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o Patients are started on doxazosin after they have failed tamsulosin in
treatment of BPH due to dizziness when standing abruptly
o Alpha-1 antagonist should not skip a dose due to low BP
Clonidine issues
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, o Has the potential of causing rebound hypertension, because of this, a dose
should not be missed or the patient should not stop taking the medication
o It is best to avoid taking clonidine and a beta blocker together because
withdrawing one or both could cause life-threatening and fatal increases in
blood pressure
If taken together, the beta blocker should be tapered first to avoid unopposed
alpha stimulation and significant hypertension
o If stopped, can result in rebound hypertension urgency and concern for
CVA
What is off-label prescribing
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• Off-label prescribing is the use of pharmaceutical drugs for an unapproved
indication or an unapproved age group, dosage, or route of administration.
o It is legal if there is scientific evidence for the use; it is illegal if it violates
ethical guidelines for safety regulations
Educate the patient
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Giving the patient informational instructions for and warning about treatment
What is one reason to be careful of drug interactions
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, If one drug inhibits the CYP mediated metabolism of another drug, the second
drug may accumulate within the body to toxic levels, hence these interactions
may necessitate dosage adjustments or choosing drugs that do not interact
with the CYP system
Donepezil prescribing considerations
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o Can be given once daily increasing adherence
o Has a decreased number of peripheral ADRs; common include headache,
nausea, diarrhea and insomnia
o Food has no effect on its absorption
o Bioavailability is 90% or higher; no dosage adjustments are recommended in
patients with renal impairment
o Hepatic impairment bay decrease clearance of drug
o Pregnancy category C
Anticholinergics uses
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o Patients are started on doxazosin after they have failed tamsulosin in
treatment of BPH due to dizziness when standing abruptly
o Alpha-1 antagonist should not skip a dose due to low BP
Clonidine issues
Give this one a try later!
, o Has the potential of causing rebound hypertension, because of this, a dose
should not be missed or the patient should not stop taking the medication
o It is best to avoid taking clonidine and a beta blocker together because
withdrawing one or both could cause life-threatening and fatal increases in
blood pressure
If taken together, the beta blocker should be tapered first to avoid unopposed
alpha stimulation and significant hypertension
o If stopped, can result in rebound hypertension urgency and concern for
CVA
What is off-label prescribing
Give this one a try later!
• Off-label prescribing is the use of pharmaceutical drugs for an unapproved
indication or an unapproved age group, dosage, or route of administration.
o It is legal if there is scientific evidence for the use; it is illegal if it violates
ethical guidelines for safety regulations
Educate the patient
Give this one a try later!
Giving the patient informational instructions for and warning about treatment
What is one reason to be careful of drug interactions
Give this one a try later!
, If one drug inhibits the CYP mediated metabolism of another drug, the second
drug may accumulate within the body to toxic levels, hence these interactions
may necessitate dosage adjustments or choosing drugs that do not interact
with the CYP system
Donepezil prescribing considerations
Give this one a try later!
o Can be given once daily increasing adherence
o Has a decreased number of peripheral ADRs; common include headache,
nausea, diarrhea and insomnia
o Food has no effect on its absorption
o Bioavailability is 90% or higher; no dosage adjustments are recommended in
patients with renal impairment
o Hepatic impairment bay decrease clearance of drug
o Pregnancy category C
Anticholinergics uses
Give this one a try later!
