NPLEX 2 Pharm
Acyclovir - ANTIVIRAL (Inhibits DNA polymerase)
IND:
- HSV ixn and prevention, VZV, EBV, disseminated neonatal herpes, CMV ixn
ACT:
- Nucleoside analog inhibiting viral replication, NON-CURATIVE
A/E:
- HA, diarrhea, nausea, delirium, tremor, Htn, transent renal dysfunction w/ high doses, encephalopathy
(IV), CAN PROMOTE EMERGENCE OF RESISTANT STRAINS
C/I:
- Preg C
INT:
- Synergistic toxicity w/ ZIDOVUDINE (AZT).
MONITOR: urinalysis, BUN, serum creatinine, LV enz, CBC
Rx: Oral, topical, IV
Acetaminophen - NON-NARCOTIC ANALGESIC/ ANTIPYRETIC (Tylenol)
IND:
- Mild pain, acute MSK pain, OA, RA, fever
ACT:
- Inhibits CNS prostaglandin synthesis, analgesic, anti-pyretic, NOT anti-inflammatory, Does not affect
platelet agg or uric acid metabolism
A/E:
- MAY INHIBIT CARTILAGE FORMATION, HEPATITIS (BLACK BOX WARNING FOR HEPATOTOXICITY)
- Preg B
- OD can cause potentially lethal hepatotoxicity (overwhelms glutathione detox system in LV), or
nephrotoxicity
,- ANTIDOTE; Charcoal, N-Acetylcysteine (glutathione precursor).
C/I:
- LV dz, LV failure, alcoholism
INT:
- Barbituates, carbamazepine, phenytoin, isoniazid OBCP, and rifampin all activate LV breakdown of
acetaminophen and cause it to be more hepatotoxic and less active.
- Acetamin. may decrease activity of lamotrigine, zidovudine and loop diuretics,
- May interfere w/ home glucose monitors.
**Monitor for HEPATOTOXICITY W/ INGESTION > 4g/DAY
Adalimumab - DMARD (Antirheumatic, TNF-alpha inhib)
IND:
- RA, psoriatic arthritis, ankylosing spondylitis, Crohn's dz, severe psoriasis, JRA
ACT:
- Fully-humanized anti TNF-alpha IgG; anti-inflammatory and immunosuppressive
A/E:
- injection site rxn's, increased risk of dangerous ixn's (TB), herpes zoster re-activation, cancers (ESP
LYMPHOMA IN CHILDREN)
- Loss of efficacy over time, Liver failure (rare)
C/I:
- exposure to risky pathogens, receiving live vaccines
INT:
- Do not combine w/ other anti-TNF drugs
- Combination w/ Methotrexate can cause serious ixns
Rx: SubQ inj
Adefovir - ANTIVIRAL
IND: Chronic Hep B - any stage
,ACT: adenosine monophosphate nucleotide analog
A/E: resistance with chronic use, NEPHROTOXICITY, hepatitis, lactic acidosis
C/I: reduce dose in KD failure
Monitor: creatinine, urine protein
Albuterol/ Salbutemol - SHORT-ACTING BETA2 AGONIST
IND:
- Acute asthma attacks, acute and chronic bronchitis
Alendronate - BISPHOSPHONATE DERIVATIVE
IND:
- Osteoporosis in posmenopausal women and males, Paget's dz of the bone
ACT:
- Inhibits bone resorption by binding to bone hydroxyapatite and INHIBITS OSTEOCLAST-MEDIATED BONE
RESORPTION, also inhibits osteoclast precursors
A/E:
- Esophagitis, esophageal ulcers, HA, transient hypocalcemia, GI distress, abdominal pain, acid reflux,
nausea
C/I:
- Hypocalcemia, esophageal abnormalities, INABILITY TO SIT UPRIGHT FOR AT LEAST 30 MIN.
INT:
- IV Ranitidine doubles bioavailability,
- Estrogen may ENHANCE therapeutic effect
- GI distress increases with aspirin
MONITOR: ALP, serum Ca and Phos, pain and fracture rate, hormonal status, bone mineral density
Rx: Oral - take w/ full glass of H2O in am at least 30 min b/f food and other meds; Ensure adequate Ca
and VitD intake
Alprazolam - Xanax - ANTI-ANXIETY (INTERMEDIATE ACTING BENZODIAZEPINE)
IND:
, - Anxiety, panic disorder with or w/o agoraphobia
ACT:
- Unknown MOA, can also exhibit anti-depressant properties
A/E:
- Increase or decrease in appetite, Weight gain, Reduced salivation/ xerostomia, Constipation, confusion,
dysarthria, SOMNOLENCE, memory impairment, light headed, reduced libido
C/I:
- Narrow angle glaucoma, Pregnancy (1st trimester)
- Caution w/ seizure hx, suicidality hx, abrupt w/drawal, Liver dz
INT:
- DO NOT USE W/ KETOCONAZOLE OR ITRACONAZOLE
Amantadine - ANTICHOLINERGIC/ ANTIPARKINSONIAN
IND:
- Extrapyramidal dz, Parkinsonism, Influenza A
A/E:
- LIVEDO RETICULARIS
Amiodarone - ANTI-ARRHYTHMIC
IND:
- SERIOUS Ventricular arrhythmias, chemical cardioversion of atrial fibrillation: NOT A FIRST-LINE
ANTIARRHYTHMIC BECAUSE OF SIGNIFICANT (POTENTIALLY FATAL) SIDE EFFECTS
ACT:
- Class 3 anti arrhythmic agent: SODIUM CHANNEL BLOCKER with affinity for inactive channels unlike
quinidine.
A/E:
- Acute: Hypotension, AV block, bradycardia
- Chronic: Hypo/hyperthyroid, PULMONARY FIBROSIS, peripheral deposition (bluish discoloration to
skin), Arrhythmias, CORNEAL DEPOSITION
