(1)Lipitor®
Generic / Indication(s) / Formulations / Dose/Daily Dose
Atorvastatin / Hyperlipidemia, hypertriglyceridemia / Tablets: 10, 20, 40, 80mg / Initial: 10mg/d
May ↑to 80mg/d
Pharm. Class. / Action / Adverse Effects / Monitoring Parameters
Antihypelipidemic- HMG-CoA Reductase Inhibitor / Inhibits HMG-CoA reductase and cholesterol synthesis in the liver and increases the number of hepatic LDL receptors on the cell-surface to enhance uptake and catabolism of LDL, thus lowering plasma lipoprotein and cholesterol levels / Myopathy, HA, Arthralgia, Myalgia, GI Upset, Chest Pain, Edema, Insomnia, Dizziness / LTFs
Patient Counseling / Contraindications / Caution / Drug Interaction(s)
Report unusual muscle pain or weakness / Active Liver Dz
Unexplained ↑ LFTS / Pregnancy Code X
(2)Nexium®
Generic / Indication(s) / Formulations / Dose/Daily Dose
Esomeprazole / Short term (4-8wks) for Erosive Esophagitis/GERD; H. Pylori infxn in combo w/antibiotic / Capsule: 20, 40mg
IV:20, 40mg / GERD/Erosive Gastritis
§  20-40mg/d PO x 4-8 wk
§  20-40mg IV 10-30 min inf or >3min IV Push 10 d max
§  Maint: 20mg/d PO
H. Pylori Infxn:
§  40mg/d PO + Clarithromycin 500mg PO BID + Amoxicillin 1000mg BID for 10d
Pharm. Class. / Action / Adverse Effects / Monitoring Parameters
Proton Pump Inhibitor / ↓Gastric Acid / HA, Diarrhea, Abn Pain,
Patient Counseling / Contraindications / Caution / Drug Interaction
Do not chew; may open capsule and sprinkle on apple sauce / Component Sensitivity / ?
(3)Plavix®
Generic / Indication(s / Formulations / Dose/Daily Dose
Clopidogrel / Antiplatelet agent; reduce atherosclerotic events; administer ASAP in ECC setting w/high risk ST depression or T-wave inversion / Tablets: 75, 300mg / §  75mg/d
§  300-600mg PO x 1 dose to load patient
§  300mg PO, then 75mg/d 1-9 month
Pharm. Class. / Action / Adverse Effects / Monitoring Parameters
Antiplatelet / ↓Platelet Aggregation / ↑ Bleeding Time; GI Intolerance; HA; Dizziness, Rash; Thrombocytopenia; ↓WBC
Patient Counseling / Contraindications / Caution / Drug Interaction
Report unusual bleeding / Coagulation Disorders; Active/Intracranial Bleeding; CABG planned w/in 5-7 d / Active Bleeding; risk of bleeding from trauma & other; Thrombotic Thrombocytopenic Purpura; Liver Dz
(4)Advair Diskus®
Generic / Indication(s / Formulations / Dose/Daily Dose
Fluticasone Propionate and Salmeterol Xinafoate / Asthma Maint. Rx / Diskus=metered-dose inh powder 100/50, 250/50, 500/50
HFA=aerosol 45/21, 115/21, 230/21mg / Adults & Peds >12 y: 1 Inh bid q 12h; titrate to lowest effective dose (4 Inh or 920/84 mcg/d max)
Pharm. Class. / Action / Adverse Effects / Monitoring Parameters
Corticosteroid w/LA Bronchodilator β2 Agonist / URTI; Pharyngitis; HA
Patient Counseling / Contraindications / Caution / Drug Interaction
Do not wash mouthpiece; do not exhale into device / Acute Asthma Attack; Conversion from PO Steroids; w/Phenothiazines / ↑ Risk of worsening wheezing or asthma-related death w/long-acting β2 Adrenergic Agonist
(5) Prevacid®
Generic / Indication(s / Formulations / Dose/Daily Dose
Lansoprazole / Duodenal ulcers; GERD; prevent & treat NSAID gastric ulcers, active gastric ulcers, H. pylori infxn, erosive esophagitis, & hypersecretory conditions / Caps: 15, 30mg
Granules for susp: 15, 30mg
IV: 30mg
Once-daily tabs: 15, 30mg
Prevacid solutab: 15, 30mg ODT / 15-30mg/d PO
NSAID ulcer prevention: 15mg/d PO =12wk; NSAID ulcers: 30mg/d PO X 8wk; hypersecretory condition: 60mg/d before food; 30mg IV daily X 7d change to PO for 6-8wk
Decrease dosage w/ severe hepatic impair
Pharm. Class.
Proton pump inhibitor / Action
Inhibits the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell / Adverse Effects
N/V, abd pain, HA, fatigue / Monitoring Parameters
Patient Counseling / Contraindications / Caution / Drug Interaction
Do not crush or chew granules or caps; take before meals; mix granules w/ 30mL of water, stir well and drink immediately; store in a cool dry place away from sunlight and children / Hypersensitivity to any component of the formulation / Pregnancy category B / B/c it causes a profound and long lasting inhibition of gastric acid secretion it may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (eg. Ketoconazole, Ampicillin esters, iron salts, digoxin, atazanavir)
Lansoprazole should be taken 30 min prior to sulcrafate
(6)Seroquel®
Generic / Indication(s / Formulations / Dose/Daily Dose
Quetiapine / Acute exacerbation of schizophrenia / Generic oral tabs: 25, 50 100mg
Seroquel oral tabs: 25, 50, 100, 200, 300, 400mg
Seroquel XR: 200, 300, 400mg / ·  150-750mg/d; Initiate at 25-100 mg bid-tid; slowly ↑ dose
·  XR: 400-800mg PO q P.M.; start w/ 300mg/d, ↑ 300mg/d, 800mg/d max
·  ↓dose w/ hepatic & geriatric pts
Pharm. Class.
Antipsychotic / Action
Antagonize dopamine D2 and serotonin 5HT2 receptors / Adverse Effects
Confusion w/ nefazodone; HA; somnolence; ↑ wgt; ↓BP; dizziness, cataracts; neuroleptic malignant syndrome; tardive dyskinesia; ↑QT interval / Monitoring Parameters
suicidality and/or unusual changes in behavior; signs and symptoms of hyperglycemia (ie, polydipsia, polyuria, polyphagia, and weakness); signs and symptoms of extrapyramidal effects and tardive dyskinesia; fasting blood glucose; baseline and periodically during therapy; eye examination (eg, slit lamp exam); initiation of treatment or shortly thereafter, and every 6 months for long term use; ECG; baseline and periodically during treatment; clinical worsening of depression; blood pressure and heart rate; reassess the need for maintenance treatment periodically; fever or other signs or symptoms of infection; in patients with neutropenia; CBC; baseline and periodically during therapy; in patients with pre-existing low WBC or history of drug-induced leukopenia/neutropenia;
Patient Counseling / Contraindications / Caution/ Warning / Drug Interactions
Seroquel RX should be swallowed whole; do not drink alcohol or use other CNS depressants while taking this drug; use w/ caution when rising from sitting/lying down, as drug may cause orthostatic hypotension; avoid activities requiring mental alertness or coordination until drug effects are realized, as drug may cause dizziness and somnolence; this drug may cause weight gain, hyperglycemia and impair heat regulation / Hypersensitivity to any component of the formulation / Closely monitor pts for worsening depression or emergence of suicidability (BBW), particularly in ped pts; not for use in peds; ↑ mortality in elderly w/ dementia-related psychosis (BBW)
Pregnancy category C / CYP 3A4 substrate
Additive effects w/ antihypertensives
Antagonizes hypoglycemic effects of glucose lowering drugs
(7)Singulair®
Generic / Indication(s / Formulations / Dose/Daily Dose
Montelukast / Prevent/ treat chronic asthma ≥ 12mo; seasonal allergic rhinitis ≥ 2y; perennial allergic rhinitis ≥6mo; prevent exercise bronchoconstriction ≥15y / Singulair
Oral tabs: 10mg
Chew tabs: 4, 5mg
Granules: 4mg/pack / Asthma: Adults & peds >15y: 10mg/d PO in P.M.
6-23mo: 4mg pack granules q d; 2-5y: 4mg/d PO q P.M.; 6-14y: 5mg/d PO q P.M.
Pharm. Class.
Antiasthmatic / Action
Selective and active leukotriene receptor antagonist
Binds to cysteinyl leukotrienes (CysLT) type-1 receptors found in human airway (smooth muscle cells and macrophages), which prevents airway edema, smooth muscle contraction and other respiratory inflammation / Adverse Effects
HA; dizziness; fatigue; rash; GI upset; Churg-strauss syndrome; flu; cough / Monitoring Parameters
Clinical improvement in asthma symptoms, pulmonary function tests and/or reduction in inhaled corticosteroid/beta-agonist use.
Potential change in behavior/mood, including suicidal thinking or suicide or neuropsychiatric symptoms (eg, agitation, aggression, anxiousness, dream abnormalities, hallucinations, depression, sleep disorders (including insomnia), irritability, restlessness, and tremor)
Blood chemistry and liver function test monitoring
Patient Counseling / Contraindications / Caution/ Warning / Drug Interaction
Hypersensitivity to any component of the formulation / Pregnancy category B
Not for acute asthma
Do not doe w/in 24h of previous asthma attack
Recent concern over ↑ suicidal behavior / 2C9, 3A4 substrate (eg. Phenobarbital may increase met. Of montelukast)
and potent 2C8 inhibitor (eg. Montelukast may decrease the met of rosiglitazone and repaglinide
(8)Effexor XR®
Generic / Indication(s / Formulations / Dose/Daily Dose
Venlafaxine / Depression; generalized anxiety; social anxiety disorder; panic disorder
Off-label uses: OCD; chronic fatigue syndrome; ADHD; autism / Generic: oral tab: 25, 37.5, 50, 75, 100mg oral tabs, Extended Release: 37.5, 75, 150, 225
Effexor: oral tab: 25, 37.5, 50, 75, 100mg
Effexor XR: oral caps, Extended Release: 37.5, 75, 150mg / 75-225mg/d ÷ into 2-3 equal doses (IR) or d day (ER); 375mg (IR) OR 225mg (ER) max/d
↓dose w/ renal/hepatic impair
Pharm. Class.
Antidepressant / Action
potentiates the neurotransmitter activity in the central nervous system; also inhibits neuronal serotonin, norepinephrine and dopamine reuptake / Adverse Effects
HTN; ↑HR; HA; somnolence; GI upset; sexual dysfunction; actuates mania or seizures / Monitoring Parameters
reduction or resolution of signs/symptoms; worsening of depression, suicidality, or unusual changes in behavior, especially at initiation of therapy or when the dose increases or decreases; serum cholesterol levels during long-term treatment; serum sodium levels and signs/symptoms of hyponatremia, particularly in the elderly, volume-depleted, and patients receiving diuretics; liver function in cases of severe impairment; patients receiving warfarin therapy, carefully monitor for adverse anticoagulant effects upon venlafaxine initiation/discontinuation; renal function, particularly in the elderly; detailed psychiatric history prior to initiating treatment to determine risk for bipolar disorder; ocular pressure and mydriasis, in patients with raised ocular pressure or at risk of acute narrow angle glaucoma; regular monitoring of blood pressure; signs of discontinuation symptoms, particularly after abrupt discontinuation; signs/symptoms of interstitial lung disease and eosinophilic pneumonia such as cough, progressive dyspnea, or chest discomfort signs/symptoms of serotonin syndrome
Patient Counseling / Contraindications / Caution / Drug Interactions
Avoid alcohol; take w/ food; may take up to 1-4 weeks for symptoms to improve; Instruct patient to report use of an MAO inhibitor within the last 14 days. Avoid abrupt withdrawal; avoid drugs that increase risk of bleeding, particularly over-the-counter products (aspirin, ibuprofen, naproxen); avoid activities requiring mental alertness or coordination until drug effects are realized, as this medicine may cause dizziness or somnolence / MAOIs
hypersensitivity to venlafaxine hydrochloride , desvenlafaxine or to any excipients in the formulation / Pregnancy category C
Monitor for worsening depression or emergency suicidability, particularly in peds pts / w/ MAOIs – may cause serious, even fatal reactions
may cause serotonin syndrome w/ trazodone
(9)OxyContin®
Generic / Indication(s / Formulations / Dose/Daily Dose
Oxycodone / Moderate-severe pain / IR caps (OxyIR) 5mg;
CR Roxicodone tabs 15,30mg; ER(Oxycontin) 10, 15, 20, 30, 40, 60, 80, mg; liq 5mg/5mL; soln conc 20mg/mL / Adults: 5mg q6h PRN
Mod-severe chronic pain: 10-160 q12h (ER)
Peds: 6-12y: 1.25 mg q6h PRN
>12y: 2.5mg q6h PRN;
Those w/severe renal and liver failures should decrease dose.
Elderly pt; take w/food
Pharm. Class. / Action / Adverse Effects / Monitoring Parameters
Narcotic Analgesic / Narcotic analgesic / Hypotension, sedation, respiratory depression, dizziness, GI upset, constipation, risk of abuse / Pain reduction, improvement in ability to move, mental and respiratory, bowel movements, signs and symptoms of withdrawal.
Patient Counseling / Contraindications / Caution / Drug Interaction
Tell patient to maintain adequate hydration to prevent constipation.
Patient should monitor for and report signs/symptoms of respiratory depression, especially in elderly and debilitated patients and patients with COPD or cor- pulmonale.
If drug causes gastric irritation, tell patient to take drug with food / Allergy, respiratory depression, acute asthma, ileus w/microsomal morphine / Preg. B
Preg. D w/prolonged use or near term / Naltrexone
(10) Actos®
Generic / Indication(s / Formulations / Dose/Daily Dose
Pioglitazone / Type 2 Diabetes M / 15, 30, 45 mg Oral Tablets / 15-45mg/d PO
Pharm. Class. / Action / Adverse Effects / Monitoring Parameters
Thiazolidinedione / Increase Insulin Sensitivity / Wgt gain, Myalgia, URI, HA, hypoglycemia, edema, increase fracture risk in women / fasting blood glucose, HbA1c
blood pressure, lipid panel, eye examination, neuropathy screen
serum creatinine, microalbuminuria
hemoglobin, hematocrit
liver function signs and symptoms of heart failure symptoms of hyper or hypoglycemia
Patient Counseling / Contraindications / Caution / Drug Interaction
This drug may cause headache.
Advise patient to report signs/symptoms of congestive heart failure (rapid weight gain, edema, dyspnea).
Advise diabetic patients to monitor for signs/symptoms of hyper- or hypoglycemia and to report difficulties with glycemic control. / CHF, hepatic impairment, hypersensitivity to Actos / Pregnancy code C / Avoid or use an alternative contraception other that oral. Actos may decrease hormonal contraception levels, combo of the two cause antagonistic effects b/c hormone contraceptives cause hyperglycemia
(11)Lexapro®
Generic / Indication(s / Formulations / Dose/Daily Dose
Escitalopram / Depression, anxiety / 5, 10, 20mg ;
soln 1 mg/mL / 10-20mg PO QD, 10mg/d in Elderly & hepatic impair
Pharm. Class. / Action / Adverse Effects / Monitoring Parameters
SSRI / Enhances serotonergic activity in the central nervous system (CNS) as a result of its inhibition of serotonin (5-HT) reuptake in CNS neurons / N/V, diarrhea, sweating, insomnia, dizziness, xerostonia, sexual dysfunction, / Serum sodium levels should be monitored (levels lower than 110 mmol/L have been reported) as medically warranted. There is an increased risk of hyponatremia (as a result of the syndrome of inappropriate antidiuretic hormone secretion) in patients receiving concomitant diuretics, patients who are volume depleted, and the elderly. If hyponatremia is confirmed, escitalopram should be discontinued and medical management may be necessary.
Patient Counseling / Contraindications / Caution / Drug Interaction
Taper dose when discontinuing to avoid serious side effects.
Patient should avoid activities requiring mental alertness until drug effects are realized.
This drug may cause diaphoresis, diarrhea, nausea, sleep disorder (somnolence or insomnia), impotence, ejaculation disorder, or fatigue.
Advise patient that symptomatic improvement may not be seen for a few weeks.
Patients should report any signs/symptoms of abnormal bleeding.
Patients using concomitant NSAIDS are at a higher risk of upper gastrointestinal bleeding.
Patient should not drink alcohol while taking this drug.
Patient should avoid concurrent use of citalopram / Do not take with or within 14 days of MAOI / Pregnancy Code C
Serotonin syndrome; Use of escitalopram, w/NSAID, ASA, or other drugs affecting coagulation associated w/ increase bleeding risk / Too many to list these are the drugs that are contraindicated with Lexapro due to major drug interactions. To acquire the full list visit Micromedex
Clorgyline (theoretical)
Furazolidone (theoretical)
Isocarboxazid (theoretical)