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HOME MEDICATIONS Bryan Bledsoe, DO, FACEP, EMT-P

HOME MEDICATIONS Bryan Bledsoe, DO, FACEP, EMT-P. Home Medications. A patient’s medications can provide a tremendous amount of information regarding the patient’s underlying medical problems. Top-Ten Prescriptions in 2001. 1. Hydrocodone/APAP 2. Lipitor 3. Premarin 4. Synthroid

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HOME MEDICATIONS Bryan Bledsoe, DO, FACEP, EMT-P

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  1. HOME MEDICATIONS Bryan Bledsoe, DO, FACEP, EMT-P

  2. Home Medications • A patient’s medications can provide a tremendous amount of information regarding the patient’s underlying medical problems.

  3. Top-Ten Prescriptions in 2001 • 1. Hydrocodone/APAP • 2. Lipitor • 3. Premarin • 4. Synthroid • 5. Atenolol • 6. Furosemide • 7. Prilosec • 8. Albuterol • 9. Norvasc • 10. Alprazolam

  4. Mrs. Helen McCurdy • 76 year old female found unresponsive by rural postal carrier. No family or friends around. • Vital Signs: • Blood Pressure: 138/90 mmHg • Heart Rate: 102 bpm • Respirations: 10 per minute

  5. Mrs. Helen McCurdy • Medications found in cupboard: • Lanoxin • Lasix • Vasotec • Ismo • K-Dur • Keflex • MS-Contin

  6. Mrs. Helen McCurdy • Medications found in cupboard: • Lanoxin: CHF, atrial fibrillation • Lasix: CHF, HTN • Vasotec: CHF, HTN • Ismo: Angina • K-Dur: Potassium Depletion • Keflex: Infection • MS-Contin: Pain

  7. Mrs. Helen McCurdy • Upon evaluation at Sundown ED: • 1. Lacunar stroke due to HTN and AF • 2. CHF (mild exacerbation) • 3. Atrial Fibrillation • 4. Stable angina pectoris • 5. Moderate HTN (fair control) • 6. Chronic sciatica due to degenerative disc disease • 7. Recent sinus infection

  8. Home Medication Packaging • Shoe Box • Paper Grocery Bag (Sack) • K-Mart Plastic Bag • Wal-Mart Plastic Bag • Pill holder bought by caring family member which sorts pills by time and date (with no labels whatsoever)

  9. What medicines do you take? • Well, I take a little pink pill in the morning and two of the white pills in the evening. • Oh honey…I don’t know. You better call Dr. Williams. He keeps up with all of my medications. • Oxy-Contin….and I NEED MORE!!!

  10. Definitions • Drugs are chemical agents used in the diagnosis, treatment, or prevention of disease.

  11. Analgesics Antianginals Anxiolytics Anticoagulants Anticonvulsants Antidepressants Antidiabetic Antihypertensives Antipsychotics Beta-Blockers Bronchodilators Calcium Channel Blockers Cardiotonics Diuretics Sedatives/Hypnotics Medication Classes

  12. Analgesics • Used to alleviate pain and inflammation • Narcotics • Non-Steroidal Anti-Inflammatory Agents • Non-Narcotic/Non-NSAIDs • Anti-Migraine Agents

  13. Used to treat moderate to severe pain Morphine Codeine Vicodin Lorcet Darvocet Lortabs Percocet Percodan Oxy-Contin MS Contin Stadol NS Dilaudid Demerol Talwin Norco Fentanyl Narcotic Analgesics

  14. Alleviate pain and inflammation Motrin Toradol Naprosyn Anaprox Celebrex Lodine Relafen Tolectin Vioxx Voltaren NSAIDs

  15. Mild-moderate pain Acetaminophen Ultram Topicals Non-Narcotic/Non-NSAID

  16. Used to treat headache in documented migraineurs Inderal DHE Midrin Amerge Axert Imitrex Maxalt Zomig Anti-Migraine

  17. Anti-Anginals • Used in the treatment of angina pectoris • Nitroglycerin • Ismo • Isordil • Cardizem

  18. Antihypertensives • Used to decrease blood pressure • Adrenergic blockers • ACE Inhibitors • Angiotensin II Receptor Antagonists • Beta-Blockers • Calcium-Channel Blockers • Diuretics • Vasodilators • Combination Agents

  19. Adrenergic Blockers • Cause peripheral vasodilation • Cardura • Hytrin • Normodyne

  20. ACE Inhibitors • Cause peripheral vasodilation • Accupril • Altace • Captopril • Lotensin • Monopril • Prinivil • Univasc • Vasotec • Zestorectic

  21. Angiotensin II Receptor Antagonists • Cause peripheral vosodilation • Atacand • Avapro • Cozaar • Diovan

  22. Beta Blockers • Decrease heart rate and cause peripheral vasodilation • Betapace • Blocadren • Corgard • Inderal • Sectral • Tenormin • Toprol

  23. Calcium-Channel Blockers • Cause peripheral vasodilation and slow AV conduction • Adalat • Cardene • Cardizem • DynaCirc • Isoptin • Norvasc • Procardia

  24. Diuretics • Cause water excretion decreasing circulating volume • Dyazide • Maxzide • Demedex • Lasix • Diuril • Zaroxolyn

  25. Vasodilators • Decrease peripheral vasodilation (many agents indirectly cause this affect) • Nitrates • Calcium Channel Blockers • ACE Inhibitors

  26. Combination Agents • Usually a combination of two antihypertensive agents • Monopril HCT • Prinizide • Zestoretic • Hyzaar

  27. Antiarrhythmics • Corrects cardiac dysrhythmias • Mexitil, Quinidex, Rhythmol, Tambocor • Betapace, Brevibloc, Inderal • Cordarone, Corvert • Cardizem, Isoptin Digoxin commonly used to control rate.

  28. Antilipidemics • Lowers blood lipids (cholesterol) • Lopid • Baycol • Lescol • Lipitor • Mevacor • Pravachol • Zocor

  29. Alzheimer’s Agents • Helps manage s/s Alzheimer’s dosease • Aricept • Cognex • Reminyl

  30. Anticonvulsants • Used to prevent seizures • Nembutal • Neurontin • Depakote • Tegretol • Dilantin • Lamictal • Zaorntin

  31. Antidiabetic Agents • Used to lower blood sugar in diabetes • Insulin • Glucophage • Glycet • Precose • Diabeta • Glucotrol

  32. Antibiotics • Used to treat infections (primarily bacterial) • Cephalosporins • Macrolides • Penicillins • Quinolones • Sulfonamides • Tetracyclines

  33. Cephalosporins • Keflex • Ceclor • Cedax • Ceftin • Duricef • Suprax

  34. Macrolides • Erythromycin • Biaxin • Zithromax

  35. Penicillins • Common • Amoxicillin • Penn VK • Beta-Lactam • Augmentin • Gorrilacillins • Unasyn • Zosyn

  36. Quinolones • Cipro • Floxin • Levaquin • Noroxin • Trovan

  37. Sulfonamides • Bactrim • Septra

  38. Tetracyclines • Tetracycline • Doryx • Minocin • Vibramycin

  39. HIV/AIDS Agents • Reverse transcriptase inhibitors • Rescriptor • Viramune • Combivir • Epivir • Retrovir • Videx • Zerit

  40. HIV/AIDS Agents • Protease Inhibitors • Agenerase • Fortovase • Norvir • Viracept

  41. Anti-Viral Agents • Inhibit viral growth/reproduction • Famvir • Flumadine • Symmetrel • Valtrex • Zovirax

  42. Anti-Parkinsonian • Helps minimize the symptoms of Parkinson’s disease • Akineton • Artane • Benadryl • Levsin • Lodosyn • Mirapex • Requip • Sinnemet • Symmetrel

  43. Blood Modifiers • Decrease blood clotting and viscosity • Coumadin • Persantine • Aggrastat • Plavix • Ticlid

  44. Gastrointestinal Agents • Antacids • Anticholinergics • Antidiarrheals • Antiemetics • Antispasmodics • Laxatives • Anti-Ulcer Agents

  45. Antacids • Decrease gastric acid levels • Calcium antacids • Magnesium antacids

  46. Anticholinergics • Decreases gastric acidity and motility • Robinul • Levsin

  47. Antidiarrheals • Slow GI motility and increase stool bulk • Immodium A-D • Pepto-Bismol

  48. Antiemetics • Decreases nausea and vomiting • Compazine • Phenergan • Tigan • Zofran • Reglan

  49. Anti-spasmotics • Decreases GI motility and spasm • Donnatal • Levsin • Bentyl

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