Naplex 8

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bblapham
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229374
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Naplex 8
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2013-08-10 19:36:51
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More generic brand dosing
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  1. Prostacyclin Analogs
    Prostacyclin synthase is reduced in PAH resulting in inadequate production of prostacyclin I2; prostacyclin analogs act as potent vasodilators and inhibitors of platelet aggregation.
  2. Flolan, Veletri
    • Epoprostenol AKA prostacyclin and PGI2
    • SE: during dose titration: N/V/D (dose limiting), flushing, HA, hypoT, anxiety, chest palpitations, tachycardia, edema
    • With chronic use: anxiety, flu-like sx, and jaw pain
    • Avoid interruptions in therapy and avoid large reductions in dose
    • Flolan pump must be on ice packs
    • Veletri - no need for ice
    • IV agents are considered most potent
  3. Remodulin
    • Treprostinil IV
    • SC is very painful
  4. Tyvaso
    Inhaled Treprostinil
  5. Ventavis
    Iloprost: lockjaw, cough
  6. Endothelin Receptor Antagonists
    Block endothlin receptors on vascular endothelium and smooth muscle, endothelin is a vasoconstrictor with cellular proliferative effects
  7. Tracleer
    • Bosentan - REMS drugs
    • BBW: hepatotox, Preg Cat x, 
    • CI: pregnancy, cyclosporine, glyburide as bosentan concentration can increase
    • SE: headache, decrease in Hgb anemia, increase in LFTs
  8. Letairis
    • Ambrisentan - REMS drugs
    • CI: pregnancy, dose can't exceed 5 mg/d with cyclosporine
    • SE: peripheral edema, headache, decrease in HGb
  9. Phosphodiesterase Inhibitors
    PDE-5 inhibitors in smooth muscle of ppulmonary vasculature
  10. Revatio
    • Sildenafil
    • CI: nitrates
    • Priapism get help if erection lasts longer than 4 hours
    • Sudden vision loss in one or bouth eyes, red green color blindnes, sudden decrease in hearing, avoid use in severe hepatic impairment
  11. Adcirca
    • Tadalafil
    • Avoid use when CrCl less than 30
  12. PDE-5 Inhibitors and nitrates
    • If a patient has taken a PDE-5 inhibitor and then develops angina, NG should not be used for:
    • 12 hours after for avanafil
    • 24 hours after for sildenafil and vardenafil
    • 48 hours for tadalafil
  13. Ventolin, Proventil, ProAir, AccuNeb, VoSpire ER
    • Albuterol - SABA
    • SE: tremor, shakiness, lightheaded, cough, palpitations, hypokalemia, tachycardia, hyperglycemia
    • Used prn as rescue inhaler, DOC for exercise induced asthma
    • If using SABA greater than 2 days/week, then need to increase maintenance dose
  14. Xopenex
    Levalbuterol
  15. Serevent Diskus
    • Salmeterol - LABA
    • Increased risk of asthma related deaths, do not use LABA as montherapy with persistent asthma
  16. Advair
    • Salmeterol and fluticasone
    • 1 BID
  17. Foradil
    Formoterol - LABA
  18. Symbicort
    • Formoterol and budesonide
    • 2 BID
  19. QVAR
    Beclomethasone HFA - do not shake
  20. AeroBid
    Flunisolide
  21. Pulmicort
    Budesonide
  22. Flovent HFA
    Fluticasone
  23. Dulera
    Mometasone and formoterol
  24. Asmanex
    Mometasone
  25. Accolate
    • Zarfirlukast (inhibits D4 and E4 leukotriene)
    • 20 mg BID (empty stomach)
    • SE: HA, dizzy, ab pain, increase LFTs, URI, pharyngitis, sinusitis, and Churg-Strauss syndrome (rare)
  26. Singulair
    • Montelukast
    • 10 mg daily in evening
  27. Elixophyllin
    • Theophylline IR
    • Range 5 to 15 mcg
    • SE: N, HA, tachycardia, insomnia, tremor, and nervous
    • Signs of tox: persistent vomiting, ventricular tachys, seizures
    • Conditions that can increase theo: CHF, cirrhosis, hypothyroidism
  28. Theolair, Theo-24, Theochron
    Theophylline ER
  29. Xolair
    • Omalizumab--IgG monoclonal AB that inhibits IgE binding to the IgE receptor on mast cells and basophiils - for moderate to severe persistent asthma
    • SC every 2 or 4 weeks
    • BBW: anaphylaxis within 2 hours or even delayed up to 24 hours
    • SE: HA, injection site rxns, URI, sinusitis, viral infection arthralgia, pain
  30. Atroven
    • Ipratropium
    • Dry mouth, URI, nasopharyngitis, sinusitis, cough and bitter taste
    • Do not swallow capsules
  31. Combivent
    • Albuterol and Ipratropium
    • Contains soya lecithin--caution in patients with soybean or peanut allergy
    • Combivent is being phased out, Combivent Respimat does not contain CFCs
  32. Duoneb
    Albuterol and tiotropium
  33. Spiriva
    Tiotropium
  34. Brovana
    • Arformoterol
    • LABA
  35. Arcapta
    Indacaterol LABA
  36. Daliresp
    • Roflumilast
    • Use only in severe COPD
  37. Amerge
    Naratriptan
  38. Axert
    Almotriptan
  39. Frova
    Frovatriptan
  40. Imitrex
    • Sumatriptan
    • Nasal spray and SC injection
  41. Alsuma
    Sumatriptan
  42. Treximet
    Sumatriptan and Naproxen
  43. Maxalt
    • Rizatripta
    • ODT 
  44. Relpax
    Eletriptan
  45. Zomig
    • Zolmitriptan
    • ODT and nasal spray
  46. Rheumatrex and Trexall
    • Methotrexate - folate antimetabolite that inhibits DNA synthesis
    • Dosed weekly for RA (7.5 to 22.5 mg weekly)
    • Many BBW but usually for higher doses associated with cancer: do not use in pregnancy, hepatotoxicity, pneumonitis, bone marrow suppression, malignant lymphomas, severe and fatal dermatologic reactions, acute renal failure with higher doses
    • CI: pregnancy, alcoholism, chronic liver disease, blood dyscrasias
    • SE: N/V/D/Gi upset, anorexia, reddening of skin
  47. Plaquenil
    • Hydroxycholoroquine
    • Take with food or milke
    • 400 to 600 mg daily initially, then 200 to 400 mg daily
    • SE: decreased visual acuity, photophobia, blurred vision, corneal deposits, macular damage, N/V
  48. Sulfazine
    • Sulfasalazine
    • 5-aminosalicyclic acid derivative
    • 500 to 1000 mg BID max 3 grams/day
    • Take with food and water
    • SE: HA, anorexia, dyspepsia, GI upset, others
  49. Dynacin, Minocin, Solodyn
    Minocycline
  50. Arava
    Leflunomide
  51. Xelijanz
    • Tofacitinib
    • Inhibitor of Janus Kinase
  52. Enbrel
    • Etanercept - TNF alpha inhibitor
    • 50 mcg weekly
  53. Tumor Necrosis Factor Inhibitors
    • BBW: serious infections may occur, D/C drugs if this occurs
    • Perform test for latent TB prior to use
    • CI: sepsis
    • SE: infections and injection site reactions
    • Monitor for signs of infection, WBCs, HR, LFT, TB test, malignancies
    • Usually, MTX is 1st line and these agents are add on, but if initial presentation is severe, these can be started as initial therapy
    • Do not use biologics in combination
    • Do not give live vaccines
  54. Humira
    • Adalimumab--TNA alpha inhibitor
    • 40 mg SC every other week, or 40 mg weekly if not using MTX
  55. Remicade
    • Infliximab - TNF alpha inhibitor
    • Given with MTX
    • 3 mg/kg IV at weeks 0, 2, and 6, and then every 8 weeks
    • Infusion reactions: hypotension, fever, chills, pruritis (can pre-treat), delayed hypersens rxn
  56. Cimzia
    • Certolizumab - TNF alpha inhibitor
    • 400 mg SC at weeks 0,2, and 4, then 400 mg every 4 weeks
  57. Simponi
    • Golimumab - TNF alpha inhibitor
    • Given with MTX
    • 50 mg SC once per month
  58. Rituxan
    • Rituximab - Depletes CD20 and B cells
    • 1 gram IV on day and 15 in comb with MTX, need to pre-med with steroid, start infusion at 50mg/hr then increase to 400 mg/hr if no reaction
    • BBW: severe infusion reactions, PML due to JC virus infection, tumor lysis syndrome, fatal skin reactions
    • SE: fever chills, HA, pain, rash, pruritis, angioedema, ohers...
  59. Kineret
    • Anakinra - IL receptor antagonist
    • 100 mg SC daily
  60. Orecnia
    • Abatacept - inhibits T cell stimulation
    • 500 to 1000 mg IV based on body weigh, give at 0, 2, and 4 weeks, then every 4 weeks
  61. Actemra
    Tocilizumab - Il6 inhibitor
  62. Benlysta
    Belimumab - inhibits B lymphocyte activation
  63. Beconase, Vancenase
    • Beclomethasone allergies
    • 1 to 2 sprays in each nostril daily or BID
  64. Rhinocort Agua
    • Budesonide allergies
    • 1 to 4 sprays in each nostril daily
  65. Omnaris
    • Ciclesonide allergies
    • 2 sprays in each nostril daily
  66. Zetonna
    • Ciclesonide allergies
    • 1 spray in each nostril daily
  67. Nasarel and Nasalide
    • Flunisolide allergies
    • 2 sprays in each nostril BID to TID
  68. Veramyst
    • Fluticasone furoate for allergies
    • 2 sprays in each nostril daily
  69. Dymista
    Fluticasone furoate and azelastine for allergies
  70. Flonase
    • Fluticasone proprionate for allergies
    • 2 sprays in eahc nostril daily
  71. Nasonex
    • Mometasone
    • 2 sprays in each nostril daily
  72. Nasacort AQ
    • Triamcinolone for allergies
    • 1 to 2 sprays in each nostril daily
  73. QVAR
    Beclomethasone HFA for asthma
  74. Pulmicort
    Budesonide for asthma
  75. Symbicort
    Formoterol and Budesonide
  76. Alvesco
    Ciclesonide for asthma
  77. Aerospan HFA
    Flunisolide for asthma
  78. Flovent
    Fluticasone for asthma
  79. Adviar
    Fluticasone and salmterol
  80. Asmanex
    Mometasone for asthma
  81. Dulera
    Mometasone and formoterol
  82. Astelin and Astepro
    Azelastine
  83. Patanase
    Olopatadine intranasal
  84. Nasalcrom
    • Intranasal cromolyn
    • 4 to 7 days to see sx relief, up to 2 to 4 weeks of continued use for maximal effect, must administer q4-6H, not PRN, not as effective as other agents, consider for young children and pregnancy
  85. Atrovent Nasal Spray
    • Ipratropium nasal
    • Only effective in reducing rhinorrhea
  86. Tessalon
    • Benzonatate
    • 100 to 200 mg PO TID prn
    • Max 600 mg/d
    • avoid in children less than 10
  87. Cheratussin
    • Guaifenesin/codeine
    • Max 120 mg/d of codeine
  88. Cheratussin DAC
    • Cheratussin AC with pseudoephedrine
    • Max 40 ml/d
    • 100mg/10mg/30mg per 5 ml
  89. Phenergan
    • Promethazine
    • CV
    • Max 100 mg per day
  90. Tussionez
    • Chlorpheniramine and hdyrocodone
    • Max 10 ml/day
    • CIII
  91. Bromfed DM
    • Brompheniramine/pseudoephedrine/dextromethorphan 4 mg/60 mg/30 mg per 5 ml
    • Max 20 ml/day
  92. Promethazine DM
    • Dextromethorphan and promethazine
    • max 30 ml/d
  93. Clofera
    • Clophedianol and pseudoephedrine
    • Max 40 ml/day
  94. TOBI
    • Tobramycin inhaled solution
    • Ready to use ampules, store in fridge
    • 300 mg via neb Q12H x 28 days followed by 28 days off cycle
    • Use in patients 6 or greater years old
    • SE: ototox, tinnitus, voice alteration, dizziness, bronchospasm
  95. Cayston
    • Aztreonam Lysine Inhalation Solution
    • Reconstitute with 1ml of sterile diluent
    • 75 mg TID x 28 days, followed by 28 days off cycle
    • SE: allergic reactions, bronchospasm, fever, wheezing, cough, chest discomfort
  96. Pulmozyme
    • Dornase alfa - DNA enzyme produced from Chinese Hamster Ovary cells by recombinant gene therapy
    • SE: chest pain, fever, rash, rhinitis, laryngitis, voice alteration, and throat irritation
    • 2.5 mg via nebulizer once daily
    • Store ampules in fridge
  97. Imodium
    • Loperamide
    • 4 mg after 1st loose stool, then 2 mg after each subsequent stool
    • Don't exceed 16 mg/day
  98. Pepto-Bismol
    • Bismuth subsalicylate
    • 2 tbsp or 2 tabs every 30 to 60 minutes, up to 8 doses/day, max 2 days
    • CI: children with viral infections due to risk of Reye's syndrome
    • SE: black tongue, stool. hearing loss, tinnitus
  99. Lomitil
    • Diphenoxylate 2.5 mg with 0.025 mg atropine 
    • CV
    • 5 mg QID, max 20 mg/day
    • Sedation, constipation, urinary retention, tachycardia, blurred vision, xerostomia, dizziness, depression
  100. Bentyl
    • Dicyclomine
    • 10-20 mg QID max 160 mg/d
    • Take 30 to 60 min before meals
    • Anticholinergic SE
  101. Entocort EC
    • Budesonide
    • 9 mg/d
    • Preferred if disease is in ileum or ascending colon
  102. Apriso, Asacol, Pentasa, and Lialda
    • Long acting oral Mesalamine
    • Oral 1.5 to 4.8 g/d
    • SE: ab pain, N, HA, flatulence, eructation, pharngitis, actue intolerance syndrome
    • Avoid concom. use with antacids, H2RAs, or PPIs
    • Mesalamine better tolerated better than sulfasalazine
    • Asacol and Asacol HD are not interchangeable
  103. Canasa
    Mesalamine suppository
  104. Rowasa
    Mesalamine enema
  105. Azulfidine, Sulfazine
    • Sulfasalazine
    • 2-6 g/d
    • CI: sulfa or salicylate allergy
    • SE: HA, rash, anorexia, dyspepsia, NVD, folate deficiency oligospermia
    • Can cause yellow-orange coloration of skin-urine
    • Impairs folate absorption, give 1 mg/d folate supplement
  106. Azasan and Imuran
    Azathioprine
  107. Purinethol
    6-mercaptopurine
  108. Rheumatrex, Trexall
    Methotrexate
  109. Viagra
    • Sildenafil - PDE5 inhibitor
    • Start at 50 mg 1 hour prior to intercourse
    • In elderly patients, CrCl less than 30, liver impairment, or if on strong 3A4 inhibitors, start at 25 mg
  110. Levitra
    • Vardenafil
    • Start at 10 mg one hour before intercourse
    • With elderly and others, start at 5 mg
  111. Staxyn ODT
    • Vardenafil ODT
    • Staxyn only available as 10 mg ODT which is equal to 10 mg Levitra
  112. Cialis
    • Tadalafil
    • Start at 10 mg, with or without food, taken 1 hour before intercourse or 2.5 to 5 mg daily
    • Decrease dose to 5 to 10 mg with renal or liver impairment
  113. Stendra
    • Avanafil
    • Start at 100 mg, with or without food, 30 minutes prior to intercourse
  114. Hytrin
    • Terazosin - non-selective alpha blocker
    • Non-selective alpha blocker
    • Start at 1 mg, up to 2-10 mg daily, usually at bedtime
  115. Cardura
    • Doxazosin - non selective alpha blocker
    • Non-selective alpha blocker
    • Start 1-2 mg, up to 4-8 mg daily, usually at bedtime
  116. Flomax
    • Tamsulosin - selective alpha 1A blocker
    • Selective alpha blocker
    • 0,4 mg usually but can increase to 0.8
  117. Jalyn
    Tamsulosin + Dutasteride
  118. Uroxatral
    • Alfuzosin - selective alpha 1A blocker
    • 10 mg ER, after same meal daily
    • CrCl less than 30 use with caution
  119. Rapaflo
    • Silodosin - selective alpha 1A blocker
    • 8 mg
    • Cr Cl 30 to 50 4 mg daily
    • CrCl less than 30 CI
  120. Proscar
    • Finasteride - 5 alpha reductase inhibitor
    • 5 mg daily
  121. Propecia
    • Finasteride for hair loss
    • 1 mg daily
  122. Avodart
    • Dutasteride - 5 alpha reductase inhibitor
    • 0,5 mg daily
    • Dutasteride affects both types of 5 alpha receptors, may have better efficacy but not proven
  123. Cialis for BPH
    Tadalafil 5 mg daily

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