Exam 1 Top 41 Drugs

• alteplase (activase)

  • route: parenteral
  • general category: cardiovascular
  • pharmacologic class: thrombolytic
  • common use(s): acute ischemic stroke; myocardial infarction, pulmonary embolism
  • precautions/warning/black box: intracranial hemorrhage, subarachnoid hemorrhage, internal bleeding
  • high alert drug: *** w/ IV
  • dosage:
  • acute ischemic stroke: 0.9 mg/kg , do NOT exceed 90 mg; 10% of total dose administered IV bolus over 1 minute, infusion of remainder total dose over 60 minutes
• amiodarone (cordarone)

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: antiarrhythmic
  • common use(s): heart rhythm disorders (ventricular tachycardia or fibrillation)
  • precautions/warnings/black box: pulmonary toxicity (pneumonitis), hepatotoxicity, optic neuropathy/neuritis
  • high alert drug: ***
• apixaban (eliquis)

  • route: oral
  • general category: cardiovascular
  • pharmacologic class: anticoagulant - factor Xa inhibitor
  • common use(s): thromboembolism treatment and prevention, stroke prevention
  • precautions/warnings/black box: thrombotic events after premature discontinuation, bleeding
  • high alert drug: ***
  • dosage:
  • VTE treatment: 10 mg PO BID x 7 days, then 5 mg BID
  • VTE prevention: 2.5 mg PO BID
  • stroke prevention in nonvalvular Afib: 5 mg PO BID
• atropine (atropen)

  • route: parenteral
  • general category: cardiovascular
  • pharmacologic class: muscarinic antagonist
  • common use(s): bradycardia (advanced cardiac life support)
  • precautions/warnings/black box: narrow-angle glaucoma, myasthenia gravis
• bumetanide (bumex)

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: diuretic - loop
  • common use(s): edema
  • precautions/warnings/black box: hypokalemia, profound diuresis, electrolyte loss, dehydration, and acute renal failure w/ excessive amounts
• clopidogrel (plavix)

  • route: oral
  • general category: cardiovascular
  • pharmacologic class: antiplatelet
  • common use(s): acute coronary syndromes, MI and stroke prevention
  • precautions/warnings/black box: diminished antiplatelet activity in pts who are CYP 2C19 poor metabolizers
• dabigatran (pradaxa)

  • route: oral
  • general category: cardiovascular
  • pharmacologic class: anticoagulant - direct thrombin inhibitor
  • common use(s): thromboembolism treatment and prevention, stroke prevention
  • precautions/warnings/black box: thrombotic events after premature discontinuation, bleeding
  • high alert drug: ***
• digoxin (lanoxin [IV], digitek [PO])

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: cardiac glycoside
  • common use(s): heart failure (inotrope); atrial fibrillation (rate controller)
  • precautions/warnings/black box: heart failure, sinus bradycardia
  • high alert drug: ***
  • dosage:
  • heart failure: 0.125 - 0.25 mg PO/IV qday
• diltiazem (cardizem, tiazac)

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: calcium channel blocker
  • common use(s): atrial fibrillation (rate controller), angina, hypertension
  • precautions/warnings/black box: bradycardia (HR < 45 bpm); second or third degree heart block, severe hypotension
  • high alert drug
• dobutamine (dobutrex)

  • route: parenteral
  • general category: cardiovascular
  • pharmacologic class: inotrope - beta-adrenergic agonist
  • common use(s): cardiac decompensation
  • precautions/warnings/black box: idiopathic hypertrophic subaortic stenosis
  • high alert drug: ***
• dopamine (dopastat, inotropin)

  • route: parenteral
  • general category: cardiovascular
  • pharmacologic class: inotrope - sympathomimetic amine
  • common use(s): cardiovascular shock
  • precautions/warnings/black box: pheochromocytoma, ventricular fibrillation
  • high alert drug: ***
• enoxaparin (lovenox)

  • route: parenteral
  • general category: cardiovascular
  • pharmacologic class: low molecular weight heparin
  • common use(s): thromboembolism treatment and prevention, myocardial infarction
  • precautions/warnings/black box: thrombocytopenia or active bleeding, bleeding
  • high alert drug: ***
  • dosage:
  • treatment: 1 mg/kg SQ Q 12 H or 1.5 mg/kg Q 12 H or 40 mg SQ daily
  • renal dose adjustment: 1 mg/kg SQ daily
  • prophylaxis: 30 mg SQ daily
• furosemide (lasix)

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: diuretic - loop
  • common use(s): edema
  • precautions/warnings/black box: hypokalemia, profound diuresis, electrolyte loss dehydration, acute renal failure w/ excessive amounts
  • high alert drugs
  • dosage:
  • edema: 20 - 80 mg/dose
  • hypertension: 40 mg BID
• heparin

  • route: parenteral
  • general category: cardiovascular
  • pharmacologic class: anticoagulant
  • common use(s): thromboembolism treatment and prevention, myocardial infarction
  • precautions/warnings/black box: thrombocytopenia or active bleeding, bleeding
  • high alert drug: ***
• hydralazine (apresoline)

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: vasodilator
  • common use(s): hypertension, heart failure
• labetalol (trandate)

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: beta adrenergic blocker (noncardioselective) and alpha adrenergic blocker
  • common use(s): hypertension
  • high alert drug: ***
• metoprolol (lopressor [tartate])

  • route: parenteral (lopressor), oral (toprol, lopressor)
  • general category: cardiovascular
  • pharmacologic class: beta adrenergic blocker
  • common use(s): myocardial infarction, hypertension, angina, heart failure
  • precautions/warnings/black box: bradycardia (HR < 45 bpm); second or third degree heart block, severe hypotension
  • high alert drug: ***
  • dosage:
  • IV (myocardial infarction): 5 mg IV inj x 3 doses at 2 min intervals, then 50 mg PO Q 6 H
  • maintenance: 100 mg PO BID
• nitroglycerin (nitrostat [SL])

  • route: parenteral, SL
  • general category: cardiovascular
  • pharmacologic class: nitrate
  • common use(s): angina
  • precautions/warnings/black box: hypersensitivity to organic nitrates or any component of the formulation, concurrent use w/ PDE-5 inhibitors
  • high alert drug: ***
• norepinephrine (levophed)

  • route: parenteral
  • general category: cardiovascular
  • pharmacologic class: sympathomimetic
  • common use(s): acute hypotension
  • high alert drug: ***
• rivaroxaban (xarelto)

  • route: oral
  • general categroy: cardiovascular
  • pharmacologic class: anticoagulant - factor Xa inhibitor
  • common use(s): thromboembolism treatment and prevention, stroke prevention
  • precautions/warnings/black box: thrombotic events after premature discontinuation, bleeding
  • high alert drug: ***
  • dosage:
  • VTE: 15 mg PO BID x 21 days, then 20 mg PO daily
  • Afib: 20 mg PO daily
• sacubitril/valsartan (entresto)

  • route: oral
  • general category: cardiovascular
  • pharrmacologic class: neprolysin inhibitor (sacubitril) and angiotensin receptor blocker [ARB] (valsartan)
  • common use(s): heart failure
• ticagrelor (brilinta)

  • route: oral
  • general category: cardiovascular
  • pharmacologic class: antiplatelet
  • common use(s): acute coronary syndromes, myocardial infarction
  • precautions/warnings/black box: bleeding, do not use ASA > 100 mg
  • high alert drug: ***
  • dosage:
  • load: 180 mg PO, then 90 mg PO BID x 1st year after ACS event, then 60 mg PO BID thereafter
• verapamil

  • route: parenteral, oral
  • general category: cardiovascular
  • pharmacologic class: calcium channel blocker
  • common use(s): hypertension, angina, tachyarrhythmia
• warfarin (coumadin)

  • route: oral
  • general category: cardiovascular
  • pharmacologic class: anticoagulant
  • common use(s): anticoagulant
  • dosage:
  • various: dosage adjustment based on PT/INR lab
• insulin aspart (novolog)

  • route: parenteral
  • general category: endocrine
  • pharmacologic class: insulin - rapid acting
  • common use(s): diabetes mellitus
  • precautions/warnings/black box: severe hypoglycemia, allergy of sensitivity
  • high alert drug: ***
• insulin detemir (levemir)

  • route: parenteral
  • general category: endocrine
  • pharmacologic class: insulin - long acting
  • common use(s): diabetes mellitus
  • precautions/warnings/black box: severe hypoglycemia, allergy of sensitivity
  • high alert drug: ***
• insulin glargine (lantus, lantus star)

  • route: parenteral
  • general category: endocrine
  • pharmacologic class: insulin - long acting
  • common use(s): diabetes mellitus
  • precautions/warnings/black box: severe hypoglycemia, allergy of sensitivity
  • high alert drug: ***
• insulin lispro (humalog)

  • route: parenteral
  • general category: endocrine
  • pharmacologic class: insulin - rapid acting
  • common use(s): diabetes mellitus
  • precautions/warnings/black box: severe hypoglycemia, allergy of sensitivity
  • high alert drug: ***
• insulin NPH [human] (humulin N)

  • route: parenteral
  • general category: endrocrine
  • pharmacologic class: insulin - intermediate acting
  • common use(s): diabetes mellitus
  • precautions/warnings/black box: severe hypoglycemia, allergy of sensitivity
  • high alert drug: ***
• insulin regular [regular] (humulin R)

  • route: parenteral
  • general category: endocrine
  • pharmacologic class: insulin - short acting
  • common use(s): diabetes mellitus
  • precautions/warning/black box: severe hypoglycemia, allergy of sensitivity
  • high alert drug: ***
• fentanyl (sublimaze [IV], duragesic [transdermal])

  • route: parenteral, transdermal, oral
  • general category: analgesic
  • pharmacologic class: opioid agonist
  • common use(s): pain
  • precautions/warnings/black box: severe respiratory depression; risk of addiction, misuse, abuse, CNS depression
  • high alert drug: ***
• hydromorphone (dilaudid)

  • route: parenteral, oral
  • general category: analgesic
  • pharmacologic class: opioid agonist
  • common use(s): pain
  • precautions/warning/black box: severe respiratory depression; risk of addiction, misuse, abuse, CNS depression
  • high alert drug: ***
• ketorolac (toradol)

  • route: parenteral
  • general category: analgesic
  • pharmacologic class: non-steroidal anti-inflammatory drug (NSAID)
  • common use(s): pain, inflammation
  • precautions/warnings/black box: active or history of PUD; recent or history of GI bleeding or perforation, pts w/ advanced renal disease or risk of renal failure
• lidocaine (xylocaine)

  • route: parenteral (as anesthetic)
  • general category: analgesic
  • pharmacologic class: anesthetic - local, regional
  • common use(s): pain
  • precautions/warnings/black box: hypersensitivity to another local anesthetic of the amide type, severe degrees of SA, AV, or intraventricular heart block
  • high alert drug: *** only as antiarrhythmic
• morphine (MS contin, MIS IR)

  • route: parenteral, oral
  • general category: analgesic
  • pharmacologic class: opioid agonist
  • common use(s): pain
  • precautions/warnings/black box: severe respiratory depression; risk of addiction, misuse, abuse, CNS depression
  • high alert drug: ***
• naloxone (narcan)

  • route: parenteral
  • general category: analgesic
  • pharmacologic: opioid antagonist
  • common use(s): opioid overdose
  • dosage:
  • initial: 0.4 - 2 mg
  • maximum: 10 mg total
• cyanocobalamin (vitamin B12)

  • route: parenteral, oral
  • general category: dietary supplement
  • pharmacologic class: vitamin
  • common use(s): dietary supplement
• magnesium sulfate

  • route: parenteral, oral
  • general category: dietary supplement
  • pharmacologic class: essential mineral
  • common use(s):
  • IV: torsades de pointes
  • PO: magnesium deficiency
  • precautions/warnings/black box: heart block, IV use for pre-eclampsia
  • high alert drug: *** (IV)
• potassium chloride

  • route: parenteral, oral
  • general category: dietary supplement
  • pharmacologic class: essential mineral
  • common use(s): hypokalemia
• thiamine (vitamin B1)

  • route: parenteral, oral
  • general category: dietary supplement
  • pharmacological class: vitamin
  • common use(s): alcoholism, dietary supplement