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Week 9

Neurology, hypnotics

Generic Brand ClassIndication Side effects Counseling ContraindicationsBBW
Lacosamide Vimpat Anticonvulsant Seizures Cardiac arrhythmias, dizziness, suicidal ideation Monitor ECG in cardiac patients. Do not stop abruptly
Eletriptan Relpax Antimigtaine serotonin receptor agonist Treatment of migraines Chest/neck tightness, serotonin syndrome, HTN Take at onset or migraine (not prevention), Do not use with other triptans within 24 hours. Ischemic heart disease, History of store/TIA, uncontrolled HTN, strong CYP3A4 inhibitor
Eszopiclone Lunesta Nonbarbiturate hypnotic (C-IV) Insomnia CNS depression, next day impairment, unpleasant metallic taste. Take right before bedtime. Ensure >7-8 hours of sleep. Avoid taking with or immediately after a meal. Complex sleep behaviors
Temazepam Restoril Benzodiazepine (C-IV) Insomnia Next day drowsiness/hangover effect Take at bedtime. Avoid alcohol/opioids Concomitant use with opioids- profound sedation, respiratory depression, coma, death
Modafinil Provigil Stimulant (C-IV) Narcolepsy, OSA, shift work sleep disorder Serious rash (SJS/TEN) Psychiatric symptoms Take in AM. May reduce the effectiveness of hormonal contraceptive. Use alt contraceptive.
Prochlorperazine Compazine Phenothiazine N/V, Schizophrenia Extrapyramidal symptoms (EPS), Sedation, anticholinergic effects. Monitor for EPS symptoms. Avoid alcohol/CNS depressants Coma or presence of large amounts of CNS depressants. Postoperative management of nausea/ vomiting following pediatric surgery . Increased mortality in elderly patients with dementia related psychosis.
Promethazine Phenergan Phenothiazine antihistamine Allergy N/V Motion sickness Sedation, respiratory depression Avoid alcohol/CNS depressants. Can cause significant drowsiness Lower respiratory tract symptoms such as asthma. Fatal respiratory in children <2 year old . Severe tissue injury with IV/SQ (prefer deep IM)
Mometasone Nasonex intranasal corticosteroid Allergic rhinitis, nasal polyps viral infection, headache, nasal irritation Prime before 1st use. aim away from nasal septum.
Solifenacin Vesicare urinary antispasmodic Overactive bladder (urgency, frequency and urge incontinence) Constipation, dry mouth, QT prolongation May take few weeks to see the full effect. Monitor CrCl, hepatic function anticholinergic effects. Urinary retention, gastric retention, uncontrolled narrow angle glaucoma
Febuxistat Uloric Xanthine oxidase inhibitor Gout- hyperuricemia Cardiovascular events, Gout flares during the initiation Monitor LFT at baseline Concomitant azathioprine or mercaptopurine increased cardiovascular death
Tacrolimus Prograf Calcineurin inhibitor Prevention of organ transplant rejection nephrotoxicity, neurotoxicity (tumor, headache) hyperkalemia Monitor drug levels to assist in dose adjustment, Avoid grapefruit. Monitor renal function. Increased risk of infection, increased risk of malignancy.
Created by: angelicap
 

 



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