DCA - Spring Patient Consultation

benazepril

avoid pregnancy, side effect: dry cough, may cause dizziness, use K supplements under medical supervision, seek medical attention with any facial swelling

enalapril

avoid pregnancy, side effect: dry cough, may cause dizziness, use K supplements under medical supervision, seek medical attention with any facial swelling

lisinopril

avoid pregnancy, side effect: dry cough, may cause dizziness, use K supplements under medical supervision, seek medical attention with any facial swelling

clonidine

avoid alcohol and CNS depressants, caution with driving, swallow ER tablet whole, apply patch to hairless area and rotate locations, avoid abrupt discontinuation

carvedilol

avoid abrupt discontinuation, diabetic patients should monitor blood sugar levels

valsartan

avoid pregnancy and sudden discontinuation, use K supplements under medical supervision

losartan

avoid pregnancy and sudden discontinuation, use K supplements under medical supervision

atenolol

avoid abrupt discontinuation, diabetic patients should monitor blood sugar levels

metoprolol

avoid abrupt discontinuation, diabetic patients should monitor blood sugar levels

propranolol

avoid abrupt discontinuation, diabetic patients should monitor blood sugar levels

amlodipine

report signs of peripheral edema, fatigue, hypotension, or hepatic dysfunction

diltiazem

follow administration instructions specific to prescribed brand, some products can be opened and sprinkled on applesauce

nifedipine

take on an empty stomach, avoid sudden discontinuation and grapefruit juice, may see tablet/shell of doasge form in stool

verapamil

do not crush/chew ER products, contents of ER capsules may be sprinkled on food, avoid sudden discontinuation, rise slowly from sitting/lying position to avoid dizziness, avoid alcohol and grapefruit juice

potassium chloride (oral)

take w food, take powder/granule/oral liquid after mixing in 4 oz of water, capsules may be sprinkled on food, completely dissolve effervescent tablets in liquid

furosemide

avoid alcohol and NSAIDs, increased risk of sun-sensitivity

hydralalzine

avoid abrupt discontinuation, report chest pain

triamterene with hydrochlorothiazide

may cause dizziness, avoid foods that are high in K, avoid NSAIDs, may cause photosensitivity, caution in patients with sulfonamide allergy

spironolactone

may cause dizziness, report signs of hyperkalemia and hyponatremia, avoid K supplements and NSAIDs

chlorothalidone

take in am w food, avoid alcohol and NSAIDs, may cause dizziness

hydrochlorothiazide

take early in the day to avoid nocturia, report signs of hypotension and dizziness, avoid NSAIDs

amiodarone

use sunscreen, report signs of cardiac arrhythmias, has multiple drug interactions, take consistently w regard to meals but avoid taking w grapefruit juice

colchicine

instruct patient on appropriate dosing strategy for gout flares

rivaroxaban

educate patient on signs of bleed and interactions w other anticoagulant medications, warn of risks of epidural anesthesia, doses greater than 15 mg should be taken w food, take w evening meals for nonvalvular atrial fibrillation

warfarin

report signs of hemorrhage, avoid situations where injury is likely to occur, has many drug interactions, avoid alcohol, cranberry, and changes in vitamin K consumption

digoxin

take after am meals, report signs of bradycardia, avoid abrupt discontinuation

apixaban

educate patient on signs of bleeding, take w or w/o food, should be interrupted before dental/surgical procedures, avoid NSAIDs and aspirin

isosorbide mononitrate

take on empty stomach, swallow ER tablet whole, can cause headaches and dizziness, avoid driving and operating machinery, stand up slowly, avoid abrupt discontinuation, avoid concurrent use of PDEEs, IR dose should be taken at least 7 hrs apart

nitroglycerin (sublingual and injectable)

sit prior to administration, tablet should be dissolved under tongue, do not eat or drink after placement of tablets, rise slowly, avoid use of alcohol and CNS depressants, ointment may stain clothing

sacubatril/valsartan

avoid abrupt discontinuation, use K supplements under medical supervision, may cause dizziness, avoid driving and operating machinery, avoid NSAIDs

clopidogrel

report signs of bleeding, avoid abrupt discontinuation

cyanocobalamin (vitamin B12)

may require several weeks for effect, take ER products w food, avoid alcohol

fenofibrate

report signs of rhabdomyolysis, do not use if you have severe kidney or liver disease

gemfibrozil

take 30 min before breakfast and dinner, report signs of rhabdomyolysis, do not use if you have severe kidney or liver disease

ezetimibe

take w or w/o food, may be taken at the same time as a concurrent statin

atorvastatin

avoid alcohol and grapefruit juice, notify prescriber if muscle tenderness or weakness occurs

pravastatin

take in evening, avoid alcohol and grapefruit juice, notify prescriber if muscle tenderness or weakness occurs

rosuvastatin

avoid alcohol, notify prescriber if muscle tenderness or weakness occurs

simvastatin

avoid alcohol, notify prescriber if muscle tenderness or weakness occurs

buspirone

avoid activities requiring mental alertness, avoid abrupt discontinuation, avoid alcohol and grapefruit juice

alprazolam

may cause drowsiness, avoid alcohol, do not crush, do not self-increase or discontinue abruptly

clonazepam

may cause drowsiness, avoid alcohol, allow disintegrating tablet to dissolve under tongue

diazepam

may cause drowsiness, avoid alcohol

lorazepam

may cause drowsiness, avoid alcohol

temazepam

may cause drowsiness, avoid alcohol, take 30 min prior to bed

zolpidem

take on empty stomach, may cause drowsiness, avoid alcohol, take before bed, avoid alcohol and CNS depressants, monitor respiration at night

vareniciline

take after meal w glass of water, may be used w other nicotine replacement products, limit alcohol use

desvenlafaxine

take w or w/o food, avoid alcohol, avoid abrupt discontinuation, avoid activities requiring mental alertness

duloxetine

report withdrawal symptoms and worsening depression, avoid alcohol, taper dose slowly

venlafaxine

take w food, avoid alcohol, swallow ER capsules/tablets whole, avoid abrupt discontinuation, avoid activities requiring mental alertness, may cause dizziness

citalopram

avoid activities requiring mental alertness, report worsening depression, avoid abrupt discontinuation, avoid alcohol, NSAIDs, and aspirin

escitalopram

avoid activities requiring mental alertness, report worsening depression, avoid alcohol, NSAIDs, and aspirin

fluoxetine

take w/o meals in the morning, avoid activities requiring mental alertness, report worsening depression, avoid alcohol, NSAIDs, and aspirin

paroxetine

do not chew/crush, avoid activities requiring mental alertness, avoid abrupt discontinuation and alcohol, caution with NSAIDs and aspirin

sertraline

avoid activities requiring mental alertness, avoid abrupt discontinuation, alcohol, NSAIDs, and aspirin

amitriptyline

avoid activities requiring mental alertness, avoid abrupt discontinuation, report worsening depression

buproprion

avoid alcohol, CNS depressants, and activities requiring mental alertness, take at the same time each day, ER tablet shell may be visible in stool

trazadone

avoid driving and other activities requiring mental alertness, avoid abrupt discontinuation, avoid alcohol, barbiturates, and CNS depressants

mirtazapine

open pack with dry hands, avoid activities requiring mental alertness, report worsening depression, avoid alcohol, take in pm

prazosin

avoid activities requiring mental alertness, rise slowly, avoid abrupt discontinuation and alcohol

lithium

swallow ER tablets whole, avoid activities requiring mental alertness, report signs of toxicity, maintain adequate fluid intake

lisdexamfetamine

take in am w or w/o food, monitor growth in children, report psychiatric problems and chest pain

dextroamphetamine

avoid taking in afternoon or evening, avoid GI alkalizing agents and alcohol, report chest pain or seizures

methylphenidate

avoid taking in pm, swallow ER capsule whole, avoid abrupt discontinuation, apply patch at same time each day alternating hips

carbamazepine

may decrease effectiveness of oral contraceptives, avoid activities requiring mental alertness, take w food, avoid alcohol, grapefruit juice, and abrupt discontinuation

divalproex (includes valproate or valproic acid VPA)

avoid activities requiring mental alertness, take w food, avoid alcohol and abrupt discontinuation

gabapentin

first dose should be taken at pm, ER dose should be taken w pm meal, avoid activities requiring mental alertness, report worsening depression, avoid abrupt discontinuation, wait 2 hrs after antacid before taking

lamotrigine

seek medical attention if rash occurs, slow titration necessary, avoid alcohol, place disintegrating tablet on tongue and allow to dissolve

levetiracetam

swallow ER tablet whole, avoid activities requiring mental alertness, report mood swings, avoid abrupt discontinuation

phenytoin

shake suspension before administration, don't crush ER capsules, avoid activities requiring mental alertness, avoid alcohol, has many drug interactions

pregabalin

solution must be used w/i 45 days of opening, avoid activities requiring mental alertness and abrupt discontinuation

topiramate

avoid activities requiring mental alertness and abrupt discontinuation, maintain adequate fluid intake, decreases effectiveness of oral contraceptives, take a missed dose ASAP

carbidopa with levodopa

place disintegrating tablet on top of tongue

donepezil

take at pm w or w/o food, allow disintegrating tablet to dissolve on tongue, report signs of GI bleeding

ropinirole

take w food, avoid activities requiring mental alertness, abrupt discontinuation, alcohol, and CNS depressants

pramipexole

take w food, avoid activities requiring mental alertness, abrupt discontinuation, alcohol, and CNS depressants

memantine

may be taken w or w/o food, use packaged device for administration

atomoxetine

avoid activities requiring mental alertness, monitor growth in children, do not open capsules

aripiprazole

avoid activities requiring mental alertness, may impair heat regulation, report worsening depression and increased seizure activity, avoid abrupt discontinuation and alcohol

lurasidone

take w food, avoid activities requiring mental alertness, report worsening depression, avoid abrupt discontinuation and alcohol

olanzapine

avoid activities requiring mental alertness, may impair heat regulation, rise slowly, report symptoms of tardive dyskinesia, diabetic patients should monitor for hyperglycemia, avoid alcohol

quetiapine

take w food, avoid alcohol, avoid activities requiring mental alertness, rise slowly

clozapine

avoid alcohol, call healthcare if dose is missed, avoid abrupt discontinuation, report signs of infection, educate patients on drug-induced constipation

risperidone

take w food, avoid alcohol and CNS stimulants, avoid activities requiring mental alertness, keep tablet in blister pack until use, oral solution may be mixed w water but shouldn't be mixed w cola or tea