I Kinda Wish I'd Done This Earlier- Drugs

Study Guides

DO NOT FORGET THIS AWESOME SITE- drug endings and classes made simple:

DRUG ENDINGS

And this is a great on with pictures and mnemonics

Drug Mnemonics Sheets

  This helps me- organizing drugs by common side-effects

ABX Interactions

·         Aminoglycosides and anticalcemetics= raise levels of      anticalcimetics

·         Tetracyclines and oral ca salts= reduce levels tetracycline

Interact With Insulin

·              ACEIs- hypoglycemia

·         Levothyroxineà insulin decreases amount available

·         Beta blockersà mask hypoglycemia

·         Corticosteroids + insulin = hyperglycemia

·         MAOIs + insulin = hypoglycemia

·         Sulfonamidesà hypoglycemia

·         Thiazideà hyperglycemia

F&E Imbalances

·             Thiazide- K, BG, Na, Mg

·         Loop- metabolic acidosis, hypovolemia, Hypochloremia, hyponatremia, hypokalemia, hypomagnesemia, hypercalcemia

·         K-sparing- hyperkalemia

·         Osmotic diuretics- dehydration, hyponatremia

·         Antidiuretic hormonesà water intoxication, hyponatremia

·         Corticosteroidsà FVE, raise BG, K levels

·         Amphorecticin B + diuretics = hypokalemia

·         Antacids affect levels

·         Anti emetics

Do Not Give At Night

·             Corticosteroids

·         Thiazides

·         Loop

·         Thyroid hormones

Force Fluids

·            Lithium

·         Gout drugs

·         Aminoglycosides

·         Sulfonamides

·         Chemo drugs

Restrict Fluids

·         Antidiuretic hormones

Therapeutic Ranges

·           Lithium 0.6-12

·         Digoxin 0.5- 2

·         Theophylline 10-20

·         Depakote 50-100

Bone Marrow Suppressants

·              Methotrexate

·         Sodium iodide 131

·         Alkylating agents

Anemia

·         Methotrexate

Food Issues

·             B6- give with isoniazid to reduce peripheral neuropathy

·         Tyramine- avoid with MAOIs- raises BP

·         B12 deficiencyà cycloserine (TB drug)

·         Leucovonin (folinic acid)à prevents fatal methotrexate   toxicity

Hypotension

·            Local anesthetics

·         Rapid acting hypnotics

·         Cholinergics

·         Beat blockers

·         Inhalation anesthetics

·         Calcium channel blockers

·         Nitrates and erectile dysfunction drugs

·         Nitrates and ETOH

Hypertension

·            MAOIs and tricyclics

·         Pseudoephedrine- risk of cardiac arrest

Thrombocytopenia

·         Methotrexate

·         Thiazides

·         Heparin

·         Alkylating chemo drugs

Neutropenia

·          Thiazides

·         Antiplatelets

·         Sulfonamides

Agranulocytosis

·                          Clozapine

·         Methotrexate

·         Thiazides

·         Antiplatelets

Respiratory Depression

·             Opioids

·         Rapid acting hypnotics

·         Generalized CNS depressants

Lithium Toxicity

·           Celebrex

·         Frist-generation anti-psychotics

·         Dehydration

·         Hyponatremia

Lowers Lithium Levels

·         Verapamil

·         Osmotic diuretics

Interacts With Lithium

·         Iodine and lithium = hypothyroidism

·         Reglan alters absorption

Bleeding Risk

·                         ASA  (also GI)

·         NSAIDs

·         Corticosteroids (GI)

·         Heparin

·         Warfarin

·         Antiplatelet drugs

·         Thrombolytics

·         Anticoagulants + expectorants

·         Anticoagulants + niacin

·         Warfarin + lovastatin/simvastatin

·         Anticoagulants and loop

·         Anticoagulants + thyroid hormones

·         Tetracyclines + oral anticoagulants

·         Sulfonamides + oral anticoagulants

·         -AZOLES + oral anticoagulants = increase PT time

·         Tamoxifen + warfarin

NOT with MAOIs

·              COMT

·         Anticonvulsants within 14 days

·         Dopaminergic

·         Tricyclics

·         Wait two weeks between MOAIs and SSRIs

·         Opioids- hypertension and seizures, coma

·         St. John’s wort

·         OTC antitussives = hyperthermia and HTN

·         Decongestants

·         MOAIs + insulin = hypoglycemia

Orthostatic Hypotension

·         Parkinson’s drugs

·         COMT

·         Opioids

·         Tricyclics

·         ACEIs

·         ARBs

·         Nitrates

·         Thiazides

·         Loop

·         Skeletal muscle relaxants

·         Thorazine

CNS Depressants

·             Benzos

·         Barbiturates

·         Opioids + antihistamines, ETOH, MOAIs. Tricyclics

·         Rapid- acting hypnotics

·         Inhalation anesthetics

·         BuSpar

·         Chloral hydrate

·         Benadryl

·         Sonata

·         Ambien

·         Phenergan

·         Anti-psychotics potentiate CNS depressants

Not In Angle Closure Glaucoma

·            Benzos

·         Anticholinergics

·         Parkinson’s drugs

·         First-gen anti-psychotics

·         Atypical anti-psychotics

·         Nitrates (especially with calcium channel blockers)

·         Detrol/Enablex

·         Haldol

Digoxin Interactions

·         Beta blockers

·         Anticholinergics

·         Benzos

·         Hypokalemia

·         K-wasting diuretics

·         Calcium

·         Nexium

·         Cyclosporine

·         Erythromycin

·         Quinidine

·         Spirolactone

·         Tetracyclines

·         Verapamil

·         Calcium channel blockers

·         Succinylcholine

·         Thyroid meds

·         Bile acid sequestrants lower dig levels

Oral Contraceptives

·           Barbiturates lower effects

·         Topamax lowers effects

·         Increase risk of clotting with warfarin

·         Penicillin decreases effects

·         Tetracyclines decrease effects

·         Sulfonamides decrease effects

·         Rifampin decreases effects

ANTIDOTES

·         Atropine-ach inhibitors, cholinergics, inhalation anesthetics if tachycardia

·         Narcan-opioids

·         Mucomyst- acetaminophen poisoning

·         DigiFab- Digoxin

·         Vitamin K- warfarin

·         Protamine sulfate- Coumadin/heparin

·         Aminocaproic acid- thrombolytics

No Grapefruit Juice

·         Theophylline (raises levels)

·         BusPAr

·         Calcium channel blockers
          Tegretol
          Some Statins
          Levothyroxine
          Seroquel
          Prilosec
          Codeine
          Amiodarone

Hepatotoxic

·          Alzheimer’s drugs

·         NSAIDs

·         Methotrexate

·         Nicain

·         Immunosupressants

·         Tetracyclines

·         Erythromycin

·         Pyrazinamide

·         Anitmetabolites

·         Tylenol

·         Macrolides

·         Avandia(oral antidiabetic)

Neurotoxic

·                        Alkylating chemo drugs

·         Plant alkaloids

Nephrotoxic

·                          Immunosupressants

·         Aminoglycosides

·         Vancomycin

·         Amphotericin B

·         Nitrosoureas

Cardiotoxic

·              Cyclophosphamides

·         Anti-tumor antibiotics

·         Monoclonal antibodies

EKG Changes

·         Antimalarials

·         Direct vasodilators

·         SSRAs

·         Caffeine

·         Haldol

Ototoxic

·              ASA (tinnitus)

·         Loop diuretics + cisplatin

·         Aminoglycosides

·         Vancomycin

·         Streptomycin

·         Alkylating

·         macrolides

Take With Food

·         Lovastatin with evening meal

·         Prandin/Starlix- oral hypoglycemic with first bite of food

·         Simethicone (Gas X)

·         Pancreatic enzymes

Empty Stomach

·            Catopril

·         Bile acid sequestrants

·         Antihypercalcimetics

·         PPIs

·         Macrolides

·         Penicillin

Photosensitivity

·          Antipsychotics

·         Thiazides

·         Sulfonylureas

·         Tetracyclines

·         Fluroquinolones

·         Sulfonamides

·         Methotrexate

·         Flurouracil

·         Dilantin

Antacids-decrease absorption of other drug

·              Antipsychotics

·         Digoxin

·         Iron

·         Levothyroxine

·         Tetracyclines

·         Fluroquinolones

·         Delay absorption of isoniazid

·         Decrease absorption of H2 receptor

·         Antihypercalcimetcs + Mg antacids = hypermagnesmia

Sleep Disturbances

·         Parkinson’s

·         Corticosteroids

·         Fluroquinolones

·         Barbiturates

·         Bronchodilators-insomnia

Stevens-Johnson

·         Sulfonamides

·         Tegretol

·         Lamictal

·         Depakote

Anaphylaxis

·            Penicillin

·         Sulfonamides

·         Tetracyclines

·         Macrolides

·         Iron supplements

·         Thrombolytics

·         Alkylating agents

·         Warfarin

·         Heparin

Reye’s

·         Aspirin

·         Pepto-Bismol