Drug Card Exam 1 FDA/ Indications and Monitoring

Alendronate Sodium

Treatment of osteoporosis in post-meno women (10mg qd or 70mg qw)

Prevention of osteo in post-meno women (5mg qd or 35 mg qw)

In bone mass in men with osteo (10mg qd)

Tr of glucocorticoid induced osteo in men and women (5mg qd, except in post-meno women not taking estrogen then 10mg qd)

Tr of Paget’s disease (40mg qd x6 months)

Monitor: BMD

Raloxifene Hydrochloride

Preven and Tr of osteo in post-men women (60mg tab qd)

Reduction of invasive breast cancer risk (60mg tab qd)

Amoxicillin Trihydrate

• Ear, Nose, and Throat: Treats tonsillitis, sinus infections, and sore throats.

• Chest and Lungs: Treats bronchitis and pneumonia.

• Skin and Urinary Tract: Treats skin tissue issues and bladder or kidney infections.

Adults: 250mg -500 mg q8H or 500mg-875mg q12H

Children: 20-45 mg/kg qd. 125mg and 500mg given q8h. 200mg and 400mg given q12H

Tr of gonorrhea (adult: 3g single dose, prepubertal child over 2: 50mg/kg amoxi combined w/ 25mg/kg probenecid as single dose)

Amoxicillin with Clavulanate Potassium

• Ear infections (such as acute otitis media)

• Sinus infections (sinusitis)

• Respiratory tract infections (including pneumonia and bronchitis)

• Urinary tract infections (UTIs)

• Skin and soft tissue infections

• Dental infections

Adult less severe: 250mg q8H or 500mg q12H

Adult more severe: 500mg q8H or 875 q12H

Children: 25-45mg/kg qBID

Azithromycin Dihydrate

• Respiratory Infections (500mg single dose then 250mg qd x4 days): Treats community-acquired pneumonia (500 Intravenously first 2 days then 250mg PO BID x7-10 days) , pharyngitis (strep throat)/ tonsillitis (12mg/kg qd x5 days), acute bacterial sinusitis (500mg qd x3 days or 2g Zmax one time), and acute bacterial exacerbations of chronic bronchitis (500mg qd x3 days or 500mg single dose then 250mg qd x days 2-5).

• Skin Infections: Treats uncomplicated skin and skin structure infections. (500mg single dose first day then 250mg qd x4 days)

• Sexually Transmitted Infections: Treats urethritis, cervicitis (2g single dose), and genital ulcer disease (chancroid) caused by designated susceptible organisms like Chlamydia trachomatis (1g single dose)

• Ear Infections: Used for acute otitis media in pediatric patients (10mg/kg single dose followed by 5mg/kg qd xdays 2-5)

• MAC Infection: Used to prevent and treat disseminated Mycobacterium avium complex (MAC) disease in patients with advanced HIV/AIDS or compromised immune systems (1200mg qw)

Cefdinir

• Ear infections: Acute otitis media in children and adults. (600mg 1-2 doses) children:14mg/kg qd

• Sinus and respiratory infections: Acute bacterial sinusitis (600mg in 1-2 doses), community-acquired pneumonia (600mg in 2 doses), and flare-ups of chronic bronchitis. (600mg in one to 2 doses)

• Throat infections: Strep throat (pharyngitis and tonsillitis) (600mg 1-2 doses).

• Skin infections: Uncomplicated skin and skin-structure infections like cellulitis (600mg 1-2 doses)

• renal insufficiency: 300mg qd

Ciprofloxacin HCL

• Urinary Tract Infections (UTIs): Including kidney infections (pyelonephritis) and bladder infections. (250-500mg IR q12H or 500-1000mg XR qd)

• Respiratory Tract Infections: Including certain chest infections and pneumonia. (500-750mg q12H)

• Skin, Bone, and Joint Infections: Including severe soft tissue and bone issues. (500-750mg q12H)

• Gastrointestinal Infections: Including infectious diarrhea and typhoid fever. (500mg q12H)

• Prostate Infections: Including chronic bacterial prostatitis. (250mg single dose). Cystitis in women (100mg q12H x3 days)

• Serious Exposures: Used after exposure to anthrax or certain types of plague. (500mg PO or 400mg IV q12H x 60 day, Child: 15mg/kg q12H or 10mg/kg q12H iV x 60 days)

• Monitor: LFT

Levofloxacin

• Respiratory Tract: Pneumonia (community-acquired and nosocomial) (500mg qd x7 days or 750mg qd x5 days), acute worsening of chronic bronchitis (500mg qd x7 days), and acute sinus infections (sinusitis) (500mg qd x 10-14 days or 750mg qd x5 days).

• Urinary System: Urinary tract infections (UTIs) (250mg qd x 3 or 7-14 days or750 mg qd x5 days), kidney infections (pyelonephritis) (250 mg qd x 10 days or 750mg qd x5 days), and prostate infections (prostatitis) (500mg 1=qd x28 days).

• Skin and Soft Tissue: Infections affecting the skin and surrounding structures. (500mg or 750mg qd x7-14 days)

• Special Uses: Treatment or prevention of plague and reducing the risk of illness after exposure to inhalational anthrax. (500mg qd x 60days) children: 8 mg/kg q12H x 60days)

• Monitor: LFT

Clindamycin Hydrochloride

• Skin and soft-tissue infections: Cellulitis, abscesses, and wound infections, including certain strains of methicillin-resistant Staphylococcus aureus (MRSA).

• Respiratory and lung infections: Aspiration pneumonia, lung abscesses, and lower respiratory tract infections.

• Bone and joint infections: Osteomyelitis and septic arthritis because the drug penetrates bone tissue effectively.

• Dental and mouth infections: Severe dental abscesses or infections, often used as an alternative for people with penicillin allergies.

• Gynecological and pelvic infections: Endometritis and pelvic cellulitis.

• Adults: 150-450mg q6H

• Children: 8-20mg/kg divided into 3-4 equal doses

Doxycycline Hyclate

• Bacterial Infections: Treats respiratory tract infections (like pneumonia or bronchitis), urinary tract infections, eye infections, and severe acne. (100mg q12H single dose then 100-200mg qd in 1-2 divided doses)

• Sexually Transmitted Infections (STIs): Prescribed for chlamydia, gonorrhea (100mg BID x7 days or 300mg stat followed in one hour by 300mg dose), and syphilis (300mg qd x10 days), and used as a post-exposure prophylaxis (Doxy PEP) to help prevent bacterial STIs.

• Malaria Prevention: Taken daily when traveling to regions where malaria is common (100mg qd x 2 days prior to departure and contin 4 weeks after return)

• Children (over 8): 4.4mg/kg in 2 doses then 2.2-4.4mg/kg qd

Monitor: CBC

Minocycline HCL

• Acne Vulgaris: Treats pimples, red bumps, and inflammatory lesions in adults and children 12 years and older. (1mg/kg qd x12 weeks)

• Bacterial Infections: Fights infections in the respiratory tract, urinary tract, skin, and other parts of the body. 200mg then 100mg q12H

• Children (over 8): 4mg/kg followed by 2mg/kg q12H

Mupirocin

Impetigo: Treating contagious, crusty, or honey-colored sores on the skin caused by Staphylococcus aureus or Streptococcus pyogenes. (Oint) (cover AAA with small film TID, no results in 3-5 should be reevaluated)

Prophylaxis in nasal cavity (nasal oint) (use ½ of each single tube in each nostril BID x 5 days.

Skin Lesions (cream) (AAA TID)

Ofloxacin

Corneal Ulcer: first 2 days instill 1-2 drops in afffected eye every 30 min while awake and awaken 4-6 hours after falling asleep and instill 1-2 drops. day 3-7 instill 1-2 drops hourly while awake. after day 7 instill 1-2 drops QID

Conjunctivitis: 1-2 drops into sac every 2-4 hours while awake for 2 days and 1-2 drops QID x 5 days

Sulfamethoxazole with Trimethoprim

• Urinary tract infections (UTIs): Infections in the bladder or kidneys. (160mg of trimethoprim/ 800mg of sulfamethoxazole q12h x10-14 days, children: 8mg/kg trimethoprim and 40m/kg sulfamethoxazole q12H x10 days)

• Bronchitis: Worsening or flare-ups of chronic breathing tube infections. (160mg of trimethoprim/ 800mg of sulfamethoxazole q12h x10-14 days, children: 8mg/kg trimethoprim and 40m/kg sulfamethoxazole q12H x10 days)

• Traveler's diarrhea: Severe diarrhea caused by bacteria during travel. (1 double strength tab 1q12H x5 days)

• Shigellosis: An intestinal infection causing bloody diarrhea (160mg of trimethoprim/ 800mg of sulfamethoxazole q12h x5 days, children: 8mg/kg trimethoprim and 40m/kg sulfamethoxazole q12H x5 days)

Anastrozole

Tr of early breast cancer in post-meno women, advanced or metastatic breast cancer, advanced breast cancer following tamoxifen therapy) (1mg qd)

Monitor: Lipid panel, BMD

Tamoxifen Citrate

Tr of metastatic breast cancer in men and post-meno women (20-40mg BID)

reduction in breast cancer in high risk women including those with DCIS (20mg QD x 5 years)

Methotrexate

Autoimmune and Inflammatory Uses

• Rheumatoid Arthritis (RA): Slows joint damage and reduces pain and swelling in adults. (7.5mg weekly as 1 dose or 3 2.5mg doses q12H. Max weekly dose is 20mg)

• Juvenile Idiopathic Arthritis (JIA): Treats inflammation in children and young patients. (10mg QW max 30mg a week. doses over 20mg should be given IM or SubQ)

• Severe Psoriasis and Psoriatic Arthritis: Controls painful skin plaques and associated joint inflammation. (10-25mg qw)

• Off-Label Uses: Sometimes prescribed for conditions like lupus, Crohn's disease, and certain lung diseases

Cancer Uses

• Acute Lymphoblastic Leukemia (ALL): Used in combination regimens for adults and children. (2-5 days) Children: <1 6mg, 1 year old 8mg, 2 year old 10g, 3+ 12mg

• Lymphomas: Treats non-Hodgkin lymphoma and meningeal leukemia (10-25mg qd x4-8 days)

• Skin and Solid Tumors: Used for mycosis fungoides (cutaneous T-cell lymphoma), breast cancer, and osteosarcoma. (variable Tr)

Monitor: CBC, SCr, LFT, chest radiograph

Dexamethasone

• Inflammatory and Autoimmune Conditions: Treats severe arthritis, lupus, ulcerative colitis, and multiple sclerosis flare-ups.

• Allergies and Breathing Problems: Relieves severe allergic reactions, anaphylaxis, acute asthma attacks, and croup in children.

• Swelling and Brain Pressure: Reduces brain swelling caused by tumors, trauma, or increased intracranial pressure.

• Cancer Care: Used alongside other medications to treat cancers like multiple myeloma and lymphoma, and to help control chemotherapy-induced nausea.

• Severe Infections: Given to seriously ill patients with COVID-19 who need supplemental oxygen.

• Hormone Replacement: Replaces natural steroids when the adrenal glands do not produce enough

• (DOSAGES MUST BE INDV, Normal dose: 0.75-9mg qd)

• Multiple Sclerosis (30mg qd x7 days followed by 4-12mg qod x1 month)

Methylprednisolone

• Allergic reactions: Severe allergies, seasonal reactions, or anaphylaxis support.

• Respiratory disorders: Severe asthma attacks, chronic asthma flares, and COPD exacerbations.

• Rheumatologic and joint conditions: Rheumatoid arthritis, osteoarthritis pain, bursitis, and gout flares.

• Autoimmune flare-ups: Systemic lupus erythematosus and multiple sclerosis relapses.

• Gastrointestinal diseases: Ulcerative colitis and Crohn's disease.

• Other uses: Certain blood disorders, skin conditions, eye inflammation, and organ transplant rejection prevention

• DOSAGES MUST BE INDV (normal doses: 4-48mg qd)

• multiple sclerosis: 160mg qd x7 days then 64mg qod x1 month)

Prednisone

• Allergies and Asthma: Severe allergic reactions, asthma flare-ups, and chronic obstructive pulmonary disease (COPD).

• Arthritis and Joint Pain: Rheumatoid arthritis, gout, bursitis, and joint inflammation.

• Autoimmune Diseases: Lupus, multiple sclerosis flare-ups, and inflammatory bowel diseases like ulcerative colitis and Crohn's disease.

• Skin and Eye Conditions: Severe eczema, psoriasis, and eye inflammation.

• Other Medical Issues: Certain blood disorders, low adrenal hormone levels, and specific types of cancer

• Multiple Sclerosis: 200mg qd x7 days then 80mg qod x1 month

• DOSAGES MUST BE INDV (normal doses: 5-60mg qd)

Nitrofurantoin

• Treatment of UTIs: It stops the growth of bacteria in the bladder and lower urinary tract (such as E. coli). (50-100mg QID with food. 50-100mg HS)

• Children: 5-7mg 4 does with food

• Macrobid UTI: (1 100mg cap q12H x7 days)

BEERS LIST

Metronidazole

• Bacterial Vaginosis (BV): A common vaginal infection treated with oral pills or a topical vaginal gel. (1 ER tab qd x7 daily)

• Trichomoniasis: A sexually transmitted infection (STI) caused by a parasite. (2 grams in 1-2 doses, 250-500mg TID x7 days)

• Gastrointestinal and Stomach Infections: Including infections like Helicobacter pylori (associated with ulcers) and intestinal amebiasis. (750mg TID x5-10 days, 500-750mg TID 5-10 days)

• Internal Infections: More severe anaerobic infections affecting the bones, joints, abdomen, or brain, often treated in a clinical setting (15mg IV over 1 hour, then 6 hours after 7.5mg IV q6H x7-10 days)

Amlodipine Besylate

hypertension: start 5mg qd. added to other hypertension: 2.5 mg. max 10 mg daily

angina: 10 mg qd

monitor: BP

Amlodipine Besylate with Benazepril HCL

hypertension: 1 cap daily

monitor: K, BP, CrCl, WBC

Diltiazem HCL

• High blood pressure (hypertension): Relaxes blood vessels to lower blood pressure and reduce the risk of stroke or heart attack. (120-240mg qd in 1-2 doses, 240-360mg qd in 1-2 doses)

• Angina pectoris: Decreases the heart's workload and oxygen demand, helping to prevent chronic stable or vasospastic chest pain. (30mg QID before meals and HS, 180-360mg qd in 3-4 doses)

• Heart rhythm disorders (arrhythmias): Intravenous forms are used in emergency or clinical settings to slow rapid heart rates in conditions like atrial fibrillation, atrial flutter, or supraventricular tachycardia (SVT) (0.25mg over 2 min, repeat with 0.35mg in 15 min,. begin continuous infusion of 10-15mg/h after second bolus dose)

• monitor: BP

Hydralazine HCL

hypertension: 10mg QID x2-4 days, then increase to 25mg QID through the first week. 40-200mg qd in 2-4 doses. Children: 0.75mg qd in 4 doses, max 7.5mg or 200mg daily

Parenteral (IM or IV): 20-40mg repeated PRN. Children: 1.7-3.5mg daily in 4-6 doses

Monitor: BP

Prazosin HCL

Hypertension: 1 mg 2-3 times a day, 6-20mg qd in divided doses

with other drugs: 1-2mg TID

Monitor: BP

Terazosin HCL

Hypertension: 1mg HS, normal range: 1-5mg qd, some benefit up to 20mg qd

Benign prostatic hyperplasia: 1mg HS, may increase up to 10mg qd

BEERS LIST

IF STOPPED RESTART AT INITIAL DOSAGE

Prednisolone Acetate

• Allergic conjunctivitis: Treats severe eye allergies and surface swelling.

• Iritis: Calms inflammation of the iris (the colored part of the eye).

• Keratitis: Relieves inflammation of the cornea (the clear front window of the eye).

• Post-surgery care: Reduces swelling and speeds comfort after eye operations.

• Eye injuries: Soothes damage from thermal or chemical burns

• 2 drops in AAA QID

Olopatadine HCL

allergic conjunctivitis: 1 drop in each AA eye BID 6-8H

ocular eye itching: 1 drop in each AA eye qd

Arformoterol

bronchoconstriction: 1 vial BID via nebulization

Monitor: BG (blood glucose), K

Ipratropium Bromide

• Chronic Obstructive Pulmonary Disease (COPD): Used for maintenance therapy to prevent and control bronchospasm (narrowing of the airways) linked to chronic bronchitis and emphysema. (2 inh of aerosol or 1 unit dose vial of inh soln via nebulizer 3-4 times a day)

• Asthma: Used off-label or alongside other rescue medicines (like albuterol) to manage severe asthma flare-ups and wheezing.

Nasal Spray Uses

• Runny Nose (Rhinorrhea): Used as a nasal spray to treat a runny nose caused by seasonal allergies, year-round non-allergic rhinitis, or the common cold. (2 sprays each nostril 2-3 times a day (0.035 spray) or 3-4 times a day (0.06% spray))

Ipratropium Bromide with Albuterol Sulfate

COPD: 1 3ml vial via nebulizer or 2 sprays from MDI QID with 2 additional doses per day PRN

Monitor: FEV (how much air can you push out of lungs)

Tiotropium Bromide

COPD, bronchitis, emphysema: 1 inh qd from handihaler or 2 sprays from 2.5mcg respimat qd

Asthema in pt 6+: 2 sprays from 1.25mcg respimat qd

Monitor: FEV

Umeclidinium Bromide

COPD, chronic bronchitis, emphysema: 1 inh qd at same time every day

Monitor: FEV

Umeclidinium and Vilanterol

COPD: 1 inh of anoro ellipta qd

Monitor: K

Budesonide

asthma and prophylactic therapy: children (12months-8 years): via jet nebulizer, 0.5mgs 1-2 qd, 1mg in 1-2 doses

adults: 180 mcg (children 6+) 360 mcg in adults BID

Monitor: FEV, BMD, IOP (eye fluid pressure)

Fluticasone Propionate

asthma and prophylactic therapy: 2 puffs of 44mcg MDI BID, diskus start with 1 inh of 50mcg, 2 puffs 110 or 220 MDI BID or 1 inh 100-250 mcg diskus BID.

children (4-11): 44mcg BID

Monitor: FEV, BMD, IOP

Montelukast Sodium

• Chronic Asthma: Used as a daily maintenance treatment to reduce airway inflammation and prevent asthma attacks. It is not a rescue medication and cannot stop an ongoing asthma attack. (1 10mg tab qd HS, children (6-14): 1 5mg tab qd HS, (2-5) 1 4mg tab qd HS

• Exercise-Induced Bronchoconstriction (EIB): Taken ahead of time to prevent narrowing of the airways triggered by physical activity. (10 mg qd 2hours prior to exercise)

• Allergic Rhinitis: Treats symptoms of seasonal (hay fever) and year-round (perennial) allergies, such as sneezing, stuffiness, and a runny nose, usually prescribed when other allergy treatments are ineffective or not tolerated. (10 mg qd, children (6-14): 5mg qd, (6months-5 years): 4mg qd)

Budesonide and Formoterol Fumarate Dihydrate

asthma 12+: 2 inh BID

COPD, bronchitis, emphysema: 2 inh BID

Monitor: BMD, IOP, FEV

Fluticasone Furoate and Vilanterol

COPD, bronchitis, emphysema: 1 inh breo ellipta 100/25 qd

Asthma (18+): 1 inh breo ellipta 100/25 qd or 200/25 qd

Monitor: K, BMD, FEV

Fluticasone Furoate, Umeclidinium Bromide, and Vilanterol

asthma (18+), COPD: 1 inh 1d

Monitor: K, BMD, FEV

Fluticasone Propionate with Salmeterol Xinafoate

asthma: 1 diskus inh or two HFA inh BID

COPD, bronchitis: 1 inh advair 250/50 BID

advair diskus 100/50 BID

monitor: BMD, FEV, IOP

Albuterol Sulfate Inh

bronchospasm: 1-2 inh aerosol inhaler 4-6H, inh soln: 2.5mg 3-4 times a day via nebulization

prevention; 2 inh QID

Exercise induced: 2 inh 15 min prior to exercise

Albuterol Sulfate Oral

bronchospasm: 2-4mg 3-4 times a day

children under 12: 2mg

Butalbital, Acetaminophen, and Caffeine

headache 12+: 1-2 tabs/caps q4H prn

BEERS LIST

Tramadol Hydrochloride

• Short-Term Relief: Immediate-release forms treat sudden or acute pain, such as pain after surgery. (50-100mg PRN 4-6H)

• Long-Term Management: Extended-release capsules or tablets manage persistent, chronic pain around-the-clock. (100mg qd)

Cephalexin Monohydrate

• Skin and soft tissue infections: Like boils, impetigo, and cellulitis.

• Respiratory infections: Like strep throat, sinus infections, and tonsillitis.

• 250mg- 1g q6H

• Children: 25-100mg in 4 doses