ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
#Generic NameBrand NameTherapeutic CategoryFDA Approved IndicationBBW/Contraindications
/Warning/Precautions
Clinical Pearls/
Key Counseling Points
2
1AcetaminophenTylenol, Ofirmev (injection)Analgesic, antipyreticMild to moderate painSevere hepatotoxicity (can require liver transplant or result in death), associated with doses >4 grams/day or use of multiple acetaminophen-containing products Maximum <4 grms/day from all sources combined
Do NOT refrigerate Ofirmev (IV acetaminophen)
First-line for mild-to-moderate pain in pregnancy
MAX: 3250 mg/24 hours (of all acetaminophen combined) (most sources simplify it to 4 g/day
3
2Acetaminophen / codeineTylenol #2, #3, #4Opioid analgesic, CS IIIMild to moderate painContraindications: Children <12 years, significant respiratory depression, acute/severe bronchial asthma in an unmonitored setting, use of MAOIs within last 14 days, severe hepatic/renal impairmentLimit the use of these products to adults 18 years and older
Life-threatening respiratory depression in ultra-rapid metabolizers (UM) of codeine
4
3AcetylcysteineAcedote, Mucomyst, Mason Natural NACAntidoteAcetaminophen toxicity/overdoseUsed with caution in patients with asthma or with history of bronchospasmFor acetaminophen toxicity; must be identified early and the antidote, N-acetylcysteine (NAC), given quickly
5
4AcyclovirZoviraxAntiviral, antiherpes virus agentHerpes zoster (shingles) treatment; management of recurrent episodes of genital herpesCaution in patients with renal impairment, the elderly, receiving nephrotoxic agents. Maintain adequate hydrationAcyclovir dose is based on IBW; even in obese patients.
Transient buring or stinging with topical formulation
Do not refrigerate
6
5AdapaleneDifferinRetinoidTreatment of Acne vulgaris in patient ≥12 yearsCautions: Avoid eyes, lips, and mucous membranes.
For external use only. Minimize UV light exposure
Limit sun exposure. Apply daily, usually at bedtime, about 20 minutes after washing face. Takes 4 -12 weeks to see response; may worsen acne initially
7
6AdalimumabHumiraMonoclonal antibody, antirheumaticTreatment of autoimmune diseases (i.e., RA, psoriasis, AS, CD, UC, UV) BBW: serious infections, including TB, fungal, viral, bacterial or opportunistic; screen for latent TB (and treat if needed) prior to therapy. Lymphomas and other malignanciesTB test (prior to initiation and annually if risk factors are present). Monitor signs of infection, CBC, LFTs, HBV, symptoms of heart failure, malignancies
8
7AlbuminAlbutein, AlbuRx, Albumin X%, Plasmuin-25Plasma expanderHypovolemia with or without shock; Hypoalbuminemia; prevention of volume depletion fowllowing paracentesis due to Cirrhotic Ascites Contraindications: Hypersensitivity to commercially available albumin products, severe anemia, heart failureUse for hypovolemia or patients who are intravascularly depleted
9
8AlbuterolProAir HFA, Proventil HFA, Ventolin HFABeta-2 AgonistAsthmaCaution in CVD, glaucoma, hyperthyroidism, seizures, diabetesMonitor number of days of SABA use, symptom frequency, peak flow, pulmonary function tests, BP, HR, blood glucose, K
10
9Albuterol/IpratropiumCombivent Respimat or CombiventBeta-2 Agonist/ anticholinergicCOPD Caution in patients with narrow-angle glaucoma, myasthenia gravis, urinary retention, BPH and bladder neck obstructionS/sx at each visit, smoking status, COPD questionnaires, annual spirometry
11
10AlendronateFosamaxBisphosphonateTreatment and prevetion of osteoporosis Contraindications: inability to stand or sit upright for at least 30 minutes, abnormalities of the esophagus; difficulty swallowing or at high risk for aspiration; hypocalcemiaCheck calcium and vitamin D levels prior to initiating treatment, take oral bisphosphonates at least 30 minutes from food and most beverages
12
11AllopurinolZyloprim, AloprimAntigout, xanthine oxidase inhibitorHyperurecemia or goutHypersensitivity reactions, including severe rash (SJS/TEN); HLA-B*5801 testing prior to use (especially for Asian), hepatotoxicity, bone marrow suppressionMonitor CBC, LFTs, renal function
Take after a meal (with food in stomach) to ↓nausea
13
12AlprazolamXanaxAntianxiety, benzodiazepineGneralized Anxiety Disorder (GAD), Panic Disorder (PD)BBW: Use with opioids can result in sedation, respiratory depression, coma and deathC-IV, fast onset, often abused due to quick action
14
13AlvimopanEnteregOpioid antagonistGastrointestinal recovery following surgeries that include partial bowel resection with primary anastomosisBBW: Potential risk of MI with long-term use
Contraindications: Patients who have taken therapeutic doses of opioids for> 7 consecutive days prior to use
Only for hospitalized patients and is given prior to surgery to reduce the risk of ileus that can occur post-op
15
14AmiodaronePacerone, Cordorone, NexteroneAntiarrhythmic Recurrent ventricular fibrillation and recurrent hemodynamically unstable tachycardiaBBW: pulmonary toxicity and hepatotoxicity. Use only for life-threatening arrhythmias due to toxicities; CI in patients with iodine allergy since the drug molecule contains two iodine, hence, causing hypo-/hyperthyroidismProarrhythmic; patients should be hospitalized when loading dose is given;
Monitoring:
ECG, BP, HR, electrolytes and pulmonary function test: baseline + annually thereafter
LFTs: baseline and every 6 months
Thyroid fuction test: baseline and 3-6 moths
Ophalmologic examinations: within the first 12 months;
16
15Amoxicillin / clarithromycin / lansoprazolePrevpacAntibiotic/proton-pump inhibitorH. pylori infection Contraindications: PCN allergy, QT prolongation, Concomitant use of statins, coadministration of colchicine with renal or hepatic impairmentUse only if local resistance rates to clarithromycin are low (< 15%) and the patient has had no previous exposure to a macrolide
17
16AmitriptylineElavilTricyclic antidepressantMajor depressive disorder (MDD)Contraindications: Concurrent use with MAO inhibitors, linezolid, IV methylene blue; myocardial infarction↑ fall risk - especially in elderly due to combination of orthostasis and sedation
18
17AmlodipineNorvascCalcium channel blockerHypertension (HTN), AnginaHypotension; worsening angina or Ml; severe hepatic impairment; use caution in heart failureMonotor BP, HR, peripheral edema, start slow and titrate slowly
19
18Amoxicillin MoxatagPenicillin antibioticAcute otitis media, sinusitis, SSTIContraindications: hypersensitivity to penicillins, cephalosporins, imipenemMonitor renal function, symptoms of anaphylaxis with 1st dose, CBC and LFTs with prolonged courses
20
19Amoxicillin /clavulanateAugmentinPenicillin antibioticLower respiratory tract infection, acute otitis media, sinusitis, SSTI, UTISevere renal impairment: do not use extended-release oral forms of amoxicillin and amoxicillin/clavulanateMonitor renal function, symptoms of anaphylaxis with 1st dose, CBC and LFTs with prolonged courses
21
20Amphetamine /DextroamphetamineAdderallCentral Neurology stimulantADHDBBW: Misuse can cause sudden death and serious CV eventsC-II, should not be used in patients with heart problems or serious psychiatric conditions
22
21AnastrozoleArimidexAromatase inhibitorAdjuvant treatment for breast cancerHigher risk of osteoporosis; Higher risk of CVD compared to SERMsHazardous agent: use appropriate precautions for receiving, handling, storage, preparation, dispensing, administration, and disposal
23
22Andexanet alfaAndexxaAntidoteReversal of anticoagulation in patients taking rivaroxaban and apixaban BBW: Thromboembolic risks, ischemic events, cardiac arrest, sudden deathReversal agent for rivaroxaban and apixaban
24
23ApixabanEliquisFactor Xa inhibitor anticoagulantPrevention of stroke/VTE in patients with nonvalvular Afib; prophylaxis of VTE (DVT/PE) for patients undergoing hip/knee replacement surgeryBBW: neuraxial
anesthesia (epidural, spinal) or spinal puncture are at
risk of hematomas and subsequent paralysis
Warning: Not recommended with prosthetic heart valves
Different dosing used for different conditions; Nonvalvular AFib (stroke prophylaxis) 5 mg BID
unless patient has at least 2 of the following: age > 80 years, body weight < 60 kg, or SCr > 1 .5 mg/dL, then give 2.5 mg BID
25
24AprepitantEmendNK1R antagonist antiemetic Chemotherapy induced nausea and vomitting (CINV)Hypersensitivity For chemotherapy induced nausea/vomitting
Many DDI
26
25AripiprazoleAbilitySecond generation antipsychoticSchizophrenia, Bipolar, major depressive disorder, Tourette’s disorderBBW: Elderly patients with dementia-related psychosis treated with antipsychotic
drugs are at increase risk of death
Increased risk of cerebrovascular events
Lower risk of metabolic side effect
Comes in long acting inejction: abilify maintena, which can be given every four weeks.
27
26AtenololTenorminBeta Blocker Hypertension (HTN), angina, myocardial infarction (MI)BBW: Do not discontinue abruptly
Caution in patients with diabetes (can worsen hyper/hypoglycemia and mask hypoglycemic symptoms
Take w/ food. Avoid operating cars/ machines until you are used to the drug. Titrate q2wks and avoid abrupt withdrawal- 2-days dosage tapering.
28
27Atenolol/chlorthalidoneTenoreticBeta blocker/thiazide diureticHTNRefer to atenolol and chlorthalidone section Refer to atenolol and chlorthalidone section
29
28AtomoxetineStratteraNorepinephrine reuptake inhibitorADHDBBW: risk of suicidal ideation; monitor for suicidal thinking or behavior, worsening mood,
or unusual behavior
CI: MAO inhibitor use
within the past 14 days
Secondline agents after stimulant medications have failed, or when abuse potential
Provide Medication Guide
Do not open the capsule
30
29AtorvastatinLipitorHMG CoA reductase inhibitor (statin)Hyperlipidemia CI: Active liver disease, pregnancy, breastfeeding,
use of strong CYP3A4 inhibitors
Warning: Skeletal muscle effects, hepatotoxicity
CYP3A4 substrates, monitor LFTs at baseline, lipid panel at baseline
31
30AzelastineAsteproSecond generation antihistamineSeasonal allergic rhinitisMay cause CNS depression, which may impair physical or mental abilitiesSecond generation antihistamine
Helps with nasal congestion; can be combined with intranasal
steroid
32
31AzithromycinZithromax, Zpak, AzaSite (eyedrop)Macrolide antibioticCommunity-Acquired Pneumonia (CAP)Warning: QT prolongatoin, hepatotoxicity Common dosing: 2 tablets on day 1, followed by 1 tablet daily on days 2 to 5;
The suspension should be stored at room temperature and not be refrigerated.
Used for treatment against atypical bacteria
33
32Bacitracin / neomycin / polymyxin B / hydrocortisoneCortisporinTopical mixed-antibiotic/antiinflammatorySuperficial bacterial infectionsAllergic reaction to individual agents
Depends on epidermal integrity (intact vs abraded skin), formulation, age of the patient, prolonged duration of use, and the use of occlusive dressings
Rx topical used for superficial skin infections
34
33BaclofenLioresalCentrally acting skeletal muscle relaxantMuscle spasm BBW: Abrupt withdrawal of intrathecal baclofen has resulted in severe effects (high fever, muscle rigidity, etc.)Do not overdose in elderly (e.g., start low, titrate carefully), watch for additive side effects
35
34BeclomethasoneQVAR RedihalerInhaled corticosteroidAsthmaWarning: High doses for prolonged periods of time can cause adrenal suppression, increase risk of fractures, growth retardation, and immunosuppressionRinse mouth after each use; Used as-needed in combination with formoterol and individually or in combination for maintenance
36
35BenazeprilLotensinAngiotensin converting enzyme inhibitorHTNBBW: Can cause injury and death to the developing fetus when used in the 2nd and 3rd trimesters
CI: history of angioedema; within 36 hours of using ARNI
Warning: Angioedema, hyperkalemia, hypotension, renal impiarment, bilateral renal artery stenosis
Monitor BP, K, renal function, s/sx of angioedema
37
36BenzonatateTessalon PerlesAntitussiveSymptomatic relief of coughWarning: Do not use in children < 10 years of age; accidental ingestion and fatal overdose has been
reported
Should not be crushed or altered
38
37BenztropineCogentinAntiparkinson anticholinergicParkinson's Disease (PD); management of extrapyramidal side effects (EPS) from antipsychoticsPrecaution: elderly On Beer's list; used for drug-induced extrapyramidal symptoms (eg, dystonia, parkinsonism) and parkinson disease (for tremors)
39
38Betamethasone dipropionate Diprolene Cream AFCorticosteroidTopical therapy for dermatitisDiscontinue if skin irritation or contact dermatitis occursHigh potency topical corticosteroids
40
39Betamethasone / clotrimazoleLotrisoneCorticosteoid/antifungalTopical therapy for tinea pedis, tinea cruris, and tinea corporisSee individual agentSee individual agent
41
40BevacizumabAvastinMonoclonal antibodyDifferent types of cancerBBW: severe/fatal bleeding, Gl perforation, surgical wound dehiscence (splitting open)Impairs wound healing: do not administer for 28 days before or after surgery
42
41BimatoprostLumigan, LatisseProstaglandin analogElevated intraocular pressure in patients with open angle glaucoma; Treatment of eyelash growthHypersensitivity; rupture oculur lensRemove contact lenses before administration and wait 15 minutes before reinserting. Administer concomitant ophthalmic drugs at least 5 minutes apart. Advise permanent iris pigmentation may occur. Wipe off excess drug to avoid running onto cheek and other skin surfaces.
43
42Bismuth / metronidazole / tetracyclinePyleraH. pylori agentQuadruple therapy for H. pylori infectionHypersensitivity; alcohol useWarn patient that treatment may cause temporary and benign darkening of the tongue and/or black stools which is generally reversible within several days after the last dose. Counsel patient to use an effective non-hormonal contraceptive as therapy may decrease effectiveness of oral contraceptives. Advise patient to use sunscreen, wear protective clothing, and avoid tanning beds due to potential for photosensitivity.
44
43BleomycinBlenoxaneAntineoplastic antibioticLymphomas; Testicular Carcinoma; Malignant Pleural EffusionPulmonary fibrosis, pneumonitis; hypersensitivityTotal doses greater than 400 units should be given with great caution, as pulmonary toxicity appears to be dose-related
45
44Brompheniramine / pseudoephedrine / dextromethorphanBromfed DMAntihistamine/decongestants/cough suppressantOTC could and coldMAOIs; hypersensitivityMonitor blood pressure
46
45BudesonidePulmicort, Pulmicort Flexhaler, Pulmicort RespulesInhaled corticosteroidAsthmaHypersensitivity to milk proteinsPrime inhaler prior to use. Rinse mouth with water and spit. Not for acute asthma attack
47
46BuprenorphineBelbuca, Butrans (patch)Opioid agonist-antagonist analgesicManagement of opioid dependence/addictionExposure to risk of opioid addiction, abuse, misuse; respiratory depression; acute bronchial asthmaOpioid Analgesic REMS (SQ NOT FOR IV USE)
48
47Buprenorphine / naloxoneSuboxone, Zubslov (SL tab)Opioid agonist-antagonist analgesicManagement of opioid dependence/addictionHypersensitivityNegative urine drug screening results indicate efficacy; at least weekly for the first month and once-monthly thereafter for patients on a stable regimen. Counsel patient to report symptoms of hepatitis or respiratory depression
49
48BupropionWellbutrin SR, Wellbutrin XLAntidepressantMajor depressive disorder (MDD); seasonal affective disorder (SAD)Suicidality; increase risk of seizures, MAOIsAvoid activities that require mental alertness or coordination
50
49BuspironeBusparAntianxiety agentAnxiety disorderConcomitant use with alcohol, MAOIsAvoid activities that require mental alertness or coordination
51
50BusulfanBusulfex, MyleranAlkylatic agentChronic myeloid leukemiaSevere, prolonged myelosuppression; HypersensitivityWarn to prevent pregnancy, including sexual partner; report symptoms of hepatotoxicity
52
51ButoconazoleGynazole-1Imidazole antifungalCandidal vulvovaginitisHypersensitivity reactionsMonitor itching, soreness, and swelling. Counsel patient that product may damage condoms or diaphragms. Abstinence until infection resolves is preferable, but otherwise patient should use other means of birth control while using this medication.
53
52CalcitoninMiacalcinCalcitonin classHypercalcemia; Paget's disease; Postmenopausal osteoporosisHypersensitivity reactionsMonitor serum calcium. Maintain adequate calcium and vitamin D intake. Discard nasal bottle after 30 doses.
54
53CalcitriolRocaltrolVitamin D analogHypocalcemia secondary to hypoparathyroidism, dialysis; Plaque psoriasis; secondary hyperparathyroidismHypercalcemia, hypersensitivityMonitor serum calcium twice weekly
55
54CanagliflozinInvokanaSodium-glucose cotransporter-2 (SGLT2) inhibitorType 2 diabetes mellitus (T2DM)BBW: Lower limb amputation; CI: Severe renal impairment
Serious hypersensitivity (eg, anaphylaxis, angioedema) to canagliflozin
Take before the first meal of the day to help reduce post meal hyperglycemia. Be aware of symptoms of foot ulcers, pain or tenderness or dehydration (dizzy, low BP, decreased urination), and vaginal infections and report to HCP.
56
55CapecitabineXelodaPyrimidine analogMetastatic breast cancer; colorectal cancer BBW: increase risk of bleeding in patient taking warfarin; CI: hypersensitivity and severe renal impairment Report significant diarrhea, nausea, vomiting, or dehydration. Report symptoms of anemia, neutropenia, or thrombocytopenia. Avoid pregnancy and for 6 months after discontinuation.
57
56Carbidopa/levodopaSinemetAntiparkinsonian, decarboxylase inhibitorParkinson's diseaseCI: Hypersensitivity to carbidopa or levodopa, narrow-angle glaucoma, concurrent MAOI or linezolidReduction of extrapyramidal movements, rigidity, tremor, gait disturbances may indicate efficacy. Advise patient that wearing-off effect may occur at the end of a dosing interval. A combination product of carbidopa, levodopa, and entacapone (Stalevo) is also available. Suspension formulation (Duopa) available for continuous delivery via pump directly into jejunal tube.
58
57CarboplatinParaplatin, CARBOplatin NovaplusPlatinum analogOvarian cancerBBW: Bone marrow suppression, anemiaMonitor CBC. Avoid LIVE vaccines during therapy.
59
58CarisoprodolSomaSkeletal muscle relaxantRelief of discomfort associated with acute, painful musculoskeletal conditionsHypersensitivity to carisoprodol Use caution or avoid use as potentially inappropriate in older adults
60
59CarmustineBiCNU, GliadelNitrosoureaGlioblastoma multiforme of brain; Multiple myeloma; Non-Hodgkin's lymphomaBone marrow suppression - Thrombocytopenia, leukopeniaCBC: Weekly for a minimum of 6 weeks following each dose, include a differential
61
60CarvedilolCoregBeta blockerHeart failure (HF); HTNContraindications: Hypersensitivity, bronchial asthma, severe sinus bradycardia, 2nd- or 3rd-degree AV block, sick sinus syndrome, overt heart failure, cardiogenic shock, severe hepatic impairmentTake carvedilol with food or milk. Monitor blood pressure, heart rate, renal function, Report signs/symptoms of adverse cardiovascular effects such as hypotension (especially in elderly patients), arrhythmias, syncope, palpitations, angina, or edema.
62
61CaspofunginCancidasEchinocandin antifungalInvassive aspergillosis infection; Candidemia; Febrile neutropenia, Empiric antifungal therapyHypersensitivity to caspofunginCan cause abnormalities in liver enzymes. Monitor LFTs especially during concomitant use with Cyclosporine. IV formulation not compitable in dextrose
63
62CefdinirOmnicefCephalosporin antibioticAcute otitis media; Bronchitis; Community acquired pneumonia; Pharyngitis; SinusitisHypersensitivity to cephalosporin; caution use in patientss with penicillin allergy Complete full course of therapy. For the suspension, shake well and can be stored at room temperature. Reconsitituted solution should be discarded after 10 days
64
63CefuroximeCeftinCephalosporin antibioticGonorrhea; Lower respiratory tract infection; Meningitis; Urinary tract infectionHypersensitivity to cephalosporin; caution use in patientss with penicillin allergy Complete full course of therapy. For the suspension, shake well and can be stored at room temperature. Reconsitituted solution should be discarded after 10 days
65
64CelecoxibCelebrexSelective COX-2 inhibitorAnkylosing spondylitis; Juvenile rheumatoid arthritis; Osteoarthritis; Rheumatoid arthritisBBW: GI toxicity, cardiotoxicity, CABG
CI: Asthma, urticaria, or allergic-type reaction following aspirin or other NSAID administration; CABG surgery, treatment of perioperative pain, hypersensitivity to sulfonamides
May take with food or milk to decrease GI upset. May open capsule and pour into a teaspoon of applesauce. Elderly patients are at increased risk of GI ulceration.
Celecoxib has less risk of GI effects than other NSAIDs, but increased cardiovascular toxicity. Use the lowest dose for the shortest period of time to avoid adverse effects.
66
65CephalexinKeflexCephalosporin antibioticImpetigo; Skin and soft tissue infection; Osteomyelitis; Otitis media; Respiratory tract infection; Urinary tract infectious disease; Streptococcal pharyngitisHypersensitivity to cephalosporin; caution use in patientss with penicillin allergy Complete full course of therapy. For the suspension, shake well and can be stored at room temperature. Reconsitituted solution should be discarded after 10 days
67
66Certolizumab pegolCimziaMonoclonal antibody, TNF inhibitorAnkylosing spondylitis; Moderate to severe Crohn's disease; moderate to severe plaque psoriasis; moderate to severe RASerious infections, some fatal, including TB, fungal, viral, bacterial or opportunistic; screen for latent TB (and treat if needed) prior to therapy
CONTRAINDICATIONS: Active systemic infection, doses > 5 mg/kg in moderate-severe heart failure (infliximab), sepsis (etanercept
Can cause demyelinating disease, hepatitis B reactivation, heart failure, hepatotoxicity, lupus-like syndrome, seizures, myelosuppression and severe infections. Do not use it with LIVE vaccine
68
67CetirizineZyrtecSecond generation antihistamineSeasonal allergy; itching; urticariaHypersensitivity to cetirizine or hydroxyzinePatients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects. Product is available in several nonprescription dosage forms. Ophthalmic formulation (Zerviate) available by prescription
69
68CetuximabErbituxEpidermal growth factor receptor (EGFR) inhibitorKRAS wild-type, EGFR-expressing metastatic colorectal cancer; Squamous cell carcinomaBBW: cardiopulmonary arrest or death; fatal infusion related reactions Advise patients on cardiopulmonary arrest and severe infusion related reactions.
70
69Chlorpheniramine / hydrocodoneTussiCapsAntitussive combinationsCough, associated with allergies or a common coldCI: known allergy or sensitivity to hydrocodone or chlorpheniramine. Caution is advised in patients with narrow-angle glaucoma, asthma, or prostatic hypertrophy.Controlled substance II
71
70ChlorhexidinePeridex, PeriogardAntibacterial cleansing agentPeriodontitis; GingivitisHypersensitivity to chlorhexidineMay cause tooth discoloration and skin irritation. For oral rinse, measure out 1/2 fluid ounce (15 mL) as marked in the cap that comes with the bottle, swish the solution in mouth for at least 30 s; do not swallow
72
71ChlorthalidoneThalitoneThiazide diureticEdema; HTNCI: Hypersensitivity to chlorthalidone or sulfonamides; anuriaMonitor serum electrolytes (particularly sodium), uric acid, and renal and hepatic function at baseline and periodically.
73
72Cholecalciferol, Vit D3n/aVitamin D analogVitamin D deficiencyn/aComes as combination with alendronate: Fosamax plus D
74
73CinacalcetSensiparCalcimimeticPrimary & Secondary hyperparathyroidism; Hypercalcemia CI: hypocalcemia; Caution use in patients with a history of seizuresCan cause hypocalcemia; monitor Ca, PO4 and PTH
75
74Ciprofloxacin CiproFluoroquinolone antibioticAcute exacerbation of chronic bronchitis; Bacterial prostatitis; Bacterial sinusitis; Urinary tract infection; Hospital acquired pneumonia; plagueCI: Hypersensitivity to ciprofloxacin or other quinolonesNot approved in children <18 y of age except for anthrax and complicated UTIs. Also available in injectable, otic, and ophthalmic formulations. Take ciprofloxacin at least 2 h before or 6 h after antacids, sucralfate, or mineral supplements and multivitamins with calcium, iron, or zinc. If using the suspension, shake well before use; suspension may be stored at room temperature.
76
75Ciprofloxacin / dexamethasoneCiprodex (otic)Antibiotic corticosteroid combinationAcute otitis mediasame as above Warm solution by holding container in hands for at least 1 min before administering. Patient should lie with affected ear upward; position should be maintained for at least 1 min after instillation; repeat in the opposite ear if necessary. Available in otic formulation in combination with hydrocortisone (Cipro HC).
77
76CisatracuriumNimbexNondepolarizing Neuromuscular blockerInduction of neuromuscular blockadeHas been associated with residual paralysis; risk of seizure Short half-life
78
77CitalopramCelexaSelective-serotonin reuptake inhibitor (SSRI) antidepressantMajor depressive disorder (MDD)BBW: Suicidal ideation; not approved for use in children; CI: concomitant use of pimozide, MAOIsAvoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation, may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs or aspirin while taking this drug. Due to risk of QTc prolongation, doses >40 mg/d should be avoided. For patients >60 y of age, the maximum recommended dose is 20 mg/d due to the risk of QTc prolongation.
79
78CisplatinPlatinolPlatinum analogBladder cancer; Metastatic malignant tumor of testis; Metastatic ovarian tumorAnaphylactic-like reactions - risk increases with repeated exposure; caution when > 6 cycles of carboplatin are usedKnown to cause oto- and nephrotoxicity. Amifostine (Ethyol) can be given prophylactically to prevent nephrotoxicity. Has high ematogenic potential. Doses > 100 mg/m2/cycle must be confirmed with prescriber
80
79ClarithromycinBiaxinMacrolide antibioticBronchitis; Acute otitis media; CAP; Maxillary sinusitis; H. pylori; Streptococcal pharyngitisCI: Hypersensitivity to any macrolide; concomitant colchicine, cisapride, pimozide, astemizole, terfenadine, ergotamine, dihydroergotamine, or HMG-CoA reductase inhibitors metabolized by CYP3A4/5, history of cholestatic jaundice/hepatic dysfunction with use of clarithromycin, colchicine in renal or hepatic impairmentUse with caution in severe renal, hepatic, or cardiac disease. Extended-release and immediate-release formulations are not interchangeable. Multiple drug interactions. Max dose in children, 1 g/d.
81
80ClobetasolClobex, TemovateCorticosteroidMild to moderate plaque psoriasis CI: Primary scalp infection; Precautions: avoid application to areas not designated for, may have local reactions, overuse may lead to systemic absorption, avoid fire or heated source when applyingApply as directed with avoiding face, scalp, groin, axillae. Discontinue if signs of systemic issues such as Cushing syndrome
82
81ClonazepamKlonopinBenzodiazepineSeizure disorder; panic disorderBBW: Risk of misuse with opioids and CNS depressants and risk of dependence; Contraindicated in acute narrow angle glaucoma, significant liver diseaseAvoid alcohol use, do not abruptly stop due to risk fo withdrawal, monitor for previous seizure disorders, worsening of psych, and respiratory depression; Controlled Substance Schedule IV
83
82ClonidineCatapresCentrally acting alpha-2 agonistADHD; resistant HTNBBW for epidural solution: dilute prior to use due to risk of hemodynamic instability; Avoid use as primary antihypertensive agentComes in oral and transdermal patch dosage form; Patient should avoid activities requiring mental alertness when starting.
Avoid alcohol and do not discontinue abruptly due to rebound hypertension
84
83Codeine / PromethazinePhenerganAntitussive, opioidCough, Associated with allergies or a common coldBBW: Should not be used in patients less than 2 years old due to extreme risk of respiratory depression; Precautions: avoid in older adults due to anticholinergic effects, use in caution with those who have cardiac/hepatic/seizure disease, monitor for respiratory depression Codeine is a considered a controlled V substance due to presence of promethazine, however is a CII when prescribed alone
Avoid activities that require mental alertness when starting, caution with other medications that affect CNS or affect serotonin system
85
84ColchicineColcrysAntigoutHigh uric acid levelsHypersensitivity to colchicine; concurrent use with strong CYP3A4/5 inhibitors in patients with renal or hepatic failureInstruct patient on appropriate dosing strategy for gout flares (dosing to symptom relief or onset of adverse effects, particularly diarrhea)
86
85CyclobenzaprineFlexerilSkeletal muscle relaxantSkeletal muscle spasmCI: acute recovery from myocardial infarction, arrythmias, previous use of MAOI in last 14 days; Avoid use in elderly if possible due to anticholinergic effects, caution with other CNS depressant drugs such as BZDs, alcohol, methadone, and buprenorphine, monitor cardiac conditions and worsening of arrythmiasPatients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects. Take extended-release capsule same time each day.
87
86CyclosporineNeoral, Gengraf, Sandimmune, Restasis (ophthalmic)Calcineurin inhibitorSolid organ transplant rejectionBBW: Only have physicians experienced in immunosuppressive therapy in charge; CI: active oculat infectionCyclosprine ophthalmic comes in single-use packages. Remove contact lenses before using this medicine. Wait at least 15 min before inserting contact lenses after use. May be used with artificial tears as long as there is 15-min interval in between. Oral and injectable formulations available for transplant rejection prevention.
88
87DarbepoetinAranespErythropoiesis stimulating agent Anemia of chornic disease or inflammationBBW: Increased CV, stroke, mortality risk; cancer recurrence
Contraindication: Hypersensitivity to darbepoetin, uncontrolled HTN
In cancer patients, cannot be used if the goal is to CURE the patient of their cancer due to risk of inc. risk of progression of cancer.
89
88DenosumabProlia, XgevaMonoclonal antibodyOsteoporosis; Hypercalcemia of malignancyCI: uncorrected hypocalcemia, pregnancy; Precautions: skin reaction, new or worsening hypocalcemia, osteonecrosis of jaw, atypical fracturesMonitor for fracture or fracture pain, continue maintaining adequate Vitamin D and Calcium supplementation
90
89DesvenlafaxinePristiqSerotonin Norepinephrine reuptake inhibitor (SNRI) antidepressantMajor depressive disorderBBW: increase risk of suicidal ideation in children; Do not use in biplar disorder; Contraindicated in patients with increased risk of serotonin syndrome especially with recent MAOI use; increase risk of bleedingSymptomatic improvement may not be evident for a few weeks. Do not discontinue drug abruptly, as this may precipitate withdrawal symptoms such as dysphoric mood, irritability, and agitation. Cause increase risk of bleeding with concurrent aspirin/NSAIDs use
91
90DexamethasoneDecadronGlucocorticoidAsthma; Cerebral edema; Cushing's syndromeContraindication: hypersensitivity to glucocorticosteroids; concurrent use of live vaccines; fungal infectionsFor short-term treatment, advise patients to take doses with meals to prevent GI upset. For high dose or long-term treatment, advise patients to monitor for signs of hyperglycemia, osteoporosis, adrenocortical insufficiency, and infection. Patient may experience insomnia, anxiety, aggression at higher doses.
Avoid abrupt discontinuation in patients on long-term therapy to avoid adrenal insufficiency.
92
91DexlansoprazoleDexilantAntacid, Proton pump inhibitor (PPI)GERD; Erosive esophagitisCI: any products containing rilpivirine; Use in elderly can increase risk of C. diffile infection, increase risk of B12 deficiency and hypomagnesemia with prolonged useUse for shortest time possible. Increased risk of bone fracture with long-term use, use with caution in those with osteoporosis. Medication guide required at dispensing. Unlike lansoprazole, does not interact with clopidogrel or CYP inhibitors/inducers.
93
92DiazepamValiumBenzodiazeopineAlcohol withdrawal; anxiety; status epilepticus; Skeletal muscle spasmBBW: Risk of misuse with opioids and CNS depressants and risk of dependence; Contraindicated in acute narrow angle glaucoma, significant liver diseaseAvoid alcohol use, do not abruptly stop due to risk fo withdrawal, monitor for previous seizure disorders, worsening of psych, and respiratory depression; Controlled Substance Schedule IV
Rectal gel formulation (Diastat Acudial) allows for adjusting dose for individual patient needs.
94
93DiclofenacVoltarenNonsteroidal antiinflammatory drugs (NSAIDs)Osteoarthritic painBBW: Increase risk of cardiovascular thrombotic events with systemic absorption
CI: post CABG surgery, asthma or allergic reaction to NSAID/aspirin, mild or severe renal insufficiency; Precautions: avoid in elderly pts, monitor cardiovascular events involving thrombotic risk, inc risk of bleed with other NSAIDS, aspirin, anticoag, possible SJS risk, monitor GI if at risk of ulceration
Elderly patients are at increase risk of GI bleed and ulceration. Patients with underlying cardiac dysfunction are at increased risk of cardiovascular events. Use lowest dose for shortest period of time to minimize toxicity. Available in both sodium and potassium salts, in combination with misoprostol, and in parenteral, ophthalmic, and topical products. Medication guide required at dispensing.
95
94DicyclomineBentylAntispasmodicIrritable bowel syndromeContraindicated in patients with hypersensitivity to dicyclomine, age <6 mo, breastfeeding, GI obstruction, glaucoma, myasthenia gravis, obstructive uropathy, reflux esophagitis, severe ulcerative colitis, toxic megacolon, unstable cardiovascular state in acute hemorrhageMay cause drowsiness; avoid driving and operating heavy equipment. Injectable formulation also available for IM use only (not to be used IV). Death has been reported of use of dicyclomine in infants by serious respiratory depression
96
95DigoxinLanoxin, DigitekInotropic agent, cardiac glycosideAtrial fibrillation; HFCI: ventricular fibrillation; Precautions: do not use 1st line for elderly for atrial fibrillation; Not recommended for patients with acute ischemia or uncontrolled electrical activity, Take after morning meals (and after evening meals if giving in divided doses). Tablet and solution not interchangeable—dosing varies with dosage form. Dose should be adjust in hypothyroidism. Monitor heart rate and rhythm. Early signs of toxicity is N/V, later signs of toxicity include vision changes/seeing colors
Therapeutic levels for HF: 0.5-0.9 ng/mL
Therapeutic levels for Afib: 0.8-2.0 ng/mL"
97
96Digoxin immune FabDigiFabAntidoteDigoxin toxicityPrecautions: rapid onset of hypokalemia, cardiac dysfunction w/o inotropic support, monitor closely those with severe renal failureInstruct patient to report for delayed allergic reactions after discharge from hospital
98
97DiltiazemCardizemNon-dihyropyridine calcium channel blocker (CCB)Atrial arrhythmia; HTN; Paroxysmal supraventricular tachycardia; stable anginaCI: acute MI with pulmonary congestion, administration of IV beta-blockers within a few hours of diltiazem, cardiogenic shock, heart block, sick sinus syndrome without pacemaker, Precautions: avoid in elderly patients with reduced ejection fraction, caution with drugs reducing herat rate or contractilityBe aware of various Orange Book ratings of diltiazem; May cause gingival hyperplasia, headache, constipation. Do not abruptly discontinue or take with alcohol
99
98DiphenhydramineBenadrylFirst-generation antihistamineallergic reaction; insomnia; motion sickness; parkinsonism; AnaphylaxisCI: newborn/premature infants, nursing mothers; Precautions: High risk of anticholinergic side effects including drowsiness, avoid alcohol or other CNS depressants, caution with peptic ulcers and other 'obstructive' diseases, paradoxical reaction in childrenDo not take before activity requiring mental alertness, strong anticholinergic effects with increase risk of side effects in elderly
100
99Diphenoxylate/atropineLomotilAntidiarrhealacute diarrheaCI: Pediatric pts less than 6 years old, diarrhea associated with entero-toxin bacteria, obstructive jaundice; Caution use in elderly as antispasmodic due to high risk of delirium and dementia, abnormal liver function, anticholinergic/opioid toxicities, CNS depressants, Advise patients of anticholinergic side effects of atropine in formulation, advise patients to not do activities that may require mental alertness. If no improvement is seen within 10 days, have pt seek primary care. Avoid alcohol