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BDK
Quiz 7
| Pharmacologic Category | Generic Name | Brand Name | Classification | Common Indications | Key Side Effects | US Boxed Warnings | Contraindications | Clinical Pearls |
|---|---|---|---|---|---|---|---|---|
| Anticholinergic; Antispasmodic | dicyclomine (PO) | Bentyl | IBS | drowsiness, blurred vision, dizziness, xerostomia, constipation | gastrointestinal obstruction, reflux esophagitis, acute hemorrhage with cardiac instability, obstructive uropathy, glaucoma | |||
| Guanylate cyclase C agonist | linaclotide (PO) | Linzess | IBS-C, opioid-induced constipation | diarrhea, abdominal pain | do not use in patients <2 years of age (risk of death due to dehydration) | mechanical gastrointestinal obstruction | ||
| Osmotic laxative | polyethylene glycol 3350 (PO) | MiraLax | OTC | Constipation | abdominal cramping, electrolyte imbalance | bowel obstruction | ||
| Osmotic laxative | Lactulose (PO) | Enulose | Constipation, hepatic encephalopathy | abdominal cramps, abdominal distention, diarrhea, flatulence | ||||
| Osmotic laxative | Lactulose (PO) | Constulose | Constipation, hepatic encephalopathy | abdominal cramps, abdominal distention, diarrhea, flatulence | ||||
| Stimulant laxative | senna (PO) | Ex-Lax | OTC | Constipation | abdominal cramping, electrolyte imbalance | |||
| Stimulant laxative | senna (PO) | Senokot | OTC | Constipation | abdominal cramping, electrolyte imbalance | |||
| Stool softener | docusate (PO) | Colace | OTC | Prevent straining during defecation | do not use with mineral oil | |||
| Corticosteroid | dexamethasone (PO, IV) | DexPak | Inflammatory diseases, cerebral edema, CINV | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Corticosteroid | dexamethasone (PO, IV) | DoubleDex | Inflammatory diseases, cerebral edema, CINV | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Corticosteroid | methylprednisolone (PO, IM, IV) | Medrol | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Corticosteroid | methylprednisolone (PO, IM, IV) | Solu-Medrol | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Corticosteroid | prednisolone (PO) | Orapred | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Corticosteroid | prednisone (PO) | Deltasone | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Corticosteroid | prednisone (PO) | Rayos | Inflammatory diseases, COPD exacerbation, asthma exacerbation, acute gout | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Corticosteroid | hydrocortisone (PO) | Acute illness, adrenal insufficiency | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | ||||
| Corticosteroid | hydrocortisone (topical) | Cortaid | OTC | Inflammation, rash | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | ||
| Corticosteroid | hydrocortisone (IV) | Solu-Cortef | Acute illness, adrenal insufficiency | hyperglycemia, increased appetite with weight gain, depression, irritability, anxiety, restlessness, insomnia, osteoporosis (chronic use), Cushing's syndrome (chronic use) | risk of adrenal suppression with prolonged use | |||
| Histamine (H2) antagonist | famotidine (IV) | Pepcid | GERD, erosive esophagitis, SUP | headache, constipation, diarrhea, mental status changes | ||||
| Histamine (H2) antagonist | famotidine (PO) | Pepcid | OTC | GERD, erosive esophagitis, SUP | headache, constipation, diarrhea, mental status changes | |||
| Histamine (H2) antagonist | famotidine (PO) | Zantac 360 | OTC | GERD, erosive esophagitis, SUP | headache, constipation, diarrhea, mental status changes | |||
| Dopamine (D2) antagonist | metoclopramide (PO, IV) | Reglan | Gastroparesis, GERD, nausea, vomiting | drowsiness, dystonia, akathisia, EPS, QTc prolongation, diarrhea, hyperprolactinemia | may cause tardive dyskinesia, do not use >12 weeks | GI obstruction, perforation, or hemorrhage | ||
| Selective serotonin (5-HT3) antagonist | ondansetron (PO, IV) | Zofran | Nausea, vomiting | headache, fatigue, constipation, QTc prolongation | ||||
| Histamine (H1) antagonist | promethazine (PO, IM, IV, PR) | Phenergan | Motion sickness, nausea, vomiting | drowsiness, dry mouth, blurred vision, QTc prolongation, EPS | potential for fatal respiratory depression in patients < 2 years old; injection can cause peripheral extravasation (preferred parenteral route is IM) | |||
| Histamine (H1) antagonist | meclizine (PO) | Bonine | OTC | Motion sickness, vertigo | drowsiness, dry mouth, blurry vision | |||
| Antidiarrheal | diphenoxylate and atropine (PO) | Lomotil | CS-V | Diarrhea | nausea, confusion, drowsiness, dizziness, xerostomia, tachycardia, urinary retention | do not use in diarrhea associated with enterotoxin-producing bacteria or in children <6 years of age | ||
| Proton pump inhibitor (PPI) | dexlansoprazole (PO) | Dexilant | GERD, PUD, erosive esophagitis, SUP | headaches, abdominal pain, nausea, diarrhea, bone fracture, vitamin B12 deficiency, hypomagnesemia, increased risk of Clostridioides difficile associated diarrhea (CDAD) | ||||
| Proton pump inhibitor (PPI) | esomeprazole (PO, IV) | Nexium | PO: OTC | GERD, PUD, erosive esophagitis, SUP | headaches, abdominal pain, nausea, diarrhea, bone fracture, vitamin B12 deficiency, hypomagnesemia, increased risk of Clostridioides difficile associated diarrhea (CDAD) | |||
| Proton pump inhibitor (PPI) | lansoprazole (PO) | Prevacid | OTC | GERD, PUD, erosive esophagitis, SUP | headaches, abdominal pain, nausea, diarrhea, bone fracture, vitamin B12 deficiency, hypomagnesemia, increased risk of Clostridioides difficile associated diarrhea (CDAD) | |||
| Proton pump inhibitor (PPI) | omeprazole (PO) | Prilosec | OTC | GERD, PUD, erosive esophagitis, SUP | headaches, abdominal pain, nausea, diarrhea, bone fracture, vitamin B12 deficiency, hypomagnesemia, increased risk of Clostridioides difficile associated diarrhea (CDAD) | |||
| Proton pump inhibitor (PPI) | pantoprazole (PO, IV) | Protonix | GERD, PUD, erosive esophagitis, SUP | headaches, abdominal pain, nausea, diarrhea, bone fracture, vitamin B12 deficiency, hypomagnesemia, increased risk of Clostridioides difficile associated diarrhea (CDAD) | ||||
| Gastrointestinal protectant | sucralfate (PO) | Carafate | duodenal ulcers | constipation, bezoar formation | take on an empty stomach; many drug interactions due to reducing absorption of other drugs | |||
| Allylamine antifungal | terbinafine (PO, topical) | Lamisil | Topical: OTC | Onychomycosis | nausea, abdominal pain, diarrhea, elevated hepatic transaminases, headache | |||
| Azole antifungal | fluconazole (PO, IV) | Diflucan | Vulvovaginal candidiasis, oropharyngeal candidiasis, invasive candidiasis | nausea, abdominal pain, diarrhea, QTc prolongation, elevated hepatic transaminases | ||||
| Azole antifungal | ketoconazole (PO, topical) | Nizoral | Topical: OTC | Tinea infections | nausea, abdominal pain, diarrhea, QTc prolongation, increased hepatic transaminases | serious hepatotoxicity, including cases with a fatal outcome or requiring liver transplantation have occurred; may cause QTc prolongation and drug interactions leading to QTc prolongation | ||
| Polyene antifungal | nystatin (PO) | --- | Oropharyngeal candidiasis | phlebitis, diarrhea, vomiting, anemia, fever | ||||
| Polyene antifungal | nystatin (topical) | Nystop | Cutaneous and mucocutaneous fungal infections | burning, itching | only use oral solutions for thrush | |||
| Echinocandin antifungal | micafungin (IV) | Mycamine | Invasive candidiasis | no major side effects | ||||
| Glucocorticoid and azole antifungal | betamethasone and clotrimazole (topical) | Lotrisone | Cutaneous fungal infections | burning, itching, dryness, skin atrophy | do not use for diaper dermatitis; adrenal suppression with long-term use over large areas of skin | |||
| Neuraminidase inhibitor antiviral | oseltamivir (PO) | Tamiflu | Influenza | nausea, vomiting, neuropsychiatric events (i.e., confusion, delirium, hallucinations) in pediatric patients (rare) | ||||
| Antiviral | acyclovir (PO, IV) | Zovirax | Herpes simplex virus | nausea, increased hepatic transaminases, crystalluria | vesicant | |||
| Antiviral | valacyclovir (PO) | Valtrex | Herpes simplex virus | nausea, increased hepatic transaminases | ||||
| Antiviral | nirmatrelvir + ritonavir (PO) | Paxlovid | COVID-19 | diarrhea, dysgeusia | significant drug interactions; strong CYP3A inhibitor | |||
| Antiviral | remdesivir (IV) | Veklury | COVID-19 | hyperglycemia, renal impairment | ||||
| Nucleoside/Nucleotide Reverse Transcriptase Inhibitor (NRTI) | emtricitabine + tenofovir disoproxil fumarate (PO) | Truvada | HIV Infection, PreP, PEP | decreased bone mineral density, kidney injury, nausea, diarrhea | post treatment acute exacerbation of hepatitis B, risk of drug resistance with use for preexposure prophylaxis | |||
| Nucleoside/Nucleotide Reverse Transcriptase Inhibitor (NRTI) and Integrase strand transfer inhibitor (INSTI) | emtricitabine (NRTI) + tenofovir alafenamide (NRTI) + bictegravir (INSTI) (PO) | Biktarvy | HIV infection | increased serum bilirubin, headache, weight gain, insomnia, diarrhea, nausea | post treatment acute exacerbation of hepatitis B | take oral INSTIs 2 hours before or 6 hours after products containing calcium, aluminum, magnesium, or iron | ||
| Lincosamide antibiotic | clindamycin (PO, IV) | Cleocin | MRSA | SSTI, pharyngitis | diarrhea, Clostridioides difficile diarrhea | Clostridioides difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin, and may range in severity from mild diarrhea to fatal colitis | ||
| Sulfonamide antibiotic | sulfamethoxazole and trimethoprim (PO, IV) | Bactrim, Bactrim DS | MRSA, Enterobacteriaceae | SSTI, cystitis, pyelonephritis, opportunistic infection prophylaxis | nausea, vomiting, diarrhea, skin rashes (rarely SJS or TEN), photosensitivity, crystalluria, hyperkalemia, increased serum creatinine, hypersensitivity reactions | |||
| Urinary antibiotic | nitrofurantoin (PO) | Macrobid | Escherichia coli | Cystitis | nausea, pulmonary fibrosis (chronic use) | |||
| Urinary antibiotic | fosfomycin (PO) | Monurol | Escherichia coli | headache, diarrhea, nausea | ||||
| Aminoglycoside antibiotic | tobramycin (IV, inhaled) | Tobi (inhaled) | Escherichia coli, Pseudomonas aeruginosa | HAP, cystic fibrosis (nebulized only) | nephrotoxicity, ototoxicity | |||
| Glycopeptide antibiotic | vancomycin (PO) | Vancocin | Clostridioides difficile | CDI | nephrotoxicity, vancomycin infusion reaction, ototoxicity | |||
| Glycopeptide antibiotic | vancomycin (IV) | Vancocin | MRSA | SSTI, HAP, meningitis, endocarditis, CRBSI | nephrotoxicity, vancomycin infusion reaction, ototoxicity | |||
| Antibiotic | metronidazole (PO, IV) | Flagyl | Bacteroides species, Clostridioides difficile | Anaerobic infections, CDI | nausea, metallic taste, disulfiram reaction with alcohol, peripheral neuropathy (long-term use) | |||
| Antibiotic | mupirocin (topical) | Bactroban | Bacteroides species, Clostridioides difficile | MRSA decolonization | no major side effects | |||
| Topical antibiotic | neomycin + polymyxin B + bacitracin (topical) | Neosporin (OTC) | Topical infection prevention | reddening, itching | ||||
| Topical antibiotic | neomycin + polymyxin B + bacitracin (ophthalmic) | Neo-Polycin | Ocular infections | reddening, itching | ||||
| 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 | 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 | diclofenac (PO) | Voltaren | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | ||
| NSAID | ibuprofen (PO) | Motrin | OTC | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | |
| NSAID | ibuprofen (PO) | Advil | OTC | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | |
| NSAID | meloxicam (PO) | Mobic | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | ||
| NSAID | indomethacin (PO) | Indocin | OA, RA, acute pain, gout | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | ||
| NSAID | naproxen (PO) | Naprosyn | OTC | OA, RA, acute pain, gout | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | |
| NSAID | naproxen (PO) | Anaprox | OTC | OA, RA, acute pain, gout | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | |
| NSAID | naproxen (PO) | Aleve | OTC | OA, RA, acute pain, gout | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | |
| NSAID | ketorolac (PO, IV) | Toradol | Pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | indicated for short term use (≤ 5 days) | may reduce renal blood flow and compromise existing renal function (avoid in patients with renal disease, heart failure, and cirrhosis) | ||
| NSAID, COX-2 selective | celecoxib (PO) | Celebrex | OA, RA, acute pain | diarrhea, dyspepsia, abdominal pain, flatulence, nausea | 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 | 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 | Muscle spasm | drowsiness, dizziness, xerostomia, fatigue | CI within 14 days of MAOI therapy | use may cause prolonged cardiac arrhythmias, and tachycardia | ||
| Skeletal muscle relaxant | cyclobenzaprine (PO) | Amrix | Muscle spasm | drowsiness, dizziness, xerostomia, fatigue | CI within 14 days of MAOI therapy | use may cause prolonged cardiac arrhythmias, and tachycardia | ||
| Skeletal muscle relaxant | cyclobenzaprine (PO) | Fexmid | Muscle spasm | drowsiness, dizziness, xerostomia, fatigue | CI within 14 days of MAOI therapy | use may cause prolonged cardiac arrhythmias, and tachycardia | ||
| Skeletal muscle relaxant | baclofen (PO) | --- | Spasticity | drowsiness | ||||
| Skeletal muscle relaxant | methocarbamol (PO) | Robaxin | Muscle spasm | drowsiness | ||||
| Topical analgesic | lidocaine (transdermal) | Lidoderm | OTC | pain | dermatitis, erythema, urticaria, skin depigmentation, skin edema | patch may remain in place for up to 12 hours in any 24-hour period, patch may be cut | ||
| Antiarrhythmic | lidocaine (IV) | Xylocaine | ventricular arrhythmias | bradycardia | ||||
| 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:
CaristW