151-226

Soma

muscle relaxant

tablets: 250 and 350 mg

acute musculoskeletal conditions

unknown
may work centrally in spinal cord or descending reticular formation to produce muscle relaxation

acute intermittent porphyria
caution in liver or renal impairment
rare idiosyncratic reactions (weakness, dizziness, vision loss, euphoria, confusion)

drowsiness
dizziness
headache
nausea, vomiting, diarrhea, constipation

may take with meals if GI upset
may cause drowsiness
if dose missed, skip and return to schedule

Mevacor

antihyperlipidemic

tablets: 10, 20, 40 mg

hypercholesterolemia
atherosclerosis

inhibits HMG-CoA reductase, preventing cholesterol synthesis

pregnancy and lactation
liver disease
caution in liver dysfunction

constipation, dyspepsia, diarrhea, flatus, abdominal cramps, heartburn, nausea, headache, rash, myalgialurred vision

follow prescribed diet
take with meals
avoid overexposure to sunlight
discontinue if pregnant
report muscle pain
limit alcohol use
if missed, take asap, if within 12 hours of next dose, skip next dose and return to schedule

Plaquenil

tablets: 200mg

antimalarial, RA agent

malaria
lupus erythematosus
rheumatoid arthritis

unknown
may raise pH of parasitic components

do not use long term in children
caution in psoriasis, porphyria, pregnancy, and liver disease
may cause retinopathy long-term

headache
dizziness
nausea
visual disturbances
edema
weight loss
blood dyscrasias
nervousness
anorexia
abnormal skin pigmentation

take with food to decrease GI upset
watch for flu-like symptoms
if dose missed, take asap, but not if closer to next dose

Minocin, Dynacin, Solodyn ER

capsules, Minocin: 50, 75, 100 mg
tablets, Dynacin: 50, 75, 100 mg
ER tablets, Solodyn: 45, 55, 65, 80, 90, 105, 115, 135 mg
powder for injection: 100mg

bacterial infections
syphilis, gonorrhea, chlamydia
acne vulgaris

tetracycline antibiotic that prevents proteins synthesis by binding to 30S ribosomal subunits of bacteria

tetracycline antibiotic

children under 8
pregnancy and lactation
impaired renal function

dizziness
vertigo
nausea
emesis
diarrhea
discoloration of teeth
sore or darkened tongue
cramps
burning stomach
rare photosensitivity reactions

take on empty stomach with full glass of water
take with food or milk only if GI upset
complete full course of therapy
do not take antacids within 2 hours
if dose missed, take asap

mysoline

antiepileptic

tablets: 50, 250 mg
suspension: 250mg/5mL

control of epileptic seizures

unknown
metabolized into phenobarbital and phenylethylmalonamide
sensory cortex depression via inhibition of conduction in reticular formation at thalamus

hypersensitivity to barbiturates
porphyria
caution in pregnancy, elderly, impaired liver function
may increase suicidal thoughts

dizziness
ataxia
nausea
vomiting
drowsiness
impotency

may cause dizziness
avoid alcohol
if dose missed, take asap, unless closer to next dose

Lovaza

antihyperlipidemic

liquid-filled gel capsule: 1g with 900mg

hypertriglyceridemia

unknown
may inhibit acyl CoA -> decreased lipogenesis and increased lipase activity
may reduce triglyceride synthesis

caution in fish allergy
try lifestyle changes first (and discontinue estrogen therapy, thiazide diuretics, and beta blockers)

belching
infection
flu-like symptoms
dyspepsia
taste perversion
back pain
rash
angina

take with meals
closely follow prescribed diet
if dose missed, skip and return to schedule

Carafate

anti ulcer agent

tablets: 1g
suspension: 1g/10mL

treatment of duodenal ulcer

forms an ulcer-adherent complex that covers the ulcer site and protects from further damage

caution in chronic renal failure due to possible absorption of small amounts of aluminum

constipation

take on empty stomach
do not take antacids within 30 minutes
store away from heat, moisture, and sunlight
if dose is missed, skip
do not take within 2 hours of other meds

Lanoxin
Digitek

cardiac glycoside; antiarrhythmic

tablets: 0.125, 0.25 mg
elixir (pediatric): 0.05mg/1mL
injection: 0.1, 0.25 mg/mL

heart failure
atrial fibrillation
atrial flutter
paroxysmal atrial tachycardia

inhibits Na/K ATPase pump, leading to increase in Na inside cell, Ca 2+ enters cell, increasing force and velocity of systolic contractions, slowing of heart rate, and decreased conduction velocity through AV node

ventricular fibrillation
caution in pregnancy, nursing, severe carditis, heart failure and acute glomerulonephritis, renal impairment, hypokalemia, hypomagnesemia, hypercalcemia, acute MI, pulmonary disease, incomplete AV block, sinus node defects

anorexia
n/v
gynecomastia
blurred vision
headache
bradycardia

do not discontinue
do not take OTC cough/cold, antacids, laxatives, or antidiarrheals
if dose missed, take asap, unless closer to next dose

Nizoral

antifungal

tablets: 200mg
cream: 2%
shampoo: 2%

systemic fungal infections
seborrheic dermatitis
reduction of scaling due to dandruff

inhibits synthesis of ergosterol, the main sterol of fungal cell membranes

do not use for fungal meningitis
hepatotoxicity possible
caution in pregnancy and lactation

n/v
topical irritation

do not take with antacids
take tablets with food or acidic beverage
may cause drowsiness or dizziness
watch for signs of liver dysfunction
can remove curl from hair
if dose missed, take asap unless closer to next dose

motrin

tablets: 400, 600, 800 mg
OTC: 200mg; liquid and chewable

NSAID

mild to moderate pain
dysmenorrhea
rheumatoid arthritis
osteoarthritis
juvenile arthritis

inhibits COX, leading to decreased prostaglandin synthesis

not recommended in pregnancy
caution in renal and liver impairment, hypertension, fluid retention, heart failure, bleeding disorders, peptic ulcer
GI bleeding and blood clots possible

indigestion
constipation
abdominal cramps
flatulence
dizziness
rash
pruritus
heartburn
nausea
diarrhea
tinnitus
anorexia

up to 2 weeks before improvement seen
take with food or milk if GI upset
use with alcohol will increase ulcers
watch for rash
if dose missed, take asap, unless closer to next dose

250-350mg tid and at bedtime

muscle relaxant

C

20mg qd with evening meal

LFT, Lipid Panel

X

400-600mg qd

annual eye exam

200mg initially with 100mg every 12h

tetracycline antibiotic

D

250mg 3-4 times daily

D

1200-3200mg in 3-4 divided doses

LFT, RFT

4g in 1-2 doses with meals

lipid panel

C

1g qid on empty stomach

B

0.125-0.5mg qd

serum digoxin

C

LFT

apply bid for 4 weeks or until clinical clearing

C

Naprosyn
EC-Naprosyn

tablets (Naprosyn): 250, 375, 500mg
DR tablets (EC-Naprosyn): 375, 500mg
suspension: 125mg/5mL

mild to moderate pain
primary dysmenorrhea
acute tendonitis and bursitis
RA, osteoarthritis, ankylosing spondylitis
acute gout

NSAID

inhibits COX, resulting in decreased prostaglandin synthesis

caution in renal impairment, HTN, fluid retention, CHF, bleeding disorders, elderly
GI bleeding, stroke, clots possible

SOB
indigestion
tinnitus
edema
itching
constipation
dizziness
drowsiness
headache
nausea
vomiting

up to 2 weeks to see improvement
take on empty stomach (with food to avoid upset)
increased ulcers with alcohol
avoid aspirin
may cause drowsiness

Medrol

anti-inflammatory

tablets: 2, 4, 8, 16, 32mg
dosepak: 21 4mg tablets
injection: 40mg/mL, 125mg/mL (Na succinate)
injection: 40mg/mL, 80mg/mL (acetate)

allergic and inflammatory diseases
MS

adrenocorticoids bind to receptor proteins to form a steroid-receptor complex to inhibit transcription of mRNA

systemic fungal infections
caution in pregnancy, hypothyroidism, cirrhosis, UC, diverticulitis, renal impairment, HTN, osteoporosis, TB, peptic ulcers, DM
no immunizations

blurred vision
upset stomach
n/v
electrolyte disturbances
Cushing's syndrome
increased infections
osteoporosis

take only as prescribed
do not discontinue
may take with food or milk if GI upset

Cleocin

antbiotic

capsules: 75, 150, 300mg
granules for oral solution: 75mg/5mL

respiratory tract infections
skin infections
septicemia
other infections

binds to 50s bacterial ribosomal subunit and suppresses protein synthesis

caution in diarrhea, elderly, GI disease, atopic
do not use to treat meningitis (doesn't cross BBB)

abdominal pain
n/v
diarrhea
pruritus
vaginitis
(muscle pain, severe diarrhea, rash need to be reported to physician)

discontinue if rash or severe diarrhea
finish full course
drink a full glass of water with each dose
take without regard to meals

Breo Ellipta

antiasthmatic/anti COPD

inhalation powder: 100/25, 200/25 mcg

COPD
asthma

fluticasone - corticosteroid that promotes antiallergic/anti-inflammatory actions
vilanterol - stimulates adenyl cyclase, increasing cAMP and relaxing bronchial, uterine, and vascular smooth muscle

acute asthma or COPD
secondary fungal infections possible
caution in cardiovascular disorders, HTN, hyperthyroidism, DM, nursing, pregnancy

URTI
nasopharyngitis
headache
bronchospasm, pneumonia, immunosuppression, decrease bone mineral density, cataracts, hypokalemia, tachycardia, HTN, arrhythmia

avoid eye contact
rinse mouth after use
not intended for immediate relief

Omnicef

cephalosporin antibiotic

capsules: 300mg
powder for oral suspension: 125mg/5mL, 250mg/5mL

infections
community acquired pneumonia
otitis media
chronic bronchitis
sinusitis

inhibits bacterial cell wall synthesis via acylation of the transpeptidase enzyme

hypersensitivity to penicillins and cephalosporins
caution in impaired renal function
do not give within 2 hours of antacids or iron supplements
pseudomembranous colitis and Cdiff possible

diarrhea
vaginal moniliasis
nausea
headache
abdominal pain

shake suspension well
do not take antacids or iron within 2 hours
discard suspension after 10 days
if severe diarrhea, contact physician
complete full course

Dexilant

DR capsules: 30, 60mg
ODT: 30mg

GERD
erosive esophagitis

gastric antisecretory (PPI)

inhibits H+/K+ ATPase enzyme on gastric parietal cells to block the final step of acid production

increased risk of osteoporosis fractures

diarrhea
n/v
URTI
abdominal pain
flatulence

take without regard to meals
can open capsules and sprinkle on soft food
watch for palpitations, dizziness, seizures, tetany

Vasotec, Epaned

tablets: 2.5, 5, 10, 20mg
powder for oral solution: 1mg/mL
injection: 1.25mg in 1 and 2mL vials

ACE inhibitor

HTN
CHF

forms active metabolite enalaprilat that inhibits ACE to decrease synthesis of angiotensin II (vasoconstrictor)

do not use during pregnancy
caution in nursing, impaired renal function, surgery, anesthesia

headache
dizziness
fatigue
diarrhea
rash
hypotension
cough
nausea

take without regard to meals
avoid nonprescription cough, cold, and allergy meds
avoid salt substitutes with K
watch for neutropenia (fever, sore throat)

Glucotrol (XL)

anti diabetic

tablets: 5, 10mg
SR tablets: 2.5, 5, 10mg

non insulin dependent mild to moderate DM

sulfonylurea anti diabetic that stimulates insulin synthesis and release from beta cells

juvenile, unstable, complicated DM
sulfa allergy
diabetic ketoacidosis
caution in renal, hepatic, or thyroid impairment
caution in pregnancy and nursing
discontinue in severe burns, infections, or trauma

nausea
diarrhea
heartburn
pruritus
urticaria
hypoglycemia possible

take 30 minutes before meals
compliance is essential
follow prescribed diet and avoid excess alcohol

Kristalose, Enulose

syrup: 10g/15mL
packets for solution: 10g or 20g

constipation

laxative

broken down to lactic acid in the colon and increases the osmotic pressure and elevate pH of colon to increase water content of stool

low galactose diet
caution in diabetics

flatulence
intestinal cramps
n/v
diarrhea

may mix with fruit juice, water, or milk
takes up to 48h

Vascepa

antihyperlipidemic)

capsules: 0.5g, 1g

adjunct to statin therapy to reduce risk of MI, stroke, angina

ethyl ester of EPA, which inhibits hepatic VLDL synthesis and secretion and stimulates triglyceride clearance

caution in hypersensitivity to fish
may increase afib or atrial flutter
may increase risk of bleeding

diarrhea
abdominal discomfort
pain in extremities
bleeding possible

swallow whole
take with food
watch for fish allergy

RFT

250-500mg bid

B

individualized dosing: 4-48mg qd

150-450 mg q6h

lincosamide antibiotic

B

K, BMD, FEV

1 inhalation qd of 100/25

600mg qd in one or 2 doses

cephalosporin antibiotic

B

BMD, Mg

30mg qd for 4 weeks

B

K, BP, CrCl, WBC

5-40mg qd

D

5-20mg qd

FBG, HbA-1c

C

10-20g qd

B

lipid panel, ALT, AST

2g bid with food

Colestid

tablets: 1g
granules for oral suspension: 5g/packet

reduction of cholesterol and LDL-C

lowers serum cholesterol by binding bile acids in intestine, forming a complex that is excreted in feces
cholesterol is precursor for bile acids, by removing the acids, more cholesterol is removed from serum for bile acid formation

may decrease absorption of folic acid, vitamins A, D, KK deficiency can increase bleeding
tablets are large, use granules if issues swallowing

constipation
abdominal pain
flatulence
heartburn
n/v
diarrhea
hemorrhoids

swallow tablets whole
drink water after dose
take other oral meds 1h before or 4h after
take stool softeners or fiber to prevent constipation

Pred Forte, Red Mild, Omnipred

suspension: 0.12% (Pred Mild), 1% (Pred Forte, Omnipred)

inflammatory conditions of eyes - allergic conjunctivitis, acne rosacea, herpes zoster

adrenocorticoids bind to certain receptor proteins in cytoplasm of sensitive cells to form steroid-receptor complex to stimulate or inhibit mRNA synthesis

viral and fungal eye infections
long-term use increases risk of glaucoma, cataract formation, secondary ocular infections
monitor intraocular pressure

increased intraocular pressure (glaucoma)
increased cataracts
delayed wound healing

shake well
re-evaluate if no improvement in 2 days
use with antibiotic if bacterial infection
do not discontinue abruptly

Maxalt (MLT)

tablets: 5, 10mg
ODT (MLT): 5, 10mg

migraine

5-HT1 agonist, leading to vasoconstriction

ischemic heart disease, angina
uncontrolled HTN
caution in impaired hepatic function

fatigue
somnolence
pain/pressure
dizziness
rare cardiac events

do not exceed dosage
take when symptoms begin
can repeat in 2h
do not take more than 30mg in 24h
may cause drowsiness
use with alcohol will increase sedation

Timoptic (XR)

ophthalmic solution: 0.25%, 0.5%
ophthalmic gel (Timoptic XE): 0.25%, 0.5%

glaucoma

nonselective beta blocker that reduces intraocular pressure

bronchial asthma, COPD, sinus bradycardia, heart block, cardiac failure, cardiogenic shock
caution in systemic beta blockers and nursing
can mask hypoglycemic symptoms

eye irritation
headache
signs of systemic absorption

drop inside lower lid, then keep eye open for 30 seconds and apply pressure to inside corner of eye for 1min
wait at least 5 minutes before other drops
avoid squinting or closing eyes tightly after administration
if dose missed, instill asap, unless closer to next

Flagyl

tablets: 250, 500mg
capsules: 375mg
tablets ER: 750mg
injection: 500mg/100mL

amebiasis
bacterial vaginosis
trichomoniasis
anaerobic bacterial infections
surgical prophylaxis in colorectal surgery

reduced by proteins of bacteria to unstable intermediates that bind to DNA causing strand breakage and cell death

hypersensitivity to nitroimidazole derivatives
trichomoniasis in 1st trimester of pregnancy
caution in organic CNS diseases or severe hepatic impairment

anorexia
nausea
vomiting
diarrhea
convulsive seizures
peripheral neuropathy
abdominal cramping
headache
dysuria
metallic taste

complete full course
may take with food or milk if GI upset
avoid alcohol during therapy and for 1 day after
use condom to avoid reinfection of trichomoniasis
if missed take asap, unless closer to next dose
watch for numbness or paresthesia of extremity

Lotrisone

cream: 1% C, 0.05% B
lotion: 1% C, 0.05% B

tinea cruris
tinea corporis
tinea pedis

C increases membrane permeability by permeating chitin of fungal cell wall
B is an adrenocorticoid

hypersensitivity to imidazoles or corticosteroids
caution in pregnancy, children, and nursing

paresthesia
erythema
stinging
blistering
peeling
pruritus
urticaria
burning
irritation

discontinue after indicated time
do not use with occlusive dressings
if used on groin, use sparingly and for only 2 weeks
may stain clothing
if dose missed, apply asap

Advair

diskus: 100/50, 250/50, 500/50 mcg
HFA: 45/21, 115/21, 230/21 mcg

asthma
COPD, chronic bronchitis

F is a corticosteroid
S stimulates adenyl cyclase and cAMP, leading to bronchial relaxation via beta-2 activation

long-term use of beta-2-adrenergic agonists increases risk of asthma-related death
caution in transfer from systemic corticosteroids
fungal infections possible
caution in cardiovascular disorders, HTN, hyperthyroidism, DM, nursing, pregnancy

URTI
pharyngitis
headache
n/v
sinusitis
bronchitis
cough
rash
angioedema

avoid contact with eyes
rinse mouth after use
contact physician if effectiveness of short-acting beta-2-agonists decreases
if dose missed, skip
not for immediate relief
use on regular basis (2-14 days to see results)

Avapro

tablets: 75, 150, 300mg

HTN
diabetic neuropathy

angiotensin II receptor blocker
stimulates aldosterone secretion by adrenal cortex

aliskiren
pregnancy, nursing
caution in impaired renal function, CHF
rare oliguria, azotemia

URTI
fatigue
diarrhea
dyspepsia
musculoskeletal trauma

with or without food
discontinue if pregnant

Luvox

tablets: 25, 50, 100mg
ER tablets: 100, 150mg

OCD

SSRI
inhibits CNS neuronal uptake of serotonin

do not use within 14 days of MAOI
do not use with terfenadine or cisapride
increased risk of suicidal thoughts in children and young adults
caution in renal or hepatic dysfunction
secreted in breast milk

nausea
headache
insomnia
somnolence
asthenia
GI issues
dry mouth
nervousness
dizziness
sweating

continued therapy required for improvement
use caution when performing tasks that require alertness
if dose missed, skip

Restasis

ophthalmic emulsion:
single dose vials (0.4mL of 0.05%)
multi dose vials (5.5mL of 0.05%)

to increase tear production in ocular inflammation associated with kerato-conjunctivitis sicca

potent immunosuppressant systemically
ophthalmic MOA not known; partial immunomodulator

active ocular infection

ocular burning
conjunctival hyperemia, discharge, epiphora, eye pain, foreign body sensation, pruritus, stinging, blurring

invert to form opaque emulsion
do not wear contacts
15 minutes before artificial tears
if dose missed by more than 4h, skip

lipid panel

2g once or twice a day

2gtts in affected eye qid

C

5-10mg at first sign of migraine

C

IOP

1gtt of 0.25% into affected eye bid

C

250-500mg tid for 1 week

nitroimidazole antibiotic, antiprotozoal

B

C

aaa bid for maximum of 2 weeks

BMD, IOP, FEV

1 Diskus or 2 HFA inhalations bid

C

CrCl, BP, K

150mg qd