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UMKC Fall 2011-TOP 200 Review
Review of Drugs for Top 200 exam
83
Pharmacology
Graduate
11/17/2011

Additional Pharmacology Flashcards

 


 

Cards

Term

 

Counseling points on clopidogrel (Plavix): Anti-platelet, Thienopyridine

 

Definition
  1. Take w/or w/out meals
  2. Do not use Plavix if you are allergic to clopidogrel, or if you have any active bleeding such as a stomach ulcer or bleeding in the brain (such as from a head injury). If you have any of these other conditions, you may need a dose adjustment or special tests:
  3. A bleeding or blood clotting disorder, such as TTP (thrombocytopenic purpura) or hemophilia;

  4. a history of stroke, including TIA ("mini-stroke");
  5. a stomach ulcer or ulcerative colitis; orkidney disease.
  6. FDA pregnancy category B. Plavix is not expected to be harmful to an unborn baby. 

 

Term
gabapentin (Neurontin): Anticonvulsant, GABA Analog
Definition

 

  1.    It may take 2-3 weeks to achieve desired results. Do not stop medication abruptly, may lead to increased seizure activity.
  2. Avoid alcohol. Maintain adequate hydration, unless instructed to restrict fluid intake.
  3. You may experience drowsiness, lightheadedness, impaired coordination, dizziness, blurred vision, nausea, vomiting, anorexia, constipation, diarrhea, postural hypotension, or decreased sexual function or libido (reversible).
  4. Report persistent CNS effects (nervousness, restlessness, insomnia, anxiety, excitation, headache, sedation, seizures, mania, abnormal thinking); suicide ideation or depression; rash or skin irritation; muscle cramping, tremors, or change in gait; chest pain or palpitations; change in urinary pattern; or worsening of condition.

 

Term
Is gabapentin cleared hepatically?
Definition
a.Renal impairment: dosage adjust w/ CrCl
b.Hepatic: not hepatically metabolized
Term
Nitrofurantoin (Macrodantin, Macorbid)- Antibacterial (UTI)
Definition
Dosage: capsule
DI: Mag salts decrease effectiveness
CI: Anuria, oliguria, dec ren fxn, G6PD deficiency, peripheral neuropathy, pulmonary, C. diff
AE: N/V/D, HA, flatulence, chills, fever, cough
Term
Sulfameth/Trimeth (Bactrim, Septra)- Sulfonamide ABX
Definition
FDA: Infxn, PCP ppx, traveler's diarrhea Dosage: Tablets, Suspension, IV infusion DI: dec. effs of cyclosporine, and incr.procainamide, hydration salts,& effects of anticoag & sulfonylureas CI: <2mo old, preg, megalobastic anemic SE: N/V/D, RASH, HIVES PE: EMPTY STOMACH 1-2hr b4&post meal w/full h2o; avoid LIGHT
Term
Amoxicillin (Amoxil, Trimox)-PCN ABX Trt Infection
Definition
Dosage: Tabs, Chew, Cap., Susp. DI: ORC, probenecid dec. Renal excretion CI: allergy to PCN & CS, C.dif, Pseu. colitis ADR: N/V/D, RASH, hives, itch PE: EMPTY STOMACH 1-2H pre or post meals w/full h2o
Term
Amoxicillin w/ Clavulonate -Augmentin (XR) PCN ABX; TRT INFECTION
Definition
Dosage: Tabs, Chew, Susp DI: ORC, probenicid dec renal excretion CI: Allergy,renal, pseudo col, C. diff ADR: N/V/D , hives, itch PE: TAKE START OF MEAL to INC ABSORB & dec GI; Take at even intervals, chew tabs with full h2o, refrig susp 10d
Term
Azithromycin (Zmax,Zithromax - Macrolide ABX; TRT Infection
Definition
Dosage: Tabs, packets, susp, injection DI: ANTACIDS=SLOW AB, FOOD WILL DEC ABSORP, Nelfinavir inc [Zmax] CI: Allergy to macrolides/ketolides, impr hepatic, pseudo colitis, C.diff, compl PNA, gonorrhea, syphillis PE:TNR food, NO Antacids w/ 1hr ADR: N/V/D, abd pain PE: TAKE EMPTY STOMACH 1-2h pre or post meal w/full h2o; take even intervals; refridge soln
Term
Clindamycin (Cleocin) ABX; TRT Infection
Definition
Dosage: Caps, Grans DI: inc theophylline & carbamezepine CI: pseudo col, elderly, GI disease, not cross BBB ADR: abd pain, N/V/D, PURITIS,vaginitis, muscle pain (diff from other ABX) PE: D/C if severe diarrhea, rash, muscle pain--> con PCP; w/full h2o, TNR food
Term
Cefdinir (Omnicef) CS ABX; TRT Infection
Definition
Dosage: Cap, Grans DI: Al, Mg, ANTACIDS & Fe supp dec probenecid inc[Omnicef] CI: Hypersen, renal fxn, pseudo col, C.diff ADR: N/D (16%), vaginal moniliasis aka yeast infxn, HA ab pain PE: DON'T take with ANTACIDS or Fe supps w/in 2H of dose; Susp good for 10D
Term
Cephalein (Keflex) CS ABX; Trt Infection
Definition
Dosage: Tab, Cap, Susp DI: ORC, probenecid [inc]; False pos labs (UA, direct coombs) ADR: Allergy; Pseu col SE: N/V/D, ITCHING, RASH, HIVES PE: EMPTY STOMACHE w/full h2o, take even intervals, Refridge 14days *vs Cefdinir (Omnicef 10d)*
Term
Ciprofloxacin (Cipro XR) FQ ABX; TRT Infection
Definition
Dosage: Tab, Susp, Inject DI: ANTACIDS & FE salts [dec]; probenecid inc [ABX] bc dec renal; NSAID dec Seizure threshold, inc [theophylline] CI: Allergy, QTc prolongation HOKalemia, antiarrhythmias (quinidine, procainamide, amdiodarione, sotalol), CNS disorders, TENDON REPTURE, not for <18yo SE: RASH, PHOTO, N/V/D, Dz PE: AVOID SUN, d/c if rash, w/full h2o, TNR food (pref 2h after meal); NO ANTACIDS, Ca, Zn, Fe; Susp RT or fridge 14D
Term
Moxifloxacin (Avelox) FQ ABX; TRT Infection
Definition
Dosage: Tab, Inject
DI: ANTACIDS, WARFARIN, Sucralfate, FE, NSAIDs dec seizure threshold, theophylline
CI: QTc, allergy, HOkalemia, antiarrhythmias, CNS disorders, TENDON RUPTURE, not for <18yo
SE: N/D; Dz
PE: PHOTO, D/C if rash or TENDON RUPTURE, w/full h2o, TNR food, don't take ANTACIDS, FE, Zn, Ca, cause Dz, lightheaded
Term
Fluconazole (Diflucan)Antifungal; Trt Infection, Tinea Infxn, Seborrheic Derm, Dandruff
Definition
Dose: Tab, Sus, Inj
DI: WARFARIN, phenytoin, midazolam, cyclosporin, tolbutamide, glyburide, glipizide, Rifampin
CI: allergy, LFTs, QTc prolongation (rare), proarrhythmias
SE: N/D, HA, ab pain, Dz, dyspepsia, taste
PE: contact PCP if Rash
Term
Metronidazole Flagyl (ER); Antiprotozoal, Antibacterial; TRT Amebiasis, Trichomoniasis infection
Definition
Dosage: Tab, Cap, Inject DI: Inc WARFARIN effects, dec Barbiturates, Disulfiram-->confused state; EtoH cause disulfiram-like rxn CI: Allergy, Trichomoniasis in 1st trimester of preg, CNS dx, severe hep impair, DON'T REFridge IV Soln SE: SEIZURES, PER NEUROPATHY, anorexia, N/V/D, ab cramp, HA, dysuria, metallic taste
Term
Nystatin topical (Nystop) Antifungal; Trt Candidiasis, cutaneous or mucocutaneous mycotic infxn (binds to sterols in cell membrane of candida species)*won't absorb through skin or mucous membrane*
Definition
Dosage: Powder, cream, Ointment DI: None Known CI: PregC, not to be used in intravaginal, oral or systemic infxn ADR: Rare (itching, rash, & pain on application) PE: Don't use on eyes
Term
Doxycycline (Vibramycin, Vibra-tabs) Tetracycline (Syphyllis, Gonorhea, Chlamydia, Malaria, PPx)
Definition
Dosage: Tabs, Caps, Susp, Syrup, Inject DI: ORC, inc [Digoxin], dec [alum, bismuth, Ca, Mg, Zn, Fe] CI: Hypersensitivity, tooth dev in children <8yo, renal fxn, C.diff ADR: Dz, vertigo, N/V/D, PHOTO, DISCOLORS forming teeth, sore/dark tongue , cramps, burning stomach PE: Empty stomach w/full glass h2o; TWF if GI upset, PHOTO
Term
Minocycline (Minocin) Tetracycline (syphyllis, Gonorrhea, Chlamydia, Malaria, PPx)
Definition
Dosage: Tabs, Caps, Sus, Syrup, Inject
DI: ORC inc [dig], dec [metals]
CI: Allergy, Dz, Vertigo, N/V/D, discolor teeth, SORE/DARK TONGUE, cramps, burning stomach, PHOTO rare
PE: EMPTY STOMACH w/full h2o, TWF if GI, even interval, NO ANTACIDS
Term
Valacyclovir (Valtex) Antiviral; Trt Genital Herpes, Cold Sore
Definition
Dosage: Tab
DI: Inc [Probenecid]
CI: Allergy, dose dec in renal, precip of drug in dehydrated pts
SE: N/V, HA, abd pain
PE: Avoid sex with vis lesions, Valtrex doesn't kill latent virus & no cure, Take plenty of fluids
Term
Budesonide (Pulmicort) ihalation; Anti-asthmatic (adrenocorticoid); Maintenance tx of asthma
Definition
Dosage: Susp for inhalation MDI
DI: incr[budesonide] by Ketoconazole
CI: caution xfer pts from sys corticosteriods to Pulmicort (adrenal insufficiency), NOT FOR RAPID RELIEF, oral fungal infxn, HPA response
SE: HA, asthenia, pain, dyspepsia, N, oral candid, cough, resp infxn, rhinitis, sinusitis
PE: Avoid eyes, Use ST bronchodilators before Pulmicort, RINSE MOUTH after use, red mark = 20 dose left, avoid exp to chxpox or measiles, Tubohaler not with Spacer
Term
Fluticasone Propionate (Flovent)Anti-asthmatic (adrenocorticoid); Trt Maint Asthma
Definition
Dosage: MDI
DI: Additive eff w/systemic corticosteroids
CI: Adrenal insuff during steroid conversion, NOT for RAPID RELIEF of bronchospasm, oral fungal infxn, HPA Response
ADR: Pharyngitis, nasal congestion, URI
PE: avoid eyes, use other Bronchodilators minutes b4 Pulmicort
Term
Fluticasone Propionate w/ Salmeterol (Advair); Antiasthmatic (adrenocorticoid & inc CAMP); Main tx of Asthma COPD **long-acting beta2-adrenergic receptor agonist (LAB2A)**
Definition
Dosage: DISKUS HFA
DI: Additive effect w/ systemic corticosteriod, sympathomimetics, TCAs, MAOIs inc tox B dec eff of Salmeterol
CI: adrenal insuff during steroid conversion, not for RAPID relief, oral fungal infxn, HPA fxn, CV disorders, HN, hypthyroidism, DM
SE: URI, Pharyngitis, HA, N/V, sinusitis, bronchitis, cough, RASH, AGIOEDEMA (ACEI causes this too)
PE: Avoid eyes, Not for rapid relief, Proper use of diskus and HFA devices
Term
Montelukast (Singulair)- Antiasthmatic (Leukotriene inhibitor); Trt Chronic Asthma, Seasonal Allergies/rhinitis
Definition
Dosage: Tabs, Grans
DI: dec [probenecid], inc [pxclitaxel, rosiglitazone, repaglinide] via 2C8
CI: Not for acute attacks, NOT for monotherapy for exercise induced asthma. Rare Eosin.
SE: HA (18%), flu, cough, ab pain, dyspepsi, Dz (rare), aggressive behavior, abn dreams, depression, suicidal thinking
PE: Take regularly for asthma; chew tabs contain phenylalanine, can be mix w/spoon of soft food
Term
Raloxifene (Evista)-Osteoporosis in post-menopause
Definition
Dosage: 60 mg Tab
DI: dec[cholestyramine], Prot Bind. w/diazepam, clofibrate, indometh, naproxen, IBU, diazoxide
CI: Peg, DVT, PE, retinal vein thrombosis
ADR: Hot flashes, leg cramps, wt gain, per edema, sinusitis, rash, sweating
PE: TNR Food, D/C 72 hrs b4 and during prolonged periods of immob.; Take Ca + Vit.D
Term
Alendronate(Fosamax) Osteoporosis-Osteoclast Inhibitor --Osteo in men and women & Pagets disease
Definition
Dosage: 70 mg Qwk, 10 mg Qday, soln, Fosamax D
DI: dec [Ca]&[ANTACIDS], ASA inc GI effects
CI: Esophageal abn, HOCalcemia, renal disease
SE: Ab pain, C/D, flatulence, musculoskeletal pain, upper GI irrit (rare)
PE:Take w 6-8ox of plan h2o upon awakening, DO NOT LIE DOWN FOR 30 min after taking and not until first food of day consumed; report GI distress, swallow whole, no oral meds w/in 30 min of taking fosamax
Term
Ibandronate (Boniva) Osteoporosis (antiesorption) Tx/prevent in POSTmenopausal women
Definition
Dosage: Tabs (150mg Q month); Inject (3mg IV Q 3 Month)
DI: dec absorpt w/Ca & ATACIDS
CI: HOCa, allergy, renal impairment, JAW OSTEONECROSIS
ADR: DYSPEPSIA, D, bronchitis, PNA, UTI
PE: Take @ least 60 min b4 1st food/drink of day; take upright position - no lie down for 60 min after (swallow whole); don't take supp @ same time
Term
Esomeprazole (Nexium) PPI -GERD, Ulcers, H. pylori, Zollinger-Ellison
Definition
Dosage: Cap, Gran, Inject
DI: inc [diazepam]; changes for drugs sen to pH (keto, dig, cyanocobal., ampicillin, Fe, dec [atazanivir], inc[variconazole]
CI: Gastric carcinio tumors w/long term use; Toxic Epidermal necrolysis; SJ, erythema multiforme
SE: HA, N/C/D, gas, ab pain, DRY MOUTH
PE: take 60 min b4 eating; ANTACIDs TAKE SAME TIME OK; Capsule content add to 1 Tbsp of applesauce, swallow imm (no chew) + glass of h20; mix gransw/15mL water, stir, set it for 2-3min, take orally; Take w/in 30min of mix
Term
Lansoprazole (Prevacid) PPI -GERD, Ulcers, H. pylori, Zollinger-Ellison
Definition
Dosage: Caps XR, Tabs (ODT "Solutab"), Gran, Powder for injection
DI: take 30 min b4 sucralfate; drugs aff by pH(keto, amp, Fe, dig, theophylline dose titration)
CI: Allergy
ADR: N/N/D, ab pain,HA
PE: TAKE On EMPTY Stomach,swallow cap whole or empty into soft food swallow w/out chew; mix gran in 30ml water, stir, drink immed.
Term
Omeprazole (Prilosec) PPI-GERD, Ulcers, H. pylori, Zollinger-Ellison
Definition
Dosage: Cap
DI: inc [diazepam, phynytoin,WARFARIN]; maybe cyclosporine, disulfiram, BZD; drug aff by pH (ketoconazole, digoxin, cyanocabalamine, ampicillin, Fe, inc [voriconazole]
CI: Gastric Carcinoid tumors w/long term use
ADR: Cough, C, Rash, Dz, back pain (rare)
PE: Take 30 min B4 eating, ANTACIDs take same time OK, capsule content added to 1Tbsp of applesauce, swallow imm + h2o, don't chew or crash capsule contents
Term
Pantoprazole (Protinix)-PPI - GERD, erosive esophageal, Zollinger Ellison (not the same as Esomep, Lanso, or Omep)
Definition
Dosage: Tab, Granules for oral susp, Injection (powder)
DI: bc Panto inc pH-drugs affected by co-admin(ketoconazole, amp, Fe salts)
CI: Allergy (preg class B)
PE: TNR food, swallow whole, Grans mixed with applesauce or apple juice --swallow immed; take ANTACIDs same time
Term
Ranitidine (Zantac)-H2 blocker (Antagonist)-Anti-ulcer
Definition
Dosage: Tab, EFFERdose, Syrup (pepermint flav), Injection (NOT powder for recon.) DI: inc[WARFARIN, nifedipine, TCAs], inc absorp of triazolam CI: Imp renal & hepatic fxn, reversible hepatitis, EFFERdose tabs contain phenylalanine ADR: HA, Dz, N/C, abd pain PE: May take w/food/milk if GI upset; don't freeze syrup; must dissolve EFFERtabs in h2o
Term
Famotidine (Pepcid) - H2 blocker (antagonist)- Anti-Ulcer
Definition
Dosage: Tab, ODT, Powder for oral Susp, Injection DI: inc [WARFARIN] CI: Allergy, impaired renal fxn ADR:HA, Dz, C, D, irrit @ inject site PE: ANTACIDs may take same time,Shake susp, discard after 30
Term
Metformin Glucophage (XR)-biguanine-antidiabetic
Definition
Dosage: Tabs DI: inc [Metformin]with Lasix, cimetidine, nifedipine, EtOH may inc lactate metab CI:imp renal& hep fxn, not for use during iodinated radiologic study, DON'T use in METABOLIC acidosis/DKA ADR: dec Vit.B12 absorpt,LACTIC ACIDOSIS, N/V/D, flat, anorexia, bloating, metallic taste, Gi effects dec once dose stable; lact.acid. z/sx hypervent, myalgia, maliase, somnolence PE: TWF, avoid EtOH, keep well hydrated, cont PCP lact acid s/sx
Term
Amaryl=dec BG DM II
Glucotrol (XL)=Tx DM
Micronase, Diabeta =Tx DM
Definition
A-Glimeperide
G-Glipizide
M-Glyburide
Term
Glimeperide (Amaryl)-Beta cell stimulant- Tx DM II
Definition
Dosage: Tab
Di: 2C9 possible interxn (miconazole, phenytoin, diclofenac, IBU, naproxen, mefenamic acid)
CI: pts w/DKA, inc CV mortality
ADR: Dz,asthenia,HA,N
PE: TWF, avoid EtOH, PCP if s/sx of DKA, keep well hydrated
Term
Glipizide-Glucotrol (XL)-Sunfonylurea-Tx DM
Definition
Dosage: Tabs
DI: inc eff by Dicumarol chloramphenicol, EtOH, MAOI, phenylbutazone, Salicylates, sulfinpyrazone, sulfonamides, dec effect by Diazoxide, rifampin, thaizides
CI: not for DM TYPE I (juvenile), unstable/compl DM as monotherapy, Sulfa allergy, DKA, renal/hep impair, thyroid fxn, burns, infxn, trauma
ADR: N, pruritis/itch/Urticaria, mild HOglycemic rxns
PE: Take 30 min b4 meals; avoid excessive EtOH
Term
Glyburide (Micronase, Diabeta)-Beta cell stimulant - Tx DM
Definition
Dosage: Tabs
DI: Not for juven, unstable/complic DM as monotherapy, sulfa allergy, DKA, renal/hep impair, thyroid dysfxn, burns, infxn, truama
CI: N, HB, pruritis/Urticaria, mild HOglycemia rxn
PE: take 30min b4 meals; avoid EtOH
Term
Pioglitazone (Actos)-thiazolidinedione dec insulin resistance- Adjunct Tx DM II improve glycemic QC
Definition
Dosage: Tab
DI: ORC; inc [Actos] by ketocon, itracon, gemfibrazil, dec [Actos] by rifampin
CI: NYHA Class III or IV HF, exacerbtae CHF, need insulin to work, DON'T USE IN TYPE I DM to trt DKA, hep dysfxn
ADR: URI (13%), HA, Sinusitis, myalgia, tooth disorder, aggrev of DM, pharygitis
PE: TNR Food, Quarterly HgbA1C
Term
Sitagliptan (Januvia)-inhibits DDP4(inc insulin & dec glucagon)- Tx DM II *or adjunct ther to diet & Exercise
Definition
Dosage: Tabs
DI: may inc digoxin
CI: Allergy, renal insuff(dose adjust), concom use w/sulfonylureas or insulin =HOglycemia, pregclass B)
ADR: Nasopharygitis (5%)
PE:TNR Food; Quarterly HgbA1C
Term
Insulin Aspart - Novolog (Short Acting)
Insulin Glargine - Lantus (Long Acting)
Insluin Lispro - Humalog (SA)
Insulin - Humulin (Intermediate)
Definition
Insulin Aspart - Novolog -Type I or II
Insulin Glargine- Lantus -Type I or II
Insulin Lispro - Humulog- Type I or II
Insulin - Humulin - Type I or II
Term
Insulin Aspart (Novolog)rDNA origin - SA-Meal time Insulin analog
Definition
Dosage: SQ injection 100 units per mL; (mix 70/30)-30% insulin aspart sln 70% insulin aspart protamine susp
DI: these drug dec HOgly eff of insulin (corticosteriods, diltiazem, dobutamine, epinephrine, ORC, thiazide diuretics), thyroid, tobacco smoke; inc HOgly eff (EtOH, anabolic steroid, nonsel BB, clofibrate, MOAI, salicylates, tetracyclines etc.)
CI: HOgly, DON't MIX W/ LANTUS (mess up timing)
ADR: HOglyc, allergy (redness, swelling, itching @inject site); LIPOdystrophy at injection site
PE: admin 5-10 min b4 eating, store in fridge; consult provider if change syringe brand or dose
Term
Miscellaneous information about insulin
Definition
NPH insulin (or neutral protamine Hagedorn) (also known as Humulin N, Novolin N, Novolin NPH, NPH Lletin II, and isophane insulin), is an intermediate-acting insulin given to help control the blood sugar level of those with diabetes. NPH was created in 1936 when Nordisk formulated "isophane" porcine insulin by adding neutral protamine to regular insulin.

This is a suspension of crystalline zinc insulin combined with the positively charged polypeptide, protamine. When injected subcutaneously, it has an intermediate duration of action, meaning longer than that of regular insulin, and shorter than ultralente, glargine or detemir.
Term
Insulin glargine (Lantus)-Long acting-Tx DM I & II
Definition
Dosage: SQ injection HS
DI: dec insulin eff insulin by corticosteriods, diltiazen, dobutamine, epi, ORC, THZ diuretic, thryoid, tobacco smoke; inc effect of insulin: EtOH, anabolic steroid, non selec BB, clofibrate, fenfluramine, guanethidine, MAOIs, phenybutazone, salicylates, sulfinpyrazone, tetracyclines--> LIKE all insulins in top 200 2011
CI: Not for IV use
SE: HOgly, allergy, lipodystrophy at injection site
PE: Give 15min b4 eating, con PCP during illness, STORE in fridge
Term
Insulin (Humulin)-Intermediate Acting-aka NPH-Tx DM I & II
Definition
Dosage: SQ injection as R (also comes in U-500), NPH, Humulin 70/30, 50/50
DI: dec insulin eff insulin by corticosteriods, diltiazen, dobutamine, epi, ORC, THZ diuretic, thryoid, tobacco smoke; inc effect of insulin: EtOH, anabolic steroid, non selec BB, clofibrate, fenfluramine, guanethidine, MAOIs, phenybutazone, salicylates, sulfinpyrazone, tetracyclines--> LIKE all insulins in top 200 2011
CI: HOglycemia
ADR: HOglycemia, allergy, lipodystrophy at injection site
PE: Follow general insulin counseling card
Term
General Insulin Counseling
Definition
1. Follow prescribed diet carefully
2. Don't change brand of syringe, or dose w/consult
3. Don't change order of mixing
4. Continually monitor BG
5. S/Sx of HOglycemia (sweating, tremor, blurred vision, weakness, hunger, and confusion)
6. Trt with rule of 15s (take 15 grams of glucose and check BG in 15 minutes)
Term
General Patient Education on MDI
Definition
•Shake the MDI canister to mix med & propellant.
•Holding the MDI upright, exhale (breathe out empty lungs). Open your mouth and hold the MDI about an inch away from your lips or put lips around it.
•Begin to breathe in while press down on the canister and cont to breathe in slowly and completely.
•Hold breath for up to 10 secs to allow the medicine to reach deep into your lungs.
•Slowly breathe out.
Term
General Patient Education for DPI
Definition
•Place teeth on mouthpiece seal w/lips around it-tongue not block mouthpiece.
•several different types of DPI’s diff ways to load med -->
oAdvair DISKUS®, Plumicort Turbuhaler® ,Spiriva Handihaler®
•Breathe in quickly and deeply through your mouth activating flow of med.
•Take mouth off of the mouthpiece hold breath for up to 10 seconds and exhale.
•Slowly breathe out.
Term
Insulin Lispro (Humalog)-LA-Tx DM I & II
Definition
Dosage: SQ inject (75/25), (50/50)
DI: DI: dec insulin eff insulin by corticosteriods, diltiazen, dobutamine, epi, ORC, THZ diuretic, thryoid, tobacco smoke; inc effect of insulin: EtOH, anabolic steroid, non selec BB, clofibrate, fenfluramine, guanethidine, MAOIs, phenybutazone, salicylates, sulfinpyrazone, tetracyclines--> LIKE all insulins in top 200 2011
CI: HOglycemia
ADR: HOglycemia, allergy at inj site, lipodystrophy at inj site
PE: Give 15min B4 eating, pcp if any illness, store in refridge
Term
General Insulin Storage info
Definition
Generally - unopened refridge; opened=RT; Never freeze
*Once insulin has been opened and the seal has been punctured, use or discard insulin within 28 days.
*Insulin that is mixed with another insulin (both drawn into a syringe) should be used immediately.
*Mixing use ASAP
Term
Amitriptyline(Elavil)-Antidepressant TCA-Tx Depression
Definition
Dosage: Tab DI: inc axn dicumarol, dec eff clonidine & guanethidine, inc tox fluoxetine, in eff of direct acting sympathos, Tox w/MOAIs, INC DROWSINESS w/EtOH & other CNS depres, inc [Elavil] w/ cimetidine CI: MOAI w/in 14 days, NO preg category estab, imp hep, angle-closure glaucoma, Urinary reten, CV dx, inc IOP, hyperthyroidism ADR: TACHYCARDIA, DRY MOUTH, blurred vision, N/V/C, Dz, weakness, HA, Urine reten, WT GAIN, Drowsiness PE: no D/C, Drowsiness, no EtOH
Term
Bupropion - Wellbutrin (SR,XL)-Anti-Depressant-Tx DEPRESSION,SAD
Definition
Dosage: Tab
DI: Tox inc w/MOAIs & L-dopa, EtOH may dec seizure threshold
CI: Seizure dx, eating dx, MOAIs, can inc suicidal ideation in Kids/teens, psychomotor disturb, mania, psychosis, hallucin.
ADR: Dz, C, wt loss, DRY MOUTH, insomnia, sweating, agitation, TREMOR, dec sexual fxn
PE: Take XR Am avoid insomnia, no double dose if missed, NO OTC w/o consult,no EtOH
Term
Citalopram (Celexa)-SSRI-Tx Depression
Definition
Dosage: Tab, Soln
DI: co-admin w/MOAIs, cimetidine inc conc, co-admin w/ASA or NSAID risk upper GI bleed
CI: w/in 14 day MAOIs, ANTIDEP INCR SUICIDAL IDEATION IN CHILDREN/TEENS, HOnatremia, hepat dx,no D/C (bc irrrit, dysphoric mood, agitation, Dz, anxiety, confusion, insomnia, HA, preg C
ADR: N(21%), DRY MOUTH (20%), SOMNOLENCE(18%), ejac & impotence
PE: impair cog & motor perform, no D/C, no EtOH
Term
Duloxetine(Cymbalta)-potent inhib of serotonin & Norepi reuptake,slight dopamine-Antidepressant-Tx MDD, DM neuropathy, GAD
Definition
Dosage: Caps
DI: MAOIs, inc[Cymbalta] inhib CYP1A2 (fluvoxamine, FQ)& 2D6 (paroxetine, fluoxetine, quinidine), Cymbalta may inc level of (TCA, phenothaizines, profenone, flecainide)
CI: SUICIDE kids/teens, pt taking MOAIs taking unQC narrow angle gluacoma, hep dysfxn, EtOH, seizures, may inc BP & activate hypomania
ADR: Nausea (20%)/V/C/D, DRY Mouth, C,D, Dz, Insomnia, dec appetite, fatigue, drowsy, sweating, blurred vision, erectile dysfxn
PE: May take up to 4 wks to work, DROWSINESS, no EtOH, NO D/C
Term
Escitalopram (Lexapro)-SSRI-Tx Depression
Definition
Dosage: Tab, Oral soln
DI: MOAIs co-admin=rxn like Neuroepileptic Malig syndomr (NMS),inc by cimetidine, NSAID/ASA in risk of GI bleed
CI: MOAI w/in 14D, Suicide in kids/teens, reversible HOnatremia, liver dx
ADR: N(15%)/D, Dz, Somnolence, insomna, ejac disorder, inc sweating, dizzy, impotence
PE: Cog/motor impair, no EtOH, pcp b4 taking OTCs, no D/C
Term
Fluoxetine (Prozac)-SSRI-Tx Depression, OCD, bulimia, panic dx
Definition
Dosage: Tabs, Caps, Liquid
DI: MAOIs wait 14d to take Prozac after D/C, wt 5 wks after D/C prozac to start MAOI, inc [thioridazine]a schizo drug-wt 5 wks post d/c prozac to take, inc [TCA, BZD, phenytion, CBZ, tryptophan & sumatriptan, +ASA/NSAID inc GI bleeds
CI: MOAIs, suicide kids/teens, RASH, hep dx, not for <7yo, pregclass C
ADR: N/D, insomnia, anorexia, HA, sweating, asthenia, dec labido, ab ejac & fatigue
PE: Drowsiness, no EtOH, consult b4 OTCs, pcp if HIVES
Term
Mirtazapine (Remeron)-Antidepressant(a2,5HT,H1)-Tx Depression
Definition
Dosage: Tabs, ODTs DI: additive eff w/CNS depress, MAOIs, NSAID/ASA inc GI Bleed risk CI: suicide kids/teens, Agranulocytosis, D/C s/sx of sore throat, fever, stomatitis, infxn dec WBC, warning of abrupt D/C ADR: DROWSINESS (54%), DRY MOUTH (25%), C (13%),inc appetite(17%), wt gain (12%), Dz, flu syndrome, abn dreams PE: Drowsiness, no EtOH, no D/C
Term
Paroxetine-Paxil (CR), Pexeva-SSRI-Tx Depression, OCD, Panic Dx, Social Anxiety Disorder, CR-premenstrual dyphoric dx
Definition
Dosage: Tabs, Oral Susp DI: MOAIs, con changes w/phenytoin, phenobarb, cimetidine, may displace WARFARIN from prot bind, inc [procyclidine], 2D6 substrate may have variable eff, NSAID/ASA inc GI bleed CI: Preg,MAOIs (14d rule),Suicide kids/teen, dec dose in elderly, renal/hep impair,caution in mainia-seizure, HoNa s/sx edema-excess thirst, no D/C ADR: Somnolence,N/V/C/D, insomnia, sex dysfxn,sweating, tremor, abd pain, wt loss, gas PE: Drowsiness, PCP if inc edema/ex thirst, avoid EtOH, up 2 wks to work, consult b4 OTC use, no D/C, ONLY 1QDay
Term
Sertraline(Zoloft)-SSRI-Tx Depression, OCD, Panic Disorder, Post traumatic Stress Disorder(PTSD), PMDD
Definition
Dosage: Tabs, Oral concentrates
DI: MAOIs(14d rule), in[pimozide], may displace prot bound drugs (WARFARIN, DIGOXIN],inc [diazepam,tolbutamide], variable eff w/3A3/4 substrates, NSAID/ASA inc GI bleed risk
CI: MAOI, suicide ideation, D/C
ADR:N/D, dyspepsia, tremor, Dz, insomnia, sweating, DRY MOUTH, male sex dysfxn (ejac delay)
PE: Oral conc. dosage dilute in 4 ox h2o, ginger ale, lemon(-ade)/lime soda,OJ only ; take imm after mix; avoid EtOH, DROWSINESS, no D/C
Term
Trazodone (Desyrel)-SSRI-Tx Depression
Definition
Dosage: Tabs DI:EtOH & other CNS depr=inc DROWSINESS; inc eff of pheny, GFJ inc con, in con by 3A4 inhib (ketocon, ritonavir, indinavir) CI: Recent MI,CV, arrhythmias, PRIAPSM, no <18yo, slower/greater absorp given w/FOOD ADR:Drowsy, PRIAPSM,dry mouth, HOTN, Dz, confusion, fatigue, HA, N/V PE: TWF enhance absorp, DROWSINESSno EtOH
Term
Venlafaxine-Effexor(XR)- SNRI(Serot & norep reuptake inhib)-Tx Depression, GAD
Definition
Dosage: Tab, Cap
DI: MAOIs, *other CNS Dep (EtOH, antihist..); NSAID/ASA risk of GI bleed
CI: MAOI (14D rule); D/C Effexor 2wk b4 start MAOI, suicide ideation, HTN, mania, seizures, renal impr
ADR: N/C, DRY MOUTH, anorexia, DROWSY, insomnia, Dz, Nervousness, abn Ejaculation & dec labido, sweaty, yawning
PE: avoid EtOH; consult for OTCs
Term
Alprazolam CIV-Xanax (XR)-anxiety BZD-Tx Anxiety, Panic Disorder
Definition
Dosage: Tabs, ODT, Soln
DI: CNS depression inc w/other CNS depressants
CI: HTN, Narr-angle-glauc, caut w/primary HTN, psychosis, impaired rena/hep fx, withdrawal sx
ADR: Drowsiness, HOTN
PE: DROWSINESS, avoid EtOH, consult for OTCs
Term
Diazepam CIV (Valium)-BZD-Tx Anxiety
Definition
Dosage: Tabs, ODT, Soln DI: CNS Depress in with other CNS dep CI: HTN, unTx N angle gluac, prim depress,Preg, ren/hep impr ADR: DROWSY, ataxi, fatigue PE: Oral Conc must be diluted b4 use, Cuation DROWSINESS, no EtOH, may be habit forming
Term
Lorazepam CIV (Ativan)-Ativan-BZD-Tx Anxiety, insomnia from anxiety, pre-anesthetic, sedation, epilepsy
Definition
Dosage: Tabs, Soln, Inject DI: Inc CNS Depress, inc con w/probenacid by 50% CI: HTN, n angle gluac, caut w/primary depr, psychosis, renal/hepatic impr ADR: Drowsy, Dz, unsteadiness weakness PE: caut w/drowsiness, avoid EtOH, habit-forming
Term
Buspirone (Buspar)-ST Tx Anxiety; MOA unknown
Definition
Dosage: Tri-scored Tabs DI: +MOAIs = HTN; GFJ inc [plamsm] CI: mod-sev ren/hep fxn; Buspirone binds to dopamine recept --poss dystonia, parkinsonism, tardive dyskenesia during therapy, Preg B, caut w/lactation ADR: TACHYCARDIA, Rash, HA, fatigue, sweating, mus pain, dream disturb, Dz, Drowsy, nerv, insomnia, mood alter, dep, DRY Mouth, N/C/D, nasal congest, blur vis, tinnitis,sore throat*unique than other antidep* PE: DROWSINESS, DZ, report involun move of tongue or facial muscles, chang in motor restles, avoid GFJ
Term
Aripiprazole (Abilify)-MOA: unknown (~? 5-HT1A&2A and Dopamine D2 receptor)-Tx Anti-PSYCHOTIC (Schizo, BiPolar, acute mania
Definition
Dosage: Tabs, ODT, Oral inj DI: [dec]by 3A4 (CBZ), [inc] by 3A4 inhib (quinidine, fluoxetine, paroxetine) Ci: Hypersen, dementia, related PSYCHOSIS, NMS S/sx hyperpyrexia, muscl rigid, alt mental status, autonomic instab (irr HR, BP, Diaphoresis, cardia arrh), *CV dx, seizures, aspiration PNA ADR: TARDIVE DYSKENESIA, HA, ANXIETY, insomnia, asthenia, N/V, lighthead.,DROWSY, blurr vision PE: DROWSY,avoid EtOH, HEAT EXP/Dehydration-bc hyperpyrexia, store oral sln in fridge
Term
Which drugs cause the highest level of DROWSINESS/Somnolence?
Definition
Vicoden (Lortab, Norco, Lorcet),Alprazolam, Citalopram (som 20%), CLONAZEPAM (50 & 30% ataxia), Escitalopram (som 6%), Gabapentin (som 19% & 17% Dz), Lorazepam, Quetiapine fumerate -Seroquel som 18% & 10% Dz), ~Topiramate, Divalproex-Depakote (som 17%), Lamotrigine-Lamixtal-som14%), Diazepam, eszopiclone Lunesta >10% Drowsyness, Fluoxetine
Term
Buproprion (Wellbutrin-SR or XL)-Antidepressant-Tx Depression, Seasonal Affective Disorder "SAD"
Definition
Dosage: Tab DI: Tox inc w/MAOI & L-dopa, EtOH may lower seizure threshold CI: Seizure dx, eating dx, current MAOI therapy, can inc suicidal thoughts/axns in kids/teens, psychomotor disturb, psychosis, hallucinations ADR:Dz,C,wt loss, Dry mouth, insomnia,sweating, agitation, TREMOR, dec sex fxn
Term
Lithium Carbonate (Lithonate, Lithotabs, Lithobid)-Antipsychotic-Tx Manic episodes
Definition
Dosage: Caps, Tabs, Oral Sln DI: CBZ = neurotox, Iodides = HOthyroidism, [inc]w/NSAIDs, ACEI, thiazides, [dec]urinary alkalizers, Haloperidol-variable tox eff CI: cx renal failure, CV dx, devere debilitation, dehydration, Na depletion, *diuretics, ACEIs, preg/lact, Na deplet cause lith tox --maintain Na & fluids, NARROW TI DRUG ADR: Tox-->DIARRHEA, VOMITING, DROWSINESS, BLURRED VISION, TINNITIS, hand tremor, nausea, mild thirst ~initial therapy, extreme polyuria, muscular wkness, lack of coordin +blurred vision PE: Closely follow dose, eff takes 1-2wks b4 opt eff, take 2-3 quarts daily during therapy, avoid exposure to *HEAT
Term
Why is heat exposure a problem with people on Lithium?
Tx= Bipolar aka Manic depression
Definition
Heat Exhaustion and Lithium According to the U.S. Centers for Disease Control and Prevention, heat exhaustion is a milder form of heat-related illness to heat stroke, caused by excessive water and salt loss. Along with the other side effects mentioned above, lithium can cause dehydration, a symptom of heat exhaustion. Lithium in itself does not cause heat exhaustion but exacerbates the symptoms of it.
Term
Quetiapine-Seroquel (XR)-ATYPICAL Anti-psychotic-Tx Schizo, Bipolar DEPRESSIVE episodes & Manic episodes **multiple NT antagonist [D1,D2,H1, a1, a2, 5HT(1a,2)]
Definition
Dosage: Tabs DI: Additive effects w/CNS dep, [dec] or inc oral clear. w/pheny & thioridazine CI: DEMENTIA RELATED PSYCHOSIS PTS, MAY INC SUICIDE IDEATION in KIDS/TEENS, Neuroleptic Malignant Synd (NMS), hyperpyrexia, mus rigid, alt mental stat, auton. instab, Tardive dys (TD)--gen for antipsychotic drugs --if TD d/c warranted, orth HOTN *@initiation, CATARACTs may dev during therapy (lens exam 1st 6 month), seizures, dysphagia, hypothyroidism, hx of Breast can, HperGLy (DKA-coma/death), pregC/lact ADR: somnolence (18%), Dz(10%), C(9%), post HOTN (7%), DRY MOUTH (7%), dyspepsia (6%), 1%(Hypertonia, flu syn, anorexia, palpitation, pharygitis, rhinitis, cough, dyspnea, peripheral edema, sweating, & Leukopen) PE: Post HOTN (*from prone pos*initial dosing), DROWSINESS/SOMN., TNR FOOD
Term
Risperidone (Risperdal)-ATYPICAL Anti-Psychotic- Tx Schizo, BiPolar manic episodes or mixed episodes , AUTISTIC IRRITABILITY only Tx bipolar MANIC ep.
Definition
Dosage: Tabs, oral soln, Inject DI: inc eff of L-DOPA, [dec] by CBZ, [inc] by fluoxetine, clozapine CI: DEMENTIA RELATED PSYCHOSIS, fatal complex --NMS(s=musc rigid, hyperpyrexia, auto instab--if so D/C); May lengthen QT interval & prod orth HOTN, *bradycardiac pts, elect imbalancek, CV dx, hx seizures, HyperGly coma/death, pregC ADR: EXTRAPYRAMIDAL SYMP, Tachycardia, insomnia, agitation, anxiety, somnolence, N/C/V, dyspepsia, rhinitis, dry skin, RASH. PE: Fainting occur w/init dose, impair judgement *cars & machinery, no EtOH, TWF or milk if GI, Soln okay w/OJ, Coffee, & LOW FAT MILK, Risperdal M-tabs take asp after open, open w/dry hands, Avoid exp SUN & HEAT during therapy, consult b4 OTC
Term
Divalpoex Sodium- Depakote (ER)-Seizures (petit mal,complex abs, or complex partial seizures); Acute mania or mixed episodes ass w/BiPolar, & Migraine PPx
Definition
Dosage: Tabs, sprinkle Caps *all enteric coated DI: Prot binding w/ASA, CBZ, dicumerol, dec ren clear of phenobarb, alter levels of pheny, clonaz may cause abs of seizures CI:Cx/hx hep dx (+valproic a. =fatal), pancreat s/sx; ab pain, plt dysfxn, suicidal ideation, PREGClass D, N/V ADR: N(31%)/D(12%)/V(11%),Somnolence (17%),asthenia-wkness(20%) ab pain, TREMOR, WT GAIN & inc app(8%,6%), back pain, ALOPECIA (7%), dyspepsia (13%), Dz (12%) PE: no D/C, DROWSINESS, no EtOH, TWF or Milk if GI, Cap sprinkle swall whole or add to 1Tsp soft food
Term
Donepezil HCl (Aricept) - Reversible Acetyl Cholinesterase Inhibitor, Tx mild-sev DEMETNIA of Alzheimer's type-*96% PB; metab 2D6 & 3A4
Definition
Dosage: Tabs, Tab ODT (Aricept -ODT), Oral Sln-->QHS DI: Unknown regarding CYP intxns; min metab of terbinafine & cisapride; poss [inc]w/CBZ, pheny, phenobarb, rifampin, dexameth; [dec] keto or quin CI: Hypersen to Donepezil or piperidine deriv, D/C b4 anesthesia, VAGOTONIC effects oh heart, may inc GI acid:.*in sick sinus syn, *asthma/COPD, PregC ADR: N/V/D, muscle cramps, fatigue, anorexia SE: TNR FOOD, HS b4 bed
Term
Pregabalin (Lyrica) - Anticonvulsant/Antineuralgic -Tx Dm neuropathic pain, postherpetic neuralgia, adjunct adult partial onset seizure, fibromyalgia
Definition
Dosage: Caps
DI: add CNS dep= dec cogn & motor fxn, per edema when given w/thiazolidinedione a-DM agents
CI: Hypersen, when D/C taper over 1 wk, per edema, rare myop/rhabdo, AED gen cautions
ADR: Common --(Dz, Somnolence/Drowsiness, Dry mouth), others (ataxia, confusion, asthenia, abn thought, blurred vs, wt gain, per edem
PE: Caution w/ drowsiness, no EtOH, no D/C, report unex musc pain, tenderness, wkness, fever, malaise, TNR food
Term
Carbamazepine (Tregretol, Tegretol XR, Carbatrol ER, Equetrol ER)-Seizures Refractory to other Anticonvul. & Trigeminal neuralgia; MOA (blockage of potentiation)
Definition
Dosage: Tabs, ODT, Chewable Tabs, Caps (Equetrol, Carbatrol), Susp DI: Dec eff of ORC, Valproic acic, pancuronium; Cimetidine, isoniazide, diltiazen, fluoxetine, propoxyphene, primidone, verapmil, danazol, or MACROLIDED may [inc]; dec[doxycycline &haloperidol]; Tox w/Li, GFJ [inc] CI: Hypersen to TCA or CBZ in pts w/BMS, *preg/lact, MOAIs (14d rule),IOP, CV, ren/hep, hx hemo rxn, asplas/agran, pcp if s/sx(fever, sore throat, mouth ulcer, easy bruising, Asians HLA-B*1502-skin compl-SJS, AED generals ADR: Common (Dz,unsteady, N/V, DROWSINESS); rare aplast/agran, SJS :.report fever, sore throat, mouth ulcers, bruising, skin rash to provider or pharmD PE: TWF or milk+ full glass h2o 240mL with Chew tabs, DROWSINESS, no EtOH, Shake susp
Term
What are the drugs that are used to Tx Seizures alone?
Definition
-Levetiracetam (Keppra)ok for KIDS & **no known DI**
-Phenytoin (Dilantin, Kapseals)*lots of DI
-Clonazepam-CIV-Klonopin-Tx Lennox Gastaut Syndrome (peptit mal variant), akinetic & myoclonic seizures, & pats w/absence seizures (petit mal) failed respond to succinimides *KIDS & ADULTS
Term
Which seizure medications have additional indications?
Definition
Pregabalin (Lyrica)-AE+Antineuralgic+Post Herpetic neuralgia+Fibromyalgia
Carbamezapine(Tegratol XR, Carbatrol ER, Equetrol ER)-AE+Trigeminal Neuralgia (shock like face pain)
Gabapentin (Neurontin)- AE+postherpetic neuralgia
Topiramate (Topamax)-AE+Migraine PPx
Lamotrigine (Lamictal)-AE+BiPolar
Divalproex (Depakote,ER)-AE+antipsycho (tx seizure, bipolar mania, migrain PPx)
Term
Which antiepileptic drugs (AED) aka Anti-convulsants have ODT dosage forms?
Definition
Clonazepam (Klonopin) & Lamotragine (Lamictal)
Term
Levetiracetam (Keppra)-Anticonvulsant-Tx Seizures (OK children)
Definition
Dosage: Tabs, Caps, Susp DI: No Known clin sig DI exist CI: Hypersen, dec dose in renal, D/C slowly red trig seizure, exc breast milk *prgc/lact ADR: common (Somnolence, asthenia, infxn, Dz); Hostility & nervousness PE: DZ or DROWSINESS, **no D/C**
Term
Gabapentin (Neurontin)-Anti-epileptic-Tx Seizures, postherpetic neuralgi
Definition
Dosage: Tabs, Cap, Oral sln DI: ANTACIDS dec bioavail when co-admin CI: ped<12yo not estab, *renal ADR: Somnolence (19%), Dz (17%), ataxia (12%), fatigue (11%), nystagmus -invol eye move(8%), tremor (7%), diplopia(6%),bluvision(4%), rhinitis PE:DROWSINESS, no EtOH, no D/C taper/1wk
Term
Topiramate (Topamax)-Anti-epileptic-Tx Seizures, Migraine PPx
Definition
Dosage: Tabs, Sprinkle Caps (also in Depakote)
DI: Add CNS depress w/ EtOH or CNS dep, inc metab of estrogens, inc [metformin], *wk CA inhib avoid use w/other CAI, [dec]w/pheny & CBZ, [inc]HCTZ, co-admin w/Valproic acid=hyperammonemia
CI: HOChloremic, non-anion gap Metab acidosis (dec in Bicarb), acute myopia ass w/ 2nd an clos gluacoma, eye pain=withdraw gradually of Topa., PregC., Carbonic ANhy IN = possible kidney stones
ADR: common dose dep(Dz, nervousness,diff w/concen, confusion, diff concen, depres, anorexia, wt dec); dose indep (somnolence, dz, atax, speech diff, psycho, slow, abnorm vision, diff w/mem, paresth & diplopia)
PE: TNR Food, DROWSINESS, no EtOH, PCP if pain,blurr vision, keep hydrated reduce risk of kidney stones, Sprinkle 1 Tsp of soft food & Swallowed ASAP, not chewed
Term
Clonazepam (Klonipin CIV)-BZD-Antiepileptic-Tz Lennox Gastaut Syndrome
Definition
Dosage: ODT, Tabs DI: Additive eff w/CNS dep & EtOH CI: Hypersen, liver dx, <60 m/5yo, nangle clos gluac,unTx open-angle gluc, man inc granmal seiz & suicideal ideation, no D/C, inc salivation :.*w/chronic resp dx ADR:DROWSINESS(50%), ataxia (30%), and fatigue PE: DROWSINESS, no EtOH, WARNING: MAY BE HABIT FORMING; no D/c
Term
Phenytoin (Dilantin, Kapseals-ER version)-Tx Tonic-Clonic Seizures & Psychomotor Seizures during or post surgery *also used in peds; MOA: Sodium extrusion from neurons/myocytes
Definition
Dosage: Caps, Inject DI: [Inc] w/AMIODARONE, CHLORAMPHENICAL, CIMETIDINE, DISULFURAM, ISONIAZID, ORAL ANTICOAGS, SULFONAMIDES, FLUCONAZOLE, TRIMETHOPRIM, phenacemide phenybutazone;[dec]w/ diazoxide, folic acid, RIFAMPIN, SUCRALFATE & theophyllines; ANTINEOPLASTIC may dec axn; dec [CBZ]; inc axn by valproic acid; Hepatox w/APAP, inc metab of corticosteriods, DISOPYMIDE, doxycycline, metyrapone, mexiletine, quinidine, and THEOPHYLLINE. Dec axn of cyclosporine, levodopa, ORC, & nondepol muscle relaxants. Inc serum levels of primidone. Serous HOTN w/dopamine infusion
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