All Drugs Flashcards by Matthew Ream

This drug inhibits the 50 s ribosomal subunit to block peptide bond formation, is used for bone/joint infections and anaerobes above the diaphragm (aspiration pneumonia), has no gram negative activity, and has side effects that include pseudomembranous colitis, blood disorders and cellulitis.

Clindamycin

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These drugs inhibit the PBP transpeptidase enzyme to decrease bacterial cell wall synthesis, are bactericidal but extremely sensitive to B-lactamases. They are used for infection with strep, pneumococci, enterococci, and syphilis. A main side effect is hypersensitivity.

Penicillin G (IV, IM)
Penicillin VK (PO)

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This drug is a penicillin-ase resistant drug and is the drug of choice for infections with non-MRSA staphylococcus.

Nafcillin

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This broad spectrum drug is an amino-penicillin that is well absorbed orally, inhibits the excretion of methotrexate, and is almost always combined with clavulanic acid to inhibit B-lactamases (“Augmentin”).

Amoxicillin

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This broad spectrum amino-penicillin is the drug of choice for prophylaxis of infective endocarditis, is inactivated by hydrocortisone, and causes interactions with oral contraceptives. Renal excretion of this drug is slowed down by probenecid.

Ampicillin

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This drug is an anti-pseudomonal penicillin and is the broadest spectrum penicillin available. It is active against Pseudomonas, Klebsiella, and other G - microbes.

Piperacillin

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These drugs are 1st generation cephalosporins that are penicillin-ase resistant, used for infections with P. mirabalis, E. Coli, and Klebsiella pneumoniae. These drugs are usually used before surgery, but are not the drug of first choice for any infection.

Cefazolin

Cephalexin

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These drugs are 2nd generation cephalosporins that can be used to treat H. influenzae and some anaerobes and are B-lactamase resistant. They are also used to treat Enterobacter, Neisseria gonorrhoeae, and the microbes treated by the first generation.

Cefoxitin
Cefaclor
Cefuroxime

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This 2nd generation cephalosporin is able to cross the BBB

Cefuroxime

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These two 3rd generation cephalosporins have good activity against Gram - rods, are used for Gram - sepsis, meningitis, and anaerobes, and are good for gonococcus infection. They can cross the BBB.

Cefotaxime

Ceftriaxone

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This 3rd generation cephalosporin is active against pseudomonas

Ceftazidime

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This 3rd generation cephalosporin is used for upper respiratory infections

Cefdinir

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This 4th generation cephalosporin is active against Pseudomonas but has poor anaerobic coverage.

Cefepime

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This 5th generation cephalosporin is active against MRSA and is used for complicated skin infections and community acquired pneumonia.

Cetaroline

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This non-B-lactam drug is used topically, blocks peptidoglycan synthesis, and is active against G- and G+ microbes. Side effects include nephrotoxicity and ototoxicity.

Bacitracin

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Side effects of Cephalosporins include…

increased toxicity of aminoglycosides

pseudomembranous colitis from C. difficile superinfection

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This non-B-lactam drug binds cell wall precursors and only has G+ activity. It is best used for multi-drug resistant G+ infections like MRSA, VRE, and C. difficile. Side effects include nephrotoxicity, ototoxicity, and Red Man syndrome.

Vancomycin

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This non-B-lactam drug forms ion channels in the cell membrane, is used for MRSA and VRE (but not for pneumonia), and has side effects that include Rhabdomyolysis

Daptomycin

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This category of antimicrobials inhibits the 30s ribosomal subunit to block initiation, cause misreading, and cause premature termination. Side effects include nephrotoxicity, ototoxicity, neuromuscular paralysis and teratogenicity.

Aminoglycosides

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This drug is an aminoglycoside that is most commonly prescribed.

Gentamycin

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This aminoglycoside is used topically.

Neomycin

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This aminoglycoside has the broadest spectrum.

Amikacin

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This category of drugs inhibits the 30s ribosomal subunit to prevent the attachment of amino-acyl tRNAs. They can be used to treat acne vulgaris. They are the drugs of choice for Rickettsia, mycoplasma, chlamydia, cholera, lyme disease and plague. Adverse effects include photosensitivity, discoloration of teeth, disulfuram-like reactions, C. difficile superinfection, interactions with dairy, iron, and antacids, and teratogenicity.

Tetracyclines

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This specific tetracycline is active against MRSA, multi-drug resistant Streptococcus penumoniae, VRE, and some anaerobes.

Tigecycline.

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This category of drugs inhibit the 50s ribosomal subunit to prevent the translocation step of protein synthesis. They are broad spectrum and the safest of all antimicrobials. They are generally used for upper respiratory infections and community acquired pneumonia.

Macrolides (Azithro-, Clarithro-, and Erythro-mycin)

This Macrolide is preferred for Chlamydia and URIs (H. influenzae, moraxella, and mycobacterium)

Azithromycin

This Macrolide is used for Neisseria gonorrhoeae, Chlamydia, mycoplasma, Legionella, and non-MRSA staph.

Erythromycin

This drug inhibits the 50s ribosomal subunit (peptidly transferase enzyme), can cross the BBB, is used for life threatening infections with H. influenzae, meningitis and rickettsia in children and can cause various anemias and Gray Baby Syndrome.

Chlorempenicol

This drug inhibits the 50s ribosomal subunit, is used for MRSA, VRE, and healthcare-acquired pneumonia. Side effects include bone marrow suppression and seratonin syndrome.

Linezolid

This category of drugs inhibit the 50s ribosomal subunit and are used for life-threatening bacteremias caused by VRE as well as Vancomycin-resistant staph aureus skin infections. Side effects include myalgia/arthalgia and hyperbilirubinemia.

Streptogramins

This drug inhibits tRNA synthetase and is used topically for impetigo. It is also used for MRSA and methicillin-resistant Strep pyogenes infections.

Mupirocin

This category of drugs blocks both topo II and topo IV enzymes to prevent DNA synthesis. They distribute well though all tissues, especially the lungs. Divalent cations (like those found in dairy and antacids) interfere with the oral absorption of these drugs. They most commonly cause GI upset buy are contraindicated in pregnant women and patients that take NSAIDs, can cause photosensitivity, exacerbate myasthenia gravis, and cause tendinitis or tendon rupture

Fluroquinolones

This quinolone is the drug of choice for prophylaxis and treatment of anthrax and is the best quinolone for pseudomonas. It is also used for uncomplicated UTIs and traveler's diarrhea.

Ciprofloxacin

This 3rd generation quinolone is the only one that can cross the BBB.

Oxfloxacin

This 4th generation quinolone is the best respiratory quinolone. It can cause prolonged QT syndrome.

Moxifloxacin

This quinolone is a common cause of C. difficile superinfection. Caution should be used when given to patients with epilepsy. It will also interfere with theophylline inhalers.

Ciprofloxacin

This non-quinolone drug inhibits DNA replication by generating free radicals and is commonly used for drugs below the diaphragm (Giardia, Entamoeba, Trichomonas, Gardenella and H. pylori). It is the drug of choice for C. difficile superinfection and tetanus. Side effects include disulfuram-like reactions (avoid alcohol) and a metallic taste.

Metronidazole

This drug inhibits RNA polymerase and is used as a first line treatment of mycobacterium (Tb and Leprosy). Side effects include red/orange fluid secretions, hepatotoxicity, and increased Cyp450 activity.

Rifampin

This drug cause DNA damage via reacting intermediates and is used for UTIs because in concentrates well in the urinary tract. Side effects include hepatotoxicity, neuropathy, pulmonary fibrosis, and drug-induced Lupus. They should not be given during the last 4 weeks of pregnancy.

Nitrofurantoin

This drug is a competitive inhibitor of the enzyme dihydropteroate synthetase. It is used for Nocardia and Chlamydia, UTIs, and burns.

Sulfamethoxazole

It is used as an oral monotherapy for UTIs and burns. Adverse effects include photosensitivity, hemolytic anemia, and kernicterus in infants.

Sulfadiazine

This sulfa-drug is used topically for skin burns and superficial wounds.

Silver sulfadiazine

This drug inhibits the enzyme dihydrofolate reductase and is used for recurrent UTIs. Side effects include C. difficile overgrowth and hematological disorders (bone marrow suppression)

Trimethoprim

This drug combination is the first line treatment of Pneumocystis jirovecii in HIV patients.

TMP-SMX (Cotrimoxazole)

This drug inhibits mycolic acid synthesis and is activate by a mycobacterial enzyme. It is the drug of choice latent Tb prophylaxis. Side effects include neurotoxicity and hepatotoxicity. It must be administered with Vit. B6 to prevent neurotoxicity and is contraindicated in patients who use alcohol. This drug is also used for treatment of active Tb.

Isoniazid.

This drug is a prodrug (that requires low pH for activation) that inhibits mycolic acid synthesis and is used in the treatment of active Tb infections (especially if the infection has spread to the meninges). The main side effect is hepatotoxicity (use is discontinued after 2 months), it can cause gout, and is contraindicated in pregnancy.

Pyrazinamide

This drug is used in the treatment of active Tb infection and works by inhibiting carbohydrate polymerization catalyzed by the arabinosal transferase enzyme. This drug can cross the BBB and the main side effect is ocular toxicity (can cause blindness). Use is discontinues after 2 months for this reason.

Ethambutol

This drug is mainly used for multi-drug resistant Tb infections and it works by inhibiting the mycobacterial ATP synthase. Side effects include prolonged QT syndrome, nausea, vomiting, headaches, and arthralgias.

Bedaquiline

This drug inhibits bacterial dihydrofolate synthesis and is used for treatment of leprosy and prophylaxis against pneumocystis jirovecii.

Dapsone

This drug inhibits RNA polymerase and is used mainly for treating E. coli-caused traveler's diarrhea.

Rifaximin

This broad category of drugs work by inhibiting the cyclo-oxygenase enzymes (1 and 2)

NSAIDs

This drug is antipyretic, analgesic, and anti-inflammatory and inhibits Cox 1 and 2 irreversibly. It is valued for its anti-platelet aggregation effects. It is contraindicated in patients with renal insufficiency, gout, and bleeding disorders. It should not be given concurrently with ACE inhibitors, blood thinners, methotrexate or hypoglycemic drugs. It is contraindicated in children with viral illnesses.

Aspirin

This drug is analgesic, antipyretic, and anti-inflammatory (at high doses). It is good for pain management but can interfere with the anti-platelet aggregation of other similar drugs.

Ibuprofen

This drug is the same as ibuprofen, but lasts all day

Naproxen

Adverse of effects of NSAIDs include...

``` GI pain/upset and stomach ulcers altered liver function Reye's syndrome in children with viral illnesses asthma kidney issues ```

This drug is a Cox 2 selective inhibitor used for osteoarthritis, rheumatoid arthritis and acute pain in adults. It is analgesic, antipyretic and anti-inflammory but has NO EFFECT on platelet aggregation. It has less GI side effects than other similar drugs but lacks any cardio-protective effects and increases the risk of edema, hypertension, MI, and stroke.

Celecoxib/Celebrex

This drug is not considered and NSAID because it is NOT anti-inflammatory. It acts on the hypothalamus to lower fever and increase pain threshold. Serious side effects include hepatotoxicity.

Acetaminophen

This class of drugs are steroid hormones that inhibit the phospholipase A2 enzyme to prevent formation of arachidonic acid. They suppress immune function by decreasing inflammation

Glucocorticoids.

These glucocorticoid is short/medium acting, and is converted to its active metabolite form in the liver.

Prednisone

These glucocorticoids are short/medium acting.

hydrocortisone, cortisone, prednisone

This glucocorticoid is long acting.

dexamethasone

This drug is a non-biologic DMARD and is used as first line treatment of Rheumatoid arthritis. It works by preventing purine boisynthesis to inhibit the proinflammatory cytokines released by immune cells. Side effects include nausea, mucosal ulcers, and leukopenia. This drug can cause life-threatening side effects if taken with NSAIDs and is contraindicated in pregnancy.

Methotrexate

This drug is a non-biologic DMARD that suppresses DNA synthesis in T cells and B cells. It causes bone marrow suppression, GI upset, and can cause lymphomas.

Azothioprine (Imuran)

This biologic DMARD prevents the activation of T cells and is used for rheumatoid arthritis. It is very expensive.

Abatacept

This biologic DMARD prevents ligand binding of the TNF-alpha receptor. It is a monoclonal antibody and is used for rheumatoid arthritis, inflammatory bowel disease and refractory asthma.

Adalimumab (Humira)

This drug is best used to treat HSV 1 or 2 and works by inhibiting viral DNA polymerase. It relies on viral thymidine kinase enzymes for activation. It is administered orally, topically, or by IV. It is inexpensive.

Acyclovir

This drug is converted to acyclovir to yield a 3-5X increase in serum levels. It is only administered orally.

Valacyclovir

This drug is only administered topically for the treatment of HSV.

Penicyclovir

This drug is only used orally and is most active against Varicella Zoster virus.

Famcyclovir

When taking a --cyclovir drug, patients must stay hydrated to avoid...

cystalline nephropathy

This drug is used for the prophylaxis and treatment of CMV of HH6 infections. It has many adverse side effects that include cacinogenicity, teratogenicity, and mutagenicity. It is contraindicated in pregnancy and in males who wish to have children because it decreases spermatogenesis.

Gancyclovir

This drug is used to treat CMV and viral-induced retinitis in immunocompromised patients. It is useful in acyclovir-resistant infections because it selectively inhibits viral DNA polymerase without relying on viral enzymes for activation. Side effects include nephrotoxicity.

Foscarnet

This drug is used to treat influenza virus A or B and prevents viral spread by keeping the viral particle bound to the host. Adverse reactions include a disulfuram-like reaction as well as GI upset.

Oseltamivir (Tamiflu)

This drug is a neuroaminidase inhibitor that treats influenza A or B. It is administered via inhaler and is contraindicated in patients with COPD, sever asthma, and allergies to milk proteins.

Zanamivir (Relenza)

This drug blocks uncoating of the virus by inhibiting the viral M2 protein. It is only active against influenza A (although most influenza A is resistant). It is also used in treatment of Parkinson's disease. Adverse effects include ataxia, dizziness, and anxiety. Use is contraindicated in patients with renal impairment, epilepsy, closed angle glaucoma, and pregnancy.

Amantadine

This broad category of anitfungals disrupt membrane permeability and function.

polyenes (amphotericin B and nystatin)

There broad category of drugs can be used as an antifungal, antibacterial, antiprotozoal, or antihelminthic drug. They inhibit ergosterol synthesis via the lanosterol 14-a-demthylase enzyme to increase membrane fluidity and permeability, but lack specificity and attack human enzymes as well. They are contraindicated in pregnancy, lactation and hepatic dysfunction. Side effects include decreased gonadal steroid synthesis, loss of libido/impotency, menstrual irregularities and potentially fatal hepatotoxicity.

azoles

This broad category of antifungals inhibit cell wall synthesis

echinocandins (caspofungin)

This antifungal has the broadest spectrum and is reserved for severe infections in chronically ill patients. It is the first line of defense for invasive/life-threatening cadidemia and can also be used for aspergillosis. Immediate side effects include fever, chills, vomiting, muscle spams, head ache and hypotension. Slower side effects include renal toxicity in nearly all patients and neurotoxicity (also: impaired liver function, anemia, and thrombocytopenia)

Amphotericin B

This drug is only used topically as a mouthwash or cream mainly for oral/esophageal candidiasis or vaginal candidiasis. It is never administered systemically and can cause disulfuram-like reactions.

Nystatin

This drug is the most commonly prescribed systemic antifungal. It is the drug of choice for candidiasis and for cryptococcal meningitis in AIDS patients. It does not treat aspergillus and is highly teratogenic (contraindicated in pregnancy).

Fluconazole

This antifungal drug requires high gastric acid for activation and should not be taken with amphotericin B.

Ketoconazole

This antifungal drug is effective against aspergillus, is more toxic than fluconazole, and does not inhibit steroidogenesis.

Itraconazole

These antifungal drugs are available OTC and are used topically only. They are used to treat oral or vaginal candidiasis as well as dermatophytosis (athlete's foot/jock itch)

Clotrimazole and Miconazole

This antifungal drug is the first line treatment of Aspergillosis

Vorconizole

This antifungal drug is fungistatic and inhibits DNA/RNA synthesis. It is used for systemic fungal infections, good for fungal meningitis and has synergistic effects when administered with Amphotericin B. Adverse effects include nausea, vomiting, diarrhea, and bone marrow suppression.

Flucytosine

This drug blocks cell wall maintenance by inhibiting 1,3-B-glucan synthase. It is used for systemic infections of candida and aspergillus. Toxicity is uncommon but it is embryotoxic.

Caspofungin

This drug disrupts microtubule function and inhibits mitosis in fungi, especially dermatophytes. It only has local effects and is rarely used today.

Griseofulvin

This drug inhibits squalene epoxidase to inhibit ergosterol synthesis. It is used to treat dermatophytes and side effects include hepatotoxicity.

Terbinafine