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Deborah J McCoy-Freeman, BS, RN, NREMT-P Objectives  Discuss a variety of commonly prescribed medications  Discover the relationship between certain medications and their indication leading to more information  Describe interviewing techniques for achieving better assessment results What to do  Many medical conditions/diseases are treated with a single med or a group of meds  Certain meds can point to definite diagnoses  One solution is…  … to take a close look at the “bag „o meds”!  The medication list should never replace a good interview or assessment  Is an augmentation of your history and physical
How to learn to be a Bag „o Meds Private Eye
 Focus on the medical problem  Review the most common medications prescribed for that problem  Take a look at the “multi-taskers”  Drugs used for more than one medical malady
Pulmonary Problems
Pulmonary
o Sympathomimetics/beta agonists
o *Albuterol: Ventolin, Proventil, Combivent, ProAir
o *Metaproterenol: Alupent
o Salmetrol: Serevent, Advair
o Formoterol: Foradil, Symbicort
 *rescue inhalers
o Ipratoprium: Atrovent, Combivent
o TheoDur
o Fluticasone: Advair, Flovent
o Flunisolide: Aerobid
o Budesonide: Pulmicort, Symbicort
o Prednisone
o Methylprednisolone: Medrol
o Mometasone: Asmanex
o Montelukast: Singulair
o Zafirlukast: Accolate

Allergies
o Loratidine: Claritin, Alavert
o Fexofenadine: Allegra
o Cetirizine: Zyrtec
o Fluticasone: Flonase
o Budesonide: Rhinocort
o Triamcinolone: Nasacort
o Beclomethasone: Beconase, Vancenase
o Montelukast: Singulair

Cardiovascular Disease
o Propranolol: Inderal
o Atenolol: Tenormin
o Carvedilol: Coreg
o Metoprolol: Lopressor
o Acebutolol: Sectral
o Labetalol: Normodyne
o Clonidine: Catapres
o Methyldopa: Aldomet
o Terazosin: Hytrin
o Prazosin: Minipres
o Doxazosin: Cardura
o Hydrochlorothiazide (HCTZ): Thiazide
o HCTZ/Triamterene: Maxzide, Dyazide
o Indapamide: Lozol
o Spironolactone: Aldactone
 Diltiazem: Cardizem, Dilacor, Tiazac
 Verapamil: Isoptin, Calan, Verelan, Covera
 Amlodipine: Norvasc
 Felodipine: Plendil
 Isradipine: DynaCirc
 Nicardipine: Cardene
 Nifedipine: Procardia, Adalat
o Benazepril: Lotensin
o Captopril: Capoten
o Enalapril: Vasotec
o Fosinopril: Monopril
o Lisinopril: Prinivil, Zestril
o Moexipril: Univasc
o Quinapril: Accupril
o Ramipril: Altace
o Trandolapril: Mavik
o Losartan: Cozaar
o Valsartan: Diovan
o Irbesartan: Avapro

Combinations
o Atenolol/chlorthalidone: Tenoretic
o Bisoprolol/HCTZ: Ziac
o Metoprolol/HCTZ: Lopressor HCT
o Propranolol/HCTZ: Inderide
o Benazepril/HCTZ: Lotensin HCT
o Captopril/HCTZ: Capozide
o Enalapril/HCTZ: Vaseretic
o Lisinopril/HCTZ: Prinzide, Zestoretic
o Losartan/HCTZ: Hyzaar
o Amlodipine/benazepril: Lotrel
o Carvedilol: Coreg
o Nadolol: Corgard
o Labetalol: Normodyne
o Nitroglycerin: Minitran, Nitro-DUR, Nitrolingual,Transderm-Nitro, Nitrostat
o Isosorbide mononitrate: Imdur, Ismo
o Isosorbide dinitrate: Isordil
o Furosemide: Lasix
o Metolazone: Zaroxolyn
o Bumetanide: Bumex
o Torsemide: Demadex
o Spironolactone: Aldactone
 Potassium Replacement: KDur, KLyte
 Digoxin: Lanoxin
 Cardiovascular Disease  Peripheral Vascular Disease o Aspirin
o Warfarin: Coumadin
o Enoxaparin: Lovenox
o Rosuvastatin: Crestor
o Fluvastatin: Lescol
o Atorvastatin: Lipitor
o Lovastatin: Mevacor
o Pravastatin: Pravachol
o Simvastatin: Zocor
o Cholestyramine: Questran
o Colestipol: Colestid
o Nicotinic Acid: Niacin
o Fenofibrate: TriCor
o Gemfibrozil: Lopid
 Beta Blockers and Nitrates: AGAIN!  Calcium Channel Blockers o Diltiazem: Cardizem, Dilacor, Tiazac
o Verapamil: Isoptin, Calan, Verelan, Covera
o Amlodipine: Norvasc
o Amiodarone: Cordarone
o Procainamide: Procan
o Mexiletine: Mexitil
o Quinidine: Quinidex
o Flecainide: Tambocor
 Clopidogrel: Plavix

Peripheral Vascular Disease
 Pentoxifylline: Trental
 Cilostazol: Pletal
 Ticlopidine: Ticlid
 Aspirin/Dipyridamole: Aggrenox
 Peptic Ulcer Disease  Gastroesophageal Reflux Disease o Sucralfate: Carafate
o Ranitidine: Zantac
o Cimetidine: Tagamet
o Nizatidine: Axid
o Famotidine: Pepcid
o Omeprazole: Prilosec
o Lansoprazole: Prevacid
o Pantoprazole: Protonix
o Rabeprazole: Aciphex
o Esomeprazole: Nexium
o Metoclopramide: Reglan
o Omeprazole: Prilosec
o Lansoprazole: Prevacid
o Pantoprazole: Protonix
o Rabeprazole: Aciphex
o Esomeprazole: Nexium
o Diabetes mellitus o Hypertension: ACE Inhibitors o High Cholesterol o Calcium, Vitamin D
o Phosphate Binders: Phoslo, Phosex
o Furosemide: Lasix (usually very high doses)
o Ultrashort acting: Humalog, Novolog, Apidra
o Short acting: Humulin R, Novolin R
o Long acting: Humulin N, Novolin N
o Mixed: Humulin 70/30, Novolin 70/30
o Longer acting: Lente, Ultralente, Lantus, Levemir
o Pramlintide: Symlin
o Exenatide: Byetta
o Glipizide: Glucotrol
o Glyburide: Micronase, Diabeta, Glynase
o Glimepiride: Amaryl
o Metformin: Glucophage
o Metformin/Glyburide: Glucovance
o Sitagliptin : Januvia
o Acarbose: Precose
o Miglitol: Glyset
o Pioglitazone: Actos
o Rosiglitazone: Avandia
o Repaglinide: Prandin
o Nateglinide: Starlix
 Alzheimer‟s Disease  Seizure Disorders  Amantadine: Symmetrel
 Levodopa/Carbidopa: Sinemet
 Bromocriptine: Parlodel
 Ropinirole: Requip
 Selegiline: Eldypryl
 Benztropine: Cogentin

Alzheimer‟s Disease
 Donepezil: Aricept
 Galantamine: Reminyl
 Rivastigmine: Exelon
 Carbamazepine: Tegretol
 Gabapentin: Neurontin
 Levetiracetam: Keppra
 Lamotrigine: Lamictal
 Phenobarbital
 Phenytoin: Dilantin
 Topiramate: Topamax
 Valproic Acid: Depakote
o Non-specific: Inderal, Tenormin
o Valproic acid: Depakote
o Topiramate: Topamax
o Gabapentin: Neurontin
o Verapamil: Calan
o Amlodipine: Norvasc
o Amitriptyline: Elavil
o Fluoxetine: Prozac
o Ibuprofen: Motrin
o Ergotamine/Caffeine: Cafergot
o Sumatriptan: Imitrex
o Naratriptan: Amerge
o Almotriptan: Axert
o Zolmitriptan: Zomig
o Depression o Anxiety o Bipolar Affective Disorder o Amitriptyline: Elavil
o Nortriptyline: Pamelor
o Imipramine: Tofranil
o Fluoxetine: Prozac
o Sertraline: Zoloft
o Paroxetine: Paxil
o Bupropion: Wellbutrin
o Duloxetine: Cymbalta
o Citalopram: Celexa
o Escitalopram: Lexapro
o Fluvoxamine: Luvox
o Trazodone: Desyrel
o Venlafaxine: Effexor
o Mirtazapine: Remeron
o Nefazodone: Serzone
o Quetiapine: Seroquel
o Diazepam: Valium
o Alprazolam: Xanax
o Lorazepam: Ativan
o Clonazepam: Klonopin
o Buproprion: BuSpar
o Lithium: Lithobid, Eskalith
o Anti-psychotics
Quetiapine: Seroquel
o Valproic Acid: Depakote
 Chlorpromazine: Thorazine
 Fluphenazine: Prolixin
 Haloperidol: Haldol
 Thiothixene: Navane
 Trifluoperazine: Stelazine
 Perphenazine: Trilafon
 Aripiprazole: Abilify
 Thioridazine: Mellaril
 Risperidone: Risperdal
 Clozapine: Clozaril
 Quetiapine: Seroquel
 Ziprasidone: Geodon
 Olanzapine: Zyprexa
 Benztropine: Cogentin
o Aspirin
o Ibuprofen: Motrin, Advil
o Naproxen: Naprosyn
o Diclofenac: Voltaren
o Flurbiprofen: Ansaid
o Ketorolac: Toradol
o Ketoprofen: Orudis
o Etodolac: Lodine
o Nabumetone: Relafen
o Oxaprozin: Daypro
o Piroxicam: Feldene
o Sulindac: Clinoril
o Celecoxib: Celebrex
o NSAIDs
o Indomethacin: Indocin
o Specific Treatments
 Colchicine
 Allopurinol: Zyloprim
 Probenecid
Multi-Tasker Medications Common Multi-Tasks o Particularly Non-specific o Hypertension o Cardiovascular Disease o Congestive Heart Failure o Migraines o Arrhythmias o Anxiety o Hypertension o Cardiovascular Disease o Migraines o Esophageal Spasm o Hypertension o Congestive Heart Failure o Peripheral Edema o Renal Disease o Hypertension o Congestive Heart Failure o Diabetes Mellitus o Renal Failure o Parkinson‟s Disease o Prevention of movement complications o Muscle Spasm o Testosterone Blocker in Transgendered patients o Ascites o Hypertension o Congestive heart failure  Trigeminal Neuralgia  Bipolar Affective Disease  Headaches  Psychosis  Bipolar Affective Disease  Chronic Pain  Neuropathy including Diabetic  Headache  3rd PLACE
 Steroids, especially Prednisone
 Pulmonary Disease  Infectious Disease  Arthritic Disease  Immune Disease  Allergic Problems  2nd PLACE
 Amitriptyline
o Less often used for Depression o Chronic Pain o Insomnia o Anxiety o Headaches  THE #1 MULTI-TASKER: INDERAL
o Hardly ever used for Hypertension o Migraine o Headaches o Anxiety o Essential Tremor o Hyperthyroidism o Pheochromocytoma

Source: http://freemanemsed.com/yahoo_site_admin/assets/docs/Bag_o_meds2011.55193833.pdf