Medicine drug list and lab values

erimicrom's version from 2015-10-20 13:48


Question Answer
Keflex (cephalexin) Rx500 mg Disp 28 1PO q12 hrs
Keflex (cephalexin) indicationsstaph, strep, and limited anaerobes (E. coli and Klebsiella)
Keflex (cephalexin) requires _______ dosingrenal
Augmentin (amoxicillin / clavulanate) Rx500/125mg Disp 28 1 PO q12 hrs
Augmentin (amoxicillin / clavulanate) indicationsstaph, and some PCN-resistant bugs not covered by Keflex (Pastuerella, Baceteroides)
Kefzol (cefazolin) Rx1g IV 30-60min prior to incision
Kefzol (cefazolin) indicationssurgical prophylaxis
Cipro (ciprofloxacin) Rx500mg Disp 28 1 PO q12 hrs
Cipro (ciprofloxacin) indicationsST infection, g+ and g- coverage. Antipseudomonal!
Which 2 drugs are commonly given together for broad spectrum tx of polymicrobial DM foot?Cipro + Cleocin
Cleocin (clindamycin) Rx300mg Disp 56 1 PO q6 hrs
Cleocin (clindamycin) indicationsST infection, g+, anaerobes, SCIP
Cleocin (clindamycin) SCIP dosage600mg IV
Bactrim DS (trimethoprim / sulfamethoxazole) Rx160/800mg Disp 28 1 PO q12 hrs
Bactrim DS (trimethoprim / sulfamethoxazole) indicationsST and bone infection. MRSA!
Zyvox (linezolid) Rx600mg Disp 28 1 PO q12 hrs
Zyvox (linezolid) indicationsMRSA and VRE
Zyvox (linezolid) factoidGood IV to PO drug for MRSA when transitioning from hospital to outpatient care w/o need for PICC line
Vancomycin Rx1g IV q12 hrs
Vancomycin indicationsMRSA, SCIP
Vancomycin SCIP dosage1g IV w/i 2 hrs of incision
Vancomycin PO indicationsonly C. diff colitis (not MRSA!)
Invanz (ertapenem) Rx1g IV q24 hrs
Invanz (ertapenem) indicationsskin infection, including complicated DM foot
Zosyn (pipercillin / tazobactam) Rx3.375g IV q6 hrs
Zosyn (pipercillin / tazobactam) indicationsBroad spectrum and pseudomonas
Unasyn (ampicillin / sulbactam) Rx3g IV q6 hrs
Unasyn (ampicillin / sulbactam) indicationsskin and bone broad spectrum g+, g- and anaerobes
Drugs for MRSA (3)Bactrim DS, Zyvox (linezolid), Vancomycin

Anti-inflammatories / acute pain

Question Answer
Motrin (ibuprofen) Rx800mg Disp 120 1 PO q6 hrs
Motrin (ibuprofen) MOAnonselective COX inhibitor
Celebrex (celecoxib) Rx200mg Disp 30 1 PO QD
Celebrex (celecoxib) MOASelective COX-2 inhibitor
Celebrex (celecoxib) CIsulfa allergy
Naprosyn (naproxen) Rx500mg Disp 60 1PO q12 hrs
Naprosyn (naproxen) MOAnonselective COX inhibitor
Indocin (indomethacin) Rx50mg Disp 42 1PO q8 hrs
Indocin (indomethacin) indicationacute gout attack (2 wk course)
Indocin (indomethacin) causes ______ _______stomach irritation
Toradol (ketorolac) Rx10mg Disp 20 1PO q6 hrs
Toradol (ketorolac) MOAnonselective COX inhibitor
Toradol (ketorolac) indicationsacute post-op pain
Toradol (ketorolac) CIs (2)asthma and renal dysfunction
Toradol (ketorolac) cannot be utilized past 5 days due torenal toxicity
Benadryl (diphenhydramine) Rx50mg PO at onset of rxn
Tylenol w/ codeine (T#3) Rx300/30mg Disp 114 1-2 PO q6
Amount of acetaminophen to not exceed in 24 hrs4g
Vicodin (hydrocodone/acetaminophen) Rx5/300mg Disp 40 1-2 PO q6 hrs
Vicodin (hydrocodone/acetaminophen) alternate trade namesLorcet, Lortab, Norco, Hycet
Ultram (tramadol) Rx50mg Disp 56 1 PO q6 hrs prn pain
Ultram (tramadol) MOAacts through opioid receptors and limits norep/5-HT uptake
Narcan (naloxone) Rx0.1-0.2mg IV q3 min prn
Narcan (naloxone) indicationsopioid reversal
Nucynta (tapentadol) Rx 50mg Disp 40 1 PO q8 hrs prn pain
Nucynta (tapentadol) indicationsacute pain. An opioid that does not produce euphoria, making it unattractive to recreational users
MS Contin ER (morphine sulfate extended release) PO Rx15mg Disp 28 1 PO QD
MS Contin (morphine sulfate) IV Rx2-10mg IV q2-6 hrs
Percocet (oxycodone/acetaminophen) Rx5/325mg Disp 40 1-2 PO q6 hrs prn pain
PCA (pt controlled anesthesia) / "pain pump" drugs (2)Morphine sulfate, dilaudid
Morphine Sulfate PCA Rx1mg / mL q10 min
Morphine CIcompromised renal function
Dilaudid PCA Rx0.1mg / mL q10 min
Which PCA should you Rx for a pt w/ renal dz?Dilaudid


Question Answer
Versed (midazolam) Rx1mg IV
Versed (midazolam) indicationsPre-op sedation
Ambien (zolipidem) Rx5mg Disp 14 1PO qhs prn insomnia
Ambien (zolipidem) indicationsinsomnia w/ post-op pain
Ambien (zolipidem) has an ______ interactive effect w/ narcoticsadditive
Flexeril (cyclobenzaprine) Rx10mg Disp 40 1PO TID
Flexeril (cyclogenzaprine) indicationspain associated w/ muscle spasms. joint distraction, ex fix distraction re-alignment, major tendon Sx
Valium (diazepam) Rx5mg Disp 40 1PO TID
Valium (diazepam) indicationspain associated w/ mm spasms, anxiety, pre-op sedation (not great), and EtOH withdrawal symptoms

Chronic pain / neuropathy

Question Answer
Cymbalta (duloxetine) Rx60mg Disp 30 1 PO QD
Cymbalta (duloxetine) CIglaucoma and psychiatric illness (depression / suicidal ideation)
Neurontin (gabapentin) Rx300mg Disp 90. Taper dose 300mg QD day 1, BID day 2, TID day 3, and QID day 4 and onward (if you need to go that high.)
Neurontin (gabapentin) max dose1200mg daily
Lyrica (pregabalin) Rx50mg Disp 90 1PO TID (may increase to 100mg)


Question Answer
Lamisil (terbinafine) Rx250mg Disp 90 1PO QD
Lamisil (terbinafine) pre-Rx testLFT (liver enzymes) should be normal [[Dr. Jarrett says also get CBC.]]
Lamisil (terbinafine) may lowerWBC
Lotrisone (clotrimazole/betamethasone) Rx1% cream Disp 45g apply to feet QD
Naftin Rx1% cream Disp 15g apply to feet QD
Penlac (ciclopriox) Rx8% solution Disp 6.6mL apply to nails qhs and remove w/ EtOH q7 days
Cleocin T (clindamycin topical) Rx1% gel Disp 60g apply between digits BID
Cleocin T (clindamycin topical) indicationssecondary interdigital infections associated w/ tinea pedis


Question Answer
Medrol (methyprednisonolone) RxDose pack. Taper dose over 6 days from 24mg QD to 4mg QD


Question Answer
Phenergan (promethazine) Rx25mg Disp 12 1PO q6 hrs
Phenergen (promethazine) indicationsPost-op nausea
Phenergen (promethazine) potentiates the effects of _______narcotics
Zofran (ondanestron) Rx4mg Disp 12 1PO q8 hrs prn nausea & vomiting
Prilosec (omeprazole) Rx20mg Disp 30 1PO QD
Prilosec (omeprazole) indicationsGastric ulcer prophylaxis for NSAID using pts at risk


Question Answer
Lovenox (enoxaparin) prophylactic Rx40mg SC QD for DVT prophylaxis
Lovenox (enoxaparin) DVT/PE tx Rx1mg/kg SC q12 hrs
Coumadin (warfarin) Rx5mg Disp 30 1 PO QD
Coumadin (warfarin) indicationsextended DVT prophylaxis, or DVT tx
Heparin Rx5000 units SQ q12 hrs
Heparin indicationsDVT prophylaxis

Controlled Substance Schedules

Question Answer
Schedule IIllegal; high abuse potential with no medicinal indications in U.S.
Schedule I exheroin
Schedule IIRx required; high abuse potential; no refills or verbal orders at community pharmacy
Schedule II examphetamines, some opioids (Percocet)
Schedule IIIRx required; moderate abuse potential; max 5 refills / 6 mo; verbal orders allowed
Schedule III exsome opioids (Vicodin)
Schedule IVRx required; low abuse potential; max 5 refills / 6 mo; verbal orders allowed
Schedule IV exappetite suppressants
Schedule Vcan be Rx or OTC; limited abuse potential
Schedule V exantitussive

CBC Normal Values

Question Answer
Hgb12-17 g / dL
Plt250k-400k cells / uL
WBC4k - 10k cells / uL

Chem 7 / BMP Normal Values

Question Answer
Na135-145 meq / L
Cl100-110 meq / L
BUN5-20 mg / dL
K3.5 - 5 meq / L
HCO325-30 meq / L
Cr<1.1 mg / dL
Glucose70-110 mg / dL

WBC Differential

Question Answer
PMNs (neutrophils)<5% bands, 60% segs
Left shift, indicating infection / hemmorhage, if bands more than10%
Right shift, indicating hepatic dz, if bands less than5%

Renal function labs

Question Answer
Multiply the Cockcroft-Gault estimate of GFR by ___ for women0.85
Normal creatinine clearance GFR80-120 mL / min
Renal compromise GFR<80 mL / min
Severe renal dz GFR10-20 mL / min
Need dialysis if GFR under10 mL / min
Normal urine output per hr0.5-1 mL / kg / hr
Normal urine output per day1000-1600 mL / day

Labs Elevated w/ Infection

Question Answer
ESR & CRPnon-specific inflam markers
Lymphocytesvirus, leukemia
Total PMN countbacteria
Eosinophilsallergic / parasitic dz

Urinalysis (to check for UTI)

Question Answer
Leukocyte esterasedetects WBC activity (positive infection) in urine
Nitritesproduced by bacteria in urine from normal nitrates


Question Answer
Normal PTT25-35s
PTT checks this pathwayIntrinsic
Intrinsic pathway includes factorsI, II, V, VIII, IX, X, XI, XII
PTT is used to monitor tx w/heparin
Normal PT11-13s
PT checks this pathwayextrinsic
Extrinsic pathway factorsI, II, V, VII, X
PT is used to monitor tx w/warfarin
Which time is used to calculate INR?PT
Normal INR0.75-1.5
Normal INR if anticoag tx2-3
INR is used to monitor tx w/warfarin
Normal thrombin time10-14s
Thrombin time is checked after abnormally longPTT
Thrombin time measures conversion of _______ to _______fibrinogen, fibrin

Misc Lab Values

Question Answer
Cancel elective Sx if platelets under100,000
Spontaneous bleeding if platelets under50,000
Platelet function can be compromised by the following drugs (4)ASA, heparin, lovenox, chemotherapy
For each 1 unit drop in Hgb, Hct drop by ___ units3
Albumin3.5 - 5 g / dL
Low albumin indicatescompromised wound healing and liver dz
Pre-albumin15-30 mg / dL
Low pre-albumin (<5) indicatespoor wound healing
ALT0-35 u / L
Increased ALT indicatesliver dz
AST8-20 u / L
Increased AST indicatesliver dz or MI
ESR 0-30 mm / hr
Increased ESR indicatesinflammation / infection
CRP0-10 mg / dL (or less than 3 if high sensitivity test)
Elevated CRP indicatesinflammation / infection
3 reasons to cancel elective Sxglucose over 200, platelets under 100k, or active infection (including UTI)
Labs that suggest poor wound healing (4)low albumin, low pre-albumin, low total lymphocytes, high HgA1C

Local anesthetics

Question Answer
Local anesthetics act by blockingvoltage-gated Na channels
Function is lost to local anesthetic in this orderpain, temperature, touch, proprioception, pressure
To convert percent solution to mg/mLmultiply % by 10
Lidocaine onset time45-90s
Max dose of lidocaine plain4 mg / kg
Duration of lidocaine plain1-2 hrs
Max dose of lidocaine w/ epi7 mg / kg
Duration of lidocaine w/ epi2-4 hrs
Bupivacaine onset time10-20 min
Max dose of bupivacaine plain2 mg / kg
Duration of bupivacaine plain6-8 hrs
Max dose of bupivacain w/ epi3 mg / kg
Duration of bupivacaine w/ epi8-16 hrs