Pharmacology

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sandrabdunning
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Pharmacology
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2011-07-27 22:05:23
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pharmacology physician assistant sandy
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Drugs from rotation 1
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  1. Effexor
    Venalfaxine, an SNRI.
  2. Pristiq
    Desvenlafaxine, an SNRI
  3. Cymbalta
    Duloxetine, an SNRI. Used in fibromyalgia and with DM pts or chronic pain or who have neuropathy
  4. Savella
    Milnacipran, an SNRI.
  5. Meridia
    Sibutramine, an SNRI
  6. Zoloft
    Sertraline, an SSRI. Can increase synthroid needs in hypothyroid pts because of "upper" characteristics.
  7. Prozac
    Fluoxetine, SSRI.
  8. Celexa
    Citalopram, SSRI
  9. Lexapor
    Escitalopram, SSRI
  10. Paxil
    Paroxetine, SSRI
  11. Luvox
    Fluvoxamine, SSRI
  12. Lyrica
    Pregabalin. Used for fibromyalgia and other neuropathic pain disorders. A derivitive og gabapentin (Neurontin), so it can cause weight gain as well.
  13. Remeron
    Mirtazapine, an odd TCA. Used for treating anxiety/ depression AND used for appetite stimulant, antiemetic, insomnia (hypnotic). Causes wt gain and sedation, so taken QHS usually.
  14. Reglan
    Metaclopramide. Antiemetic and gastroprokinetic agent; used to treat n/v IV in hospital, to facilitate gastric emptying in patients with gastroparesis (s/p bariatric surg or for DM), and as a treatment for migraine headaches.
  15. Vitorin
    • Simvistatin (Zocor) AND Ezetimibe (Zetia). Statin plus "other" anti-cholesterol drug (Zetia is a drug that lowers cholesterol. It acts by decreasing cholesterol absorption in the intestine).
    • *** Statins are NEVER used in erythromycin, so if they have gastroporesis and need something, use Reglan instead of erythromycin.
  16. Zetia
    Ezetimibe is a drug that lowers cholesterol. It acts by decreasing cholesterol absorption in the intestine. Can be taken alone, or with a statin (as in Vitorin, with simvistatin)
  17. Premarin
    Compound HRT consisting primarily of conjugated estrogens; often referred to as CEE, for conjugated equine estrogens. Isolated from mare'surine (PREgnantMARes' urINe). Converted to estradiol, an active estrogen normally found in women, thus useful in perimenopause for treatment of hot flashes.
  18. Solumedrol
    METHYLPREDNISOLONE SODIUM SUCCINATE; injection for adrenal insufficiency pts, like glucagon for DM pts.
  19. Metformin
    • Biguinimide class DM drug. 1st line for new DM II pts.
    • ***Careful with renal dz bc renally cleared. If GFR < 60, beware.
    • Max dose is 2000mg, which is our goal in all DM pts, no more, no less. GI disturbance is #1 SE.
    • MOA: suppression of hepatic glucose output by inhibiting gluconeogenesis. Also increased glucose transport into muscles.
    • Plays nicely with insulin.
    • Can decrease trigs, causes wt loss! (good for PCOS as well)
  20. Sulfasalazine
    SSZ. Anti-inflammatory used to treat IBS and RA. Bad SE is thrombocytopenia.
  21. Triamterene
    Dyrenium. K spring diuretic, often used with HCTZ for HTN and edema. Have to watch for hyperkalemia with repeat labs.
  22. Sprionolactone
    • Aldactone. K spraing diuretic, have to monitor for hyperkalemia with labs. Weak diuretic on its own, often combine with HCTZ.
    • Also used in PCOS because it blocks conversion of androgens.
  23. Armour
    Dessicated procine thyroid extract. Mixed T3/T4, not well quantified. Used instead of Synthroid for granola hypothyroid pts. Elson doesn't like it because you don't know how much T3 (or T4) you're getting in each dose.
  24. TCAs in Thyroid pts
    Not a good idea because TCAs can increase HR and cause palpitations.
  25. Lasix
    Fuorosemide, a FAVORITE diuretic. IV, PO. Usually 20mg tabs, can go up to 40mg PO out pt. Have to watch for hypokalemia (condsider reflexing K script if high dose Lasix)
  26. Mirapex
    Pramipexole. Dopamine agonist for early Parkinson's and RLS.
  27. Provigil
    Modafinil. Anti-epileptic, used for narcolepsy, excessive sleepiness. MOA unknown. Works like amphetamine stimulant on the system.
  28. Imipramine
    Tofranil, TCA. Used for major depression and enuresis (inability to control urination). Can cause manic episodes in bi-polar pts.
  29. TCAs
    • Amitriptyline (Elavil)
    • Imipramine (Tofranil)
    • Clomipramine (Anafranil)
    • Nortriptyline (Pamelor)
    • Doxepin (Silenor)
  30. MOA: inhibit reuptake of serotonin and ne,
    • block alpha adrenergic, histaminergic, and cholinergic receptors.
    • SE: weight gain, dry mouth, confusion, blurred vision, urinary retention, delirium, good
    • for sleep maintenance, no rapid tolerance, use for chronic pain, contraindicated for mi/cardiac dz and elderly
  31. Alpha adrenergic agonists
    • Prazosin (Minipress), Clonidine (catapres). Used for PTSD.
    • Prazosin: decrease nightmares
    • Clonidine: use for startle, hyperarousal, hyperexcitability
  32. Risperdol
    • Risperdone. New generation (atypical) anti-psychotic. Used for PTSD, as mood stabilizer, for bi-polar, schizo.
    • SE: wt gain is BAD. Tardive dyskinesia. NEM (neuroleptic malignant syndrome: life- threatening neurological disorder most often caused by AE to neuroleptic/ antipsychotic drugs. It presents with muscle rigidity, fever, autonomic instability and cognitive changes such asdelirium, elevated creatine phosphokinase (CPK)).
  33. Nambutone
    Relafen, NSAID. Used for arthritis (OA, RA, etc.)
  34. Etodolac
    NSAID, used for arthritis and other pain.
  35. Meloxicam
    Mobic. NSAID, dosed 15mg once/day. Used for RA, OA, other chronic skeletal/muscular pain.
  36. Xanax
    Alprazolam. Short acting benzo.
  37. Atevan
    Lorezapam. Short-acting benzo.
  38. Halcion
    Triazolam. Short acting benzo.
  39. Versed
    Midazolam. Short acting benzo, has retrograde amnesia effects. Often used with fentanyl for PSA.
  40. Klonipin
    Clonazepam. Med acting benzo. (1-4 hours)
  41. Voltaren
    Topical NSAID (diclofenac).
  42. Vaniqa
    Eflornithine. Initially used for African sleeping sickness. Now used topically to treat unwanted hair growth (PCOS for instance).
  43. Topiramate
    Topamax (aka Dopamax bc of mental slowing SE). Anti-convulsant, used for epilepsy, migraines, bi-polar. Used long term, it makes people stupid.
  44. Lithium
    • Used to treat bi-polar disorder and other psych issues. Mood stabilizer.
    • SE: causes DI (diabetes insipidus) and inhibits release of T3/4 (causes hypothyroidism)
  45. Geodon
    Ziprasadone. New generation (atypical) anti-psychotic, for schizo disorders, bi-polar. D/c very slowly.
  46. Keflex
    Cefalexin. 1st generation cephalosporin, so very strong gram +, not great gram -. 1st line tx for for cellulitis (gram + staph and strep).
  47. Cephalosporins
    The first cephalosporins were designated first-generation cephalosporins, whereas, later, more extended-spectrumcephalosporins were classified as second-generation cephalosporins. Each newer generation of cephalosporins has significantly greater Gram-negative antimicrobial properties than the preceding generation, in most cases with decreased activity against Gram-positive organisms. Fourth-generation cephalosporins, however, have true broad-spectrum activity.
  48. Tricor
    • Fenofibrate. Reduces trigs, LDL and raises HDL.
    • SE: mostly GI, including bloating, gas, etc. Unusual but dangerous SE is myalgias, esp when taken with a statin like Zocor.
    • Often used in conjunction with statins anyway.
  49. Crestor
    Rosuvastatin, for high cholesterol.
  50. Coreg
    Carvedilol. A non-selective beta/alpha-1 blocker indicated in the treatment of mild to moderate congestive heart failure.
  51. Cefoxitin
    Cephamycin, often grouped with 2nd gen. cephalosporins. Its activity spectrum includes a broad range of gram-negative and gram-positivebacteria including anaerobes
  52. Imipenem
    Carbapenem calss of abx. An IV B-lactam drug, reserved for the hospital mostly. EXTREMELY broad spectrum. It is particularly important for its activity against Pseudomonas aeruginosa and the Enterococcus species. It is not active against MRSA.
  53. Compazine
    Prochlorperazine. A dopamine (D2) receptor blocker. Anti-emetic, used for n/v and vertigo at low doses/ short term. It's actually an old school typical anti-psychotic, rarely used as such.
  54. Ketoralac
    Toradol. NSAID/ analgesic, inhibits prostaglandin synthesis. Used for short term tx of moderate to severe pain. NOT addictive.
  55. Tramadol
    Ultram. Centrally acting opioidanalgesic, used in treating moderate to severe pain. The drug has a wide range of applications, including treatment for restless leg syndrome and fibromyalgia. Controversy about it's addictive properties.
  56. Diovan
    Valsartan. ARB (angiotensin receptor blocker). Used instead of ACE-I to treat HTN in pts who don't tolerate the ACE-I. Not as good for DM pts thought bc it doesn't have same renal protective properties. But it doesn't make you cough either.
  57. Questran
    • Cholestyramine. For high cholesterol; it's a bile acid sequestrant, which binds bile in the gastrointestinal tract to prevent its reabsorption. Pooping out bile means you poop out cholesterol with it, thus lowering plasma cholesterol levels.
    • Also useful for treating bile salt diarrhea (from Chrons, cholecystectomy, ileal resection pts who can't re-absorb bile). s/sx include burning diarrhea, multiple watery bowel movements, esp after meals.
  58. Cabergaline
    An ergot derivative, is a potent D2 receptor agonist. Used first line to treat secretory prolactinomas. (Recall dopamine inhibits prolactin constantly.) Can also be used in early Parkinson's instead of levodopa-carbadopa.
  59. Cardura
    • Doxazosin. An alpha blocker used to treat HTN and urinary retention associated with benign prostatic hyperplasia (BPH).
    • It is an alpha-1 adrenergic receptor blocker that inhibits the binding ofnorepinephrine (released from sympathetic nerve terminals) to the alpha-1 receptors on the membrane of vascular smooth muscle cells. The primary effect of this inhibition is relaxed vascular smooth muscle tone (vasodilation), which decreases peripheral vascular resistance, leading to decreased blood pressure.
  60. Avastin
    Bevacizumab. It's an humanized monoclonal antibody that inhibits vascular endothelial growth factor A.VEGF-A is a chemical signal that stimulates angiogenesis in a variety of diseases. So it blocks angiogenesis, the growth of new blood vessels. It is used to treat various cancers, including colorectal, lung, and kidney cancer, and eye disease.
  61. DDAVP
    • Desmopressin. A synthetic replacement for vasopressin, the hormone that reduces urine production.
    • Used in central DI (useless in nephrogenic DI).
    • Also used in nocturnal enuresis (bed-wetting).
  62. Methimazole
    Anti-thyroid drug, like PTU but less SE. Preg cat X however. Used for Graves until they decide to ablate.
  63. Hycosycamine
    Anticholinergic. Levorotary isomer of atropine. Hyoscyamine is used to provide symptomatic relief to various gastrointestinal disorders including spasms, peptic ulcers, irritable bowel syndrome, diverticulitis, pancreatitis, colic and cystitis
  64. Scopolamine
    Anticholinergic (like atropine). Very sedative. Used mostly for n/v, motion sickness (transdermal patch, often behind the ear like Joel in Belize), and to dry out the lungs, sinuses and other mucous membranes.
  65. Colace
    Ducosate. Stool softener.
  66. Reclast
    • Zolendronic acid. IV bisphosphonate for osteoporosis. Can be used for hypercalcemia from metastatic disease, and to treat Paget's disease.
    • The MOST POTENT bisphosphonate, with improvements in bone density at all measured sites. About 1/3 of pts will have acute myalgias s/p infusion the first time.
  67. Fosamax
    • Alendronate. Bisphosphonate for osteoporosis. Available generic. Taken PO, weekly.
    • Decreases risk of all types of osteoporotic fracture by about 50%.
  68. Boniva
    • Ibandronic acid. Bisphosphonate for osteoporosis (her least favorite). Dosed PO monthly or IV every 3 months.
    • Antifracture efficacy demonstrated for vertebral fractures ONLY.
  69. Actonel
    Riserdronate. Bisphosphonate. Dosed weekly or monthly. Antifracture efficacy similar to alendronate (Fosamax).
  70. Proscar/ Propecia
    • Finasteride (available generic). For BPH/ LUTS. 5 alpha reductase inhibitor (5ARI), an anti-androgen compound that inhibits conversion of testosterone to DHT and directly shrinks the prostate. Best for men with PSA > 1.5 or prostate US showing > 25 - 20 grams.
    • 5ARIs work well with alpha blockers; together they might be synergistic.

    Also known as Propecia- for male pattern baldness.
  71. Avodart
    Duasteride, for BPH/LUTS. 5ARI class, like Proscar. NOT GENERIC yet.
  72. Flomax
    Tamsulosin (available generic). 1st line for BPH/ LUTS. Alpha adrenergic blocker, works on receptors for smooth muscle in prostate and at the bladder neck.
  73. Cardura
    Doxzosin. Alpha blocker for BPH/ LUTS. Old generation (Flomax is a better drug these days); can cause orthostatic hypotension, needs to be titrated up.
  74. Cholecalciferol
    Vit D3, produced post UV photoisomerization in human skin. Bound by vitamin D binding protein (DBP) in blood, and converted to calcitriol (25OHD, the circulating form of vit D). Stays in the system longer than D2, so you have to supplement less.
  75. Ergocalciferol
    Vit D2 (from plants); possibly less potent than D3, the jury is still kinda out. Serum assay tells us how much exogenous vit D a pt is taking/ absorbing. Elson prefers this one for supplementation, but Up-to-Date prefers D3.
  76. Calcitriol
    25OHD is the main circulating form of vit D, lasts about 2-3 weeks in circulation. It is converted in the kidneys by alpha 1 hydroxylase to 1,25dihydroxyD, the intracellular truly active form of vit D.
  77. Depakote
    • Valproic acid or Valproate. Anti-epileptic, used also in mania during bi-polar disorder, and for migraine HA.
    • SE: major wt gain, thrombocytopenia, teratogenic. Possibly plays a role in osteoporosis genesis by increasing rate of vit D metabolism.
  78. Demerol
    Meperedine. Old school analgesic. The American Pain Society does not recommend meperidine’s use as an analgesic. If use in acute pain (in patients without renal or CNS disease) cannot be avoided, treatment should be limited to ≤48 hours and doses should not exceed 600 mg/24 hours.
  79. DM Goals of Therapy
    • A1c < 7%
    • BP < 130/80
    • LDL < 100
    • HDL > 40 M, > 50 F
    • Trigs < 150
    • FBG around 100
    • *** No measure of BG should ever go above 200, not even PPG, for DM pts. It should never be above 140 for non DM pts.
  80. Pre HTN?
    120-140 / 80-90
  81. HTN 1
    140-160 / 90-100
  82. HTN II
    > 160 / > 100
  83. FBG
    • < 100 = normal
    • 100-125 = pre DM (aka IFG)
    • > 126 = DM
  84. Glucose Tolerance Test (GTT)
    • < 140 = normal
    • 140-199 = pre DM (IGT)
    • >200 = DM
  85. Zestril
    Lisinopril, a common ACEI used for BP control and renal protection in DM pts.
  86. Capoten
    Captopril, an ACEI for BP control and renal protection.
  87. Lotensin
    Benazapril, an ACE-I for BP control and renal protection
  88. Univasc
    Moexipril, an ACEI for BP control and renal protection
  89. Accupril
    Quinapril, an ACEI for BP control and renal protection. This is what Dad uses!
  90. Meds for ALL DM pts!
    • - ASA 81mg PO QD
    • - ACE-I (or ARB if intolerant to ACEI)
    • *** Must follow BMP in all ACE-I pts bc of risk for hyperkalemia
  91. Albumin to Creatnine Ratio
    Premise: Cr is only excreted, not re-absorbed. So it should be constant (at about 1.0). Protein (albumin) should be re-absorbed by functioning kidneys, so when the ratio of albumin : Cr increases, it means the kidneys are filtering tons of protein, but not reabsorbing it. That's bad.
  92. Tests to Monitor DM
    • Every 3 months:
    • - A1c
    • - Microalbumin in urine
    • - BMP if on an ACE-I
    • Every 12 months:
    • - Lipids
    • - TSH
  93. Metformin (Glucophage)
    • 1st line therapy for newly dx'd DM II pts.
    • MOA: inhibits gluconeogenesis in liver, increases sensitivity to insulin and increases glucose transport into muscles.
    • SE: GI disturbance is #1 SE, so start low and go slow.
    • Wt loss!
    • Contras: CHF. Renal failure (GFR < 60 is where we get worried). Bad idea in pts with renally cleared procedures like IV contrast.
    • Dose: start at 500mg PO QD, titrate up to 2000mg total QD (dosed BID)
    • We tend to hold Metformin on most in-pts because they need imaging a lot of the time, and IV contrast kills the kidneys.
  94. Drugs to lower FPG
    • - Metformin
    • - Sulfonylureas (Glyburide, glipizide, glimeperide)
    • - Meglitinides (Nateglinide [Starlix], repaglinide [Prandin])
    • - Thiazoladinediones (Rosiglitazone [Avandia], Pioglitazone [Actos])
  95. Sulfonylureas
    2nd line meds to be added to metformin.

    Glyburide: oldest one. Cheap, but causes bad hypoglycemia, so not used a lot anymore.

    Glipizide: better choice. Generic, so good for most pts.

    Glimeperide: best choice, but not generic $$$.

    MOA: Stimulate insulin secretion from pancreas.

    Dosing: once daily, QAM

    Therapeutic effectiveness wanes with time. Not very effective as monotherapy, but work well with metformin.

    SE: Wt gain, hypoglycemic episodes
  96. Glucotrol
    • Glipizide. Middle of the road sulfonylurea.
    • Decreases FPG, but not PPG.
    • Dose: 5mg PO QAM (12-24 hour duration)
  97. Amaryl
    • Glimeperide.
    • Best sunfonylurea ($$$).
    • Decreases FPG, but not PPG.
    • Dose: 1-2mg PO QAM (or with first meal of day)
  98. Meglitinides
    • Modified sunfonylureas, but not as potent.
    • Starlix (nateglinide)
    • Prandin (repaglinide)
    • MOA: Stimulates insulin secretion
    • Dose: 5-30 min before a meal
  99. Metaglip
    Metformin + Glipizide.
  100. Starlix
    • Nateglinide.
    • Meglitinide class of modifided sulfonylureas.
    • $$$
    • Safe in mild renal insufficiency.
    • Dose: 30 min b4 a meal
  101. Prandin
    • Repaglinide.
    • Meglitinide class of modifided sulfonylureas.
    • Now generic, so cheaper!
    • Good option for pts who can't take sulfonyl drugs and who can't do their own insulin therapy.
    • Dose: 30 min b4 meal, TID
  102. Thiazoladinediones (TZDs)
    • Rosiglitazone (Avandia)
    • Pioglizatone (Actos)
    • SE: wt gain, edema, liver damage
    • *** Must get LFTs before starting a TZD, and monitor them q 3mo. NEVER use in CHF or liver failure pts.
    • Good SE: Increase HDL, pio lowers trigs, lower BP
    • Basically these are a good option for CKD pts and those who are sulfa allergic.
    • Dose: QD
  103. Avandia
    • Rosiglitazone. Thiazoladinedione class of anti DMII meds.
    • Concern over increased CV risk has scared a lot of providers away from Avandia.
    • SE: wt gain, higher HDL, lower BP.
    • NEVER use in CHF or liver failure pts.
    • Dose: QD
  104. Actos
    • Pioglitazone. TZD class of anti DM II meds.
    • New data indicates possible link btwn pioglitazone and increased risk for bladder CA.
    • SE: wt gain, higher HDL, lower trigs, lower BP
    • *** Never use in CHF pts or hepatic failure pts
    • Dose: QD
  105. Alpha-glucosidase inhibitors
    • Acarbose (Precose)
    • Miglitol (Glyset)
    • MOA: competitively inhibitor brush border absorption in small intestines, preventing absorption of CHO. Excellent safety profile.
    • Reduce risk of progression to full-blown DM by 50% (like Metformin)
    • *** BEST class of drugs for reducing CV risk of all the drugs we have in DM II arsenal.
    • SE: Gi disturbance, but these improve with time. No wt gain (also like Metformin).
    • Contras: Cirrhosis, IBS or other bowel disease.
    • Dose: 3X daily, with first bite of meal.
  106. Drugs that lower PPG
    • - Alpha-glucosidase inhibitors (Acarbose [Precose], Liglitol [Glyset]). RARELY USED.
    • - DPP4 Inhibitors (Sitagliptin [Januvia], Saxagliptin [Onglyza])
    • - Meglitinides (Repaglinide [Prandin], Nateglanide [Starlix]) ???
  107. Acarbose
    • Precose. Alpha-glucosidase inhibitor.
    • Lowers PPG!
    • Great safety profile, BEST class of drugs for improving CV risk in DM pts.
    • SE: GI issues, improve with time
    • Contras: Cirrhosis, ISB or bowel disease
    • Dose: 3Xdaily, with first bite of meal.
  108. Miglitol
    • Glyset. Alpha-glucosidase inhibitor. Lowers PPG!Great safety profile, BEST class of drugs for improving CV risk in DM pts.
    • SE: GI issues, improve with time
    • Contras: Cirrhosis, ISB or bowel disease
    • Dose: 3Xdaily, with first bite of meal.
  109. DPP4 Inhibitors
    • Sitagliptin (Januvia)
    • Saxagliptin (Onglyza)

    New, so $$$$$

    • MOA: Increase postprandial insulin secretion and suppress glucagon secretion.
    • Reduce FPG and PPG

    SE: well tolerated. Rare pancreatitis, possible cancer risks but unsubstantiated as of yet.

    Contras: NONE (yet)

    Dose: Once QD
  110. Sitigliptin
    • Januvia. DPP4-inhibitor class.
    • New, so $$$$$
    • MOA: Increase postprandial insulin secretion and suppress glucagon secretion. Reduce FPG and PPG
    • SE: well tolerated. Rare pancreatitis, possible cancer risks but unsubstantiated as of yet.
    • Contras: NONE (yet)
    • Dose: Once QD
  111. Saxagliptin
    • Onglyza. DPP4-Inhibitor class.
    • New, so $$$$$
    • MOA: Increase postprandial insulin secretion and suppress glucagon secretion. Reduce FPG and PPG
    • SE: well tolerated. Rare pancreatitis, possible cancer risks but unsubstantiated as of yet.
    • Contras: NONE (yet)
    • Dose: Once QD
  112. Combo Therapies for DM II
    1st line: Metformin + Sulfonylurea (Metaglip for eg). These work well together because Metformin makes you take up more glucose into muscles and more sensitive to insulin, and Sunfonylureas make the pancreas secrete more insulin.
  113. Byetta
    • Exenatide. Incretin mimetic, used as SQ injection (available in pens)
    • Dose: 60 min b4 AM and PM meals (BID)
  114. Florinef
    • Fludricotrisone. The only Rx we have for mineralicorticoid replacement in primary adrenal insufficiency or hypoaldosteronism pts.
    • MOA: Turns on the Na/K/ATPase channel on basement membrane (side of cell facing capillaries), which bring more Na and H20 into the body and makes you piss out K.
    • SE: edema, HTN and hypokalemia. Can cause hyperglycemia
  115. Hydorcortisone
    • Straight-up cortisol. IV, PO, topical. Least potent
    • 8-12 hr duration.
    • G = M
    • Preferred therapy (100mg IV starting bolus) for adrenal crisis.
  116. Prednisone
    • PO only.
    • Medium potency, medium acting. Converted to prednisolone in the body.
    • 12- 36 hr duration.
    • G:M is 5:1 (so five times more glucorticoid activity than mineralocorticoid)
    • 2.5mg maintenance dose is common in trnasplant pts for the rest of their lives. This is BAD when they have DM since cortisol increases BG.
  117. Methylprednisolone
    • PO, IV, topical.
    • Medium potency, medium duration.
    • 12-26 hour duration (like pred)
    • G:M is 10:1 (so very little mineralocorticoid activity compared to glucocorticoid)
  118. Dexamethasone
    • PO, IV, topical.
    • High potency, long acting.
    • 24-72 hour duration.
    • G:M is 100:0 (ie; NO mineralocorticoid effects)
    • Used for suppression test when we're working-up patients for adrenal insufficiency (Addison's)
    • *** Dex to pred conversion is 1:5. ie; if you're switching pt to PO pred to go home, and they were on 10mg of Dex IV, give them 50mg Pred PO.

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