Meds and Terms Final Exam 2015

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Alpha-1 Adrenergic Blockers

Doxazosin (Cardura), Tamsulosin (Flomax), Terazosin (Hytrin)

Tamsulosin (Flomax) and Terazosin (Hytrin) both come as?

Capsules

Doxazosin (Cardura) comes as?

Tablet

Alpha-1 Adrenergic Blockers tx?

HTN and BPH

Doxazosin dosing?

1mg QD, max 16mg/day (BPH usually 8mg)

Tamsulosin dosing?

0.4mg QD, increase in 2-4weeks to 0.8mg/day

Terazosin dosing?

1mg QD, max is 20mg/day

Alpha-1 adrenergic blockers DIs?

concomitant anti-HTN, PDE-5 inhibitors both causes additive hypotension

Alpha-2 adrenergic Agonist?

Clonidine

Clonidine (Catapres) comes as?

Tablet, Patch, Injection

Alpha-2 adrenergic agonist (Clonidine) tx?

HTN and ADHD

Clonidine dosing?

0.1mg BID, can increase in 1 week of 2.4mg/day

Catapres-TTS dosing?

patch applied every 7 days (need to overlap oral therapy 1-2 days when starting patch) can increase 1-2 week intervals

Clonidine interacts with?

Concomitant Anti-HTN, TCAs, Beta blockers, and Cyclosporine

ACE inhibitors include?

Lotensin(beazepril), Vasotec (Enalapril), Altace (Ramipril), Prinivil/Zestril (Lisinopril)

Lotensin dosing?

10mg-40mg QD/DD is max (80mg is possible but limited)

Vasotec dosing?

5mg - 40mg DD

Lisinopril dosing?

5-40mg QD (can be 80mg)

Altace dosing?

2.5mg-20mg QD/DD

Lotensin and Lisinopril come as?

Tablet

Vasotec comes as?

Tablet and injection (enalaprilat)

Altace comes as?

Capsule and Tablet

ACE inhibitors tx?

Diabetic nephropathy, HF, HTN

ACE Inhibitors DIs?

Concomitant Anti-HTN, ARBs, K+sparing diuretics, Bactrim,Aldosteroneblockers,Diuretics, NSAIDs, Cyclosporine, Lithium

ACE inhibitors CIs?

angioedema with previous ACE inhibitor use

ARBs tx?

HF, HTN, diabetic nephropathy

ARBs DIs?

Concomitant Anti-HTN, K+ supp. and K+ sparing diuretics, Lithium, ACE inhibitors, Bactrim,Aldosterone blcokers

ARBs include?

Cozaar (Losartan), Benicar (Olmesartan Medoxomil), and Diovan (Valsartan)

Cozaar dosing?

25mg-100mg DD

Benicar dosing?

20-40mg QD

Valsartan dosing?

40mg QD- 320mg DD

Benicar, Diovan, and Cozaar comes as?

Tablet

Anti-arrhythmics include?

Amiodarone, Digoxin, and Sotalol

Amiodarone AKA?

Cordarone and Pacerone

Amiodarone comes as?

Injection and Tablet

Digoxin comes as?

Injection, Tablet, Capsule, Solution

Amiodarone tx?

Atrial arrhythmias, life threatening ventricular arrhythmias, post-op AFib in cariothoracic surgery, prevention for pts with defibrillators

Amiodarone DIs?

prolong QT int., warfarin, Beta blockers, dilitiazem, digoxin, verapmil,cimetidine, ~zole drugs, Zpack, HIV~vir, cyclo/tac/siro,lova/simvast

Amiodarone CIs?

Severe bradycardia, 2/3rd degree AV block, cardiogenic shock

Amiodarone dosing?

200-400mg QD

Digoxin AKA?

Lanoxin, Digitek

Digoxin tx?

HF-stage C, supra ventricular arrhythmias

Digoxin dosing?

0.125-0.5mg QD

Digoxin DIs?

Amiodarone, Clar/ery-mycin, CCBs, Beta blcokers, Cyclosporine, Colestyramine, Verapamil, TCAs, ~vir, dilitiazem, dronedarone, ~zole, sucralf

Sotalol AKA?

Betapace

Sotalol Comes as?

Tablet and IV solution

Sotalol dosing?

up to 160mg BID

Sotalol DIs?

CCB, Digoxin, QT long drugs, F/I/K/V-conazole, antacids with Al/MG OH

Sotalol CIs?

Baseline Qt >450msec,long QT syndrome, HF, CrCl < 40mL/min, hypoK, Bradycardia, 2/3 AV block

Atenolol is ...?

beta-1 selective

Atenolol dosing?

25-100mg QD

Carvediolol is...?

non selective with alpha 1-blockage

Carvedilol comes as?

tablet and ER capsule

Carvedilol dosing?

Regular: 3.125-50mg BID, ER: 1-80mg QD

Metoprolol Tartrate vs Succinate

Succinate is XL/ER and dosed QD

Metoprolol is available as?

Tablet and Injection

Metoprolol dosing?

25-50mg BID (QD if XL), up to 450mg DD (QD if XL)

Bystolic AKA?

Nebivolol

Bystolic comes as?

Tablet

Bystolic dosing?

5mg QD-40mg QD

Propanolol is...?

non-selective

Propanolol AKA?

Inderal and InnoPran XL

Propanolol comes as?

tablet, capsule SR, solution, injection

Propanolol dosing?

40mg BID (XL is QD), up to 320mg in 2-4 doses (QD if XL)

Beta Blockers CIs?

Sinus bradycardia, cardiogenic shock, 2/3 degree heart block

Beta Blocker DIs?

Amiodarone, Clonidine, Digoxin, diltiazem, dronedarone, verapamil, oral anti-DM agents, insulin (masks Sx of hypoglycemia)

CCBs, Dilitiazem tx?

Atrial arrhythmias, HTN

Dilitiazem AKA?

Cardizem, Cartia, Tiazac

Diltiazem dosing?

120-540mg QD-QID depends on formulation

Dilitiazem DI?

CYP3A4 inhib,~azole, tacr/cyc,statins,Carbamazepine, Clarythromycin, Rifampin,Sildenafil, Anti-HTN agents, Amiodarone, digoxin,BetaB,Phenyt

Dilitiazem CIs?

A Fib/flutter, cardiogenic shock, HF with 2/3 degree heart block

CCB DHPs tx?

Chronic stable angina, HTN

CCB DHPs DIs?

CYP3A4 inh, Carbamazepine, Sildenafil, ~azole, rifampin, anti-HTN, simvastatin, tacrolimus

Amlodipine dosing?

2.5-10mg QD

Felodipine AKA?

Plendil

Nifedipine AKA?

Adalat CC, Nifedical XL, Procardia XL

Nifedpine comes as?

tablet and capsule

Nifedipine dosing?

30-180mg QD (in 3 doses or QD, depends on formulation)

Amlodipine and Felodipine come as?

tablet

CCBs Verapamil AKA?

Calan, Isoptin, Verelan

Verapamil comes as?

tablet, capsule, injection

Verapamil dosing?

120-480mg QD (QD or DD depends on formulation)

Verapamil DIs?

Amiodarone, Beta blockers, Carbamazepine, Clarythromycin, ~azole, Digoxin, Dofetilide, Cyclo, phenytoin, theopylline, lova/simvasatin

Verapamil CIs?

Severe left ventricular dysfunction/cardiogenic shock/HF, 2/3 degree AV block, A fib/flutter with an accessory bypass tract

Lasix comes as?

tablet, solution, injection

Laxis dosing?

20-40mg BID up to (600mg in 2-4 doses)

Lasix DIs?

NSAIDs, Aminoglycosides, Lithium, Digoxin

Isosorbide Mononitrate AKA?

Imdur

Imdur comes as?

Tablet

Imdur dosing?

20-240mg QD/DD (QD only for ER version)

Nitrates are?

Imdur and Nitrostat

Nitrostat dosing?

0.3-0.6mg repeated at 5 minutes intervals for 3 doses! Prophylactically 5-10 minutes before activities that ppt attack

Spironolactone AKA

Aldactone

Aldactone comes as?

Tablet

Aldactone tx?

edema/ascities in patients with cirrhosis, HF

Aldactone dosing?

12.5-25mg QD (HF); 25-200mg (DD)

Aldactone DIs?

K+ supplements, ACE inhibitors, ARBs, trimethoprim

Spironolactone CIs?

In HF pts with Serum Cr >2 (female) > 2.5 (men) and K+ levels above 5mEq/L

HCTZ AKA?

Microzide

HCTZ comes as?

tablet, capsule

HCTZ dosing?

12.5-50mg QD

HCTZ DIs?

Loops, NSAIDs, Digoxin, Dofetilide, Lithium