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DI/Dose Adjust

NAPLEX

QuestionAnswer
Statin with lowest risk of drug interactions? Pravastatin
Pt has Sulfa Allergy. Avoid what NSAID? Brand? Celexcoxib; Celebrex
Which beta-lactams do/do no need RENAL dose adjustment? Don't: Ceftriaxone, naficillin, oxacillin Do: The rest
Non-beta lactam anti-infectives require RENAL dose adjustment? Key: Aminoglycosides Quniolones (except Moxifloxacin) Vancomycin Fluconazole Misc: AmphoB, TB meds, antivirals, SMX/TMP
Cariovascular drugs the require renal dose adjustment? Key: LMWH Rivaroxaban (for AFib) Apixaban (for AFib) Dabigatran (for AFib) Misc: Most arrhythmics, certain statins
Statins that require renal dose adjustment? Pravastatin Rosuvastatin
GI drugs that require renal dose adjustment? Brand? Key H2RAs -Famotidine/Pepcid -Ranitidine/Zantac Metoclopramide/Reglan
Drugs that require renal dose adjustment for following d/o? - Bone mineral density - Mood stabilization Bisphosphonates Lithium
Drug(s) contraindicated when CrCl < 60? Nitrofurantoin (Macrobid)
At what CrCl are tenofavir version contraindicated? Brand names of products containing them? Tenofavir disoproxil fumarate < 50 - Complera, Delstrigo, Stribild, Symfi Tenofavir alafenamide < 50 - Biktarvy, Descovy, Genvoya, Odefsey, Symtuza
Antifungal contraindicated when CrCl < 50? IV voriconazole
Drug(s) contraindicated when CrCl < 30? Tenofovir alafenamide NSAIDs Dabigatran for DVT/PE
Metformin renal considerations? eGFR < 45 --> Do not start eGFR < 30 --> Do not give at all
Created by: dromeur.exe
 

 



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