ÐÏࡱá>þÿ prþÿÿÿmnoÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á7 ø¿žebjbjUU &Ö7|7|J½ÿÿÿÿÿÿlÌÌÌÌÌÌÌàòZòZòZ8*[4^[$à°zŽ\ ˜_®_®_®_®_0Þ_ú_«««««««$—± ·³Œ6«¡Ì `®_®_ ` `6«¥ÌÌ®_®_ׯ¥¥¥ `ð.Ì®_Ì®_«¥ `«¥ž¥¢¥Vœª@ÌÌ«®_‚\ pî¡" UËàWòZúŽÖܪ(«í¯0°« C´Ð¤4C´«¥ààÌÌÌÌÙDrug list for NPLEX 2 This list is NOT all inclusive of what is on NPLEX, but will likely have many NPLEX answers in it. I wrote this study list before taking NPLEX II examination. This list in no way tells people what specific questions were on nplex list, This list is based upon the 2009 NPLEX drug list, which may have been updated. Ignore numbers on left hand side CARDIOVASCULAR Hypertension and arrhythmia drugs ----OLOL = Beta blocker ’! have exercise intolerance as side effect, don't give to young athletes ----PRIL = ACE inhibitor lowers: Na increases K ----SARTAN = ARB (angiotensin receptor blocker) lowers Na Increases K ----reserpine = lowers catecholamines which lowers blood pressure (won't cause depression unless pts catecholamine are all ready low) all the rest are Ca channel blockers Be aware of what HTN drugs raise and lower K+ (will ask what can/can't be given w/ licorice) Amlodipine: long acting Ca+ channel blocker tx: HTN, ch stable angina and vasospastic angina Amiodarone ’! Beta blocker for ventricular arhythmia 1 very long ½ life ’! used to make fatal arrhythmias go away, good emergency drug don't want to go home w/ perscription ’! get sick is on it long term, LV, edema and 1 out of 10 ’! lung toxicity and die Atenolol and Metoprolol ’! Beta 1 blockers for HTN 3 enhance effect of digitalis (if combined will cause bradycardia) its so strong that hypotension is side effect when 1st put on it decreases cardiac output and renin release low beta-1 receptor side effects Clopidogrel and ASA ’! reduce risk of MI and stroke 5 ’! GI distress, bleeding, tinnitus, occult blood clopidogrel is used to lower chance of cardio event, but is really just expensive ASA Celocoxib ’! expensive cox-2 less GI distress than ASA, less GI distress than ASA, gas, D/ abd pn Digoxin ’! ST scooping, yellow halo around vision, blurred vision, 6 can monitor blood levels with blood test ’! used for CHF, paraoxmal atypical tachycardia, a-fib, a-flutter for CHF or the atrium ’! monitor serum levels ’! steady state achieved in 1  2 weeks Doxorubicin ’! causes cardiomyopathy (give carnitine and CoQ10 w/ it to prevent ht dz) Is an abx that used in chemo for leukemia, hodkins and many other ca's dont take w/ NAC 7 Enalapril and Lisinopril ’! ACE inhibitors may cause scalded mouth syndrome w/ metalic taste, angioedema, neutropenia 9 lowers Na and increases K dry persistent cough side effect ’! so may need to switch to a & .sartan ACE inhibitors and ARB's have same effect, except the ACE inhibitors have bad cough side effect. If a pt can't hanle ACE inhibitor, give a ARB other side effects: tachycardia, hypotension, uticaria, renal dysfxn, h/a Don't give in pregnancy ’! fetal abnormalities and death 2cd/3rd trimester HCTZ (hydrochlorothiazide) ’! distal tuble dieurtic (so it is weak diuretic) 11 the entry level diuretic. TX htn and edema w/ focus on HTN Sulfa drug and allergy sensitivity side effects: hypokalemia and hyperglycemia (so watch blood sugar) raizes serum Ca+ ’! indicated for osteoporosis can induce DKA in type I DM (just as steroids do) can be used (as can a low Na+ diet) for tx of menires dz Isosorbide monitrate ’! is a amyl nitrate ’! tx's angina prophylactically 13 side effects: throbbing h/a dizziness hypotension, tachycardia, bradycardia antidote for cyanide poisoning Hypotension when combined with sildenfil (ED medication)* Furosemide ’! loop diuretic (loop is stronger than distal) stronger than HCTZ 14 tx Edema and HTN w/ a focus on EDEMA side effects (hypokalemaia, hyperglycemai, just as HCTZ) ototoxic and hypovolemia (Watch for hearing loss) drops K+ quickly ’! hearing loss K+ levels drop unless supplementing w/ k+ must supplement thiamine (reduces B1 just as the herb equisteum) Losartan and Valsartan ’! ARB (angiotension receptor blocker) ’! use if ACE give cough side effect 16 side effects: hypotension, RENAL dsyfxn and hyperkalemia (the other side effects are same as ACE inhibitors enalapril and lisinopril) The ARB's just don't have lung side effects Nitroglycerin ’! used to tx angina (acutly) 21 side effect: h/a, dizziness, hyptension, tachycardia, bradycardia, rash (from vasodilation?) used topically for raynauds Propranolol ’! B1 and B2 blocker, many side effects because it's a nonselective Beta-blocker 22 abrupt discontinuation ’! tachycardia and rebound htn b/c it blocks so many recpetors B2 blocking action in lungs ’! asthamatic and bronch-spasm NEVER GIVE TO AN ASTHMATIC pt May mask hypoglycemia, so be cautious in diabetic pts Propafendone: anti-arrythmic drug only for pts who without heart disease treats: paroxsmal a-fib/a-flutter paroxismal suprventricular tachycardia Rauwoulfia serpentina: depletes catacholamines ’! tx essential htn 23 do not give in 2 weeks of giving a MAO (not sure if on nplex) on NPLEX just don't give to depressed pts, otherwise it's OK side effects would be low epi/nor-epi ’! drowsiness, sedation, nervous, depressed, low HR, nasal congestion, N, D, JUST THING PARA-SYM dominance by closing the afferent arteriole to glomerulus is renal protective Spironolactone ’! aldosterone antagonist, K+ sparring diruetic 24 hyperkalemia and HORMONAL affects (breast deformity and tenderness steroid hormone antagonist ’! collateral steroid damage) also used to tx PCOS and hirsuitism Trimterene ’! K+ sparring diuretic (works on distal tuble) 25 side effect is hyperkalemia (so combined w/ HCTZ to have on drug raise K+ and the other lowers K+ so the effect balances out may turn urine blue Verapamil, Diltiazem, amlodipine ’! Ca++ channel blcokers 28 tx angina, htn, afib and a flutter Given for angina b/c they lessen demand on ht for Oxygen and better than all the side effects of the nitrates (atropines) side effects: constipation, CHF, edema, N, ha, weakness, according to ndolc ’! GERD blood sugar, lipids and hyper coag drugs Ezetimibe 10 decreases cholesterol and fat soluable nutrient absorbtion in gut often given w/ statins (or combined in same pill) Gemfibrozil ’! decrease production of TAGs side effects are myositis, and ^LV enzymes, reversible when discontinued ’! do not give in LV and renal failure dz drug interaction: Statin drugs: Concomitant administration of fibrates (including gemfibrozil) with statin drugs increases the risk of muscle cramping,  HYPERLINK "http://en.wikipedia.org/wiki/Myopathy"myopathy, and  HYPERLINK "http://en.wikipedia.org/wiki/Rhabdomyolysis"rhabdomyolysis. Glyburide ’! stimulates insuline release, inhibits glucose production 35 don't give is sulfa allergy (is in sulfonylureas catagory) Heparin ’! intrinsic angi-coag, used in hospitals ’! prevent DVT 12 ’! given IV, for quick anti-coag effect be concerned about LV,chills, pruritis and so on when come out of hospital Diathermy reduces effectiveness of anti-coags Lovastatin, Simvastatin, atorvastatin ’! check ASTa dn ALT prior to Rx and 6 weeks after 19 if muscle pn then discontinue metformin ’! use to tx PCOS, can tx PCOS as hyperglycemia *Diarrhea and Naussea are big side effects Niacine ’! tx hyperlipidemia ’! give w/ B complex and vit C to avoid hepatic effect 20 raizes HDL, lowers LDL, give other B's b/c B imbalance injures the LV Warfarin ’! vitamin K antagonist (factors 2, 7, 9, 10) 29 interaction w/ vit Ea dn EFA, bromelain, garlic, onion or anything else that will  thin the blood on NPLEX ’! thrombosis, rheumatic ht dz, embolism, ischemic ht dz ’! out pt anti coag of choic ’! causes some bleeding and purpurea ’! must change diet slowly but no sudden changes ’! can slowly adjust warfarind, if suddenly don't eat veggies then will bleed Hormonal, endocrine, gyn (not homones) Alendronate and risedronate ’! bisphophonates 31 ’! need to sit or stand for 2 hours after taking b/c tears down mucous membranes ’! jaw necrosis take ½ an hour before breakfast with a lot of water* Calcitonin ’! spray for severe osteroporosis or bone pn related to ca 32 blocks ca++ excreation in kdy's must monitor Ca++ and vit D status b/c if hyp-calcemic they can't get Ca++ out of bones give vit D and Ca with it. Clomiphene stimulates the release of hormones needed to cause  HYPERLINK "http://www.webmd.com/hw-popup/ovulation"ovulation. 170 Clomiphene therapy is typically used for 5 consecutive days early in the  HYPERLINK "http://www.webmd.com/hw-popup/menstrual-cycle"menstrual cycle, for 3 to 6 monthly cycles clomiphene challenge test, which is sometimes used to evaluate a woman's ovulation and egg quality ( HYPERLINK "http://www.webmd.com/hw-popup/aging-egg-supply"ovarian reserve). When given early in a woman's menstrual cycle for 5 days, clomiphene elevates a woman's follicle-stimulating hormone (FSH) level. On the next day, an FSH blood level that has dropped back to normal is a sign of a normal ovarian reserve and ovulation. An elevated FSH is a sign of low ovarian reserve. Women with a diminished ovarian reserve can use donor eggs, which greatly improves their chances of giving birth to a healthy child. Side effects of clomiphene include:  HYPERLINK "http://www.webmd.com/hw-popup/ovarian-hyperstimulation-syndrome"Ovarian hyperstimulation, ranging from mild, with enlarged ovaries and abdominal discomfort; to moderate, additionally causing nausea, vomiting, or shortness of breath; to severe and life-threatening Clonidine: TX high PB and hot flashes in menopausal women b/c non hormonal, women w/ breast ca hx can use to tx menopause side effect: dry mouth, severe rebound h/a and htn Iodine ’! use high dose to suppress thryroid in hyperthyroidism 39 ’! if I toxicity then pt gets a bad h/a if pt had a thyroid gland ablation, don't let them around children for 10 days or the radiation goes to the children adverse effects: skin, FV, h/a metformin ’! increases cell sensitivity to glucose and stops lv from making glucose rare side effect is lactic acidosis *most common side effect is Naussau 42 Oxytocin ’! stimulates smooth muscle of uterus, 43 used to induce labor and control post partum hemorrhage adverse effects: uterine rupture, subarachnoid hemorrhage, seizure, htn arrhythmia post partum hemorrhage, fetal PVC, and fetal anoxia, distress Propranolol ’! B1 and B2 blocker used to tx hyperthyroidism protects heart from too much thyroid hormone Note: hyperthyroid pts are usually given a B-blocker to protect the heart Over dose of a blood sugar control agent ’! hypoglycemia, only give 1 drug of each category at a time Raloxifene (a serm ’! selective estrogen receptor modulator) 46 give to women a/ breat ca tx side effects: hot flashes, arthralgia, myalfia, peripherally go into menopause it binds to estrogen sites, but keeps E acticvity going on bone Raloxifene given after breast ca thromboembois is a big side effect Rosiglitazone ’! a thiazolidinediones ’! targe cell sensitivity to insulin and improve resistance 47 caution giving in LV and CV dz used to tx NIDDMa dn PCOS similar to metformin Trastuzmab: HERA metastatic breast CA ’! lead to cardiomyopathy Hormones (sorry if this part is a bit confusing, needs some editing, not sure what they want you to know, questions where more general and not specific about which exact estrogen or progestin) DHEA –> tx Alzheimer, asthma, depression, RA, anti aging, CV dz 33 don't give with some hormone sensitive tumors Thyroid ca may be E responsive (so don't let anyone with thyroid CA or suspected thyroid ca take this) Conjugated estrogens: NEVER ever give unopposed Estrogen else risk chance of endometrial cancer always give progresterone with estrogen Ethinyl estradiol; ==? fat soluable ’! when absorbed by patch through skin avoids 1st pass LV metabolizsm Estradiol ’! don't give if smoke ’! thromboembolis, watch for TIA or stroke combination OCP: take actitve pills 21 days and placeobo 7 days and will get withdrawal bleeding during hormone free interval Estradiol (Bi-est/tri-est) ’! may have lest risk thatn conjugated estrogens 171 Acetaminophe and ascorbic acid ’! may increaes ethinyl estradiol [plasma] Statin's may increase [plasma] Hypericum, anti fungals Azoles... carbamazepine, phenytoin penicillins, tetracyclines ’! may decreased effectiveness of OCP young women on pill and smoke ’! embolism medroxy-progesterone ’! IM injection given 1st 5 dyas of menes and repeated q 3 months acne, hirsuitism, weight chagne used to tx endometriosis, abnormal menstrual bleeding or amenorrhea. Birth defects if used 1st 4 mo of pregnancy Do not give this in pregnancy used to tx: endometriosis, amenorrhea Norgestimate ’!  GEST in name ’! is a progestin norgestimate is P combined w/ estradiol for birth control norgestimate is used for menopausse use for contraception and endometriosis may have breakthrough bleeding Norelgestromin is a molecule used in  HYPERLINK "http://en.wikipedia.org/wiki/Hormonal"hormonal  HYPERLINK "http://en.wikipedia.org/wiki/Contraceptives"contraceptives. This form of progestin is used in the contraceptive patch, Ortho Evra. Progestin only ’! thickens cervical mucous and lowers midcycle FSH/LH will have  GEST or  DRONE in name progestin only ’! given to nursing women can conceive if miss only 1 dose\ may cause acne and hirsuisim carefully monitor blodd glucose in preDM and DM pts ’! norgestimate, norelgestromin and medroxyprogesterone can all be used in OCP norelgsetromin ’! in the patch norgestimate is also combined w/ estradiol ’! tx menopause medroxyprogesereone (form of progestin) ’! tx endometriosos, and bleeding abnormalities. Progestin ’! will suppress ovulation 44 used to tx DUB, contraception, secondary amenorrhea endometrial or renal ca side effecs: depression, thromboembolism, pulmonary embolism amenorrhea, rash acne, hirsuitism, weight changes NPLEX progestins are norgestimate ’! generally used w/ estrogen Drospirenone ’! used in coumpound OCK will cause hyperkalcemia (spirolactone analog) medroxy-progesterone ’! give q 3 mo. IM increase LDL, cause acne and more hair Norgestromin ’! used w/ estrogen in  the patch , 3 weeks patch, 1 wk no patch withdrawal bleeding 4th week (the wk w/o patch) can use high dose progestin to abort up to 72 hrs a/ conception Progesterone: 45 progestin withdrawal test to see if amenorrhea is 2cd to luteal defect ’! give lots of progestin and if bleeding there is a luteal defect used to tx DUB, HRT and leuteal defects hydrocortisone = ¼ of same dose of pregnisone 37 used: inflammation, adrenal insufficiency adverse effects: adrenal suppression, osteoporosis, skin atrophy, glucose intolerance growth suppression has more mineralcorticoid effect than prednisone *’! unilateral hip pan ’! in young people w/ ch streoid use from ch inflammatory dz ’! long term use of steroids ’! clots and tesnt to emboli from femur in other words, avascular necrosis of the hip ’! prednisone is the same, but know abrupt withdrawal may be fatal! Insulin 38 common questions: what are sort or long acting insuling What do you give if fingerstick is at 600 glucose ’! answer is the shortest acting insulin long acting insulin are used to cover pt during non meal time ---> inject morning and evening and lowers how much they take w/ meals if type I dm is going unconscious ’! did they inject insulin and then not eat? ’! if so give them sugar and get them to walk Short acting (emergency) insulins: humalog, novolog, humalin R novoin R, glulisin, semilente intermediate insulins: humulin N, novoin N, lente long acting insulins: ultralentel, lantus, levemir Was not on last NPLEX, but andersen said it usually is, need to know names of short and long acting insulins, so those name are listed here, although blueprint only says Insulins Levothyroxine ’! t4 ’! stead state in 6  8 wekks ’! OD tachycardia, arrhythmia, cardiac decompensation 40 nervous, insomnia, menstrual changes, rash, weight loss Testosterone ’! class 3 drug. All bio-identical T and older T is associated w/ ca Testoserone: legally in same class hydrododone ’! it is a controlled substance. Class 3 drug 48 uses: delayed puberty, androgen deficiency, postpartum breast pn palliative tx for female breast ca adverse effects: pro static hyperplasia, low sperm count, hyperliidemia atherosclerosis, cholestatic hepatitis, hirsutism, hypercalcemia tx: senile osteoporosis, wasting from CA tx USP thyroid ’! some people will develop Ab to it Pain and some random recreational drugs acinominphen (tylenol) ’! can cause acute jaundice max dose is 4g/day, if need more strength combine w/ hydrododone (vicodine) (must know all about acinominphen and doses, many pts on cases will be on it know make doses and effects of OD, both acute and chronic) 23 NAC is antidote in high dose never take w/ ETOH since toxic dose is 7 – 10 g #1 drug cause of LV failure dis regulates hypothalamus drive to increase body temp central acting pn medication stops bile conjugation pathway ASA ’! salycism ’! simlar to cincohism ’! tinnitus, hearing loss, vertigo, 26 low pt and thrombocytopenia recall: don't give ASA if had a seizure ’! reyes syndrome ’! encephalopathy and fatty degeneration of LV must know all about ASA, just as w/ acinominphen, even if there is no direct question on these drugs, many NPLEX pt cases will have pt's on these, so need to know if it is or not a factor in each case. Benzocaine: is the active ingridiant is OTC anastheic oinments Cannabis ’! releases dopain ’! opiate ’! revoves gaba inhibition ’! less blood flow to brain ’! less atttenion, memory and impaired learning Carisoprodol ’! a muslce relaxer ’! acute painful Musculo/skeloto conditions 42 drowsy, dizzy, hypotention etc... don't give w/ CNS depressants including ETOH don't give to children Cocaine ’! blocks reuptake of dopamine, norepi and serotonin can induce sinus tachycardia, and lots cocaine causes glaucoma Capsaicin ’! depletes substance P ’! never use on mucous membraines or EYE ’! topical for pn associated w/ HSV, neuralgia, DM neuropathiy, OA, RA stinging or buringing pn upon application and may irritate codeine is the weakest opiod  > if totally OD on it ’! respiratory distress Hydrocodone is next strongest opiod oxycodine ’! moderate to severe pain opiods cause sedation and resp distress are para-sympatholytic tolerance may develop slows down GI ’! N/V/constipation many of these are combined w/ acetaminophen or ASA Tramodol: synthetic codenine analog w/ lower opoid affinity ’! centally acting for moderate and severe pn, neuralgia, trigen-neuralgia will lower seizure threshold Cyclobenzaprien ’! for muscle spasm long ½ life, drowsy, dizzy, syncope, slow ht, etc don't use for longer than 2  3 weeks ’! lowers LV FXN anti-muscarinic side effects Fentayl: only give to pt who was alread on a weaker opiate ’! else cause resp depression, dizziness and aphasia. Patch is 80X stronger than morphine Ibuprofen ’! monitor blood levers for toxicity when used w/ digoxin, Lithium or anti-coagulants so know can check blood levels Don't ever use a NSAID w/ ashthma may be asked for dosing of this (also acetaminophen and ASA) Methyl salicylate (salicylic acid) ’! topical anagesic MDMA (ecstasy) ’! sudden realease of all serotonin, sudden cardiac death Naproxen ’! NSAIDS ’! better tolerated than ASA Pregabalin ’! originally for DM periphearlly neuropathy and post herpetic neuralgia, this seizure drug is now used for Fibro myalgia ’! blurred vision, weight gain and thinking abnormally peripheral edema and exercise cautiously is also an atypical anti-seizure drug and good for general anxiety Sulfasalazine is a  HYPERLINK "http://en.wikipedia.org/wiki/Sulfa_drug"sulfa drug, used primarily as an anti-inflammatory agent in the treatment of  HYPERLINK "http://en.wikipedia.org/wiki/Inflammatory_bowel_disease"inflammatory bowel disease as well as for  HYPERLINK "http://en.wikipedia.org/wiki/Rheumatoid_arthritis"rheumatoid arthritis. Rapid discontinuation ’! toxic megacolon Sumitriptan ’! for vascular h/a 164 acute attacks w or w/o an aura don't give if hx of ischemic ht dz Tramadol ’! centrally acting synthetic opioid seizure risk if pt taking SSRI's, TCA or other Opioids adjunct to NSAIDS in OA post op dental CA and acute M/S pn GI Atropine ’! is a parasympatholytic and used to treat diarhea para-sym-lytic. *belladonna herb may also be to tx Diarhea (remember, NPLEX assumes you have a dispensary full of toxic herbs, and you will use them for some questions) 51 side effects: constipation, abd pn or distension and nausea, + many others Bisacodyl ’! is a true motility stimulator 52 for constipation ’! do not mix w/ milk or antacids b/c it can prematurly dilute the enteric coating of the tablet Docusate ’! DO NOT GIVE WITH WARFARIN  > will decrease warfarin effect 53 soften stool. TOXIC ’! with concomitant mieral oil use HCL ’! dont give to a pt w/ an ulcer. OD will damage esophageal and stomach epithelium 54 Hyoscyamine ’! belladonna alkaloid ’! from hyoscyamus niger 55 tx D ’! less sweating, less GI motility, less saliva, less bronchial secration VISION CHANGE dn pupillary dilation. Basically like belladonna tict. Loperamide ’! acts directly on intestinal muscles to inhibit peristalsis and prolong transit time 56 Hepatotoxic in h igh doses. Other effects ’! constipation, dry mouth, abd pn, skin rash Metoclopramide ’! for short term use only 57 Centally acts as an anti psychotic ’! low dose it ups transit time and less stomach reflux B/c moves thigs out of GI it is used w/ opiates (to couter the slowing down effect of & .opines and decreases N/ and constipation) side effects ’! extrapyramidal Milk of magnesia (saline) ’! draws water into lumen ’! use for only short term tx. Can ’! N/V/D Prazole 61 if it ends in Prazole ’! PPI Omeprazole, Lansoprazole, Pantoprazole, Exomeprazole ’! h/a, D, abd pn, vomiting, flatulence, URI, rash think of dysbiosis for a side effect interacts with drugs that require a low gastric pH (but he doesn't list those) Prochlorperazine ’! an anti  DOPA antiemetic 62 Extrapyramidal side effects originally a psych drug, it's now used to tx N/ from chemo Psyllium and guar gum ’! sweels in water to form gel or viscous solution 63 adverse effect is flatus, takes 1  3 days to work Rantidine ’! blocks H2 64 if it ends in idine ’! H2 blocker slows down p450 some small change of CNS and sexual effects, decrease absorbtion of Fe Chelators Ca-EDTA ’! takes out lead ’! neutral ca effect (hypercalcemia?) Deferoxamine ’! for Fe toxicosis (think De  Fe-roxamine, it lowers iron, hence the DE - Fe) don't give w/ vitamin C also tx thalassemai, aluminum toxicosis during dialysis DMPS ’! generally given in IV ’! for Hg poisoning (also detox gold and arsenic) ’! Hypomagnesmeia DMSA ’! same hypomagnesmeia as DMPS ’! lead and mercuery side effects of chelators is arrthmia and MI, less toxic if taken orally Penicillamine ’! chelated heave metels esp Cu 15 may cause sideroblastic anemia INFEXIOUS and some other misc drugs (lots just lumped in here) Acetic acid ’! otic solution for external ear infx ’! cuases ear irritation, urticaria 66 start with a [low] ’! else it'll burn Acyclovir, valacyclover and famcyclovier 67 all are static, not cidal are the anti-virals  > HSV type I and II, varicell, enecephalits ’! N/ and rash are bic acyclover side effects val and famclyclovier ’! metablize to acyclovier in the body use for all herpes EXCEPT ’! CMV Amoxicillin ’! some g+, some g- 68 dental prophylaxix There is a combined amoxicillin + clavulanate bread spectrum, inhibits penicillinases *maculopapular rash is a side effect (also may get from Penicillin allergy) consider cause if child gets a rash over body after getting ABX in hospital Aminoglycosides: tobramycin ’! IV or eye drops, or inhaled, or IM 69 OTOTOXICITY( d/t quick drop in K+), neurotoxic, for g- worsens parkinsons, ototoxic w/ loop diuretics (esp furosemide) don't give to myasthemia-gravis pts Amoxicillina nd clavulanate ’! is also effective Vs B-lactamase organisms 70 use this if Penicillin doesn't work on something EENT infx, esp G+ aerobis, dental, sinusitis, strep and staph, sinusitis Boric acid ’! fungal-static ’! vag candidat ’! kills everything, neet to repopulate vag a/ use Cephalexin ’! NEVER GIVE TO A PENicillin allergic pt 10 - 15% have cross rxn to pen if allergic (will be on nplex) URI, GI, cutaneious, N, D, maculopapular rash, anaphylaxis, serum sickness ’! are side effects it is a broad spectrum Abx Ceftriaxone is a third-generation  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"c HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"ephalosporin. Pnem HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"onia and bac meningitis  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin" NEVER GIVE A PENICILLIN allergic pt   HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"It must not be mixed or administered simultaneously (within 48 hours) with calcium-containing solutions or products, even via different infusion lines (rare fatal cases of calcium-ceftriaxone precipitates in lung and kidneys in  HYPERLINK "http://en.wikipedia.org/wiki/Neonates"neonates HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin" have been described)   HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin" has been mixed w/ lidocaine for IM  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"Cefdinir --> bacterialcidal  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"never give to Penicillin allergic pt  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"semi-synthetic,  HYPERLINK "http://en.wikipedia.org/wiki/Broad-spectrum_antibiotic"broad-spectrum antibiotic HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin" in the third generation of the  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"cephalosporin HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin" class, proven effective for common  HYPERLINK "http://en.wikipedia.org/wiki/Bacteria"bacterial HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"  HYPERLINK "http://en.wikipedia.org/wiki/Infection"infections HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin" of the ear, sinus, throat, and skin.  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"The pediatric version of Omnicef can bind to iron in the digestive tract. In rare cases, this creates a discoloration of the stool to a rust or red color. Some patients may interpret this as blood in the stool, although in reality  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"blood appears dark brown or black in the stool  HYPERLINK "http://en.wikipedia.org/wiki/Cephalosporin"According to the Omnicef website, side effects include "(...) diarrhea, vaginal infections or inflammation, nausea, headache, and abdominal pain  Chloroquine ’! side effect is cinchonism (ha, dizzy, pruritis, neuropathy, seizures, retinal changes ototoxic) ’! to tx malaria and extraintestinal amebias Also tx AI dz Chloroquine ’! cinchonism tinnitus/hearing loss, H/A and N/, dizzyness, vertio, visual changes this one is used for malaria Ciprofloxin and levofloxacin ’! floxacine ’! bread specturm and kills GI bugs can tx UTI's and pyelonephritis  > black box achilles tendon rupture ’! arrest growth plate in children ’! not if under age 18 don't take there w/ milk or dairy Clindamycin ’! causes pseudomembranous colitis as a side effect (C diff overgrowth) used to tx resp infx and good for ppl w/ penicillin allergy Clotrimazol ’! is a topical and oral anti- fungal 81 kills more than just candida and stronger than nystatin N/V, vag buring or irriation, elevated LV fxn tests Clotrimazol is much stronger than nystatin Cyclosporine ’! gout is a side effect (renal toxic) and increased risk colon cancer 82 use in organ transplant pts, RA, psoriasis basically an immune suppressant higher risk of some CA's, lymphoma and skin Cyclophosphamide ’! CA drug, activated in LV, marrow suppression, bladder irritation (cystitis), alopecia, myelosupression also tx AI dz Doxycycline ’! malaria prophylaxis, otherwise use as tetracycline Doxorubicin ’! an anthratracycline ’! use w/ L-carnitine and Q10, don't use w/ NAC cardiac toxicity and alopecia Erythromycin and azithromycin ’! is a macrolide 90  ROMYCIN = macrolide pneumonia and C pneumonia. Erythromycin has more abd pn, N, D and vomiting Azithromycin has less pills to take, so elss side effects DON T GIVE IN PREGNANCY often used if there is a penicillin allergy Etoposide ’! testicular CA, derived from poppophylum 91 HIV drugs 99 NRTI ’! zidoiudine, lamivudine, nevirapine, didanosine, and abacavir NNRI ’! none seem listed Protease inhibitor ’! saquinavir, Idinavir Triple therapy = 2 NRTI's and one of of either NNRI or protease question will be on how to pick Ziovudine (AZT) ’! lowers platlets, megoblastic anemia OK to give to children and adults and preg women for prophylaxis Didanosine ’! NRTI, this one causes pancratitis, must monitor serum amylse dose limiting toxicity is peripheral neurophathy Idinavir ’! side effect is buffalo hump also get man boobs, kdy stones and elevated bilirubin pt must drink 1.5 L water/day when on this drug Lamivudine (also used to tx hep B) Fluconazole (in triazole class) ’! kills fungus 103 AZOLE is an anti fungal, PRAZOLE is a PPI azole will increase liver enzymes primary site of action is in lv, 5 days on and 2 days off topical and oral versions Gentian violet ’! oral candida ’! mouth rinse, may stain skin or clothing 104 DO not use on ULCERS OF FACE or skin--> will tatoo lesions Methotrexate ’! inhibits dihydreofolate ’! stops folate dependant rxn's 6 uses: severe RA, prevent organ transplant rejection cancer chemo, sever psoriasis synergistic toxicity w/ NSAIDs, folate reduces side effects but lowers anti-ca effects teratogenic, difficulty breathing, arrhythmias Metronidazole ’! DO NOT TAKE W/ETOH ’! 7 tx amoeba, trich, giardia, bacterial vaginosis, H pylori #1 abx to shut down lv ’! which leases to uncontrollable violent vomiting causes metallic taste mupirocin ’! for nasty skin or MRSA prophylaxix 10 tx impetigo and MRSA, low adverse effects, B-hemolytic strep can used intra-nasally (stick it up the nose) seems to be a topical Nitrofurantoin monohydrate 11 ’! bad on kdys and fetus ’! one hit wonder for UTI, is kdy excreted (although just need one dose for it to work, widely used for prophylaxis and long term suppression UTI do not give in 3rd tremester ’! causes hemolytic dz of new born don't give if pt has kdy dz, or lower the dose Nystatin ’! for contact dermatis or candida ’! poorly absorbed 12 also intestinal, cutaneous, vag and any surface candida Oseltamivir ’! only for influenza if dosed 1st 48 hrs 13 sx: no gi sx's except in children ^^^FV 10  105 and productive cause Penicillin ’! tx gram + cocci, anaerobic bacteria, syphilis 14 NOT EFFECTIVE ’! B- anaerobes body rash is a side effect of allergy Penicillin G: was on last test (although not on NPLEX blueprint) Permethrin ’! if not given correctly can be neurotoxic to children 16 ’! causes paralysis ’! tx scabies, pediculosis (head lice) adverse effects ’! pruritis, edema, rash, buring or stinging ’! don't want to use incorrectly or it'll poison children Piperazine ’! paralizes worms, which is then passed in stool ascariasis 17 common round worms and pin worm causes resp depression in large doses Silver nitrate: medicine as a cautery and antiseptic prevents opthalmia neonaturum tx severe burns to prevent infx Sulfamethoxazole (if sulf in name ’! folate blocker bacterial static) 18 Sulfamethoxazole/trimethoprim if sulfa allergy do not give these or sulfasalazine (an anti-inflammatory for things like RA) ’! or thiazide diuretic 0r oral DM drugs ’! many potential side effects ’! RASH, SEIZURES, steven johnson syndrome/TEN pneumocystis carinii,travelers's D, main use is for UTI and URI don't use w/ cranberry juice ’! it'll change the pH and interfere (botanical uva usi for UTI should also not be taken w/ vit C or cranbery b/c it'll acidify the urine and deactivate the herb) Tetnus ’! need booster if didn't have in last 5  7 years 19 other vacines, ’! rememeber don't give to a sick child DPT booster is every 10 years Tetracyclin ’! not for use in children under 9 yo ’! teeth 20 susceptible g+ and g- ’! chlamydia and lyme adverse effects ’! intracanial htn, photosensitiiv, increased pigmentation and other common side effects. Causes normal anion gap acidosis (fanconis) chelates out Ca++ (don't take w/ milk or anything w/ ca+ Zn and Fe will also lower absorption Doxycycline ’! same but less nephrotoxic than tetracycline Terbinafine ---> topical and oral ’! for the finger nail ’! still check LV fxn test 21 fingernail onychomycosis and toenail onychomycosis if used orally then lots of side effects, lowers wbc, lv failure, rash, puritis, stevens johnsn Tobramycin ’! mycin = aminoglycoside. 22 Romycin = macrolide tobramycin ’! severe ototoxicity ’! worse toxicity in peds kills stuff other abx don't ’! enterobacter was 1st broad spectrum ’! many death children Must remember is Nephrotoxic, Ototoxic, and Teratogen Vinblastine: an  HYPERLINK "http://en.wikipedia.org/wiki/Mitotic_inhibitor"anti-mitotic  HYPERLINK "http://en.wikipedia.org/wiki/Medication"drug used to treat certain kinds of  HYPERLINK "http://en.wikipedia.org/wiki/Cancer"cancer, including  HYPERLINK "http://en.wikipedia.org/wiki/Hodgkin's_lymphoma"Hodgkin's lymphoma, non-small cell  HYPERLINK "http://en.wikipedia.org/wiki/Lung_cancer"lung cancer,  HYPERLINK "http://en.wikipedia.org/wiki/Breast_cancer"breast cancer, head and neck cancer, and  HYPERLINK "http://en.wikipedia.org/wiki/Testicular_cancer"testicular cancer. Sever myelosuppression Psych and neurology ( because emotions are evil, and you need to be pacified) [this section is super confusing and sub-divided but many drugs used in different ways, so sub-sections are not concrete, just learn basics] Neuro-degenerative diseases Clonidine ’! use to tx touretts Diphenyldramine: can be used prophylactially to prevent acute dystonia (involutary m contrations/spas Donepezil ’! alzeimers dementia can also give phospho-choline Divalproet: to tx absence seizure or is combined wt/ other seizure drugs tx manic and biplar and pn side effects: dark urine and teratogenic Levidopa don't give w/ vit B6 b/c it'll increase peripheral conversion L-dopa/carbidopa for hallicinations and parkinsons don't give with tyrsosine rich foods, and don't give w/ vit B6 Nicotine ’! induce remission in Ulcerative colitis nicotine patch is used to tx torettes Pramipexole ’!1st line for tx parkinsons, and restless leg syndrome Phenytoin Can monitor blood levels, monitor for poorly controlled seizures Toxicity: nystagmus, atasxia, disorientation may cause gingival hyperplasia will lower vit D, B12, folate Vit B6 will lower phenytoin's effectiveness contraindicated w/ breastfeeding d/t vit K inhibition teratogenic topiramate ’! tx epilepsy in adults and in children wil increase Ca-Oxalate and Ca phosphate kidney stones ___________________________________________________________________________________ Anti-depressants  note, many sources list drugs that can't mix with MAO's. As far as I could tell there are ZERO MAO's on NPLEX, therefore you should not be asked any suck question. Serotonin syndrome ’! FV, hyperreflexia, BP change, coma, death Amitriptyline ’! is a tyrcyclic antidepressant 25 used in low dose for ch pn, somnolence is a side effect ’! give it to depressed pts who can't sleep used for pn: post herpetic neuralgia, migraine has anti-muscarinic side effects Cyclobenzapine: a TCA relaxant Bupropion ’! NE and dopa activity so can be used w/ SSRI lowers seizrue threshold!!!! b/c so strong catecholamine release used to help STOP SMOKING, OCD, PTSD is an aytpical anti-depressant Carbamazepine and phenytoin resemble each other ’! they act like digitalis and slows down ht for anti-anxiety OD and they will slow down skeleton muscle can use for absence and myoclonic seizures used in children w/ cerebral palsy #1 choice for trigemian neuralgia trough sample required, steady state after a few days Citalapram: anti depressant for use in alcohoics and depreassts wts w/ tardive dyskinesia (used when can't use a TCA such as amitryptiline, because this one won't aggrevate tardive dyskinesia) Hypericum ’! does slow down p-450 as does barbiturates, glucocorticoids, and phenytoin  remarkable w/ birth control altered menstrual flow, bleeding, and unwanted pregnancies in women taking birth control pills and St. John's wort at the same time Nicinamide ’! this is used for deperession Venlafaxine, Duloxetine, citalopram (causes more jitters than venlafaxine) 168 ’! serotonin and norepi inhibitors (SNRI) give tryptophan and tyrosine if weaning off Diastolic HTN is venlafaxine side effectiveness contra indicated in pregnancy and glaucoma H1 blockers Cetirizine, Loratadine and fexofenadine ’! are H1 blockers that are non sedating used for allergies (not really part of this section directly, but must be able to contrast with the sedating H1 blockers) Diphenhydramine and promethazine ’! sedating H1 blockers Diphenhydramin is benadryl dose for emergency: Never use these w/ other anti-ach drugs such as oxybutin or tolterodine Diazepam, Alprazolam, lorazepam ’! are the benzodiazepines don't mix with ETOH very addictive, hard to take off Alprazolam: contraindicated in narrow angle glaucoma, increases concentration if taken w/ ETOH, graprefruit, sedation herbs Diazepama nd Lorazepam: 1st line for status epilepticus Anxiety (not anti-depressive mood disorders) and other's not sure where to put Buspirone ’! anti  anxiety, takes 1 month to start to work non addictive have bad rebound effects when coming off side effects ’! hypotension, lightheadiness, constipation also tx ADHD, smokinga nd ETOH withdrawal, HTN, pn, insomnia Gabapentin ’! tx mania ’! isn't metabolized by LV, all by the KDY carful in kdy disease will tx post partial seizures if less than 12 y.o. glycine ’! extreme caution in BIPOLAR ’! triggers mania 150 helpful for anxiety, wound healing and muscle spasm Lithium Can monitor blood levels common side effects: thyroid, renal and hematological change toxic effects ’! N/D/V neurological deficits and coma can't concentrate mind, and also low ADH serum and toxicity levels do not correlate at all times, caused by high variability must do a TSH on these pts Respiradone ’! in the benzisoxazole class 162 Doesn't say much about, just that it is neuroleptic LV damage and need to do slow withdrawal risperidone ’! Extry-pyramydal side effects Temazepam ’! immidiate release benzodiazepine Quetiapine ’! hypotension is common side effect Olanzapine ’! weight gain common side effectiveness Rispirdone, quetiapine and olanzapine are the 3 nplex anti-psychotics) Progesterone ’! stimulates gaba I the brain, so can have relaxing effects Propoxyphene  analgesic, for restless leg syndrome, opioid withdrawal OD ’! resp depression, peripheral edema, stops peristalsis and induces vomiting Prochlorperazine ’! is a neuroleptic drug, used to tx N/ of chemotherapy/CA other neuroleptics ’! respiradone, quetiapine, olanzapine neuroleptic drugs ’! adverse effects: tremors, tardive dyskinese and belladonna like effects. Neuroletptic = antipsychosis or for schizo Prochlorperazine ’! extrapyramidal rxtsns tardive dyskinesia (involutary repetative movements), low bp and belladonna like is a dopamine blocker and slows down brain upper spasm or like really sea sick Lamotrigine ’! 2cd line mood stabilizer and is an anti-convulsant for epilepsy and bipolar side effects: blurred vision, stevens johnson syndrome, GI ___________________________________________________________________________________ Sleep clonazepam ’! many patients will be using this for insomnia, anxiety and sometimes drug detox eszopiclone ’! non benzodiazapam for sleep Ramelteon ’! expensive melatonin Trazadone and Nefazodone’! given to depressed ppl for sleep 165  > bad round insomnia from withdrawal as hard to get off as other serotonin drugs, but not an SSRI trazodone nly ’! priapism is rare side effect Zolipidem ’! sleep ’! non immidieate release non benzodiazepine 2  3 hour ½ life RESPIRATORY (must know what are for acute attacks and what are taken ch. To prevent attacks) Albuterol ’! acute ashtma, last 3  4 hours contra- idicated if pt has DM (as a beta-2-agonist will increase insulin release) use ipratropium if intoleratnt of B-2-agonists Amphetamines ’! release nor-epi ’! use for ADD, parkinson's, narcolepsy Atropine ’! in emergency, give after epi b/c epinephrine doesn't last long emergency bronchodilator Beclomethasone (topical and inhaled) and trimcinolone (topical, inhaled and injected IM) tx: astham, allergic rhinitis, drug transfusion allergies osteoporosis is most common sterod side effect classic cushings side effects may cause hyperglycemia and hyperkalemia Cromolyn sodium ’!resp prophylaxis only ’! take 3  5 X/day to work throat irritation Diphenhydramine ’! allergic rxns d/t type 1 allergies or for insomnia Don't mix w/ ETOH or valium ’! somenlence lowers platltes and WBC's don't really want to give to depressed pts Dextromethorphan ’! anti-tussive commonly found in OTC cough medicine formulas side effect is vomming Ephedra ’! stimulates alpha-1 ’! bronchdilation for asthma and nasal congstion ’! similar to amphetamiens Epinephrine ’! effects all alpha and beta ’! open lungs can cause siezure if have a seizure disorder us for anaphylactic shock severe bronchoconstriction ’! acute inject IM or inhaled for anphalactic shock ipratropium ’! ATROPA ’! prophylaxis  > is like inhaled atropine not for acute Montelukast ’! athma prophylaxis will increase liver enzymes, cause h/a and dyspepsia leukitriene receptor antagonist Boswelia may potentiate such drugs Mometasone ’! prophylaxis for asthma and season allergies/perenial allergic rhinitis used as a topical creamfor eczema and psoriasis Non sedating H1 blockers ’! use for allergic rhinitis fexofenadine and loratatdine, and cetirizine don't mix fexofenadine w/ erythromycin and m/b not w/ azoles Oxymetaoline  alpha-1-agonist ’! decongestant spray (OTC) ’! withdrawal side effect is rebound conjection Promethazine ’! used for N/ and to calm ppl down. Highly brain absorbed (sedating) 196 blocks vomit center Pseudoepedrine ’! decongestant ’! interacts w/ antihypertensive meds ’! causing htn rebound withdrawal conjestion salmeterol ’! long acting B-2 agonist ’! tx asthma, COPD, emphysema Salemetrol xinafoate powder ’! use b/f exercise for exercsie asthma increaed risk of asthma related death from forgetting dose and rebound asthma salemetrol is a long acting B2 agonist ’! ch use only side effects ’! cardiace sens and infx Steroids ’! anything that ends in sone, onide or zone ’! is for asthma maintenance, never acute 200 fluticasone and Budesonide ’! inhaled steroid DERMATOLOGY Hydrocortisone ’! for inflammation and anti -itch 100 side effect is that it thins out the skin strong anti-inflammatories ’! triamcinoline ’! last longer and more potent thatn hydrocortisone ’! inhaled and intransal version for asthmatics niacinamide ’! 3-%% topical for acne isotretinoin ’! very hard on LV, teratogenic ’! must have neg PG test severe acne vinegar/h20 ’! rinse off body louse steroids ’! give for brown recluse spider, fiddle back in south east us 201 (painful bite ’! red then swells, then dusky, necrotic over 7 days, eschar sheds in 3 weeks. Systemic h/a, FV, rash may be allergic to bite possible sequlae of tissue destructive venom nail fungus ’! tinea unguim ’! tx w/ fluconazole acne ’! tetracycline UROLOGY, men's health Allopurinol ’! gout and hyperuricemia ’! adverse effect include rash and stevens'johnson syndrome monitor blood levels for toxicity when used w/ digoxin, Li+ or anti-coags Given to CA pts on chemo to prevent increase in uric acid and thus, prevent gout inhibits hepatic enzymes ’! hepatitis monitor blood levels for toxicity when used w/ digoxin, lithium or anticoagulatns hydro - Chlorothiazide ’! is a SULFA allergy drug tx htn and edema furosemide also htn and edema both of these hyokalemia and hyperglycemia furosemide would be more for bad edema Colchicine ’! acute gout or maintenance thereapy. May cause aplastic anemia, don't give in LV, renal, or GI dz ’! low therapeutic threshold ’! pt will slowly did over 3 days, no antidote so must dose carfully don't give if CV, LV, KDY or GI dz Oxybutynin (short term use) and tolterodine (use chronically) ’! anti muscarinic (belladonna like) agents for bladder control (people just keep on peeing, will relax bladder, to hold more) could also just give tincture of belladonna don't give if glaucoma Hyoscyamus ’! atropine containing herb ’! can use for bad D/ Interstitial nephritis ’! acute associated w/ abx: Penicillin, less urine, w/ blood in it, and FV, edema Phenazopyridine hydrocloride ’! tx pn with UTI Question: know that it interferes w/ urinalysis, so don't let pt take it before they come in and get tested cause h/a, N/, rash local analgesic derived from coal tar tx pn of UTI, just need to give 1 does (however MD uses is prophetically) red/orange urine and GI irritation (don't give before collecting a urine sample b/c it will contaminate, give only after) hemolytic anemia, jaundice w/ long term use Sildenafil ’! for ED *(will lead to hypotensive crisis is cobined with isoboride) side effect ’! quick drop in BP and death ED supplements (arginin, Mg, Zn+) Tamsulosin: alpha-1 agonist used to tx BPH Emergency medicine must know dosing of epi and benadryl must know oxygen masks must know dosing of ASA and acetaminophen end notes misc ibuprophen, ASA ’! can cause a rebound H/A is going off ASA ’! makes pn of osteoma feel better (osteoma worse w/ ETOH) NEVER mix ETOH / Barbiturates / Benzodiazepines !!!!!!!!! OCP ’! may need tup up thyroid hormone dose Latanoprost ’! for glaucoma or ocular htn by reducing intraoccular pressure carbamazepine ’! drug of choice for trigeminal neuralgia temazepam ’! for short term depressio, only 7  10 days dextromethorphan ’! anti-tussive, works by affecting the brain Titropium bromide ’! 24 hour tx of COPD, is a broncho-dilator piperazine ’! kills worms pregbalin ’! anti-seizure, pn from dm neuralgia or herpes nitrofurantoin ’! abx to tx UTI's calcitonin ’! for osteoporosis and paget's dz DHEA ’! does tx SLE diclofenac ’! for the pn of RA and OA hydroxyzine ’! ch uticaria and dermatitis Albuterol is for acute and ch. Bronchitis clonidine ’! tx high bp and hot flashes in menopausal women Diclofenac ’! tx pn, dysmenorrhea, ocular implantation, OA, RA, ankalizing spondylitis, actinic keratosis TX Fe toxicity w/ activated charcoal triple abx therapy = bacitracin, meomycin, polynyxin B, for topical cuts tx minor cuts, burns fluticasone ’! steroid for asthma and allergic rhinittis and in cream for exzema/psoriasis topiramate: tx epilepsy in adults and children also is and anti-depressant?PTSD hydroxyzine ’! is a sedating H1 antagonist, tx ch urticaria, dermatitis and histamine mediated ithching.  PAGE 1 f j  Þ001À4Â4&5(5*5:5<5L5N5¾5À5Â5Þ5à5|?Š?œ?ª?¥B¦BÚBÛBÜBåBæB6C7CqCrCsC‚CƒC C¹CDDADBDCDRDSD4F5FF‚FƒF›FœFWWò[ö[­\¯\È_ä_``x`z`|`Œ`Ž``’`ýýûöîöëööãöëößßö×öëööÏöëöÍöÅöëöö½öëöýýýÍöµöëööjÔUjãUjU5jGUj†U5\j½U0JjU jU>*H*Gy¶Rs‚¤¥Ât j‘¶  @ s t h ¸   j ö € õõõõõõóóóóóóóóóóóóóóóóóóóóóó &dPÆ~eœeýý€ Þ (*ú’¶¸ò‚„ bæ–˜DÖüTð,ÀZì† ýýýýýýýýýýýýýýýýýýýýýýýýýýýýý "º:†tÞXZêŠÌDFà2¨X²8 : ´ !€! 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½J½X½[½333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333"&yRI½J½T½[½ÿÿSaulFC:\drsaulmarcus internet files\img\pharmacology for NPLEX 2in word.docÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÆ°ÿÆ@ÿÆÐÿÆ`ÿÆðÿÆ€ÿÆÿÆ ÿÆ0 Æ“OJQJ^J·ð ÆVOJQJ^J·ð Æ OJQJ^J·ð ÆÜ OJQJ^J·ð ÆŸOJQJ^J·ð ÆbOJQJ^J·ð Æ%OJQJ^J·ð ÆèOJQJ^J·ð Æ«OJQJ^J·ðÆÐ.Æ8.Æ .Æ.èÆp.ÆØ .Æ@ .ƨ .Æ.ÿÿÿÿÿÿÿÿÿÿÿÿÿÿWW8Num2WW8Num3ÿÿÿ@€QQx<:Qyœ¥¥    &'()+,./1$2$3$6$7$:$>$@AAABCDFNPQRUWX[\]aklnopqstuvwz{€‚ƒ…‡‰¥Š¥‹¥¥¥’”•–d—d™dšdždŸd¢d£‹¤‹¥‹§‹¬‹¯‹°‹±‹µ‹·Z½`@``@` ```````` `"`&`*`,`.`0`2`4`8`„@`H`J`L`N`R`¨@`V`X`¸@`^```f`h`n`v`ô@`|`ü@`€`‚`†`–`š`œ`ž`¤`¨`ª`°`²`´`x@`Æ`È`Ì`Î`Ð`Ò`Ö`Ø`Ú`Ü`Þ`ä`æ`ð`ô`ö`ô@`ü`@```` `@````0@``` `(`*`0`d@`4`6`:`D`J`L`N`V`ZÿÿUnknownÿÿÿÿÿÿÿÿÿÿÿÿGï:àAxÀ ÿTimes New Roman5€Symbol3& ÿ:àCxÀ ÿArialO& ÿ€k9¿Lucida Sans Unicode5& ÿ:á[`À)ÿTahoma=¯€êìOpenSymbolBˆÅh/%×ÆÔ{éfaœOƒL¬FÕ’Î[!20¬¿Ùìqÿÿ"Drug study guide for NPLEX clincal Saul MarcusSaulþÿà…ŸòùOh«‘+'³Ù0\˜ ÌØìøÄÔ äð   $ 0<DLTä#Drug study guide for NPLEX clincalsrug Saul MarcusaulÁPurpose of this is to give a comprehensive and all inclusive yet quick and efficient review of all NPLEX drugs. 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