Naplex 9

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bblapham
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229553
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Naplex 9
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2013-08-13 14:59:09
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  1. Ditroptan
    • Oxybutynin - antimuscarinic
    • Also available as a patch and gel
    • 5 mg PO BID to TID
    • Patch is dosed 3.9 mg daily applied 2x/week
    • SE: dry mouth, constipation, dry eyes/blurred vision, urinary retention, drowsiness (especially with oxybutynin and tolterodine)
  2. Oxytrol
    • Oxybutynin patch
    • Changed twice weekly, apply on abdomen, hips or buttocks, causes less dry mouth and constipation than oral form
  3. Gelnique
    Oxybutynin topical
  4. Detrol
    • Tolterodine IR 1-2 mg PO BID
    • Tolterodine ER 2-4 mg PO daily
  5. Sanctura
    • Trospium
    • 20 mg BID or 60 mg XR daily, take on empty stomach
  6. Vesicare
    • Solifenacin
    • 5 to 10 mg PO daily
  7. Enablex
    • Darifenacin
    • 7.5 to 15 mg PO daily
    • May cause most constipation
  8. Toviaz
    • Fesoterodine
    • 4-8 mg PO daily
  9. Myrbetriq
    • Mirabegron - activates beta 3 receptors which increases bladder capacity
    • SE: HTN, nasopharyngitis, UTI, HA
    • 25-50 mg daily
    • Reduce dose with reduced CrCl
  10. Opthalmic Beta Blockers Effects
    Nonselective, reduce aqueous humor production
  11. Timoptic and Timoptic XE
    • Timolol opth is QD or BID
    • Timolol XE is a gel used QD
  12. Betagan
    Levobunolol opth
  13. Ocupress
    Carteolol opth
  14. OptiPranolol
    Metipranolol
  15. Betoptic, Betoptic S
    Betaxolol
  16. Prostaglandin Analogs Effects
    Increase aquoues outflow
  17. Travatan Z
    • Travoprost - prostaglandin analog
    • Travatan X doesn't contain benzalkonium chloride but has different preservative
  18. Lumigan
    Bimatoprost - prostaglandin analog
  19. Latisse
    Bimotoprost opth indicated for eyelash hypotrichosis
  20. Xalatan
    • Latanoprost - prostaglandin analog
    • Keep unopened bottles in fridge
  21. Zioptan
    • Tafluprost - comes in foil pouches of 10 single use containers
    • Keep refrigerated
  22. Miotics Effects
    Increase aqueous outflow
  23. Isopto, Miostat
    Carbachol - miotic
  24. Isopto Carpine
    Pilocarpine - miotic
  25. Carbonic Anhydrase inhibitor Effect
    Reduce aqueoue humor production
  26. Diomax
    • Acetazolamide
    • 250 to 500 mg oral 1-4x daily
  27. Azopt
    • Brinzolamide
    • TID
  28. Trusopt
    • Dorzolamide
    • TID
  29. Cosopt
    Dorzolamide/Timolol
  30. Adrenergics opth effect
    Increase aqueoue outflow and decrease production
  31. Iopidine
    • Apraclonidine TID
    • Adrenergic
  32. Alphagan P
    • Brimonidine TID
    • Adrenergic
  33. Propine
    • Dipivefrin
    • Adrenergic
  34. Combigan
    Brimonidine + Timolol
  35. Alpha blocker ocular SE
    Floppy iris syndrome causing difficulty in cataract surgery
  36. Amiodarone ocular SE
    Corneal deposits, optic neuropathy
  37. Bisphosphonates ocular SE
    Ocular inflammation
  38. Digoxin ocular SE
    Yellow/green vision, blurriness, halos
  39. Ethambutol ocular SE
    Optic neuropathy especially with chronic use
  40. Linezolid ocular SE
    Optic neuropathy, especially with chronic use
  41. Plaquenil ocular SE
    retinopathy
  42. Isoniazid ocular SE
    Optic neuritis
  43. Isotretinoin ocular SE
    decrease in night vision which may be permanent, dry eyes/irritation
  44. Quinolones ocular SE
    Retinal detachment
  45. Viagra ocular SE
    greenish tinge around objects, possible permanent vision loss in one or both eyes, also hearing loss
  46. Tamoxifen ocular SE
    corneal changes, decreased color perception
  47. Telithromycin ocular SE
    blurry vision, diplopia
  48. VFEND ocular SE
    abnormal vision, color vision change, photophobia
  49. Zaditor, Alaway
    Ketotifen
  50. Naphcon, Opcon, Visine
    Naphazoline/pheniramine
  51. Xyzal opth
    Levocetirizine
  52. Emadine
    Emedastine
  53. Acular opth
    Ketorolac
  54. Alomide
    Lodoxamine - mast cell stabilizer
  55. Alocril
    Nedocromil - mast cell stabilizer
  56. Alamast
    Pemirolast - mast cell stabilizer
  57. Optivar
    Azelastine-mast cell stabilizer and antihistamine
  58. Elestat
    Epinastine - mast cell stabilizer and antihstamine
  59. Patanol
    Olopatadine - antihistamine and mast cell stabilizer
  60. Alrex
    Loteprednol opth
  61. Lotemax
    Loteprednol opth
  62. Restasis
    • Cyclosporine Emulsion Eye Drops
    • 1 drop to each eye BID
    • Open one pack per use
  63. Azasite
    Azithromycin opth - stored in refrigerator, 14 days at room temp
  64. Vigamox
    Moxifloxacin opth
  65. Besivance
    Besifloxacin opth
  66. Antiobiotic/steroid opth
    Tobramycin/dexamethasone
  67. Ciloxan
    Ciprofloxacin opth
  68. Ocuflox
    Ofloxacin opth
  69. Garamycin
    Gentamicin opth
  70. Tobrex
    Tobramycin opth
  71. Polytrim
    trimethoprim/polymyxin
  72. Bleph-10
    sulfacetamide
  73. Sulamyd
    Sulfacetamide
  74. Neosporin
    Neomycin, bacitracin, polymyxin
  75. Auralgan
    Antipyrine and benzocaine otic
  76. A/B Otic
    Antipyrine and benzocaine otic
  77. Americaine Otic
    Benzocaine otic
  78. Cipro HC
    Ciprofloxacin and hydrocortisone
  79. Ciprodex
    Ciprofloxacin and dexamethasone
  80. FLoxin
    Ciprofloxacin Otic
  81. Cortisporin-TC
    Neomycin and hydrocortisone
  82. Debrox
    Carbamide peroxide
  83. Cerumenex
    Triethanolamine
  84. Anticonvulsants Pregnancy D category (6)
    • (Carbamazepine, clonazepam, phenobarbital, phenytoin, topiramate, and valproate)
    • Valproate has highest risk of fetal harm
    • All other AEDs are pregnancy category C
  85. AEDs that are strong inducers (7)
    Carbamazepine, oxcarbazepine, primidone, phenobarbital, phenytoin, and topiramate
  86. Anticonvulsants with modest weight loss (3)
    Topiramate, Zonisamide, levetiracetam
  87. Klonopin for Seizures
    • Clonazepam - enhanced activity of GABA
    • Available: tablet, ODT
    • 0.5 BID to TID
    • Max 20/day
    • Somnolence, dizziness/ataxia, drooling, cognitive impairment, depression, mood changes, physiological dependence, tolerance
  88. Onfi for Seizures
    • Clobazam
    • Available: tablet
    • less than 30 kg 5 daily, max 10
    • more than 30 kg 10 daily max 20
  89. Tegretol for Seizures
    • Carbamazepine - fast NA channel blocker
    • Inital 200 mg BID, daily if XR
    • Max 1600 mg/day
    • Therapeutic range: 4-12 mcg/ml
    • Available: capsule, tablet, suspension
    • BBW: serious skin reactions, test for HLAB1502, fatal blood cell abnormalities
    • SE: N/V, dizzy, drowsy, rare - serious skin reactions, hepatotoxicity, SIADH, vit D and Ca deficiency
  90. Carbatrol
    Carbamazepine
  91. Epitrol
    Carbamazepine
  92. Equetro
    Carbamazepine for bipolar
  93. Zarontin
    • Ethosuximide - T type calcium channel blocker
    • Initial 250 mg BID
    • Max 1500 mg/day
    • DOC for absence
    • Available: capsule, solution
  94. Luminal
    • Phenobarbital - enhances GABA mediated chloride influx CIV
    • Available: tablet, solution, injection
    • Initial 1-3 mg/kg/day
    • Max 300 mg/day
    • Therapeutic range 20-40 mcg/ml in adults, 15 to 30 mcg/ml in children
    • SE: Major sedation, cognitive impairment, dizziness/ataxia, dependence, tolerance
  95. Mysoline
    Primidone - prodrug of phenobarbital
  96. Dilantin
    • Phenytoin - fast sodium channel blocker
    • Michalis Mentin kinetics
    • If albumin is low, the true phentoin levels will be higher than it appears
    • Enteral feedings may decrease phenytoin absorption, must separate
    • IV to oral: 1 to 1
    • SE: chronic therapy - gingival hyperplasia, lupus-like syndrome, connective tissue disorder, hirsutis,, peripheral neuropathies, vit D and cal deficiency
    • Toxic sx: ataxia/slurred speech, nystagmus, blurred vision, diplopia, lethary, HA, drowsiness
    • SErious adverse affects: skin reaction, purple glove syndrome
    • See menumonic
    • Mix injection in NS only, max infusion rate 50 mg/min
    • Available: capsules, tablts, suspensions, injections
    • Initial 100 mg TID
    • Max 600 mg/day
  97. Fospheytoin
    • Pro-drug of phenytoin IV or IM
    • I mg PE = 1 mg PHT
    • Max 150 mg PE/min
    • Can mix in NS or D5W
  98. Depakote
    • Divaloproex - T type calcium channel blocker an fast sodium channel blocker
    • Sodium valproate and valproic acid in a 1:1 ratio
    • Depakote - delayed release tablet
    • Depakote ER - ext release tablet
    • Depakote Sprinkle
    • Can increase lamotrigine levels
    • See valproic acid for SE
  99. Depakene
    Valproic acid - capsules, solution
  100. Stavzor
    • Valproic Acid
    • Delayed release capsules
  101. Depacon
    • Valproic acid IV
    • Initial 125 to 250 mg BID
    • Max 60 mg/k/day
    • Range 50 to 100 mcg/ml
    • If albumin is low, true valproate level may be higher
    • BBW: hepatic failure, teratogen neural tube defects, pancreatitis
    • SE: GI, ab painm dizziness, asthenia, alopecia (treat with selenium and zinc), somnolence, tremor, weight gain, polysystic ovary syndrome, thrombocytopenia, vit D an cal deficiency
  102. Lamictal
    • Lamotrigine - inhibits release of glutamate and aspartate
    • Dosing: slow taper, being with 25 mg/day x 2 weeks, then 50 mg/day x 2 weeks, increase by 50 mg every 1 to 2 weeks, may have to titrate deifferently based on co-meds (carbamazepine, phenytoin, valproate, phenobarbital, primidone)
    • BBW: serious skin reactions
    • SE: N, sleepy, dizzy, diplobia, blurred vision, ataxia, rash, increased risk of aseptic meningitis
    • Available: tablet
  103. Keppra
    • Levetiracetam
    • Max 3000 daily
  104. Trileptal
    • Oxcarbazepine
    • Hyponatremia, more common with oxcarbazepine
    • Max 2400 mg daily
    • Carbazepine: oxcarb dose conversion: 1.2-1.5x carbamazepine dose
  105. Lyrica
    • Pregabalin¬†
    • CV
    • Initial 75 mg BID
    • Max 450 mg/day
    • Decrease dose if CrCl less than 60
  106. Neurontin
    • Gabapentin
    • Max 3600 mg/day
    • Decrease dose if interval less than 60
  107. Topamax
    • Topiramate
    • Decrease dose if CrCl less tha 70
    • Rare side effects: oligohydrosis, hyperthemia, nephrolithiasis (kidney stones)
  108. Zonegran
    • Zonisamide
    • Initiall 100 daily, max 400 daily
    • Don't use if CrCl less than 50
    • Rare SE: oligohydrosis, nephrolithiasis, serious skin reactions
    • Don't use if allergic to sulfonamides
  109. Potiga
    • Ezogabine
    • Initial 100 mg TID
    • Max 1200 daily
  110. Felbatol
    • Felbamate
    • Initial 1200 mg daily divded TID to QID and reduce concomitant AED dose by one-third
    • BBW: hepatic failure and aplastic anemia
  111. Vimpat
    • Lacosamide CV
    • Initial 50 mg BID
    • max 400 daily
    • Decrease if CrCl less than 30
    • Prolongs PR interval, get ECG before therapy starts
  112. Banzel
    • Rufinamide
    • Initial 200 to 400 mg BID
    • Max 3200 mg daily
    • QT shortening
  113. Gabitril
    • Tiagabine
    • Initial 4 mg daily
    • Max 56 mg daily
  114. Sabril
    • Vigabatrin
    • Intial 500 mg BID
    • Max 3000 mg daily
    • ONly available through SHARE progrma
    • BBW: can cause permanent vision loss
  115. Fycompa
    • Perampanel
    • Initial 2 mg QHS
    • Max 12 mg/day
  116. Interferons for MS (3)
    • Have antiviral and antiproliferative effects
    • Avonex, Rebif, and Betaseron or Extavia
    • SE: flu like reactions, injection site reactions, depression/suicide
  117. Avonex
    • Interferon beta-1a
    • 30 mcg weekly
    • Powder for reconstitution, pre-filled syringes and pens - refrigerate
  118. Rebif
    • Interferon beta-1a
    • SC: 22 mcg or 44 mcg three times weekly
    • Pre-filled syringes--refrigerate
  119. Betaseron
    • Interferon beta 1b
    • SC: 0.25 mg every other day
    • Power (for reconstitution) store at room temperature
  120. Extavia
    • Interferon beta 1b
    • SC: 0.25 mg every other day
    • Power (for reconstitution) store at room temperature
  121. Copaxone
    • Glatiramer aceate - immune modulator
    • 20 mg SC daily, single use syringe, referigerate
    • INjection site reactions vasodilation, rash dyspnea, etc.
  122. Tysabri
    • Natalizumab - recombinant humanized monoclonal antibody
    • 300 mg IV given over 1 hour every 4 weeks
    • Can cause progressive mutifocal leukoencephalopathy
  123. Gilenya
    • Fingolimod - oral immune modulator
    • 0.5 mg capsule daily with or without food
    • SE: decrease in heart rate, mascular edema, increase in infections, decrease in pulmonary function tests, increase in LFTs
  124. Aubagio
    • Teriflunomide - prymidine synthesis inhibitor
    • Active metabolite of lefluonmide
    • 7 mg or 14 mg daily
    • BBW: severe liver tox and teratogenicity
  125. Ampyra
    • Dalfampridine - K channel blocker, may increase nerve signal conduction
    • 10 mg BID Ext Rel tablets

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