Week 3 & 4 PPP Drugs.pdf

PHAR4009 I Professional Pharmacy Placement Year 4 Semester 1, 2024 Week 3 Drug class (1) Indication(s) (2) Dosing (2) Counselling (3)...

PHAR4009 I Professional Pharmacy Placement Year 4 Semester 1, 2024 Week 3 Drug class (1) Indication(s) (2) Dosing (2) Counselling (3) Monitoring (2) Apixaban Direct oral anti- Non-valvular AF and Px of emboli in AF Common Renal function (dose coagulants high risk of stroke or Oral, 5mg bd o Nausea adjustment) (DOACs) systemic embolism Weight 80 years, serum (anaemia) Sx of unusual bleeding inhibitor elective hip/knee creatinine Infrequent: (bruising, nosebleeds, replacement >133 micromol/L Thrombocytopenia, blood in urine/stools) MOA in patient Tx of acute VTE and px o 2.5 mg abnormal liver fx Platelet levels – friendly language: of subsequent VTE bd Rare: anticoagulant thrombocytopenia Apixaban help nephropathy (kidney *Drug interactions - prevent blood clots Px of VTE after injury – foamy urine) strong cytochrome by thinning your hip/knee replacement Tell your doctor P450, CYP3A4 inhibitors blood Oral, 2.5mg bd, immediately if you or inducers -> dose starting 12-24 hrs have any unexplained adjustment after surgery. bruising, bleeding, Continue for 10-14 pink, red or dark days after knee brown urine, or red or replacement or 32- black faeces. 38 days after hip CAL 10b: Don’t take replacement aspirin or anti- inflammatory Tx of acute VTE and px medicines while being of subsequent VTE treated with this Oral, 10mg bd for 7 medicine unless days, then 5mg bd advised Consider reducing CAL 18: Avoid eating after 6 months to grapefruit or drinking 2.5mg bd if grapefruit juice extended tx is Avoid activities that needed increase risk of bleeding or injury e,g contact sports  PHAR4009 I Professional Pharmacy Placement Year 4 Semester 1, 2024 Amoxicillin + Clavulanic Amoxicillin – Hospital acquired Adult Ask about penicillin Sx of seizures – rapid IV acid penicillin pneumonia Oral, 500-875mg allergy -> seizures antibiotic Urinary tract infection every 12 hrs for 5- Common Liver function (AST/ALT) Clavulanic acid – (UTI) 10 days or longer o Transient increase Renal function (dose beta lactamase Acute cholecystitis IV, 1g every 8 hrs, in liver enzymes adjustment) inhibitor Melioidosis can increase to and bilirubin Allergic reactions – skin Pelvic inflammatory every 6 hours in o Rash >7days of tx rash, SOB, cough, MOA in patient disease (PID) (not serious infections o Pain/inflammation swelling, etc friendly language: sexually acquired) (max 2g every 6 at injection site (IV) Amoxicillin kills Epididymo-orchitis hrs) o Nausea, diarrhoea, bacteria, Clavulanic (urinary tract source) Renal impairment vomiting acid extend the Bites and clenched o CrCl 10- o Candida causing spectrum of fist injuries 30mL/min, IV 1g oral thrush or amoxicillin to treat Acute otitis media every 12 hrs vaginal infections (unresponsive to o CrCl Rare amoxicillin) decreased inflammatory disease COPD exacerbation Rare Sx of infection immunity Osteoarthritis Oral, 40-50mg o Tendon rupture BMD S: sad -> Depression Replacement therapy d for 5-14 days (Achilles Sx of S: salt -> water/salt retention in adrenal Acute gout tendon) cataracts/glaucoma (hypertension) insufficiency Oral, 20-50mg o Peptic S: sex -> decreased libido d for 3-5 days ulceration  PHAR4009 I Professional Pharmacy Placement Year 4 Semester 1, 2024 S: swollen -> water gain -> Autoimmune/Inflam o Cartilage oedema /weight gain matory disease damage (intra- S: sight -> cataracts Oral, initially 5- articular 60mg -> 3.5- injection) 15mg d CAL B; with or soon Intra-articular after food injection CAL L: caution not to No more than 4 be taken in single joint (enema/supp) Avoid of no CAL 6: fridge (eye response after drops, oral solution) 2 consecutive CAL 7b: discard injections after___ (oral solution, enema/supp) Child CAL 9: don’t stop Acute asthma abruptly (unless short Oral, 1mg/kg courses) (max 50mg) d CAL 13: remove for 3-5 days packaging when dose Autoimmune/inflam required matory disease (enema/supp) Oral, initially 1- Breastfeeding – feed 2mg/kg (max after 4 hrs 60mg) d -> Tell doc, surgeons, taper dentists, that you are taking. May need increased dose. Vit D + calcium supplement Tiotropium + combinations Long acting COPD COPD Common Renal function muscarinic Maintenance of Braltus Zonda, Spiriva o Dry mouth (increase anti- 1. Tiotropium (Spiriva) antagonist moderate/severe Handihaler (DPI); 1 cap o Throat cholinergic adverse 2. Tiotropium + asthma adjunct to ICS (10 mcg) inh d irritation effects) olodaterol Infrequent Sx COPD/asthma o Used in COPD o Blurred vision PHAR4009 I Professional Pharmacy Placement Year 4 Semester 1, 2024 o Beta 2 agonist Spiriva Respimat o Dizziness Pulmonary function – o 2 inh d (MDI); 2 inh (f 2.5mc) d o Urinary spirometry retention Asthma Rare Spiriva Respimat; 2 inh o Constipation (of 2.5mcg) d CAL 7b: 3 months (Respimat) CAL 13: don’t remove from packaging till dose required CAL 22: use approved device Don’t allow powder to come in contact with eyes Long-acting – not to be used for immediate sx relief