Antiplatelet / Anticoagulant

Drug Indication Dose Route Form Strength MOA C/I Key Points
clopidogrel ➢ Acute coronary syndrome 75mg QD Oral Tab 75, 300mg Irreversibly blocks ➢ Hypersensitivity ➢ Rash
Thienopyri
Plavix ➢ Recent MI, stroke or Loading dose: 300-600mg the P2Y1,2 component ➢ Active pathological bleeding ➢ Increased bleeding risk

Platelet
Anti-

dine
established peripheral of ADP receptors on BBW: Diminished antiplatelet effect in pts
artery disease the platelet surface with two loss-of-function alleles of the

enoxaparin DVT px 30mg SQ Q12H or 40mg SQ SQ Inj. 30/0.3 Strong inhibitor of

CYP2C19 gene
➢ Hypersensitivity to heparin or pork ➢ Bleeding

Weight Heparin

➢ No routine lab monitoring

Low Molecular

Lovenox QD 40/0.4 factor Xa products

60/0.6 ➢ Thrombocytopenia associated with a ➢ Inject in the fatty areas at

PE/DVT tx 1mg/kg Q12H or 1.5mg/kg

QD
80/0.8
100/1
positive test for antiplatelet antibodies
in the presence of enoxaparin
the sides of the waist
➢ Inject prefilled air bubble

Acute coronary syndrome

120/0.8
150mg/1mL
➢ Active major bleeding
BBW: Spinal/Epidural hematoma
with medication

rivaroxaban
Xarelto
➢ DVT px and tx
➢ Pulmonary Embolism tx
DVT Px: 10mg QD
DVT Tx/recurrent Px: 20mg
Tab 10, 15,
20mg
Inhibits platelet
activation and fibrin
BBW:
Premature DC
➢ No routine lab monitoring
➢ s/s: bleeding/clotting

Factor Xa Inhibitor

➢ 2° prevention of DVT QD clot formation via increases the ➢ Missing a single dose
Oral
and/or pulmonary direct, selective and risk of increases clotting risk
➢ Hypersensitivity
embolism reversible inhibition thrombotic ➢ Take with food for doses
➢ Active pathological
Nonvalvular A-Fib 20mg QD Tab therapy pack of free and clot- events 15mg or higher
bleeding
apixaban ➢ DVT DVT/PE Px: 2.5mg BID Oral Tab 2.5, 5mg bound factor Xa Spinal/Epidural
Anti-coagulant

Eliquis ➢ Post-op DVT px DVT/PE Tx: 10mg BID x7d, hematoma

I
➢ Pulmonary embolism then 5mg BID Risk of
bleeding
Nonvalvular A-Fib 5mg BID
dabigatran ➢ DVT tx and px DVT/PE Px/Tx: 150mg BID Oral Cap 75, 110, Specific, reversible, ➢ Hypersensitivity ➢ Do not chew/crush/open

Direct Thrombin

Pradaxa ➢ Post-op DVT px (after 5-10 days parenteral 150mg direct thrombin ➢ Active pathological bleeding capsule. Must dispense in

am i
Inhibitor

➢ Pulmonary Embolism px anti-coagulation) inhibitor (free and ➢ Patients with mechanical prosthetic manufacturers bottle.

tx and px fibrin-bound
thrombin)
heart valves ➢ s/s: bleeding/clotting
➢ No routine lab monitoring

Nonvalvular A-Fib 150mg BID BBW: Thrombotic events, ➢ Missing a single dose
Spinal/Epidural hematoma increases clotting risk

warfarin
Coumadin
➢ DVT px and tx
➢ Pulmonary Embolism
2-10mg QD Oral Tab 1,2,2.5,3,4,5
,6,7.5,10mg
Inhibits subunit 1 of
the multi-unit VKOR
➢ Hemorrhagic tendencies
➢ Spinal puncture or recent CNS or eye
➢ Monitor INR
➢ Diet should be consistent

Jantoven px/tx complex, leading to surgery for Vitamin K intake

antagonist
Vitamin K

depletion of factors ➢ Patients with high potential for non- ➢ Inform pharmacist or
II, VII, IX, and X and compliance prescriber of new

proteins C and S ➢ Pregnancy medications and herbal

products

IV Solution reconstituted BBW: Bleeding risk ➢ Bleeding

Antilipemic agents

Drug
atorvastatin
Indication
➢ Dyslipidemia
Dose
10-80mg QD
Form (PO)
Tablet
Strength
10, 20, 40, 80mg
MOA C/I Key Points

Lipitor ➢ Prevention of CVD

HMG-CoA Reductase Inhibitors

pravastatin ➢ Hyperlipidemia 40-80mg QD Tablet 10, 20, 40, 80mg

Pravachol
rosuvastatin
➢ Prevention of CVD
➢ Hypercholesterolemia 10-20mg QD may titrate to Tablet 5, 10, 20, 40mg
Inhibits 3-hydroxy-3-methylglutaryl
➢ Active liver disease
➢ Muscle pain and
weakness
coenzyme A (HMG-CoA) reductase

Crestor ➢ Hyperlipidemia
➢ Prevention of CVD
40mg/day ➢ Unexplained persistent elevations ➢ Diarrhea
of transaminases

simvastatin
Zocor
➢ Hyperlipidemia
➢ 2° prevention of CV events
5-40mg QD Tablet
Suspension
5, 10, 20, 40, 80mg ➢ Pregnancy and breastfeeding
➢ Simvastatin only: CYP3A4i

simvastatin +
ezetimibe
➢ Hypercholesterolemia
➢ Hyperlipidemia
See individual agents Tablet See individual agents See individual agents

➢ 1° and 2° prevention of

Vytorin
atherosclerotic CVD
ezetimibe ➢ Hypercholesterolemia 10mg QD Tablet 10mg Inhibits absorption of cholesterol at ➢ Concurrent use with a statin in ➢ Fatigue

2-azetidinone

Zetia ➢ Hyperlipidemia the brush border of the small patients with active hepatic ➢ Diarrhea
intestine via the sterol transporter, disease ➢ Arthralgia

Niemann-Pick C1-Like 1 (NPC1L1) ➢ Pregnancy and breastfeeding

when used with statin

gemfibrozil ➢ Hypertriglyceridemia 600mg BID 30min. ACB & Tablet 600mg Inhibits lipolysis and decreases ➢ Hepatic or severe renal function ➢ Upset stomach

Lopid ➢ Dyslipidemia ACD subsequent hepatic fatty acid uptake,

inhibits hepatic secretion of VLDL
➢ Primary biliary cirrhosis
➢ Preexisting gallbladder disease
➢ Fatigue and lethargy
➢ Abdominal pain

➢ Concurrent use with dasabuvir,

repaglinide, or simvastatin

fenofibrate + ➢ Hypercholesterolemia 30-160mg QD Tablet Agonist for the nuclear transcription ➢ Active liver disease ➢ Abdominal pain
Fibric acid

derivatives ➢ Hyperlipidemia factor PPAR-α, downregulates ➢ Severe renal impairment or ESRD ➢ Hepatic injury
Tricor apoprotein C-III (an inhibitor of ➢ Myalgia
Trilipix lipoprotein lipase) and upregulates ➢ Diarrhea
Triglide the synthesis of apolipoprotein A-I,
Antara Micronized fatty acid transport protein and
Fenoglide lipoprotein lipase resulting in an
Fibricor increase in VLDL catabolism, fatty acid
Lipofen oxidation and elimination of
triglyceride-rich particles
niacin ➢ Dyslipidemia IR: 1.5-3g QD in 2-3 divided Tab ER 500, 750, 1000mg Inhibits release of free fatty acids ➢ Active liver disease ➢ Flushing reaction (less
➢ Active peptic ulcer
Vitamin

Niaspan doses Max 6g/day Capsule from adipose tissue and increases severe over time): take
ER: 1-2g QHS Max 2g/day Tablet lipoprotein lipase activity ➢ Arterial hemorrhage with cold water/food
Powder to reduce
➢ Hepatic injury
omega-3 fatty ➢ Hypertriglyceridemia 2g BID or 4g QD Capsule 300, Reduction in hepatic production of Hypersensitivity ➢ Diarrhea
acids 500, VLDL and a reduction in the hepatic ➢ Nausea/Dyspepsia
Lovaza Oral 1000mg synthesis of triglycerides ➢ Abdominal pain
Cap DR ➢ Ensure no seafood
Chew Tab allergies
 Antihypertensive
Drug Indication Dose Route Form Strength C/I Key Points
amlodipine ➢ HTN 5-10mg QD Tablet 2.5, 5, 10mg Hypersensitivity ➢ Peripheral edema
Norvasc ➢ Angina Suspension ➢ Flushing
Dihydropyridine Oral
➢ Lightheadedness, dizziness,
orthostasis, hypotension
nifedipine HTN: IR/ER IR: 10-20mg TID Max 180mg/day*angina only Capsule 10, 20mg STEMI ➢ Peripheral edema
➢ Flushing
Ca2+ Channel Blocker

Adalat Angina: IR ER: 30-90mg QD Max 120mg/day Tab ER 24hr 30, 60, 90mg
Oral
Afeditab ➢ Hypotension
Procardia ➢ Gingival hyperplasia
diltiazem ➢ HTN 120-320mg QD Max 480mg/day Cap ER 12hr 60, 90, 120mg ➢ Sick sinus syndrome,
a
f Tatanagar
i.am
Antiarryth:

➢ Angina ➢
Non-Dihydropyridine

Cardizem Cap ER 24hr 120, 180, 240, 300, 360, 2nd or 3rd degree AV block
Class 4

Cartia Oral 420mg ➢ Hypotension ➢ Peripheral edema

Taztia Tablet 30, 60, 90, 120mg ➢ Acute MI ➢
Antianginal Agent

Bradycardia
Tiazac Tab ER 24hr 180, 240, 300, 360, 420mg ➢ Constipation
verapamil
Verapamil ➢ Angina IR: 80-160mg TID Tablet ➢ Sick sinus syndrome ➢ Lightheadedness, dizziness,
Calan Calan ➢ A-Fib ER: 240-480mg QD or 2 even doses Oral Tab ER ➢ 2nd or 3rd degree AV block orthostasis, hypotension
fHqpfIgpyy.ifY't
Verelan
Verelan ➢ HTN Cap ER 24hr ➢ Hypotension or cardiogenic shock
➢ SV tachycardias IV Solution ➢ Wolf-Parkinson-White syndrome
atenolol ➢ Acute MI 25-50mg QD, may ↑ to 100mg QD Tablet 25, 50, 100mg ➢ Sinus bradycardia
Tenormin ➢ Angina caused (BID doses are acceptable) Solution ➢ Heart block > 1st degree

Forecourts
Oral Hypotension
by coronary ➢ Cardiogenic shock
ODT
➢ Uncompensated cardiac failure

Bathhouses
atherosclerosis
➢ HTN IM 5mmol
Solution for recon. BBW: Cessation of Therapy
metoprolol ➢ Angina: IR/ER 50-100mg BID Tab 25, 37.5, 50, 75, 100mg ➢ Sinus bradycardia
B1-Selective

IR

Lopressor ➢ HTN: IR/ER Does not treat HF (tartrate) ➢ 2nd or 3rd degree heart block
Toprol XL ➢ A-Fib: IR/ER Angina and HTN: 25-100mg QD Oral ➢ Cardiogenic shock Hypotension
➢ HF: ER A-Fib: 50-400mg QD Tab ER 25, 50, 100, 200mg BBW: Ischemic heart disease ➢ Bradycardia
ER

➢ MI HF: Initiate 12.5-25mg QD and (succinate) (or rebound

titrate to target 200mg QD IV Solution (tartrate) tachycardia
Beta-Blocker

bisoprolol HTN 5-10mg QD Max 20mg/day Oral Tablet 5, 10mg ➢ Sinus bradycardia if stopped
Zebeta ➢ Heart block > 1st degree abruptly)
Hypotension
➢ Cardiogenic shock ➢ Fatigue and
➢ Overt cardiac failure lethargy
carvedilol HTN 6.25-25mg BID Max 25mg BID Cap ER 24hr 10, 20, 40, 80mg ➢ Severe bradycardia ➢ Impotence
Coreg ➢ 2nd or 3rd degree AV block
β+α

Orthostatic
HF 25mg BID Max 50mg BID Oral Tablet 3.125, 6.25, 12.5, 25mg ➢ Severe hepatic impairment
hypotension
Nonselective

➢ Bronchial asthma or related

bronchospastic conditions
propranolol ➢ HTN IR: 80-240mg QD in 2-3 even doses Tablet 10, 20, 40, 60, 80mg ➢ Severe sinus bradycardia
Inderal ➢ Essential ER: 80-160mg QD Cap ER 24hr ➢ Heart block > 1st degree
β1 + β2

Oral Depression/
ions tremor
➢ Migraine px
Solution
➢ Uncompensated congestive HF
➢ Bronchial asthma
Vivid dreams

benazepril HTN 20-80mg QD or 2 even doses

IV
Oral
Solution
Tablet 5, 10, 20, 40mg anatase ➢ May cause dry cough
BBW: Cardiac ischemia dt abrupt DC

Lotensin ➢ Angioedema
ACE Inhibitor

enalapril ➢ Heart failure 5-40mg QD or 2 even doses Oral Tablet 2.5, 5, 10, 20mg ➢ K+ and sCr may be ↑, check
Vasotec ➢ HTN >20mg should be taken BID Solution within 1-2wks of starting.
lisinopril ➢ Acute MI 5-40mg QD Tablet 2.5, 5, 10, 20, 30, 40mg ➢ Lightheadedness, dizziness,
➢ Hx angioedema

mode
Prinivil ➢ HF Oral BBW: orthostasis, hypotension

i
➢ Concurrent use of
Zestril ➢ HTN Solution Fetal
aliskiren in pts with DM

Bata
irbesartan ➢ Diabetic 150-300mg QD Oral Tablet 75, 150, 300mg toxicity ➢ K+ and sCr may be ↑, check
Avapro
losartan
Nephropathy
➢ HTN 50-100mg QD Oral Tablet
i 25,
hypersensitivity
50, 100mg
within 1-2wks of starting
➢ Lightheadedness, dizziness,
ARB

Cozaar orthostasis, hypotension

olmesartan HTN 20-40mg QD Oral Tablet 5, 20, 40mg
Benicar
 Antihypertensive (continued)
Drug Indication Dose Route Form Strength MOA C/I Key Points
furosemide ➢ Edema 20-80mg QD up Tablet 20, 40, 80mg Inhibits Na+ and Cl-reabsorption ➢ Hypersensitivity ➢ Hypokalemia
Lasix ➢ HTN to Q6H Oral Solution which ↑ excretion of H2O, Na+, Cl-, ➢ Anuria ➢ Take in AM
Loop

Mg+ and Ca2+ inascendingioopor ➢ Hyperuricemia

Inj. Solution Henieproximalanddistairenaiabue BBW: Fluid/electrolyte loss ➢ Possible sulfa cross-allergy
hydrochlorothiazide ➢ Edema 12.5-50mg QD Tablet 12.5, 25, 50mg Inhibits Na+ reabsorption in the ➢ Hypersensitivity ➢ Hypokalemia
Thia
zide

➢ HTN ➢ Anuria ➢ Photosensitivity

Diuretic

Microzide Oral Capsule distal tubules which ↑ excretion of

Na+, H2O, K+ and H+ ➢ Possible sulfa cross-allergy
spironolactone ➢ Edema 25-100mg QD Oral Tablet 25, 50, 100mg Competes with aldosterone for ➢ Anuria or significant renal ➢ Hyperkalemia
Receptor Ant.
Aldosterone

Aldactone ➢ HTN HF: Max receptor in distal tubules which ↑ impairment ➢ Gynecomastia
Sparing

➢ Hypokalemia 50mg/day ➢ Hyperkalemia

Na+, Cl- and H2O excretion (K+ and H+
➢ 1° hyper- conserved) ➢ Addison’s disease

of teroneon➢ Use with eplerenone

K+

aldosteronism
➢ Severe HF ABLEarthes BBW: Tumorigenic
hydralazine HTN 10-50mg QID Oral Tablet 10, 25, 50, Direct vasodilation of arterioles ➢ CAD ➢ Headache
Vasodil.

Apresoline Max 300mg/day 100mg ➢ Mitral valve rheumatic ➢ Palpitations/↑HR

Inj. Solution heart disease ➢ Lupus-like syndrome (Rare)
doxazosin ➢ BPH 1-8mg QD Tablet 1, 2, 4, 8mg Competitively inhibits postsynaptic Hypersensitivity ➢ Dizziness
α1 Blocker

Cardura ➢ HTN Max 8mg/day Tab ER 24hr 4, 8mg α1 receptors ➢ Orthostatic hypotension
Oral
TMdopp
➢ Lethargy

a tBE
Cap ER 12hr

clonidine HTN 0.1mg BID

teal foeman
IV
Top.
Cap ER
Solution
Weekly 0.1mg/24hr Stimulates a2-adrenoceptors in the Hypersensitivity
➢ Take at bedtime

➢ Anticholinergic effects
Catapres Max 2.4mg/day patch 0.2mg/24hr brain stem, thus activating an ➢ Lightheadedness, dizziness,
α2 Agonist

0.3mg/24hr inhibitory neuron, resulting in orthostasis, hypotension

Tablet 0.1, 0.2, 0.3mg reduced sympathetic outflow from ➢ Rebound hypertension if abrupt
Oral Tab ER 12hr 0.1mg the CNS BBW: Epidural use DC
➢ Na+, H2O retention

Antihypertensive combination drugs

Drug Indication Dose Route Form MOA C/I BBW Key points
amlodipine + benazepril HTN See individual agents Oral Cap See individual agents See individual agents See individual agents
Lotrel
lisinopril + HCTZ HTN See individual agents Oral Tab See individual agents See individual agents See individual agents
Zestoretic Max 80mg/50mg QD
irbesartan + HCTZ HTN See individual agents Oral Tab See individual agents See individual agents See individual agents
Avalide
losartan + HCTZ HTN See individual agents Oral Tab See individual agents See individual agents Fetal toxicity See individual agents
Hyzaar
olmesartan + HCTZ HTN See individual agents Oral Tab See individual agents See individual agents See individual agents
Benicar HCT
valsartan + HCTZ HTN 160/12.5mg–320/25mg QD Oral Tab See individual agents See individual agents ➢ Hypotension
Diovan HCT ➢ Rarely angioedema
➢ ↑SCr
triamterene + HCTZ HTN 37.5/25mg – 75/50mg QD Oral Cap Triamterene (K+ sparing diuretic): ➢ Anuria Hyperkalemia ➢ Photosensitivity
Dyazide Edema Tab Blocks epithelial Na+ ch. in the DCT and ➢ Acute or chronic renal insufficiency/impairment ➢ Hyperkalemia
Maxide
pie collecting duct, leading to K+ retention
and ↓Ca2+, Mg+, H+ excretion
➢ Pts receiving other K+ sparing diuretics or K+
supplements
➢ Hyperkalemia
➢ Monitor renal fxn.

decrease or.namepase
 Antianginal agent + Vasodilator
Drug Indication Dose Route Form Strength MOA C/I Key Points
isosorbide dinitrate Angina pectoris IR: 10-40mg BID or TID Tablet 5, 10, 20, 30mg
Isordil prevention SR: 40-160mg QD Tab ER 40mg
Oral
Nitrate free time: IR >14h; SR 24hr ➢ May cause headache, dizziness.
>18h Cap ER 40mg ➢ For angina, should be dosed to preserve a
isosorbide Angina pectoris IR: 20mg BID 7hrs apart Tablet 10, 20mg nitrate-free period
mononitrate prevention XR: 60-120mg QD Activates cGMP
Oral Tab ER 30, 60, 120mg
Imdur leading to
24hr
dephosphorylation Concurrent use with PDEi
nitroglycerin ➢ Angina SL: 0.3-0.6mg Q5M Max 3 tabs Tablet 0.3, 0.4, 0.6mg ➢ Place under tongue, do not swallow or chew.
Sublingual of myosin light or riociguat
Nitrolingual ➢ ADHF within 15mins Oral packet ➢ Keep in original bottle – Replace routinely and
chains and smooth
Extravasation

Nitrostat PO: 2.5mg-6.5mg TID or QID Solution check exp. date.

Antidote:

Translingual muscle relaxation

Nitro-Bid Aerosol Solution ➢ May use up to 3 doses q5 min. If no symptom
Nitro-Dur Oral Cap ER relief after 1 dose, call 911.
24hr Patch ➢ Used for chest pain, sit before taking dose, may
Transdermal cause dizziness
Ointment
Rectal Ointment

Antiarrhythmic Agent
Drug Indication Dose Route Form Strength MOA C/I Key Points
digoxin ➢ A-Fib 0.125- Tablet 0.0625, 0.125, 0.1875, Inhibits Na+/K+ ATPase pump in myocardial cells ➢ Hypersensitivity ➢ Can cause bradycardia
Glycoside

Digitek ➢ Heart failure 0.25mg QD Oral 0.25mg leading to increased contractility ➢ Ventricular fibrillation ➢ Hyperkalemia
Cardiac

Digox Solution Directly suppresses AV node conduction to ➢ Toxicity: Vision halos, N/V
Lanoxin Inj. Solution increase effective refractory period and ➢ Narrow therapeutic index: monitor levels.
decrease conduction velocity
 Antidiabetic agents
Drug Dose Route Form Strength MOA C/I Key Points
lispro Solution 100units/mL
SQ
Humalog Solution Pen-injector

Rapid
aspart 0.5-1u/kg/day in divided doses within Solution 100units/mL
Novolog 15min (rapid) / 30 min (short) of SQ Solution Cartridge
meals
Type 1 Diabetes

Solution Pen-injector Facilitates the ➢ Inject SQ into preferred 1. Abd;

regular Solution 100units/mL uptake of glucose or alternate 2. Anterolateral
Insulin

Short

Humulin R Solution Pen-injector 500units/mL Use during episodes of

SQ from the thigh, 3. Upper arm
Novolin R hypoglycemia
bloodstream into ➢ Signs, symptoms &
detemir ~1/3 total daily insulin requirement in Solution 100units/mL cells management of hypoglycemia
SQ
Levemir 1-2 divided doses Solution Pen-injector
Long

glargine ~1/3-1/2 total daily insulin Solution 100units/mL

Lantus requirement QD (> 40units can be SQ Solution Pen-injector 300units/mL
Toujeo BID)
exenatide IR: 5-10mcg BID 60min AC Pen-injector 2mg GLP1 increases ➢ Hx or family hx of BBW: ➢ Hypoglycemia esp. when used
GLP-1 receptor agonist

Bydureon XR: 2mg SQ QW Solution Pen-injector 10mcg/0.04mL glucose-dependent medullary thyroid Thyroid in combo with sulfonylureas
Byettta SQ insulin secretion, carcinoma C-cell ➢ Inj. Site reaction; rotate sites
5mcg/0.02mL
Reconstitution (ER) 2mg decreases glucagon ➢ Pts with multiple tumors ➢ Pancreatitis symptoms: severe
liraglutide DM: 0.6mg SQ QD x1wk, then 1.2mg SQ Pen-injector 18mg/3mL secretion, increases endocrine neoplasia stomach/upper abdominal pain
Victoza (DM) SQ QD Max 1.8mg B-cell growth, slows syndrome radiating to back
Type 2 Diabetes

Saxenda (wt. Wt. loss: 0.6-3mg QD gastric emptying ➢ Pregnancy (only ➢ Persistent N/V: eat slower &
loss) and decreases food liraglutide) smaller meals to avoid
intake overeating
metformin IR: 500mg BID or 850mg QD Max Tablet 500, 850, Decreases hepatic ➢ CrCl < 30 ➢ N/V: take with food
Fortamet 2,550mg/day 1000mg glucose production, ➢ Acute or chronic metabolic ➢ Gas, bloating, diarrhea –
Glucophage ER: 500-1,000mg QD Max Tab ER 24hr 500, 750, decreasing acidosis develop tolerance with
Biguanide

Glumetza 2,000mg/day 1000mg intestinal continued use; Titrate dose/XR

Oral Solution absorption of BBW: Lactic acidosis formulation may reduce GI
glucose and effects
improves insulin ➢ Risk for lactic acidosis: ensure
sensitivity hydration and follow renal
dosing guidelines
pioglitazone 15-45mg QD Oral Tablet 15, 30, 45mg Selective PPAR-γ ➢ NYHA Class III/IV Heart failure ➢ Peripheral edema
Thiazolidin

Actos agonist which ➢ Worsening heart failure

edione

improves target cell BBW: Congestive heart failure ➢ Weight gain

response to insulin ➢ Takes weeks to show effects on
BG
saxagliptin 2.5-5mg QD Oral Tablet 2.5, 5mg Inhibits DPP4
➢ Congestion, sore throat
DPP-4i

Onglyza enzyme resulting in

➢ Hypersensitivity ➢ Unlikely, but symptoms of
sitagliptin 100mg QD Oral Tablet 25, 50, 100mg prolonged active
pancreatitis
Januvia incretin levels
sitagliptin + See individual agents Tablet See individual See individual agents See individual agents
metformin Oral Tab ER agents
Janumet
 Corticosteroid
Drug Indication Dose Route Form Strength MOA C/I Key Points
budesonide ➢ Chron’s Disease Oral: 9mg QAM x8wks Capsule DR Decreases inflammation ➢ Inhaled: Oral thrush, upper
Oral
Entocort ➢ Ulcerative colitis Nasal: 1-2 sprays (32- Tab ER 24hr by suppression of respiratory tract infection,
Uceris ➢ Allergic rhinitis 64mcg) in each nostril QD Nasal Suspension migration of cough
Rhinocort ➢ Asthma Inhaled: 360-720mcg BID Aerosol Powder 90, 180mcg polymorphonuclear ➢ Topical: Apply thin layer and
Pulmicort Breath leukocytes and reversal of avoid broken skin and sensitive
Activated increased capillary areas
Oral Inh. Suspension 0.25/2 permeability ➢ Oral: Headache, diarrhea,
0.5/2 respiratory tract infection,
1mg/2mL decreased cortisol, take with
food
fluticasone ➢ Allergic and Nonallergic Nasal: 2 sprays each nostril Nasal Suspension Potent vasoconstrictive ➢ Primary treatment of acute
Flonase Rhinitis QD or 1 spray (50mcg) each Oral Inhalation and anti-inflammatory asthma episodes
Flovent ➢ Asthma nostril BID activity ➢ Severe hypersensitivity to
Lotion 0.05%
Inhaled: 88mcg BID Max milk proteins
Top. Cream 0.05%
880mcg/day Ointment 0.005% ➢ Oral thrush
mometasone ➢ Allergic Rhinitis Nasal: 2 sprays into each Suspension ➢ Take med as scheduled
Nasal
Nasonex ➢ Asthma nostril QD Implant ➢ Upper respiratory tract
Asmanex ➢ Itchy and inflammatory Inhaled: 1 inhalation QD to Inhalation Aerosol infection
Oral ➢ Headache
Elocon dermatoses BID Inhalation Breath Activated Powder
Cream 0.1%
Ointment
Top.
Lotion
Solution
methylprednisolone Specific endocrine Asthma: 40-60mg QD; may Tablet 4, 8, 16, 32mg Decreases inflammation ➢ Systemic fungal infection
Depo-Medrol conditions divide doses by suppression of ➢ Intrathecal administration
Oral
Medrol Allergic reaction Allergic conditions: taper Therapy pack migration of ➢ Live or attenuated vaccines
Solu-Medrol per dose-pak instructions polymorphonuclear
Inflammatory conditions Anti-inflammatory: 4-48mg Inj. Suspension leukocytes and reversal of
in 1-4 divided doses initially increased capillary
➢ Increase in glucose
followed by a gradual permeability
➢ Poor wound healing
reduction to the lowest
possible effective dose ➢ Edema
➢ Weight gain
prednisone ➢ Allergic reaction 5-60mg QD Tablet 1, 2.5, 5, 10, 20, ➢ Administration of live
Deltasone ➢ Dermatologic conditions 50mg attenuated vaccines with
➢ Respiratory disease Tab DR immunosuppressive doses
➢ Gastrointestinal diseases Oral of prednisone
Solution
➢ Rheumatic disorders Concentrate ➢ Systemic fungal infections
Tab therapy pack
budesonide + ➢ Asthma 2 inhalations BID; titrate Oral Inh. aerosol 80-4.5 See budesonide + Primary treatment of acute ➢ Oral thrush
formoterol ➢ COPD dose by choosing higher 160mcg-4.5mcg Formoterol relaxes asthma or COPD episodes ➢ Cough
β2 agonist: Long-Acting

Symbicort strength bronchial smooth muscle ➢ Upper respiratory tract

by selective action on B2 BBW: Asthma related death infection
receptors ➢ Headache
fluticasone + ➢ Asthma Diskus: 1 inhalation BID Oral Inh. Aerosol See fluticasone + ➢ Primary treatment of acute ➢ Oral thrush
salmeterol ➢ COPD HFA: 2 inhalations BID Powder salmeterol relaxes asthma episodes ➢ Take med as scheduled
Advair bronchial smooth muscle ➢ Severe hypersensitivity to ➢ Upper respiratory tract
AirDuo by selective action on B2 milk proteins infection
receptors BBW: Asthma related death ➢ Headache
 Misc. (Non-corticosteroid)
Drug Indication Dose Route Form Strength MOA C/I Key Points
albuterol Bronchospasm 1-2 inhalations Aerosol powder 90mcg/actuation Relaxes bronchial smooth muscle Severe hypersensitivity to ➢ Upper respiratory tract
ProAir Q4-6H PRN breath activated by action on B2 receptors milk products infections
Proventil Aerosol solution 90mcg/actuation ➢ Cough
Ventolin Inh. Nebulizing 0.63mg/3mL ➢ Tremor and jitteriness
β2 agonist: Short Acting

Vospire solution 1.25mg/3mL ➢ Always carry this as a

2.5mg/3mL (0.083%) rescue inhaler
2.5mg/0.5mL (0.5%)
Syrup 2.5mg/5mL
Oral Tablet

ipratropium COPD 2 inhalations QID Oral Inh. tag

Tab ER 24hr
Solution team
20mcg ipratropium- See albuterol + ipratropium: Hypersensitivity ➢ Upper respiratory tract
bromide + Max 12inh/day Nebulizer 100mcg albuterol per blocks the action of acetylcholine infection
albuterol inhalation at parasympathetic sites in ➢ Cough
Anti-Cholinergic

Combivent bronchial smooth muscle causing ➢ Tremor

bronchodilation ➢ Rhinitis
dicyclomine Irritable bowel 20-40mg QID Cap 10mg Blocks the action of acetylcholine ➢ Obstructive diseases of ➢ Dizziness
Bentyl syndrome Oral Tab 20mg at parasympathetic sites in the GI tract ➢ Blurred vision
Solution smooth muscle, secretory glands ➢ Severe ulcerative colitis ➢ Xerostomia
IM Solution and the CNS ➢ Breastfeeding ➢ Nausea

montelukast Asthma 10mg QD

Top. Gel
Tablet 10mg Antagonizes leukotriene
i Hypersensitivity
Reflux esophagitis
➢ Take in the evening
Leukotriene

Antagonist

➢ Cough
Receptor

Singulair Chew Tab receptors, leading to relaxation of

Oral Packet bronchial smooth muscle ➢ Bronchitis

Vaccines
Drug Indications Dose Route Form Strengths MOA C/I Key Points
pneumococcal Pneumococcal IM Susp. 13 serotypes Promotes active ➢ Severe allergic reaction to any diphtheria toxoid-
Inactivated (Bacterial)

conjugate disease prevention immunization against containing vaccine

vaccine invasive disease caused
➢ Chills
Synflorix by S. pneumoniae
Single 0.5mL IM ➢ Skin rash
Prevnar 13
dose ➢ Local erythema
pneumococcal Pneumococcal IM Susp. 23 serotypes ➢ Severe allergic reaction to pneumococcal vaccine
➢ Arthralgia
polysaccharide disease prevention
vaccine
Pneumovax 23
varicella vaccine Prevention of Two 0.5mL doses SQ Injection 1350PFU/0.5mL Induced cell mediated ➢ Hypersensitivity to the vaccine, neomycin or gelatin ➢ Injection site reaction
Varivax varicella separated by at and humoral immune ➢ Immunosuppressed/deficient individuals ➢ Fever
(chickenpox) least 4 weeks responses ➢ Active, untreated TB or other current febrile illness
Live (Viral)

➢ Pregnancy
zoster vaccine Prevention of Single 0.65mL SQ SQ Unit dose Stimulates active ➢ Hypersensitivity to he vaccine, neomycin or gelatin ➢ Injection site reaction
Zostavax herpes zoster dose vial for immunity to disease ➢ Immunosuppressed/deficient individuals ➢ Chicken pox-like rash may
(shingles) recon. caused by the varicella- ➢ Pregnancy develop post admin. (rare)
zoster virus
 Antigout agents
Drug Indication Dose Form Strength MOA C/I Key Points
allopurinol Gout Initiate 100mg QD until desired Tablet 100, 300mg Inhibits xanthine oxidase, enzyme Hypersensitivity ➢ Diarrhea
Xanthase

otar
Inhibitor
Oxidase

Zyloprim Cancer therapy- uric acid level is achieved (max: Soln. responsible for the conversion of ➢ Skin rash
Aloprim induced
hyperuricemia bytes Maxso
day
800mg/day)
1ay
mg
d (IV) hypoxanthine to xanthine to uric acid ➢ Keep taking even if you are not
experiencing a gout flare

colchicine Gout flares 1.2mg once, then 0.6mg one hour Capsule 0.6mg Inhibits β-tubulin polymerization into Concomitant use of P-gp or strong ➢ Diarrhea
Colcrys
Prophylaxis
later Max 1.8mg
win
0.6mg QD or BID Max 1.2mg/day
Tablet microtubules, preventing activation,
degranulation, and migration of
CYP3A4 inhibitor in the presence of
hepatic impairment – requires dose
➢ Fatigue and lethargy
➢ Nausea
neutrophils adjustment

Antirheumatic, disease modifying

thrown
Drug Indication Dose Form Strength MOA C/I BBW Key Points
adalimumab ➢ Crohn’s disease Pen-inj. Kit 40mg/0.8mL Binds and interferes ➢ Don’t take if pt. is sick
➢ Psoriasis ➢ Pt. should screen Hep B and TB
agent

Humira Pre-filled syr. 10/0.2 with human TNFα

GI

40mg SQ QOW
TNF Blocker

➢ Rheumatoid Arthritis 20/0.4 receptor sites and before initiating

➢ Ulcerative Colitis 40mg/0.8mL subsequent cytokine- ➢ Serious infections ➢ Inj. Site rxn: common but well-
etanercept ➢ Ankylosing spondylitis Auto inj. 50mg/mL driven inflammatory Sepsis ➢ Malignancy tolerated
Enbrel ➢ Psoriasis Prefilled syr. 25mg/mL processes. ➢ Takes time to see effects (RA):
50mg SQ QW
➢ Psoriatic arthritis Soln. for recon. don’t DC when pts does not see
➢ Rheumatoid arthritis results immediately
methotrexate Psoriasis 10-25mg Tablet 2.5mg Irreversibly inhibits ➢ Breastfeeding ➢ Intrathecal/high-dose tx ➢ Don’t take if pt. is sick
Antineoplastic agent

Immunosuppressant

Rasuvo PO/SQ/IM QW dihydrofolate ➢ Pregnancy ➢ Appropriate use ➢ Take with folic acid as
Trexall Rheumatoid arthritis 7.5mg Soln. (PO) reductase, interfering ➢ Liver disease ➢ Pregnancy instructed by the prescriber
(antifolate)

PO/SQ/IM QW with DNA synthesis, ➢ Bone Marrow Suppression ➢ Mucositis, GI upset,

Specific cancers Soln. (Inj.) repair and cellular ➢ Hepatotoxicity nephrotoxicity may occur
replication. ➢ Renal impairment ➢ Routine bloodwork
Auto-inj. (SQ)
➢ Pneumonitis ➢ Make sure pt is NOT pregnant
➢ GI toxicity or intends to get pregnant
➢ Secondary malignancy

Osteoporosis: Bisphosphonate Derivative

Drug Prophylaxis Treatment Form Strength MOA C/I Key Points
alendronate Female 5mg QD or 35mg QW Tablet 5, 10, 35, 40, 70mg Inhibits bone resorption via ➢ Hypocalcemia ➢ Take on an empty stomach ACB with a full glass of water. Do
Fosamax 10mg QD or 70mg QW Solution actions on osteoclasts or on ➢ Esophageal not eat, drink or take other meds for at least 30 mins post
Male
Tablet Effervescent osteoclast precursors; abnormalities dose. Remain upright for 30 minutes after dose
risedronate Female 5mg QD or 35mg QW or 150mg QM Tablet 5, 30, 35, 150mg decreases the rate of bone ➢ Inability to ➢ Notify your dentist you are taking this medicine (due to very
Actonel Male 35mg QW Tab DR resorption, leading to an sit/stand upright rare osteonecrosis of the jaw)
indirect increase in bone for 30mins ➢ Maintain calcium & vit. D supplementation if diet inadequate
mineral density ➢ Bone pain

Ophthalmic agent, Antiglaucoma

Drug Indication Dose Route Form Strength MOA C/I Key Points
timolol Gel: 1 gtt into affected eye(s) QD Opht. Soln. 0.25%, 0.5% Blocks β1 and β2 adrenergic ➢ Bronchial asthma or severe COPD ➢ Burning/stinging of eyes
nonselectiv
β-blocker

Betimol Soln: 1 gtt into affected eye(s) BID; Gel forming solution receptors and reduces intraocular ➢ Sinus bradycardia ➢ Rarely bradycardia
Timoptic may decrease to QD if well controlled pressure by reducing aq. humor ➢ 2nd or 3rd degree AV block
e)

Oral Tab
production and possibly increases
Elevated the outflow of aq. humor
latanoprost intraocular Opht. Soln. 0.005% Hypersensitivity ➢ Erythema of eyelid
Xalatan pressure ➢ Conjunctival hyperemia
Prostaglandin

➢ Burning/stinging/itching in eyes
Prostaglandin analog which
travoprost 1 gtt in affected eye(s) QPM Opht. Soln. 0.004% ➢ Ocular hyperemia
increases the outflow of aq. humor
Travatan ➢ Increased growth of eyelashes
➢ Burning/stinging/itching of eyes
➢ Decreased visual acuity
 Anti-Emetic
Drug Indication Dose Route Form Strength MOA C/I Key Points
ondansetron N/V 8-16mg PO 30min-1hr Tablet 4, 8mg Selective 5HT3 receptor antagonist ➢ Hypersensitivity ➢ Headache
Selective 5HT3
Antagonist

Zofran before therapy ODT 4, 8mg ➢ Use with apomorphine ➢ Malaise

Zuplenz Oral ➢ Fatigue
Solution
Film ➢ Constipation
Inj. Solution
promethazine ➢ N/V Allergies, N/V: 12.5-25mg Oral Tablet 12.5, 25, 50mg Blocks postsynaptic mesolimbic ➢ Hypersensitivity ➢ Sedation
Phenadoz ➢ Motion PO/ PR QHS or Q4-6H PRN Syrup dopaminergic receptors in the brain; ➢ Treatment of lower respiratory ➢ Possible EKG changes
Phenothiazine
H1 Antagonist

Phenergan sickness Motion sickness: 25mg Rectal Suppository exhibits a strong alpha-adrenergic tract symptoms, including
Derivative
1st gen.

Promethegan ➢ Sedation PO/PR 30min – 1hr before blocking effect and depresses the asthma
departure release of hypothalamic and ➢ Children < 2yo
Inj. Solution hypophyseal hormones; competes BBW: Pediatrics: Respiratory
with histamine for the H1 receptor. depression; Injection: Severe
tissue injury, including gangrene

GERD
Drug Indication Dose Route Form Strength MOA C/I Key Points
famotidine ➢ GERD Oral Tablet 10, 20, 40mg
20-40mg QD or BID
Pepcid ➢ Gastric Ulcer IV Solution suspensionreconstituted
Histamine H2
Antagonist

ranitidine ➢ GERD Tablet 75, 150, 300mg Competitively inhibits histamine at H2

Hypersensitivity to other H2 ➢ Headache
Zantac ➢ Gastric and Duodenal Capsule receptors of the gastric parietal cells,
Oral antagonists ➢ Diarrhea
Ulcer 150mg BID or 300mg QHS Solution reconstituted which inhibits gastric acid secretion
➢ Erosive Esophagitis Syrup
Inj Solution
esomeprazole
Nexium
➢ GERD
➢ H. pylori Eradication Oral or
Tablet
Cap DR
20, 40mg
➢ Headache
➢ Risk reduction of 20-40mg QD Packet ➢ Take 60 mins before food
gastritis and ulcer IV Solution reconstituted
PPI: Substituted Benzimidazole

bleeding
lansoprazole ➢ GERD Cap DR 15, 30mg
15-30mg QD
Prevacid ➢ Peptic Ulcer Disease Oral Suspension
H. pylori Eradication 30mg BID or TID ODT
omeprazole ➢ GERD Cap DR 10, 20, 40mg Suppresses gastric acid secretion by
Prilosec ➢ Gastric and Duodenal inhibition of H+/K+ ATPase in the gastric Hypersensitivity to PPIs ➢ Headache
Tab DR
Ulcer 20-40mg QD Oral parietal cell ➢ Diarrhea
Solution
➢ H. pylori Eradication ➢ Take 30 mins before food
Packet
➢ Omeprazole only: May
pantoprazole ➢ GERD Tab DR 20, 40mg diminish effect of
Oral
Protonix ➢ Erosive esophagitis 40mg QD or BID Packet clopidogrel
IV Solution reconstituted
rabeprazole ➢ GERD Tab DR 20mg
20mg QD
Aciphex ➢ Duodenal ulcers Oral
H. pylori Eradication 20mg BID Cap Sprinkle

Vitamin / Supplements
Drug Indication Dose Route Form Strength MOA C/I Key Points
folic acid Megaloblastic / 0.4-1mg QD Tablet 400mcg, 800mcg, 1mg Necessary for formation of a Hypersensitivity ➢ Take regularly, even on days
Vitamin

Oral
macrocytic anemia Capsule number of coenzymes in not taking methotrexate
Inj. Solution many metabolic systems ➢ Side effects are mild and
well-tolerated
potassium chloride Hypokalemia 20-100mEq in 1-4 Tab ER 8, 10, 20mEq Provides K+, the major ➢ Hyperkalemia, renal failure, and ➢ Hyperkalemia
K-Tab evenly divided Cap ER intracellular cation, for conditions in which K+ retention ➢ IV form: phlebitis
Supplement
Electrolyte

Oral
Klor-Con dose Max single
sign Packet various metabolic functions is present
Micro-K dose 20-25mEq Solution ➢ Structural, pathological and/or
IV Solution pharmacologic cause for delay or
arrest in passage through the GI
tract