Top 400 - High Yield Information

SULFA allergy

What is the high yield information needed to know with ALL thiazides?

• Hydrochlorothiazide

• Chlorothiazide (Diuril)

Ethacrynic Acid (Ecedrin)

Which loop diuretic does NOT have a sulfa allergy?

Sulfa Allergy

What is the high yield information needed to know for bumetanide (Bumex)?

1 mg PO Bumex = 40 mg PO Lasix

What is the dosing conversion for bumetanide (Bumex) to furosemide (Lasix)?

• Protect IV form from LIGHT

• IV:PO = 1:2

What is the high yield information needed to know for furosemide (Lasix)?

Maxzide; Dyazide

What is the brand name of triamterene with hydrochlorothiazide?

Metolazone (Zaroxolyn)

Which thiazide medication can be used in renal failure?

Gynecomastia

What is a side effect of spirinolactone (Aldactone)?

50 mg QD

What is the dosage of spirnolactone (Aldactone) for the treatment of heart failure?

• Do not use in pregnancy

• High levels of lithium

• Watch out for HYPERKALEMIA

What is the high yield information needed to know for ACE Inhibitors?

• Benazepril (Lotensin)

• Enalapril (Vasotec)

• Lisinopril (Zestril; Prinvil)

• Lisinopril/HCTZ (Zestoretic)

• Quinapril (Accupril)

• Ramipril (Altace)

Enalapril (Vasotec)

Which is the only ACE Inhibitor that comes in IV form?

Ramipril (Altace)

Which is the only ACE Inhibitor that comes in capsules?

Entresto (Generic: Sacubitril + valsartan)

Which antidiabetic agent should NOT be given within 36 hours of ACE Inhibitors?

• Benazepril (Lotensin)

• Enalapril (Vasotec)

• Lisinopril (Zestril; Prinvil)

• Lisinopril/HCTZ (Zestoretic)

• Quinapril (Accupril)

• Ramipril (Altace)

• Do NOT use in pregnancy

• Does not affect bradykinin, therefore, can use if a patient has cough with ACE inhibitor

What is the high yield information needed TO know for ARB Inhibitors?

• Irbesartan (Avapro)

• Losartan (Cozarr)

• Losartan/HCTZ (Hyzaar)

• Valsartan (Diovan)

• Valsartan/HCTZ (Diovan HCT)

• Olmesartan (Benicar)

• Telmisartan (Micardis)

Post myocardial infarction, angina, tachycardia, stable heart failure, migraine

What is the indication for beta-blockers?

Labetalol (Normodyne)

Which beta-blocker is safe to be used in pregnancy?

• Hydrochlorothiazide

• Chlorothiazide (Diuril)

Which medications are thiazide diuretics?

• Chlorthalidone

• Indapamide (Lozol)

• Metolazone (Zaroxolyn)

Which medications are thiazide-like diuretics?

• Bumetanide (Bumex)

• Ethacrynic acid (Edecrin)

• Furosemide (Lasix)

• Torsemide (Demadex)

Which medications are loop diuretics?

• Benazepril (Lotensin)

• Enalapril (Vasotec)

• Lisinopril (Zestril; Prinvil)

• Lisinopril/HCTZ (Zestoretic)

• Quinapril (Accupril)

• Ramipril (Altace)

Which medications are ACE inhibitors?

• Irbesartan (Avapro)

• Losartan (Cozarr)

• Losartan/HCTZ (Hyzaar)

• Valsartan (Diovan)

• Valsartan/HCTZ (Diovan HCT)

• Olmesartan (Benicar)

• Telmisartan (Micardis)

Which medications are Angiotensin II Receptor Blockers (ARB)?

• Selective - “MAN BABE”

  • Metoprolol tartrate (Lopressor)

  • Metoprolol succinate (Toprol XL)

  • Nebivolol (Bystolic)

  • Bisoprolol (Zebeta)

    • Ziac (Bisoprolol/HCTZ)

  • Atenolol (Tenormin)

  • Betaxolol (Eye drops)

  • Esmolol

• Non-selective - “CLP”

  • Carvedilol (Coreg, Coreg CR)

  • Labetalol (Normodyne)

  • Propranolol (Inderal)

Which medications are beta-blockers?

• Non-DHP

  • Verapamil (Calan SR, Veralan, Veralan PM)

  • Diltiazem (Cardizem, Tiazac, Taztia XT)

• DHP

  • Amlodipine (Norvasc)

  • Felodipine (Plendil)

  • Nifedipine (Procardia, Procardia XL)

Which medications are calcium channel blockers?

• Clonidine

  • Catapres

  • Catapres TTS

  • Kapvay

• Guanfacine (Tenex, Intuniv)

Which medications are central alpha 2-agonists?

Hydralazine (Apresoline)

Which medication is a vasodilator?

• Alfuzosin (Uroxatral)

• Tamsulosin (Flomax)

• Prazosin (Minipress)

• Silodosin (Rapaflo)

• Terazosin (Hytrin)

• Doxazosin (Cardura, Cardura XL)

Which medications are alpha 1-blockers?

• Do not use in pregnancy

• Does not affect bradykinin, therefore, can use if a patient has a cough with an ACE Inhibitor

What is high yield information to know with Angiotensin II Receptor Blockers (ARB)?

• Irbesartan (Avapro)

• Losartan (Cozarr)

• Losartan/HCTZ (Hyzaar)

• Valsartan (Diovan)

• Valsartan/HCTZ (Diovan HCT)

• Olmesartan (Benicar)

• Telmisartan (Micardis)

Labetalol (Normodyne)

Which beta-blocker is safe to use in pregnancy?

1. Carvedilol (Coreg, Coreg CR) - non-selective

2. Labetalol (Normodyne) - non-selective

3. Propanolol (Inderal) - non-selective

4. Metoprolol tartrate IR (Lopressor) - selective

Which 4 beta-blockers should be take with food?

Nebivolol (Bystolic)

Which beta-blocker is known to increase Nitric oxide (vasodilation)?

Metoprolol succinate (Toprol XL)

Which beta-blocker can be split in half?

Start at 12.5 mg, then increase to target of 200 mg/day

What is the dosage for metoprolol succinate (Toprol XL) in patients with heart failure?

ZIAC

What is the brand name for the beta-blocker combination of bisoprolol + hydrochlorothiazide?

• PO and IV (for ventricular rate control)

• Inhibitor and substrate of 3A4

Describe the high yield information needed for non-DHP calcium channel blockers?

• Verapamil (Calan SR, Veralan, Veralan PM)

• Diltiazem (Cardizem, Tiazac, Taztia XT)

• Nifedipine (Procardia, Procardia XL)

• Amlodipine (Norvasc)

• Felodipine (Plendil)

Which calcium channel blockers are substrates of CYP3A4?

• “NAF”

• Do not crush or few - must be given every day

• MOA: Inhibit L-type calcium channels causing a decrease in calcium entry into cells and resulting in vasodilation, decreased contractility, and a reduction in heart rate

What is the high yield information needed for the calcium channel blocker, felodipine (Plendil)?

• Dry mouth

• Constipation

• Sedation

What is the high yield information needed to know for central alpha-2-agonists?

• Clonidine (Catapres, Catapres TTS, Kapvay)

• Guanfacine (Tenex, Intunix)

• 1 patch every 7 days

• KAPVAY is clonidine ER = ADHD

What is the high yield information needed to know for the central alpha-2-agonist, clonidine (Catapres, Catapres TTS, Kapvay)?

• Tenex = hypertension

• Intuniv = ADHD

What is the high yield information needed to know for the central alpha-2-agonist, guanfacine (Tenex, Intuniv)?

• Safe in pregnancy

• BiDil (Isosorbide dinitrate + hydralazine) = heart failure

• S/E:

  • Most common = cough

  • Least common = rash / lupus

What is the high yield information needed to know for the vasodilator, hydralazine?

• Short-acting

• Not for BPH, only for HYPERTENSION

What is the high yield information needed to know for the alpha-1 blocker, prazosin (Minipress)?

• Indicated for hypertension and benign prostate hyperplasia

• Titrate due to risk of orthostatic low blood pressure

What is the high yield information needed to know for the following alpha-1 blockers?

• Doxazosin (Cardura, Cardura XL)

• Terazosin (Hytrin)

• SULFA

• Take 30 minutes after same meal each day (morning/breakfast)

What is the high yield information needed to know for the alpha-1 blocker, tamsulosin (Flomax)?

• Take every day with food

• Capsules can be opened and Sprinkled onto appleSauce

What is the high yield information needed to know for the alpha-1 blocker, Sildosin (Rapaflo)?

• Take with same meal each day

• Better in the evening/dinner due to drowsiness

What is the high yield information needed to know for the alpha-1 blocker, alfuzosin (Uroxatral)?

• Class: Alpha-1 blocker

• MOA: Inhibit postsynaptic alpha-adrenergic receptors which result in vasodilation of blood vessels (veins and arterioles) and a decrease in blood pressure

  • In BPH, inhibit postsynaptic alpha-1 adrenergic receptors in prostate and bladder neck tissues leading to a relaxation of smooth muscles and alleviating urinary symptoms in BPH

0.5 mg PO QD alone or in combo with tamsulosin (Flomax)

What is the dosage of the 5 alpha-reductase inhibitor, dutasteride (Avodart) for BPH in males?

• Proscar: 5 mg for BPH

• Propecia: 1 mg for alopecia / male pattern baldness

What is the dosage of the 5 alpha-reductase inhibitor, finasteride (Proscar) (Propecia)?

• CCB + Statin

  • Amlodipine + atorvastatin (Caduet)

• CCB + ACE

  • Amlodipine + benazepril (Lotrel)

  • Amlodipine + perindopril (Prestalia)

  • Verapamil + trandolapril (Tarka) → with food

• CCB + ARB

  • Amlodipine + olmesartan (Azor)

  • Amlodipine + telmisartan (Twynsta)

  • Amlodipine + valsartan (Exforge)

• CCB + NSAID

  • Amlodipine + celecoxib (Consensi)

List all of the combinations for hypertension

• Isosorbide mononitrate (Imdur)

• Isosorbide dinitrate (Isordil)

• Nitroglycerin (Nitrostat, NitroBid)

• Ranolazine (Ranexa)

List the medications used for angina (chest pain)?

20 mg BID with the 2 doses given 7 hours apart (8 AM and 3 PM)

What is the dosage for isosorbide mononitrate (Imdur) IR?

• Don’t administer around the clock to prevent tolerance to nitrate effect; allow nitrate-free interval 14+ hours for IR products and 18+ hours for SR products

• IR products: For BID dosing

  • 8 AM &

  • 1 PM

• TID dosing:

  • 8 AM,

  • 1 PM, &

  • 6 PM

What is the dosage for isosorbide dinitrate (IsorDIL)?

IV must be in GLASS bottle

What is the high yield information needed to know for nitroglycerin (Nitrostat, NitroBid)?

• Indicated for chronic stable angina

• Contraindicated in hepatic impairment (LIVER)

What is the high yield information needed to know for the anti-anginal, ranoLazine (Ranexa)?

• Heparin

• Enoxaparin (Lovenox)

• Dabigatran (Pradaxa)

• Apixaban (Eliquis)

• Rivaroxaban (Xarelto)

• Warfarin (Jantoven, Coumadin)

List the anticoagulants

• IV / subcutaneous

• Monitor:

  • Hgb

  • Hct

  • Platelet

  • aPTT

  • Signs of bleeding

• Heparin lock flush is intended to maintain IV line open (NOT to be used for anticoagulant therapy)

• Doses: 1, 2, 10 and 100 units/mL

What is the high yield information needed to know for the anticoagulant heparin?

• Platelet count

• Hemoglobin

• Hematocrit

• Fecal occult blood

• Signs of bleeding

• Anti-factor Xa levels (as appropriate)

  • Pregnancy

  • Renal failure

  • Severely underweight / overweight patients

• Serum creatinine at baseline and during therapy; RENALLY adjusted medication

• Monitoring of PT and/or aPTT is NOT necessary

List the monitoring needed for enoxaparin (Lovenox)

• 30 mg subcutaneous Q12 hours; start 12-24 hours post-op for 7-10 days

• Alternative:

  • 40 mg SQ QD is for HIP replacement

• CrCl <30 mL/min : 30 mg

What is the dosage of enoxaparin (Lovenox) for DVT prophylaxis in hip/knee replacement?

• 40 mg subcutaneous QD

• Start 2 hours pre-operation

• No more than 12 days

What is the dosage of enoxaparin (Lovenox) for DVT prophylaxis in abdominal surgery?

• 1 mg/kg subcutanous Q12 hours or 1.5 mg/kg every day

• CrCl <30 mL/min: 1 mg/kg SC QD

What is the dosage of enoxaparin (Lovenox) for the treatment of DVT?

• Dose

  • Initial: 30 mg IV single bolus, then

  • 1 mg/kg SC Q12H with aspirin

• Contraindicated in patients with pork allergy

• Antidote: Protamine

What is the high yield information needed to know for enoxaparin (Lovenox) in the treatment of MI / unstable angina / thrombolytic adjunct / PCI?

• Direct thrombin inhibitor → inhibits factor IIa

• Antidote: Idarucizumab (Praxbind)

• KEEP IN ORIGINAL BOTTLE

• Once opened → 4 months

What is the high yield information needed to know for dabigatran (Pradaxa)?

• Factor Xa inhibitor

• Dosed TWICE daily

• Antidote: Andexanet alfa (Andexxa) (IV)

What is the high yield information needed to know for apixaban (Eliquis)?

• Hip = 10 mg QD for 35 days

• Knee = 10 mg QD for 12 days

What is the dosage of rivaroxaban (Xarelto) for hip and knee DVT prophylaxis?

• CrCl 50+ mL/min

• 20 mg QD with evening meal

What is the dosage of rivaroxaban (Xarelto) for stroke prophylaxis in non-valvular a-fibrilation?

• 15 mg BID x 12 days, THEN

• 20 mg QD for 3 months or greater

What is the dosage of rivaroxaban (Xarelto) for the treatment of DVT and/or pulmonary embolism (PE)?

Andexanet alfa (Andexxa) (IV)

What is the antidote for rivaroxaban (Xarelto)?

• INR

• Hgb

• Hct

• Hematocrit

• Signs of bleeding

List the labs needed to monitor when a patient is taking warfarin (Jantoven, Coumadin)

Vitamin K (phytonadione) (Mephyton)

What is the antidote for warfarin (Jantoven, Coumadin)?

MANY DRUG INTERACTIONS

• CYP Inhibitors will INCREASE INR → “GPAC”

  • Grapefruit juice

  • Protease Inhibitors

    • Ritonavir

  • Amiodarone

  • Azoles

  • Calcium channel blockers

  • Clarithromycin / erythromycin

  • Cobicistat

• CYP Inducers will DECREASE INR → SR COP2

  • St. John’s Wort

  • Sustiva (Efavirenz)

  • Rifampin

  • Carbamazepine / oxcarbazepine

  • Phenytoin / Phenobarbital

What is the high yield information needed to know for warfarin (Jantoven, Coumadin)?

• Clopidogrel (Plavix)

• Prasugrel (Effient)

• Ticagrelor (Brilinta)

• Dipyridamole + aspirin (Aggrenox)

What medications are antiplatelets?

• Loading dose: 300 mg; then 75 mg PO QD

• CYP2C19 Inhibitors DECREASE Plavix

  • Fluoxetine (Prozac)

  • Omeprazole (Prilosec)

  • Ritonavir

  • Oral contraceptives

What is the high yield information needed to know for clopidogrel (Plavix)?

60 mg loading dose, then 10 mg QD

What is the dosage of the antiplatelet, prasugrel (Effient)?

• LD: 180 mg (two 90 mg tablets)

• MD: 90 mg BID

• Boxed warning: Aspirin dose 100+ mg reduces effectiveness

What is the dosage / high yield information needed to know for the antiplatelet, ticagrelor (Brilinta)?

Contraindicated in patients with salicylate allergy

What is the high yield information needed to know for the antiplatelet, dipyridamole + aspirin (Aggrenox)?

• Amiodarone (Pacerone, Nexterone)

• Dronedarone (Multaq)

• Sotalol (Betapace, Betapace AF)

• Flecainide

• Dofetilide (Tikosyn)

Which agents are anti-arrhythmics?

• Major CYP3A4 substrate

• Drug interaction with warfarin → INCREASES INR

• Do NOT give Sofosbuvir (Sovaldi)

• SIDE EFFECTS

  • A = abnormal thyroid

  • M = muscle weakness

  • I = interstitial lung disease

  • O = optic neuropathy / ocular corneal micro deposits

  • D = discoloration (blue skin)

  • A = ataxia / tremors

  • R = reduction in HR and BP

  • O = phOtOsensitivity

  • N = nausea / vomitting / constipation

  • E = enzyme fluctuations in the liver

What is the high yield information needed to know for amiodarone (Pacerone, Nexterone)?

• K+ channel blocker

• With FOOD

• Avoid grapefruit juice

• Watch for liver failure and heart failure

What is the high yield information needed to know for dronedarone (Multaq)?

Available only PO

What is the high yield information needed to know for the antiarrthymic, flecainide?

• PO; do not use if CrCl < 20

• Contraindicated with HCTZ and citalopram (Celexa) → QT prolongation

What is the high yield information needed to know for the antiarrhythmic, dofetilide (Tikosyn)?

• Chronic heart failure

• Atrial fibrilation

Digoxin (Lanoxin, Digitek, Digox) is used for which disease states?

DigiTAB

What is the antidote for digoxin (Lanoxin, Digitek, Digox)?

• Statins

• Fibrates

• PCSK9 Inhibitors

What are the medication classes used in the treatment of dyslipidemia?

• Lipid panel

• LFT → baseline

• Muscle aches

• CPK note routinely measured → check CPK if muscle aches

What is the high yield information needed to know for statin medications?

• Atorvastatin (Lipitor)

• Atorvastatin + amlodipine (Caduet)

• Rosuvastatin (Crestor)

• Simvastatin (Zocor)

• Simvastatin + ezetimibe (Vytorin)

• Pravastatin (Pravachol)

• Lovastatin (Mevacor)

List the statin medications

80 mg

What is the maximum dosage for atorvastatin (Lipitor)?

40 mg

What is the maximum dosage for simvastatin (Zocor)?

• Least drug interactions

• Max: 80 mg

What is the high yield information needed to know for pravastatin (Pravachol)?

• IR with evening meal

• Max: 80 mg

What is the high yield information needed to know for lovastatin (Mevacor)?

• Gemifibrozil (Lopid)

• Fenofibrate (Tricor, Lipofen, Antara, Lofibra)

• Fenofibric acid (Trilipix, Fibricor)

List the fibrate agents

Do not use with statins due to increased risk of myopathy

What is the high yield information needed to know for gemifibrozil (Lopid)?

Lipofen and Antara is to be taken with food

What is the high yield information needed to know for fenofibrate (Tricor, Lipofen, Antara, Lofibra)?

• SQ once every 2 weeks

• In the refrigerator

What is the high yield information needed to know for the PS2K9, inhibitor, Alirocumab (Praluent)?

1. Alirocumab (Praluent)

2. Evolocumab (Repatha)

Which 2 agents are PCSK9 inhibitors used in dyslipidemia?

• SQ 140 mg Q2 weeks or 420 mg once monthly

• In the refrigerator

What is the high yield information needed to know for the PSK29, evolocumab (Repatha)?

• Ezetimibe (Zetia)

• Ezetimibe + simvastatin (Vytorin)

• Niacin (Vitamin B3, Niacor, Niaspan)

• Omega-3 (Lovaza)

List the additional / other medications used in dyslipidemia?

10 mg QD

What is the dosage for ezetimibe (Zetia)?

• With food

• Take aspirin 325 mg 30 minutes before dose to reduce flushing

• Can cause hyperuricemia

What is the high yield information needed to know for niacin (Vitamin B3, Niacor, Niaspan)?

Increased risk of bleeding with warfarin

What is the high yield information needed to know for omega-3 (Lovaza)?

• Levothyroxine (Synthroid, Levoxyl, Levothyroid)

• Liothyronine (Cytomel, Triostat)

Which medications are used for hypothyroidism?

• Propylthiouracil (PTU)

• Methimazole (Tapazole)

Which medications are used for hyperthyroidism?