Sweat Box Meds

Atorvastatin (lipitor)

Class: Statin

Indication: hyperlipidemia

How it works: ↓ Cholesterol synthesis in liver

S/E: muscle pain (myalgia), headache, GI upset

Serious A/E: Rhabdomyolysis, hepatotoxicity

N/C: monitor LFTs, report muscle pain, avoid grapefruit

Simvastatin (zocor)

Class: statin

Indication: hyperlipidemia

How it works: ↓ LDL cholesterol

S/E: myalgia

Serious A/E: rhabdomyolysis 

N/C: monitor LFTs, avoid grapefruit

Lisinopril (prinivil)

Class: ACE inhibitor

Indication: hypertension, HF

How it works: vasodilation, ↓ BP

S/E: dry cough

Serious A/E: angioedema, hyperkalemia

N/C: monitor BP & K+, avoid pregnancy

Fenofibrate (tricor)

Class: fibrate

Indication: high triglycerides

How it works: ↓ triglycerides

S/E: GI upset

Serious A/E: myopathy (muscle disease)

N/C: monitor lipids, LFTs (ALT, AST, ALP, GTT, albumin, bilirubin, total protein)

Lisinopril/HCTZ (zestoretic)

Class: ACE inhibitor + diuretic

Indication: hypertension

How it works: ↓ BP via vasodilation and diuresis

S/E: dizziness

Serious A/E: electrolyte imbalance

N/C: monitor BP, K+ (3.5-5)

losartan (cozaar)

Class: ARB

Indication: hypertension

How it works: blocks angiotensin II receptor

S/E: dizziness

Serious A/E: hyperkalemia

N/C: monitor BP, K+ (3.5-5)

Losartan Potassium (cozaar)

Class: ARB

Indication: hypertension

How it works: vasodilation

S/E: fatigue

Serious A/E: renal impairment

N/C: assess renal function

Metoprolol (lopressor)

Class: beta blocker

Indication: hypertension, angina

How it works: ↓ HR, BP

S/E: fatigue

Serious A/E: bradycardia, heart block

N/C: check HR before & after, hold if <60, check BP

Metoprolol ER (toprol XL)

Class: beta blocker

Indication: hypertension, HF

How it works: ↓ cardiac workload

S/E: fatigue

Serious A/E: hypotension, bradycardia

N/C: DO NOT crush ER

Atenolol (tenormin)

Class: beta blocker

Indication: hypertension

How it works: ↓ HR, BP

S/E: bradycardia

Serious A/E: hypotension, HF

N/C: check HR & BP, monitor pulse

Amlodipine (norvasc)

Class: calcium channel blocker

Indication: hypertension, angina

How it works: vasodilation

S/E: edema, headache

Serious A/E: severe hypotension

N/C: monitor BP, ankle swelling

Carvedilol (coreg)

Class: beta blocker

Indication: hypertension, HF

How it works: ↓ HR, BP

S/E: dizziness

Serious A/E: bradycardia

N/C: give with food

Furosemide (lasix)

Class: loop diuretic

Indication: edema, HF

How it works: remove excess fluid

S/E: hypokalemia

Serious A/E: dehydration

N/C: monitor electrolytes

Hydrochlorothiazide

Class: thiazide diuretic

Indication: hypertension

How it works: ↑ urine output

S/E: hypokalemia

Serious A/E: electrolyte imbalance

N/C: monitor potassium

Heparin

Class: anticoagulant

Indication: DVT prevention

How it works: inhibits clot formation

S/E: bleeding

Serious A/E: HIT (heparin induced thrombocytopenia)

N/C: monitor aPTT, platelets, antidote = protamine sulfate, given IV or sub Q

Warfarin (Coumadin)

Class: anticoagulant

Indication: thromboembolism

How it works: inhibits vitamin K clotting factors

S/E: bleeding

Serious A/E: hemorrhage

N/C: monitor INR, antidote = vitamin K, given PO

Aspirin (ASA)

Class: antiplatelet/NSAID

Indication: cardiovascular protection (stroke, MI)

How it works: inhibits platelet aggregation

S/E: GI upset

Serious A/E: bleeding, GI bleeding

N/C: monitor for bleeding, avoid w/ bleeding risk

Clopidogrel (plavix)

Class: antiplatelet

Indication: stroke prevention

How it works: prevents platelet aggregation

S/E: bruising

Serious A/E: bleeding

N/C: monitor for bleeding, initiate bleeding precautions

Digoxin (lanoxin)

Class:cardiac glycoside

Indication: HF, atril fibrillation

How it works: ↑ heart contractility, ↓ HR

S/E: nausea, vomiting, fatigue

Serious A/E: digoxin toxicity (0.5-2.0)

N/C: check apical pulse, monitor med level

Metformin (glucophage)

Class: biguanide

Indication: type 2 diabetes

How it works: ↓ glucose production

S/E: GI upset, diarrhea

Serious A/E: lactic acidosis

N/C: HOLD for contrast

Levothyroxine (synthroid)

Class: thyroid hormone

Indication: hypOthyroidism

How it works: replaces T4

S/E: weight LOSS

Serious A/E: hyperthyroidism

N/C: take AM empty stomach

Prednisone (deltasone)

Class: corticosteroid

Indication: inflammation

How it works: ↓ inflammation, suppresses immune system

S/E: hyperglycemia, weight GAIN

Serious A/E: adrenal suppression

N/C: taper dose

Methylprednisolone (medrol)

Class: corticosteroid

Indication: inflammation

How it works: anti-inflammatory

S/E: hyperglycemia, fluid retention

Serious A/E: infection

N/C: monitor glucose

Allopurinol (zyloprim)

Class: xanthine oxidase inhibitor

Indication: gout (painful inflammatory arthritis b/c build up of lactic acid)

How it works: ↓ uric acid

S/E: rash

Serious A/E: stevens-johnson syndrome

N/C: hydration, stop if rash

Albuterol (ventolin)

Class: bronchodilator

Indication: asthma

How it works: relaxes airway smooth muscle

S/E: tremor

Serious A/E: tachycardia

N/C: assess lung sounds before/after, monitor HR, rescue med for ACUTE asthma

Montelukast (Singulair)

Class: leukotriene inhibitor

Indication: asthma

How it works: ↓ inflammation

S/E: headache

Serious A/E: mood changes

N/C: monitor behavior, NOT for acute attack

Fluticasone (flonase)

Class: corticosteroid

Indication: allergic rhinitis (inflammation: runny, stuffy, itchy nose, sneezing)

How it works: ↓ inflammation

S/E: nasal irritation

Serious A/E: epistaxis (nose bleed), immunosuppression

N/C: rinse mouth, daily use

Sertraline (zoloft)

Class: SSRI

Indication: depression

How it works: ↑ serotonin

S/E: nausea

Serious A/E: serotonin syndrome 

N/C: takes weeks, monitor mood

Fluoxetine (prozac)

Class: SSRI

Indication: depression

How it works: ↑ serotonin

S/E: anxiety, insomnia

Serious A/E: serotonin syndrome, suicidal ideation

N/C: long half-life, monitor behavior

Citalopram (celexa)

Class: SSRI

Indication: depression

How it works: ↑ serotonin

S/E: dry mouth

Serious A/E: QT prolongation

N/C: ECG monitoring

Escitalopram (lexapro)

Class: SSRI

Indication: anxiety

How it works: ↑ serotonin

S/E: fatigue, insomnia

Serious A/E: serotonin syndrome, QT prolongation

N/C: gradually taper, ECG, monitor mood

Venlafaxine (effexor)

Class: SNRI

Indication: depression

How it works: ↑ serotonin & norepinephrine

S/E: hypertension

Serious A/E: withdrawal

N/C: taper slowly, monitor BP

Duloxetine (cymbalta)

Class: SNRI

Indication: depression, pain

How it works: ↑ serotonin & norepinephrine

S/E: dry mouth, nausea

Serious A/E: liver injury

N/C: monitor LFTs

Bupropion (Wellbutrin)

Class: NDRI

Indication: depression

How it works: ↑ dopamine & norepinephrine

S/E: insomnia

Serious A/E: seizures

N/C: avoid history of seizures

Alprazolam (xanax)

Class: benzodiazepine (flumazenil = antidote)

Indication: anxiety

How it works: CNS depressant

S/E: drowsiness

Serious A/E: dependence

N/C: short term use, fall risk

Zolpidem (ambien)

Class: hypnotic

Indication: insomnia

How it works: sedative effect, induces sleep

S/E: dizziness

Serious A/E: sleep walking

N/C: safety precautions, give at bedtime

Trazodone (oleptro)

Class: atypical antidepressant

Indication: insomnia

How it works: sedation

S/E: orthostasis, sedation

Serious A/E: priapism (persistent, painful erection)

N/C: fall precautions, bedtime

cyclobenzaprine (flexeril)

Class: muscle relaxant

Indication: muscle spasms

How it works: CNS depression

S/E: drowsiness

Serious A/E: arrhythmias

N/C: short-term use

Gabapentin (neurontin)

Class: anticonvulsant

Indication: neuropathy

How it works: ↓ nerve excitation/pain

S/E: drowsiness

Serious A/E: CNS depression, suicidal ideation

N/C: renal dosing?, taper slowly

Levetiracetam (keppra)

Class: anticonvulsant

Indication: seizures

How it works: ↓ neuronal firing

S/E: fatigue, mood changes

Serious A/E: suicidal ideation

N/C: monitor behavior/mood

Phenytoin (dilantin)

Class: anticonvulsants

Indication: seizures

How it works: stabilizes neurons

S/E: gingival hyperplasia (gum overgrowth)

Serious A/E: toxicity

N/C: monitor levels

Amphetamin/Dextroamphetamine (adderall)

Class: stimulant

Indication: ADHD

How it works: ↑ CNS stimulation

S/E: insomnia

Serious A/E: cardiac events

N/C: monitor BP

Hydrocodone/APAP

Class: opioid combo

Indication: moderate to severe pain

How it works: CNS pain relief

S/E: constipation

Serious A/E: respiratory depression

N/C: RR ≥ 12

Tramadol (ultram)

Class: opioid agonist

Indication: moderate to moderately severe pain

How it works: CNS pain relief

S/E: nausea

Serious A/E: seizures 

N/C: caution with SSRIs

Azithromycin (Zithromax)

Class: macrolide

Indication: infection

How it works: inhibits bacteria; protein synthesis

S/E: GI upset

Serious A/E: QT prolongation

N/C: complete full course, ECG history

Amoxicillin (amoxili)

Class: penicillin

Indication: infection

How it works: cell wall inhibition; kills bacteria

S/E: rash

Serious A/E: anaphylaxis

N/C: check allergies

Amoxicillin/clavulanate (augmentin XR)

Class: penicillin combo

Indication: infection

How it works: broad spectrum

S/E: diarrhea

Serious A/E: hepatotoxicity

N/C: take with food

Omeprazole (Prilosec)

Class: proton pump inhibitor

Indication: GERD

How it works: ↓ gastric acid production

S/E: headache

Serious A/E: C. diff, fractures

N/C: short term use, BEFORE meals

Pantoprazole (protonix)

Class: proton pump inhibitor

Indication: GERD

How it works: ↓ gastric acid

S/E: diarrhea

Serious A/E: C diff., hypomagnesemia

N/C: short term use, monitor electrolytes

Tamsulosin (flomax)

Class: alpha 1 blocker

Indication: benign prostatic hyperplasia

How it works: relaxes prostate

S/E: dizziness

Serious A/E: orthostatic hypotension

N/C: give at bedtime, change positions slowly