(Select) Counseling Points

metronidazole

avoid alcohol or propylene-glycol containing products

causes darkened urine, metallic taste

-statins

may cause myopathy or rhabdomyolysis,

(do not use in pregnancy, lactation, liver disease),

avoid grapefruit juice

beta-blockers

may cause bradycardia, fatigue, hypotension

do not stop suddenly, taper over 12 weeks

ACE inhibitors

causes dry cough, hyperkalemia

do not take with ARBs or ARNIs

BBW: fetal harm and death

ketoconazole

shampoo may alter hair structure and texture

cephalosporins

cross-sensitivity with penicillin allergy

may cause serious skin reactions

fluoroquinolone antibiotics

increased risk of seizure

(BBW: tendon inflammation, CNS effects,

separate from nonvalent cations,

avoid in pregnancy and lactation)

Nitrostat

keep in its original amber container and at room temp

(do not use with PDE-5 inhibitors)

propranolol

non-selective so it can be used for migraine prophylaxis

labetalol

is the choice for HTN treatment in pregnancy

warfarin

may cause purple toe syndrome, (tissue necrosis, skin bruising

do not take when pregnant)

Pradaxa

swallow the capsules whole, must be kept in its original container

loop diuretics

avoid use with NSAIDs, take in the morning to prevent leaking, sulfa allergy cross sensitivity

(can cause alkalosis)

diuretics in general

depletes electrolytes

potassium sparing diuretics

increase risk of hyperkalemia

Enoxaparin

comes as a pre-filled syringe, do not expel air bubble from syringe prior injection

CaroSpir

causes gynecomastia, hyperkalemia, breast tenderness

interacts with lithium

ACE inhibitors (all)

Common Indications: Hypertension, heart failure

BBW: Fetal harm and death (avoid in pregnancy)

Contraindications: History of angioedema, Do not use within 36 hours of Entresto (valsartan/sacubitril).

Warnings/Precautions: Angioedema, hyperkalemia, hypotension, renal impairment, avoid use if bilateral renal artery stenosis

Side Effects: Dry cough, hyperkalemia, increase in SCr, hypotension, dizziness

Drug Interactions: Do not use in combination with ARBs or ARNI. Increased risk of lithium toxicity.

Counseling points: Avoid salt substitutes containing potassium

clonidine

do not D/C suddenly or risk rebound hypertension

patch may cause skin reaction

cordarone

avoid grapefruit juice

Tambocor

may cause visual disturbances, dyspnea

(BBW: proarrhythmic effects)

Cardura

causes ghost tablet in stool

doxycyline

take with water and sit upright for at least 30 min after

Tamiflu

is the most effective when taken within 48 hours

(neuropsychiatric or skin reactions may occur)

chlorhexidine gluconate

may cause teeth discoloration

nitrofurantoin

warning: hemolytic anemia

(do not use in renal impairment, may cause brown urine concentration)

-triptans

take for migraines, every 2 hour needed

Scopolamine

if you accidentally touch your eyes it may stinging

valproic acid

increases lamotrigine lvels

Dilantin

causes heair growth

Sinemet

don’t take within 14 days of MAOi, may cause dark urine or hallucinations o

opioids

may cause constipation m

MS Contin

may cause severe itching

NSAIDs

they can increase the risk of bleeding

Ketorolac

can only take for 5 days maz

SSRIs

(/most antidepressants) increased risk of security

Pristiq

may cause ghost tablet in stool

Namenda

can be sprinkled into opposites

acne drugs

avoid in pregnancy

Metformin

causes vitamin-B 12 deficiency, ER formulation may contribute to this

SGLTs

acute-kidney injury

bisphosphonates

polyvalent cations, take 30 min before food

birth controls

take the same time every day

PPIs

increased risk of osteoporosis, may need to give vitamin C and D supplements

Ditropan

avoid mouthwashes that contain alcohol

Pyridium

discolors the urine to red-orange color s

sulfasalazine

causes yellow-orange skin discoloration

folic acid

can decrease risk of neural tube defects

Lovaza

use with caution in shellfish hypersnsitiivty

prostaglandins

darkening of the iris and lengthening of the eyelashes

respiratory drugs

know which ones need to be shaken before use (priming it)

corticosteroids

know which one to rinse your mouth after

varenicline

begin use on week prior stop hate

tetracycline

separate from antacids and polyvalent cations (at least 1-2 hours prior or 4 hours after chlelating drug);

may cause permanent teeth discoloration in pregnant/lactating women, in pt < 8 yrs