By Michael A. Mancano, Jason C. Gallagher
Often Prescribed medicinal drugs: medicines you must be aware of is a realistic research device designed to coach and try out scholars concerning the medications which are most typically utilized in perform, in addition to a important reference on drug details for healthiness execs. This finished source reports vital strategies in regards to the use of particular medicinal drugs and gives transparent and succinct info for the medication which are ordinarily used in medical perform, ambulatory perform, and clinic perform, together with details on prescription, over the counter, and usual items.
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Often Prescribed drugs: medications you must understand is a realistic research software designed to teach and try scholars concerning the medicinal drugs which are most ordinarily utilized in perform, in addition to a invaluable reference on drug details for health and wellbeing execs. This finished source experiences vital options concerning the use of particular drugs and offers transparent and succinct info for the medication which are quite often used in scientific perform, ambulatory perform, and health center perform, together with info on prescription, over the counter, and traditional items.
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Pioglitazone D. indd 22 10/15/10 6:00:53 PM Chapter 3 Anti-Infective Agents Jason C. Gallagher, PharmD, BCPS Carol Holtzman, PharmD, MSc Drug Class: Aminoglycosides Introduction Aminoglycosides are bactericidal, Gram-negative agents that are used in serious infections. They are notable for their toxicities, namely nephrotoxicity and ototoxicity. They are often used empirically and then transitioned to more safe agents as culture results become available. Gentamicin and tobramycin are extremely similar drugs, with virtually identical pharmacokinetics and dosing.
COX-2 inhibitors do not appear to block COX-1 as extensively as nonselective NSAIDs, decreasing the toxicity to the GI mucosa. indd 9 • FAP: 400 mg twice daily • Renal dosage adjustment: No specific dosing recommended; avoid in advanced renal disease • Hepatic dosage adjustment: Reduce 50% in moderate impairment; not recommended in severe impairment Drug Class: Nonsteroidal Anti-Inflammatory Drug Propoxyphene-n/Acetaminophen’s Effect on Other Drugs Adverse Reactions: Most Common • Nausea, GI ulcers, peripheral edema, hypertension, headache, diarrhea Adverse Reactions: Rare/Severe/Important • GI perforation and bleeding, thrombosis, renal toxicity, exfoliative dermatitis, Stevens–Johnson syndrome and toxic epidermal necrolysis, fulminant hepatitis, liver failure, acute renal failure Major Drug Interactions Drugs Affecting Celecoxib • Antacids: Decrease absorption of celecoxib • Corticosteroids: Increase GI side effects • Ethanol: Increased GI irritation • Fluconazole can increase concentrations of celecoxib Celecoxib’s Effect on Other Drugs • ACE inhibitors and angiotensin II receptor blockers: Decrease antihypertensive effect and increase renal toxicity • Anticoagulants: Increase bleeding risk • Aspirin: Increases bleeding risk; diminishes cardioprotective effect • Cyclosporine: Increases cyclosporine levels • Diuretics: Decreased effects • Lithium: Increased concentrations Counseling Points • Be informed about signs and symptoms of GI bleeding • Take with food if GI upset occurs • Take as directed • Avoid OTC products unless approved by prescriber • Do not take with antacids Chapter 1â•…Analgesics 9 10/15/10 5:36:47 PM Key Points • Patients with hypersensitivity reactions to sulfonamides (especially nonantibiotic sulfonamides) should avoid celecoxib • Patients with “aspirin triad” (bronchial asthma, aspirin intolerance, rhinitis) may be at increased risk of hypersensitivity.
Most significantly, they are classified as rapid-acting, short-acting, intermediate-acting, or long-acting types of insulin. Insulin lowers blood glucose by stimulating peripheral glucose uptake, especially in skeletal muscle and fat, and by inhibiting hepatic glucose production. indd 17 • Administer Sub-Q 15 minutes before or immediately after starting a meal ■■ Insulin NPH Brand Names Humulin N, Novolin N Generic Name Insulin NPH (intermediate-acting insulin) Chapter 2â•…Antidiabetic Agents 17 10/15/10 6:00:51 PM Dosage Forms Dosage Forms Injection, suspension, 100 units/ml (10-ml vial and 3-ml cartridge for pen use) Injection 100 units/ml (10-ml vial and 3-ml cartridge for pen use) Dosing ■■ • NPH should only be mixed with regular insulin • Draw regular insulin into the syringe first; then add the NPH insulin to the syringe ■■ Insulin Regular Brand Names Insulin Glargine Brand Name Lantus Generic Name Insulin glargine (long-acting insulin) Humulin R, Novolin R Dosage Forms Generic Name Injection 100 units/ml (10-ml vial and 3-ml cartridge for pen use) Insulin regular (short-acting insulin) Dosage Forms Dosing • When changing to insulin glargine from once-daily NPH, the initial dose of insulin glargine should be the same.