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Adverse eff &Warning
Adverse effects and Warning labels
| Question | Answer |
|---|---|
| Adverse effects of 5-alpha reductase inhibitors ( finasteride, dutasteride) | Erectile dysfunction, Decreased sex desired, Reduced semen |
| Adverese reactions from the use of phosphodiesterase inhibitors( sildenafil, tadalafil, verdenafil)results from | Vasodilation : increased dilation of blood vessels |
| A fatal drop in blood pressure (severe fatal hypotension can occur when using | Phosphodiesterase inhibitors who are taking nitroglycerines |
| B-adrenergic blockers are contra-indicated in person with | Asthma (because they can produce bronchospasm) and Diabetes (because they mask sign of hyperglycemia) |
| Hydrochlorothiazide diuretics | May potentiate sulfa allergy. Ensure that patient knows to take diuretic in the morning (am) |
| Spironolactone | It is K sparing diuretic , therefor caution is required when combining it with a K supplement( Slow K) |
| Nitroglycerines | Packaged in amber glass bottles and shoud be dispensed in the manufacturer's original container |
| Nitrolingual spray | The spray is used on/under the tongue, not inhaled. Not to shake nitrolingual spray. Pt must be instructed to use only 3 sprays max. |
| Nitro-Dur patch | Pt should be instructed only apply the patches for 12 hrs, not 24 hrs |
| atenolol-Tenormin-beta blocker | May cause dizziness or lightheadedness |
| indapamide-Lozide-thiazide diuretic | Take with food |
| hydralazine-Apresoline-direct vasodilator | Take with food |
| Enalaprilate | The injectable form of enalapril-Vasotec |
| enalapril-Vasotec-ACE inhibitor | May cause a dry cough, if is persist, report to your doctor |
| furosemide-Lasix-Loop diuretic | May be advisable to eat bananas or drink orange juice |
| metformin-Glumetza | It is a long acting med so tid dosing may not be warranted (should be od or bid) |
| Flovent (fluticasone) inhaler | Shake well before use. Rinse mouth after use. |
| Qvar ( beclomethasone) 100 mcg inhaler | Inhaled corticosteroid/ICS= Preventor |
| HP-Pac | Check for penicillin allergy since HP-Pac contains amoxicillin. Also it comes in a 7 days course |
| metoclopramide-Reglan-Prokinetic drug | Should be 1/2 hr before meal (ac) |
| rabeprazole-Pariet/Aciphex-PPI | Ideally should be once daily before meal:breakfast |
| Duragesic 25 mcg | It is applied for 72 hrs continuously |
| paroxetine-Paxil-SSRI | Not indicated for children under 18 yrs old |
| Premarin 0.625 mg | Correct if pt has had a hysterectomy. If pt still hv intact uterus, then pt shoud also receive a progestin ( Provera possibly) |
| Prometrium 100 mg | Contraindicated in pt who hv a peanut allergy ( cap.contain peanut oil) |
| ethinyl estradiol/levonorgestrel-Aleese/Seasonale-Extened BCP | Extended BCP, continuously 91 days ( 84 hormone pills + 7 inactive tabs) |
| levonorgestrel-Plan B-emergency BCP | Dose is either 2 STAT or 1 STAT in 12 hrs |
| ethinyl estradiol+drospirenone-Yazmin/Yaz | SIG: Take 1 tab for 21 days, stop for 7 days, then repeat. Antibiotic-minocycline can decrease efficacy of BCP |
| Phosphodiesterase inhibitor | Avoid nitrates ( A fatal drop in blood pressure may occur when take them together) |
| Tamsulosin | Swallow whole, don't crush or chew |
| 5 alpha reductase inhibitor-finasteride, dutasteride | Avoid contact with pregnant women |
| alprostadil inserts-Caveject/Muse-Prostagladin | Refrigerate, don't freeze administered via intraurethral and intracarnosal |
| oxybutynin-Ditropan XL | extended release formulation and should typically be dosed once daily. |
| Diflucan 150 mg | It is now OTC called Canes Oral (single dose oral Tx) |
| terbinafine-Lamisil | It is supplied in cream or spray |
| ciclopirox-Penlac/Loprox | Ensure that pt understand that med should be applied to the nails, not skin |
| azithromycin 250 mg | for traveller's diarrhea, 2 tabs daily for 3 days |
| cipro 250 mg | Fluoroquinolone antibiotics are not indicated for children due to osteomalacia (poor bone or cartilage formation) |
| Parafer (ferrous fumarate)-Anemia therapy | Potential drug interaction if take together with levaquin/levofloxacin. Separate dose. |
| Zostrix cream | It is OTC. Clarify if this Rx should be Zovirax cr for cold sore |
| 3TC | unusual to hv only one HIV drug, they are usually prescribed in combination |
| Broad spectrum antibiotics | May get a yeast infection or vulvovaginal candidiasis= yeast vaginitis |
| goserelin-Zoladex LA | Route of administration = Subq |
| gabapentin-Neurontin | Avoid antaacid |
| Tegretol XR 200 mg-carbamazepine | Swallow whole, don't crush or chew |
| Dilantin-phenytoin-Hydantoin anticonvulsant | Commnon side effects:hirsutism= excessive growth of body hair and gingival hyperplasia=excessive growth of gum tissue |
| methotrexate/MTX-antimetablite | Avoid aspirin and NSAIDs because these drugs may decrease MTX clearance and cause toxicity |
| Topamax-topiramate: broad spectrum anti-seizure | Topamax is available in tabs and sprinkle caps in 25 mg strength |
| tranylcypromine-Parnate | It is MAOIs, pt on this med, is advised to avoid eating food containing tyramine to avoid risk of hypertension |
| tipranavir | FDA requires black box warning |
| caspofungin-Echinocandins | powder for injection |
| Isoniazide | Treat tuberculosis |
| bromocriptine | Treat amenorrhea-absense of normal menstruation |
| enfuvirtide-fusion inhibitor | Treat HIV |
| alprostadil-Caverject/Muse-Prostaglandin | Route of administration=intraurethral pellets and intracarvenosal inj |
| Vinca alkaloid | Not administerd via spine |
| Besides of nitroglycerines, pt with Viagra should avoid another drug -drug interaction | alpha1 blocker - tamsulosin, terazosin,alfuzosin |
| Carbamazepine, oxcarbamazepine | May decrease the effectiveness of oral contraceptives |
| Auxiliary labels for antibiotics | Empty stomach:ciprofloxacin, levofloxacin, moxifloxacin Sunlight: ciprofloxacin, sulfisoxazole Take with food : Septra, cefaclor Decreases contraceptives : minocycline |
Created by:
jijy
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