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What is the generic name for Aldomet? dosage strength? indications?
- -125, 250, 500mg
- -intial 250 mg BID - TID
- -HTN also for pregnancy
Aldomet (Methyldopa) MOA?
-central alpha 2 agonist, decreases NE
What is the other medication for HTN in pregnancy?
Coumadin (Warfarin) match color to strength
Coumadin (Warfarin) match color to strength
What is the generic name for Pradaxa? dosage strength? indications?
- 75 mg & 150 mg BID
- afib, stroke prophylaxis
Pradaxa (Dabigatran) MOA & impt notes
- direct thrombin inhibitor
- BEER's list >75 yrs
- CrCl >30mL/min 150 mg BID
- CrCl < 30mL/min 75 mg BID w/ or w/out food
- routine INR not required
Nitroglycerin SL tabs?
0.3, 0.4, 0.6 mg
Nitro-Dur Patches ?
0.1, 0.2, 0.3, 0.4, 0.6, 0.8 mg/hr
Nitrolingual Pump spray?
- 0.4 mg/metered dose:
- 200 sprays or 60 sprays
- DO NOT SHAKE
Nitro-Bid ointment? strength? important points
- 2% 0.5 to 2 inches applied in AM and 6hrs later
- 10-12 hr nitrate free perion
- can be used Q8hrs
Mechanism of Action of NTG products?
relaxation of vascular smooth muscle via stimulation of intracellular cGMP
NTG Side effect?
- most common is HA
- 0.4 mg = 1/150gr
- If, after first SL dose, no improvement or worsening, call 911
- original glass container
What is the active long-acting metabolite of Isosorbide Dinitrat?
Imdur dosage strengths?
How long does it last?
- 30, 60, 120 mg ER
- 12 hours
- Daily HAs marker of drug activity
- APAP relieves nitrate HA w/low risk
Bidil (Isosorbid dinitrate & hydralazine) special indication?
- Heart failure as an adjunct in self-indentified black patients
- 20 mg ISDN & 37.5 mg hydralazine, 1-2 TID
Ranexa generic name?
- Ranolazine ER
- 500 mg BID (up to 1000 mg BID)
- metabolized by CYP-450 & WILL NOT abate an acute angina episode, may cause dizziness
Persantine generic name?
- 25, 50, 75 mg
- adjunct to coumarin type anticoagulants to inhibit platelet aggregation
- orthostasis, GI upset
- 200 mg ER dipyridamole with 25 mg aspirin
- stroke, stroke prophylaxis, TIA
How should Aggrenox be dosed?
What is required for absorption?
What acid is included in the formulation to improve absorption?
Improved antithrombotic action b/c?
Know this drug, commonly used
- 1 cap BID, morning and evening w/or w/out food
- tartaric acid
- additive antiplatelet effects of both drugs
K-Dur, Klor-Con ER, K-tabs & Micro-K, what dosage strengths are available?
10mEq (750 mg), 20mEq (1500 mg) 15mEq
What can be substituted if pt cannot swallow K-Dur or put it in water?
Klor-Con ER is smaller
KCl 8 mEq
- 600 mg
- swallow only
KCl 25 mEq effervescent tabs
- place in water and drink
- 10% (20 mEq/15ml) and 20% (40 mEq/15mL)
IV potassium should NEVER BE GIVEN as a?
T/F K-Dur can be mixed in water to drink?
Name the loop diuretics
- Lasix (furosemide)
- Bumex (Bumetanide)
- Demadex (Torsemide)
- Edecrin (ethacrynic acid)
Where do loops work?
- Ascending loop
- to inhibit Na/K/2Cl cotransport, Na, Cl, & water retained in tubule; loss of Na, K, Mg, & Ca
What loop can be used if pt has sulfa allergy?
Edecrin (ethacrynic acid)
Recall the strength conversions for loops
- Lasix 40 mg = Bumex 1 mg
- Lasix 40 mg = Demadex 20 mg
T/F Loops have a ceiling? ie. higher dose no increase in water removal
False. Loops have no ceiling but thiazides do.
Where do thiazides work?
What mineral/s are loss?
What mineral/s retained?
- inhibits reabsorption of Na & Cl, :. water retained in tubule
- 12.5, 25, 50 mg, also Microzide caps (12.5 mg)
- Na, K, Mg
Name the thiazide type products and doses
- Lozol (indapamide) 1.25 & 2.5 mg QD
- Hygroton (Chlorthalidone) 25, 50, 100 mg QD longest acting
- Zaroxolyn (Metolazone) 2.5, 5, 10 mg can be used in renally impaired w/ loops
What is Dyazide?
- Triamterene plus HCTZ
- 37.5-25 mg
- also Maxzide same as above and Maxzide 75-50 mg
Ascites in cirrhosis dose?
K sparing diuretic
- HTN 25 mg BID
- Ascites in cirrhosis 25-50 mg or even higher QID
- Tabs 25, 50 mg QD or BID
- hyperkalemia, CYP-450 3A4 products
What is the BBW for Beta Blockers?
Avoid abrupt D/C. risk of angina and MI.
- Inderal (propranolol)
- Corgard (Nadolol)
- Visken (Pindolol) with ISA
- Coreg (Carvedilol)
- reduce cardiac output, negative ionotrope and negative chronotrope
Impt notes for DM
Impt nots for asthma
- tabs 10, 20, 40, 60, 80 mg
- caps 60, 80, 120, 160 mg
- may mask signs and symptoms of hyperglycemia
- blocks B2 in lungs
- False. most lipophilic
Inderal (propranolol) recall PK parameters
only 1 out of a 40 mg PO left in circulation (i.e. 1mg IV is equal to 40 mg PO)
- tabs 20, 40, 80, 120, 160 mg QD
- long acting, renally eliminated
- tabs 5, 10 mg BID
- partial BBlocker, inhibit EPI & NE yet has some stimulating beta effect
- less bradycardia
similar to acebutolol (Sectral) B-1 selective
- Bystolic (Nebivolol)
- Lopressor (Metoprolol)
- Tenormin (Atenolol)
T/F decreases NO production resulting in vasodilation
Bi = 2 stolic =systolic?
- tabs 2.5, 5, 10 mg/day
- False. Increases NO product/ resulting in vasodilation
- 2 ways to lower systolic BP
Lopressor (Metoprolol tartrate)
tabs 50, 100 (brand) also 25 mg generic, QD or BID
Toprol XL (Metoprolol succinate)
tabs 25, 50, 100, 200 mg QD or BID
- tabs 25, 50, 100 mg, inj
- most hydrophilic
- tabs 3.125, 6.25, 12.5, 25 mg BID
- caps 10, 20, 40, 80mg QAM
- take w/food to slow absorption & avoid orthostasis
Coreg (Carvedilol) conversion to CR
3.125 mg BID
6.25 mg BID
25 mg BID
- 10 mg
- 20 mg
- 40 mg
- 80 mg all doses QD
- tabs: yellow 0.125mg, white 0.25mg
- sol 50mcg/mL
- half life = 40hrs do not double up if dose missed
Whats used for Lanoxin (Digoxin) toxicity?
What are the S/sx?
- Digibind & Digifab
- GI upset, slow pulse, visual disturbance,