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94 Cards in this Set
- Front
- Back
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Goals of Asthma therapy (6)
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1)minimize day/night symptoms
2)minimize exacerbations/hospital visits 3)minimize limits on activity and missed days 4)maintain near normal pulmonary fxn 5)minimize need for B2 agonist 6)minimize ADR's from meds |
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____= too much SABA use (2)
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more than 2 canisters/month
over 2x use per week |
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Asthma monitoring parameters (4)
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1)day/night symptoms
2)limits on acitivty/days missed/hospital visits 3)B2 agonist utilization 4)peak expiratory flow rate as % of best |
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COPD monitoring parameters (5)
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1)symptoms
2)limits on activity/days missed/hospital visits 3)bronchodilator utilization (if prn) 4)+ drug specific ones 5)#1 cause is smoking |
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Allergic rhinitis
a)monitoring parameters (2) b)drug selection (5) c)nonpharma tx |
a1)histamine related symptoms
a2)nasal congestion b1)antihistamines b2)decongestants b3)intranasal corticosteroids b4)mast cell stabilizers b5)intranasal anticholinergic c)AVOID ALLERGEN |
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B2 agonist bronchodilators
a)precautions (2) |
a1)CV disease (potential for incr HR)
a2)DM (potential for incr in blood glucose) |
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B2 agonist bronchodilators
a)class ADR's (4) |
a1)cough
a2)nervousness/anxiety a3)tremor/tachycardia/palpitations a4)worsen hypokalemia if used w/ K+ wasting diuretics |
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B2 agonist bronchodilators
a)class pt consultation (4) |
a1)for ACUTE asthma symptoms ONLY
a2)monitor frequency of use (daily/freq use suggests poor control or underlying disease) a3)can "pre-treat" prior to exercise or before exposure to known triggers a4)agent-specific admin technique |
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Proventil
a)dosage forms (3) b)pt consultation (2) |
a1)aerosol inhaler
a2)solution for inhalation via nebulizer a3)syrup and oral tablets too b1)for exercise induced bronchospasm, pretx 15min prior b2)shake aerosol prior to use |
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Xopenex
a)generic b)dosage form c)pt consultation (3) |
a)levalbuterol
b)available as solution for neb & inhaler (xopenex HFA) c1)neb (do NOT mix w/ other meds) c2)use within 2wks of opening foil c3)less ADR's than alubterol |
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Maxair
a)generic b)dosage forms (2) c)pt consultation (3) |
a)Piralbuterol
b1)aerosol inhaler b2)AUTOHALER c1)admin technique dependent on dosage form c2)shake aerosol well c3)for exercise induced bronchospasm, pretx 15min prior |
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Serevent Diskus
a)dosage form b)CI c)pt consultation (2) |
a)serervent
b)not for acute asthma c1)use on schedule as directed c3)if used for exercise induced bronchospasm, pretx 30-60min prior |
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Inhaled corticosteroids
a)CI/precautions (3) b)class ADRs (3) c)other |
a1)not for primary tx of status asthmaticus
a2)appropriate transfer from system steroids (to avoid renal insufficiency) a3)secondary oral fungal infexn may occur b1)pharyngitis b2)cough b3)hoarseness c)DRUG OF CHOICE FOR MAINTENANCE THERAPY |
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Inhaled corticosteroids
a)class pt consultation***** (4) |
a1)not for acute symptoms
a2)daily compliance to control inflammation and prevent exacerbations a3)may take up to 4WEEKS to see FULL effect after initiation or dosage incr a4)rinse mouth and spit following use |
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Azmacort
a)generic b)dosage form detail c)pt consultation |
a)triamcinolone
b)built-in spacer c)shake well |
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Flovent
a)generic b)dosage forms c)ADR's (2) d)consultation |
a)fluticasone
b)disk(rotodisk) & inhaler c)HA, pharyngitis d)aerosol so shake well |
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Pulmicort
a)generic b)dosage forms (3) c)pt consultation (2) |
a)budesonide
b1)turbuhaler (dry powder) (is now discontinued) b2)respules (inhalation suspension for neb) b3)flexhaler (replaced turbuhaler) c1)turbuhaler NOT for use w/ spacer c2)can be mixed w/ other meds |
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Advair
a)generic b)strengths c)FDA indications d)ADR's e)pt consultation |
a)Fluticasone & salmeterol
b)100/50, 250/50, 500/50 (50mg salmeterol in all) c)asthma & COPD d)see ADR's of corticosteroid and salmeterol e)diskus is DPI and NOT for immediate relief of symptoms |
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Intal
a)mechanism b)FDA indication/dose c)ADR (2) d)pt consultation (3) e)generic |
a)mast cell stabilizer
b)2 puffs qid for long term maintenance & bronchospasm prevention c)cough & sore throat d1)use one hour before activity for bronchospasm prevention d2)may take up to 4wks for effect d3)for MAINTENANCE only e)cromolyn |
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Tilade
a)generic b)mechanism c)FDA indication d)ADR (2) e)pt consultation |
a)Nedocromil
b)mast cell stabilizer c)2 puffs qid for long term maintenance and bronchospasm prevention d)cough, sore throat e)may take over 1wk for initial response |
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Theophylline
a)drug interactions (5) |
1)quinolones
2)macrolides 3)smoking 4)charcoal beef 5)cimetidine |
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Theophylline
a)consultation (1) b)other (3) |
a1)do NOT crush tabs
b1)NTI b2)needs monitoring b3)aminophylline is injection |
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Atrovent
a)generic b)dosage forms (3) c)FDA indications (2) d)CI/precautions (2) |
a)ipatropium
b1)aerosol b2)inhalation solution (neb) b3)nasal spray c1)maintenance tx for COPD c2)rhinorrhea (allergic and non-allergic)--nasal spray d1)not for acute attacks d2)anticholinergic precautions |
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Atrovent
a)oral ADR's (3) b)nasal ADR's (4) c)pt consultation (2) |
a1)dry mouth
a2)cough a3)HA b1)dryness b2)epistaxis (nose bleed) b3)irritation b4)HA c1)SCHEDULED use for COPD c2)shake aerosol well |
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Spiriva
a)generic b)FDA indications c)dosage form/dose d)PK (2) e)Drug interactions |
a)tiotropium
b)COPD c)inhalation powder for use with Handihaler (one capsule by inhalation daily) d1)half life is 5-6h d2)selective muscarinic receptor antagonist e)NOT likely due to low systemic absorption |
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Spiriva
a)CI b)ADR's (2) c)Pt consultation (3) |
a)anticholinergics
b1)dry mouth b2)constipation c1)do NOT swallow capsules**** c2)keep in original packaging until use c3)not a "rescue" med |
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Duoneb
a)generic b)dosage form c)pt consultation d)FDA indication |
a)ipatropium & albuterol
b)one amp via NEB qid; can use 2 additional doses if needed per day c)protect from heat/light & keep in original foil d)COPD pts w/ reversible bronchospasm |
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Combivent
a)generic b)dosage form c)FDA indication (2) |
a)ipatropium & albuterol
b)aerosol c1)COPD pt on bronchodilator w/ evidence of bronchospasm who require 2nd agent c2)COPD pts w/ reversible bronchospasm |
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Accolate
a)generic b)mechanism c)drug interactions (4) |
a)zafirlukast
b)LK antagonist c1)warfarin c2)phenytoin c3)tegretol c4)CCB |
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Accolate
a)precautions b)ADR c)pt consultation (2) d)dose schedule |
a)NOT for acute asthma tx
b)HA c1)take on an EMPTY STOMACH c2)used for daily/chronic tx d)BID |
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Singulair
a)generic b)mechanism c)dosage forms (3) d)dosing schedule (2) |
a)montelukast
b)LK antagonist c)tablet, chewable, granules d1)asthma take HS (once daily) d2)rhinitis take qd ANY TIME |
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Singulair
a)CI b)ADR c)pt consultation (2) |
a)NOT for acute asthma
b)HA c1)used for daily/chronic tx c2)prevent exercise induced bronchospasm (take 2hrs prior) |
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Allegra/Allegra-D
a)FDA indications (3) b)CI c)ADR's (2) d)pt consultation (2) |
a1)seasonal allergic rhintits
a2)chronic idiopathic urticaria (not Allegra-D) a3)60mg is q12h; 180mg is qd b)severe HTN/CAD (w/ allergra-D) c1)HA w/ no D c2)HA, insomnia, nausea w/ D d1)take on empty stomach d2)avoid OTC cough, cold, allergy products |
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Clarinex
a)FDA indications (2) b)precautions c)ADR (2) d)pt consultation (2) |
a1)seasonal/perennial allergic rhinitis
a2)chronic idiopathic urticaria b)impaired liver fxn c)HA, dry mouth d1)avoid OTC cough, cold, allergy products d2)ONCE DAILY DOSING |
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Zyrte/Zyrtec-D
a)dosage forms (2) b)FDA indications (2) c)precautions (2) d)ADR's (4) e)pt consultation (2) |
a)tablets, syrup
b1)seasonal allergic rhinitis b2)perennial allergic rhinitis c1)additive w/ CNS depressants (no D) c2)additive w/ sympathomimetics (w/ D) d1)drowsiness/somnolence d2)fatigue d3)dry mouth d4)nervousness/insomnia (w/ D) e1)may cause drowsiness (w/o D) e2)avoid alcohol |
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Patanol
a)generic b)dosage form c)mechanism d)indication e)counsel |
a)olpatadine
b)opthalmic c)H-1 antagonist d)allergic conjunctivitis e)remove contact lenses prior to inserting; wait 10min before reinserting |
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Phenergan
a)dosage forms (4) b)FDA indications (2) c)ADR (2) d)pt consult (2) e)BLACK BOX WARNING |
a1)tablets
a2)syrup a3)suppositories a4)injexn b1)allergic rhinitis b2)urticaria c1)drowsy c2)dry mouth d1)may cause drowsy d2)avoid alcohol e)DO NOT GIVE TO PTS LESS THAN 2YO |
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Astelin
a)generic b)mechanism c)FDA indications d)ADR (3) e)consult |
a)Azelastine
b)H1 antagonist c)rhinitis d1)bitter taste in mouth d2)HA d3)drowsy e)may cause drowsiness |
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Nasal corticosteroids
a)class precautions (2) b)Class ADR (4) |
a1)bacterial/viral infexns of upper airways
a2)unhealed nasal wounds b1)HA b2)pharyngitis b3)epistaxis (nose bleed) b4)cough |
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Nasal corticosteroids
a)class pt consultation (6) |
a1)shake well before use
a2)may require priming a3)clear nasal passages before use (blow nose) a4)CAN use concomitant decongestans a5)effects not seen before a few days (up to 3wks) a6)use daily for optimal effects |
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Flonase
a)generic b)dosage form c)FDA indication d)dose schedule |
a)fluticasone
b)nasal spray c)allergic rhinitis d)QD |
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Nasonex
a)generic b)dosage form c)FDA indication d)dose schedule |
a)mometasone
b)nasal spray c)allergic rhinitis d)QD |
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Nasacort AQ
a)generic b)dosage form c)FDA indication d)dose schedule |
a)Triamcinolone
b)nasal spray c)allergic rhinitis d)QD |
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Rhinocort AQ
a)generic b)dosage form c)FDA indication d)dose schedule |
a)budesonide
b)nasal spray c)allergic rhinitis d)QD |
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Atarax
a)generic b)FDA indications (2) c)pharmacology d)drug interaxns (2) e)ADR (2) |
a)hydroxyzine
b)pruritis, anxiety c)ZYRTEC is a metabolite of hydroxyzine d1)CNS depressants d2)alcohol e1)drowsy e2)dry mouth |
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Sudafed
a)CI (2) b)precautions (3) c)pt consultation (4) |
a)CAD, HTN
b)HTN, DM, BPH c1)only available thru pharmacy c2)9g/month limit c3)3.6g/day limit of sudafed base c4)=146 30mg tablets |
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Tessalon Perles
a)generic b)PK c)CI (2) d)ADR (2) e)pt consult |
a)Benzonatate
b)onset within 15-20min c1)caution w/ PABA anesthetic allergy c2)bronchospasm/CV collapse IF CHEWED/SUCKED d)drowsy, HA e)seek medical attn if difficulty breathing/swallowing |
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Tussionex
a)FDA indication b)drug interaxns c)CI/precautions (2) d)pt consultation (2) e)generic |
a)cough
b)CNS depressants c1)pulmonary disease/asthma c2)BPH d1)may cause drowsiness d2)avoid alcohol e)chlorpheniramine and HC |
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Mytussin AC
a)generic b)control level? c)FDA indications d)drug interaxns e)pt consultation (2) |
a)codeine and guaifenisen
b)C5 c)cough d)CNS depressants e1)may cause drowsiness e2)avoid alcohol |
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Guiafenex DM
a)generic b)use |
a)guaifenisin and DXM
b)symptomatic relief of cough |
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Guiafenex PSE
a)generic b)use c)cousel |
a)guaifenisin and pseudofed
b)symptomatic relief of cough and nasal congestion c)XR tablet; may break in half. Do NOT chew/crush |
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Aricept
a)generic b)FDA indication c)dose schedule d)drug interactions (3) |
a)Donepezil
b)Alzeheimer's c)HS dosing d1)phenytoin d2)carbamazepine d3)phenobarbital (PCP) |
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Aricept
a)precautions (3) b)ADR (2) c)pt consultation d)mechanism |
a1)sick-sinus syndrome (due to vagotonic effects)
a2)prior ulcers/GI bleeds a3)asthma/COPD b1)n/d b2)anorexia common c)take @ bedtime w/o regard to food d)AChesterase inhibitor |
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Exelon
a)generic b)FDA indications c)dose schedule d)drug interaxns (2) |
a)Rivastigmine
b)Alzeheimer's c)titrate every 2wks according to response d1)anticholinergics d2)cholinergic potentiation |
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Exelon
a)ADR's (4) b)pt consultation c)mechanism |
a1)n/v/d
a2)anorexia a3)dizziness a4)HA b)observe for anorexia/wt loss c)AChesterase inhibitor |
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Namenda
a)generic b)dosing (2) c)mechanism d)drug interaxns e)ADR (3) |
a)Memantine
b1)titrate no more often than weekly b2)RENAL dose adjustment c)NMDA inhibitor = decr glutamate effect d)carbonic anhydrase inhibitors alkalinize urine and decr memantine clearance e1)dizziness e2)HA e3)constipation |
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Parkinson's Disease
a)common problems/options (5) |
a1)"wearing off" phenomenon
a2)"on-off" phenomenon a3)peak dose dyskinesia a4)mainstay is Sinemet a5)if pt has parkinson's and alzeheimers TREAT ALZEHEIMER'S FIRST |
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Cogentin
a)generic b)indication c)mechanism d)CI |
a)Benztropine
b)Parkinson's, controls EPS (treats resting tremor better than big tremor) c)anticholinergic d)kids less than 3yo |
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Cogentin
a)precautions (2) b)ADR (4) c)pt consultation (2) |
a1)risk of tachycardia
a2)aggravation of BPH b1)dry mouth b2)blurred vision b3)consitpation b4)nausea c1)take w/ food/milk if GI upset c2)do NOT abruptly DC |
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Comtan
a)generic b)FDA indications (3) c)mechanism d)CI e)Precautions (3) |
a)Entacapone
b1)adjunct Parkinson's for "wearing off" b2)ONLY GIVEN WITH SINEMET b3)Sinemet therapy may require adjustment after initiation c)COMT inhibitor d)MAOI's e1)do NOT abruptly dc e2)hypotension e3)movement disorders after initiation |
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Comtan
a)ADR (3) b)pt consultation (2) |
a1)n/d
a2)dyskinesia/hyperkinesia a3)orthostasis b1)admin w/ sinemet dosages b2)may see urine color change |
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Eldepryl
a)generic b)mechanism c)indication d)CI e)drug interaction (3) f)pt consultation |
a)Selegiline
b)MAOB inhibitor c)adjunct in Parkinson's d)no use w/ MEPERIDINE e1)meperidine e2)TCA's (serotonin syndrome) e3)SSRI's (serotonin syndrome) f)do NOT exceed daily recommended dose |
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Mirapex
a)generic b)FDA indications c)precautions (2) d)ADR (3) e)pt consult (2) |
a)Pramipexole
b)Parkinson's c1)orthostasis c2)renal dysfxn d1)dizziness/somnolence d2)nausea d3)orthostasis e1)hallucinations e2)do not rapidly stand or sit up |
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Requip
a)generic b)FDA indications (2) c)ADR's (3) d)pt consultation (3) |
a)Ropinirole
b1)Parkinson's b2)Restless Leg c1)nausea c2)dizziness c3)somnolence d1)orthostasis d2)drowsiness d3)hallucinations |
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Sinemet
a)generic b)mechanism c)dosage form (2) d)FDA indications e)CI/precautions (4) |
a)L-dopa/carbidopa
b)L-dopa crosses BBB to provide dopamine precursor, carbidopa doesn't inhibits peripheral conversion of L-dopa to dopamine (so more is available to brain) c)regular/CR d)Parkinson's e1)glaucoma e2)dermatologic concerns e3)MAOI e4)CV disease |
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Sinemet
a)ADR's (2) b)Pt consultation (4) |
a1)nausea
a2)dystonia/involuntary mvmnts b1)food/milk w/ it if GI upset b2)avoid vitB6 supplements b3)can half CR tabs, but do NOT crush/chew b4)watch for dark urine |
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Symmetrel
a)generic b)FDA indication c)ADR (3) d)pt consult (2) |
a)Amantadine
b)Parkinson's c1)nausea c2)dizzy c3)insomnia d1)avoid alcohol d2)orthostasis |
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Seizure disorders
a)generalized serizures (2) b)Partial seizures (3) |
a1)Tonic-clonic
a2)absence b1)simple b2)complex b3)secondary generalized |
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Depakote
a)generic b)dosage forms (3) c)FDA indications (2) d)drug interaxn e)CI (2) |
a)valproic acid
b)capsules, EC tabs, ER tabs c)seizures, mania d)taking carbamazepine = decr depakote levels e1)hepatic disease e2)if pt experiences severe ADR's like decr platelet count and pancreatitis |
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Depakote
a)dosing schedule b)ADR (4) c)Pt consultation (5) |
a)ER is dosed daily
b1)n/d b2)dyspepsia b3)somnolence b4)dizzy c1)food/milk to avoid GI upset c2)do NOT dc abruptly c3)capsules can be sprinkled on soft food and swallowed whole c4)do NOT cursh or chew ER tabs c5)contact MD for persistent GI ADR's |
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Dilantin
a)generic b)precautions c)ADR (3) d)signs of toxicity (5) |
a)Phenytoin
b)impaired liver fxn c1)dizzy c2)nausea c3)GINGIVAL HYPERPLASIA d1)ataxia d2)slurred speech d3)confusion d4)rash d5)nystagmus |
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Dilantin counsel points (5)
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1)take w/ food
2)no alcohol w/o MD direction 3)good oral hygeine (due to dental hyperplasia) 4)contact MD if rash develops 5)do NOT stop w/o contacting MD |
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Lamictal
a)generic b)dosing influenced by... c)PK d)drug interactions (4) |
a)Lamotrigine
b)concomintant EIAED (enzyme inducing anti-epileptic drugs) influences dosage c)half-life dependent on concomitant drugs d1)phenyotin d2)carbamazepine d3)phenobarbital (PCP decr lamictal levels) d4)valproic acid INCR lamictal levles |
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Lamictal
a)precausions (3) b)pt consultation (2) |
a1)serious rash within weeks of initiation (and more common in kids or current use of depakote)
a2)hypersensitivity/fever a3)opthalmic effects b1)promptly report fever/rash b2)chewable tabs can be dispersed in small amount of liquid |
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Neurontin
a)generic b)dosing c)PK d)drug interactions |
a)Gabapentin
b)high doses often used and renal adjustment reqd c)RENALLY EXCRETED UNCHANGED d)antacids |
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Neurontin
a)ADR (2) b)pt consultation (3) |
a1)somnolence
a2)dizziness b1)drowsy b2)avoid alcohol/antacids b3)do NOT abruptly dc |
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Phenobarbital
a)contol level b)PK (2) d)precautions (2) e)pt consult f)where used most often |
a)C4
b)enzyme induction/long half-life c1)elderly c2)impaired liver fxn d)counsel on drowsy and alcohol use e)primary tx in neonates/kids for seizure |
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Tegretol
a)dosage forms (2) b)CI c)precautions d)pt consultation (4) |
a)chewable, oral/XR tabs
b)bone marrow depression c)rare cases of aplastic anemia and agranulocytosis d1)take w/ food/milk; avoid alcohol d2)do NOT sopt w/o MD d3)follow chewable tabs w/ water; do NOT crush XR d4)counsel on bone marrow depression precautions |
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Topamax
a)generic b)dosing c)PK/pharmacology (2) d)drug interaxns |
a)topiramate
b)renal adjustment reqd c1)weak carbonic anhydrase inhibitor c2)primarily excreted in urine unchanged d)CNS depressants |
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Topamax
a)precautions (2) b)ADR (4) c)pt consult (2) |
a1)myopia/secondary angle closure glaucoma
a2)kidney stones b1)drowsy/dizzy (not DR) b2)fatigue, nervous, anorexia (DR) c1)avoid alcohol c2)maintain hydration |
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Trileptal
a)generic b)dosage forms (2) c)drug interaxns (5) |
a)oxcarbazepine
b)tablets, oral suspension c1)phenytoin c2)carbamazepine c3)phenobarbital (PCP) c4)valproic acid c5)verapamil (VV) |
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Trileptal
a)ADR (3) b)pt consult (3) |
a1)dizzy
a2)somnolence a3)skin rxns b1)drowsiness b2)avoid alcohol b3)shake suspension well |
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Zonegran
a)generic b)FDA indication c)unlabeled use d)dosing e)drug interactions |
a)Zonisamide
b)partial seizure c)bipolar disorder d)dose reduction w/ renal or hepatic dysfxn e)substrate for CYP3A4 (azoles, macrolides) |
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Klonopin
a)generic b)Control level c)ADR (2) d)consultation (2) |
a)Clonazepam
b)C4 c1)drowsy/fatigue c2)ataxia d1)avoid alcohol d2)do NOT stop med abruptly |
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Imitrex
a)generic b)dosage forms (3) c)CI (2) d)watch w/... |
a)Sumatriptan
b)injexn, tablet, nasal c1)ischemic heart disease c2)uncontrolled HTN d)watch w/ heart conditions |
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Imitrex pt consultation (4)
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1)take as direct (do NOT exceed dosage)
2)separate injexns by atleast 1hr 3)separate oral doses by atleast 2hr 4)indicated to relieve (not prevent) migraine HA |
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Maxalt/Maxalt MLT
a)generic b)FDA indications c)CI (2) d)pt consultation (4) |
a)Rizatriptan
b)migraine HA ABORTIVE tx c1)ischemic heart disease c2)uncontrolled HTN d1)take as directed--do not exceed dosage d2)separate doses by atleast 2hrs d3)indicated to relieve (not prevent) migraines d4)place MLT tablet on TOP of tongue--saliva will dissolve |
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Zomig/Zomig MLT
a)generic b)dosage forms (3) c)CI (3) d)pt consultation (4) |
a)zolmitriptan
b)tablet, oral disintegrating tablet, nasal c1)ischemic heart disease c2)uncontrolled HTN c3)hepatic impairment d1)take as directed--do NOT exceed dosage d2)place MLT tablet on TOP of tongue--saliva will dissolve d3)oral/nasal dosage may be repeated after 2hrs d4)indicated to relieve (not prevent) migraine HA |
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Midrin
a)dosing b)CI/precautions (6) c)ADR (2) d)pt consult |
a)dosed differently for tension/migraine HA
b1)glaucoma b2)severe renal disease b3)HTN b4)MAOI b5)PVD b6)recent CV attacks c)dizziness/skin rash d)NO more than 5 capsules in 12hr |
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Fioricet
a)generic b)control level c)drug interaction d)CI e)pt consult (3) |
a)butabital, APAP, caffeine
b)NOT controlled c)oral anticoagulants d)hypersensitivity e1)alcohol e2)drowsiness e3)concomitant APAP |
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Fiorinal
a)generic b)control level c)drug interactions d)CI (3) e)pt consultation (3) |
a)Butabital, ASA, caffeine
b)C3 c)oral anticoagulants d1)hypersensitivity to ASA d2)PUD d3)coagulation disorders e1)alcohol e2)drowsiness e3)concomitant ASA |
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2 Seizure meds that are COMPLETELY renally excreted unchanged
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1)neurontin
2)topamax |
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Meds used to tx exercise induced asthma (6)
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1)albuterol (15min prior)
2)maxair (15min prior) 3)serevent (30-60min prior) 4)intal (60min prior) 5)singulair (2hr prior) 6)OR incr maintenance therapy |
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Only inhaled steroid available as neb?
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pulmicort
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