Top 200 #5
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| Anti-inflam, Calcineurin inhibitor, immune suppressant | Restasis | Cyclosporine | Keratoconjunctivitis sicca | 0.05% ophthalmic emulsion | Eye | 1 drop each eye BID (q12hr) | 16 Yrs+: same as adult | Thought to act as a partial immunomodulator (increases tear production)
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| Anti-inflam, Leukotriene Pathway Inhibitor | Singulair | Montelukast | Asthma (treatment & prophylaxis), exercise-induced asthma (prophylaxis), perennial & seasonal allergic rhinitis | Granules: 4mg; Tablets: 10mg; Chew Tabs: 4mg, 5mg | Oral | 10mg QPM or 2 hrs before exercise | 1-5 YO: 4mg QPM; 6-14 YO: 5mg QPM; 15 YO+: 10mg QPM | Leukotriene receptor antagonist. It binds to (CysLT) type-1 receptors found in human airway (smooth muscle cells and macrophages), which prevents airway edema, smooth muscle contraction and other respiratory inflammation.
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| Antimuscarinic, Bronchodilator | Spiriva | Tiotropium | COPD | Capsule: 18 mcg | Oral | 1 capsule via 2 inhalations QD using Handihaler (do not swallow capsule) | N/A | Long-acting, antimuscarinic agent which is often referred to as an anticholinergic. In airways, Tiotropium induces bronchodilation via inhibition of the M3 receptor on airway smooth muscle.
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| Anti-inflam/ Bronchodilator Combo: β2 adr. Agonist (LABA) | Symbicort | Budesonide/ Formoterol | Asthma, COPD | 80mcg/4.5mcg, 160mcg/4.5mcg | Oral | 2 puffs BID (either strength) Max: 4 puffs/day | 12 YO+: same as adult | Budesonide: anti-inflam synthetic corticosteroid w/ potent glucocorticoid & weak mineralcorticoid activity
Formoterol: long-acting bronchodilator that exerts agonist effects on beta(2)-adrenergic receptors found in bronchial smooth muscle
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| Antitussive | Tessalon | Benzonatate | Cough | Capsule: 100mg, 200mg | Oral | 100-200mg TID PRN (MAX: 600mg/day and 200mg/dose) | 10 Yrs+: same as adult | Suppresses cough through a peripheral action, anesthetizing the stretch or cough receptors of vagal afferent fibers
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| Antiglaucoma, Beta-Adrenergic blocker (nonselective) | Timoptic | Timolol | Ocular HTN, Open-angle Glaucoma, Migraine prophylaxis | 0.25%, 0.5% drops or gel-forming drops | Eye | 1 drop in affected eye(S) QD-BID Gel forming: 1 drop QD | 1 drop (either strength) QD | Non-selective beta(1) and beta(2) adrenergic receptor blocking agent which reduces the vasodilator, bronchodilator, positive chronotropic & inotropic responses
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| Antiglaucoma, Prostaglandin | Travatan Z | Travoprost | Raised intraocular pressure (in pts w/ open-angle glaucoma or ocular HTN) | 0.004% ophthalmic soln. | Eye | 1 drop in affected eye(s) QPM (also max) | 16 YO+ | Selective FP prostanoid receptor agonist, lowers intraocular pressure (IOP) by increasing the uveoscleral outflow
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| Antiglaucoma, Prostaglandin | Xalatan | Latanoprost | Ocular HTN, Open-angle Glaucoma | 0.005% ophthalmic soln. | Eye | 1 drop in affected eye(s) QPM (also max) | N/A | Prostaglandin F 2-alpha analog believed to reduce IOP by increasing outflow of aqueous humor (studies suggest main MOA is increased uveoscleral outflow)
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| Vaccine | Gardasil | Human Papillomavirus Quadrivalent Vaccine | Adenocarcinoma in situ of cervix; anal cancer; cervical cancer; anal, cervical, vaginal, vulva intraepithelial neoplasia, genital warts, malignant tumor of vagina/vulva(proph.) | Susp. | IM (Deltoid or upper thigh) | 26 YO and younger: 0.5 mL IM for 3 doses at 0, 2, and 6 Months (3 dose series) | 9 YO+: same as adult | Development of humoral immune response against HPV types 6, 11, 16, and 18
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| Vaccine | Pneumovax 23 | Pneumococcal polysaccharide vaccine | Pneumococcal vaccination | Injectable: 25mcg/0.5ml | SubQ, IM (Deltoid or mid-thigh) | 19-64 YO: 0.5 mL IM or subQ as single dose at least 8 wks after last PCV13 Revaccination: in 5 yrs (max 2 doses) | 2 YO+: same as adult | Induce type-specific antibodies that enhance opsonization, phagocytosis, and killing ov pneumococci by leukocytes and other phagocytic cells
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| Vaccine | Varivax | Varicella vaccine | Varicella (Varivax) prophylaxis | SubQ powder for soln. 19400 PFU | SubQ | 0.5 mL subQ x2 doses; allow at least 4 weeks to elapse between doses | 12 mos-12 yrs: 0.5 mL subQ; allow at least 3 months to elapse if 2nd dose is given | Induces varicella antibodies and a cell-mediated immune response, which produce active immunity against varicella infection
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| Vaccine | Prevnar 13 | Pneumococcal conjugate vaccine | Pneumococcal vaccination, 13-valent conjugate vaccine | Susp. | IM | 0.5 mL IM followed by 1 dose of 23-valent 8 or more weeks later | Primary series: 0.5 mL IM for 4 doses at 2, 4, 6, and 12-15 mos | Causes a T-cell dependent immune response which signals the maturation of B-cells to produce antibodies and memory cells to pneumococcal polysaccharides
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| Vaccine | Zostavax | Zoster Vaccine | Herpes zoster (Zostavax) prophylaxis | SubQ powder for Soln. 19400 PFU | SubQ | 50 YO+: 0.65 mL subQ (FDA recommends at 50 yrs; advisory committee on immuniz practices recommends at 60 yrs | N/A | Induces antibodies and a cell-mediated response
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| Antiasthma; Anti-inflam/ Bronchodilator Combo; β2 adr. agonist (LABA) | Advair | Fluticasone/ Salmeterol | Asthma, COPD | 100/50, 250/50, 500/50; HFA: 45/21, 115/21, 230/21 | Oral | 1 puff BID; HFA can be 2 puffs BID | 4-11 YO: 100/50mcg BID; 12 YO: any strength HFA: 2 puffs BID | Fluticasone: (synthetic trifluorinated corticosteroid w/ powerful anti-inflam effects) – human glucocorticoid receptor antagonist that inhibits multiple cell types & mediator production/secretion involved in asthmatic response
Salmeterol
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| Bronchodilator; Β2 adr. agonist | Combivent | Ipratropium bromide/ Albuterol Sulfate | COPD (for pts requiring 2nd bronchodilator) | Aerosol: 103/18mcg; Inhalation Sol’n: 100/20mcg | Oral | 103/18mcg: 2 puffs QID (max 12 puffs/24 hrs) 100/20mcg: 1 inhalation TID | N/A | Reduces bronchospasm through both anticholinergic & sympathomimetic mechanisms; Albuterol is highly selective for beta 2-adrenergic receptors leading to adenylyl cyclase activation increase cAMP, resulting in airway smooth muscle relaxation; Ipratropium
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| Adrenal Glucocorticoid; Anti-inflam; Corticosteroid, (Intermediate) | Flonase | Fluticasone | Allergic rhinitis, Asthma, Atopic dermatitis, disorder of skin (corticosteroid-responsive dermatoses), rhinitis (non-allergic) | 50mcg/spray | Nasal | 1 spray each nostril BID or 2 sprays each nostril QD | 4-11 YO: 1 spray each nostril BID or 2 sprays each nostril QD | Human glucocorticoid receptor agonist
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| Adrenal Glucocorticoid; Anti-inflam; Corticosteroid (strong) | Nasonex | Mometasone Furoate | Allergic rhinitis (seasonal & perennial), Asthma, Inflam hyperkeratotic dermatosis, Nasal Congestion; Nasal polyp, Seasonal allergic rhinitis (prophylaxis) | 50mcg/ spray | Nasal | 2 sprays each nostril QD | 2-11 YO: 1 spray each nostril QD | Corticosteroid with anti-inflam, antipruritic, and vasoconstrictive properties. Corticosteroids inhibit the release of arachidonic acid by inducing lipocortins that inhibit phospholipase A2.
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| Antihistamine | Patanol; Pataday | Olopatadine | Allergic conjunctivitis, Seasonal allergic rhinitis | Patanol: 0.1%; Pataday: 0.2% | Eye | 0.1%: 1 drop BID (at 6-8 hr interval) 0.2%: 1 drop QD | 2 YO+: same as adult | Selective histamine H(1)-antagonist
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| Beta-2 Adrenergic Agonist; Bronchodilator; Sympathomimetic | ProAir HFA; Proventil; Ventolin | Albuterol Aerosol | Asthma, Exercise-induced asthma (prophylaxis) | 90mcg/ puff | Oral | 2 puffs q4-6 hrs or q4 hr PRN; Exercise-induced: 2 puffs 15-30 mins prior to exercise | 4 YO+: same as adult | Beta-adrenergic agonist that selectively acts on the beta (2)-adrenergic receptors of intracellular adenyl cyclase
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| Adrenal Glucocorticoid, Anti-Inflam, Endocrine-Metabolic Agent, GI Agent | Pulmicort (oral); Rhinocort Aqua (nasal) | Budesonide | Asthma, Crohn’s Disease, Rhinitis (allergic & non), Ulcerative colitis | 0.25mg/2ml, 0.5mg/2ml, 90mcg/ puff, 180mcg/ puff; Rhinocort: 32mcg/ spray | Oral, Nasal | Flexhaler: initial = 360mcg BID, then 180mcg BID (max 720mcg BID) | 6 YO+: same as adult | Anti-inflam synthetic corticosteroid with potent glucocorticoid and weak mineralcorticoid activity
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