Integumentary, Musculoskeletal, and Nervous System Drug Therapy

Prozac (fluoxetine) vs. Proscar (finasteride)

Prozac (fluoxetine) is used for depression, whereas Proscar (finasteride) is used for an enlarged prostate.

Celexa (citalopram) vs. Cerebyx / Celebrex

Celexa (citalopram) is used for depression/anxiety, Cerebyx is an anticonvulsant, and Celebrex is used for arthritis.

Zoloft (sertraline) vs. Zocor (simvastatin)

Zoloft (sertraline) is used for depression, whereas Zocor (simvastatin) is used for high cholesterol.

Controlled Substance Schedules

Amphetamine salts (ADHD stimulants) are C-II; Diazepam, Lorazepam, and Modafinil are C-IV; Lacosamide is C-V; Eszopiclone, temazepam, and triazolam are controlled insomnia drugs; Ramelteon is NOT controlled.

Cyclobenzaprine

Skeletal muscle relaxant contraindicated with or within $14$ days of MAOI use; avoid in hyperthyroidism, heart failure/blockage, or recent MI.

Felbamate

Anticonvulsant with serious adverse effects that require a signed patient/guardian waiver before dispensing.

Lamotrigine

Anticonvulsant carrying a boxed warning for fatal rashes.

Tiagabine

Anticonvulsant carrying a boxed warning for an increased risk of seizures.

CNS Stimulants (ADHD)

Class of ADHD medications carrying a boxed warning for potential for dependence.

Wellbutrin XL (bupropion)

Antidepressant that is contraindicated in patients with a history of seizures.

Thioridazine

Antipsychotic with a ceiling dose of $800\text{mg}$; doses above that limit cause retinal pigment deposits and blindness.

Clozapine

Antipsychotic contraindicated in patients with a history of severe neutropenia/agranulocytosis.

Etanercept

Biologic drug contraindicated in patients with active sepsis.

Sulfa Allergy Cross-Reactivity

Cross-reactivity risk in sulfa-allergic patients occurs with Celecoxib, Zonisamide, and Sulfasalazine (also avoid Sulfasalazine if allergic to salicylates).

Skin Layers

The three layers of skin from outer to inner are the epidermis, dermis, and subcutaneous layer.

Aloe Gel

Topical agent that inhibits bradykinin and slows thromboxane synthesis to help heal burns and sun overexposure.

Isotretinoin

Oral retinoid for severe acne that requires iPLEDGE program enrollment before dispensing; side effects are increased when combined with tetracycline.

Dapsone (Aczone)

Topical therapy that treats leprosy, spider bites, and skin infections; contraindicated under age $12$ and is NOT a retinoid gel.

Clindamycin Brand Names

Topical brand names include Evoclin, Veltin, and Ziana (Azelex is azelaic acid, not clindamycin).

Metronidazole Topical

Topical agent used for rosacea available as a gel, cream, and lotion (NOT available as a foam).

Calcineurin Inhibitors (tacrolimus, pimecrolimus)

Topical immunomodulators that block T-cell activation and reduce inflammatory mediators; pimecrolimus may enhance adverse effects of other immunosuppressants.

Hydrocortisone 0.5%

An OTC-strength topical corticosteroid.

Zinc Oxide

Barrier and drying agent used for the treatment of diaper rash.

Selenium Sulfide

Active ingredient in dandruff shampoos such as Selsun Blue.

Nizoral (ketoconazole) Shampoo

Antifungal shampoo used daily for $2$ weeks to treat fungal scalp infections.

Calamine

Topical antipruritic that relieves itching via counterirritant cooling and evaporation action.

Docosanol

OTC topical treatment for Herpes simplex type I (cold sores) that blocks viral entry and is most effective at the first sign of an outbreak.

Retapamulin Ointment

Topical antibiotic applied BID for $5$ days to treat impetigo caused by Streptococcus.

Furuncle

A staph infection starting in a sebaceous gland or hair follicle.

Ivermectin

Prescription medication used to treat head lice as well as inflammatory rosacea lesions