Thursday, February 2, 2017

Random thoughts on meds

Today was a good day, thinking that I only have to work 2 more days before my weekend :)

Let's go:

  • What are the typical doses for ZENATANE (isotretinoin)?
    • Available in 10, 20, 30, 40mg 
    • Weight base dose:
      • Adult 
        • Manufactured: 0.5-1mg/kg/day in 2 divided dose x 15-20 weeks
        • Alternative: 0.5mg/kg/day in 2 divided dose x 1 month ⟹ then ↑ 1mg/kg/day in 2 divided doses as tolerated until a cumulative dose of 120-150mg/kg
      • Pediatric
        • Manufactured: 0.5-1mg/kg/day in 2 divided dose x 1-20 weeks
        • Alternative: 0.5mg/kg/day in 2 divided doses x 1 month ⟹ ↑ 1mg/kg/day in 2 divided doses as tolerated until a cumulative dose of 120-150mg/kg
    • Monitoring:
      • CBC with differential and platelet count
      • Pregnancy test
      • Lipids
      • Liver function test
    • Adverse reactions:
      • ↑ serum triglycerides
    • Warnings/precautions:
      • Many many many...
  • ZOMIG (zolmitriptan)
    • Dose
      • Nasal (available 2.5, 5mg)
        • 2.5-5mg (may repeat in 2 hours; daily MAX = 10mg)
      • Oral (available 2.5, 5mg PO & ODT)
        • PO: 1.25-5mg (may repeat in 2 hours; daily MAX = 10mg)
        • PO ODT: 2.5-5mg (may repeat in 2 hours; daily MAX = 10mg) 
  • KETOCONAZOLE topical
    • Indications
      • Cutaneous candidiasis
      • Dandruff
      • Seborrheic dermatitis
      • Tinea corporis (general skin fungal infection), tinea crusis (jock itch), tinea pedis (athlete's foot)
    • Protect from light
    • How about feet? Still protect from light?
  • FELBAMATE (anticonvulsant; available - suspension (600mg/5ml), tablets (400, 600mg)
    • What is this??? 
    • Dosing
      • Inital = 1,200mg/day in 3-4 times daily (MAX = 3,600mg/day)
    • Side effects
      • Drowsy, dizzy, fatigue
  • GRISEOFULVIN 
    • Microsize (Grifulvin V; available - not anymore)
      • 500mg/day in single or divided doses
    • Ultramicrosize (GRIS-PEG; available - 125, 250, 500mg)  
      • 375mg/day in single or divided doses
  • SENSIPAR (cinacalcet; available = 30, 60, 90mg)
    • Indications - hyperparathyrodism 
    • Dosing
      • 30mg BID upto 90mg 3-4 times daily as necessary to normalize calcium levels
    • Adverse reactions
      • parasthesia (tingling sensation)

Wednesday, February 1, 2017

Opioid Med Flyer for patient

This is a pdf file from Mendocino county opioid coalition. It's meant for patients. It makes me wonder about its claim:

Side Effects of Opioids include these following peculiar ones:

  • Loss of strength
  • Decreased sex drive
  • Infertility
  • Low testosterone in males
  • More pain and pain sensitivity
  • Compromised Immune System
  • Memory loss
How in the world do I explain these side effects??

Monday, January 30, 2017

Monday, Happy Monday...


I feel like an outsider inside the pharmacy, and so I'm going to keep writing until I can rise above :)

It was manageable all day until the afternoon until flood gate opens and everything just sort of spirals out of order...


  • INTUNIV (guanfacine ER)
    • ADHD - there is a target dose, increase weekly by clinical response and tolerability
  • MALARONE (atovaquone & proguanil
  • MINOXIDIL 
    • Indicated for HTN
  • DOXEPIN (SILENOR)
    • Indicated for SLEEP, 3-6mg 30-min before bed (MAX = 6mg daily)
  • PYRANTEL PAMOATE 
    • Indicated for PINWORM
    • Other treatment options for PINWORM
  • PENTOXIFYLLINE
    • Indicated for INTERMITTENT CLAUDICATION, 400mg TID

Sunday, January 29, 2017

SUNDAY...oh, SUNDAY...

SUNDAY is busy...I guess I'll have to get used to that fact it'll never be like Ft Bragg's Sunday :(
Here we go:

  • ADDERALL side effects are...
  • OMNITROPE equivalent (from the perspective of the insurance company) 從沒聽過 :(
    • GENOTROPIN
    • HUMATROPE
    • NORDITROPIN flexpro
  • LIDEX cream
  • SERTRALIE side effects are...
    • What about other SSRI??

Saturday minus 1 person

➞This sounded like a disaster to begin, but Ashton is totally amazing in his super energetic and caring demeanor! We have lots things to go over, and so here we go:

  • BASAGLAR (insulin glargine)  VS. LANTUS (from Sanofi Aventis)
    • Another long acting insulin, from LILLY
    • A biosimilar drug to LANTUS, might be cheaper

  • LOTRISONE (betamethasone & clotrimazole)
  • PROVIGIL (modafinilvs. NUVIGIL (armodafinil)

  • METRONIDAZOLE 0.75% (cream, gel, lotion) for the ACNE ROSACEA
    • Apply BID
  • AVENOVA 
  • OXYTROL vs. OXYBUTYNIN ER
  • HYDROQUINONE 
    • Indicated for - bleaching for areas on the skin where there are changes in color; 
    • MOA - reversible suppression of melanocyte metabolism --> so UV/sun light can produce re-pigmentation of the bleached area 
  • METHENAMINE hippurate
    • Indicated for - UTI prophylaxis/suppression to keep urine acidic
    • 1,000mg AM & PM
  • CEFDINIR (3rd generation cephalosporin)
    • stored reconstituted suspension at room temperature x 10 days (so need to pay attention of how to dispense to patients so that in case the dose needs to be > 10 days; however, most direction call for 10-day treatment)
  • CLEOCIN / CLINDAMAX (clindamycin 2% vaginal cream)
    • 7 Disposable plastic applicators are provided with this package. They are designed to allow proper vaginal administration of the cream.

  • Figure
    Remove cap from cream tube --> Screw a plastic applicator on the threaded end of the tube --> Rolling tube from the bottom, squeeze gently and force the medication into the applicator.
    The applicator is filled when the plunger reaches its predetermined stopping point.
    Unscrew the applicator from the tube and replace the cap.
    While lying on your back, firmly grasp the applicator barrel and insert into vagina as far as possible without causing discomfort.
    Slowly push the plunger until it stops. Carefully withdraw applicator from vagina, and discard applicator.
    Figure
    • Indicated for - bacterial vaginosis
    • Nightly for either 3 or 7 nights for non-pregnant, 7 nights for pregnant women