Quarter 3 Drugs Grp 2

Buspirone

Generic: Buspirone

Brand: BuSpar

Indication: Anxiety

MOA: Selective serotonin-5-HT1A receptor partial agonist

Box warning: None

Pregnant: low risks

Contrain: Hypersensitivity

PTPs: Avoid activities that require mental awareness until drug effects fully realized. May be weeks before symptomatic improvements. Take drug consistently with or without food. Avoid con. use with MAOI, avoid alcohol and/or large amounts of grapefruit juice.

Mirtazapine

Generic: Mirtazapine

Brand: Remeron

Indication: depression

MOA: Increases noradrenergic (norepinephrine) activity and enhanced 5-HT (serotonin) activity at 5-HT1A receptors.

Box warning: Suicidality, avoid in children

Pregnant: Moderate risk — human data

Contrain: Hypersensivity, con use with MAOIs, linezolid, and IV methylene use

PTPs:ORally disintegrating tablet → handle with dry hands, don’t push out packets. Take immediately, cannot store opened packets. Avoid activities that require mental awareness until drug effects fully realized. Report worsening depression, suicidal ideation, or unusual bleeding/behaviors.

Nortriptyline

Generic: Nortriptyline

Brand: Pamelor

Indication: Depression

MOA:Tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin.

Box Warning: Suicidality, not approved in children

Preg: low risk

Contrain: Hypersent to product, con use with there TCAs, MAOIs, IV methylene dye. Don’t use during MI recovery period.

PTPs: Avoid activities that require mental awareness until drug effect fully realized. Report worsening depression, suicidal ideation, and unusual bleeding/bruising. Avoid abrupt stop, alcohol, and CNS depressants.

Aripiprazole

Generic: Aripiprazole

Brand: Abilify

Indication: Depression, bipolar disorder, schizophrenia, Tourette syndrome, and irritability with autistic disorder

Box: Dementia, suicidality

PReg: Low risk

Contrain: Hypersent to product

PTPs:Avoid activités that require mental awareness until drug effects fully realized. Report worsening depression, suicidal ideation, unusual bleeding/behavior. Drug may impair temperature regulation and lower seizure threshold. Report increase of seizure activity, signs of hyperglycemia, extrapyramidal effects, and neuroleptic malignant syndrome. children adolescents and you adults at higher risks of side effects. Avoid abrupt stop and alcohol.

Divalproex Sodium

Generic: Divalproex

Brand: Depakote

Indication: Migraine prophylaxis, absence seizures, manic bipolar disorder, complex partial epileptic seizures

MOA: Consists of valproic acid and sodium valproate that work by increasing levels of GABA in the brain.

Box: Hepatotoxicity, patients with mitochondrial disease, teratogenicity, pancreatitis

Preg: suggest risks

Contrain: Hypersensitivity, hepatic disease, and urea cycle disorder

PTPs: Avoid activities that require alertness until rug effects fully realized. Monitor for liver dysfunction seen via dark urine, ight colored stool, and yellowing eyes/skin, especially within first 6 mos of taking drug. Avoid abrupt stop as can increase precipitate of seizures and alcohol. may open capsule and sprinkle on food, do not chew.

Levetiracetam

GEneric: Levetiracetam

brand: Keppra, Keppra XR

Indication: Myoclonic seizure partial seizure, and tonic-clonic seizure. the myoclonic seizures involve sudden muscle jerks; partial seizures affect only one part of the brain, while tonic-clonic seizures cause loss of consciousness and muscle stiffening.

MOA: pyrrolidine derivative MOA unknown

Box: None

Preg: suggests risk

Contrain: Hypersent.

PTPs: Do not chew or break extended release tablet → swallow whole. Avoid activators that require mental awareness until drug effects fully realized. Report worsening depression, suicidal ideation, an unusual behavior/bleeding.

Ropinirole

Generic: Ropinirole

Brand: Requip, Requip XL

Indication: Parkinson disease, restless legs syndrome

MOA: acts as a dopamine agonist, stimulating dopamine receptors to improve motor control and reduce symptoms.

Box: none

Preg: suggests risks

Contrain: Hypersent

PTPs: Take with food to reduce nausea. Monitor for signs in changes in BP, dyskinesia, fainting, or unusual urges. Avoid abrupt stop, alcohol, and other CNS depressants.

Donepezil

Generic: Donepezil

Brand: aricept

indication: Alzeheimer disease, dementia

MOA: inhibits acetylcholinestearse to prevent hydrolysis of Acetylcholine to enhance action

Box: none

preg: suggests low risk

Contrain: hypersent to product, piperidine

PTPs: take at bedtime with or without food. disintegrating product. Dose escalation may cause adverse effects more frequently but tend to resolve with continued use. Report signs and symptoms of bleeding.

Diazepam

Generic: Diazepam

Brand: Valium

Indication: Substance abuse withdrawal symptoms, anxiety, seizures

MOA: Enhance postsynaptic effect of GABA

Box: Con. use with opioids, addiction/dependence withdrawal reactions

Preg: Human data suggests risk 1st and 3rd trimesters

Contrain: Hypersent to benzodiazepines, narrow-angle glaucoma, severe liver disease, myasthenia gravis, sleep apnea, respiratory insufficiency, children <6mos

PTPs: avoid activities that require mental awareness and alcohol.

Tamsulosin

Generic: Tamsulosin

Brand: Flomax

Indication: Benign prostatic hyperplasia

MOA: quinazoline derivatives that selectively block alpha 1 adrenergic receptors

Box: none

Preg: Animal data → suggest low risks

Contrain: Hypersent

PTPs: Admin 30 mins after same meal each day as fasting increases bioavailability. Avoid activities that require coordination until drug effects fully realized. Sit up slowly after taking → lost of consciousness possible with 1st dose especially in upright position.

Sildenafil

Generic: Sildenafil

Brand: Viagra

Indication: Erectile dysfunction, pulmonary HTN

MOA: inhibition of phosphodiesterase type 5 PDE5 increase count of cyclic guanosine monophosphate enhancing erectile unction and pulmonary vasculature relaxation

Box: none

Preg: animal data - suggests low risks

Contrain: hypersent, con use with nitrates, con use HIV protease inhibitors when use to treat pulmonary HTN, con guanylate cyclase stimulators.

PTPs: Take 30 min-4hurs prior to anticipated sexual activity but do not take more frequently than once q24h

Tadalafil

Generic: Tadalafil

Brand: Cialis, Adcirca

Indication: Erectile dysfunction, Pulmonary NTH, benign prostatic hyperplasia

MOA: Inhibits phosphodiesterase 5 (PDE5) to increase cyclic guanosine monophosphate enhancing erectile function and pulmonary vasculature relaxation

Box: none

Preg: weigh risks and benefits

Contrain: Hypersent. con use with nitrates, con use guanylate cyclase inhibitors

PTPs: Take 30 minutes before sexual activity. only take 1x/d. Avoid activities that require mental awarenesss until drug effects fully realized. Report SOB, chest pains,erection lasting longer than 4 hours, tinnitus.

Finasteride

Generic: Finasteride

Brand: Proscar, Propecia

Indication: Benign prostatic hyperplasia, male pattern alopecia

MOA: Inhibits production of testosterone to 5a-dihydrotestosterone

Box: none

Preg: contraindicated

Contrain: Hyppersent, pregnant, use in children

PTPs: For hair loss may take 3 mos for improv. For enlarged prostate ~6mos for effects. Pregnant women avoid as can prevent genitalia development in male fetuses, also avoid semen of men on finasteride. Report SOB, chest pains, breast swelling or breast mass.

Pregabalin

Generic: Pregabalin

Brand: Lyrica

Indication: neuropathic pain, fibromyalgia, seizures, postherpetic neuralgia

MOA: GABA analogue reduce calcium dependent neurotransmitters but exact MOA unknown

Box: none

Preg: animal data suggests moderate risks

Contrain: hypersent

PTPs: Solution must be used w/n 45 days of first opening the bottle. Avoid activities that require mental awareness until drug effects fully realized. Avoid abrupt discontinuation, alcohol, and CNS depressants.

Hydroxyzine

Generic: hydroxzine

Brand: Atarax, vistaril

indication: Anxiety, pruritus, sedation

MOA: suppress activity in key subcortical locations in CNS

Box: none

Preg: human data suggests low risk

Contrain: hypersensitive cetirizine or hydroxyzine

PTPs: Avoid activities that require mental awareness until drug effects fully known

Latanoprost

Generic: Latanoprost

Brand: Xalatin, Xelpros

Indication: Ocular HTN

MOA: Prostaglandin analog that increases outflow of aqueous humor from the eye.

Box: none

Preg: considered safe during pregnancy with monitoring -prob compatible

Contrain: Hypersent

PTPs: Wash hands and remove eye contact before use. Pull head back and use finger to pull bottom of eye down to create pocket. Drop liquid into pocket before gently closing your eye and placing your finger over inner corner of eye for 1 min. Don’t touch/wipe/etc dropper → simply place cap back on right away.

Timolol

Generic: timolol

Brand: Betimol, timoptic

Indication: Glaucoma

MOA: beta-blocker that blocks beta 1/2 receptors

Box: none

Preg: Human data suggests risk 2/3rd trimester

Contrain: Hypersent, asthma, COPD, sinus bradycardia, heart failure, carcinogenic shock

PTPs: Wash hands and remove eye contacts. Lean head back and pull down bottom of eye with finger to create pocket. drop liquid in pocket then gently close eyes before placing index finger on inner corner of eye for 1 min. Do not touch/wipe drop top just place cap on. Separate from other eye drop for 5 minutes. Reinsert eye contact lens after 15 min

Alendronate

Generi: Alendronate

Brand: Fosmax, Binosto

Indication: Osteoporosis, Paget disease

Box: none

Preg: animal data suggests risk

Contrain: hypersent, esophageal abnormalities/increased risk for esophageal effects, hypocalcemia, inability to sit/stand for at least 30 min

PTPs: Swallow non-effervescent tablet whole with a large glass of water (240mL). Dissolve effervescent tablet in 120 mL water → once effervescent stops wait 5 min and stop for 10s before drinking. Remain upright for at least 30 mins after swallowing before eating/drinking anything else. Do not lie down until you eat something after that 30 mins.

Oxybutynin

Generic: Oxybutynin

Brand: Ditropan

Indication: Overactive neurogenic bladder

MOA: Muscarinic receptor antagonist that decreases bladder contractions and urgency.

Box: none

PReg: Animl data suggest risks

Contrain: HYpersent, urinary retention, gastric retention, glaucoma

PTPs: Drug may cause anticholinergic effects (constipation, urinary retention, blurred vision, dyspepsia, or xerostomia). Heat prostration can occur when used in hot environment

Benzonatate

Generic: Benzonatate

Brand: Tessalon Perles

Indication: Cough

MOA: Anesthetizes stretch receptors located in rspiratory passages, lungs, and pleura to reduce cough reflex

Box: none

Preg: Weigh risks and benefit

Contrain: Hypersent

PTPs: Do not chew or crush capsule → must swallow whole. Admin with food or milk if GI upset occurs. Accidental ingestion of 1-2 by children has been fatal. Keep out of reach children