key drugs guy / study tip gal

Warm compress & hyaluronidase

1. NK1-RA+ 5HT3A + Dexamethasone
2. Netupitant/palonosetron (Akynzeo) + Dexamethasone
3. Olanzapine + Palonosetron + Dexamethasone

All in the high risk group +
4. 5HT-3A + Dexamethasone

1. 5HT-3A
2. Dexamethasone
3. Prochlorperazine
4. Metoclopramide

LMWH

ASA if no C/I

Dabigatran, Xaralto, Eliquis or Edoxaban

Argatroban & Bivalirudin

Warfarin

H2RA + CCS (~ Dexa) + Diphenhydramine (Due to BBW hypersensitivity rxn caused by Chremephor in solvent)

Argatroban (IV)
(HIT Dx: Unexplained platelet drop >50% baseline

Warfarin (Resolved when platelets > 150,000)

Quetiapine

Tricyclic - preferably seconadry amines
(desipramine or nortryptiline)

Lamotrigine (not effective for acute mania)

Latuda (Lurasidone)

Valproate OR lithium + antipsychoticx

Prozac or Zoloft

PCN G Benzathine (Bicillin L-A)

2.4 million units intramuscularly x 1 dose
(BBW: IV can cause death)

1.Taper off antipsychotic
2.Cardio-resp, heme, & e-lyte support
3. Cooling bed & antipyrretics
4. BZD or Dantrolene or Bromocriptine

Narcolepsy with cataplexy

Centrally acting anticholinergic
Benztropine or Diphenhydramine

Anticholinergics
Propranolol
BZD (Lorazepam last line)

Can only try other agent - best quetiapine or clozapine

Merrem

Amoxicillin 80-90 mg/kg/day
or
Augmentin 90 mg/kg/day

Leucovorin (Fusilev)
*Required if dose > 500mg/m2

Caspofungin

Amoxicillin

2 grams PO x 1 dose

Doxycycline

Vanco

*Consider different agent if MIC >/= 2 mcg/mL

Cefazolin (1G) or cefuroxime (2G)

*BL allergy: Vanco or Clinda

Cefazolin

*BL allergy: Vanco or Clinda

Cefotetan or Cefoxitin (2Gs)

BL allergy: Clinda + (AMG or FQ or AZA)
or
Flagyl + (AMG or FQ)

Dexamethasone 15-20 min prior to 1st dose of abx

Ampicillin* + Cefotaxime or Gentamicin

*Ampicilln for listeria coverage

Cefotaxime or Ceftriaxone + Vancomycin

Cefotaxime 2g IV Q4-6H or Rocephin 2g Q12H
+
Vanco 30-45 mg/kg/day in divided doses
(Adult doses)

Vanco + ampicillin* + (Rocephin or cefotaxime)

Moxi or Levofloxacin + Vanco (with or without Bactrim for listeria coverage)

Amoxicillin 80-90 mg/kg/day Q12H

Augmentin 90mg/kg/day Q12H

Cefdinir, Cefuroxime, Cefpdoxime, or Ceftriaxone

Prevnar 13 starting at 2 mo of age
Influenza starting >/= 6mo of age

Augmentin
Adults x 5-7 days
Children x 10-14 days

Doxycycline 100mg PO BID x 5-7 days

1. Azithromycin 500mg x 1, then 250 mg QD x 2-5 days
2. Clarithromycin 500 mg BID or 1g ER x 7 days
3. Bactrim DS 1 tab BID x 14 days

Augmentin x 5-10 days

Macrolide or doxycycline x 5 days

Two options:
1. Cefpodoxime or Cefdinir + Macrolide or doxycyclnie

2. Respiratory FQ monotherapy (G,L,orM)

x 5 days

Two options:
1. BL + macrolide OR doxycycline
*Preferred BL: Ceftriaxone or Cefotaxime
*Preferred macrolide: Azithromyin

2. FQ Monotherapy (G, M, or L)

x 5 days

Zosyn
Cefepime
Levaquin
Primaxin or Merrem

x 7 days

Zosyn
AZA
Cefepime
Levofloxacin
Primaxin, Merrem

+ Vanco or Linezolid

x 7 days

Elimite
(Cream formulation of permethrin)

OTC: 2G antihistamine e.g. Diphenhydramine
Rx: Hydroxyzine (Vistaril)

Pyrethrins (Permethrin)

Imiquimod (Aldara, Zyclara)
Inpatient HAP with high risk mortality or ABX within past 90 days
or

(Choose 2, avoid 2 BL's)
Zosyn
AZA
Cefepime, Ceftazidime
Levofloxacin
Primaxin, Merrem
Tobramycin, gentimicin, amikacin*
Colistin, polymyxin B*

+ Vanco or linezolid

x 7 days

INH x 9 mo. Preferred for HIV+, pregnant, & children
Rifampin x 4 month
INH and Rifapentin (Priftin) once weekly x 12 weeks

Rifampin: 10mg/kg QD
INH: 5mg/kg QD + 25 mg PO Pyridoxine
Pyrazinamide
Ethambutol

Give entire regimin x 8 weeks. If Pt. susceptible to INH and RIF d/c P&E and continue INH & RIF for 4 months

PCN, ampicillin, or rocephin +/- gentimicin for synergy

BL allergy: Vancomycin

Nafcillin or cefazolin

BL allergy: Vanco (+ gentamicin if PV)

Vanco (+ gentamicin if PV)

PCN or ampicillin + gentamicin for synergy

BL allergy: Vancomycin

Amoxicillin 2 grams PO x 1 dose

PCN allergy: Clindamycin 600mg or
Azithro or clarithromycin 600mg

PCN allergy and NPO: Clindamycin 600mg IM/IV

(PEK)

Rocephin x 5-7 days

PCN VK
Keflex
Dicloxacillin
Clindamycin

PO thx x 5 days

PCN
Rocephin
Cefazolin
Clindamycin

IV thx x 5 days

Vanco + Beta lactam (Zosyn, Primaxin, or Merrem)
Necrotizing fascitis

PCN G + Clindamycin

Bactrim DS BID
or
Doxycycline 100 mg BID

+ I/D

Nitrofurantoin 100 mg BID w/ food x 5d
or
Bactrim 1 DS tab BID x 3d
or
Fosfomycin 3g 1 dosein 40z H20

FQ-R < 10%: PO Cipro x 7d or PO Levo x 5d

FQ-R > 10%: Rocephin 1g IV x1 or AMG IV x 1 then PO BL x 14 days

Initial IV then step down to PO and treat for 14 days total

Augmentin or PO Ceph x 3-7 days

Phenazopyridine
200mg x 2 days
*Take with food & 8oz H20

Flagyl 500mg PO TID x 10-14 days

Flagyl 500mg PO TID x 10-14 days
(same as first time therapy)

Vanco taper pulse therapy:
125 mg PO -
QID x 10-14 days
BID x 1 week
QD x 1 week
then, 125mg Q2-3d/wk x 2-8wks

Vanco 125 mg PO QID x 10-14 days

Vanco 125 mg PO QID x 10-14 days (Same as first)

Vanco pulse/taper therapy

Vanco 500 mg PO QID + Flagyl 500 mg IV Q8H
or
*If complete ileus: Vanco per rectum 500mg in 100mL NS Q6H

Vanco 500 mg PO QID + Flagyl 500mg IV Q8H

Vanco taper/pulse therapy

Azithromycin 1000mg PO x1 or 500mg PO QD x 1-3 days

Bicillin L-A!!! (PCN G BENZATHINE)
2.4 million units IM x 1

Bicillin L-A
2.4 million units IM x Qwk x 3

*If pregnant desensitize and use PCN*

Rocephin 250 mg IM x 1 (Use Suprax 400mg PO x 1 if no Rocephin)
+
*Azithromycin 1 gram PO x 1
or
Doxycyclnie 100mg PO BID x 7 days

If using Suprax do cure test in 1 wk

:) This tx also covers chlamydia

Azithromycin 1 gram PO x1
*Preferred for pregnancy too

Carbapenems

Hydration + IV bisphosphonate (Zometa)

No medications

Voriconazole

Pilocarpine (Salagen) (PO agent so can be difficult)

Posaconazole
*PO preferred, must be with food

Clotriamazole & Nystatin

PO Fluconazole

Fluconazole or echinocandin

Echinocandin

Terbinafine

Induction: AmphoB + flucytosine

Consolidation: Fluconazole

Oseltamivir

TRMT: 75 mg BID x 5 days

PFX: 75mg QD x 10 days

Effective when started within 48 hour of illness.
Must be >/= 12 yo

Zanamivir: Neuramidase inhibitor inhaler
(1 inhalation = 5mg)

TRMT: >/=7 yo: 10 mg BID x 5 days

PFX >/=5 yo: 10mg QD x 10 days (household) or if community outbreak x 28 days

Peramivir: Neuramidase inhibitor injectiono

600 mg IV 1xdose

*Can cause weird behavior

Acyclovir 400 mg PO three times daily (or 200 mg 5x/day)
OR Valtrex 1 g PO twice daily
OR Famvir 250 mg PO TID.

The duration of HSV-2, first episode, should be 7-10 days.

IV acyclovir 10 mg/kg/dose Q8H x 14-21 dats

Zovirax, Famvir, or Valtrex

Ganciclovir or valgancyclvoir

G: TRMT: 5mg/kg IV BID, 2PFX 5mg/kg IV QD

V: TRMT 900 mg PO BID x 21 d, 2PFX 900 mg PO QD

No treatment

Bactrim DS PO QD x 21 days

*Dapsone if sulfa allergy. If giving with pyrimethamine add leucovorin to decrease myelosuppression

Bactrim DS tab Daily

*Same alternative as PCP if sulfa allergy

Pyrimethamine + leucovorin +/- sulfadiazine

Azithromycin 1,200mg PO Qwk
or
Azithromycin 600mg twice weekly
or
Clarithromycin 500 mg PO BID

+ Ethambutol

Fluconazole

none

Low dose fluconazole

low dose valganciclovir

same as treatment regimens

PO anti-pseudomonal agents (3 options)
1. Cipro + Augmentin
2. Cipro +/- Clindamycin
3. Levofloxacin

IV anti-PsA antibiotics (5 options)
1.Cefepime
2.Ceftazidime
3. Zosyn
4.Imipenem-cilastin
5.Merrem

Bactrim or dapsone depending on sulfa allergy

INSTI based:
Triumeq
Truvada
Descovy
Genvoya
Stribild

PI-Based:
Darunavir + ritonavir + truvada

Truvada 1 tab PO QD

Truvada + Dolutegravir or Raltegravir


PI-based:
Truvada + Darunavir

within 72 hours, x 28 days

Isentress + Truvada

Within 72 hours, x 28 days

2 NRTI + boosted-PI or INSTI

NRTI: Epzicom, Truvada, or Lamivudine

PI: Atazanavir or darunavir + ritonavir

INSTI: Raltegravir

ICS

Budesonide (Rhinocort)

*Flagyl 500mg PO BID x 7 days
or
*Flagyl 0.75% gel 5g intravaginally QD x 5 days
or
Clindamycin 2% cream 5 g intravaginally HS x 7 days

Flagyl (Or tinidazole) 2 grams PO x 1
*Use same for pregnancy

Doxycycline 100 mg PO/IV BID x 5-7 days
*Would use in child in this case*

Doxycycline x 7 days

Doxycycline x 10-21 days
or
Amoxicillin or cefuroxime x 14-21 days

Albuterol

Budesonide

SABA or LABA

LABA or LAMA

LAMA

LABA + LAMA

PTU

ACE or ARB

Metformin

Fludrocortisone

Cholestyramine

Methotrexate (+DMARD after bridge in moderate/severe dz)

Hydroxychloroquine +/- prednisone (or methylprednisonsolone) +/- Cytotoxic agent

Copaxone +/- Interferon-beta agent

Nifedipine (DHP)
(Procardia, adalat)

Tazorotene & Calcipotriene

Norepinephrine 0.1-1.3 mcg/kg/min

Phentolamine

Queitiapine

Lifestyle
Pyridoxine (B6) +/- doxylamine

Tums

Simethicone

Fiber
(Psyllium, Calcium polycarbophil, methylcellulose)
+ Lots of fluids

Chlorpheniramine (1G antihistamine)
Chronic allergy: Budesonide or Beconase AQ
*Important to use the inhaled in the first trimester*

Amoxicillin & ampicillin
Cephalosporins
Erythro & Azithromycin

Topical OTC antifungals x 7 days

Keflex: 600mg PO Q6H x 7 day
or
Ampicillin 500mg PO Q6H x 7 days

Levothyroxine
Must increase dose by 30-50%

Labetalol
Methyldopa
Nifedipine

Metformin
Insulin
Glyburide

Combination oral contraceptives (COC)

Duavee
Conjugated Estrogens & Bazedoxifene

Bisphosphonates

Teriparatide (Forteo)

Cream: Estrace - to be inserted in vagina
Ring: Estring - Q3mo
Foam: Vagifem

Estrace

PremPro & Premphase

Once weekly
Menostar
Climara
Given Twice Weekly:
Minivelle
Vivelle-dot
Alora

Femring

Premarin
Tablet, vaginal cream, and injection

Paroxetine
For dysparenunia

Dysparenunia

Tamoxifen

Aromatase Inhibitor

Chemical castration
Gonadotropin release hormone agonist or antagonist

BCR-ABL
(Imatinib, dasatinib, nilotinib)

BRAF inhibitors, often in combination with MEK 1 and 2 inhibitors

Crizotinib (ALK inhibitor)

EGFR inhibitors

Palbociclib with fulvestrant or letrozole
(Ibrance + Faslodex)

Tretinoin

Cold compress & IV Totect

Cool compress & DMSO (dimethyl sulfoxide)

Atropine

Loperamide
*UGT1A1*28 at increased risk (also for neutropenia)

Venlafaxine

Kegel exercises 3x/wk

PO Budesonide

Mesalamine (5-ASA) rectal &/or PO preferred

Anti-platelet therapy:
3 options
1. Aspirin
2. Aspirin + ER dipyridamole
3. Clopidogrel

Anti-coagulation therapy

Nimodipine (Nymalize)
-highly lipophilic specific to blood vessels
-Good to pierce and squirt medication into pt mouth
-Use up to 21 days
DO NOT USE IV

Retinoid Topicals
(e.g. Atralin, Renova, Retin-A)

PO isotretanoin
*causes a lot of dryness. hydrate, lip balm, eye drops*

Finasteride
Propecia
OR
Minoxidil topical OTC

Suave "dandruff"

Petrolatum ointment w/ zinc oxide
e.g. Desitin

Topical steroids & HYDRATION

Topical antifungal

Thiazide
CCB
ACE
ARB

CCB
Thiazide

ACE or ARB

Methyldopa
Labetalol
Nifedipine ER

Amiodarone

Digoxin

Amifostine (Ethyol)

lifestyle and diet modifications are recommended first, if still inadequate, insulin is tx of choice

Fasting <=95
1 hour post-meal =<140
2 hour post meal = <120

Polyuria
Polyphagia (excessive hunger)
Polydipsia (excessive thirst)
Blurred vision
Fatigue

A1c of 6 is approximately 126 mg/dL

each 1% increase in A1c is equal to about 28 mg/dL

(A1c-2) x30

Beta blockers
Diuretics
Immunosuppressants
Niacin
Protease inhibitors
Quinolones
Atypical antipsychoics
Statins
Systemic steroids

A1c <7
Preprandial glucose 80-130
Postprandial glucose <180

Lifestyle modifications + metformin

* if A1c >9 consider starting with dual therapy
*if A1c >10 and BG >300 consider stated with combination injectable therapy

Choose one to add on:
SU
TZD
DPP-4 inhibitor
SGLT2 inhibitor
GLP-1 agonist
Basal insulin

Most 3 drug combinations are acceptable

DO NOT USE: due to lack of studies or similar MOA
Metformin + DPP-4 + GLP-1 agonist
Metformin + SU + basal insulin

If still not working switch to injectables or add basal insulin

Insulin
SU
Meglitinides

Metformin

GLP-1 agnoists
DPP4-inhibitors
Pramlinitide

GLP-1 agnoists
Pramlinitide

SGLT2 inhibitors

TZDs
Metformin

Metformin + sitagliptin

Saxagliptin/dapagliflozin

Liraglutide/insulin degludec

Loxisenatide/insulin glargine

Biguanide glass

Works by decrease glucose production, decrease absorption of glucose and increasing insulin sensitivity

1st line therapy in DM2

BBW: lactic acidosis, renal impairment w/ contrast dyes

C/I: eGFR <30

Do not initiate if eGFR 30-45

Monitor renal function

ER formulations can leave ghost tablet in stool

Give with a meal to decrease GI upset, N/V/D, flatulence, abdominal cramping

Alcohol can increase risk for LA

Contrast media can increase risk of lactic acidosis, restarted 48 hours after procedure

SUs
Meglitinides

Stimulate insulin secretion from pancreatic beta cells to decrease postprandial blood glucose

Meglitinides have faster onset (15-60 minutes) and shorter DOA and require multiple daily dosing

Repaglinide (15-30 minutes before meal)
Nateglinide (1-30 minutes before meal)

Warnings: hypoglycemia
SEs: weight gain

Glipizide (glucotrol)
Glimepiride (Amaryl)
Glyburide

Warnings: hypoglycemia
SEs: weight gain, nausea

Glipizide IR is taken 30 minutes before a meal all others can be taken with breakfast, hold dose if pt NPO

Glucotrol XL can leave ghost tablet in stool

Glyburide is renally cleared, not preferred in renal insufficiency

Insulin, SU, and meglitinides should never be used in combination due to risk of hypoglycemia

PPAR-gamma agonists that cause increase in peripheral insulin sensitivity

Pioglitazone (actos)
Rosiglitazone)

C/I: Class 3/4 heart failure
Warnings: hepatic failure, edema

Pioglitazone: increase risk of urinary bladder tumors, do not use in pts with active bladder cancer

SEs: peripheral edema, weight gain

Reduce reabsorption of filtered glucose (increasing urinary glucose excretion)

Canagliflozin (invokana)
Dapagliflozin (farxiga)
Empagliflozin (jardiance)

BBW canagliflozin: increase risk of leg and foot amputations
C/I: eGFR <30

Warnings: ketoacidosis, genital mucotic infections, urosepsis, pyelonephritis, hypotension due to AKI, canagliflozin can cause hyperkalimia

SEs: weight loss

Increased risk of intravascular volume depletion causing hypotension and AKI hen used with a diuretics, RAAS inhibitors or NSAIDS

Monitor K closely in pts on cana

Prevent enzyme DPP-4 from breaking down incretin hormones (like GLP-1) and increase insulin release and decrease glucagon secretion

Sitagliptin (januvia)
Saxagliptin
Linagliptin
Alogliptin

Warnings: acute pancreatitis, risk of HF (saxa and alo)

Lina does not require renal dose adjustments

Acarbose
Miglitol

Inhibit metabolism of intestinal sucrose which delays glucose absorption

Does no cause hypoglycemia but if a pt becomes hypoglycemic cannot treat with sucrose, MUST use glucose tablets or gel

Take each dose with 1st bite of meal

GI side effects are common

Colesevelam

Constipation is most common side effect
Also used for hyperlipidemia

Bromocriptine

Inhibits lactation (c/i in those breastfeeding)

Do not use with other dopamine agonists

Analogs of GLP-1 which increase glucose dependent insulin secretion and decrease glucagon secretion

Exenatide (BID) & Exenatide ER (weekly)
Liraglutide (victoza) --> daily
Dulaglutide (trulicity) -->weekly
Albiglutide (tanzeum)--> weekly
Lixisenatide (adlyxin) --> daily

Warnings: pancreatitis, not recommended in pts with severe GI disease
SEs: nausea, weight loss

Slow gastric emptying and can decrease extent and rate of absorption of orally administered drugs

Can increase INR in pts on warfarin

Synthetic analog of amylin which helps control postprandial glucose by slowing gastric emptying

Can use in type 1 and type 2 DM

Admin SC prior to each meal

BBW: severe hypoglycemia
C/I: gastroparesis
Warnings: hypoglycemia (reduce meal time insulin by 50% when starting)
SEs: N/V, anorexia, HA, weight loss

Convert glucose into glycogen
Helps muscle cells take up glucose
Converts excess glucose to fat for storage in adipose tissues

Aspart (novolog)
Lispro (humalog)
Afrezza (oral inhalation powder)

Aspart/lispro
--> hypoglycemia, hypokalmia
-->SEs weight gain

Afrezza:
-->BBW acute bronchospasm
--> C/I in asthma/COPD
--> replace inhaler every 15 days

Onset within 30 minutes, peak around 1 hr, duration only a few hours

Regular insulin (humulin R, novolin R)
Concentrated regular insulin (U-500)

Regular: can be used in IV solutions, available w/o a prescription

U-500: 5 times as concentration (500 units/mL)
--> all pts using must be prescribed a u500 syringe, each marking represents 5 units and no dose conversions are needed
--> do not mix with any other kind of insulin

Onset within 30 minutes, peak around 3-4 hours, duration up to 12 hours

NPH insulins (humulin N, novolin N)

Same as rapid acting insulins plus:
Cloudy in color
Available without a prescription
Can mix with rapid or short acting insulins (clear before cloudy)

Onset within a couple hours, peak around 10 hours, duration up to 24 hours

Detemir (levemir)
Glargine (Lantus)

Same as rapid acting insulins above

Onset within 4 hours, no peak, duration >24 hours

70/30, 75/25, 50/50 (higher percent longer acting)

Given BID w/ meals according to rapid/short acting component

Humulin and novolin 70/30 are available without a prescription

NPH and protamine are cloudy

TDD = 0.6 units/kg/day based on actual body weight

Divide in 2 to get basal and bolus insulin

Divide bolus insulin into 3 meals

IF using NPH and regular use 2/3 of TDD as NPH and 1/3 as regular insulin dose

Rule of 500 (rapid acting insulin)= 500/TDD = g of carbs covered by 1 unit of rapid acting insulin

Rule 450 (regular insulin)= 450/TDD= g of carbs covered by 1 unit of regular insulin

Amount of insulin needed to return their blood glucose to a normal range (added to the dose they would normally take for that meal)

1800 rule (rapid acting)= 1800/TDD= correction factor for 1 unit for rapid acting insulin

1500 rule (regular)= 1500/TDD= correction factor for 1 unit of regular insulin

Correction dose:
(blood glucose now- target glucose)/ correction factor

Basal insulin 0.1-0.2 units/kg/day using actual body weight, or 10 units/day

Dose is titrated 10-15% once or twice weekly to reach astinng blood glucose control

1:1 unit:unit conversion of TDD can be used in most cases (assuming good control)

BID NPH--> QD glargine use 80% of total NPH dose
Toujeo-->lantusasaglar use 80% of total daily toujeo dose

Afrezza- 3 days

10 days:
--humalog 50/50 and 75/25 pens
--humulin 70/30 pens

14 days
--humulin N pen
--novolog 70/30 pen

28 days
--apidra, humalog, novolog vials and pens
--humalog 50/50 and 75/25 vials
--Novolog 70/30 vial
-humulin U500 pen
--Lantus vial/pen, basaglar pen

30 days
--humulin R u100 and 70/30 vials

40 days
humulin r u500 vial

42 days
novolin R, N and 70/30 vials
Toujeo pen
levemir vial/pen

FlexPen: novlog products
KwikPen: humalog / humulin / basaglar
FlexTouch: levemir and tresible
SoloStart: lantus and toujeo

lesss than <70 mg/dL

15-20 grams of glucose/simple carbs
recheck BG in 15 minutes
If persists, repeat step 1
Once back to normal patient should eat small snack or meal

Type 1 diabetics

BG >250
Ketones in urine
Anoin gap metabolic acidosis

-Fluids (start with NS when BG <250 change to D5W1/2NS)
-Regular insulin infusion (0.15 units/kg bolus then 0.1 units/kg/hr)
-Monitor potassium to prevent hypokalemia
-Give sodium bicarb if needed

Type 2 DM

Serum ketones are not present because DM2s have enough insulin to suppress ketogenesis

BG >600
Extreme dehydration
Altered consciousness

Insulin
Metformin
SUs
TZDs
GLP-1 agonists

Klebsiella pneumoniae (ESBL, CRE)
Escherichia coli (ESBL, CRE)
Acinetobacter baumanii
Enterococcus faecalis, Enterococcus faecium (VRE)
Staphylococcus aureas (MRSA)
Pseudomonas aeruginosa

PS PORCS: phenytoin, smoking, phenobarbital, oxcarbazepine, rifampin, carbamazepine, St. John's wort

G PACMAN: grapefruit, protease inhibitors, azole antifungals, cyclosporine (also cimetidine, cobicistat), macrolides (clarithro, erythro), amiodarone, non-DHP CCBs (diltiazem and verapamil)

Orange Book (FDA)

Pink Book (CDC)

Pink Sheet (Pharma Intelligence)

Purple Book (FDA)

Red Book, Pharmacy

Red Book, Pediatrics (AAP)

Yellow Book (CDC)

Green Book (FDA)

Lorazepam, Amiodarone, Taxanes, Tacrolimus, Insulin, Nitroglycerin

("A DIAbetic Can't Eat Pie")
Ampicillin, Daptomycin, Infliximab, Amp/Sulbactam, Caspofungin, Ertapenem, Phenytoin

("Obese Bakers Avoid Salt")
Oxaliplatin, Bactrim, Amphotericin B, Synercid

*Pushy Guys (and gals) in LA LA land*

*P*henytoin
*G*olimumab

*L*ipids (1.2 micron - larger pore size filter required)
*A*mphotericin B (lipid formulations - prepare using 5 micron filter)
*L*orazepam
*A*miodarone

*Most require 0.22 micron filter during administration*

Additional drugs: *Isavuconazonium*

(Dear Sweet Pharmacist, Freezing Makes Me Edgy)
Dexmedetomidine, SMX/TMP, Phenytoin, Furosemide, Moxifloxacin, Metronidazole, Enoxaparin

(Protect Every Necessary Med from Daylight)
Phytonadione, Epoprostenol, Nitroprusside, Micafungin, Doxycycline
Others: Ampho B Deoxycholate, Anthracyclines, Dacarbazine, Pentamidine, Thiotepa

ratio or interval data:
ratio - age, height, weight, time BP
interval - Celsius or F temp scales

also categorical data:
nominal - gender, ethnicity, marital status, mortality
ordinal - NYHA Functional Class, pain scale

false positive, the incorrect rejection of a null hypothesis, related to alpha level
found a difference when there actually is not one

false negative, incorrectly accept the null hypothesis
not finding a difference when there actually is one

The ability to detect a difference btw study groups if one actually exists.
*Indirectly related to the likelihood of making a Type II (b) error*...As power increases, chance of type II error decreases

We are 95% confident that the true population value lies somewhere between ___ and ___ (range).

For every 45 patients who receive [treatment] for [one year], [outcome (e.g. HF progression)] is prevented in one patient
(*ROUND UP NNT* so you don't overestimate benefit)

One additional case of [major bleeding] is expected to occur for every 90 patients taking [drug] instead of [placebo/other drug].
(*ROUND DOWN NNH* so you don't underestimate harm)

one-sample t-test

dependent/paired t-test

unpaired student t-test

ANOVA

Chi-square test
(Fisher's exact for a very small trial)

used when two or more interventions have already demonstrated equivalency in outcomes and the costs of each intervention are being compared

compares the costs and benefits between unrelated or related programs, as long as the outcome is monetary

outcomes are measured in natural units (e.g. life years gained, mmHg blood pressure, % at treatment goal)

measured in QALY

minimize the risk of microorganisms or other contaminants in sterile preparations

keep the compounder safe and reduce risk of exposure to the HD

*needs to be separate and distinct from any sterile compounding
*can be performed in ambient (room) air
*must have adequate space for orderly work with shelving and storage & no storage on the floor
*needs to be adequate plumbing and 2 types of water: potable (tap water) to wash hands (along with soap and single-use towels or a hand dryer) and purified/distilled water for compounding and rinsing equipment
*well-lit, controlled HVAC, with temperature and humidity monitoring

*anteroom, buffer area and a PEC (hood) with specific ISO air requirements
*all surfaces must be smooth, impervious, free from cracks or crevices and non-shedding so they are easy to clean
*walls - locked, sealed panels
*floors overlaid with wide, sheet vinyl flooring with heat-welded seams
*buffer area cannot contain sinks or floor drains
*required air and surface sampling, temp and humidity requirements to test for contaminants

*Containment*-PEC or SEC (vertical flow hood)
*permissible to perform both sterile and non-sterile HD compounding in same area as long as ISO 7 air is maintained, kept 1 meter apart, no HD powders at the same time as sterile compounding
*negative air pressure in C-SEC and C-PEC & externally exhausted or use redundant HEPA filters (* if non-sterile HD ONLY*)
*non-sterile HD ACPH 12/sterile 30