4.14 Miscellaneous Drugs
Other common prescription drugs fit in less anatomically based areas. A sample is offered in Table 4.19. Skin conditions such as eczema, psoriasis, and allergic reaction from bug bites or dermatitis from poison ivy are often treated with corticosteroids that can be applied topically, or on the skin.
Rashes are often caused by allergic reactions and can be dealt with by OTC medications. If they persist or are severe, a prescription may be needed from a physician.
Triamcinolone is a corticosteroid and is the most frequently prescribed topical drug, available in different strengths in both a cream and an ointment form. Triamcinolone is more potent than the OTC drug hydrocortisone.
Since many diuretics can lower blood potassium levels, which increases the risk of toxicity from the heart drug digoxin, prescription-strength levels of potassium are needed. Potassium chloride (K-Dur, Klor-Con) can be prescribed alongside these drugs as one or two daily doses in tablet, capsule, or liquid form. This medication should be taken with food and a glass of water so that it does not irritate the esophagus.
Table 4.19 Miscellaneous Agents
Generic Name |
Trade Name |
Classification |
Indication |
|---|---|---|---|
cholecalciferol (vitamin D) |
Many |
Fat-soluble vitamin |
Vitamin D, calcium, and phosphate deficiency, osteoporosis |
folic acid |
Many |
B vitamin |
Heart disease, with MTX |
potassium chloride |
K-Dur, Klor-con |
Mineral |
Potassium replacement |
triamcinolone |
Kenalog |
Topical steroid |
Inflammatory skin disease, eczema |
Vitamin D and folic acid are commonly prescribed vitamins. Both are available over the counter, though the higher dosages must be carefully prescribed and monitored. For example, vitamin D is available as an OTC agent in dosages of 400 to 2,000 international units (IU) per day; a common prescription dose is 50,000 IU once a week. Vitamin D improves the absorption of calcium and is usually prescribed or recommended for patients who have or are at risk for osteoporosis.
The potent drug methotrexate (MTX) is commonly prescribed for rheumatoid arthritis. Folic acid may reduce some of this drug’s toxicity. Folic acid is also recommended for patients who are or may become pregnant to decrease the risk of spina bifida (a birth deformity) in the child. High doses of folic acid are found in all prenatal vitamins. Some cardiologists recommend taking folic acid to reduce blood levels of homocysteine, which is thought to be a risk factor for heart disease.