Community Block I Medication List

Albuterol brand name

ProAir HFA, ProAir Digihaler, Proventil HFA, Ventolin HFA, ProAir Respiclick

Albuterol class

Selective β2-Adrenergic Agonist

Albuterol dosage forms

MDI, Aerosol Solution for Inhalation, Aerosol Powder for Inhalation, Dry Powder for Inhalation, Oral Tablet, Oral Tablet, Extended Release, Syrup, Nebulization Solution for Inhalation

Albuterol indications

Asthma (acute exacerbation and bronchospasm), exercise induced asthma, COPD

Albuterol mechanism of action

Albuterol is a selective β2-adrenergic agonist that acts on β2-adrenergic receptors of intracellular adenylyl cyclase to increase cyclic AMP levels, resulting in bronchial smooth muscle relaxation.

Albuterol Contraindications

Hypersensitivity

Albuterol Adverse Reactions

Common: Nausea, pharyngitis, rhinitis, throat irritation, upper respiratory tract infections, tremor, nervousness

Rare, but serious: Paradoxical bronchospasms, pulmonary edema, atrial fibrillation

Albuterol counseling points

Instruct patient on inhaler technique, including priming and shaking well before using. Wash the mouthpiece and air dry thoroughly at least once a week (may cease to deliver medication if mouthpiece becomes blocked). Part of the extended-release tablet may pass into stool. Contact prescriber if more albuterol is needed to control symptoms than usual as this may indicate acute asthma exacerbation. Do not use more frequently than recommended. DPI does not require shaking or priming but does require deep inhalation for use. When inhaling contents, hold breath for at least 10 s, if possible, to allow albuterol to travel deeper into the lungs

Alprazolam brand name

Xanax

Alprazolam class

Benzodiazepine, Short or Intermediate Acting. C-IV

Alprazolam dosage form

Oral tablet, oral disintegrating tablet, oral tablet XR, oral solution

Alprazolam indications

Anxiety, panic disorder

Alprazolam mechanism of action

Enhances the postsynaptic effect of the inhibitory neurotransmitter, γ-aminobutyric acid (GABA)

Alprazolam contraindications

Hypersensitivity to benzodiazepines, narrow-angle glaucoma, concurrent ketoconazole, or itraconazole

Alprazolam adverse reaction

Common: Ataxia, lethargy, retrograde amnesia, somnolence, weight gain, change in appetite, constipation, fatigue, cognitive dysfunction, decreased libido, rash

Rare, but serious: Seizures, mania, depression, liver failure, Stevens-Johnson syndrome

Alprazolam counseling points

May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol. Do not crush or break extended-release product. Oral disintegrating tablet may be divided but are unstable after breaking. May mix solution in liquid or semi-solid food for administration. If only 1/2 tablet taken, discard the other half. Allow oral disintegrating tablet to dissolve on your tongue. Do not self-increase or abruptly discontinue use

Amlodipine brand name

Norvasc

Amlodipine class

Dihydropyridine calcium channel blocker

Amlodipine dosage form

Oral tablet, suspension

Amlodipine indications

Hypertension; chronic stable angina; vasospastic (Prinzmetal) angina; coronary artery disease

Amlodipine mechanism of action

Blocks L-type calcium channels in vascular smooth muscle causing arterial vasodilation and decreased blood pressure

Amlodipine contraindications

Hypersensitivity

Amlodipine adverse reaction

Common: peripheral edema, headache, flushing, dizziness, fatigue.

Serious: severe hypotension, worsening angina, myocardial infarction (rare), hepatic injury.

Amlodipine counseling points

Take at the same time each day. Swelling of the ankles is common. Rise slowly if dizzy. Continue even if you feel well.

Amphetamine/Dextroamphetamine brand name

Adderall, Mydayis

Amphetamine/Dextroamphetamine class

CNS stimulant C-II

Amphetamine/Dextroamphetamine dosage form

Oral tablet, oral capsule XR

Amphetamine/Dextroamphetamine indications

ADHD, narcolepsy

Amphetamine/Dextroamphetamine mechanism of action

Amphetamines are non-catecholamine sympathomimetic amines with CNS stimulant activity. Amphetamines are thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space

Amphetamine/Dextroamphetamine contraindications

Hypersensitivity to amphetamines, cardiovascular disease, concurrent MAOIs, drug dependence, glaucoma, hypertension, hyperthyroidism

Amphetamine/Dextroamphetamine adverse reactions

Common: Hypertension, weight loss, loss of appetite, xerostomia, headache, insomnia

Rare, but serious: Myocardial infarction, seizures, psychosis, mania

Amphetamine/Dextroamphetamine counseling points

Avoid late evening doses due to resulting insomnia. Extended-release capsules may be swallowed whole with or without food. The entire capsule contents may be sprinkled on applesauce and consumed immediately; the applesauce with sprinkled beads should be consumed in its entirety without chewing. Do not divide the dose of a single capsule.

Atorvastatin brand name

Lipitor

Atorvastatin class

HMG-CoA Reductase Inhibitor

Atorvastatin dosage form

Oral tablet, oral suspension

Atorvastatin indications

Primary and secondary prevention of atherosclerotic cardiovascular disease, Secondary prevention of cardiovascular events in patients with or at high risk for CAD, and Familial hypercholesterolemia (homozygous or heterozygous)

Atorvastatin MOA

HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol also can decrease because of decreased production of VLDL-cholesterol or increased VLDL; removal by LDL receptors

Atorvastatin contraindications

Hypersensitivity to atorvastatin, use in breastfeeding, active liver disease, unexplained persistent elevations of serum transaminases

Atorvastatin adverse reactions

Common: Myopathy, diarrhea, headache, nasopharyngitis

Rare, but serious: Rhabdomyolysis, tendon rupture, liver failure

Atorvastatin counseling points

Avoid excessive alcohol, grapefruit, and grapefruit juice (>1 L/d) consumption while taking drug. Atorvastatin does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels. Notify HCP if unexplained muscle tenderness or weakness occurs. When using the oral suspension, separate doses from food by at least 2 h

Bupropion brand name

Aplenzin, Forfivo XL, Wellbutrin SR, Wellbutrin XR

Bupropion class

Monocyclic antidepressant

Bupropion dosage form

Oral tablet IR, oral tablet ER 12h, oral tablet ER 24h

Bupropion indication

Depression, seasonal affective disorder, smoking cessation

Bupropion MOA

Bupropion is a monocyclic antidepressant, unique as a mild dopamine and norepinephrine uptake inhibitor with no direct effect on serotonin receptors or MAO.

Bupropion contraindications

Seizure disorder; history of anorexia/bulimia; use of MAOI within 14 d; patients undergoing abrupt discontinuation of ethanol, benzodiazepines, ?barbiturates, or antiepileptics, hypersensitivity to bupropion

Bupropion adverse reactions

Common: Agitation, constipation, dizziness, headache, insomnia, nausea, tachyarrhythmia, tremor, xerostomia

Rare, but serious: Cardiac dysrhythmia, mania, seizure, suicidal thoughts, wide QRS complex

Bupropion counseling points

Take without regard to food. Avoid alcohol, CNS depressants, and activities requiring mental alertness. Take at the same time each day and at bedtime if possible. If taking the extended-release tablet, the tablet shell may remain intact and be visible in the stool. Do not chew, crush, or divide long-acting tablets.

Buspirone brand name

Buspar

Buspirone class

Antianxiety

Buspirone dosage form

Oral tablet

Buspirone MOA

Buspirone is the first of a class of selective serotonin-5-HT1A receptor partial agonists. It also has some effect on dopamine-D2 auto-receptors and, like antidepressants, can downregulate β-adrenergic receptors. Unlike benzodiazepines, it lacks amnestic, anticonvulsant, muscle relaxant, and hypnotic effects. Its exact anxiolytic mechanism of action is complex and not clearly defined

Buspirone contraindications

Hypersensitivity, use of MAOIs within 14 d or concomitant use of MAOIs

Buspirone adverse reactions

Common: dizziness

Rare, but serious: Mania, psychiatric disorder, drug-induced movement, serotonin syndrome

Buspirone counseling points

Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for a few weeks. Do not discontinue drug suddenly. Take with or without food but should always take drug consistently. Do not drink alcohol or large amounts of grapefruit juice while taking this drug. Avoid concomitant use with MAOI

Carvedilol brand name

Coreg, Coreg CR

Carvedilol class

α/β-Adrenergic Blocker

Carvedilol dosage form

Oral tablet, oral capsule XR

Carvedilol indications

Heart failure and hypertension

Carvedilol MOA

Carvedilol is a selective α1- and nonselective β-adrenergic blocker that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmia.

Carvedilol contraindications

Hypersensitivity, bronchial asthma, severe sinus bradycardia, 2nd- or 3rd-degree AV block, sick sinus syndrome, overt heart failure, cardiogenic shock, severe hepatic impairment

Carvedilol adverse reactions

Common: Cold extremities, dizziness, diarrhea, fatigue, hypotension, weight gain

Rare, but serious: Heart failure, hepatotoxicity, Stevens-Johnson syndrome

Carvedilol counseling points

Take carvedilol with food or milk. Report signs/symptoms of heart failure, bradyarrhythmias, bronchospasm, hypotension, syncope, or exacerbation of angina with initial dosing and dose changes. Avoid abrupt discontinuation, may cause rebound HTN. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert. Diabetic patients should carefully follow blood sugar levels as beta-blockers may mask symptoms of hypoglycemia.

Duloxetine brand name

Cymbalta

Duloxetine class

Serotonin/Norepinephrine Reuptake Inhibitor

Duloxetine dosage form

Oral capsule delayed release and oral capsule delayed release sprinkle

Duloxetine indication

Anxiety, depression, diabetic peripheral neuropathy pain, and fibromyalgia, musculoskeletal pain

Duloxetine MOA

Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor that exerts its antidepressant and pain inhibitory actions by potentiating the serotonergic and noradrenergic activity in the CNS. It has no significant affinity for adrenergic, dopaminergic, cholinergic, opioid, glutamate, or histaminergic receptors in vitro and does not inhibit monoamine oxidase.

Duloxetine contraindications

Hypersensitivity to duloxetine, MAOI, TCA, linezolid use, uncontrolled glaucoma, concurrent methylene blue administration

Duloxetine adverse reactions

Common: Abdominal discomfort, drowsiness, headache, nausea, xerostomia

Rare, but serious: Fracture, hepatotoxicity, serotonin syndrome, suicidal thoughts, stroke, GI bleed, SIADH

Duloxetine counseling points

Report withdrawal symptoms (eg, dysphoric mood, irritability, agitation, sensory disturbances), especially during abrupt discontinuation of therapy. Drug may cause hepatotoxicity and increased risk of bleeding (GI, ecchymosis, epistaxis, petechiae). May require 1-4 wk for improvement of depression symptoms. Report worsening depression, suicidal ideation, or unusual changes in behavior, especially at initiation of therapy or with dose changes. Children are at higher risk for these effects during the first few months of therapy. Patient should watch for signs/symptoms of bleeding events and hepatotoxicity. Avoid alcohol. Monitor carefully if on concurrent medications that alter coagulation. If discontinuing therapy, taper dose downward slowly and do not discontinue abruptly.

Empagliflozin brand name

Jardiance

Empagliflozin class

Class: Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor, Antidiabetic

Empagliflozin dosage form

Oral tablet

Empagliflozin indication

Diabetes, chronic kidney disease, heart failure

Empagliflozin MOA

MOA. Empagliflozin inhibits sodium-glucose cotransporter 2 (SGLT2) in the proximal renal tubules, reducing reabsorption of filtered glucose from the tubular lumen resulting in increased urinary secretion and reduced plasma glucose.

Empagliflozin contraindications

Hypersensitivity

Empagliflozin adverse reactions

Common: none

Rare, but serious: Acute kidney injury, hypersensitivity, hypotension, ketoacidosis, increased risk of bone fractures, increased risk of lower limb amputations

Empagliflozin counseling points

Key Patient Counseling Points. Take in the morning with or without food. A dietary plan, weight management and exercise are critical components for managing diabetes.

Escitalopram brand name

Lexapro

Escitalopram class

SSRI antidepressant

Escitalopram dosage form

Oral tablet, oral solution

Escitalopram indication

Depression, and generalized anxiety disorder

Escitalopram MOA

MOA. Escitalopram is the S-enantiomer of racemic citalopram and is an antidepressant that is a selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI). It does not affect reuptake of norepinephrine or dopamine and has a relative lack of affinity for muscarinic, histamine, α1- and α2-adrenergic, and serotonin receptors.

Escitalopram contraindications

Hypersensitivity to citalopram or escitalopram; concurrent MAOI, methylene blue, or pimozide

Escitalopram adverse reactions

Common: Diarrhea, headache, impotence, insomnia, nausea, sedation

Rare, but serious: Serotonin syndrome, suicidal thoughts, torsades de pointes, AMI

Escitalopram counseling points

Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for 4-6 wk. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs or aspirin while taking this drug. May take without regard to food.

Fluoxetine - Brand name

Prozac; Sarafem

Fluoxetine - Class

Selective serotonin reuptake inhibitor (SSRI)

Fluoxetine - Dosage forms

Capsule; tablet; delayed-release capsule; oral solution

Fluoxetine - FDA-approved indications

Major depressive disorder; OCD; panic disorder; bulimia nervosa; premenstrual dysphoric disorder; bipolar major depression

Fluoxetine - Mechanism of action

Fluoxetine is a bicyclic antidepressant that is a selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI).

Fluoxetine - Contraindications

Hypersensitivity; concomitant pimozide, thioridazine, or MAOIs

Fluoxetine - Adverse reactions

Common: Diarrhea, headache, insomnia, nausea, somnolence, tremor, xerostomia, decreased appetite

Serious: Prolonged QTc interval, serotonin syndrome, suicidal thoughts, torsade de pointes, SIADH

Fluoxetine - Patient counseling

Take with or without food in the morning. Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks, while adverse effects often present in the 1st wk of therapy. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding to HCP. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.

Fluticasone nasal - Brand name

Flonase, Xhance

Fluticasone nasal - Class

Intranasal Adrenal Glucocorticosteroid

Fluticasone - Dosage forms

Nasal spray, nasal exhaler suspension

Fluticasone nasal - FDA-approved indications

Nonallergic rhinitis, Allergic rhinitis, rhinosinusitis with nasal polyps

Fluticasone nasal - Mechanism of action

Fluticasone has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2-inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.