Top Drugs P2 Fall DKQ
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Questions and Answers

What is the indication for Beclomethasone (Qvar, Qnasl)?

  • Asthma (correct)
  • Rhinitis
  • Allergic reactions
  • COPD

    • What are the common side effects of Budesonide (Pulmicort)?

    Vertigo, Upper Respiratory Infections

    Fluticasone (Flovent, Flonase) has a boxed warning regarding Pneumonia Risk.

    True (A)

    Ipratropium is used for COPD and Acute asthma (off-label); it works by being an anticholinergic agent that works on M3 receptors, leading to a decrease in secretions and __________.

    <p>bronchodilation</p> Signup and view all the answers

    Match the following medications with their indications:

    <p>Montelukast (Singulair) = Asthma, exercise induced rhinitis Roflumilast (Daliresp) = COPD Tiotropium (Spiriva) = COPD, Asthma (Respimat only)</p> Signup and view all the answers

    What is the relative potency of Dexamethasone compared to Methylprednisolone?

    <p>Dexamethasone 0.75 mg</p> Signup and view all the answers

    Which corticosteroid must be tapered slowly if receiving over 10-14 days of therapy due to HPA axis suppression?

    <p>Prednisone / Prednisolone 5 mg</p> Signup and view all the answers

    Which corticosteroid medication has the adverse effect of 'mask symptoms of infection'?

    <p>Dexamethasone (D)</p> Signup and view all the answers

    Match the corticosteroid medication with its primary side effect:

    <p>Hydrocortisone = Cushing (moon face, buffalo hump, somatic muscle wasting) Methylprednisolone = Live vaccines Prednisone / Prednisolone = HPA axis suppression: must taper slowly if receiving over 10-14 days of therapy</p> Signup and view all the answers

    What is the primary function of thyroid hormones?

    <p>Increases cellular metabolism and plays an important role in growth, development, CNS and bone functions, food metabolism and body temperature</p> Signup and view all the answers

    Which of the following drugs is used for both asthma and COPD?

    <p>Theophylline (C)</p> Signup and view all the answers

    Antithyroid agents work by enhancing the synthesis of thyroid hormones.

    <p>False (B)</p> Signup and view all the answers

    _______ is responsible for competitive inhibition of histamine at H2 receptors of the gastric parietal cells.

    <p>Famotidine</p> Signup and view all the answers

    What is the purpose of Pylera? (List all drugs included)

    <p>Bismuth/Metronidazole/Tetracycline</p> Signup and view all the answers

    Which drug is an osmotic laxative?

    <p>Miralax (D)</p> Signup and view all the answers

    Docusate is a stool softener. (True/False)

    <p>True (A)</p> Signup and view all the answers

    What is the chloride channel activator used as a treatment for constipation?

    <p>Lubiprostone</p> Signup and view all the answers

    Match the drug with its primary usage:

    <p>Metoclopramide = Diabetic gastroparesis Sucralfate = Duodenal ulcer Lactulose = Hepatic encephalopathy</p> Signup and view all the answers

    What are common symptoms of GI obstruction and bowel perforation?

    <p>Discomfort, abdominal distention/pain, N/V</p> Signup and view all the answers

    What is the purpose of Diphenoxylate in the context of GI motility?

    <p>Inhibit peristalsis (D)</p> Signup and view all the answers

    Loperamide acts through the opioid receptor to stimulate peristalsis.

    <p>False (B)</p> Signup and view all the answers

    Loperamide is commonly used for managing diarrhea; however, OTC products should be used for less than __ days.

    <p>2</p> Signup and view all the answers

    Match the following drug with its primary indication: Dicyclomine

    <p>Dicyclomine = Functional bowel/IBS</p> Signup and view all the answers

    Dexamethasone is relative potent compared to Methylprednisolone, with a potency of ____ mg.

    <p>0.75</p> Signup and view all the answers

    Which side effect is NOT associated with chronic use of corticosteroids?

    <p>Pancreatitis (A)</p> Signup and view all the answers

    Match the corticosteroid with its relative potency level:

    <p>Dexamethasone = 0.75 mg Methylprednisolone = 4 mg Prednisone / Prednisolone = 5 mg Hydrocortisone = 20 mg</p> Signup and view all the answers

    What is the primary usage of Xanthine Derivatives in blocking PDE?

    <p>increases cAMP and promotes epinephrine release</p> Signup and view all the answers

    What is the common side effect associated with Theophylline?

    <p>Nausea, Vomiting, Insomnia, Tremor</p> Signup and view all the answers

    Which medication should be separated by 4 hours from antacids, iron, and calcium?

    <p>Levothyroxine (B)</p> Signup and view all the answers

    Antihistamines like Diphenhydramine can cause central nervous system (CNS) depression.

    <p>True (A)</p> Signup and view all the answers

    Histamine (H2) Receptor Antagonists competitively inhibit histamine at H2 receptors of the gastric __________ cells.

    <p>parietal</p> Signup and view all the answers

    What is the mechanism of action of Polyethylene glycol 3350?

    <p>Causes water retention in the stool, increasing stool frequency</p> Signup and view all the answers

    What is the mechanism of action of Docusate?

    <p>Draws water into the stool, softening the stool and achieving ease in bowel movement</p> Signup and view all the answers

    What is the mechanism of action of Alosetron?

    <p>Selective 5-HT3 receptor antagonist, blocking ligand-gated ion channels on the enteric nervous system</p> Signup and view all the answers

    What is the mechanism of action of Linaclotide?

    <p>Guanylate cyclase agonist, increasing intracellular and extracellular cGMP, leading to increased intestinal fluid and decreased GI transit time</p> Signup and view all the answers

    What is the mechanism of action of Lubiprostone?

    <p>Chloride channel activator, increasing intestinal fluid secretion and improving fecal transit</p> Signup and view all the answers

    What is the mechanism of action of Lactulose?

    <p>Bacteria in the colon break down lactulose into lactic acid, increasing osmotic pressure and acidifying intestinal contents, softening the stool</p> Signup and view all the answers

    What is the mechanism of action of Metoclopramide?

    <p>Dopamine antagonist, blocking dopamine receptors and enhancing the response to acetylcholine, causing increased motility and accelerated gastric emptying</p> Signup and view all the answers

    What is the mechanism of action of Sucralfate?

    <p>Formation of an ulcer-adherent complex, protecting the ulcer site from acid, pepsin, and bile salts</p> Signup and view all the answers

    What is the mechanism of action of Sulfate salts?

    <p>Providing sulfate anions, which are poorly absorbed, causing an osmotic effect and retaining water in the gastrointestinal tract</p> Signup and view all the answers

    What is the brand name of the medication Linaclotide?

    <p>Linzess (B)</p> Signup and view all the answers

    What is the brand name of the medication Sucralfate?

    <p>Carafate (A)</p> Signup and view all the answers

    What is the generic name for the drug also known as Qvar and Qnasl that is used for inhibition of inflammatory response in the airways?

    <p>Beclomethasone</p> Signup and view all the answers

    Which side effect is common for Fluticasone?

    <p>Throat Irritation (E)</p> Signup and view all the answers

    Combination of corticosteroid and LABA improves pulmonary function more than using the products alone. (True/False)

    <p>True (A)</p> Signup and view all the answers

    ___ is an example of a SABA (Short Acting Beta Agonist) used for asthma rescue.

    <p>Albuterol</p> Signup and view all the answers

    What is the common purpose of Diphenoxylate/Atropine?

    <p>Inhibiting excessive GI motility and GI propulsion</p> Signup and view all the answers

    Loperamide acts directly on the circular and longitudinal intestinal muscles to stimulate peristalsis.

    <p>False (B)</p> Signup and view all the answers

    What is the common purpose of Somatostatin Analog?

    <p>Decreasing growth hormone (GH) and IGF-1 in acromegaly (B)</p> Signup and view all the answers

    Dicyclomine (Bentyl) is commonly used for functional bowel disorders like ___ and IBS.

    <p>IBS</p> Signup and view all the answers

    What does Levothyroxine treat?

    <p>Hypothyroidism</p> Signup and view all the answers

    Which common side effects are associated with Antihistamine Cetirizine?

    <p>Headache (B), Sedation (C), Anticholinergic adverse drug reactions (ADR) (D)</p> Signup and view all the answers

    Proton Pump Inhibitors block the final step in gastric acid production.

    <p>True (A)</p> Signup and view all the answers

    Which adverse effect is common with Suprep Bowel Kit used for colonoscopy prep?

    <p>Fluid/electrolyte abnormalities (A)</p> Signup and view all the answers

    What are the relative side effects associated with dexamethasone?

    <p>increased appetite, weight gain, Na/H2O retention, hypokalemia, CNS effects, indigestion, hypertension, hyperglycemia, immunosuppression, impaired wound healing, mask symptoms of infection, acne, myopathy</p> Signup and view all the answers

    What is the primary function of Diphenoxylate in the commercial preparations?

    <p>inhibits excessive GI motility and GI propulsion</p> Signup and view all the answers

    Lomotil is a medication used to treat __________.

    <p>diarrhea</p> Signup and view all the answers

    Hydrocortisone is also known as _____ and _____

    <p>Cortef, Solucortef</p> Signup and view all the answers

    For which condition is Methylprednisolone commonly used?

    <p>COPD exacerbations (A), Asthma (B), Rheumatoid arthritis (C), Acute gout (D)</p> Signup and view all the answers

    Loperamide demonstrates antisecretory activity.

    <p>True (A)</p> Signup and view all the answers

    Prednisolone can cause growth retardation.

    <p>True (A)</p> Signup and view all the answers

    Match the following common side effects with the respective medication:

    <p>Drowsiness, Euphoria = Diphenoxylate/Atropine (Lomotil) Abdominal pain, Constipation = Loperamide (Imodium) Hyperhidrosis, Abdominal pain = Somatostatin Analog (Octreotide)</p> Signup and view all the answers

    Match the corticosteroid with its relative potency:

    <p>Dexamethasone = 0.75 mg Methylprednisolone = 4 mg Prednisone / Prednisolone = 5 mg Hydrocortisone = 20 mg</p> Signup and view all the answers

    What is the primary use of Pylera (Bismuth/Metronidazole/Tetracycline)?

    <p>H. pylori infection</p> Signup and view all the answers

    What is the primary purpose of polyethylene glycol (Miralax)?

    <p>Relieving constipation (A)</p> Signup and view all the answers

    Docusate (Colace) is primarily used for treating diarrhea. (True/False)

    <p>False (B)</p> Signup and view all the answers

    Alosetron (Lotronex) is indicated for women with severe ____-predominant IBS.

    <p>diarrhea</p> Signup and view all the answers

    Match the GI agent with its primary purpose:

    <p>Lubiprostone (Amitiza) = Treating IBS with constipation Metoclopramide (Reglan) = Enhancing motility and accelerating gastric emptying Sucralfate (Carafate) = Antiulcer activity Enulose/Kristalose (Lactulose) = Treating constipation and hepatic encephalopathy</p> Signup and view all the answers

    What is the mechanism of action of inhaled steroids?

    <p>Inhibition of inflammatory response in the airways and increase the sensitivity of beta-2 receptors</p> Signup and view all the answers

    What is the indication for Beclomethasone?

    <p>Asthma, COPD, allergic rhinitis (B)</p> Signup and view all the answers

    What is the common side effect of inhaled steroids?

    <p>Throat Irritation, Cough, Thrush, Headache</p> Signup and view all the answers

    What is the benefit of ICS/LABA combination?

    <p>Both A and B (C)</p> Signup and view all the answers

    What is the mechanism of action of Short Acting Muscarinic Antagonist?

    <p>Anticholinergic agent that works on M3 receptors, leading to a decrease in secretions and bronchodilation</p> Signup and view all the answers

    What is the indication for Tiotropium?

    <p>Asthma and COPD (C)</p> Signup and view all the answers

    What is the common side effect of Long Acting Muscarinic Antagonist?

    <p>Constipation, Xerostomia, Headache, Cough</p> Signup and view all the answers

    What is the mechanism of action of Short Acting Beta Agonist?

    <p>Activation of Beta-2 Receptors (A)</p> Signup and view all the answers

    What is the common side effect of Short Acting Beta Agonist?

    <p>Tachycardia, Tremor, Nausea, Pharyngitis</p> Signup and view all the answers

    What is the mechanism of action of Leukotriene Modifier?

    <p>Both A and B (C)</p> Signup and view all the answers

    What is the common side effect of Phosphodiesterase 4 inhibitor?

    <p>Weight Loss, Diarrhea, Nausea, Decrease in Appetite</p> Signup and view all the answers

    What is the mechanism of action of Systemic glucocorticoids?

    <p>All of the above (D)</p> Signup and view all the answers

    Study Notes

    Inhaled Steroids

    • Inhibit inflammatory response in the airways and increase sensitivity of beta-2 receptors
    • Beclomethasone (Qvar, Qnasl): common side effects include throat irritation, cough, thrush, and headache
    • Budesonide (Pulmicort): serious side effects include vertigo, upper respiratory infections, and pneumonia risk; systemic side effects are not common
    • Fluticasone (Flovent, Flonase): common side effects include pneumonia risk, HPA axis suppression, and growth retardation; avoid grapefruit juice
    • Mometasone (Asmanex): common side effects include pneumonia risk, HPA axis suppression, and growth retardation

    ICS/LABA Combination

    • Combination of corticosteroid and LABA improves pulmonary function and control
    • Fluticasone/salmeterol (Advair): avoid grapefruit juice; LABA monotherapy can increase risk of asthma-related deaths and hospitalizations
    • Fluticasone/vilanterol (Breo Ellipta): avoid grapefruit juice; common side effects include hoarseness, cough, thrush, and headache
    • Budesonide/formoterol (Symbicort): avoid grapefruit juice; common side effects include upper respiratory infections, fib, and hypokalemia
    • Mometasone/formoterol (Dulera): avoid grapefruit juice; common side effects include upper respiratory infections, fib, and hypokalemia

    Short Acting Muscarinic Antagonist

    • Ipratropium (Atrovent): common side effects include dry mouth, bitter taste, anticholinergic effects, and bronchitis

    Long Acting Muscarinic Antagonist

    • Tiotropium (Spiriva): common side effects include constipation, xerostomia, headache, and cough; serious side effects include closed angle glaucoma

    Short Acting Beta Agonist

    • Albuterol (ProAir, Ventolin, Proventil): common side effects include tachycardia, tremor, nausea, pharyngitis, and cough; serious side effects include A-Fib, hypertension, and hyperglycemia

    SABA/SAMA Combination

    • Albuterol/ipratropium (Combivent, DuoNeb): common side effects include see individual drug side effects

    Leukotriene Modifier

    • Montelukast (Singulair): common side effects include headache, dizziness, dyspepsia, and flu-like symptoms; serious side effects include suicidal thoughts and altered behavior

    Phosphodiesterase 4 Inhibitor

    • Roflumilast (Daliresp): common side effects include weight loss, diarrhea, nausea, and decrease in appetite; serious side effects include suicidal thoughts

    Systemic Glucocorticoids

    • Suppresses neutrophil migration and decreases inflammatory mediators
    • Dexamethasone (DexPak): common side effects include increased appetite, weight gain, and Na/H2O retention
    • Hydrocortisone (Cortef, Solucortef): common side effects include hypokalemia, CNS, and indigestion
    • Methylprednisolone (Medrol, Solumedrol): common side effects include Cushing, dermal thinning, and diabetes
    • Prednisone (Deltasone): common side effects include Cushing, osteoporosis, and glaucoma
    • Prednisolone (Millipred): common side effects include Cushing, osteoporosis, and glaucoma

    Xanthine Derivative

    • Blocks PDE, causing increased cAMP, which promotes epinephrine release### Theophylline
    • Used to treat asthma and COPD
    • Causes bronchodilation
    • Common side effects: nausea, vomiting, insomnia, tremor
    • Serious side effects: atrial fibrillation, tachyarrhythmia, seizures
    • Interacts with ciprofloxacin, carbamazepine, and phenytoin
    • Dosing based on ideal body weight
    • Therapeutic range: 5-15 mcg/mL

    Thyroid Hormones

    • Increase cellular metabolism and play a role in growth, development, CNS, and bone functions
    • Levothyroxine (Synthroid) is used to treat hypothyroidism
    • Common side effects: increased appetite, weight loss, insomnia, hyperhidrosis
    • Serious side effects: menstrual irregularities, heat intolerance
    • Liothyronine (Cytomel) is used for TSH suppression
    • Desiccated thyroid (Armour thyroid) is a combination of T3 and T4

    Antithyroid Agents

    • Inhibit the synthesis of thyroid hormones
    • Methimazole (Tapazole) is preferred in 2nd and 3rd trimesters of pregnancy
    • Common side effects: hypothyroidism, GI upset
    • Serious side effects: hepatotoxicity, agranulocytosis, hypothrombinemia
    • Propylthiouracil is preferred in the first trimester of pregnancy and thyroid storm

    Antihistamine (H1 Receptor Antagonists)

    • Block H1 receptors to decrease the actions of histamine
    • Cetirizine (Zyrtec) causes CNS depression
    • Diphenhydramine (Benadryl) is used for upper respiratory allergies and urticaria
    • Common side effects: sedation, anticholinergic ADR, HA
    • Serious side effects: QT prolongation

    Histamine (H2) Receptor Antagonists

    • Competitive inhibition of histamine at H2 receptors of gastric parietal cells
    • Famotidine (Pepcid) is used to treat GERD, heartburn, gastric/duodenal ulcer, and erosive esophagitis
    • Common side effects: abdominal pain, headache
    • Serious side effects: altered mental status/confusion

    Proton Pump Inhibitors

    • Decrease acid secretion in gastric parietal cells through inhibition of (H+, K+)-ATPase enzyme system
    • Omeprazole (Prilosec) is used to treat GERD, erosive esophagitis, and H. pylori treatment
    • Common side effects: abdominal pain, diarrhea
    • Serious side effects: fracture risk, C. difficile infection risk
    • Long-term use associated with Vitamin B12 deficiency and hypomagnesemia

    Osmotic Laxative

    • Polyethylene glycol 3350 causes water retention in the stool, increasing stool frequency
    • Common side effects: N/D, abdominal fullness, cramping
    • Serious side effects: dermatitis, rash

    Stool Softener

    • Docusate (Colace) draws water into the stool, softening the stool and achieving ease in bowel movement
    • Common side effects: N/D, abnormal taste
    • Serious side effects: intestinal obstruction

    Selective 5-HT3 Receptor Antagonist

    • Alosetron (Lotronex) is used to treat irritable bowel syndrome

    • Common side effects: constipation, abdominal pain

    • Serious side effects: ischemic colitis

    • Caution in mild-moderate hepatic impairment### Linaclotide (Linzess)

    • Used to treat IBS with constipation and opioid-induced constipation

    • Acts locally on the gastrointestinal tract to increase intestinal fluid secretion and improve fecal transit

    • Contraindications: less than 6yo, GI obstruction

    • Common side effects: diarrhea, abdominal pain, flatulence

    • Serious side effects: dehydration

    Lubiprostone (Amitiza)

    • Used to treat IBS with constipation and opioid-induced constipation
    • Acts as a chloride channel activator to increase intestinal fluid secretion and improve fecal transit
    • Contraindications: GI obstruction, not approved for males with IBS-C
    • Common side effects: N/V/D, flatulence, abdominal pain
    • Serious side effects: dyspnea, hypotension

    Lactulose (Enulose, Kristalose)

    • Used to treat constipation and hepatic encephalopathy
    • Acts as an osmotic laxative to increase stool water content
    • Common side effects: bloating, diarrhea, flatulence, N/V
    • Serious side effects: hypernatremia, hypokalemia

    Metoclopramide (Reglan)

    • Used to treat GERD, diabetic gastroparesis, hiccups, and nausea/vomiting
    • Blocks dopamine receptors and enhances the response to acetylcholine in the upper GI tract
    • Contraindications: GI obstruction, perforation, or hemorrhage, history of seizure, use with other drugs causing EPS
    • Common side effects: drowsiness, insomnia, extrapyramidal symptoms, dizziness
    • Serious side effects: depression, neuroleptic malignant syndrome, tardive dyskinesia

    Sucralfate (Carafate)

    • Used to treat duodenal ulcer
    • Forms an ulcer-adherent complex that protects the ulcer site from acid, pepsin, and bile salts
    • Common side effects: constipation
    • Serious side effects: aluminum toxicity in patients with renal impairment

    Sodium/Potassium/Magnesium (Suprep Bowel Kit)

    • Used for colonoscopy prep
    • Provides sulfate anions that cause water to be retained within the gastrointestinal tract
    • Contraindications: GI obstruction, bowel perforation, gastric retention, ileus, toxic colitis
    • Common side effects: discomfort, abdominal distention/pain, N/V
    • Serious side effects: fluid/electrolyte abnormalities, cardiac arrhythmia, seizure

    Diphenoxylate/Atropine (Lomotil)

    • Used to treat diarrhea
    • Inhibits excessive GI motility and propulsion
    • Contraindications: obstructive jaundice, diarrhea associated with pseudomembranous enterocolitis or enterotoxin-producing bacteria
    • Common side effects: drowsiness/sedation, euphoria, N/V, flushing
    • Serious side effects: paralytic ileus, toxic megacolon, anaphylaxis, anticholinergic hyperthermia, urinary retention, respiratory depression

    Loperamide (Imodium)

    • Used to treat diarrhea
    • Acts directly on intestinal muscles to inhibit peristalsis and prolong transit time
    • Contraindications: children younger than 2 years, abdominal pain without diarrhea, acute dysentery, active ulcerative colitis, bacterial enterocolitis
    • Common side effects: dizziness, abdominal pain, constipation, drowsiness
    • Serious side effects: torsades de pointes

    Octreotide (Ocphyl, Sandostatin)

    • Used to treat acromegaly and off-label for esophageal varices bleeding and sulfonylurea toxicity
    • Mimics natural somatostatin by inhibiting serotonin release and secretion of various hormones
    • Common side effects: hyperhidrosis, abdominal pain, headache, sinusitis
    • Serious side effects: bradyarrhythmia, hyper/hypoglycemia, cholelithiasis

    Dicyclomine (Bentyl)

    • Used to treat functional bowel/IBS
    • Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and the CNS
    • Contraindications: obstructive disease of GI tract, severe ulcerative colitis, glaucoma, myasthenia gravis, breast feeding, infants
    • Common side effects: anticholinergic, lightheadedness
    • Serious side effects: tachyarrhythmia, psychosis, dyspnea

    Inhaled Steroids

    • Inhibit inflammatory response in the airways and increase sensitivity of beta-2 receptors
    • Beclomethasone (Qvar, Qnasl): common side effects include throat irritation, cough, thrush, and headache
    • Budesonide (Pulmicort): serious side effects include vertigo, upper respiratory infections, and pneumonia risk; systemic side effects are not common
    • Fluticasone (Flovent, Flonase): common side effects include pneumonia risk, HPA axis suppression, and growth retardation; avoid grapefruit juice
    • Mometasone (Asmanex): common side effects include pneumonia risk, HPA axis suppression, and growth retardation

    ICS/LABA Combination

    • Combination of corticosteroid and LABA improves pulmonary function and control
    • Fluticasone/salmeterol (Advair): avoid grapefruit juice; LABA monotherapy can increase risk of asthma-related deaths and hospitalizations
    • Fluticasone/vilanterol (Breo Ellipta): avoid grapefruit juice; common side effects include hoarseness, cough, thrush, and headache
    • Budesonide/formoterol (Symbicort): avoid grapefruit juice; common side effects include upper respiratory infections, fib, and hypokalemia
    • Mometasone/formoterol (Dulera): avoid grapefruit juice; common side effects include upper respiratory infections, fib, and hypokalemia

    Short Acting Muscarinic Antagonist

    • Ipratropium (Atrovent): common side effects include dry mouth, bitter taste, anticholinergic effects, and bronchitis

    Long Acting Muscarinic Antagonist

    • Tiotropium (Spiriva): common side effects include constipation, xerostomia, headache, and cough; serious side effects include closed angle glaucoma

    Short Acting Beta Agonist

    • Albuterol (ProAir, Ventolin, Proventil): common side effects include tachycardia, tremor, nausea, pharyngitis, and cough; serious side effects include A-Fib, hypertension, and hyperglycemia

    SABA/SAMA Combination

    • Albuterol/ipratropium (Combivent, DuoNeb): common side effects include see individual drug side effects

    Leukotriene Modifier

    • Montelukast (Singulair): common side effects include headache, dizziness, dyspepsia, and flu-like symptoms; serious side effects include suicidal thoughts and altered behavior

    Phosphodiesterase 4 Inhibitor

    • Roflumilast (Daliresp): common side effects include weight loss, diarrhea, nausea, and decrease in appetite; serious side effects include suicidal thoughts

    Systemic Glucocorticoids

    • Suppresses neutrophil migration and decreases inflammatory mediators
    • Dexamethasone (DexPak): common side effects include increased appetite, weight gain, and Na/H2O retention
    • Hydrocortisone (Cortef, Solucortef): common side effects include hypokalemia, CNS, and indigestion
    • Methylprednisolone (Medrol, Solumedrol): common side effects include Cushing, dermal thinning, and diabetes
    • Prednisone (Deltasone): common side effects include Cushing, osteoporosis, and glaucoma
    • Prednisolone (Millipred): common side effects include Cushing, osteoporosis, and glaucoma

    Xanthine Derivative

    • Blocks PDE, causing increased cAMP, which promotes epinephrine release### Theophylline
    • Used to treat asthma and COPD
    • Causes bronchodilation
    • Common side effects: nausea, vomiting, insomnia, tremor
    • Serious side effects: atrial fibrillation, tachyarrhythmia, seizures
    • Interacts with ciprofloxacin, carbamazepine, and phenytoin
    • Dosing based on ideal body weight
    • Therapeutic range: 5-15 mcg/mL

    Thyroid Hormones

    • Increase cellular metabolism and play a role in growth, development, CNS, and bone functions
    • Levothyroxine (Synthroid) is used to treat hypothyroidism
    • Common side effects: increased appetite, weight loss, insomnia, hyperhidrosis
    • Serious side effects: menstrual irregularities, heat intolerance
    • Liothyronine (Cytomel) is used for TSH suppression
    • Desiccated thyroid (Armour thyroid) is a combination of T3 and T4

    Antithyroid Agents

    • Inhibit the synthesis of thyroid hormones
    • Methimazole (Tapazole) is preferred in 2nd and 3rd trimesters of pregnancy
    • Common side effects: hypothyroidism, GI upset
    • Serious side effects: hepatotoxicity, agranulocytosis, hypothrombinemia
    • Propylthiouracil is preferred in the first trimester of pregnancy and thyroid storm

    Antihistamine (H1 Receptor Antagonists)

    • Block H1 receptors to decrease the actions of histamine
    • Cetirizine (Zyrtec) causes CNS depression
    • Diphenhydramine (Benadryl) is used for upper respiratory allergies and urticaria
    • Common side effects: sedation, anticholinergic ADR, HA
    • Serious side effects: QT prolongation

    Histamine (H2) Receptor Antagonists

    • Competitive inhibition of histamine at H2 receptors of gastric parietal cells
    • Famotidine (Pepcid) is used to treat GERD, heartburn, gastric/duodenal ulcer, and erosive esophagitis
    • Common side effects: abdominal pain, headache
    • Serious side effects: altered mental status/confusion

    Proton Pump Inhibitors

    • Decrease acid secretion in gastric parietal cells through inhibition of (H+, K+)-ATPase enzyme system
    • Omeprazole (Prilosec) is used to treat GERD, erosive esophagitis, and H. pylori treatment
    • Common side effects: abdominal pain, diarrhea
    • Serious side effects: fracture risk, C. difficile infection risk
    • Long-term use associated with Vitamin B12 deficiency and hypomagnesemia

    Osmotic Laxative

    • Polyethylene glycol 3350 causes water retention in the stool, increasing stool frequency
    • Common side effects: N/D, abdominal fullness, cramping
    • Serious side effects: dermatitis, rash

    Stool Softener

    • Docusate (Colace) draws water into the stool, softening the stool and achieving ease in bowel movement
    • Common side effects: N/D, abnormal taste
    • Serious side effects: intestinal obstruction

    Selective 5-HT3 Receptor Antagonist

    • Alosetron (Lotronex) is used to treat irritable bowel syndrome

    • Common side effects: constipation, abdominal pain

    • Serious side effects: ischemic colitis

    • Caution in mild-moderate hepatic impairment### Linaclotide (Linzess)

    • Used to treat IBS with constipation and opioid-induced constipation

    • Acts locally on the gastrointestinal tract to increase intestinal fluid secretion and improve fecal transit

    • Contraindications: less than 6yo, GI obstruction

    • Common side effects: diarrhea, abdominal pain, flatulence

    • Serious side effects: dehydration

    Lubiprostone (Amitiza)

    • Used to treat IBS with constipation and opioid-induced constipation
    • Acts as a chloride channel activator to increase intestinal fluid secretion and improve fecal transit
    • Contraindications: GI obstruction, not approved for males with IBS-C
    • Common side effects: N/V/D, flatulence, abdominal pain
    • Serious side effects: dyspnea, hypotension

    Lactulose (Enulose, Kristalose)

    • Used to treat constipation and hepatic encephalopathy
    • Acts as an osmotic laxative to increase stool water content
    • Common side effects: bloating, diarrhea, flatulence, N/V
    • Serious side effects: hypernatremia, hypokalemia

    Metoclopramide (Reglan)

    • Used to treat GERD, diabetic gastroparesis, hiccups, and nausea/vomiting
    • Blocks dopamine receptors and enhances the response to acetylcholine in the upper GI tract
    • Contraindications: GI obstruction, perforation, or hemorrhage, history of seizure, use with other drugs causing EPS
    • Common side effects: drowsiness, insomnia, extrapyramidal symptoms, dizziness
    • Serious side effects: depression, neuroleptic malignant syndrome, tardive dyskinesia

    Sucralfate (Carafate)

    • Used to treat duodenal ulcer
    • Forms an ulcer-adherent complex that protects the ulcer site from acid, pepsin, and bile salts
    • Common side effects: constipation
    • Serious side effects: aluminum toxicity in patients with renal impairment

    Sodium/Potassium/Magnesium (Suprep Bowel Kit)

    • Used for colonoscopy prep
    • Provides sulfate anions that cause water to be retained within the gastrointestinal tract
    • Contraindications: GI obstruction, bowel perforation, gastric retention, ileus, toxic colitis
    • Common side effects: discomfort, abdominal distention/pain, N/V
    • Serious side effects: fluid/electrolyte abnormalities, cardiac arrhythmia, seizure

    Diphenoxylate/Atropine (Lomotil)

    • Used to treat diarrhea
    • Inhibits excessive GI motility and propulsion
    • Contraindications: obstructive jaundice, diarrhea associated with pseudomembranous enterocolitis or enterotoxin-producing bacteria
    • Common side effects: drowsiness/sedation, euphoria, N/V, flushing
    • Serious side effects: paralytic ileus, toxic megacolon, anaphylaxis, anticholinergic hyperthermia, urinary retention, respiratory depression

    Loperamide (Imodium)

    • Used to treat diarrhea
    • Acts directly on intestinal muscles to inhibit peristalsis and prolong transit time
    • Contraindications: children younger than 2 years, abdominal pain without diarrhea, acute dysentery, active ulcerative colitis, bacterial enterocolitis
    • Common side effects: dizziness, abdominal pain, constipation, drowsiness
    • Serious side effects: torsades de pointes

    Octreotide (Ocphyl, Sandostatin)

    • Used to treat acromegaly and off-label for esophageal varices bleeding and sulfonylurea toxicity
    • Mimics natural somatostatin by inhibiting serotonin release and secretion of various hormones
    • Common side effects: hyperhidrosis, abdominal pain, headache, sinusitis
    • Serious side effects: bradyarrhythmia, hyper/hypoglycemia, cholelithiasis

    Dicyclomine (Bentyl)

    • Used to treat functional bowel/IBS
    • Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and the CNS
    • Contraindications: obstructive disease of GI tract, severe ulcerative colitis, glaucoma, myasthenia gravis, breast feeding, infants
    • Common side effects: anticholinergic, lightheadedness
    • Serious side effects: tachyarrhythmia, psychosis, dyspnea

    Inhaled Steroids

    • Inhibit inflammatory response in the airways and increase sensitivity of beta-2 receptors
    • Beclomethasone (Qvar, Qnasl): common side effects include throat irritation, cough, thrush, and headache
    • Budesonide (Pulmicort): serious side effects include vertigo, upper respiratory infections, and pneumonia risk; systemic side effects are not common
    • Fluticasone (Flovent, Flonase): common side effects include pneumonia risk, HPA axis suppression, and growth retardation; avoid grapefruit juice
    • Mometasone (Asmanex): common side effects include pneumonia risk, HPA axis suppression, and growth retardation

    ICS/LABA Combination

    • Combination of corticosteroid and LABA improves pulmonary function and control
    • Fluticasone/salmeterol (Advair): avoid grapefruit juice; LABA monotherapy can increase risk of asthma-related deaths and hospitalizations
    • Fluticasone/vilanterol (Breo Ellipta): avoid grapefruit juice; common side effects include hoarseness, cough, thrush, and headache
    • Budesonide/formoterol (Symbicort): avoid grapefruit juice; common side effects include upper respiratory infections, fib, and hypokalemia
    • Mometasone/formoterol (Dulera): avoid grapefruit juice; common side effects include upper respiratory infections, fib, and hypokalemia

    Short Acting Muscarinic Antagonist

    • Ipratropium (Atrovent): common side effects include dry mouth, bitter taste, anticholinergic effects, and bronchitis

    Long Acting Muscarinic Antagonist

    • Tiotropium (Spiriva): common side effects include constipation, xerostomia, headache, and cough; serious side effects include closed angle glaucoma

    Short Acting Beta Agonist

    • Albuterol (ProAir, Ventolin, Proventil): common side effects include tachycardia, tremor, nausea, pharyngitis, and cough; serious side effects include A-Fib, hypertension, and hyperglycemia

    SABA/SAMA Combination

    • Albuterol/ipratropium (Combivent, DuoNeb): common side effects include see individual drug side effects

    Leukotriene Modifier

    • Montelukast (Singulair): common side effects include headache, dizziness, dyspepsia, and flu-like symptoms; serious side effects include suicidal thoughts and altered behavior

    Phosphodiesterase 4 Inhibitor

    • Roflumilast (Daliresp): common side effects include weight loss, diarrhea, nausea, and decrease in appetite; serious side effects include suicidal thoughts

    Systemic Glucocorticoids

    • Suppresses neutrophil migration and decreases inflammatory mediators
    • Dexamethasone (DexPak): common side effects include increased appetite, weight gain, and Na/H2O retention
    • Hydrocortisone (Cortef, Solucortef): common side effects include hypokalemia, CNS, and indigestion
    • Methylprednisolone (Medrol, Solumedrol): common side effects include Cushing, dermal thinning, and diabetes
    • Prednisone (Deltasone): common side effects include Cushing, osteoporosis, and glaucoma
    • Prednisolone (Millipred): common side effects include Cushing, osteoporosis, and glaucoma

    Xanthine Derivative

    • Blocks PDE, causing increased cAMP, which promotes epinephrine release### Theophylline
    • Used to treat asthma and COPD
    • Causes bronchodilation
    • Common side effects: nausea, vomiting, insomnia, tremor
    • Serious side effects: atrial fibrillation, tachyarrhythmia, seizures
    • Interacts with ciprofloxacin, carbamazepine, and phenytoin
    • Dosing based on ideal body weight
    • Therapeutic range: 5-15 mcg/mL

    Thyroid Hormones

    • Increase cellular metabolism and play a role in growth, development, CNS, and bone functions
    • Levothyroxine (Synthroid) is used to treat hypothyroidism
    • Common side effects: increased appetite, weight loss, insomnia, hyperhidrosis
    • Serious side effects: menstrual irregularities, heat intolerance
    • Liothyronine (Cytomel) is used for TSH suppression
    • Desiccated thyroid (Armour thyroid) is a combination of T3 and T4

    Antithyroid Agents

    • Inhibit the synthesis of thyroid hormones
    • Methimazole (Tapazole) is preferred in 2nd and 3rd trimesters of pregnancy
    • Common side effects: hypothyroidism, GI upset
    • Serious side effects: hepatotoxicity, agranulocytosis, hypothrombinemia
    • Propylthiouracil is preferred in the first trimester of pregnancy and thyroid storm

    Antihistamine (H1 Receptor Antagonists)

    • Block H1 receptors to decrease the actions of histamine
    • Cetirizine (Zyrtec) causes CNS depression
    • Diphenhydramine (Benadryl) is used for upper respiratory allergies and urticaria
    • Common side effects: sedation, anticholinergic ADR, HA
    • Serious side effects: QT prolongation

    Histamine (H2) Receptor Antagonists

    • Competitive inhibition of histamine at H2 receptors of gastric parietal cells
    • Famotidine (Pepcid) is used to treat GERD, heartburn, gastric/duodenal ulcer, and erosive esophagitis
    • Common side effects: abdominal pain, headache
    • Serious side effects: altered mental status/confusion

    Proton Pump Inhibitors

    • Decrease acid secretion in gastric parietal cells through inhibition of (H+, K+)-ATPase enzyme system
    • Omeprazole (Prilosec) is used to treat GERD, erosive esophagitis, and H. pylori treatment
    • Common side effects: abdominal pain, diarrhea
    • Serious side effects: fracture risk, C. difficile infection risk
    • Long-term use associated with Vitamin B12 deficiency and hypomagnesemia

    Osmotic Laxative

    • Polyethylene glycol 3350 causes water retention in the stool, increasing stool frequency
    • Common side effects: N/D, abdominal fullness, cramping
    • Serious side effects: dermatitis, rash

    Stool Softener

    • Docusate (Colace) draws water into the stool, softening the stool and achieving ease in bowel movement
    • Common side effects: N/D, abnormal taste
    • Serious side effects: intestinal obstruction

    Selective 5-HT3 Receptor Antagonist

    • Alosetron (Lotronex) is used to treat irritable bowel syndrome

    • Common side effects: constipation, abdominal pain

    • Serious side effects: ischemic colitis

    • Caution in mild-moderate hepatic impairment### Linaclotide (Linzess)

    • Used to treat IBS with constipation and opioid-induced constipation

    • Acts locally on the gastrointestinal tract to increase intestinal fluid secretion and improve fecal transit

    • Contraindications: less than 6yo, GI obstruction

    • Common side effects: diarrhea, abdominal pain, flatulence

    • Serious side effects: dehydration

    Lubiprostone (Amitiza)

    • Used to treat IBS with constipation and opioid-induced constipation
    • Acts as a chloride channel activator to increase intestinal fluid secretion and improve fecal transit
    • Contraindications: GI obstruction, not approved for males with IBS-C
    • Common side effects: N/V/D, flatulence, abdominal pain
    • Serious side effects: dyspnea, hypotension

    Lactulose (Enulose, Kristalose)

    • Used to treat constipation and hepatic encephalopathy
    • Acts as an osmotic laxative to increase stool water content
    • Common side effects: bloating, diarrhea, flatulence, N/V
    • Serious side effects: hypernatremia, hypokalemia

    Metoclopramide (Reglan)

    • Used to treat GERD, diabetic gastroparesis, hiccups, and nausea/vomiting
    • Blocks dopamine receptors and enhances the response to acetylcholine in the upper GI tract
    • Contraindications: GI obstruction, perforation, or hemorrhage, history of seizure, use with other drugs causing EPS
    • Common side effects: drowsiness, insomnia, extrapyramidal symptoms, dizziness
    • Serious side effects: depression, neuroleptic malignant syndrome, tardive dyskinesia

    Sucralfate (Carafate)

    • Used to treat duodenal ulcer
    • Forms an ulcer-adherent complex that protects the ulcer site from acid, pepsin, and bile salts
    • Common side effects: constipation
    • Serious side effects: aluminum toxicity in patients with renal impairment

    Sodium/Potassium/Magnesium (Suprep Bowel Kit)

    • Used for colonoscopy prep
    • Provides sulfate anions that cause water to be retained within the gastrointestinal tract
    • Contraindications: GI obstruction, bowel perforation, gastric retention, ileus, toxic colitis
    • Common side effects: discomfort, abdominal distention/pain, N/V
    • Serious side effects: fluid/electrolyte abnormalities, cardiac arrhythmia, seizure

    Diphenoxylate/Atropine (Lomotil)

    • Used to treat diarrhea
    • Inhibits excessive GI motility and propulsion
    • Contraindications: obstructive jaundice, diarrhea associated with pseudomembranous enterocolitis or enterotoxin-producing bacteria
    • Common side effects: drowsiness/sedation, euphoria, N/V, flushing
    • Serious side effects: paralytic ileus, toxic megacolon, anaphylaxis, anticholinergic hyperthermia, urinary retention, respiratory depression

    Loperamide (Imodium)

    • Used to treat diarrhea
    • Acts directly on intestinal muscles to inhibit peristalsis and prolong transit time
    • Contraindications: children younger than 2 years, abdominal pain without diarrhea, acute dysentery, active ulcerative colitis, bacterial enterocolitis
    • Common side effects: dizziness, abdominal pain, constipation, drowsiness
    • Serious side effects: torsades de pointes

    Octreotide (Ocphyl, Sandostatin)

    • Used to treat acromegaly and off-label for esophageal varices bleeding and sulfonylurea toxicity
    • Mimics natural somatostatin by inhibiting serotonin release and secretion of various hormones
    • Common side effects: hyperhidrosis, abdominal pain, headache, sinusitis
    • Serious side effects: bradyarrhythmia, hyper/hypoglycemia, cholelithiasis

    Dicyclomine (Bentyl)

    • Used to treat functional bowel/IBS
    • Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and the CNS
    • Contraindications: obstructive disease of GI tract, severe ulcerative colitis, glaucoma, myasthenia gravis, breast feeding, infants
    • Common side effects: anticholinergic, lightheadedness
    • Serious side effects: tachyarrhythmia, psychosis, dyspnea

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    Identify key information about top drugs including generic and brand names, indications, adjustment routes, boxed warnings, contraindications, and side effects.

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