Pharmacy Practice III Closeouts

Metformin (brand name)

Glucophage

Metformin (class)

Biguanide

Metformin (indication)

Type 2 diabetes

Metformin (dosing)

IR: QD-TID ER: QD

With food

Metformin (side effects)

N/V/D, flatulence, vit B12 deficiency, lactic acidosis (black box warning, rare)

Metformin (key counseling)

Avoid excessive alcohol, start low and go slow (XR formulation more tolerable), lifestyle modifications

Fluticasone/Salmeterol (brand name)

Advair

Fluticasone/Salmeterol (class)

ICS/LABA

Fluticasone/Salmeterol (indication)

Asthma, COPD

Fluticasone/Salmeterol (dosing)

BID

Fluticasone/Salmeterol (side effects)

Thrush, upper respiratory tract infections, pharyngitis

Fluticasone/Salmeterol (key counseling)

Rinse mouth after use, use appropriate techniques, use regularly

Breathe out away from device, hold breath for 10 seconds, breathe out slowly

Doxycycline (brand name)

Vibramycin, Vibratabs, Doryx

Doxycycline (class)

Tetracycline

Doxycycline (indication)

Bacterial infections

Doxycycline (dosing)

QD or BID

Doxycycline (side effects)

N, photosensitivity

Doxycycline (key counseling)

Take with a full glass of water, avoid lying down for 30 min, not for <8yo, avoid taking with antacids, multivitamins, and dairy products, complete the full course, hyclate and monohydrate are equally effective once absorbed, but monohydrate has fewer GI side effects

Alendronate (brand name)

Fosamax

Alendronate (class)

Bisphosphonate

Alendronate (indication)

Osteoporosis

Alendronate (dosing)

QWeek

Alendronate (side effects)

N/V, heartburn, RARE: atypical femur fracture, osteonecrosis of jaw

Alendronate (key counseling)

Take on empty stomach with a full glass of water, avoid lying down for 30 min, augment with calcium and vitamin D, take regularly

Insect stings (symptoms)

Been outside, red, raised, itchy, painful

Insect stings (product)

Local anesthetics (benzocaine, pramoxine, benzyl alcohol, lidocaine, dibucaine, or phenol), topical diphenhydramine

Insect stings (dosing)

Apply TID-QID X7

Insect stings (side effects)

Sensitization (contact dermatitis/skin irritation)

Insect stings (key counseling)

PCP if symptoms persist/worsen after 7 days of treatment

Insect stings (non-pharm)

DEET to prevent future bites, avoid standing water or dense woods, window screens, cuffed clothing, ice pack wrapped in a washcloth

Pediculosis (symptoms)

White (nit casing) and gray in the hair

Pediculosis (product)

Pyrethrins or permethrin

Pediculosis (dosing)

Pyrethrin shampoo: apply for 10 minutes, rinse, use a nit comb to remove dead lice and eggs

Pediculosis (side effects)

Skin irritation

Pediculosis (key counseling)

Retreat in 7-10 days if active lice detected, use with a nit comb. If lice still present after two rounds of treatment, contact PCP for a prescription product

Pediculosis (non-pharm)

Comb with an FDA-approved nit comb, AirAlle (machine that applies heat to scalp to dehydrate and kill lice and nits), don't share items, wash fabric in hot water and dryer, regularly vacuum carpets, rugs, and furniture

Burn/wound (symptoms)

Blisters, red

Burn/wound (product)

APAP, topical anesthetics (benzocaine and lidocaine), and Aquaphor

Burn/wound (dosing)

APAP NTE 4000mg, 2T Q4-6H

Burn/wound (side effects)

APAP liver damage if high doses

Burn/wound (key counseling)

Tetanus shot for breaks in skin, PCP if wound isn't healing after 7 days

Burn/wound (non-pharm)

Clean with cool running water, silicone gel after wound has healed to prevent scarring, moist protective dressing (ex. hydrocolloid)

Allergy (symptoms)

Sneezing, itchy nose or eyes, and a runny nose, clear nasal discharge

Allergy (product)

Non-sedating antihistamines (loratadine, cetirizine, fexofenadine)

Allergy (dosing)

QD

Allergy (side effects)

Drowsiness (more common with older antihistamines), dry mouth, headache

Allergy (key counseling)

Some achieve symptomatic relief in 3-4 days, full relief may take 2-4 weeks. PCP if no improvement in 2-4 weeks

Allergy (non-pharm)

Avoid allergens, use HEPA air filters, shower after outdoor exposure

Fungal infection (symptoms)

Feet, groin, scalp, or underarms, rash, itching

Fungal infection (product)

Antifungal (miconazole, clotrimazole, terbinafine, tolnaftate)

Fungal infection (dosing)

QD or BID

Fungal infection (side effects)

Tolnaftate may sting

Fungal infection (key counseling)

If improvement is seen in 1st week, still continue treatment for 1-4 weeks. Can take 4-6 weeks of treatment. PCP no improvement in 6 weeks

Fungal infection (non-pharm)

Keep skin clean and dry, avoid sharing clothing, avoid contact with fomites (ex. shared towels), launder fabrics in hot water/dryer, tea tree oil 10%

Contact dermatitis (symptoms)

Lesions, wheals, or fluid-filled vesicles, itching, pain, redness

Inflammatory skin reaction caused by exposure to an irritant (irritant, ICD) or an antigen (allergic, ACD)

Contact dermatitis (product)

Hydrocortisone (inflammation and pruritis), colloidal oatmeal/calamine (soothing), aluminum acetate (weeping lesions), Tecnu/Zanfel (immediately after poison oak/ivy)

Contact dermatitis (dosing)

Hydrocortisone TID-QID

Contact dermatitis (side effects)

Skin irritation

Contact dermatitis (key counseling)

PCP if no improvement in 1 week

Contact dermatitis (non-pharm)

Remove exposure, wash everything that came into contact, cleanse with mild soap, should resolve on its own