Pharmacology Considerations for Common Medications

Naproxen

They rapidly reduce inflammation and pain by blocking prostaglandin production.

Colchicine

Used for acute gout; interacts with CYP3A4 inhibitors; can cause GI upset and bone marrow suppression.

Allopurinol

Hypersensitivity syndrome: rash, fever, eosinophilia, organ dysfunction.

IV Calcium Chloride

Do not use with ceftriaxone in neonates—can cause fatal precipitation.

Methotrexate

CBC, liver enzymes, kidney function to watch for toxicity.

Hydroxychloroquine

Annual eye exams are needed to monitor for retinal toxicity.

Alendronate

Take with full glass of water on empty stomach, stay upright 30 mins.

Raloxifene

Avoid immobility; report leg pain or swelling.

NPH Insulin

Can be mixed with regular insulin; draw regular insulin first.

Insulin Lispro

Given before meals, dose based on blood glucose.

Insulin Glargine

Given once daily, never mix with other insulins.

Glipizide

Alcohol causes disulfiram-like reaction; beta blockers mask hypoglycemia.

Metformin

Patients with renal impairment or lactic acidosis risk.

Methimazole

Agranulocytosis; avoid in first trimester pregnancy.

Levothyroxine

Give via IV; separate from calcium/iron; enhances warfarin effects.

H. pylori triple therapy

Clarithromycin, amoxicillin, and PPI for 14 days.

Metronidazole

Alcohol—causes disulfiram-like reaction.

Omeprazole

Hypomagnesemia, fracture risk, C. diff.

Laxative abuse

Dehydration, electrolyte imbalances, dependency.

Psyllium

Take with water immediately; prevent choking/blockage.

Magnesium Hydroxide

Elderly and those with renal impairment.

Docusate

For patients who should not strain, e.g., post-op.

Ondansetron

Headache, constipation, fatigue.

Promethazine

Sedation, respiratory depression, EPS.

Sildenafil

Avoid nitrates/alpha blockers; risks include priapism, vision/hearing loss.

Finasteride

Decreased libido, ejaculate volume, gynecomastia.

Morphine

Tolerance = higher dose needed; adverse = sedation, respiratory depression.

Naloxone

To reverse opioid overdose or respiratory depression.

Acetaminophen

Liver toxicity, especially with alcohol; interacts with warfarin.

Acetylcysteine

Prevent or treat acetaminophen-induced liver damage.

Aspirin

GI bleeding, tinnitus, Reye's syndrome in children.

Sumatriptan

Those with cardiovascular disease; risks include vasospasm, chest pain.