Top 200: Spring 2011

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re.pitt
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Top 200: Spring 2011
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2011-05-04 00:57:58
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Spring 2011: Top 200 Drugs
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  1. Major Classes of Medications: Drugs that sensitize the body to insulin and/or control hepatic glucose production?
    -Thiazolidinediones (TZD)

    -Biguanides
  2. Major Classes of Medications: Drugs that stimulate the pancreas to make more insulin?
    -Sulfonylureas

    -Meglitinides

    -DPP-IV Inhibitors

    -Incretin mimetics
  3. Major Classes of Medications: Drugs that slow the absorption of glucose from the gut?
    -Alpha-glucosidase Inhibitors
  4. Major Classes of Medications: Reduces glucose production?
    -DPP-IV Inhibitors

    -Thiazolidinediones (TZD)

    -Biguanides

    -Sulfonylureas (rate)
  5. glyburide
    Brand name(s): Micronase, Glynase, DiaBeta

    Drug Class: Sulfonylureas

    • Adverse Effects:
    • -hypoglycemia
    • -weight gain

    • Other Information:
    • -Sulfonylureas increase endogenous insulin secretion
    • -Reduces rate of hepatic glucose production
    • -Generally the least expensive class of medication
  6. glimeperide
    Brand name(s): Amaryl

    Drug Class: Sulfonylureas

    • Adverse Effects:
    • -hypoglycemia
    • -weight gain

    • Other Information:
    • •Sulfonylureas increase endogenous insulin secretion
    • •Reduces rate of hepatic glucose production
    • •Generally the least expensive class of medication
  7. glipizide
    Brand name(s): Glucotrol, Glucotrol XL

    Drug Class: Sulfonylureas

    • Adverse Effects:
    • -hypoglycemia
    • -weight gain

    • Other information:
    • •Sulfonylureas increase endogenous insulin secretion
    • •Reduces rate of hepatic glucose production
    • •Generally the least expensive class of medication
  8. pioglitazone
    Brand name: Actos

    Drug Class: Thiazolidinediones

    • Adverse Effects:
    • –weight gain
    • –edema
    • –hypoglycemia (if taken with insulin or agents that stimulate insulin release)
    • –contraindicated in patients with abnormal liver function or CHF

    • Other information:
    • •Decrease insulin resistance by making muscle
    • and adipose cells more sensitive to insulin.
    • •Suppress hepatic glucose production.
    • •6 weeks for maximum effect
    • •Improves HDL cholesterol and plasma
    • triglycerides; usually LDL neutral
  9. rosiglitazone
    Brand name: Avandia

    Drug Class: Thiazolidinediones

    • Adverse Effects:
    • –weight gain
    • –edema
    • –hypoglycemia (if taken with insulin or agents that stimulate insulin release)
    • –contraindicated in patients with abnormal liver function or CHF

    • Other information:
    • •Decrease insulin resistance by making muscleand adipose cells more sensitive to insulin
    • •Suppress hepatic glucose production
    • •6 weeks for maximum effect
    • •Improves HDL cholesterol and plasmatriglycerides; usually LDL neutral

    • Warning:
    • Congestive Heart Failure and Myocardial Ischemia
  10. metformin
    Brand name(s): Glucophage, Glucophage XL

    Drug Class: Biguanides

    • Adverse Effects:
    • -Diarrhea and Abdominal Discomfort
    • -Lactic Acidosis if improperly prescribed

    • Other Information:
    • •Decrease hepatic glucose production
    • •Increase insulin-mediated peripheral glucose
    • uptake
  11. repaglinide
    Brand name: Prandin

    Drug Class: meglitinides

    • Adverse Effects:
    • –Hypoglycemia (although may be less than with sulfonylureas if patient has a variable eating schedule)
    • –Weight gain

    • Other Information:
    • •Stimulate insulin secretion (rapidly and for a short duration) in the presence of glucose.
  12. acarbose
    Brand name: Precose

    Drug Class: Alpha-glucosidase Inhibitors

    • Adverse Effects:
    • –Flatulence or abdominal discomfort

    • Patient Education:
    • •Take with food!!

    • Other Information:
    • •Block the enzymes that digests glucose in the
    • small intestine (delays glucose uptake)
  13. miglitol
    Brand name: Glyset

    Drug Class: Alpha-glucosidase Inhibitors

    • Adverse Effects:
    • –Flatulence or abdominal discomfort

    • Patient Education:
    • •Take with food!!

    • Other Information:
    • •Block the enzymes that digests glucose in thesmall intestine (delays glucose uptake)
  14. sitagliptin
    Brand name: Januvia

    Drug Class: Dipeptidyl-Peptidase 4 (DPP4) Inihibitor

    • Adverse Effects:
    • -GI side effects

    • Efficacy:
    • –Decrease fasting blood glucose 10-15 mg/dl
    • –Decrease A1C 0.5-0.6%
    • –Decrease post-prandial glucose 50 mg/dl

    • Other Information:
    • •Stimulates the beta cell to release insulin
    • •Decreases hepatic glucose production
  15. exenatide
    Brand name: Byetta

    Drug Class: Incretin Mimetics

    • Other Information:
    • •Incretin: hormone in the gut which act on the pancreas to increase insulin production
    • •Stimulates pancreas to make more insulin
    • •Increases B-cell growth/replication
    • •Treats type 2 diabetes
    • •Administered SQ
  16. Insulin Aspart
    Brand Name(s): NovoLOG, NovoLOG FlexPen

    Drug Class: Rapid Acting Insulin

    • Patient Education:
    • •Given SQ
    • •Proper injection is KEY
    • •Stored in fridge or at room temperature
    • –Unopened vials kept in fridge until expiration date
    • –Opened vials good at room temp for 30 days
  17. Insulin Glargine
    Brand Name(s): Lantus

    Drug Class: Long Acting Insulin

    • Patient Education:
    • •Given SQ
    • •Proper injection is KEY
    • •Stored in fridge or at room temp
    • –Unopened vials kept in fridge until expiration date
    • –Opened vials good at room temp for 30 days
  18. Insulin Lispro
    Brand Name(s): HumaLOG

    Drug Class: Rapid Acting Insulin

    • Patient Education:
    • •Given SQ
    • •Proper injection is KEY
    • •Stored in fridge or at room temp
    • –Unopened vials kept in fridge until expiration date
    • –Opened vials good at room temp for 30 days
  19. Insulin
    Brand Name(s): Iletin® II Regular Purified Pork

    Drug Class: Insulin

    • Patient Education:
    • •Given SQ
    • •Proper injection is KEY
    • •Stored in fridge or at room temp
    • –Unopened vials kept in fridge until expiration date
    • –Opened vials good at room temp for 30 days
  20. Ibuprofen
    Brand name(s): Motrin, Advil

    Drug Class: NSAID

    • Indications for Use:
    • -Inflammatory disease
    • -Rheumatoid disorders
    • -mild to moderate pain
    • -fever

    • Adverse Effects:
    • -Abdominal pain
    • -Constipation
    • -Indigestion

    • Patient Education:
    • -Take with food or milk
    • -Avoid Aspirin
    • -Adult Max Dose = 3.2 grams per day

    • Patient Dosing:
    • Pediatric dosing:
    • -Approved for use in children 6 months of age and older
    • -Temp <102.5: 5mg/kg/DOSE
    • -Temp >102.5: 10mg/kg/DOSE
    • -Dosed every 6-8 hours
    • -Max dose: 40mg/kg/DAY
    • Adult dosing:
    • -Max adult dose 3.2 grams/day
    • Ibuprofen Dosing Chart for Pediatrics:

    • Ibuprofen Guide to Dosing for Children:
  21. Acetaminophen (APAP)
    Brand name(s): Tylenol

    Drug Class: Analgesic

    Indication for use: Relief of mild to moderate pain and/or fever.

    • Adverse Effects:
    • -rash
    • -anemia

    • Patient Education:
    • -VERY weak COX-1 and COX-2 inhibitor (no significant anti-inflammatory effects)
    • -Ethanol use (increases risk of acetaminophen-induced hepatotoxicity)

    • Patient Dosing:
    • Children < 12 years of age:
    • -10 to 15 mg/kg q4h prn
    • -do not exceed 5 doses (2.6 g) in 24 hours
    • Adults:
    • -325 to 650 mg q4h
    • -1000 mg 3 to 4 times per day
    • -do not exceed 4 g in one day

    APAP Dosing Guide:

  22. Aspirin
    Generic name(s): Aspirin, Acetylsalicylic acid

    • Drug Class: Analgesic, NSAID *Aspirin was the first NSAID
    • Indications for Use:
    • -mild to moderate pain
    • -inflammation
    • -fever
    • -prevention of MI & other cardiac conditions
    • -inhibits prostaglandin synthesis
    • -Debate about adult dosage (81 mg vs. 325 mg)

    • Contraindications:
    • -hypersensitivity
    • -bleeding disorders (e.g. with warfarin)
    • -Children <16 years old should not use Aspirin (association with Reye's syndrome)

    • Pregnancy:
    • -Do not use when pregnant
    • -Crosses placenta & enters fetal circulation
    • -3rd trimester particularly vulnerable because Aspirin may promote premature closure of the ductus areteriosus in the fetus

    • Adverse Effects:
    • -Bleeding (caution dose)
    • -fatigue
    • -rash
    • -abdominal pain

    • Patient Education:
    • -Caution OTCs
    • -Toxic dose causes salicylism (vomiting, vertigo & tinnitus)
  23. Celecoxib
    Brand name(s): Celebrex

    Drug Class: Cox II Inhibitor, NSAID

    Indications for Use: Relief of osteoarthritis and rheumatoid arthritis.

    • Adverse Effects:
    • -GI irritation
    • -Headache

    • Patient Information:
    • Other similar products have been taken off the market due to increased risk of heart attack & stroke.
  24. Meloxicam
    Brand name(s): Mobic

    Drug Class: Analgesic, NSAID

    Indications for Use: Relief of symptoms of Osteoarthritis, Rheumatoid and Juvenile Rheumatoid arthritis

    • Adverse Effects:
    • -Edema
    • -Headache
    • -Dizziness

    • Patient Education:
    • -Take with food or milk
    • -Avoid aspirin
  25. Etodolac
    Brand name(s): Lodine

    Drug Class: NSAID

    Indications for Use: Relief of osteoarthritis and rheumatoid arthritis.

    • Adverse Effects:
    • -Abdominal pain
    • -Constipation
    • -Nausea

    • Patient Education:
    • -Take with food or milk
    • -Avoid Aspirin
  26. Nabumetone
    Brand name(s): Relafen

    Drug Class: NSAID

    Indications for Use: Relief of osteoarthritis and rheumatoid arthritis.

    • Adverse Effects:
    • -Abdominal pain
    • -Constipation
    • -Nausea

    • Patient Education:
    • -Take with food or milk
    • -Avoid Aspirin
  27. Diclofenac Potassium
    Brand name(s): Cataflam

    Drug Class: NSAID

    Indications for Use: Treatment of osteoarthritis, rheumatoid arthritis & pain management.

    • Adverse Effects:
    • -Nausea
    • -Indigestion
    • -Constipation

    • Patient Education:
    • -Take with food or milk
    • -Avoid Aspirin
  28. Diclofenac Sodium
    Brand name(s): Voltaren

    Drug Class: NSAID

    Indications for Use: Relief of osteoarthritis and rheumatoid arthritis.

    • Adverse Effects:
    • -Nausea
    • -Indigestion
    • -Constipation

    • Patient Education:
    • -Take with food or milk
    • -Avoid aspirin
  29. Naproxen
    Brand name(s): Naprosyn

    Drug Class: NSAID

    • Indications for use:
    • -Inflammatory disease
    • -rheumatoid disorders
    • -mild to moderate pain
    • -fever

    • Adverse Effects:
    • -Indigestion
    • -Abdominal pain
    • -Constipation

    • Patient Education:
    • -Take with food or milk
    • -Avoid aspirin
    • -Adult Max Dose = 1200-1650 mg/day
  30. Diphenhydramine
    Brand name(s): Benadryl

    Drug Class: Antihistamine (first generation)

    Indications for use: relief of allergic symptoms; for moderate or severe allergic reaction

    Adverse Effects: drowsiness, dizziness, dry mouth

    • Patient Education:
    • -Enters breast milk
    • -May cause drowsiness, fatigue, diarrhea

    Children's Dosing: 5 mg/kg/day (divided doses q 6-8 hrs)
  31. Meclizine
    Brand name(s): Antivert

    Drug Class:
    Antihistamine (first generation)

    Indications for use:
    motion sickness, vertigo

    Adverse Effects:
    many random symptoms

    • Patient Education: Avoid alcohol
  32. Hydroxyzine
    Brand name(s): Antivert

    Drug Class:
    Antihistamine (first generation)

    Indications for use:
    pruritis (desire to itch), sedation

    Adverse Effects:
    dry mouth, transitory drowsiness

  33. Promethazine
    Brand name(s): Phenergan (also available with Codeine)

    Drug Class: Antihistamine (first generation), Antiemetic, Sedative

    Available Formulations: Table, syrup, suppository, injection

    Indications for use: allergic reactions, sedative, motion sickness, post-operative pain

    Adverse Effects: drowsiness, dizziness, dry mouth

    • Patient Education:
    • -Enters breast milk
    • -May cause drowsiness, fatigue, diarrhea

    • Other information:
    • -Refrigerate suppositories
    • -onset of action for suppositories: 15-30 mins
    • -not for children < 2 years
  34. Fexofenadine
    Brand name(s): Allegra

    Drug Class: Antihistamine (second generation)

    Available formulations: tablet, suspension

    Indications for use: urticaria, seasonal allergic rhinitis

    • Adverse Effects: headache, upper respiratory tract infection, back pain
  35. Desloratidine
    Brand name(s): clarinex

    Drug Class: Antihistamine (second generation)

    Available formulations: tablet, syrup

    Indications for use: urticaria, seasonal allergic rhinitis

    Adverse Effects: dry mouth, somnolence (drowsiness), pharyngitis

    Patient Education: may be taken without regard to meals
  36. Guaifenesin
    Brand name(s): Mucinex

    Drug Class: Expectorant

    Indications for use: loosens phlegm, increases lubrication of lungs, allow for a productive cough and decreased chest congestion

    Adverse Effects: nausea, vomiting, dizziness, headache

    • Patient Education:
    • -Drink water!

    • Other Information:
    • -comes in many dosage forms
  37. Chlorpheniramine & Hydrocodone

    Brand name(s): Tussionex

    Drug Class: Antitussive

    Indications for use: relief of cough

    Adverse Effects: drowsiness, constipation

    • Patient Education:
    • -SHAKE WELL!
    • -Avoid alcohol
    • -could be habit forming
    • -not for children < 6 years old
    • -not for asthmatics

  38. Benzonotate

    Brand name(s): Tessalon or Tessalon Perles

    Drug Class: Antitussive

    Indications for use: relief of cough

    Adverse Effects: headache, constipation, nausea

    • Patient Education:
    • -*LIFE THREATENING RXN with patients allergic to tetracaine or procaine
    • -Do not crush, chew or dissolve
    • -not for children < 10 years old
  39. Codeine (and derivatives)
    Brand name(s): various

    Drug Class: Narcotic; Opiod

    Indications for use: found in many cough products

    Adverse Effects: dizziness, constipation, sedation

    Patient Education: avoid alcohol

    • Other Information:
    • -Binds to opiate receptors in the CNS
    • -causes cough suppression by direct central action in the medulla
    • -produces generalized CNS depression
  40. Cyclobenzaprine
    Brand name(s): Flexeril, Amrix, Fexmid

    Drug Class: muscle relaxant

    • Indications for use: May be used for relief of spasticity in neuromuscular diseases, such as
    • - multiple sclerosis
    • - spinal cord injury
    • - stroke
    • Also used for pain relief in minor strain injuries.

    Adverse Effects: dizziness, drowsiness, dry mouth, fatigue, blurred vision, headache, nervousness, confusion

    Patient Education: avoid alcohol
  41. Carisoprodol
    Brand name(s): Soma

    Drug Class: muscle relaxant

    • Indications for use: May be used for relief of spasticity in neuromuscular diseases, such as:
    • - multiple sclerosis
    • - spinal cord injury
    • - stroke
    • Also used for pain relief in minor strain injuries.

    Adverse Effects: dizziness, drowsiness, headache

    Patient Education: may be taken with meals if GI upset occurs
  42. Metaxalone
    Brand name(s): Skelaxin

    Drug Class: muscle relaxant

    • Indications for use: May be used for relief of spasticity in neuromuscular diseases, such as:
    • - multiple sclerosis
    • - spinal cord injury
    • - stroke
    • Also used for pain relief in minor strain injuries.

    Adverse Effects: nausea, vomiting, GI discomfort, dizziness, drowsiness, headache, nervousness

    Patient Education: avoid alcohol
  43. Tizanidine
    Brand name(s): Zanaflex

    Drug Class: muscle relaxant

    • Indications for use: May be used for relief of spasticity in neuromuscular diseases, such as:
    • - multiple sclerosis
    • - spinal cord injury
    • - stroke
    • Also used for pain relief in minor strain injuries.

    Adverse Effects: dizziness, drowsiness, dry mouth

    Patient Education: may be taken with food or milk if GI upset occurs
  44. Methocarbamol
    Brand name(s): Robaxin

    Drug Class: muscle relaxant

    • Indications for use: May be used for relief of spasticity in neuromuscular diseases, such as:
    • - multiple sclerosis
    • - spinal cord injury
    • - stroke
    • Also used for pain relief in minor strain injuries.

    Adverse Effects: dizziness, drowsiness, nausea

    • Patient Education:
    • -may be taken with meals if GI upset occurs
    • -avoid alcohol
  45. Donepezil
    Brand name(s): Aricept

    Drug Class: Acetylcholinesterase Inhibitor

    Indications for use: Alzheimer's Dementia

    Adverse Effects: insomnia, nausea, diarrhea

    • Patient Education:
    • -will not cure disease
    • -typically tritrated after 4-6 weeks
  46. Memantine
    Brand name(s): Namenda

    Drug Class: glutamate or N-Methyl-D-Aspartate (NMDA) Receptor Antagonist

    Indications for use: Alzheimer's Dementia

    Adverse Effects: cardiovascular and central nervous system effects, many others

    • Patient Education:
    • - will not cure disease
    • - typically tritrated after 4-6 weeks
  47. Sumatriptan
    Brand name(s): Imitrex

    • Drug Class: Antimigraine, Serotonin 5-HT1B, 1D Receptor Agonist
    • Indications for use: migraines
    • Available dosage forms: oral, nasal, injection

    Adverse Effects: abnormal sensations (tingling, warmth/burning, pressure, etc.), dizziness, muscle weakness

    • Patient Education:
    • -Do not exceed dosage!
    • -Do not exceed two doses in 24 hours!

    • Other Information:
    • -comes in tablet or nasal spray dosage forms
  48. rizatriptan
    Brand name(s): Maxalt

    Drug Class: Antimigraine, Serotonin 5-HT1B, 1D Receptor Agonist

    Indications for use: migraine, with or without aura

    Available dosage forms: tablet

    • Adverse Effects: asthenia (lack of energy), dizziness, drowsiness
  49. naratriptan
    Brand name(s): Amerge

    Drug Class: Antimigraine, Serotonin 5-HT1B, 1D Receptor Agonist

    Indications for use: migraine, with or without aura

    Available dosage forms: tablet

    Adverse Effects: GI upset, nausea, neurological

    Patient Education: do not take if pregnant
  50. zolmitriptan
    Brand name(s): Zomig

    Drug Class: Antimigraine, Serotonin 5-HT1B, 1D Receptor Agonist

    Indications for use: migraine, with or without aura

    Available dosage forms: tablet, orally disintegrating tablet, nasal spray

    • Adverse Effects: abnormal pain, pressure and temperature sensations, GI upset
  51. almotriptan
    Brand name(s): Axert

    Drug Class: Antimigraine, Serotonin 5-HT1B, 1D Receptor Agonist

    Indications for use: migraine, with or without aura

    Available dosage forms: tablet

    • Adverse Effects: nausea, paresthesia (abnormal sensations), dry mouth
  52. omeprazole
    Brand name(s): Prilosec

    Drug Class: Proton Pump Inhibitor (PPI); gastric antisecretory

    Indications for use:

    Adverse Effects:

    Patient Education:
  53. Esomeprazole
    Brand name(s): Nexium

    Drug Class: Proton Pump Inhibitor (PPI); gastric antisecretory

    Indications for use:

    Adverse Effects:

    Patient Education:
  54. Lansoprazole
    Brand name(s): Prevacid

    Drug Class: Proton Pump Inhibitor (PPI); gastric antisecretory

    Indications for use:

    Adverse Effects:

    Patient Education:
  55. Pantoprazole
    Brand name(s): Protonix

    Drug Class: Proton Pump Inhibitor (PPI); gastric antisecretory

    Indications for use:

    Adverse Effects:

    Patient Education:
  56. Rabeprazole
    Brand name(s): Aciphex

    Drug Class: Proton Pump Inhibitor (PPI); gastric antisecretory

    Indications for use:

    Adverse Effects:

    Patient Education:
  57. Ranitidine
    Brand name(s): Zantac

    Drug Class: H2 antagonist; gastric antisecretory

    Indications for use:

    Adverse Effects:

    Patient Education:
  58. Famotidine
    Brand name(s): Pepcid

    Drug Class: H2 antagonist; gastric antisecretory

    Indications for use:

    Adverse Effects:

    Patient Education:
  59. Promethazine
    Brand name(s): Phenergan (also available with codeine)

    Drug Class: Antiemetic, Antihistamine (first generation), Sedative, H1 antagonist, anticholinergic

    Available formulations: tablet, syrup, suppository, injection (PO, IR, IM) *IV not recommended because of extravasation

    Indications for use: allergic reactions, sedative, motion sickness, post-operative pain

    Adverse Effects: drowsiness, dizziness, dry mouth

    Patient Education: refrigerate suppositories, onset of action is 15 to 30 minutes, not for children < 2 years old
  60. Ondansetron
    Brand name(s): Zofran

    Drug Class: 5-HT3 (Serotonin) antagonist

    Available formulations: PO, IV

    • Indications for use: commonly used for chemotherapy-induced nausea and vomiting
  61. Metoclopramide
    Brand name(s): Reglan

    Drug Class: Pro-motility agent; Antiemetic

    Mechanism of Action: dopamine antagonist

    • Indications for use: GERD, nausea/vomiting, gastroparesis (paralysis of the stomach
    • due to damage of nerve damage in gut)

    Common Adverse effects: somnolence (drowsiness), weakness

    Rare Adverse effects: tardive dyskinesia (involuntary repetitive body movements), neuroleptic malignant syndrome
  62. Alendronate
    Brand name(s): Fosamax

    Drug Class: bisphosphonates

    Indications for use: prevention & treatment of osteoporosis (first line)

    Adverse Effects: heartburn, indigestion, jaw bone pain

    Patient Education: MUST follow proper administration technique: Take first thing in the morning, Take with a full glass of water, Nothing other than water should be taken within 30 minutes, Remain sitting up right or in a standing position for at least 30 minutes

    Other Information: Inhibit osteoclast activity and reduce bone resorption and turnover; long half-life; treatment of osteoporosis in men; combination tablet with vitamin D available; avoid in renal insufficiency
  63. Risedronate
    Brand name(s): Actonel

    Drug Class: bisphosphonates

    Indications for use: prevention & treatment of osteoporosis (first line)

    Adverse Effects: heartburn, indigestion, jaw bone pain

    Patient Education: MUST follow proper administration technique: Take first thing in the morning, Take with a full glass of water, Nothing other than water should be taken within 30 minutes, Remain sitting up right or in a standing position for at least 30 minutes

    • Other Information: Inhibit osteoclast activity and reduce bone resorption and turnover; long half-life; treatment of osteoporosis in men; avoid in renal insufficiency
  64. Ibandronate
    Brand name(s): Boniva

    Drug Class: bisphosphonates

    Indications for use: prevention & treatment of osteoporosis (first line)

    Adverse Effects: heartburn, indigestion, jaw bone pain

    • Patient Education: MUST follow proper administration technique: Take first thing in the morning, Take with a full glass of water, Nothing other than water should be taken within 30 minutes, Must not eat and remain sitting up right or in a standing position for at least 60 minutes after dose
    • Other Information: Inhibit osteoclast activity and reduce bone resorption and turnover; long half-life; PO or IV available; APAP given at time of IV treatment; avoid in renal insufficiency; for women only
  65. Raloxifene
    Brand name(s): Evista

    Drug Class: Selective Estrogen Receptor Modulator (SERM)

    Indications for use: osteoporosis (second line), breast cancer, hormone replacement therapy

    Adverse Effects: Hot flashes, night sweats, leg cramps, blood clots

    Patient Education: estrogen-like activity on the bones
  66. Conjugated Estrogens
    Brand name(s): Premarin

    Drug Class: Estrogen derivative

    Indications for use: Hormone replacement therapy; menopause

    Adverse Effects: Vaginal bleeding, venous thromboembolism, stroke

    Contraindications: In women with a uterus, unopposed estrogen increases risk of endometrial cancer; Estrogen derivatives are contraindicated in women with a history of breast cancer
  67. Ethinyl Estradiol/Drosperinone
    Brand name(s): Yaz®, Yasmin® *Ocella®

    Drug Class: oral contraceptive

    Indications for use: Prevent pregnancy, Regulate menstrual cycles, Treat acne

    Adverse Effects: many

    • Other information:
    • •Anti-mineralcorticoid activity
    • •Avoid use in renal/adrenal insufficiency
    • prevents ovulation (98-99% effective); alters endometrial lining
  68. Ethinyl Estradiol/Norgestimate
    Brand name(s): *TriNessa®, Ortho® Tri-Cyclen® (Lo)

    Drug Class: oral contraceptive

    Indications for use: Prevent pregnancy, Regulate menstrual cycles, Treat acne

    Adverse Effects: many

    Patient Education: prevents ovulation (98-99% effective); alters endometrial lining
  69. Ethinyl Estradiol/ Norethindrone
    Brand name(s): *Loestrin 24 FE®, Necon 7/7/7®

    Drug Class: oral contraceptive

    Indications for use: Prevent pregnancy, Regulate menstrual cycles, Treat acne

    Adverse Effects: many

    Patient Education: prevents ovulation (98-99% effective); alters endometrial lining
  70. Ethinyl Estradiol/ Etonogestrel
    Brand name(s): *NuvaRing®

    Drug Class: contraceptive

    Indications for use: birth control; prevents ovulation

    Adverse Effects: many

    • Patient Education:
    • •Inserted every 3 wks on day 1 of cycle
    • •Use back up contraception if removed > 3 hrs
  71. Tolterodine
    Brand name(s): Detrol LA

    Drug Class: antimuscarinic

    Indications for use: Urinary Incontinence (UI)

    Available formulations: administer once (ER) or twice (IR) daily

    Adverse Effects
    : dry mouth, headache, constipation, blurred vision, dizziness

    Other information
    : increased selectivity for M3 bladder receptors (vs. M2 salivary glands); dose reductions may be necessary in hepatic or renal insufficiency

    Patient Education: decreases urge, decreases urination, decreases bladder contractions and detrusor pressure, decreases incomplete voiding, may take 6 weeks or more (several months) to see full effect
  72. Tamsulosin
    Brand name(s): Flomax

    Drug Class: alpha-1 adrenergic blocker antagonist

    Indications for use: Benign Prostatic Hyperplasia (BPH)

    Administration: may be used alone or in combination with 5-alpha reductase inhibitor; combination therapy results in increased urine flow rate

    Adverse Effects: Orthostatic hypotension, dizziness,weakness, libido, insomnia, rhinitis, abnormal ejaculations, ejaculatory problems,intraoperative floppy iris syndrome

    Patient Education: Administer 30 minutes after the same meal each day. Generic now available!
  73. Finasteride
    Brand name(s): Proscar

    Drug Class: 5 alpha reductase inhibitor

    Indications for use: Benign Prostatic Hyperplasia (BPH)

    • Administration: Treatment of symptomatic BPH alone or with an α-adrenergic blocker (usually Doxazosin) Combination therapy resulted in ↑ symptom relief and ↑ urine flow rate
    • Adverse Effects: Erectile dysfunction, ↓ libido, ↑breast size/tenderness, rash

    Patient Education: decreases prostate size; Pregnancy Category X
  74. Sildenafil
    Brand name(s): Cialis

    Drug Class: Phosphodiasterase (PDE) 5 Inhibitor

    • Mechanism of Action: PDE5 is inhibited so that cGMP can act longer by causing increased blood flow to the penis. Nitric Oxide, which causes smooth muscle relaxation necessary for an erection is released from NANC = Nonadrenergic/Noncholinergic Neurons.
    • Indications for use: Erectile Dysfunction (ED)

    Adverse Effects: headache, flushing, dyspepsia, rhinitis, impaired color discrimination, dizziness, hypotension, Cardiovascular effects, sudden hearing loss

    Patient Education: contraindicated with nitrates; use caution with alpha blockers and some antibiotics/antifungals; grapefruit juice may increase plasma concentrations of drug; take without food 30 to 60 minutes before intercourse; use up to once daily; avoid high fat foods because they increase total max concentration

    Other information: duration of about 4 hours
  75. Tadalafil
    Brand name(s): Cialis

    Drug Class: Phosphodiasterase (PDE) 5 Inhibitor

    Indications for use: Erectile Dysfunction (ED)

    • Mechanism of Action: PDE5 is inhibited so that cGMP can act longer by causing increased blood flow to the penis. Nitric Oxide, which causes smooth muscle relaxation necessary for an erection is released from NANC = Nonadrenergic/Noncholinergic Neurons. .
    • Adverse Effects: headache, flushing, dyspepsia, rhinitis, impaired color discrimination, dizziness, hypotension, Cardiovascular effects, sudden hearing loss

    Patient Education: contraindicated with nitrates; caution with alpha blockers and some antibiotics/antifungals; grapefruit juice may increase plasma concentrations of drug; take with or without food 30 minutes before intercourse; use up to once daily; avoid high fat foods because they increase total max concentration to 2 hours

    Other information: duration of 24-36 hours
  76. Zolpidem, Zolpidem (CR)
    Brand name(s): Ambien, Ambien CR

    Drug Class: Sedative

    Indications for use: Insomnia

    Adverse Effects: headache, drowsiness, nausea

    Patient Education: do not crush or chew; may be habit forming; avoid alcohol
  77. Eszopiclone
    Brand name(s): Lunesta

    Drug Class: Sedative

    Indications for use: Insomnia

    Adverse Effects: drowsiness, headache, unpleasant taste sensation

    Patient Education: preferably take on empty stomach; high fat meals may delay onset of action; may be habit forming
  78. Latanoprost
    Brand name(s): Xalatan

    Drug Class: Glaucoma

    Indications for use: Glaucoma

    Adverse Effects: blurred vision, burning/stinging, foreign body sensation

    Patient Education: Store unopened bottle in refrigerator; Once opened, store in a cool place away from light for up to 6 weeks
  79. Travoprost
    Brand name(s): Travatan, Travatan Z

    Drug Class: Glaucoma

    Indications for use: Glaucoma

    Adverse Effects: hyperemia, decreased visual acuity, eye discomfort, pruritis

    Patient Education: Teach how to instill drops correctly; drops may tint iris brown; may increase eyelash growth
  80. Brimonidine Tartrate
    Brand name(s): Alphagan P

    Drug Class: Glaucoma

    Indications for use: Glaucoma

    Adverse Effects: Allergic conjunctivitis, conjunctival hyperemia, eye pruritis

    Patient Education: Teach how to instill drops correctly
  81. Moxifloxacin HCl (ophthalmic)
    Brand name(s): Vigamox

    Drug Class: ophthalmic antibiotic

    Indications for use: Conjunctivitis

    Adverse Effects: eye irritation, decreased visual acuity, dry eyes

    Patient Education: complete full course of therapy; cannot wear contact lenses
  82. Gatifloxacin (ophthalmic)
    Brand name(s): Zymar

    Drug Class: ophthalmic antibiotic

    Indications for use: Conjunctivitis

    Adverse Effects: conjunctival irritation, tearing, inflammation

    Patient Education: contraindicated with quinolones; complete full course of therapy; cannot wear contact lenses
  83. Olopatadine HCl (ophthalmic)
    Brand name(s): Patanol, Pataday

    Drug Class: ophthalmic anti-allergy

    Indications for use: Conjunctivitis

    Adverse Effects: headache, asthenia, blurred vision

    Patient Education: do not wear contact lenses if eye is red
  84. Methylprednisolone
    Brand name(s): Medrol

    Drug Class: Anti-inflammatory, Corticosteroid

    Indications for use: Autoimmune disorders

    Adverse Effects: many side effects, such as blurred vision, upset stomach, nausea & vomiting, etc.

    Patient Education: Do not discontinue abruptly; Take with food
  85. Dexamethasone (oral)
    Brand name(s): Decadron

    Drug Class: Anti-inflammatory, Corticosteroid

    Indications for use: Autoimmune disorders

    Adverse Effects: many side effects, such as blurred vision, upset stomach, nausea & vomiting, etc.

    Patient Education: Do not discontinue abruptly; Take with food
  86. Sterapred or Deltasone
    Brand name(s): Prednisone

    Drug Class: Anti-inflammatory, Corticosteroid

    Indications for use: Autoimmune disorders

    Adverse Effects: many side effects, such as blurred vision, upset stomach, nausea & vomiting, etc.

    Patient Education: Do not discontinue abruptly; Take with food
  87. Warfarin
    Brand name(s): Coumadin

    Drug Class: Anticoagulant, Vitamin K Antagonist

    Indications for use: prevention & treatment of thrombosis

    Adverse Effects: bleeding, skin necrosis

    Patient Education:

    Other Information: Dosed daily, drug/food interactions, monitor INR closely, Pregnancy Category X
  88. Heparin
    Brand name(s): Hep-Lock

    Drug Class: Anticoagulant, Thrombin & Factor Xa Inhibitor

    Indications for use: prophylaxis/treatment of thrombosis

    Adverse Effects: bleeding, heparin-induced thrombocytopenia (HIT)

    Patient Education:

    Other Information: Does NOT enter breast milk

    Antidote: Protamine
  89. Enoxaparin
    Brand name(s): Lovenox

    Drug Class: Anticoagulant

    Indications for use:

    Adverse Effects:

    Patient Education:
  90. Clopidogrel
    Brand name(s): Plavix

    Drug Class: Antiplatelet

    Indications for use: prophylaxis of thrombosis

    Adverse Effects: bleeding, neutropenia

    Mechanism of Action: Irreversibly inhibits the binding of ADP on platelet receptor; ADP induces platelet aggregation

    Other Information: often used WITH aspirin
  91. START HERE
    Brand name(s):

    Drug Class:

    Indications for use:

    Adverse Effects:

    Patient Education:

    Other Information:

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