GIN Exam 2

Apixaban brand

Apixaban brand

Eliquis

Apixaban class

Factor Xa inhibitor, DOAC

Apixaban MOA

Factor Xa inhibitor, inhibiting blood coagulation

Apixaban side effects

Bleeding, anemia, nausea

Apixaban dose

5 mg PO BID

Apixaban contraindications

Pregnancy, active bleeding, unstable PE

Apixaban BBW

Increased risk when stopped too soon, risk of hematoma with epidural or spinal puncture

Dabigatran brand

Pradaxa

Dabigatran class

Anticoagulant, direct thrombin inhibitor

Dabigatran MOA

Directly inhibits thrombin

Dabigatran side effects

Dabigatran dose

150 mg PO BID

Dabigatran contraindications

Dabigatran BBW

Increased risk of thrombotic events with premature discontinuation

Heparin brand

Heparin

Heparin class

Anticoagulant

Heparin MOA

Activates antithrombin, which inhibits coagulation factors

Heparin side effects

Heparin dose

80 units/kg IV push followed by 18 units/kg/hr continuous infusion

Heparin contraindications

Severe thrombocytopenia, uncontrolled active bleeding, history of HIT

Heparin BBW

None

Warfarin brand

Coumadin, Jantoven

Warfarin class

Anticoagulant, vitamin K inhibitor

Warfarin MOA

Inhibits vitamin K dependent coagulation factor synthesis

Warfarin side effects

Bleeding, abdominal cramps/pain, nausea, vomiting, diarrhea, fatigue, headache, taste changes, edema

Warfarin dose

Individualized

Warfarin contraindications

Pregnancy, active bleeding, blood dyscrasias, spinal puncture

Warfarin BBW

Risk of major or fatal bleeding, must monitor closely

Rivaroxaban brand

Xarelto

Rivaroxaban class

Anticoagulant, factor Xa inhibitor, DOAC

Rivaroxaban MOA

Selectively blocks active site of factor Xa, inhibiting blood coagulation

Rivaroxaban side effects

Bleeding, back pain, abdominal pain, pruritus, dizziness

Rivaroxaban dose

10-20 mg PO qD

Rivaroxaban contraindications

Major bleeding, acute PE, prosthetic heart valve, pregnancy

Rivaroxaban BBW

Increased thrombotic and stroke risk if treatment is stopped prior to completion, hematoma risk with spinal puncture

Polyethylene glycol brand

GlycoLax, MiraLax

Polyethylene glycol class

Osmotic laxative

Polyethylene glycol MOA

Causes water retention in stool

Polyethylene glycol side effects

Nausea, abdominal distension, cramping, flatulence, diarrhea

Polyethylene glycol dose

17 g PO qD

Polyethylene glycol contraindications

GI obstruction, known or suspected

Polyethylene glycol BBW

None

Docusate brand

Colace, Surfak

Docusate class

Emollient laxative

Docusate MOA

Facilitates the mixing of stool fats and water

Docusate side effects

Diarrhea, abdominal cramps, rash, bitter taste

Docusate dose

50-300 mg divided qD or BID

Docusate contraindications

Fecal impaction, appendicitis, GI obstruction

Docusate BBW

None

Loperamide brand

Imodium

Loperamide class

Antidiarrheal

Loperamide MOA

Slows intestinal motility

Loperamide side effects

Loperamide dose

Loading dose: 4 mg, then 2 mg after each loose stool for up to 16 mg/day, chronic idiopathic constipation: 24 mcg PO BID

Loperamide contraindications

Loperamide BBW

Torsade’s de pointes, sudden death, abuse potential

Ondansetron brand

Zofran

Ondansetron class

5HT3 receptor antagonist

Ondansetron MOA

Selectively antagonizes serotonin 5-HT3 receptors

Ondansetron side effects

Dizziness, headache, diarrhea, constipation, urinary retention, fatigue, agitation

Ondansetron dose

4-8 mg PO/IV q8h PRN

Ondansetron contraindications

Congenital long QT syndrome

Ondansetron BBW

None

Promethazine brand

Phenergan

Promethazine class

1st generation antihistamine, antiemetic

Promethazine MOA

Antagonizes central and peripheral H1 receptors, also possess anticholinergic properties resulting in antiemetic and sedative effects

Promethazine side effects

Drowsiness, sedation, blurred vision, dizziness, confusion, disorientation, photosensitivity, dermatitis, urinary retention

Promethazine dose

6.25-25 mg TID or QID PRN

Promethazine contraindications

Age < 2, respiratory depression, coma, SQ injection

Promethazine BBW

Contraindicated in patients under 2, injection can cause severe tissue damage, caution advised

Dicyclomine brand

Bentyl

Dicyclomine class

Anticholinergic

Dicyclomine MOA

Antagonizes acetylcholine at muscarinic receptors, relaxes smooth muscle, inhibits bradykinin and histamine induced muscle spasms

Dicyclomine side effects

Dizziness, blurred vision, nausea, nervousness, constipation, dry mouth, urinary retention

Dicyclomine dose

20-40 mg PO QID

Dicyclomine contraindications

Patients <6 months, unstable CV status, glaucoma, ulcerative colitis, obstructive GI disease

Dicyclomine BBW

None

Meclizine brand

Antivert, Bonnie

Meclizine class

1st generation antihistamine, antiemetic

Meclizine MOA

Suppresses vestibular end-organ receptors and inhibits activation of central cholinergic pathways

Meclizine side effects

Dizziness, drowsiness, headache, urinary retention, blurred vision, tachycardia, photosensitivity

Meclizine dose

25-100 mg qD in divided doses

Meclizine contraindications

None

Meclizine BBW

None

Amoxicillin brand

Amoxil, Moxatag

Amoxicillin class

Beta-lactam penicillin antibiotic

Amoxicillin MOA

Inhibits cell wall synthesis

Amoxicillin side effects

Nausea, vomiting, diarrhea, rash

Amoxicillin dose

250-500 mg q8h

Amoxicillin contraindications

Allergy to any beta-lactam antibiotics

Amoxicillin BBW

None

Metronidazole brand

Flagyl

Metronidazole class

1st generation nitroimidazole

Metronidazole MOA

Inhibits nucleic acid synthesis

Metronidazole side effects

Nausea, vomiting, stomach discomfort, diarrhea, metallic taste, rash, headache, dizziness

Metronidazole dose

500 mg PO q8h

Metronidazole contraindications

1st trimester pregnancy, alcohol use during or 14 days after use

Metronidazole BBW

Carcinogenic in mice, avoid unnecessary use

What is the MOA of antacids?

Neutralizes acid

What is the chemical reaction involved with antacids?

NaHCO3 + HCl → NaCl + H2CO3