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Classification: Corticosteroid
Route:
Oral
Adult:
tablet-5 mg, 10 mg, 20 mg
Powder for injection: 100 mg, 250 mg. 500 mg, 1g
Oral, Intramuscular or Intravenous: 15 to 240 mg/day.
Inflammation: 15-24 mg PO/IM/IV q12hr
Status Asthmaticus: 1-2 mg/kg IV q6hr for 24 hrs.
Acute Adrenal Crisis: 100 mg IV bolus, then 300 mg/day IV
divided q8hr
Pregnancy: Category C
Drug enters breast milk; use with caution
Intravenous
Mode of Action:
Glucocorticoid; elicits mild mineralocorticoid activity and moderate anti-inflammatory
effects; controls or prevents inflammation by controlling rate of protein synthesis,
suppressing migration of polymorphonuclear leukocytes and fibroblasts, and
reversing capillary permeability.
Common side effects:
Acne, Delayed wound healing, depression, Hyperglycemia, Insomnia, Tachycardia
Mode of elimination:
Half-Life: Plasma, 1-2 hr; biologic, 8-12 hr
Excretion: Urine (mainly), feces (minimally)
Carbamazepine
enzyme CYP3AF metabolism. Monitor closely. Use alternatives if available.
Cimetidine will increase the effect of hydrocortisone by affecting hepatic enzyme
Cimetidine
CYP3A4 metabolism. Monitor closely. Use alternatives if possible.
Clarithromycin will increase the effect of hydrocortisone by affecting hepatic enzyme
Clarithromycin
CYP3A4 metabolism. Monitor closely. Use alternatives if possible.
Prepared by: Novelyn C. Agsamosam
Remarks:
Classification: Carbapenems
Route:
Intravenous
Mode of Action:
Inhibits cell wall synthesis by binding to penicillin-binding proteins; resistant to most
beta-lactamases.
Common side effects:
Constipation (1-7%), Diarrhea (4-5%)
Headache (2%), Inflammation at injection site (2%)
Nausea or vomiting (1-4%)
3 important issues you would counsel patients with:
1. Advise the patient to report the signs of super infection (vaginal itch or discharge, loose or foul smelling stools) and allergy
2. May cause dizziness. Caution patient to avoid driving.
3. Caution patient to notify health care professional if fever and diarrhea occurs, especially if stool contains blood, pus, or mucus. Advise patient not to
treat diarrhea without consulting health care professional.
List 3 drugs which significantly interact with this class and state what action you would take
Interaction
Corrective action
Meropenem decreases effects of BCG live vaccine by pharmacodynamics
Digoxin
Applies only to oral form of both agents. Significant interaction possible, monitor
(Significant-monitor closely)
closely.
Meropenem will decrease the level or effect of pyridoxine by altering intestinal flora.
Pyridoxine
Minor or non-significant interaction.
(minor)
Prepared by: Novelyn C. Agsamosam
Remarks:
Intravenous
Pregnancy: Category C
Distributes into human milk; use caution
Indication/s for use:
Duodenal cancer
Helicobacter pylori infection
Gastric ulcer
Mode of elimination:
Urine (80%)
Feces
Mode of Action:
Omeprazole is a selective and irreversible proton pump inhibitor. It suppresses
stomach acid secretion by specific inhibition of the H +/K + ATPase system found at the
secretory surface of gastric parietal cells.
Common side effects:
Headache (7%)
Abdominal Pain (5%)
Nausea (4%)
Flatulence (3%)
Rash (2%)
3 important issues you would counsel patients with:
1. Swallow the capsule and tablet forms of omeprazole whole. Do not open the capsule. Do not crush, break, or chew the capsule or the tablet.
2. May cause occasional drowsiness or dizziness. Caution patient to avoid driving or other activities requiring alertnes until response to medication is
known.
3. Instruct patient to notify health care professional of onset of black, tarry stools, diarrhea; abdominal pain; or persistent headache or if fever and diarrhea
develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.
List 3 drugs which significantly interact with this class and state what action you would take
Interaction
Corrective action
Carbamazepine
Carbamazepine will decrease the level or effect of omeprazole by affectinghepatic
(Serious- Use alternative)
enzyme CYP2C!9 metabolism. Monitor closely. Use alternatives if possible.
Ampicillin
Omeprazole will decrease the level or effect of ampicillin by increasing gastric ph.
(Significant- monitor closely)
Applies only to oral form of both agents. Potential for interaction, monitor.
Lidocaine
Omeprazole will decrease thelevel or effect of lidocaine by affecting hepatic enzyme
(Minor)
CYP1A2 metabolism. Minor or non significant interaction.
Prepared by: Novelyn C. Agsamosam
Remarks:
Mode of Action:
Antipseudomonal penicillin plus beta-lactamase inhibitor; inhibits biosynthesis of cell
wall mucopeptide synthesis by binding to 1 or more of the penicillin-binding proteins
and is effective during active-multiplication stage.
Remarks:
Intravenous
Mode of Action:
Bicarbonate reacts with H+ ions to form water and carbon dioxide. It acts as a buffer
against acidosis by raising blood pH.
Common side effects:
Edema, Hypernatremia, Hypocalcemia, Hypokalemia, Tetany
Remarks:
Classification: Electrolyte
Route:
Intravenous
Inhalation
Oral
Mode of Action:
Provides moisture to dry or inflamed mucus membranes, and helps thin mucus.
Remarks:
Oral
Mode of Action:
Essential in physiologic processes
Remarks:
Inhalation
Mode of Action:
Anti inflammatory corticosterod;controls rate of protein synthesis; decreasesd
inflammation by suppressing migration of polymorphonuclear leukocytes and
reducing capillary permeability.
Common side effects:
Headache (21%)
Acne (5-15%)
Nausea (11%)
Backpain (7%)
3 important issues you would counsel patients with:
1. For tablets, swallow this medication whole. Do not crush or chew. Take this medication by mouth with or without food as directed by your doctor,
usually once daily in the morning. Take this medication by mouth with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you
otherwise.
2. Suspension should be administered via jet nebulizer connected to air compressor with adequate air flow and equipped with mouthpiece or suitable
mask; ultrasonic nebulizer should be used.
3. Patient should wash mouth after inhalation to prevent oral thrush.
List 3 drugs which significantly interact with this class and state what action you would take
Interaction
Corrective action
Ergotamine
Budesonide will decrease the level or effect of ergotamine by affecting
hepatic/intestinal enzyme CYP3A4 metabolism. Monitor closely. Use alternatives if
posible.
Cilostazol
Budesonide will decrease the level or effect of cilostazol by affecting
hepatic/intestinal enzyme CYP3A4 metabolism. Significant interaction possible,
monitor closely.
Isoniazid
Isoniazid will increase the level or effect of budenoside by affecting hepatic/intestinal
enzyme CYP3A4 metabolism. Significant interaction possible, monitor closely.
Prepared by: Novelyn C. Agsamosam
Remarks:
Classification: Analgesic/Antipyretic
Route:
IV
Rectal
Oral
Mode of Action:
acetaminophen appears to produce analgesia by elevation of the pain threshold. The
potential mechanism may involve inhibition of the nitric oxide pathway mediated by a
variety of neurotransmitter receptors including N-methyl-D-aspartate and substance
P
Common side effects:
nausea, upper stomach pain, itching, loss of appetite;
dark urine, clay-colored stools; or
jaundice (yellowing of the skin or eyes).
Probenecid
(Minor)
Some minor drug interactions may not be clinically relevant in all patients. Minor
drug interactions do not usually cause harm or require a change in therapy.
However, your healthcare provider can determine if adjustments to your medications
are needed.
Remarks:
1 year to 4 years:
Nebulizer: 1.25 to 2.5 mg every 4 to 6 hours with subsequent
doses titrated based on clinical response.
5 years or older:
Metered-dose inhaler (HFA): 2 puffs (216 mcg) every 4 to 6
hours as needed.
Inhalation capsules: 200 mcg inhaled every 4 to 6 hours.
May increase to 400 mcg inhaled every 4 to 6 hours, if
necessary.
5 years to 11 years:
Nebulizer: 2.5 mg every 4 to 6 hours with subsequent doses
titrated based on clinical response.
12 years or older:
Nebulizer: 2.5 to 5 mg every 6 hours as needed.
2 years to 5 years:
Syrup or tablets: 0.1 to 0.2 mg/kg 3 times daily. Do not exceed
12 mg a day.
6 years to 11 years:
Syrup or tablets: 2 to 6 mg orally 3 to 4 times a day. May
increase stepwise to a maximum of 24 mg/day in divided doses.
Adult:
ASTHMA:
Metered-dose inhaler: 2 puffs every 4 to 6 hours as needed.
Oral
Mode of Action:
Salbutamol stimulates 2 adrenergic receptors which are predominant receptors
in bronchial smooth muscle of the lung. Stimulation of 2 receptors leads to the
activation of enzyme adenyl cyclase that form cyclic AMP (adenosine-monophosphate) from ATP (adenosine-tri-phosphate). This high level of cyclic AMP
relaxes bronchial smooth muscle and decreases airway resistance by lowering
intracellular ionic calcium concentrations. Salbutamol relaxes the smooth muscles
Remarks: