OSCE

Benzodiapepine drug(s)

Generic	Brand
Alpralozem	Xanax
Clonazepam	Klonipin
Diazepam	Valium
Lorazepam	Ativan

Alpralozem

Xanax

Clonazepam

Klonipin

Diazepam

Valium

Lorazepam

Ativan

Benzodiazepine common effects

• Fatigue/sedation

• Dizziness

Benzodiazepine rare effects

• Confusion

• Memory and recall impairment

• Respiratory depression (enhanced risk with opioids)

Benzodiazepine counseling points

• Take as needed for symptomatic relief

• Avoid use with alcohol

• If using chronically, do not stop abruptly.

SSRI drug(s)

Generic	Brand
Citalopram	Celexa
Escitalopram	Lexapro
Fluoxetine	Prozac
Paroxetine	Paxil
Sertraline	Zoloft
Vortioxetine	Trintellix

Citalopram

Celexa

Escitalopram

Lexapro

Fluoxetine

Prozac

Paroxetine

Paxil

Sertraline

Zoloft

Vortioxetine

Trintellix

SSRI common effects

• Sexual dysfunction

• Fatigue and insomia

• Dry mouth

• Headache

SSRI rare effects

• Hyponatremia

• Bleeding (additive risk with anticoagulants)

• Serotonin syndrome

SSRI counsleing points

• Takes 1-2 weeks to feel a benefit and 6-8 weeks for full effect on mood

• Do not stop abruptly, taper off

TCA drug(s)

Generic	Brand
Amitriptyline	Elavil
Nortriptyline	Pamelor

Amitriptyline

Elavil

Nortriptyline

Pamelor

TCA common effects

• Orthostasis, tachycardia

• Weight gain

• Dry mouth, blurred vision, urinary retention, constipation (“can’t see, can’t pee, can’t spit, can’t sxxx)

• Major sedation

TCA rare effects

• Overdose can cause fatal arrhythmias (QT prolongation) - moniter for suicidial ideation

TCA counseling points

• Takes 1-2 weeks to feel an effect, and 6-8 weeks for full effect on mood

• Take at night/PM

NSAIDs drug(s)

Generic	Brand
Celecoxib	Celebrex
Diclofenac	Voltaren, Voltaren Gel
Ibuprofen	Advil, Motrin
Indomethacin	Indocin, Tivorbex
Meloxicam	Mobic
Naproxen	Aleve, Naprosyn

Celecoxib

Celebrex

Diclofenac

Voltaren, Voltaren gel

Ibuprofen

Advil, Motrin

Indomethacin

Indocin, Tivorbex

Meloxciam

Mobic

Naproxen

Aleve, Naprosyn

NSAIDs common effects

• Increased blood pressure

• Photosentativity

NSAIDs rare effects

• GI bleeding/ulceration

NSAIDs counseling points

• Take with food

• Don’t take cardiac issues, kidney dysfunction, or pregnant

• Use sunscreen and sun-protective clothing

Opioid Analgesics drug(s)

Generic	Brand
Codeine/APAP	Tylenol with Codeine
Fentanyl (transdermal)	Duragesic
Hydrocodone/APAP	Lortab, Norco, Vicodin
Hydromorphone	Dilaudid
Methadone	Methadose
Morphine	Avinza, MS Contin, Kadian
Oxycodone	Oxycontin
Oxycodone/APAP	Endocet, Percocet, Roxicet

Codeine/APAP

Tylenol with Codeine

Fentanyl (transdermal)

Duragesic

Hydrocodone/APAP

Lortab, Norco, Vicodin

Hydromorphone

Dilaudid

Methadone

Methadose

Morphine

Avinza, MS Contin, Kadian

Oxycodone

Oxycontin

Oxycodone/APAP

Endocet, Percocet, Roxicet

Opioid Analgesics common effects

• Constipation

• Nausea and Vomiting

• Sedation and Dizziness

Opioid Analgesics rare effects

• Itching

• Tolerance and physical dependence

Opioid Analgesics counseling points

• Take with food or milk if upset stomach (not oxymorphone)

• Offer presciprton of naloxone

Vitamin K antagonist drug(s)

Generic	Brand
Warfarin	Coumadin, Jantoven

Warfarin common effects

• Bleeding and bruising

Warfarin rare effects

• Tissue necrosis/gangrene

Warfarin counseling points

• Keep vitamin K intake consistent

• Consult a managing healthcare professional if/when starting or stopping medication

• Do not take if pregnant.

DOACs drug(s)

Generic	Brand
Apixaban	Eliquis
Rivaroxaban	Xarelto

DOACs common effects

• GI bleeding

DOACs rare effects

• Boxed warning for hematomas in patients receiving spinal/epidural anesthesia; may result in long-term or permanent paralysis

DOACs counseling points

• Apixaban and Rivaroxaban can be crushed and put in applesauce

Apixaban

Eliquis

Rivaroxaban

Xarelto

P2Y12 Inhibitor drug(s)

Generic	Brand
Clopidogrel	Plavix

Clopidogrel

Plavix

P2Y12 common effects

• Bleeding

P2Y12 rare effects

• TTP (mental status, change, vision changes, one-sided weakness, purple spots on skin/mouth, yellow skin, diarrhea, fast heartbeat, fever, headache)

Levothyroxine

Synthroid, Tirosint, Unithroid

Levothyroxine common effects

• Hyperthyroidism

• Sweating

• Weight loss

• Insomnia

• Hyperactivity

• Heart rhythm irregularities

Levothyroxine counseling points

• Space between PPIs by 4 hours

• Space apart between Antacid (Fe, Ca, Mg, Al)