Feb 22, 2011

frequently ask drugs

DRUG

Schedule of administration

FACTS

  • H2 Antagonists

nizatidine (Axid)

famotidine (Pepcid)

cimetidine (Tagamet)

ranitidine (Zantac)

  • Proton pump inhibitors

omeprazole (Prilosec)

pantoprazole (Protonix)

esomeprazole (Nexium)

lansoprazole (Prevacid)

  • Antacids

Aluminum based: Amphogel

Magnesium based:

Milk of magnesia

Aluminum and Magnesium:

Maalox

Mylanta

Calcium based:

Tums

  • Mucosal protective agent

misoprostol (Cytotec)

sucralfate (Carafate)

  • Pancreatic enzyme replacement

pancrelipase (Creon-5)

pancrelipase (Viokase)

pancrelipase (Pancrease)

1 hour AC

with meals and hs

without regard to meals and hs

AC

Without regard to meals

1 hour AC

30 min AC

1 hour PC and hs

1-3 hours PC and hs

PC and hs

1 hour PC and hs

with meals and hs

empty stomach/ 1 hour AC and hs/ 2 hours PC

give with meals and snacks

give with meals and snacks

give with meals and snacks

Ø avoid smoking and using alcohol

Ø administer another antacid 1 hour apart

Ø take antacids 1 hour apart from another antacids

Ø encourage increased fluid intake and high fiber; causes constipation

Ø magnesium based antacid causes diarrhea

Ø causes constipation

Ø prevent use of drug during pregnancy

ANTIBIOTICS

  • Aminoglycosides

streptomycin

gentamicin (Garamycin)

amikacin (Amikin)

  • Cephalosporins

1st generation:

cefadoxil (Duricef)

cefazolin (Ancef)

cephalexin (Keflex)

cephapirin (Cefadyl)

cephradine (Velosef)

2nd generation:

cefaclor (Ceclor)

cefmetazole (Zefazone)

cefonicid (Monocid)

cefotetan (Cefotan)

cefoxitin (Mefotin)

cefpodoxime (Vantin)

cefprozil (Cefzil)

cefuroxime (Ceftin , Zinacef)

loracarbef (Lorabid)

3rd generation:

cefdinir (Omnicef)

cefixime (Suprax)

cefoperazone (Cefobid)

cefotaxime (Clorofan)

ceftazidime (Fortaz)

ceftibuten (Cedax)

ceftizoxime (Cefizox)

ceftriaxone (Rocephin)

4th generation:

cefepime (Maxipime)

  • Flouroquinolones

ciprofloxacin (Cipro, Ciloxan)

enoxacin (Penetrex)

levofloxacin (Levaquin)

norfloxacin (Noroxin)

ofloxacin (Floxin, Ocuflox)

sparfloxacin (Zagam)

trovofloxacin (Trovan)

  • Macrolides

erythromycin (Erythrocin, E-Myrin, Ilosone)

azithromycin (Zithromax)

clarithromycin (Briaxin)

dirithromycin (Dynabec)

  • Penicillins

amoxicillin (Amoxil, Augmentin)

ampicillin (Unasyn)

penicillin G

  • Sulfonamides

sulfadiazine

sulfisoxazole (Gantrisin)

trimethoprim sulfamethoxazole (Bactrim, Septra)

  • Tetracycline

demeclocycline (Declomycin)

doxycycline (Vibramycin)

minocycline (Minocin)

oxytetracycline

( Teramycin)

tetracycline (Achromycin)

  • Antitubercular

isoniazid

ripampin

  • Antifungals

amphotericin B

fluconazole (Diflucan)

miconazole Minostat)

ketoconazole (Nizoral)

nystatin (Mycostatin)

  • Antiprotozoals

metronidazole (Flagyl)

(Flagyl ER)

phenazopyridine (Pyridium)

PC

take in an empty stomach (may be taken with food if GI irritation occurs)


take 2 hours PC or 2 hours before or after antacids or iron (take with food if GI distress occurs)

1 or 2 hours PC

“:

1-2 hours AC or 2-3 hours PC

1 hour AC or 2 hours PC; if with nausea administer with food

take on an empty stomach/ 1 hour before or 2 hours after food/ beverage

1 hour AC or 2 hours PC

empty stomach/ 1 hour AC or 2 hours PC

Take with meals

1 hour AC or 2 hours

PC

PC

Ø causes ototoxicity

Ø hepatotoxic and ototoxic: watch for tinnitus and vertigo

Ø increase fluid intake to prevent crystalluria

Ø hepatotoxic

Ø causes red-orange discoloration of urine

Ø hepatotoxic and nephrotoxic

Ø ketoconazole is neurotoxic

Ø may cause discoloration in the urine

  • Anti-anxiety Drugs

alprazolam (Xanax)

chlordiazepoxide (Librium)

chlomazepam (Klonopin)

clorazepate (Tranxene)

diazepam (Valium)

lorazepam (Ativan)

midazolam (Versed)

oxazepam (Serax)

buspirone HCL (Buspar)

doxepin (Sinequan)

meprobamate (Miilltown, Equanil)

  • SSRI

fluxetine (Prozac)

fluvoxamine (Luvox)

paroxetine (Paxil)

sertraline (Zoloft)

  • TCA

amitryptyline (Elavil)

doxepin (Senequan)

imipramine (Tofranil)

desipramine (Norpramine)

nortriptilline (Pamelor)

clomipramine (Anafranil)

  • MAOI

Tranylcypromine sulfate (Parnate)

Phenelzine (Nardil)

Isocarboxazid (Marplan)

Give with liquid other than grapefruit (tid or bid)

Take in the AM to avoid insomnia

Give with food in AM

Morning or evening with or without meals

Administer at bedtime (hs) due to sedation

Administer with food and in AM

Ø avoid tyramine containing foods to prevent hypertensive crisis

· Anti-Manic

lithium carbonate (Eskalith, Lithobid, Lithonate)

Take PC

Ø avoid strenuous activities that causes perspiration

Ø avoid hot bath

Ø watch for evidence of toxicity (diarrhea, vomiting, tremors, dizziness, muscle weakness, ataxia)

Ø maintain adequate sodium intake

  • Antipsychotics

chlorpromazine HCL

( Thorazine)

clozapine (Clozaril)

fluphenazine decanoate (Prolixin)

haloperidol (Haldol, Serenace)

mesoridazine besylate (Serentil)

olanzapine (Zyprexa)

prochlorperazine (Compazine)

thioridazine (Mellaril)

trifluoperazine (Stelazine)

risperidone (Risperdal)

give daily dose 1-2 hours before bedtime

Ø watch for anticholinergic s/e: blurring of vision, urinary retention, constipation, orthostatic hypotension, photosensitivity, urinary retention, dry mouth

Ø watch for evidence of neuroleptic malignant syndrome: high fever; extrapyramidal syndrome

Ø chlorpromazine is more likely to cause photosensitivity than any other drug in its class

Ø clozapine carries a significant risk of agranulocytosis (check WBC frequently)

  • Diuretics

Loop diuretics

bumetamide (Bumex)

furosemide (Lasix)

Thiazides

chlorothiazide (Diuril)

Potassium Sparing

amiloride (Midamor)

spironolactone (Aldactone)

triamterene (Dyrenium)

Isotonic

Isosorbide (Ismotic)

Mannitol (Osmitrol)

Take with meals or PC in AM

Ø increase potassium in the diet

Ø may predispose digoxin toxicity: watch for hypokalemia

Ø instruct client that increasing potassium in the diet is not indicated

Ø Mannitol is commonly used to prevent increased intracranial pressure

  • Antiplatelet

Aspirin

clopidogrel (Plavix)

dipyridamole (Persantine)

ticlopidine (Ticlid)

Take with food

Ø watch for symptoms of bleeding such as bruising, bleeding gums, dark tarry stool

Ø watch for tinnitus in long term aspirin therapy (s/sx of toxicity)

  • NSAIDs

ibuprofen (Motrin)

indomethcin (Indocin)

meloxicam (Mobic)

naproxen (Naprosyn)

Take with food

Ø watch for signs of bleeding

  • Corticosteroids

dexamethasone (Decadron)

betamethasone (Celestone)

hydrocostisone (Solu-Cortef)

prednisolone

Take with milk or food/ if in single dose give in AM for less toxicity

Ø predisposes the individual to immunosuppression (provide health measures to avoid acquiring infection)

Ø

  • Cardiac Glycosides

digoxin (Lanoxin)

nitroglycerin

Without meals

Empty stomach

Ø before administering digoxin check for pulse rate

Ø nitroglycerin patch should be rotated in different areas and placed in non-hairy skin

Ø earliest sign of digoxin toxicity includes anorexia or loss of appetite

Ø hypokalemia predisposes digoxin toxicity

Ø in administering nitroglycerin for angina give two tablets with 5 minutes interval

  • ACE inhibitors

captopril (Capoten)

enalapril (Vasotec)

Without food/ 1 hour AC

Without regards to food

  • Angiotensin II Recepttor Blockers (ARBS)

candesartan (Atacand)

losartan (Cozaar)

Without regards to meals

  • Beta Adrenergic Blockers

propanolol (Inderal)

metoprolol (Lopressor)

esmolol (Brevibloc)

atenolol (Tenormin)

  • Alpha Adrenergic Blockers

prazocin ( Minipress)

Take with food

  • Calcium Channel Blockers

amlodipine (Norvasc)

diltiazem (Cardizem)

nifedipine (Adalat, Procardia)

verapamil (Calan)

Take with meals

Ø instruct patent to move slowly in changing position (causes hypotension)

  • Antihistamines

hydroxyzine (Atarax, Vestaril)

promethazine (Phenergan)

loratadiine (Claritin)

diiphenhydramine (Benadryl)

Take with food

  • Anticholinergics

atropine

benztropine mesylate (Cogentin)

trihexyphenidyl (Artane)

Take 30 minutes after meals

  • Antidiabetic

metformin (Glucophage)

chlorpropamide (Diabenese)

tolazamide (Tolinase)

tolbutamide (Orinase)

glipizide (Glucotrol)

glyburide (Micronase)

Take with meals

  • Xanthines

aminophylline

theophylline (Theo-Dur)

1 hour AC or 2 hours PC

With meals/ 1 hour AC or 2 hours PC

  • Thyroid hormone Antagonists

methimazole (Tapazole)

Lugol’s solution

propylthiouracil (PTU)

  • Thyroid hormone Replacement

levothyroxine Na (Synthroid)

liothyronine Na (T3)

  • Pituitary hormones

desmopressin acetate (DDVAP)

vasopressin (ADH)

Take with meals

Dilute solution with water, milk, or fruit juice and give PC

Take with meals

Take at the same time each day, before breakfast

Ø at risk for agranulocytosis; watch s/sx

Ø watch for complaints of tachycardia, insomnia, nervousness, and tremors

Ø given to patient with diabetes insipidus

  • Antineoplastic

leuprolide acetate (Lupron Depot)

tamoxifen citrate

vincristine (Oncovin)

Ø given for advanced prostate cancer, endometriosis

Ø acts as antiestrogen; do not take antacids 2 hours of dose

Ø causes peripheral neuropathy; watch for leucopenia and thrombocytopenia

Ø monitor WBC regularly

  • Antigout

alluporinol (Zyloprim)

colchicine

After meals

With meals

Ø Given to polycythemia because of hyperuricemia

Ø watch for symptoms of colchicine overdose: (nausea, vomiting, abdominal pain, diarrhea, unusual bleeding, bruising, tiredness, weakness, numbness, or tingling)

  • Vitamins

Iron preparation

Calcium supplements

Between meals/ empty stomach

With food

Ø take with vit.C to enhance absorption

Ø

  • Narcotic and Opioid Analgesics

fentanyl (Duragesic)

meperidine hydrochloride (Demerol)

morphine sulfate

  • Non-narcotic analgesics

acetaminophen (Tylenol)

Take before pain becomes intense

Ø monitor for respiratory depression

Ø keep narcotic antagonists (naloxone)

Ø drug of choice for MI pain

Ø not indicated for gallbladder pain may cause spasm of the sphincter of Oddi

Ø hepatotoxic

  • Stimulants

methylphenedate HCL (Ritalin)

Give in the morning

Ø given for ADHD

  • Cholinergics

endrophonium choride (Tensilon)

neostigmine bromide (Prostigmin)

pyridostigmine bromide (Mestinon)

bethanechol chloride (Urecholine)

Take with meals

Take tablets at the same time each day at

least 6 hours apart

Give on an empty stomach at regular intervals

Ø increased muscle strength after injection confirms myasthenic crisis

Ø Schedule dose 30 minutes before each meals for patients with dysphagia

Ø Taken lifetime

Ø Indicated for urinary retention

  • Anticoagulants

warfarin (Coumadin)

Heparin

Enoxaparin sodium (Lovenox)

Ø monitor for INR and PT

Ø instruct patient to avoid green leafy vegetables because this may decrease the potency of the drug

Ø monitor for bleeding tendencies

Ø monitor PTT

Ø watch for symptoms of bleeding

Ø watch for signs of bleeding

Ø given SC

  • Anticonvulsant

carbamazepine (Tegretol)

magnesium sulfate

phenytoin (Dilantin)

Take with meals

Take with food

Ø Check CBC frequently

Ø Given to patient with trigeminal neuralgia (tic douloureux)

Ø Watch for respiratory depression

Ø Prepare calcium gluconate as antidote

Ø Disappearance of patellar reflex is an impending signs of magnesium toxicity

Ø Instruct good oral hygiene and to massage gums to prevent gingival hyperplasia

Ø Flush IV tubing with NSS to prevent precipitate formation

Ø hepatotoxic

alendronate sodium (Fosamax)

isotretenoin (Accutane)

raloxifene HCL (Evista)

sildenafil citrate (Viagra)

sulfasalazine (Azulfidine)

vancomycin hydrochloride (Vancocin)

Foscarnet sodium (Foscavir)

latanoprost (Xalatan)

30 minutes before food preferably in the morning

with food in AM

without regards to food

1 hour before sexual activity

give with food

Ø instruct not to lie down for 30 minutes to reduce risk of esophageal irritation; treatment of osteoporosis in post-menopausal women

Ø do not give in pregnant women due to its teratogenic effects

Ø take with calcium and Vit.D

Ø do not administer together with nitroglycerin

Ø nephrotoxic

Ø monitor for “red man syndrome” w/c occurs if drug is infused rapidly

Ø report ringing in ears( ototoxic)

Ø nephrotoxic

Ø emphasize the importance of adequate hydration throughout the therapy

Ø indicated for CMV retinitis in patients with AIDS and acyclovir resistant herpes simplex virus

Ø indicated for increased IOP in open angle glaucoma

Ø may gradually change eye color, increasing brown pigment in the iris

Ø apply pressure in the lacrimal sac 1 minute after instillation to minimize systemic absorption