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drug interactions:
simvastatin + gemfibrozil
combo may increase simvastatin level, risk of myopahty, rhabdomyolysis
CYP2C8
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How many refills can a C-II have?
None
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How many refills can a C-III, C-IV, & C-V have?
- 5 refills
- Refills are valid for up to 6 months from written date.
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NPLEX
- National Precursor Log Exchange
- Dear valued customer, as you may be aware, many cold and allergy medications containing pseudoephedrine are regulated by state & federal laws. Sales of these medications are monitored to help stop the illicit manufacture of methamphetamine and other dangerous drugs.
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Common adverse effect to counsel patient on for promethazine
Promethazine (Phenergan) is a 1st generation antihistamine that is used for the prevention of n/v. However, taking this medication can cause drowsiness.
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promethazine vs. children
BBW: cannot give promethazine to children < 2 y/o d/t fatal respiratory depression.
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SLUDGE(M) acronym
- S = salivation stimulation
- L = lacrimation stimulation
- U = urination (relaxation of the internal sphincter muscle of urethra)
- D = defecation (relaxation of internal anal sphincter)
- G = gastrointestinal upset (diarrea)
- E = emesis (vomiting)
- M = miosis/muscle spasm (pupillary constrictor)
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s/s of HYPERthyroidism
- nervousness
- irritability
- difficulty sleeping
- unblinking stare
- hoarseness/deep voice
- dry/sore throat
- difficulty swallowing
- rapid heartbeat
- menstrual irregularities
- infertility
- weight loss
- frequent bowel movements
- increased sweating
- warm, moist palms
- excessive vomiting in pregnancy
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s/s of HYPOthyroidism
- tiredness
- puffy eyes
- forgetfullness/slower thinking
- moodiness/irritability
- hoarseness/deepening of voice
- depression
- dry/sore throat
- difficult swallowing
- thinning hair/hair loss
- slower heartbeat
- loss of body hair
- menstrual irregularities
- infertility
- constipation
- dry skin
- weight gain
- cold intolerance
- muscle weakness/cramps
- elevated cholesterol
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treatment of n/v for children <2 y/o
n/v can cause a lot of patients to throw-up & loosing water. Therefore, dehydration is a common thing. Ask parents to replenish with popsicle or any other water source and refer them to see a PCP.
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Can montelukast (Singulair) treat an asthma attack?
No b/c montelukast (Singulair) is a leukotriene inhibitor that can only prevent asthma from happening, NOT treating it.
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Which drug requires the coadministration of vitamin B9 (folic acid)?
methotrexate (Trexall) is a DMARDs & immunosuppressnat drug that requires the administration of folic acid to reduce hematologic, gastrointestinal, & hepatic adverse events
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Which adverse effect should outpatient be counseled on while on ACE-inhibitor?
coughing d/t bradykinin release
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BBW for metoclopramide (Reglan)
tardive dyskinesia - involuntary muscle movement
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What are the ingredients of Tussionex?
chlorpheniramine/hydrocodone
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MAX dose of Tussionex in 24hr for adults
5 mL every 12 hours; do not exceed 10 mL/24 hours
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Librax
chlordiazepoxide/clidinium
-
Drug interactions:
potassium chloride vs. Librax
Concurrent use of CLIDINIUM and POTASSIUM CHLORIDE may result in risk of gastrointestinal lesions.
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Zoloft
- sertraline
- Antidepressant
- SSRIs
- selectively inhibits serotonin reuptake
-
Celexa
- citalopram
- Antidepressant
- SSRIs
- selectively inhibits serotonin reuptake
-
Paxil
- paroxetine
- Antidepressant
- SSRIs
- selectively inhibits serotonin reuptake
-
Examples of SNRIs
- venlafaxine (Effexor)
- duloxetine (Cymbalta)
- milnacipran (Savella)
-
Dysrel
- trazodone
- Antidepressant
- SARI
- inhibits serotonin reuptake, antagonizes alpha-1 adrenergic and serotonin 5-HT2A/C receptors
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wax-coated drug puropose
delays absorption by allowing the drug to reach the stomach before it is breaking down for absorption
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Examples of 1st-Gen Antihistamine
- 1st-Gen = sedation
- cetirizine (Zyrtec)
- chlorpheniramine (Chlor-Trimeton)
- diphenhydramine (Benadryl)
- promethazine (Phenergan)
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Examples of 2nd-Gen Antihistamines
- 2nd-Gen = non-sedation
- cimetidine (Tagamet)
- famotidine (Pepcid)
- ranitidine (Zantac)
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