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DEENT 2, CNS, MS/SK
CNS 5, Musculoskeletal
| Pharmacologic Category | Generic | Brand | Classification | Common Indication | Key Side Effects (EK) | Other Notes (EK) | US Boxed Warning (EK) |
|---|---|---|---|---|---|---|---|
| Alpha1 agonist | pseudoephedrine (PO) | Sudafed | OTC | Nasal congestion | increased blood pressure, tachycardia, palpitations, insomnia, restlessness | sold behind the counter, avoid during first trimester of pregnancy | |
| Corticosteroid | fluticasone (intranasal) | Flonase | OTC | Allergic rhinitis | nasal dryness, epistaxis, nasal burning, headache | ||
| Corticosteroid | triamcinolone (intranasal) | Nasacort | OTC | Allergic rhinitis | nasal dryness, epistaxis, nasal burning, headache | ||
| Histamine1 blocker | azelastine (intransal) | Astepro | OTC | Allergic rhinitis | headache, nasal dryness, epistaxis, bitter taste, drowsiness | ||
| Histamine1 blocker | diphenhydramine (PO, IV) | Benadryl | PO: OTC | Allergic rhinitis, allergic reaction, insomnia | drowsiness, constipation, xerostomia, urinary retention, cognitive impairment | for OTC use, do NOT use in children < 6 years of age | |
| Histamine1 blocker | hydroxyzine (PO, IV) | Atarax, Vistaril | Pruritus, nausea, anxiety | dizziness, somnolence, xerostomia, blurred vision, QTc prolongation | |||
| Histamine1 blocker | cetirizine (PO) | Zyrtec | OTC | Allergic rhinitis | drowsiness, dizziness, headache | ||
| Histamine1 blocker | loratadine (PO) | Claritin | OTC | Allergic rhinitis | drowsiness, dizziness, headache | ||
| Histamine1 blocker | fexofenadine (PO) | Allegra | OTC | Allergic rhinitis | drowsiness, dizziness, headache | ||
| Histamine1 blocker | levocetirizine (PO) | Xyzal | OTC | Allergic rhinitis | diarrhea, drowsiness, headache | ||
| Histamine1 blocker | olopatadine (ophthalmic) | Pataday, Patanol | OTC | Allergic conjunctivitis | ocular burning, discomfort, dryness | ||
| Histamine1 blocker and opioid analgesic | promethazine and codeine (PO) | Phenergan with Codeine | CS-V | Cough | dizziness, somnolence, xerostomia, blurred vision, constipation, respiratory depression (dose-related) | opioid-containing cough and cold products no longer indicated for use in patients < 18 years of age | concomitant use of opioids with benzodiazepines or other CNS depressants (including alcohol), may result in profound sedation, respiratory depression, coma, and death |
| Opioid analgesic and expectorant | codeine and guaifenesin (PO) | Robitussin AC, Cheratussin AC | CS-V | Cough | dizziness, somnolence, constipation, respiratory depression (dose-related) | opioid-containing cough and cold products no longer indicated for use in patients <18 years of age | |
| Antianxiety agent | buspirone (PO) | Buspar | Anxiety | dizziness, drowsiness, nausea | do not use with MAOI | ||
| Benzodiazepine | alprazolam (PO) | Xanax | CS-IV | Anxiety | daytime sedation, performance impairment, tolerance, dependence, anterograde amnesia, withdrawal, dizziness, ataxia | risk of profound sedation, respiratory depression, coma and death with opioids; risk of abuse, misuse, and addiction; risk of dependence and withdrawal reactions | |
| Benzodiazepine | clonazepam (PO) | Klonopin | CS-IV | Anxiety, seizure disorders | daytime sedation, performance impairment, tolerance, dependence, anterograde amnesia, withdrawal, dizziness, ataxia | risk of profound sedation, respiratory depression, coma and death with opioids; risk of abuse, misuse, and addiction; risk of dependence and withdrawal reactions | |
| Benzodiazepine | diazepam (PO, IV) | Valium | CS-IV | Anxiety, seizure disorders, acute alcohol withdrawal | daytime sedation, performance impairment, tolerance, dependence, anterograde amnesia, withdrawal, dizziness, ataxia | risk of profound sedation, respiratory depression, coma and death with opioids; risk of abuse, misuse, and addiction; risk of dependence and withdrawal reactions | |
| Benzodiazepine | lorazepam (PO, IV) | Ativan | CS-IV | Anxiety, seizure disorders, acute alcohol withdrawal | daytime sedation, performance impairment, tolerance, dependence, anterograde amnesia, withdrawal, dizziness, ataxia | IV: parenteral formulation contains propylene glycol and may be associated with toxicity if used >= 48 hours | risk of profound sedation, respiratory depression, coma and death with opioids; risk of abuse, misuse, and addiction; risk of dependence and withdrawal reactions |
| Benzodiazepine | midazolam (IV, IM) | Versed | CS-IV | Anesthesia, sedation | hypotension, apnea, bradypnea | risk of profound sedation, respiratory depression, coma/death with opioids or when used for sedation in noncritical settings; risk of abuse, misuse, addiction; risk of dependence/withdrawal reactions; dose must be individualized; no rapid inj in neonates | |
| Hypnotic | zolpidem (PO) | PO: Ambien, Ambien CR SL: Edluar | CS-IV | Insomnia | decreased ability to function the next morning, somnolence, headache, dizziness, xerostomia, anterograde amnesia, parasomnias | serious injuries, including death, have occurred because of complex sleep behaviors (i.e., sleepwalking, sleep driving, engaging in other activities while not fully awake); CI in patients with history of complex sleep behaviors | |
| Sleep aid | melatonin (PO) | OTC | Insomnia, jet lag | drowsiness, daytime somnolence | |||
| Sedative, general anesthetic | propofol (IV) | Diprivan | Sedation for mechanical ventilation, procedural anesthesia, status epilepticus | bradycardia, hypotension, hypertriglyceridemia, propofol-related infusion syndrome (rare) | formulated as a 10% lipid emulsion containing 1.1 kcal/mL | ||
| Alpha2 agonist, sedative | dexmedetomidine (IV) | Precedex | Sedation for mechanical ventilation or procedures | bradycardia, hypotension | tolerance and tachyphylaxis may occur if used longer than 24 hours | ||
| Alpha2 agonist | tizanidine (PO) | Zanaflex | Spasticity | drowsiness, hypotension, dizziness, xerostomia, weakness | |||
| Aminoquinolone | hydroxychloroquine (PO) | Plaquenil | RA, SLE, malaria | retinal toxicity, rash, diarrhea | long-term use has been associated with cardiomyopathy, bone marrow suppression, QT prolongation, and neuromuscular effects (i.e., myopathy, palsies, and progressive weakness) | ||
| NSAID | diclofenac (topical) | Voltaren Gel | OTC | OA | pruritus, rash | ||
| NSAID | diclofenac (PO) | Voltaren | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
| NSAID | ibuprofen (PO) | Motrin, Advil | OTC | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation |
| NSAID | meloxicam (PO) | Mobic | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | may reduce renal blood and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
| NSAID | indomethacin (PO) | Indocin | OA, RA, acute pain, gout | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
| NSAID | naproxen (PO) | Naprosyn, Anaprox, Aleve | OTC | OA, RA, acute pain, gout | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation |
| NSAID | ketorolac (PO, IV) | Toradol | Pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) BW: indicated for short term use <= 5 days | may increase the risk of serious (and potentially fatal) cardiovascular thrombotic events, MI, and stroke; may increase the risk for serious (and potentially fatal) gastrointestinal adverse events including ulceration, bleeding, and perforation | |
| NSAID, COX-2 selective | celecoxib (PO) | Celebrex | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | ||
| Skeletal muscle relaxant | cyclobenzaprine (PO) | Flexeril, Amrix, Fexmid | Muscle spasm | drowsiness, dizziness, xerostomia, fatigue | use may cause prolonged cardiac arrhythmias, and tachycardia; CI within 14 days of MAOI therapy | ||
| Skeletal muscle relaxant | baclofen (PO) | Spasticity | drowsiness | ||||
| Skeletal muscle relaxant | methocarbamol (PO) | Robaxin | Muscle spasm | drowsiness | |||
| Transdermal: topical analgesic IV: antiarrhythmic | lidocaine (transdermal, IV) | Transdermal: Lidoderm IV: Xylocaine | Transdermal: OTC | Transdermal: pain IV: ventricular arrhythmias | transdermal: dermatitis, erythema, urticaria, skin depigmentation, skin edema IV: bradycardia | patch may remain in place for up to 12 hours in any 24-hour period, patch may be cut | |
| Antigout agent | colchicine (PO) | Colcrys | Gout | diarrhea, nausea, vomiting, bone marrow suppression, myopathy (including rhabdomyolysis) | |||
| Xanthine oxidase inhibitor | allopurinol (PO) | Zyloprim | Gout | diarrhea, nausea, rash, leukopenia, thrombocytopenia | rare association with severe (and potentially fatal) allopurinol hypersensitivity syndrome (risk highest in certain Asian populations) | ||
| Depolarizing neuromuscular blocking agent | succinylcholine (IV) | Anectine | Neuromuscular blockade for intubation or procedures | hyperkalemia, myalgia, malignant hyperthermia (rare) | acute rhabdomyolysis and hyperkalemia leading to cardiac arrest and death in pediatric patients with undiagnosed skeletal muscle disease | ||
| Anti-tumor necrosis factor alpha inhibitor | etanercept (SQ) | Enbrel | RA | infection, injection site reaction, headache, nausea | serious infections, malignancies such as lymphoma | ||
| Anti-tumor necrosis factor alpha inhibitor | adalimumab (SQ) | Humira | RA, Crohn's Disease, Ulcerative Colitis | infection, injection site reaction, headache, nausea | serious infections, malignancies such as lymphoma |
Created by:
kapena5