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Pain/Heme/Onc 1-3

BDK

Pharmacologic CategoryGeneric NameBrand NameCommon IndicationKey Side EffectsUSBW
Opioid analgesic fentanyl CS-II Transdermal: Duragesic: IV: Sublimaze Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) potential for medication errors when converting between dosage forms; use with CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase concentrations; avoid exposing transdermal patch to external heat
Opioid analgesic hydromorphone CS-II Dilaudid Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) risk of medication errors w/ high potency, use in opioid-tolerant patients only
Opioid analgesic morphine (extended release) CS-II MS Contin, Kadian Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) coingestion w/ alcohol may result in potentially fatal overdose
Opioid analgesic morphine (intermediate release) CS-II IV: Duramorph, Infumorph Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) risks of addiction, misuse, overdose, fatal respiratory depression, neonatal withdrawal, severe withdrawal if stopped abruptly, and dangerous sedation when combined with benzodiazepines, alcohol, or other CNS depressants.
Opioid analgesic oxycodone CS-II OxyContin, Roxicodone Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) use w/ CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase concentrations
Opioid analgesic methadone CS-II Dolophine Opioid use disorder, severe chronic pain dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related), QTc prolongation QTc prolongation and serious arrhythmia (Torsades de Pointes) have occurred during treatment; concomitant use w/ CYP3A4, 2B6, 2C19, or 2D6 (or stopping the same inducers) can increase concentrations
Analgesic (non-opioid), antipyretic acetaminophen PO/PR: Tylenol; IV: Ofirmev Pain, fever nausea, vomiting, increased hepatic transaminases total daily dose from all sources should not exceed maximum daily limit; hepatotoxicity
Central analgesic; partial opioid agonist tramadol CS-IV Ultram, Ultram ER Pain dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) risks of addiction, misuse, overdose, fatal respiratory depression, neonatal withdrawal, severe withdrawal if stopped abruptly, and dangerous sedation when combined with benzodiazepines, alcohol, or other CNS depressants., ON: lower seizure threshold
Opioid and nonopioid analgesic combination hydrocodone and acetaminophen CS-II Lortab, Vicodin, Norco Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritis, respiratory depression (dose-related) use w/ CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase oxycodone concentrations; hepatotoxicity
Opioid and nonopioid analgesic combination oxycodone and acetaminophen CS-II Percocet, Endocet, Roxicet Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritis, respiratory depression (dose-related) use w/ CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase oxycodone concentrations; hepatotoxicity
Opioid and nonopioid analgesic combination codeine and acetaminophen CS-III Tylenol with Codeine #3, Tylenol with Codeine #4 Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritis, respiratory depression (dose-related) concomitant use or discontinuation of CYP3A4 inducers, 3A4 or 2D6 inhibitors requires careful consideration; respiratory depression and death in children after tonsillectomy or adenoidectomy who are ultra-rapid metabolizers of codeine; hepatotoxicity
Opioid antagonist naloxone Narcan, Narcan Spray (OTC), Zimhi Opioid overdose opioid withdrawal syndrome opioid-dependent populations, pain ---
Partial opioid agonist and opioid antagonist buprenorphine and naloxone CS-III Suboxone Opioid use disorder opioid withdrawal syndrome in opioid-dependent populations, constipation, headache, diaphoresis ON: potentially life-threatening respiratory depression (when combined w/ other CNS and respiratory depressants); addition of naloxone to buprenorphine reduces the possibility of parenteral misuse by producing opioid withdrawal syndromes when injected
Antimetabolite (folic acid antagonist) methotrexate Trexall RA, Crohn's Disease, psoriasis, various hematologic and solid tumors stomatitis, diarrhea, nausea, vomiting, thrombocytopenia, leukopenia, increased hepatic transaminases, pulmonary fibrosis (rare) serious toxic rxns, fetal death/abnormalities, severe bone marrow suppression, aplastic anemia, toxicity w/ NSAIDS, may cause hepatotoxicity, lung disease, severe GI toxicity ON: use folic acid supplements to reduce side effects
Aromatase inhibitor anastrozole Arimidex Hormone receptor positive breast cancer fatigue, rash, flushing, hot flashes, arthralgia, nausea, vomiting, hypertension, peripheral edema, osteoporosis ON: cardiovascular effects (hypercholesterolemia, CAD); fetal toxicity (CI in pregnancy)
Iron supplement ferrous sulfate FeroSul, SlowFe Iron deficiency anemia nausea, stomach upset, constipation dose-related), dark and tarry stools accidental overdose of iron is leading cause of fatal poisoning in children <6yo
Water-soluble vitamin cyanocobalamin (vitamin B12) OTC --- Vitamin B12 deficiency (manifests as macrocytic anemia) no major side effects ---
Water- soluble vitamin folic acid OTC --- Folic acid deficiency (manifests as macrocytic anemia) prevention of neural tube defects in pregnancy no major side effects ---
Antineoplastic agent, anthracycline doxorubicin Adriamycin Adjuvant therapy for breast cancer, various cancers cardiomyopathy, alopecia, nausea, vomiting, bone marrow suppression may cause secondary malignancies, extravasation can result in severe local tissue injury and necrosis. ON: may cause red discoloration of urine, tears, sweat, and saliva
Antineoplastic agent, platinum -based compound cisplatin Kemoplat Advanced bladder, ovarian, and testicular cancer; various cancers bone marrow suppression, nausea, vomiting, nephrotoxicity, neurotoxicity, ototoxicity may cause severe myelosuppression, nausea and vomiting, renal toxicity, and dose-related neuropathy
Antineoplastic agent, monoclonal antibody pembrolizumab Keytruda Various cancers peripheral edema, pruritis, skin rash, endocrine and metabolic abnormalities, constipation, N/V/D, hematuria, anemia, increased liver enzymes, fatigue, musculoskeletal pain, increased serum creatinine, dyspnea ---
Selective estrogen receptor modulator (SERM) tamoxifen Soltamox Hormone receptor-positive breast cancer hot flashes/ night sweats, vaginal bleeding/discharge, decreased bone density (in premenopausal females) increased risk for uterine or endometrial cancer and thromboembolic events; ON: contraception should be used in premenopausal females due to teratogenicity of the drug; do not use w/ warfarin or h/o DVT/PE
Created by: TORICBC
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