidence of bronchospasm who require 2nd agent (albuterol)
Accolate Zafirlukast chronic asthma tx: 20mg bid (>12 y/o) •PK: CYP 2C9, 3A4 •Food ↓ bioavailability so take on empty stomach •IX: warfarin, phenytoin, Carbamazepine, CCBs
Singulair Montelukast Chronic asthma tx 4 mg q pm (age 2-5) 5 mg q pm (age 6-14) 10 mg q pm (age > 15) •Also indicated for allergic rhinitis
Allegra Fexofenadine allergic rhinitis: 60mg bid or 180mg daily (adult) also for chronic idiopathic urticaria •©: EMPTY stomach, avoid OTC cough/cold/allergy products
Allegra-D Fexofenadine/pseudoephedrine allergic rhinitis: 12 hour tab bid; 24 hour tab daily do not use other decongestants CI/PC: severe HTN/CAD •AE: HA, insomnia, nausea Take on empty stomch
Clarinex desloratidine allergic rhinitis/chronic urticaria: 5mg daily (adult) •PC: impaired liver fxn avoid other cough/cold products
Zyrtec cetirizine allergic rhinitis/chronic urticaria: 10mg daily (adult) available OTC syrup •AE: drowsiness/somnolence, fatigue, dry mouth
Zyrtec-D cetirizine/ pseudoephedrine seasonal/perennial allergic rhinitis: 1 tab bid (adult) •Each tab contains 120mg PSE; NMT 240 mg/d •PC: additive CNS depressants/sympathomimetics avoid EtOH
Patanol Olopatadine allergic conjunctivitis: 1gtt bid at 6-8 hour interval Histamine H-1 antagonist remove contacts before and 10min after admin
Phenergan Promethazine allergic rhinitis, urticaria: 12.5mg qid prn inj/sup/tab/syrup •BBox: CI if < 2 yo •AE: drowsiness, dry mouth, avoid EtOH
astelin Azelastine non-allergic and seasonal allergic rhinitis: 2 sprays in each nostril bid •©: drowsiness
Flonase Fluticasone allergic rhinitis: 2 sprays in each nostril daily, f 2 sprays can be reduced to 1 after a few days
Nasonex mometasone allerigic rhinitis: 2 sprays in each nostril daily. m not prn tx!
Nasacort AQ triamcinolone allerigic rhinitis: 2 sprays in each nostril daily. t not prn tx!
Rhinocort AQ budesonide allerigic rhinitis: 2 sprays in each nostril daily. b not prn tx! up to 3 weeks for full effect
atarax hydroxyzine pruritus: 25mg tid-qid •Recall that Zyrtec (cetirizine) is a metabolite of hydroxizine) •IX: CNS depressants (↑ drowsiness)
atarax for tension hydroxyzine for anxiety anxiety/tension: 50-100mg qid •IX: CNS depressants (↑ drowsiness) •AE: DROWSINESS, dry mouth
sudafed pseudoephedrine nasal congestion: 30-60mg q 4-6 h prn 240mg/day max •CI: severe CAD, HTN •PC: HTN, DM, BPH
tessalon perles Benzonatate symptomatic relief of cough: 100mg tid prn Swallow whole! onset w/in 15-20 min
Tussionex chlorpheniramine/hydrocodone cough/upper resp. symp: 1 tsp q 12 h CIII •IX: CNS depressants •CI/PC: pulmonary disease/asthma, BPH
Histinex HC hydrocodone/ phenylephrine/ chlorpheniramine relief of cough/nasal congestion: 2 tsp q 4 hours •CIII •NMT 8 tsp/d •IX: CNS depressants •CI/PC: pulmonary disease/asthma, BPH
Mytussin AC codeine/guaifenesin symptomatic relief of cough: 1 - 2 tsp q 4 - 6 hours •C-V •NMT 12 tsp/d •IX: CNS depressants
Guaifenex DM guaifenesin/ dextromethorphan symptomatic relief of cough: 1-2 tab bid •Drink ↑ fluids •Watch IX w/ narcotics
Guaifenex PSE guaifenesin/ pseudoephedrine sympt cough/nasal cong: 1 tab bid •ER tab; may break tab in half, but do NOT crush of chew •Watch PSE daily intake
Created by: nickh88
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