COMM exam 4 brand/name/counseling

clopidogrel; antiplatelet

plavix

clopidogrel

• bleeding

• interactions with PPIs

• avoid NSAIDs'/Aspirin and in patients with ulcers/GI bleeding

• for clots/post stent/MI

Plavix

clopidogrel (brand name)

warfarin; vit k antagonist

Coumadin

warfarin

• SE: bleeding; need INR (blood level monitoring)

• consistent vit K diet

• interactions with FFFAB 5 drugs

• most sued over drug

• uses: prevent/treat venous thrombosis (blood clot in veins), AFib, valve replacement, ect.

Coumadin

warfarin (brand name)

anticoagulant

blood thinner medications that delay the clotting of blood

antiplatelets

keep blood clots from forming by keeping blood platelets from sticking together

anticoagulant and antiplatelet counseling

• increase the risk of bleeding; excessive bleeding must seek medical help

• avoid NSAIDs/Aspirin

• avoid in patients with history of ulcer or GI bleeding

• notify physician prior to dental work

rivaroxaban; factor Xa inhibitor

Xarelto

rivaroxaban

• take with food (anticoagulant)

• blood test not required

• increase risk of bleeding; call DR if excessive bleeding

• avoid NSAID/Aspirin

• avoid in patients with ulcer or GI bleeding history

• notify prior to dental work or surgery

Xarelto

rivaroxaban (brand name)

apixaban; factor Xa inhibitor

Eliquis

apixaban

• anticoagulant

• increase risk of bleeding; call DR if excessive bleeding

• blood monitoring not required (INR)

• avoid NSAID/Aspirin

• avoid in patients with ulcer or GI bleeding history

• notify prior to dental work or surgery

Eliquis

apixaban (brand name)

nitroglycerin; nitrate

Nitrostat

nitroglycerin

(anti-anginal/vasodilators)

• rapid-acting; sublingual (under tongue)

• dose is 1 every 5 minutes (up to 3) then go to ER

• bitter taste; HA; Dz; flushing

• keep in original container

• avoid other vasodilators

Nitrostat

nitroglycerin (brand name)

isosorbide mononitrate; nitrate

Imdur

isosorbide mononitrate

• long acting/prevention

• dont crush/chew

• HA, Dz, flushing

Imdur

isosorbide mononitrate (brand name)

ranolazine; anti-anginal

Ranexa

ranolazine

• long acting non-nitrate (prevention)

• improves metabolism in ischemic heart cells; reduces heart damage

• SE:light headed/dizzy/HA/nausea

• avoid grapefruit juice

• dont crush, chew, break

Ranexa

ranolazine (brand name)

digoxin; anti-arrhythmic

Lanoxin

digoxin

• slows heart rate (neg chronotropic) with powerful contraction (positive inotrope)

• used for: heart failure, A.Fib

• check blood levels to prevent toxicity

• SE: rhythm disturbances, GI side effects, CNS side effects (visual)

• blurred vision, green-yellow color disturbances (halo effect)

Lanoxin

digoxin (brand name)

amiodarone; anti-arrhythmic

Cordarone

amiodarone

• watch for iodine allergy

• monitor for thyroid, lung, vision, liver changes

• sun-sensitivity → will turn skin blue/gray

• avoid grapefruit juice and FFFAB 5

Cordarone

amiodarone (brand name)

sotalol; anti-arrhythmic

Betaplace

sotalol

• beta-blocking activity

• avoid/caution in patients with asthma and diabetes

• SE: lightheaded; Dz; slow HR

• avoid antacids within 2 hours of taking

Betaplace

sotalol (brand name)

carbidopa/levodopa; dopamine precursor

Sinemet

carbidopa/levodopa

• used to treat Parkinson’s

• urine, sweat, saliva turns dark in color (red/brown) → not harmful but may cause staining of clothes/bed sheets

• high protein decreases absorption levels

Sinemet

carbidopa/levodopa (brand name)

ropinirole; dopamine agonist

Requip

ropinirole

• used to treat Parkinson’s

• also used for restless leg syndrome

• SE: DZ/Drowsy; avoid EtOH and other CNS depressants

• orthostatic hypotension

• increase in sexual urges, urges to gamble, ect.

• psychosis risk

Requip

ropinirole (brand name)

donepezil; cholinesterase inhibitor

Aricept

donepezil

• 1st line for Alzheimers

• SE: N/V, GI issues, weight loss, syncope

• avoid alch; DZ/drowsy; caution driving

Aricept

donezepril (brand name)

memantine; NMDA inhibitor

Namenda

memantine

• used for more severe Alzheimer’s disease

• SE: DZ; HA: confusion; constipation

• avoid with other NMDA inhibitors (tramadol, ketamine)

topiramate; anti-epileptic

Topamax

topiramate

broad spectrum

• also used for weight loss, migraines, mania

• SE:DZ/drow/no alch; no machinery. dont stop abruptly; mood changes. decrease if BC effectiveness

• nerve pain, tingling, numbness; taste disturbances

• stone formation -→ drink lots of water

Topamax

topiramate (brand name)

divalproex; anti-epileptic

Depakote

divalproex

broad spectrum

• SE:DZ/drow/no alch; no machinery. dont stop abruptly

• also used for mania and migraines

• GI side effects; take with food. watch for severe belly pain

• LFT (liver function testing)

Depakote

divalproex (brand name)

lamotrigine

broad spectrum

• also used for mania

• SE:DZ/drow/no alch; no machinery. dont stop abruptly

• rash

• COC’s can decrease lamotrigine levels

Lamictal

lamotrigine (brand name)

levetiracetam; anti-epileptic

Keppra

levetiracetam

broad spectrum

• low drug interactions; better for pregnancy (Category C)

• SE:DZ/drow/no alch; no machinery. dont stop abruptly

• rash (not as common)

Keppra

levetiracetam (brand name)

phenytoin; anti-epileptic

Dilantin

phenytoin

narrower spectrum

• gingival hyperplasia → good dental hygiene

• blood dyscrasis = hyperglycemia

• Nystagmus (invol rapid eye movement)

Dilantin

phenytoin (brand name)

phenobarbitial (CIV); barbiturate

barbiturate

phenobarbitial (CIV)

anti-epileptic narrow spectrun

• SE:DZ/drow/no alch; no machinery.

• abuse potential

• common in pets

• can be written in grains

• P-450 enzyme inducer

clonazepam; benzodiadepine

Klonopin

Klonopin

clonazepam (brand name)

clonazepam (CIV)

• also used for anxiety/panic disorder

• abuse potential

• SE:DZ/drow/no alch; no machinery

gabapentin

• used for nerve pain (narrow)

• space out from antacids; can be abused (not controlled in OK)

• SE:DZ/drow/no alch; no machinery

Neurontin

gabapentin (brand name)

pregabalin

used for neuropathic pain from diabetic peripheral neuropathy

• post herpetic neuralgia

• peripheral edema/weight gain

• SE:DZ/drow/no alch; no machinery. dont stop abruptly

• adj therapy for partial onset seizures

Lyrica

pregabalin (brand name)

sumatriptan; serotonin agonist

Imitrex

sumatriptan

used for migraine/cluster HA

• cause constriction cerebral blood (tightens arteries in brain)

• chest tightness, numbness, tingling, heavy feeling, cold/hot feeling

• SE:DZ/drow/no alch; no machinery.

• avoid other constriction drugs/patients where constriction is bad

• serotonin syndrome -→ rebound headache

Imitrex

sumatriptan (brand name)

butalbital/APAP/caffeine (C-III)

Fioricet

Fioricet

butalbital/APAP/caffeine (brand name)

butalbital/APAP/caffeine

• used for tension HA

• SE:DZ/drow/no alch; no machinery

• watch daily APAP intake → 3-4 grams/day

• abuse potential (C-III)

• rebound HA

cluster headache

pain in/around one eye

tension headache

most common type of HA; tight band around head/forehead

GERD counseling

• avoid food/drinks that cause discomfort (spice, alcohol, ect)

• avoid NSAIDs/Aspirins; avoid smoking

• loose weight; avoid tight clothing

• avoid meals close to bed; raise head of bed

protein pump inhibitors

ER tablets/capsules are the most common

• given one dose daily 30-45 minutes before breakfast (empty stomach)

• may take 1-4 days to kick in

• long term use = decrease calcium absorption = increase osteoporosis

lansoprazole; protein pump inhibitor

Prevacid

Prevacid

lansoprazole (brand name)

omeprazole; protein pump inhibitor

Prilosec

Prilosec

omeprazole (brand name)

esomeprazole; protein pump inhibitor

Nexium

Nexium

esomeprazole (brand name)

pantoprazole; proton pump inhibitor

Protonix

Protonix

pantoprazole (brand name)

anti-epileptics

decreased birth control effectiveness

all cause DZ/DSY/ no alch/ no machinery

dont stop abruptly (may cause seizure)

be cautious of mood change

famotidine: H2 antagonist

pepcid

famotidine

• used for prevention/treatment of heartburn/upset stomach

• onset is about 30 minutes

Pepcid

famotidine (brand name)

sucralfate; ulcer protectant

Carafate

sucralfate

used for the protection of stomach ulcers

• taken 4 times daily

• avoid any medications within two hours before/after taking medication as this will slow absorption

Carafate

sucralfate (brand name)

promethazine; phenothiazine

Phenergan

promethazine

used for nausea and vomiting

• SE: DZ/DROWSY/no alch/no machinery

• sun sensitivity

• dry mouth, dry eyes, constipation

• uncontrolled abnormal muscle movement

phenothiazine

older antipsychotic

additional categories in one:

= DA antagonist, antihistamine, anticholinergic

ondansetron; 5-HT3 serotonin receptor antagonist

Zofran

ondansetron

used to treat nausea/vomiting

• category B (pregnancy)

• ODT → oral disintegrating tablet

• dont remove from blister until ready to use; use with dry hands

• DZ/DROWSY/no alch/no machinery

• cautinon with other 5-HT medications → serotonin syndrome

Zofran

ondansetron (brand name)

dicyclomine; anticholinergic

Bentyl

dicyclomine

used to treat GI spasms

• dry eyes, dry mouth, constipation