PPC EXAM 1 (DRUGS 11-20)

Generic: Aspirin

Brand: Bayer

Aspirin (drug class)

Drug class:

-platelet aggregation inhibitor

-antiplatelet

Antiplatelet Adverse Effects

Adverse effects:

-bleeding

-gastrointestinal ulceration or bleeding

Antiplatelet Counseling

Counseling points:

-monitor for signs/symptoms of bleed

-caution with other drugs that increase bleed

*high monitoring med: May need to be held before procedure

Generic: Clopidogrel

Brand: Plavix

Clopidogrel (drug class)

Drug class: platelet aggregation inhibitor

Indications for antiplatelets

Indications:

-blood thinning

-acute coronary syndrome (MI, revascularization)

-secondary prevention CV events

Generic: Warfarin

Brand:

-coumadin

-jantoven

Warfarin (drug class)

Drug class:

-anticoagulant

-vitamin K antagonist

Warfarin (indications)

Indications:

-atrial fibrillation

-pulmonary embolism (PE)

-deep vein thromboembolism (DVT)

-prevention of clots

Warfarin (adverse effects)

Adverse effects:

-bleeding

Warfarin (counseling points)

Counseling points:

-monitor international normalized ration (INR), should be 2-3

(how long it takes for blood to clot)

-monitor signs/symptoms of bleed

-drug-drug and drug-food interactions!! -maintain consistent vitamin K volume in diet

-monitor regularly, patient adherence

Generic: Atorvastatin

Brand: Lipitor

Atorvastatin (drug class)

Drug class: HMG-CoA reductase inhibitor

Atorvastatin (indications)

Indications:

-hypercholesterolemia (familial)

-reduce LDL (1st line)

-primary & secondary prevention CV events

Atorvastatin (adverse effects)

Adverse effects:

-arthralgia (joint pain)

-myalgia (muscle pain)

-myopathy (muscle weakness)

-rhabdomyolysis (destruction of striated muscles)

-joint/muscle pain

-hepatic failure

Atorvastatin (counseling points)

Counseling points:

-lipid panel

-liver function tests (LFTs)

-monitor for muscle pain/weakness/heaviness

-avoid grapefruit juice

-may be more effective at night

Generic: Ezetimibe

Brand: Zetia

Ezetimibe (drug class)

Drug class: cholesterol absorption inhibitor

Ezetimibe (indications)

Indications:

-hypercholesterolemia (familial)

-lowers LDL

Ezetimibe (adverse effects)

Adverse effects:

-gastrointestinal effects/ diarrhea

Ezetimibe (counseling points)

Counseling points:

-lipid panel

-patient adherence

Generic: Fenofibrate

Brand: Tricor

Fenofibrate (drug class)

Drug class: fibric acid

Fenofibrate (indications)

Indications:

-hypertriglyceridemia

-hypercholesterolemia

Fenofibrate (adverse effects)

Adverse effects:

-gastrointestinal upset

-abdominal pain

-indigestion

-increased LFTs (liver inflamed)

Fenofibrate (counseling points)

Counseling points:

-monitor lipid panel, LFTs

-patient adherence

-lifestyle changes (decrease foods high in saturated fat)

Generic: Famotidine

Brand: Pepcid

Famotidine (drug class)

Drug class: histamine 2 receptor blocker/antagonist (H2RA)

Famotidine (indications)

Indications:

-gastroesophageal reflux disease (GERD)

-Esophagitis

-heartburn

-peptic ulcer disease

Famotidine (adverse effects)

Adverse effects:

-gastrointestinal upset

Famotidine (counseling points)

Counseling points:

-most effective taken with meal

-monitor efficacy/ plateau

-can be taken as needed

Generic: Omeprazole

Brand: Prilosec

Omeprazole (drug class)

Drug class: proton pump inhibitor (PPI)

Omeprazole (indications)

Indications:

-gastroesophageal reflux disease (GERD)

-heartburn

-peptic ulcer disease

-Zollinger-Ellison syndrome (digestive disorder)

Omeprazole (adverse effects)

Adverse effects:

-bone fractures

-c. diff (diaherea)

-infection risk

-hypomagnesemia (Low Mg)

Omeprazole (counseling points)

Counseling points:

-take in fasted state

-adverse effects

-monitor t-score (bone density)

-duration of therapy

-drug interaction: Clopidogrel

Generic: Alendronate

Brand: Fosamax

Alendronate (drug class)

Drug class: bisophonate

Alendronate (indications)

Indications:

-osteoporosis

-Paget's disease

Alendronate (adverse effects)

Adverse effects:

-esophageal/gastric ulceration

-bone necrosis of jaw

-atypical fracture

Alendronate (counseling points)

Counseling points:

-monitor T score, calcium, and vitamin D intake

-take 30+ minutes before food, drink, other meds; remain upright

-dosed once a week, "drug holiday" after 5 years

Generic: Levothyroxine

Brand:

-Synthroid

-Levoxyl

Levothyroxine (drug class)

Drug class: thyroid supplement (synthetic thyroxine/T4)

Levothyroxine (indications)

Indications:

-hypothyroidism

Levothyroxine (adverse effects)

Adverse effects:

-Heart issues if overdoes (palpitations, hypertension)

-Fatigue

-Cold

-Weight gain

Levothyroxine (counseling points)

Counseling points:

-take 30 mins to 1hr before meals, 4 hrs before other meds

-frequent monitoring

-TSH/T4, hypo and hyperthyroid symptoms

-body weight dosing

-patient adherence

Antiplatelets

Aspirin and Clopidigrel

Anticoagulant

Warfarin

Lowers LDL

Atorvastatin and Ezetimibe

Lowers Triglycerides

Fenofibrate