Anti-infective agents Flashcards
acyclovir
Brand - Zovirax
Class - Viral DNA Polymerase Inhibitor
Indication - Varicella/Chickenpox and Herpes Zoster/Shingles, Cold Sores/Genital herpes simplex
Counseling - Complete full course of therapy and ensure adequate hydration. Most effective if initiated within 24 hours of rash onset, should improve within 2-3 days.
MoA - Inhibits viral DNA synthesis
amoxicillin
Brand - Amoxil
Class - Beta-Lactam Antibiotic
Indication - Ear, nose, or throat infection, skin/sq tissue, genitourinary system, acute otitis media, lower respiratory tract infection, pharyngitis tonsillitis, streptococcal pharyngitis
Pregnancy: Risk
Counseling - Complete full course of therapy, shake and store in fridge, can take with food if upset stomach; use condom/may decrease birth control effectiveness.
MoA - Semisynthetic penicillin derivative that inhibits the synthesis of bacterial wall mucopeptide; active against Streptococcus, Enterococcus, Staphylococcus, and Enterobacteriaceae.
amoxicillin / clavulanate K+
Brand - Augmentin
Class - Beta-Lactam Antibiotic
Indication - Acute otitis media, Community-acquired pneumonia, Lower respiratory tract infection, Sinus, infection of skin/sq tissue, genitourinary/UTI
Pregnancy: Risk (amoxicillin)
Contraindication: No extended release products for patients with a history of jaundice/hepatic dysfunction
Counseling - Complete full course of therapy, shake and store in fridge, can take with food if upset stomach; use condom/may decrease birth control effectiveness.
MoA - Clavulanate is a β-lactamase inhibitor that protects amoxicillin from degradation by β-lactamases, amoxicillin is a semisynthetic penicillin derivative that inhibits the synthesis of bacterial wall mucopeptide; active against Streptococcus, Enterococcus, Staphylococcus, and Enterobacteriaceae.
azithromycin
Brand - Zithromax
Class - Macrolide Antibiotic
Indication - Acute infective exacerbation of COPD, skin or tissue infection, Bacterial sinusitis, Chancroid, community acquired pneumonia, Sexually transmitted infections, Streptococcal pharyngitis
Counseling - Complete full course of therapy, can take with food if upset stomach
MoA - Binds to the 50S ribosomal subunit, thus interfering with microbial protein synthesis
cefdinir
Brand - Omnicef
Class - (3rd Gen) cephalosporin Antibiotic
Indication - Acute otitis media, Bronchitis, Community-acquired pneumonia, COPD, Streptococcal pharyngitis
Counseling - Complete full course of therapy, store at room temperature, separate administration of antacids, iron, and vitamins by 2 h.
MoA - Activity against a number of gram-positive and gram-negative bacteria including β-lactamase–producing strains
cephalexin
Brand - Keflex
Class - (1st Gen) cephalosporin Antibiotic
Indication - Infection of skin and/or subcutaneous tissue, Osteomyelitis, Otitis media, respiratory tract infection, Streptococcal pharyngitis, Impetigo, ecthyma, Cellulitis (nonprulent, erysipelas)
Counseling - Seek medical attention if rash develops, complete full course of therapy, store in fridge.
MoA - Inhibits bacterial wall synthesis of actively dividing cells by binding to ≥1 penicillin-binding proteins (PBPs)
chlorhexidine
Brand - Peridex, Paroex, Hibiclens
Class - Antibacterial cleansing agent
Indication - Gingivitis, Skin/wound cleansing, periodontitis
Counseling - Follow vehicle admin directions (rinse vs topical)
MoA - Cation binds to - bacterial walls (gram + & -) and yeast - antiseptic depending on concentration
ciprofloxacin (oral)
Brand - Cipro
Class - Fluroquinolone Antibiotic
Indication - Anthrax, Bacterial prostatitis, Bronchitis, lower respiratory tract infection, UTI
Pregnancy: Contraindicated
Contraindication: Concomitant tizanidine
Black Box: May exacerbate muscle weakness, tendon inflammation/rupture, peripheral neuropathy, CNS effects, cardiac, dermatologic and hypersensitivity reactions, aortic dissection and rupture, hypoglycemia, mental health adverse effects
Counseling - Take with/without food, but not with milk or other dairy products. Take ciprofloxacin at least 2 h before or 6 h after antacids, sucralfate, or mineral supplements and multivitamins with calcium, iron, or zinc. Seek medication if decreased urination, yellowing of eyes, blistering skin rash or extreme fatigue, unusual bruising or bleeding, shortness of breath or chest pain, tendon pain, muscle weakness, a “pins and needles” tingling or pricking sensation, numbness in the arms or legs, confusion or hallucinations
MoA - Inhibits bacterial DNA gyrase (transcription). It is highly active against aerobic, gram-negative bacilli.
ciprofloxacin (otic)
Brand - Cetraxal, Otiprio
Class - Fluroquinolone Antibiotic
Indication - Otitis externa or media w/ effusion
Pregnancy: Weigh risks/benefits
Counseling - Warm solution in hands, lie w/ ear upwards, maintain position for 1 min after drops
MoA - Inhibits bacterial DNA gyrase (transcription). It is highly active against aerobic, gram-negative bacilli.
clarithromycin
Brand - Biaxin
Class - Macrolide Antibiotic
Indication - Acute infective exacerbation of bronchitis, community-acquired pneumonia, disseminiated infection due to M. avium group, H. pylori GI infection (w/ amox and PPI), Strep pharyngitis (group A), COPD
Contraindication: Concomitant colchicine, cispride, pimozide, astemizole, terfenadine, ergotamine, dihydroergotamine, or statins metabolized by CYP3A4/5, history of cholesaatic jaundice/hepative dysfunction, renal impairment
Counseling - Complete full course of therapy, if symptoms don’t improve in 2-3 days seek follow up w/ HCP
MoA - Inhibits RNA-dependent protein synthesis by binding to the 50S subunit of the 70S ribosome
clindamycin (oral)
Brand - Cleocin
Class - Lincosamide Antibiotic
Indication - Bacterial infectious disease, Infection of skin and/or subcutaneous tissue, Infection of disease of abdomen, Lower respiratory tract infection, Pelvic inflammatory disease, Septicemia, Osteomyelitis, Diabetic foot infection
Black Box: Colitis
Counseling - Tk w full glass of water and remain upright for 30 minutes after dose to minimize risk of GI ulceration; complete full course of therapy
MoA - Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit; it is bactericidal or bacteriostatic depending on the concentration, organism, and inoculums.
clindamycin (topical)
Brand - Cleocin T, Clindagel
Class - Lincosamide Antibiotic
Indication - Acne vulgaris, Bacterial vaginosis
Counseling - Apply to cleansed, dry face, avoiding eyes/mucous membranes/cuts. Alcohol is flammable.
MoA - Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit; it is bactericidal or bacteriostatic depending on the concentration, organism, and inoculums. Gram - aerobes are resistant, so are enterococci and C difficile
doxycycline
Brand - Vibramycin
Class - Tetracycline Antibiotic
Indication - Acinetobacter infection, Acne vulgaris, Gonorrhea, Staphylococcal infection, Pneumonia
Pregnancy: Contraindicated
Counseling - Take with water, do not take with calcium foods, may cause photosensitivity (wear sunscreen and avoid UV), discontinue at sign of skin redness.
MoA - Broad-spectrum bacteriostatic compound that inhibits protein synthesis at the 30S ribosomal subunit
erythromycin
Brand - Erythrocin
Class - Macrolide Antibiotic
Indication - Bacterial infections
Contraindication: Concomitant cispride, astemizole, terfenadine, ergotamine, lovastatin, simvastatin
Counseling - Seek medical attention iif rash develops. Complete full course of therapy, if symptoms don’t improve in 2-3 days seek follow up w/ HCP
MoA - Inhibits RNA-dependent protein synthesis by binding to the 50S subunit
fluconazole
Brand - Diflucan
Class - Imidazole Antifulgal
Indication - Candidal vulvo, Candidal vulvovaginitis, Cryptococcal meningitis, Oropharyngeal candidiasis
Pregnancy: Risk (>400 mg/d)
Contraindication: Concurrent ergot alkaloids, CYP3A4/5 substrates that prolong QTc
Counseling - If weekly dose, take at same time, many OTC meds interact w/ fluconazole, consult your PCP or Pharmacist first.
MoA - Inhibits biosynthesis of ergosterol or other sterols, damaging the fungal cell wall membrane and altering its permeability
hydroxychloroquine
Brand - Plaquenil
Class - Aminoquinoline
Indication - Lupus erythematosus, Malaria, Rheumatoid arthritis
Contraindication: Retinal/visual field changes from prior use; long-term use in children
Counseling - If weekly dose, take at same time w/ food.
MoA - Effective in treating P vivax, P malariae, and susceptible strains of P falciparum.
ketoconazole (topical)
Brand - Nizoral
Class - Imidazole Antifulgal
Indication - Pityriasis versicolor, Seborrheic dermatitis (skin or dandruff), Tinea corpois/cruis/pedis
Counseling - Apply thin layer to intact skin, do not wash for at least 3 h, avoid mucous membranes, wait 20 min before sunscreen or cosmetics, alcohol vehicles are flammable
MoA - Inhibits biosynthesis of ergosterol or other sterols, damaging the fungal cell wall membrane and altering its permeability
levofloxacin
Brand - Levaquin
Class - Fluroquinolone Antibiotic
Indication - Bacterial prostatitis/sinuitis, Bronchitis, Community acquired pneumonia, Infection of skin and/or SQ tissue, Pyelonephritis
Pregnancy: Contraindicated
Contraindication: Concomitant tizanidine
Black Box: Myasthenia gravis, tendon inflammation and rupture, peripheral neuropathy, CNS effects, cardiac dermatologic and hypersensitivity reactions, aortic dissections and ruptures
Counseling - Take with/without food, but not with calcium-containing or dairy products. Take ciprofloxacin at least 2 h before or 6 h after antacids, sucralfate, or mineral supplements and multivitamins with calcium, iron, or zinc. Seek medication if decreased urination, yellowing of eyes, blistering skin rash or extreme fatigue, unusual bruising or bleeding, shortness of breath or chest pain, tendon pain, muscle weakness, a “pins and needles” tingling or pricking sensation, numbness in the arms or legs, confusion or hallucinations.
MoA - Inhibits bacterial DNA gyrase (transcription). It is highly active against aerobic, gram-negative bacilli.
metronidazole
Brand - Flagyl
Class - Nitroimidazole Antibiotic
Indication - Abscess, Amebic dysentery, Bacterial vaginosis, Trichomoniasis
Contraindication: 1st trimester of pregnancy, then low risk
Black Box: Carcinogenic
Counseling - Avoid alcohol while taking this medicaiton and for 3 days after, may cause severe disulfiram-like reaction, tk w food if GI upset, complete full course
MoA - Active against T. vaginalis (trichomoniasis), E. histolytica (amebiasis), and G. lamblia (giardiasis); it is bactericidal against nearly all obligate anaerobic bacteria including B. fragilis
muprocin
Brand - Bactroban
Class - Topical antibiotic
Indication - Impetigo, Secondary Skin infections, Eradication of nasal colonization of MRSA during institutional outbreaks
Counseling - Instruct patients on proper application technique, avoid drug exposure to open wounds, burns, or eyes.
MoA - Active against a wide range of gram-positive bacteria (including methicillin-resistant Staphylococcus aureus) and certain gram-negative bacteria. Mupirocin inhibits bacterial protein synthesis by reversibly and specifically binding to bacterial isoleucyl transfer-RNA synthetase. Because of this unique mode of action, it demonstrates no in vitro cross-resistance with other classes of antimicrobial agents.
nitrofurantoin
Brand - Macrobid, Macrodantin
Class - Nitrofuran Antibiotic
Indication - UTI
Pregnancy: Risk (hemolytic anemic, anuria, or oliguria)
Counseling - Makes urine brown, complete full course, shake and store at room temp
MoA - Inactivates bacterial ribosomes and is bactericidal in urine at therapeutic doses. It is active against most bacteria that cause UTIs except nearly all strains of Pseudomonas are resistant.
oseltamivir (PO4^3-)
Brand - Tamiflu
Class - Antiviral, Neuraminidas Inhibitor
Indication - Influenza virus types A and B
Pregnancy: maternal benefit > embryo-fetal risk
Counseling - Complete full course of therapy, instruct oral syringe, tk w food to minimize GI upset.
MoA - Inhibitor of influenza virus neuraminidase, which prevents viral progeny detaching from the cellular envelope
sulfamethoxazole / trimethoprim
Brand - Bactrim, Septra
Class - Antibiotic
Indication - UTI, Traveler’s Diarrhea, HIV infection, Acute infective COPD
Contraindication: < 2 months age, nursing mothers/near term pregnancy
Counseling - Makes urine brown, complete full course, shake and store at room temp
MoA - Sulfonamides are structural analogs and competitive antagonists of PABA, which prevent normal bacterial utilization of PABA for synthesis of folic acid, which is required for bacterial DNA synthesis
valacyclovir
Brand - Valtrex
Class - Viral DNA Polymerase Inhibitor
Indication - Varicella/Chickenpox and Herpes Zoster/Shingles, Cold Sores/Genital herpes simplex
Counseling - Ensure adequate hydration. Seek medical attention if decreased urination, unusual bruising or bleeding, blistering skin rash, or shortness of breath.
MoA - Prodrug of acyclovir > Inhibits viral DNA synthesis
