Comprehensive Medication Reference Guide, Exams of Nursing

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CPJE TOP 400 DRUGS & DOSES

Tylenol - Answers -Acetaminophen I: fever/pain D: 325-650mg, max < 4000mg/day from all sources *OD = liver damage, use NAC for antidote Ofirmev (IV) - Answers -Acetaminophen I: fever/pain D: < 4000mg/day from all sources *Can treat more severe pain *OD = liver damage, use NAC for antidote NAC - Answers -N-acetylcysteine I: APAP overdose Daypro - Answers -Oxaprozin I: fever/pain/inflammation *Similar caution to piroxicam: high risk for GI tox and severe SJS *BBW: COX-1 selectivity NSAID = GI bleed Voltaren - Answers -Diclofenac (gel) I: pain/inflammation Dose: AAA 2-4g QID Toradol - Answers -Ketorolac I: analgesia D: -IV/IM 30mg x 1, or 30mg QID (max 120mg/d) -PO: 20mg once after IV or IM, then 10mg q4-6hr (max: 40mg/d) *Max = 5 days of treatment *Most GI toxic w/ piroxicam *BBW: COX-1 selectivity NSAID = GI bleed Indocin - Answers -Indomethacin -I: fever/pain/inflammation, gout -D: 25-50mg IR, 75mg BID CR *High risk for CNS SE and GI toxicity *BBW: COX-1 selectivity NSAID = GI bleed Clinoril - Answers -Sulindac *less common NSAID that may be better w/ reduced renal function *BBW: COX-1 selectivity NSAID = GI bleed Relafen - Answers -Nabumetone I: fever/pain/inflammation

D: 1000-200mg qd or bid Feldene - Answers -Piroxicam I: fever/pain/inflammation D: 10-20mg qd *High risk for GI tox and severe SJS *Most GI toxic w/ ketorolac *BBW: COX-1 selectivity NSAID = GI bleed Mobic - Answers -Meloxicam I: fever/pain/inflammation D: 7.5-15mg po (Max: 15mg/d) *COX-2 selectivity NSAID: CV event (MI, stroke) Bayer - Answers -Aspirin I: fever/pain/inflammation D: 81-325mg qd CI: pregnancy (esp 3rd trimester), OD = tinnitis *BBW: COX-1 selectivity NSAID = GI bleed Motrin, Advil - Answers -Ibuprofen I: fever/pain/inflammation Dose -OTC: 200-400mg q 4-6 hrs -Rx: 600-800 mg tid, max 3200mg/d *BBW: COX-1 selectivity NSAID = GI bleed Naprosyn - Answers -Naproxen, Aleve I: fever/pain/inflammation D: -OTC: 220mg qd -Rx: 250-550mg bid *Higher GI side effects *BBW: COX-1 selectivity NSAID = GI bleed Celebrex - Answers -Celecoxib I: fever/pain/inflammation D: 200mg qd or BID *lowest GI bleed risk but highest CV risk *COX-2 selectivity NSAID: CV event (MI, stroke) Humira - Answers -Adalimumab I: arthritis, psoriasis, Crohn's, UC, etc D: 40mg SC every other week *BBW: fatal infections, malignancy, TB

Remicade - Answers -Infliximab I: arthritis, psoriasis, Crohn's, UC, etc D: 3 mg/kg IV on weeks 0, 2 and 6, then q8w *Delayed hypersensitivity reactions *BBW: fatal infections, malignancy, TB Enbrel - Answers -Etanercept I: arthritis, psoriasis, Crohn's, UC, etc D: 50mg SC weekly *BBW: fatal infections, malignancy, TB Orencia - Answers -Abatacept I: arthritis D: 500-1000mg IV at 0, 2 and 4 weeks, then qm, 125mg SC weekly *NS only *Warnings: malignancies, serious infections, may worsen COPD sx Kineret - Answers -Anakinra I: RA D: 100mg SC qd *Warnings: malignancies, serious infections Arava - Answers -Leflunomide I: DMARD D: 100mg PO x 3d, then 20mg PO qd *BBW: embryo-fetal toxicity, hepatotoxicity *CI: pregnancy (must have negative preg test and 2 forms of birth control & wait 2 yrs after DC to have kids) Azulfidine - Answers -Sulfasalazine I: DMARD D: 500-1000mg qd, then 1000mg BID *CI: sulfa allergy Rheumatrex - Answers -Methotrexate I: DMARD D: 7.5-20mg once weekly (never daily for RA) *BBW: hepatotoxicty, myelosuppression, mucosititis/stomatitis Plaquenil - Answers -Hydroxychloroquine I: DMARD D: 400mg qd, then 300mg qd *Warnings: irreversible retinopathy Imuran - Answers -Azathioprine I: RA, transplant

D: 1.5-3mg/kg/d IV or PO *BBW: increased risk of malignancy in IBD *Warning: hematologic toxicity, increased risk of myelosuppression in TPMT pts Veetids - Answers -Penicillin VK I: infection D: hella *Renal toxicity Dynapen - Answers -Dicloxacillin I: staph infection D: 125-500mg q6h PO Unasyn - Answers -Ampicillin/sulbactam D: 1.5-3 g q6h *NS only Principen - Answers -Ampicillin D: 250-500mg po q6h, 1-2g IV q4-6h *Empty stomach *NS only Amoxil, Moxatag - Answers -Amoxicillin D: 250-500mg q8-12h, 500-875 q12h *Take w/ food Augmentin - Answers -Amoxicillin/clavulanic D: 875/125mg po q12hr *Take w/ food Zosyn - Answers -Piperacillin/tazobactam D: -3.375 g QID IV -4.5 TID-QID -3.375-4.5g IV TID (each dose infused over 4 hrs) Ancef - Answers -Cefazolin 1-2g q8hr IV/IM *1st gen Ancef, Kefzol - Answers -Cefazolin 1-2g q8hr IV/IM *1st gen Keflex - Answers -Cephalexin

250-500mg po qid *1st gen Cefzil - Answers -Cefprozil 250-500mg po qd or bid *2nd gen Mefoxin - Answers -Cefoxitin 1-2g q4-6hr IV/IM *2nd gen Ceclor - Answers -Cefaclor 250-500mg po tid *2nd gen Ceftin - Answers -Cefuroxime 0.25-1.5g IV/IM/PO q8-12hr *2nd gen Rocephin - Answers -Ceftriaxone 1-2g qd or bid IV/IM *3rd gen *hepatotox Suprax - Answers -Cefixime 200-400mg po qd or bid *3rd gen Claforan - Answers -Cefotaxime 1-2g IV/IM q6-8hr *3rd gen Fortaz - Answers -Ceftazidime 1-2g IV/IM tid *3rd gen Omnicef - Answers -Cefdinir 300-600mg po qd or bid *3rd gen *don't need to refrigerate Maxipime - Answers -Cefepime 0.5-2g IV/IM tid *4th gen Teflaro - Answers -Ceftaroline

400-600mg IV bid *5th gen *covers MRSA Levaquin - Answers -Levofloxacin 500-750mg IV/PO qd *BBW: tendon rupture, peripheral neuropathy, CNS effect *Warnings: photosensitivity, hypoglycemia, seizures *don't refrigerate Cipro - Answers -Ciprofloxacin -250-750mg po qd or bid -200-400mg IV tid *BBW: tendon rupture, peripheral neuropathy, CNS effect *Warnings: photosensitivity, hypoglycemia, seizures *don't refrigerate Floxin - Answers -Ofloxacin (otic) 400mg bid *don't refrigerate Avelox - Answers -Moxifloxacin 400mg qd IV/PO *BBW: tendon rupture, peripheral neuropathy, CNS effect *Warnings: photosensitivity, hypoglycemia, seizures *No renal adj Flagyl - Answers -Metronidazole 500mg q6h PO/IV *Take with food *Avoid alcohol *don't refrigerate! Macrobid - Answers -Nitrofurantoin monohydrate 100mg po BID *less SEs bc of slower absorption *serious lung problems, C. diff Macrodantin - Answers -Nitrofurantoin macrocrystal 100mg po QID *serious lung problems, C. diff Vancocin - Answers -Vancomycin -15mg/kg -500mg to 2g/d q6-12h *nephro/ototoxicity, RMS

Cleocin - Answers -Clindamycin -450mg po tid or qid -600-900 mg IV q6-8h *BBW: C. diff! Zithromax, Z-Pak - Answers -Azithromycin -500mg po on Day 1, then 250mg Days 2- *empty stomach *QT prolongation Ery-Tab - Answers -Erythromycin 400mg PO QID *QT prolongation Biaxin - Answers -Clarithromycin 1 g po qd *metallic taste *QT prolongation Bactrim, Septra - Answers -Trimethoprim/sulfamethoxazole -SS: 400mg SMX/80mg TMP -DS: 800mg SMX/160 mg TMP *CI: sulfa allergy *Take with food *SJS, crystalluria, photosensitivity Zyvox - Answers -Linezolid 600mg BID po/iv *Myelosuppression Minocin, Dynacin - Answers -Minocycline 100mg po bid *CI: </= 8 yoa, pregnancy *Warnings: photosensitivity Vibramycin - Answers -Doxycycline 100mg po bid *take with food *CI: </= 8 yoa, pregnancy *Warnings: photosensitivity Tygacil - Answers -Tigecycline 100mg IV x 1, then 50mg bid IV *CI: </= 8 yoa, pregnancy *Warnings: photosensitivity

Diflucan - Answers -Fluconazole -500mg qd -150mg po x 1 *hepatotoxicity, SJS Lamisil - Answers -Terbinafine 250mg po qd *hepatotoxicity Mycostatin - Answers -Nystatin -Suspension for oral yeast infection (swish and swallow 4-5 times daily) -Vaginal insert: 100,000 unit x 2 weeks VFEND - Answers -Voriconazole -300mg po bid -4-6mg/kg IV *DOC for Aspergillus *SEs: visual changes, photosensitivity, hepatotoxicity *take on empty stomach Demerol - Answers -Meperidine 100mg IV/SC/IM *short DOA (3hrs) *SE: serotoninergic, CNS toxicity MS Contin, Roxanol, Oramorph, Kadian, Avinza - Answers -Morphine ER -15-200mg po bid-tid -10mg q4h IV Infumorph, Duramorph - Answers -Morphine IR -30mg po q4h prn -10mg q4h IV Norco, Lortab, Lorcet, Vicoden - Answers -Hydrocodone/acetaminophen 2.5-10/325mg po q4h prn Vicoprofen - Answers -Hydrocodone/ibuprofen 2.5-10/325mg po q4h prn Roxicodone - Answers -Oxycodone IR 10-30mg po q4-6hr OxyContin - Answers -Oxycodone CR 10-80mg po bid

Percocet - Answers -Oxycodone/acetaminophen 2.5-10/325mg po q6hr Percodan - Answers -Oxycodone/aspirin 4.83/325mg po q6h prn (max 12 tabs/hr) Dolophine - Answers -Methadone 2.5-10mg q8-12hr *BBW: QT prolongation *used for treating opioid addiction Dilaudid - Answers -Hydromorphone -PO: 7.5mg q4h -IV/SC: 1.5 mg q6h Sublimaze - Answers -Fentanyl injection -50-100mcg IM or IV 30-60min pre-op -25-100mcg IV over 1-2 min peri-op Duragesic - Answers -Fentanyl patch 1 patch q72h Actiq - Answers -Fentanyl lozenge 200mcg x 4 Nubain - Answers -Nalbuphine I: pain in labor/anesthesia max 160mg/day Ultram - Answers -Tramadol 25-50mg po q4h prn *CIV *CI: <12 yoa *Seizure, serotonin syndrome risks Nucynta - Answers -Tapentadol 50-100mg q4-6 hr prn *CII *less GI effects than opioids Narcan - Answers -Naloxone 0.4-2mg q2-3 min or IV infusion Revex - Answers -Nalmefene *for opioid OD

ReVia - Answers -Naltrexone -25mg po x 1, then 50mg po qd on Day 2 *for alcohol and opioid dependence INH - Answers -Isoniazid 300mg po qd x 9 months *BBW: severe/fatal hepatitis *monotherapy for latent TB *Warning: neurotoxic (take w/ pyridoxine aka Vit B6), lupus Rifadin - Answers -Rifampin 600mg po qd *Warning: orange urine/body fluid, flu-like syndrome, hepatotoxicity Pegasys & PegIntron - Answers -Peginterferon alfa 2a & 2b -2a: Pegasys 180 mcg SC qw -2b: PegIntron 1.5mcg/kg SC qw *BBW: worsening autoimmune system, infection, psych problems, ischemic problems, blood problems Rebetol, Copegus, Ribasphere - Answers -Ribavirin 200mg po bid *BBW: hemolytic anemia *must be taken w/ PEG-IFN bc monotherapy isn't effective *CI: pregnancy *Combo SEs: anemia, birth defects, eye problems Olysio - Answers -Simeprevir I: Hep C genotype 1 & 4 D: 150mg po qd x 12 weeks + PEG-IFN/RBV or sofosbuvir *Take w/ food *SEs: anemia, requiring ESA, photosensitivity Zovirax - Answers -Acyclovir I: HSV, shingles -200mg po 2-5 times daily -Apply cream 6 times/day x 7 days *Take w/ water to prevent kidney stones Valtrex - Answers -Valacyclovir I: HSV, shingles 2g po BID x 1 day *Prodrug of acyclovir Famvir - Answers -Famciclovir I: HSV, shingles

-Shingles: 500mg po tid x 7 days w/in 72 hrs onset Symmetrel - Answers -Amantadine I: Parkinson's disease D: 100mg po bid or tid *For initial tremor tx Tamiflu - Answers -Oseltamivir I: flu tx and ppx D: -Tx: 75mg po BID x 5 d -Ppx: 75mg po QD x 10 d *Must be started w/in 48 hrs *SEs: N/V *For >/= 1 yoa Relenza - Answers -Zanamivir I: flu tx and ppx D: -Tx: 10mg po BID x 5 d -Ppx: 10mg po QD x 10 d *oral inhalation *for >/= 7 yoa Foscavir - Answers -Foscarnet *BBW: only for immunocompromised pts w/ CMV retinitis and acyclovir-resistant HSV, renal impairment, seizures Pulmozyme - Answers -Dornase alfa I: cystic fibrosis D: 2.5mg nebulizer qd or bid if needed Combivir - Answers -Zidovudine/lamivudine *NRTI *SE: lactic acidosis Epzicom - Answers -Lamivudine/abacavir *NRTI *SE: lactic acidosis Requires HLA-B5701 testing for hypersensitivity Trizivir - Answers -Zidovudine/lamivudine/abacavir *NRTI *SE: lactic acidosis Truvada - Answers -Tenofovir/emtricitabine

*NRTI

*SE: lactic acidosis NOF *N = nephrotoxicity *O = osteomalacia/osteoporosis *F = Fanconi syndrome (kidney issues) Atripla - Answers -Tenofovir/emtricitabine/efavirenz *NRTI + NNRTI *Efavirenz: CNS effects *TAKE WITHOUT FOOD NOF *N = nephrotoxicity *O = osteomalacia/osteoporosis *F = Fanconi syndrome (kidney issues) Invirase - Answers -Saquinavir *PI *Increase in lipids, BG, weight/fat redistribution *TAKE WITH FOOD *Take with booster Kaletra - Answers -Lopinavir/ritonavir *PI *Take without food Tenormin - Answers -Atenolol Max dose: 100mg qd *Cardioselective *BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness Lopressor - Answers -Metoprolol tartrate *IR *Cardioselective *Max: 450mg/d (doses are bid) *BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness Toprol XL - Answers -Metoprolol succinate *Cardioselective *Max doses -HTN: 400mg/d (doses are qd) -HF: 200mg/d

*BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness *preferred BB in HF Brevibloc - Answers -Esmolol *IV only for HTN emergency *Cardioselective *BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness Inderal - Answers -Propranolol *IR: 80mg BID, ER: 80mg QD (Max for both: 640mg/d) *Nonselective *Take with food *BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness Blocadren - Answers -Timolol 40mg po BID *Nonselective *BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness Timoptic - Answers -Timolol I: Glaucoma *CI: asthma/COPD, bradycardia, CHF, depression or MG *SE: bronchospasm, bradycardia, low BP and libido, CNS depression Cosopt - Answers -Timolol/dorzolamide I: Glaucoma *CI: sulfa allergy, kidney disease *SE: metallic taste, HA, hypokalemia Normodyne, Trandate - Answers -Labetalol 800mg po BID (Max: 2400mg/d) *Nonselective *Take with food *Also has alpha-1 blockage (vasodilation) *BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness

Coreg - Answers -Carvedilol *Nonselective *preferred in HF *Take with food *BBW: Do not stop abruptly to avoid acute tachycardia, HTN and/or ischemia *CI: diabetes, asthma/COPD, bradycardia, heart block *SE: dyslipidemia, weight gain, fluid retention, fatigue, dizziness Ocupress - Answers -Carteolol I: glaucoma *CI: asthma/COPD, bradycardia, CHF, depression or MG *SE: bronchospasm, bradycardia, low BP and libido, CNS depression Betoptic - Answers -Betaxolol I: glaucoma *CI: asthma/COPD, bradycardia, CHF, depression or MG *SE: bronchospasm, bradycardia, low BP and libido, CNS depression Cardizem - Answers -Diltiazem I: HTN, angina Max dose: 120mg/day qd, bid or tid *non-DHP (more cardioselective) *Preferred if CKD and nephropathy *SE: bradycardia, gingival hyperplasia, constipation *Ok to give in HF if EF is normal Calan, Isoptin, Verelan, Covera - Answers -Verapamil I: HTN, angina Max dose: 120mg/day qd, bid or tid *non-DHP (more cardioselective) *Preferred if CKD and nephropathy *SE: bradycardia, gingival hyperplasia, constipation *Ok to give in HF if EF is normal Norvasc - Answers -Amlodipine I: HTN, angina Max dose: 10mg/d *CI: CHF and do not give w/ BB if acute MI *SE: reflex tachycardia, HA, flushing, edema Plendil - Answers -Felodipine ER I: HTN, angina Max dose: 10mg/d *CI: CHF and do not give w/ BB if acute MI *SE: reflex tachycardia, HA, flushing, edema

DynaCirc - Answers -Isradipine CR I: HTN, angina Max dose: 10mg/d *CI: CHF and do not give w/ BB if acute MI *SE: reflex tachycardia, HA, flushing, edema Cardene - Answers -Nicardipine I: HTN, angina D: 60mg BID or TID *CI: CHF and do not give w/ BB if acute MI *SE: reflex tachycardia, HA, flushing, edema Adalat CC, Procardia XL - Answers -Nifedipine ER I: HTN, angina Max dose: 90mg/d *CI: CHF and do not give w/ BB if acute MI *SE: reflex tachycardia, HA, flushing, edema Cardura - Answers -Doxazosin I: HTN (2nd or 3rd line), BPH D: -HTN: 16mg po qhs -BPH: 8mg po qhs *Caution: syncope, dizziness, fatigue --> Titrate *must taper off Minipress - Answers -Prazosin I: HTN (2nd or 3rd line), BPH D: 5mg po bid or tid (for both indications) *Caution: syncope, dizziness, fatigue --> Titrate *must taper off Hytrin - Answers -Terazosin I: HTN (2nd or 3rd line), BPH D: -HTN: max 20mg po qhs -BPH: 10mg po qhs *Caution: syncope, dizziness, fatigue --> Titrate *must taper off Catapres, Catapress TTS-1,2,3 - Answers -Clonidine I: resistant HTN or pts who can't swallow *off-label: opioid withdrawal, anxiety and sleep D: -0.1-0.3 mg po BID -0.1, 0.2, 0.3 mg/24 hr/wk *Apply to upper outer arm or chest and rotate site weekly

*Caution: bradycardia, dry mouth, fatigue, depression, psych rxns, impotence, rebound HTN *must taper off Aldomet - Answers -Methyldopa D: 500mg BID (max 3000mg/d) *SE: lupus sx, hepatitis, myocarditis, hemolytic anemia *Caution: bradycardia, dry mouth, fatigue, depression, psych rxns, impotence, rebound HTN *preferred in pregnancy *must taper off Serpasil - Answers -Reserpine I: HTN D: 0.05-0.25mg qd *Caution: bradycardia, depression *must taper Apresoline - Answers -Hydralazine I: HTN D: 75mg po qid *SE: lupus *Caution: reflex tachycardia Loniten - Answers -Minoxidil I: HTN D: 40mg po qd *SE: hair growth *Caution: reflex tachycardia Diuril - Answers -Chlorothiazide I: HTN, edema D: 500-1000mg qd or bid *CI: Sulfa allergy *SE: metabolic alkalosis, decreases K+, Na+ and Mg2+, increases BG, TG, Chol, uric acid and Ca2+ *Diuretic of choice if no renal impairment Microzide - Answers -Hydrochlorothiazide I: HTN, edema D: 12.5-50mg po qd *CI: Sulfa allergy *SE: metabolic alkalosis, decreases K+, Na+ and Mg2+, increases BG, TG, Chol, uric acid and Ca2+ *Diuretic of choice if no renal impairment

Dyazide - Answers -HCTZ/triamterene I: HTN, edema D: 1-2 tabs po qd *CI: Sulfa allergy *SE: metabolic alkalosis, decreases K+, Na+ and Mg2+, increases BG, TG, Chol, uric acid and Ca2+ *Diuretic of choice if no renal impairment Thalidone - Answers -Chlorthalidone I: HTN D: target dose 25mg qd *CI: Sulfa allergy *SE: metabolic alkalosis, decreases K+, Na+ and Mg2+, increases BG, TG, Chol, uric acid and Ca2+ *Diuretic of choice if no renal impairment Zaroxolyn - Answers -Metolazone I: HTN, edema D: target dose 20mg/d *CI: Sulfa allergy *SE: metabolic alkalosis, decreases K+, Na+ and Mg2+, increases BG, TG, Chol, uric acid and Ca2+ *Ok if there's renal dysfunction Lozol - Answers -Indapamide I: HTN, edema D: Target dose 2.5mg/d *CI: Sulfa allergy *SE: metabolic alkalosis, decreases K+, Na+ and Mg2+, increases BG, TG, Chol, uric acid and Ca2+ *Diuretic of choice if no renal impairment Lasix - Answers -Furosemide I: HTN, HF, edema D: Target dose 40mg po BID (max: 600mg/d) *CI: sulfa allergy *SE: metabolic alkalosis, Decreases K+, Na+, Mg2+, Ca2+ and bone density, increases BG, TG, Chol, and uric acid *Requires K+ supp *Diuretic of choice for renal disease *IV: Ototoxicity and avoid use w/ aminoglycosides *Equivalency: BTFE = 1:20:40: Demadex - Answers -Torsemide I: HTN, HF, edema D: Target dose 10mg qd

*CI: sulfa allergy *SE: metabolic alkalosis, Decreases K+, Na+, Mg2+, Ca2+ and bone density, increases BG, TG, Chol, and uric acid *Requires K+ supp *Diuretic of choice for renal disease *IV: Ototoxicity and avoid use w/ aminoglycosides *Equivalency: BTFE = 1:20:40: Bumex - Answers -Bumetanide I: HTN, HF, edema D: Target dose: 1mg po bid *CI: sulfa allergy *SE: metabolic alkalosis, Decreases K+, Na+, Mg2+, Ca2+ and bone density, increases BG, TG, Chol, and uric acid *Requires K+ supp *Diuretic of choice for renal disease *IV: Ototoxicity and avoid use w/ aminoglycosides *Equivalency: BTFE = 1:20:40: Edecrin - Answers -Ethacrynic acid I: HTN, HF, edema D: 25-50mg po qd *only loop ok if sulfa allergy *SE: metabolic alkalosis, decreases K+, Na+, Mg2+, Ca2+ and bone density, increases BG, TG, Chol, and uric acid *Requires K+ supp *Diuretic of choice for renal disease *IV: Ototoxicity and avoid use w/ aminoglycosides *Equivalency: BTFE = 1:20:40: Dyrenium - Answers -Triamterene I: HTN, glaucoma, edema D: 300mg po qd *K+-sparing diuretic *SE: metabolic acidosis, Increase K+, decrease Ca2+, gout *CI if CrCl < Midamor - Answers -Amiloride I: HTN, glaucoma, edema D: 20mg po qd *K+-sparing diuretic *SE: metabolic acidosis, Increase K+, decrease Ca2+, gout *CI if CrCl < Aldactone - Answers -Spironolactone I: HF (decreases morbidity), HTN

D: 25-50mg po qd *K+-sparing diuretic *SE: gynecomastia, metabolic acidosis, Increase K+, decrease Ca2+, gout *CI: pregnancy, CrCl < Inspra - Answers -Eplerenone I: HF (decreases morbidity), HTN D: 25-50mg po qd *K+-sparing diuretic *SE: metabolic acidosis, Increase K+, decrease Ca2+, gout *CI: pregnancy, CrCl < Lotensin - Answers -Benazepril I: HTN, HF Target dose: 40mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage Capoten - Answers -Captopril I: HTN, HF Target dose: 50mg po tid *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage Vasotec - Answers -Enalapril I: HTN, HF Target dose: 20mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage Monopril - Answers -Fosinopril I: HTN, HF Target dose: 40mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage Zestril, Prinivil - Answers -Lisinopril I: HTN, HF Target dose: 20mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage

Univasc - Answers -Moexipril I: HTN, HF Target dose: 15mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage Accupril - Answers -Quinapril I: HTN, HF Target dose: 40mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage Altace - Answers -Ramipril I: HTN, HF Target dose: 10mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage Atacand - Answers -Candesartan I: HTN, HF Target dose: 32mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, angioedema *Avoid w/ NSAIDs bc of renal damage Avapro - Answers -Irbesartan I: HTN, HF Target dose: 300mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, angioedema *Avoid w/ NSAIDs bc of renal damage Cozaar - Answers -Losartan I: HTN, HF Target dose: 50-100mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, angioedema *Avoid w/ NSAIDs bc of renal damage Diovan - Answers -Valsartan I: HTN, HF Target dose: 320mg po qd

*BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, angioedema *Avoid w/ NSAIDs bc of renal damage Benicar - Answers -Olmesartan I: HTN, HF Target dose: 40mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, angioedema *Avoid w/ NSAIDs bc of renal damage Micardis - Answers -Telmisartan I: HTN, HF Target dose: 80mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, angioedema *Avoid w/ NSAIDs bc of renal damage Tekturna - Answers -Aliskiren I: HTN Target dose: 300mg po qd *BBW: pregnancy, bilateral renal artery stenosis *SE: metabolic acidosis, increase K+, dry cough, angioedema *Avoid w/ NSAIDs bc of renal damage *High fat meals decreases absorption Mevacor - Answers -Lovastatin IR I: high cholesterol D: 20 po qd or bid (Max: 80mg/d) *CI: Pregnancy *Caution: rhabdomyolysis, myopathy *low-medium intensity *Take with food Lipitor - Answers -Atorvastatin I: high cholesterol D: 10-80mg po qd *CI: Pregnancy *Caution: rhabdomyolysis, myopathy *medium-high intensity Lescol - Answers -Fluvastatin IR I: high cholesterol D: 20-80mg po qd *CI: Pregnancy *Caution: rhabdomyolysis, myopathy

*low-medium intensity *Take at bedtime Crestor - Answers -Rosuvastatin I: high cholesterol D: 5-20mg po qd *CI: Pregnancy *Caution: rhabdomyolysis, myopathy *medium-high intensity Pravachol - Answers -Pravastatin I: high cholesterol D: 10-80mg po qd *CI: Pregnancy *Caution: rhabdomyolysis, myopathy *low-medium intensity Zocor - Answers -Simvastatin I: high cholesterol D: 10-40mg po qd *CI: Pregnancy *Caution: rhabdomyolysis, myopathy *low-medium intensity *Take at bedtime Zetia - Answers -Ezetimibe I: high cholesterol D: 10mg po qd *Caution: myopathy *Can be used w/ statin Niaspan, Niacor, Niacin - Answers -Niacin (B3) I: high TG D: men 16mg/d, women 14mg/d, pregnancy 18mg/d, breastfeeding 17mg/d *only for >18 yoa *CI: peptic ulcer, bleeding *Caution: flushing/itching, gout, diabetes, myopathy/rhabdomyolysis if used w/ statin *Take ER at qhs after low-fat snack *Take IR w/ food Welchol - Answers -Colesevelam I: high cholesterol D: 6 tabs po qd *CI: bowel obstruction *SE: constipation, gas, bloating (Welcol has less GI SEs) *OK w/ statins and hepatic disease

*2nd line Colestid - Answers -Colestipol I: high cholesterol D: max 16g tab/d or 30g powder/d *CI: bowel obstruction *SE: constipation, gas, bloating *OK w/ statins and hepatic disease *2nd line Questran, Prevalite - Answers -Cholestyramine I: high cholesterol *CI: bowel obstruction *SE: constipation, gas, bloating *OK w/ statins and hepatic disease *2nd line Lopid - Answers -Gemfibrozil I: high TG D: 600mg po bid *CI: liver/renal/gallbladder disease *SE: rhabdomyolysis, myopathy *Avoid w/ statin *Take 30 min before breakfast and dinner Tricor, Triglide, TriLipex, Antara - Answers -Fenofibrate I: high TG D: 145mg po qd *CI: liver/renal/gallbladder disease *SE: rhabdomyolysis, myopathy *Avoid w/ statin *Take w/ food Nitrostat, Nitroquick - Answers -Nitroglycerin SL I: angina attack and prevention D: 0.3-0.6 mg q5m, max 3 doses in 15 minutes *CI: PDE-5 inhibitors (sildenafil, tadalafil) *SE: HA, flushing, burning, stinging in mouth, hypotension, dizziness *Avoid alcohol Nitrolingual - Answers -Nitroglycerin spray I: angina attack and prevention D: 1-2 (0.4mg) sprays onto or under tongue q5m for max 3 doses in 15 min *CI: PDE-5 inhibitors (sildenafil, tadalafil) *SE: HA, flushing, burning, stinging in mouth, hypotension, dizziness *Avoid alcohol

*Don't shake *Pump must be primed *Close mouth after spraying Minitran, Nitro-Dur - Answers -Nitroglycerin patch I: angina prevention D: Titrate to 0.4-0.8mg/hr *CI: PDE-5 inhibitors (sildenafil, tadalafil) *SE: HA, flushing, burning, stinging in mouth, hypotension, dizziness *Avoid alcohol *Tolerance is minimized by using patch 12 hrs on/12 hrs off *Rotate patch sites Nitro-Bid - Answers -Nitroglycerin ointment 2% I: angina prevention D: Apply 1/2-2 in to chest or back (max 2 doses/d) by placing applicator on skin and taping it into place *CI: PDE-5 inhibitors (sildenafil, tadalafil) *SE: HA, flushing, burning, stinging in mouth, hypotension, dizziness *Avoid alcohol *Allow for nitrate-free interval of 12hr/d Tridil - Answers -Nitroglycerin infusion D5W I: HTN/ischemic emergency D: 5mcg/min q5min (Max 400mcg/min) *CI: PDE-5 inhibitors (sildenafil, tadalafil) *SE: HA, flushing, burning, stinging in mouth, hypotension, dizziness *Avoid alcohol *Absorption occurs w/ soft plastic (PVC) Isordil - Answers -Isosorbide dinitrate I: angina prevention, HF to decrease mortality w/ hydralazine (BiDil) D: -IR: 5-40mg bid-tid -SR: 40mg po qd-bid *CI: PDE-5 inhibitors (sildenafil, tadalafil) *SE: HA, flushing, burning, stinging in mouth, hypotension, dizziness *Avoid alcohol Plavix - Answers -Clopidogrel I: ACS, recent MI/stroke, PAD D: 300-600mg LD, 75mg po qd maintenance *SE: bleeding, bruising, TTP *Caution: may need to test for CYP2C19 poor metabolizers *Avoid w/ omeprazole and cimetidine

Ticlid - Answers -Ticlopidine I: ACS, recent MI/stroke, PAD D: 250mg BID *SE: bleeding, bruising, risk of neutropenia and hematopoietic disorders Reopro - Answers -Abciximab I: PCI only D: 0.25mg/kg bolus pre-PCI, then 0.125mcg/kg/min x 12hr *IV only *SE: thrombocytopenia, bleeding, hypotension *refrigerate *filter Integrilin - Answers -Eptifibatide I: ACS + PCI D: 180mcg/kg bolus, then 2mcg/kg/min x 25h *IV only *SE: thrombocytopenia, bleeding, hypotension *refrigerate *protect from light Persantine - Answers -Dipyridamole I: TIA/stroke prevention D: 75-100mg po QID *SE: CP, HA, dizziness, angina exacerbation, abnormal ECG Aggrenox - Answers -Aspirin/dipyridamole I: TIA/stroke prevention D: 25mg/200mg po BID *SE: HA, dyspepsia, N/D, bleeding Pletal - Answers -Cilostazol I: intermittent claudication D: 100mg po bid 30 min before or 2 hrs after meals x 3 months Trental - Answers -Pentoxifylline I: intermittent claudication D: 400mg po TID Norpace - Answers -Disopyramide I: arrhythmia *SE: increase QT interval, HF, anticholingeric *Avoid: urinary retention, BPH, glaucoma, MG *Class 1a *Take on empty stomach