Other
Categories:
- Erythropoietin (EPO)
- Worsening Hypertension (30%), less common in Subcutaneous route
- Prevention: Slow Hematocrit rise (goal 30-35%)
- Hypertensive encephalopathy
- Treatment
- Dialysis
- Headaches (15%), Flu-like symptoms (5%)
- Red Cell Aplasia
- Worsening Hypertension (30%), less common in Subcutaneous route
- PDE-5 Inhibitors
- Sildenafil, Vardenafil, Tadalafil
- All used for ED and pulmonary hypertension
- Tadalafil can also be used for BPH
- SE: Cyanopsia (hypotension worse w/nitrates, alpha blockers), Blue color vision, non-arteritic anterior ischemic optic neuropathy, priapism, flushing, headache, heading loss
- Contraindicated in patients taking alpha blockers, nitrates due to hypotension
- Sildenafil, Vardenafil, Tadalafil
- Cholinergic Receptors
- Found on the dome of the bladder, contraction of which facilities voiding
- Phenazopyridine
- Analgesic for urinary tract mucosa frequently used to treat the dysuria of cystitis (after infection or instrumentation)
- May worsen stone formation
- L-Methylfolate (Deplin)
- Stimulates WBC and platelet production in Folate Deficiency Anemia
- Improves antidepressants effect in people with BMI ≥35
- Ofatumumab (Kesimpta)
- Dimethyl Fumarate (Tecfidera)
- SE: Nausea, vomiting, upper abdominal pain, elevated LFTs
- Other
- Permethrin
- Inhibits Na+ Channel Deactivation
- Causing membrane depolarization
- Malathion
- Acetylcholinesterase inhibitor
- Neurotoxicity
- Lindane
- Blocks GABA channels
- Neurotoxicity
- Permethrin
- BPH Meds
- Alpha 1 Adrenergic Antagonists
- First Line Therapy
- Tamsulosin, doxazosin, terazosin, alfuzosin, and prazosin
- Decrease systemic vascular resistance and resistance to urinary flow by relaxing the smooth muscle of the bladder neck and prostate gland, prostate capsule and urethra, reduce outlet obstruction
- SE: Orthostatic hypotension, dizziness, night sweats
- 5-alpha-reductase inhibitors
- Finasteride, dutasteride
- Use with Severe symptoms, ≥40g prostates, alpha-1s not working, hypotensive patient, taking sildenafil
- Inhibit conversion of testosterone to dihydrotestosterone
- Reduce prostate gland size, takes 6-12months
- SE: Decreased libido, erectile dysfunction
- Antimuscarinics
- Tolterodine
- Used to treat overactive bladder (urinary frequency, urgency and incontinence
- SE: Urine retention, dry mouth
- Alpha 1 Adrenergic Antagonists
- Memantine
- NMDA receptor (glutaminergic) antagonist
- Useful if pt with dementia cannot tolerate other drugs 2/2 nausea or vomiting
- SE: hallucinations
- Testosterone
- Topical (Fortesta, Vogelxo, Androgel, Testim)
- Subq (Androderm, Xyosted)
- Oral (Jantenzo)
- IM (Aveed)
- Alcohol Cessation
- Combo of naltrexone and acamprosate preferred
- Naltrexone
- Mu-opioid receptor antagonist
- Can’t be used on patients on opioids, liver disease (check lfts)
- Reduces 30-day readmission and ED visits when given
- SE: Nausea 10%, headache 7%, dizziness 4%, anxiety 2%
- Acamprosate
- NMDA/glutamate modulation
- Contraindicated in severe renal disease
- Usually used after withdrawal phase
- Discourage alcohol relapse
- Disulfiram (2nd line)
- Inhibits acetaldehyde dehydrogenase
- Monitor liver function (check flts)
- Can only be given to abstinent and highly motivated patients
- CI in severe cardiac disease, pregnancy, psychosis
- Disulfiram (2nd line)
- Topiramate
- Smoking Cessation
- 1) Varenicline with nicotine replacement therapy
- Varenicline (Chantix)
- Alpha 4 beta 2 acetylcholine receptor partial agonist, diminish cravings
- Mood changes, suicidality, CV risk
- Not any more
- Nicotine Replacement Treatment
- Varenicline (Chantix)
- Bupropion
- Topiramate (Topamax)
- 1) Varenicline with nicotine replacement therapy
- Nicotine Withdrawal
- Nicotinic acetylcholine receptors
- Irritability, fatigue, difficulty concentrating, headaches, constipation