Unit 2 Gold Standard Drugs

Diazepam (Valium)

Benzo: CNS depressant, interacts with alcohol, opioids, barbiturates

Midazolam (Versed)

Benzo: CNS depressant, interacts with alcohol, opioids, barbiturates

Lorazepam (Ativan)

Benzo:CNS depressant, interacts with alcohol, opioids, barbiturates

Flumazenil (Romazicon)

Benzo antagonist: antidote to benzo overdose

Buspirone (Buspar)

Atypical anxiolytic/Nonbarbiturate anxiolytic: used for long term anxiety, effects develop slowly, interacts w tyramine

paroxetine (Paxil)

SSRI-antidepressant: takes 4-6 weeks to work, decreased libido, risk of serotonin syndrome

sertraline (Zoloft)

SSRI-antidepressant: takes 4-6 weeks to work, decreased libido, risk of serotonin syndrome

citalopram (Celexa)

SSRI-antidepressant: takes 4-6 weeks to work, decreased libido, risk of serotonin syndrome

fluoxetine (Prozac)

SSRI-antidepressant: takes 4-6 weeks to work, decreased libido, risk of serotonin syndrome

Duloxetine (Cymbalta)

SNRI- antidepressant: takes 4-weeks to work, not good for bipolar, risk of serotonin syndrome, similar effects of SSRI

Venlafaxine (Effexor)

SNRI- antidepressant: takes 4-weeks to work, not good for bipolar, risk of serotonin syndrome, similar effects of SSRI

Bupropion (Wellbutrin)

Atypical antidepressant: not good for those w/ hx of seizures, anorexia & bulemia increase risk of seizures, int; MAOI

amitriptyline (Elavil)

TCA -Tricyclic antidepressant: neuro & insomnia, overdose/toxicity can be lethal, limit # in people w/ suicide attempts

phenelzine (Nardil)

MAO inhibitors: *LOTS of interactions, HTN crisis, orthostathtn, tyramine interacts, pt ed needed

Selegline (Eldepryl)

MAO inhibitors: *LOTS of interactions, HTN crisis, tyramine interacts, pt ed needed

lithium carbonate (Lithobid)

Anti-manic, antipsychotic/mood stabilizer: bipolar disorder, *narrow therapeutic window, maintain Na consumption to avoid toxicity (don’t increase or decrease)

haloperidol (Haldol)

High potency typical antipsychotic: schizo, bipolar, hallucinations, opposite-causes parkinson symptoms=acute dystonia (muscle contractions), tardive dyskinesia (lip smack, mouth mvmt), airway patency=vital

chlorpromazine (Thorazine)

High potency typical antipsychotic: schizo, bipolar, opposite-causes parkinson symptoms=acute dystonia (muscle contractions), tardive dyskinesia (lip smack, mouth mvmt) airway patency=vital

risperidone (Risperdal)

Atypical antipsychotics: block sero & dopa receptors, more effective than 1st gen antipsychs, fewer side effects, int w/ immunosuppressants, alc, opiods, TCAs, *monitor for DM development= mess w metab, hyperglycemia, weight gain and insulin resistance

olanzapine (Zyprexa)

Atypical antipsychotics: block sero & dopa receptors, more effective than 1st gen antipsychs, fewer side effects, int w/ immunosuppressants, alc, opiods, TCAs

quetiapine (Seroquel)

Atypical antipsychotics: block sero & dopa receptors, more effective than 1st gen antipsychs, fewer side effects, int w/ immunosuppressants, alc, opiods, TCAs (Ronda)

Furosemide (Lasix)

Loop diuretic (Potassium wasting): used for CHF, PE, HTN, potential for ototoxicity if IV not pushed slow, lose Na and K+

HCTZ (hydrochlorothiazide)

Thiazide diuretic (Potassium wasting): lose Na & K+, int w/ digoxin, Li, NSAIDS

Spironolactone (Aldactone)

Potassium sparing diuretic: retains K+, avoid K+ rich foods

Mannitol

Osmotic diuretic: used in acute RF and intracranial pressure, sugar increases osmotic pressure pulls out H2O, and increases diuresis

Lisinopril (Prinivil)

(ACE) inhibitors: (-PRIL drugs): blocks AI to AII, dry cough= comp, monitor kidney fxn (BUN ,creatinine), don’t stop abruptly= rebound HTN, K+ sparing diuretic=additive effect

Captopril (Capoten)

(ACE) inhibitors (-PRIL drugs): blocks AI to AII, dry cough= comp, monitor kidney fxn (BUN ,creatinine), don’t stop abruptly= rebound HTN, K+ sparing diuretic=additive effect

Losartan (Cozaar)

Angiotensin-receptor blocker (ARB): HTN, alternate to ACE inhibitors (no cough)

Metoprolol (Lopressor)

Beta Blockers (-LOL drugs): selective beta, masks hypoglycemia, *check BP and pulse before admin, int: CCBs, antiHTN, insulin, monitor for bradycardia

Carvedilol (Coreg)

Beta Blockers(-LOL drugs): non-selective alpha & beta, masks hypoglycemia, *check BP and pulse before admin, int: CCBs, antiHTN, insulin

Propranolol (Inderal)

Beta Blockers(-LOL drugs): non-selective B1 & B2, masks hypoglycemia, *check BP and pulse before admin, int: CCBs, antiHTN, insulin

Diltiazem (Cardizem)

Calcium channel blocker (CCB): HTN, angina, dysrhythmias, blocks repolarization of muscles, increase vasodilation, decrease cardiac workload, int: beta-blockers, digoxin, grapefruit juice

Hydralazine (Apresoline)

direct vasodilator: relax vessels, monitor BP for hypotension

Nitroglycerin (NTG)

nitrate: angina relief, high 1st pass effect-do NOT give orally

digitalis glycoside (Digoxin)

cardiac glycoside: narrow therapeutic range, decreased workload, more efficient, pt education-monitor for yellow green halo/ blurry vision, diarrhea, vomitting, increased risk of toxicity, monitor for K+

Atorvastatin (Lipitor)

HMG CoA Reductase Inhibitors Statins: decrease LDL, hepatotoxicity, myopathy, int: erythromycin, grapefruit juice

Lovastatin (Mevacor)

HMG CoA Reductase Inhibitors Statins: decrease LDL, hepatotoxicity, myopathy, int: erythromycin, grapefruit juice

Simvastatin (Zocor)

HMG CoA Reductase Inhibitors Statins: decrease LDL, hepatotoxicity, myopathy, int: erythromycin, grapefruit juice

Cholestyramine (Questran)

Bile Acid Sequestrants(-col): promotes HDL, decrease LDL, constipation- bowel obstruction, give other meds at least 1 hr before or 4-6 hrs after-decreased absorption, do NOT give if hx of paralytic ileus (Shirley)

Colesevelam (Welchol)

Bile Acid Sequestrants(-col): promotes HDL, decrease LDL, constipation- bowel obstruction, give other meds at least 1 hr before or 4-6 hrs after-decreased absorption, do NOT give if hx of paralytic ileus

Heparin

Heparin anticoagulant: acute, strokes, PE, DVT, monitor appT,

*protamine sulfate=antidote

Enoxaparin (Lovenox)

low molecular weight heparin: long-term, daily, DVT prophylaxis in post-op, *protamine sulfate=antidote

Warfarin (Coumadin)

Vitamin K antagonist: blood thinner, block 4 coag factors, prevent DVT, PE, A fib, decrease risk of TIA, oral *Vit K=antidote

Dabigatran (Pradaxa)

Direct thrombin inhibitor: prevents thrombin from forming, used daily for A-fib, int: thrombolytics, anticoags, herbal supplements

Rivaroxaban (Xarelto)

Factor Xa Inhibitor: brain comp, oral, int: thrombolytics, anticoag, herbal supplements

Aspirin

Anti-platelet: MI prophylaxis, ischemic stroke, TIA, int: garlic, gingko, heparin, warfarin, tylenol, corticosteroids

tPA (alteplase)

Thrombolytic: does NOT help in clot prevention, CLOT BUSTER, acute treatment, BLACK BOX- no prior hemorrhagic stroke

Metformin (Glucophage)

Biguanide: decrease glucose in liver, increase uptake and use in : peripheral cells, complications: lactic acidosis, somnolence, int: iodine containing contrast-harsh on kidneys

Glipizide (Glucotrol)

Sulfonylureas: bind to specific beta cells in pancreas to make extra insulin, monitor for hypoglycemia, int: alc, NSAIDS, sulfonimides, Beta blockers (mask hypoglycemic effects)

Glyburide (Diabeta)

Sulfonylureas: bind to specific beta cells in pancreas to make extra insulin, monitor for hypoglycemia, int: alc, NSAIDS, sulfonimides, Beta blockers (mask hypoglycemic effects)

Pioglitazone (Actos)

Glitazone: decrease insulin resistance by increasing glucose uptake by muscle and adipose tissue decrease production in liver, exasperates CHF- BLACKBOX, int: insulin

Exenatide (Byetta)

Incretin mimetics: GI effects- fuller longer, diarrhea, nausea, slows contraceptives-2nd form needed

Semaglutide (Ozempic)

Incretin mimetics: GI effects- fuller longer, diarrhea, nausea, slows contraceptives-2nd form needed,

Lispro (Humalog)

Insulin: rapid acting, onset: 15-30 min, peak: 30min-1hr, duration: 3-5hr

Regular: (Humulin R, Novolin R)

Insulin: short, 30min-11hr, peak: 1-5hr, 6-10 hr, meal times, sliding scale/carb control

NPH: (Humulin N, Novolin N)

Insulin: onset: 1-2hr, peak: 4-14 hr, duration:14-24 hr intermediate, slide scale, meal time

Glargine (Lantus)

Insulin: long, peak: 1-4 hr, no peak, duration: 24 hr, baseline control, consistent lvl

Methimazole (Tapazole)

Thyroid peroxidase inhibitor: hyperthyroidism, prevents production, *1st line drug, may take 3-12 weeks for full effect, agranulocytosis-monitor for fever & sore throat, effects of hypothyroidism

Propylthiouracil (PTU)

Thyroid peroxidase inhibitor: hyperthyroidism, less potent, 2nd gen, safe during preg, 1st choice-less side effects, agranulocytosis-monitor for fever & sore throat, effects of hypothyroidism-bradycardia

Radioactive Iodine (RAI)

oral radiation quickly absorbed by overactive thyroid, 2-3 mo for full effect, avoid contact w kids and preg

Levothyroxine (Synthroid)

Thyroid hormone replacement: hypothyroidism, *1st line treatment, converts to T3 in body, osteoporosis, effects of hyperthyroidism

Prednisone (Deltasone)

corticosteroid: anti-inflam, immunosuppress, inhibit allergic reaction, increase BGL & Na, decrease K+ & Ca, concern w/ diuretics, osteoporosis- bone fractures

Dexamethasone, hydrocortisone

corticosteroid: anti-inflam, immunosuppress, inhibit allergic reaction, increase BGL & Na, decrease K+ & Ca, concern w/ diuretics, osteoporosis- bone fractures

Conjuaged equine estrogens (Premarin)

reproductive: contraception (made from horse urine) used in conjuct w/ progest, acne, post-meno relief, prostate cancer, int; nicotine-increases effects, phenytoin-decreases effects

Progesterones (Progestin)

reproductive: used in conjuct w/ estrogen, palliative care-breast cancer, amenorrhea, contraception, prevent preterm birth, *prevent cancer w estrogen, int; carbamazepine, pheytoin, rifampin- decrease effectiveness of contra-use 2nd method, cortico, anticoags, smoking (nic)

Ethinyl estradiol and drospirenone (Yasmin)

reproductive, hormonal contraceptive: Birth Control, prevent ov, thcken mucus lining, acne, int; carba, pheobarbital, rifampin, St. John’s wort, Warfarin, TCA, diazepam*Concern for DVTs & monitor BP

Levonorgestrel (Plan B)

reproductive: inhibits ov & sperm access if taken~72hrs, *won’t terminate against already established preg

Mifepristone and misoprostol (abortion pill)

reproductive: conjunctions mif=terminate, mis=eliminates, prevent preg ~5days, medical induction of preg term

Testosterone

reproductive: delayed puberty, anemia, muscle wasting in AIDS, testicular failure, int; oral anticoags, insulin & adntidiuretic, hepatoxic meds

Tamsulosin (Flomax)

reproductive (alpha 1 adrenergic antagonist): HTN (F), relax smooth muscle in bladder neck of & prostate (BPH), non-selective vasodilate (decrease BP), int; antihypertensives, PDE5 inhib, nitro

Finasteride (Propecia)

reproductive (5-Alpha reductase inhib): use testosterone to decrease prostate size and increase hair growth, alopecia, BPH, decrease libido, increase breast growth, int; none

Sildenafil (Viagra)

reproductive (Phosphodiesterase type 5 inhib-PDE5 inhib): ED, BPH, risk for MI, priapism-erect for hours, sudden hearing loss, int; grapefruit juice, CYP450, *NO NITROGLYCERIN