P3 SL Wk 9 Drugs

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Baclofen - Brand

Lioresal, Ozobax, Fleqsuvy

Baclofen - Class

Centrally Acting Skeletal Muscle Relaxant

Baclofen - Indication/Dosing

Spasticity: 5 mg po tid; may increase by 5 mg/dose every 3d based on response; max dose in Adults and Children ≥12 y of age, 80 mg/d po; max dose in Children ≥8 y of age, 60 mg/d; max dose in Children 2-7 y of age, 60 mg/d po

Baclofen - MOA

inhibits both monosynaptic and polysynaptic reflexes at the spinal level, possibly by hyperpolarization of afferent terminals

Baclofen - BBW

Avoid abrupt discontinuation of intrathecal product

Baclofen - Contraindications

Hypersensitivity

Baclofen - Common AE

Nausea, asthenia, dizziness, somnolence, confusion

Baclofen - Rare but serious

Slowed or difficult breathing when used in combination with opioids, pneumonia, GI hemorrhage, seizure

Baclofen - Counseling

patients should be cautioned regarding the operation of motor vehicles or dangerous machinery while taking baclofen. Patients should be cautioned that the CNS effects of baclofen may be additive to those of alcohol and other CNS depressants. Oral packet doses should be taken within 2 h when mixed with food.

Lisdexamfetamine - Brand

Vyvance

Lisdexamfetamine - Class

Amphetamine, CNS Stimulant C-II

Lisdexamfetamine - Indication/Dosing

1. Attention-deficit hyperactivity disorder (ADHD): 30 mg po daily in the morning, may titrate in 10-20 mg/d increments at weekly intervals to max dose of 70 mg po daily; discontinue if improvement not observed after 1 mo of dosage titration

2. Binge eating disorder (moderate to severe): 30 mg po daily in the morning, may titrate weekly in 20 mg increments to 50-70 mg po daily

Lisdexamfetamine - MOA

Amphetamines cause the release of dopamine and norepinephrine at presynaptic nerve terminals and may block the reuptake of norepinephrine and dopamine by competitive inhibition

Lisdexamfetamine - BBW

Risk of abuse, misuse, diversion

Lisdexamfetamine - Contraindications

Hypersensitivity/idiosyncrasy to sympathomimetic amines

MAOIs

symptomatic cardiovascular disease or advanced arteriosclerosis

moderate-severe HTN

hyperthyroidism

glaucoma

agitated states

history of drug dependence

Lisdexamfetamine - Common AE

Insomnia

Irritability

Loss of Appetite

Upper Abdominal Pain

Xerostomia

Lisdexamfetamine - Rare but serious

Chest pain, new worsening existing psychotic disorders, AMI, stroke, sudden cardiac death, tachycardia, anaphylaxis, peripheral vasculopathy (including Raynaud’s), serotonin syndrome

Lisdexamfetamine - Counseling

Take dose in the morning with or without food. If capsule opened for administration, drug should be dissolved in water, yogurt, or orange juice and consumed immediately. Report new or worsened psychiatric problems (behavior and thought problems, bipolar illness, aggressive behavior or hostility), difficulty sleeping, and changes in mood. Also report chest pain, palpitations, dyspnea, or signs/symptoms of cardiac dysrhythmia, AMI, or cerebrovascular accident.

Hydroxyzine - Brand

Atarax, Vistaril

Hydroxyzine - Class

Histamine H1 antagonist, First Gen

Piperazine Derivative

Hydroxyzine - Indication/Dosing

1. Anxiety: 25-50 mg po qid prn, max 400 mg/d

2. Pruritus: 25 mg po tid-qid prn

3. Urticaria: 10-25 mg po HS, max 200 mg/d

Hydroxyzine - MOA

Antagonize Histamine receptors in the CNS

Hydroxyzine - BBW

None

Hydroxyzine - Contraindications

Hypersensitivity to cetirizine or hydroxyzine, prolonged QT interval, pregnancy (early)

Hydroxyzine - Common AE

None

Hydroxyzine - Rare but serious

Respiratory depression, seizures, exanthematous pustulosis, torsades de pointes

Hydroxyzine - Counseling

Patients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects. May take with or without food.

Clobetasol - Brand

Impoyz, Temovate

Clobetasol - Class

Topical corticosteroid

Clobetasol - Indications/Dosing

1. Skin disorders, corticosteroid responsive: Children ≥12 y of age and Adults, apply thin layer topically to affected area bid for a max of 2 wk

2. Plaque psoriasis: Children >12 y of age and Adults, apply thin layer topically to affected area bid for a max of 2-4 wk

Clobetasol - MOA

Clobetasol has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2-inhibitory proteins, lipocortins

Clobetasol - BBW

None

Clobetasol - Contraindications

Hypersensitivity

Clobetasol - Common AE

Pruritus

Clobetasol - Rare but serious

HPA suppression

Hydrocortisone - Brand

Cortenema, Locoid, Westcort

Hydrocortisone - Class

Topical Corticosteroid

Hydrocortisone - Indications

Skin disorders

Crisaborole - Brand

Eucrisa

Crisaborole - Class

Phosphodiesterase-4 enzyme inhibitor

Crisaborole - Indications

Atopic Dermatitis

Carisoprodol - Brand

Soma, Vanadom

Carisoprodol - Class

Centrally acting skeletal muscle relaxant. C-IV

Carisoprodol - Indications

Disorder of the musculoskeletal system

Fluocinonide - Brand

Lidex, Vanos

Fluocinonide - Class

Topical Corticosteroid

Fluocinonide - Indications

Skin Disorders

Plaque Psoriasis

Atopic Dermatitis