Week 1 Generic Alendronate Brand Fosamax Risidronate Actonel Raloxifene Evista Calcitonin Salmon Miacalcin Generic Clindamycin Brand Cleocin Metronidazol Flagyl Nitrofurantoin Macrodantin, Macrobid, Furadantin Generic Levothyroxine Brand Synthroid, Levoxyl Generic Bisoprolol/ HCTZ Brand Ziac Losartan/ HCTZ Hyzaar Lisinopril/ HCTZ Zestoretic Amlodipine/ Benazepril Lotrel OSTEOPOROSIS Indication(s) Usual Dose Prevention and Prophylaxis: 5mg QD treatment of or 35 mg weekly osteoporosis, Paget’s Treatment: 10mg QD or disease 70 mg weekly * Must be taken first thing in the morning, 30 minutes before meal. Prevention and Pagets: 30mg QD for 2 treatment of months osteoporosis, Paget’s Osteoporosis: 5mg QD disease (or 35 mg weekly) *Taken 30 mins before 1st food or drink of the day Prevention and 60 mg tablet QD treatment of osteoporosis Treatment of Paget’s I.M.: 100 units/day disease, adjunctive Intranasal: 200 therapy for units/day (one spray hypercalcemia, alternating nostrils osteoporosis daily) OTHER ANTIBIOTICS Indication(s) Usual Dose Treatment against 150mg-450 mg every 6aerobic and anaerobic 8H streptococci, PID, Lotion: apply BID severe acne Anaerobic bacterial and 500-750 mg Q8H for 5protozoal infections, 10 days CNS infections, 250 mg Q8H for 7 days bacterial vaginosis, H. 500 mg Q6-8H Pylori 250-500 mg Q3-4 times a day for 10-14 days Prevention and 50- 100 mg Q6H treatment of UTI caused by gram + and gram – bacteria. THYROID REPLACEMENT Indication(s) Usual Dose Hypothyroidism 25 to 300 mcg daily (1.7 mcg/kg/day) HYPERTENSION COMBINATIONS Indication(s) Usual Dose Hypertension Start: one 2.5/6.25 mg QD; titrate up to max: two 10/6.25 mg tabs QD Hypertension 50/12.5 mg to 100/25 mg QD Hypertension 10/12.5 mg, 20/12.5 mg or 20/25 mg QD Hypertension 2.5/10 mg, 5/10 mg, 5/20 mg, or 10/20 mg QD Anticipated and Adverse Effects Abdominal pain, constipation, diarrhea, flatulence, musculoskeletal pain, rare: irritation of upper GI mucosa Back pain, abdominal pain, hypertension, diarrhea, arthalgia, UTI, HA, rash, edema, nausea Hot flashes, leg cramps, weight gain, peripheral edema, sinusitis, rash, sweating Rhinitis, nasal irritation, back pain, flushing, nausea, rash, irritation of respiratory tract, anorexia, edema, polyuria Anticipated and Adverse Effects Abdominal pain, nausea, vomiting, diarrhea, puritus, vaginitis, muscle pain, sever diarrhea, rash Anorexia, nausea, vomiting, diarrhea, convulsive seizures, periperal neuopathy, abdominal cramping, HA, dysuria, metallic taste in mouth Nausea, HA, flatulence, vomiting, diarrhea, fever, cough, chills Anticipated and Adverse Effects Rare: fever, hypoglycemia, heart failure, fluid loss, tachycardia, anxiety, insomnia Anticipated and Adverse Effects Fatigue, HA, dizziness, diarrhea, decreased sexual activity, bradycardia, edema, CHF, depression, constipation, N/V URTI, dizziness, cough, back pain, rhabdomyolysis (rare) Dizziness, HA, fatigue, cough, diarrhea, hypotension, rash, hyperkalemia, N/V, abdominal pain Cough, HA, dizziness, edema, rash, angioedema, nausea, flushing, fatigue, abdominal pain, somnolence Valsartan/ HCTZ Diovan HCT Hypertension (not initial therapy) 80/12.5 mg, 160/12.5 mg, 160/25 mg QD Dizziness, hypotension, increased serum potassium, abdominal pain, cough, viral infection Week 2 Generic Fluconazole Brand Diflucan Terbinafine Lamisil Nystatin Bio-Statin, Mycostatin, various others Generic Clonidine Brand Catapres Doxazosin Cardura Terazosin Hytrin Generic Tamsulosin Brand Flomax Generic Sildenafil Brand Viagra Vardenafil Levitra Tadafil Cialis Generic Gemfibrozil Brand Lopid ANTIFUNGAL MEDICATIONS Indication(s) Usual Dose Candidiasis, 200 mg QD cryptococcal Varying doses (150 meningitis, antifungal 400 mg QD) prophylaxis Fungal infections, 250 mg QD, also onychomycosis of available in topical toenail or fingernail, cream- apply BID athletes foot, jock itch, ring worm Candida fungal Oral Suspension: swish infections and swallow 4 times/day Troche: 4-5 times/day Topical: apply 2-3 times a day Vaginal tablets: insert 1 tablet/day at bedtime for 2 weeks ALPHA ADRENERGIC AGENTS Indication(s) Usual Dose Mild to moderate 0.2 to 0.8 mg in divided hypertension doses (titrated from 0.1 mg BID) Hypertension, BPH 1 mg QD up to 2 mg QD; Hypertension: max 16mg/day; BPH: 48mg/day Use for mild to 1 to 5 mg QD (but up to moderate hypertension 20 mg) in combo with diuretics or beta-blockers, BPH Indication(s) BPH BPH Usual Dose 0.4 mg ERECTILE DYSFUNCTION Indication(s) Usual Dose Psychotropic-induced 25-50 mg prn, ~1 hour sexual dysfunction, before sexual activity primary pulmonary hypertension Erectile dysfunction 5, 10, 20 mg prn, ~1 hour before sexual activity Erectile dysfunction 5, 10, 20 mg prn, taken before sexual activity FIBRIC ACID DERIVATIVES Indication(s) Usual Dose Hyperlipidemia (types 600 mg BID 30 min IV and V) prior to morning and evening meals Anticipated and Adverse Effects Nausea, HA, abdominal pain, diarrhea, dizziness, dyspepsia, taste perversion Oral: diarrhea, dyspepsia, abdominal pain, rash, pruritus, taste disturbances; Topical: irritation, burning/tingling, itching, and dryness Contact dermatitis, Stevens-Johnson syndrome, N/V, diarrhea, stomach pain; rare but serious: hypersensitivity reactions Anticipated and Adverse Effects Dry mouth, drowsiness, dizziness, HA, fatigue, edema, constipation, impotence Dizziness, edema, fatigue, rhinitis, HA Asthenia, palpitations, nausea, HA, nasal congestion, peripheral edema, dizziness *Cannot use with erectile dysfunction meds Anticipated and Adverse Effects Orthostatic hypotension, HA, dizziness, abnormal ejaculation, rhinitis, chest pain, somnolence, insomnia, vertigo, diarrhea, nausea Anticipated and Adverse Effects HA, flushing, dyspepsia, nasal congestion, UTI, abnormal vision, diarrhea, dizziness, rash HA, flushing, nasal congestion, dyspepsia HA, dyspepsia, back pain, flushing, nasal congestion, myalgia Anticipated and Adverse Effects Dyspepsia, abdominal pain, diarrhea, nausea, fatigue Fenofibrate Antara, Lofibra, TriCor Hyperlipidemia 145 mg QD with meals (Antara: 43-130 mg/day Lofibra: 67mg/day TriCor: 48mg/day up to 145) Abnormal liver function; rare but serious: rash, muscle pain, tenderness or weakness Week 3 Generic Betamethasone Brand Celestone, Soluspan, Beta-Val Triamcinolone Nasacort AQ (Triamcinolone) Azmacort Fluocinonide Lidex Generic Morphine Brand Roxanol, MS Contin, MSIR Duragesic Fentanyl Transdermal System CORTICOSTEROIDS Indication(s) Usual Dose Inflammatory Oral: 2.4-4.8mg/day in dermatoses (seborrheic 2-4 doses or atopic dermatitis, IM: 0.6-9 mg/day neurodermatitis, divided every 12-24 psoriasis) hours Topical: apply thin film 2-4 times/day. Perennial and seasonal 220 mcg/day as 2 allergic rhinitis sprays in each nostril QD Asthma Two inhalations three to four times daily (max 16 inhalations daily) Relief of inflammatory Topical: apply a thin and pruritic layer to affected area 2manifestations 4 times daily OPIOID ANALGESICS Indication(s) Usual Dose Chronic pain 10-30 mg every 3-4H, lots of different doses Chronic pain, Sedation, pain relief 25 mcg patch, change every 3 hours; Patches increase to 50, 75, 100 mcg and so on SSRI’S Indication(s) Usual Dose Major depressive 20 mg QD in morning, disorder, bulimia up to 80 mg. nervosa, OCD, panic (Taper up dose) disorder Major depression, 25- up to 200mg QD OCD, panic disorder, (preferably in the PTSD, premenstrual morning) dysphoric disorder, (Taper up dose) social anxiety disorder. Generic Fluoxetine Brand Prozac Sertraline Zoloft Paroxetine Paxil Depression, OCD, panic disorder, social anxiety disorder, GAD, PTSD 20 mg QAM, up to 60 mg/ day (Taper up dose) Citalopram Celexa Depression 20-40mg QD (Taper up dose) Escitalopram Lexapro Major depressive disorder or generalized anxiety disorder. 10-20 mg QD (Taper up dose) Anticipated and Adverse Effects Insomnia, nervousness, increased appetite, indigestion CHF, hypertension, fever, HA, vertigo, diarrhea, diarrhea, dyspepsia Hoarseness, dry mouth Burning, itching, irritation, dryness, folliculitis, hypopigmentation Anticipated and Adverse Effects Lightheadedness, constipation, N/V, asthenia, dizziness, HA, sedated, urinary retention Nausea, vomiting, constipation, confusion, drowsiness, dizziness, dry mouth, sweating, mild itching/redness Anticipated and Adverse Effects Insomnia, HA, anxiety, nervousness, nausea, diarrhea, anorexia, xerostomia, weakness, tremor, yawn, dizziness. Insomnia, somnolence, dizziness, HA, fatigue, xerostomia, diarrhea, nausea, decreased libido, constipation, vomiting, weight gain, tremors, abnormal vision * Avoid Alcohol HA, somnolence, dizziness, insomnia, nausea, xerostomia, diarrhea, constipation, weakness, anxiety, agitation, anorexia, impotence *Avoid Alcohol Somnolence, insomnia, nausea, xerostomia, diaphoresis, anxiety, agitation, rush, vomiting, diarrhea, weight gain * Avoid Alcohol HA, somnolence, insomnia, nausea, chest pain, hypertension, palpitations, dizziness, fatigue, migraine * Avoid Alcohol OTHER ANTIDEPRESSANTS Indication(s) Usual Dose Depression, adjunct in 100 mg BID, up to TID smoking cessation. 150 mg BID Generic Bupropion Brand Wellbutrin, Zyban Venlafaxine Effexor Major depressive disorder, General anxiety disorder, social anxiety disorder. Extended Release tablets 75 mg QD with food 75 mg/day in 2-3 divided doses Mirtazapine Remeron Depression 15 mg HS, up to 45mg Trazodone Desyrel depression 50 mg TID, up to 600 mg/day Generic Olanzapine Brand Zyprexa Risperidone Risperdal ANTIPSYCHOTICS Indication(s) Usual Dose Schizophrenia, acute 2.5 up to 20 mg QD mania episodes, bipolar disorders, acute agiations Schizophrenia, acute 0.5 up to 6 mg BID mania episodes, bipolar disorders Anticipated and Adverse Effects Dizziness, HA, insomnia, nausea, xerostomia, pharyngitis, arrhythmias, chest pain, hypertension, agitation, anxiety, confusion, irritability, anorexia, diarrhea * Avoid Alcohol HA, somnolence, dizziness, insomnia, nervousness, nausea, xerostomia, anorexia, constipation, weakness, Hypertension, chest pain, anxiety, agitation * Avoid Alcohol Somnolence, increased cholesterol, constipation, xerostomia, increased appetite, weight gain, hypertension, edema, dizziness, vomiting, abdominal pain * Avoid Alcohol Dizziness, HA, sedation, nausea, xerostomia, blurred vision, hypertension, hypotension, edema, confusion, fatigue, diarrhea, constipation, decreased concentration * Avoid Alcohol Anticipated and Adverse Effects HA, somnolence, insomnia, agitation, nervousness, dizziness, constipation, weight gain, weakness Insomnia, agitation, anxiety, HA, dizziness, weight gain, hypotension, sedation Week 4 Generic Valsartan Brand Diovan Losartan Cozaar Irbesartan Avapro Generic Cyclobenzaprine Brand Flexeril Carisoprodol Soma ANGIOTENSIN II RECEPTOR ANTAGONISTS Indication(s) Usual Dose Hypertension, heart 40, 80, 160, 320 mg failure. QD (hypertension) BID (heart failure) Hypertension, heart 25, 50, 100mg BID or failure. QD Hypertension, heart 75, 150, 300mg QD failure. MUSCLE RELAXANTS Indication(s) Usual Dose Relief of discomfort 5 mg 3 times/day may associated with acute, increase to 10 mg 3 painful musculoskeletal times/day if needed; Do conditions. Relaxes not use for more than 23 weeks muscles. Skeletal muscle 350 mg 3-4 times/day relaxant Anticipated and Adverse Effects Dizziness, fatigue, abdominal pain, cough, viral infection Chest pain, fatigue, hypoglycemia, anemia, weakness, back pain, diarrhea, cough, hypotension, dizziness, upper respiratory tract infection Fatigue, diarrhea, dyspepsia, upper respiratory tract infection, cough Anticipated and Adverse Effects Drowsiness, dizziness, xerostomia, fatigue Drowsiness, chest tighteness, dizziness, HA, fast heartbeat, low BP Metaxolone Skelaxin Generic Doxycycline Brand Adoxa, Doryx, Monodox, Periostat, Vibramycin Dynacin, Minocin Minocycline Relief of discomfort 800 mg 3-4 times daily associated with acute, painful musculoskeletal conditions; Relaxes muscles TETRACYCLINES Indication(s) Usual Dose Anthrax, community 100-200 mg Q12H acquired pneumonia and other bacterial infections Nausea, constipation, dry mouth, headache, blurred vision, lightheadedness, dizziness, drowsiness Gram negative and gram positive bacterial infections, anthrax, acne, meningococcal carrier state, gonorrhea Gram negative and gram positive bacterial infections, acne, gonorrhea, syphilis, multi-drug regimen for eradication of H. pylori 200mg, then 100mg Q12 hours (infection) 50mg 1-3 times a day (acne) Teeth discoloration, lightheadedness, vertigo, nausea, diarrhea, photosensitivity 250-500 mg Q6H (adults) 25-50mg/kg/day in divided doses Q6H (children) 500 mg Q2-4 times a day (H. pylori) Pericarditis, nausea, vomiting, diarrhea, anorexia, photosensitivity Tetracyclines Sumycin, Wesmycin Generic Hydrochlorothiazide Brand Microzide DIURETICS Indication(s) Usual Dose Edema, hypertension 25-100mg QD Furosemide Lasix Edema, hypertension 40mg BID Triamterene/ HCTZ Dyazide, Maxzide Hypertension 1 tab QD Spironolactone Aldactone Edema, hypertension, hypokalemia, aldosteronism, 50-200mg QD, NTE 400mg/day Anticipated and Adverse Effects Photosensitivity, rash, anorexia, diarrhea, nausea Anticipated and Adverse Effects Hypotension, vasculitis, photosensitivity, hyperglycemia, constipation, diarrhea, N/V, dizziness, HA, blurred vision Constipation, diarrhea, N/V, dizziness, HA, blurred vision, vertigo, rash Chest pain, hypotension, rash, abnormal electrolytes, abdominal pain, constipation, diarrhea, N/V, dizziness, HA, blurred vision, anxiety, insomnia Rash, hyperkalemia, diarrhea, N/V, stomach cramps, HA, lethargy, confusion Week 5 Generic Mupirocin Brand Bactroban Generic Digoxin Brand Lanoxin Generic Brand TOPICAL ANTIBIOTICS Indication(s) Usual Dose Impetigo (skin Small amount to infection) due to infected area 2-5 staphylococcus aureaus. times/day for 5-14 days DIGITALIS GLYCOSIDES Indication(s) Usual Dose Treatment of CHF and 125, 250 mcg QD to slow ventricular rate in tachyarrhythmias NITRATES Indication(s) Usual Dose Anticipated and Adverse Effects Dizziness, HA, rash, dry skin, nausea, burning, stinging. Anticipated and Adverse Effects Headache, dizziness, N/V, diarrhea, mental disturbances Anticipated and Adverse Effects Nitroglycerin Nitro-Bid, Nitrostate, NitroQuick Angina pectoris, pulmonary hypertension, CHF Isosorbite Mononitrate Imdur, Ismo, Monoket Prophylactic treatment of angina pectoris (chest pain) Patch: 0.2-0.4 mg/hr Sublingual: 0.2-0.6mg every 5 minutes max 3 doses Translingual: 1-2 sprays every 3-5 minutes max 3 doses Buccal: 1 mg Q3-4H while awake (three times a day) Oral: 2.5-9 mg 2-4 times a day 5-10 mg BID (8am and 3pm) (immediate release) 30-60 mg QD (extended release) HA, lightheadedness HA, dizziness, N/V Week 6 ANTIHISTAMINES Indication(s) Usual Dose Relief of nasal and non- 5 mg QD nasal symptoms of allergic rhinitis, perennial allergic rhinitis, chronic idiopathic urticaria Perennial and seasonal 5-10 mg QD allergic rhinitis Generic Desloratadine Brand Clarinex Cetirazine Zyrtec Fexophenadine Allegra Generic Promethazine Brand Phenergan Hydroxyzine Atarax, Vistaril Meclizine Antivert Anxiety, preoperative sedative, antiprurtic, antiemetic Prevention and treatment of motion sickness, management of vertigo Generic Brand Indication(s) Seasonal allergic rhinitis, chronic idiopathic urticaria 60 mg BID 180 mg QD ANTINAUSEA/ ANTIHISTAMINE Indication(s) Usual Dose Treatment of allergic 25 mg HS or reactions, antiemetic, 12.5-25 mg Q4-6H motion sickness, sedative, post-op pain, anesthetic 25-100 mg QID 12.5-25 mg Q1H before travel, repeat Q12-24H 25-100 mg/day in divided doses CEPHALOSPORINS Usual Dose Anticipated and Adverse Effects HA, fatigue, somnolence, dizziness, dysmenorrhea, xerostomia, nausea, dyspepsia, myalgia, pharyngitis *Major metabolite of loratadine HA, somnolence, insomnia, fatigue, malaise, dizziness, abdominal pain, dry mouth, diarrhea, N/V, pharyngitis *Do not use if allergic to hydoxyzine) *Avoid Alcohol *No if allergic to hydroxyzine HA, fever, dizziness, pain, drowsiness, fatigue, nausea, dyspepsia, back pain, otitis media, cough *Separate administration with mag. or alum. antacids and fruit juices Anticipated and Adverse Effects Bradycardia, hypertension, postural hypotension, tachycardia, confusion, dizziness, drowsiness, fatigue, hallucinations, insomnia, nervousness, dermatitis, constipation, N/V, xerstomia, impotenece Drowsiness, HA Drowsiness, thickening of bronchial secretions, HA, fatigue, nervousness, dizziness, appetite increased, weight gain, nausea, abdominal pain, dry mouth Anticipated and Adverse Effects Cephalexin Keflex Cefprozil Cefzil Cefuroxime Ceftin, Zinacef Respiratory tract infections, otitis media, skin infections, bone infections, genitourinary tract infections Infections caused by Pseudomonas aeruginosa and infections due to other susceptible aerobic gram-netagive organisms Infections caused by group B staphylococci, E.coli, salmonella, lower respiratory tract, otitis media, skin infections, bone infections, sepsis and gonorrhea 250-1000mg Q6H Agitation, confusion, dizziness, fatigue, rash, abdominal pain, diarrhea, N/V, vaginitis 250-500 mg Q8-12 H Diarrhea, dizziness, fever, HA, stevens-johnson syndrome, vomiting, vaginitis 125, 250 or 500 mg BID; Take with food Eosinophilia, decreased hemoglobin and hematocrit, increased transaminases, increased alkaline phosphatase, thrombophlebitis Week 7 INCONTINENCE Indication(s) Usual Dose Antispasmodic for 5 mg 2-3 times/day neurogenic bladder max is 4 times/day (urgency, frequency) 5-10 mg QD max is 30 mg /day for extended release Treatment of overactive 2 mg BID if immediate bladder release 4 mg QD if extended release BREAST CANCER TREATMENT Indication(s) Usual Dose Breast cancer, prevent 20 mg QD or 20 mg breast cancer in high BID if 40 mg a day risk patients BENZODIAZEPINES Indication(s) Usual Dose General anxiety 0.25-5 mg TID up to disorder, panic disorder, 4mg anxiety Generic Oxybutynin Brand Ditropan, Ditropan XL Oxytrol Tolterodine Detrol, Detrol LA Generic Tamoxifen Brand Nolvadex Generic Alprazolam Brand Xanax Clonazepam Klonipin Seizures, panic disorders 0.5 mg TID Diazepam Valium 2-10 mg 2-4 times a day Lorazepam Ativan Anxiety disorders, ethanol withdrawals, skeletal muscle relaxant in treatment of convulsive disorders Anxiety disorders or short term relief of the symptoms of anxiety associated with depressive disorders 2-6 mg in divided days Anticipated and Adverse Effects Xerostomia, constipation, dizziness, nausea, HA Dry mouth, HA (anticholinergic effects) Anticipated and Adverse Effects Fluid retention, sking changes, hot flashes, nausea, weight loss, menstrual irregularities Anticipated and Adverse Effects Depression, drowsiness, fatigue, HA, irritability, sedation, libido decreased, menstrual disorders, weight gain/loss, xerostomia, hypotension Edema, palpitation, amnesia, confusion, depression, dizziness, drowsiness, fatigue, fever, HA, insomnia, agitation, anxiety, sleep disturbances Hypotension, drowsiness, ataxia, slurred speech, fatigue, insomnia, HA, anxiety, depression, confusion, changes in libido, nausea, constipation, urinary retention Sedation, respiratory depression, hypotension, confusion, dizziness, HA, depression, amnesia, rash, nausea, weakness Temazepam Restoril Generic Amitriptyline Brand Elavil Nortriptyline Pamelor, Aventyl Anxiety, panic attacks 15-30 mg HS TRICYCLIC ANTIDEPESSANTS Indication(s) Usual Dose Depression 50-150mg QD usually at HS but my take in divided doses. Avoid Alcohol Depression 25 mg Q6-8H up to 150mg day Confusion, dizziness, drowsiness, fatigue, anxiety, HA, lethargy, rash, decreased libido, blurred vision Anticipated and Adverse Effects Orthostatic hypotension, tachycardia, MI, stroke, restlessness, dizziness, insomnia, sedation, fatigue, anxiety, rash, weight gain, xerostomia, nausea, headache Postural hypotension, arrhythmia, hypertension, heart block, MI, confusion, delirium, restlessness, insomnia, anxiety, agitation, alopecia, rash, xerostomia, constipation, N/V * Avoid alcohol