Acquired immune-deficiency syndrome (AIDS)

Post-exposure prophylaxis (PEP)

• TC: Anti-retroviral
• PC: Nucleoside reverse transcription inhibitor (NRTI)
• Acts by inhibiting the reverse transcriptase enzyme when it begins to synthesize viral DNA, causing a defective DNA strand to be created. 
• Side effects may include fatigue, weakness, anorexia, nausea, diarrhea, headache, and possible CNS effects. Black box warning that rare cases of fatal lactic acidosis with hepatomegaly and steatosis have been reported. 
• Pregnancy category C.
• Contraindicated in patients with a hypersensitivity to the drug, with pre-existing anemia or neutropenia. Blood counts should be monitored frequently during therapy to prevent hematologic toxicity. Patients with reduced renal or hepatic impairment require a reduction in dosage. 

• TC: anti-retroviral
• PC: non-nucleoside reverse transcriptase inhibitor (NNRTI)
• Acts by inhibiting reverse transcriptase. Used to treat HIV.
• Side effects may include sleep disorders, nightmares, dizziness, reduced ability to concentrate, and delusions. 
• Pregnancy category C. 
• Contraindicated in patients in the child bearing years and pregnant patients. 

• TC: Anti-retroviral
• PC: Protease inhibitor
• Acts by inhibiting the hepatic breakdown of lopinavir, thus permitting serum levels of lopinavir to increase by more than 100 fold. 
• Side effects may include diarrhea, headache, nausea, vomiting, dyspepsia, and abdominal pain. Drug may worsen effects of diabetes mellitus. Long term therapy may cause lipodystrophy syndrome. Pancreatitis is a rare side effect. 
• Pregnancy category C.
• Contraindicated in patients with liver impairment. Hepatic levels should be monitored regularly. Use with caution in patients with cardiac disease. Women should not breast feed because of the risk of passing HIV to the baby.  

• TC: anti-retroviral
• PC: nucleoside analog
• Acts by preventing viral DNA synthesis, decreasing the duration and severity of acute herpes episodes. Used for the treatment of HSV-1 and HSV-2.
• Side effects may include nephrotoxicity and neurotoxicity. 
• Pregnancy category C. 
• Contraindicated in patients with a hypersensitivity to the drug. 

Malignant tumors

Nausea and vomiting: treatment

• TC: Anti-neoplastic
• PC: Alkylating agent; nitrogen mustard
• Acts by attaching to DNA and disrupting replication, particularly in rapidly dividing cells. Used to treat Hodgkin’s disease, lymphoma, multiple myeloma, breast cancer, and ovarian cancer. 
• Side effects may include potentially fatal bone marrow suppression, thrombocytopenia, nausea, vomiting, anorexia, diarrhea, reversible alopecia, possible hemorrhagic cystitis if urine becomes concentrated. 
• Pregnancy category C.
• Contraindicated in patients with a hypersensitivity to the drug or those who have active infections or severely suppressed bone marrow. 

• TC: Anti-neoplastic
• PC: antimetabolite, folic acid analog
• Acts by blocking the synthesis of folic acid which inhibits replication, particularly in rapidly dividing cells. Used to treat choriocarcinoma, osteogenic sarcoma, leukemia’s, head and neck cancers, breast carcinoma, and lung carcinoma.  
• Side effects may include nausea and vomiting. Black box warning that NSAID’s may cause severe and possibly fatal myelosuppression. Drug is hepatotoxic and may cause liver cirrhosis if used long term. Possible life threatening infections may occur during therapy. Possible severe dermatologic reactions such as toxic epidermal necrolysis and Steven’s-Johnson syndrome. 
• Pregnancy category X. 
• Contraindicated in patients with thrombocytopenia, anemia, leukopenia, concurrent administration of hepatotoxic drugs and hematopoietic suppressants, alcoholism, or lactation. Do not use in pregnant women.  

• TC: Anti-neoplastic
• PC: Anti-tumor antibiotic 
• Acts by attaching to DNA, distorting its double helical structure and preventing normal DNA and RNA synthesis. Used to treat solid tumors in the lungs, breast, ovary, bladder, and for various leukemia’s and lymphomas. 
• Side effects may include low blood cell counts, nausea, vomiting, reversible alopecia. Drug is cardiotoxic. Black box warning that severe myelosuppression may occur. Severe thrombocytopenia, leukopenia, and anemia may occur. Cardiac adverse effects can be life threatening and may include sinus tachycardia, bradycardia, delayed heart failure, acute left ventricular failure, and myocarditis. 
• Pregnancy category D.
• Contraindicated in patients who are pregnant, lactating, have myelosuppression, thrombocytopenia, pre-existing cardiac disease, obstructive jaundice, lactation, or previous treatment with complete cumulative doses of doxorubicin. 

Vincristine (Oncovin)

• TC: Anti-neoplastic
• PC: Vinca alkaloid, mitotic inhibitor, natural product
• Acts by preventing cancer cells ability to complete mitosis by attacking cancer cells in the M-phase of the cell cycle. Used to treat Hodgkin’s and non-Hodgkin’s lymphoma’s, leukemia’s, Kaposi’s sarcoma, Wilms’ tumor, bladder carcinoma, and breast carcinoma. 
• Side effects may include numbness and tingling in limbs, muscular weakness, loss of neural reflexes, pain, severe constipation, paralytic ileus, and reversible alopecia. 
• Pregnancy category D. 
• Black box warning that myelosuppression may be severe and predispose to opportunistic infections. 
• Contraindicated to the use of vincristine include obstructive jaundice, men and women of child-bearing age, active infection, adynamic ileus, radiation of the liver, infants, pregnancy, and lactation. 

• TC: Antineoplastic
• PC: Estrogen receptor blocker
• Acts by blocking estrogen receptors on breast cancer cells, but tamoxifen actually activates estrogen receptors in other parts of the body. Used to treat breast cancer. 
• Side effects may include hot flashes, fluid retention, vaginal discharge, hypertension, and edema. 
• Pregnancy category D. 
• Black box warning of increased risk of endometrial cancer. 
• Contraindicated to the use include anti-coagulant therapy, pre-existing endometrial hyperplasia, history of thromboembolic disease, pregnancy, and lactation. Patients should be observed in patients with blood disorders, visual disturbances, cataracts, hypercalcemia, and hypercholesterolemia. 

• H1 – responsible for the allergic symptoms. 
• H2 - found in the gastric mucosa and responsible for peptic ulcers.

• TC: Drug to treat allergies
• PC: H1 – receptor antagonist; antihistamine
• Acts by binding to H1 receptors to treat minor symptoms of allergy and the common cold. Used to treat allergies and the common cold.  
• Side effects may include drowsiness, excitability, dry mouth, tachycardia, mild hypotension, and photosensitivity. 
• Pregnancy category C. 
• Contraindicated in patients with a hypersensitivity to the drug, prostatic hypertrophy, narrow-angle glaucoma, and gastrointestinal obstruction. Do not use in patients with asthma or hyperthyroidism. 

• TC: drug for allergic rhinitis
• PC: intranasal corticosteroid
• Acts by decrease local inflammation in the nasal passages, thus reducing nasal stuffiness. 
• Side effects include nasal irritation and epistaxis. 
• Pregnancy category C. 
• Contraindicated in patients with a prior hypersensitivity to the drug. Patients with known bacterial, viral, fungal, or parasitic infections should not receive  this drug. 

• TC: Nasal decongestant
• PC: sympathomimetic 
• Acts by activating alpha-adrenergic receptors in the sympathetic nervous system causing the nasal passages to constrict, thus drying the mucous membranes. 
• Side effects may include rebound congestion, and minor stinging and dryness in the nasal mucosa. 
• Pregnancy category C. 
• Contraindicated in patients with thyroid disorders, hypertension, diabetes, or heart disease. 

• TC: cough suppressant
• PC: drug for increasing cough threshold
• Acts on the medulla to help suppress cough. 
• Side effects may include dizziness, drowsiness, GI upset, slurred speech, ataxia, hyper excitability, stupor, respiratory depression, seizures, coma, and toxic psychosis. 
• Pregnancy category C. 
• Contraindicated in patients with chronic cough due to excessive bronchial secretions, asthma, smoking, and emphysema. 

• TC: bronchodilator
• PC: beta2-adrenergic agonist
• Acts by relieve the bronchospasm associated with asthma helping inhibit the release of inflammatory chemicals from mast cells. Used to treat sudden onset of asthma symptoms.
• Side effects may include palpitations, headaches, throat irritation, tremor, nervousness, restlessness, and tachycardia, insomnia, dry mouth, chest pain, paradoxical bronchospasm, and allergic reactions. 
• Pregnancy category C. 
• Contraindicated in patients with hypersensitivity to the drug. Administer with caution in patients with a history of cardiac disease or hypertension. 

• TC: bronchodilator
• PC: anticholinergic 
• Acts by blocking the parasympathetic nervous system and leading to bronchodilation. Used to treat COPD, bronchitis, and emphysema. 
• Side effects may include cough, drying of the nasal mucosa, hoarseness, and epistaxis. 
• Pregnancy category B. 
• Contraindicated in patients with hypersensitivity to soya lecithin or related food products like soybean and peanut. Drug can cause a bitter taste so teach patients to rinse mouth once done taking medication. 

• TC: anti-inflammatory drug for asthma and allergic rhinitis
• PC: inhaled corticosteroid
• Acts by reducing inflammation, thus decreasing the frequency of asthma attacks. Used for the long term management of persistent asthma. 
• Side effects may include hoarseness, dry mouth, changes in taste, development in cataracts in adults, growth inhibition in children. 
• Pregnancy category C. 
• Watch for signs of corticosteroid toxicity. Contraindicated in patients with a hypersensitivity to the drug. Growth of pediatric patients should be monitored carefully. 

• TC: anti-inflammatory drug for asthma prophylaxis
• PC: leukotriene modifier
• Acts by preventing airway edema and inflammation by blocking leukotriene receptors in the airways. Used to preemptively treat persistent, chronic asthma.
• Side effects may include headache, nausea, and diarrhea. 
• Pregnancy category B. 
• Contraindicated in patients with hypersensitivity to the drug. Rare cases of hepatic failure have been reported.