Antibiotics Flashcards
Penicillin
Pen-VK 300mg tabs Q6H
food impairs absorption
Amoxicillin
250mg, 500mg tabs or 250mg/5ml, 125mg/5ml susp Q8H
dose with food, shake well and refrigerate suspension
Cloxacillin
250mg, 500mg tablets, 125mg/5ml susp Q6H
dose 1-2h before food, refrigerate suspension
Amoxicillin/Clavulanate
Clavulin 250/125mg, 500/125mg 875/125mg tabs Q8-12H or 125/31.25mg, 200/28.5mg, 250/62.5mg, 400/57mg suspension
dose with or without food (better absorption of clavulanate without, less GI upset with)
shake well and refrigerate suspension
Difference between Clavulin F and Clavulin suspensions?
the difference is in how many days it can be stored refrigerated:
for Clavulin 125F & 250F its 10 days
for Clavulin 200 & 400 its 7 days
Which preparations have 4:1 Amoxicillin/Clavulanate ratio?
Clavulin 125F, Clavulin 250F suspensions
Clavulin 500F tablets
Which preparations have 7:1 Amoxicillin/Clavulanate ratio?
Clavulin 200, Clavulin 400 suspensions
Clavulin 875 tablets
Which preparations have 2:1 Amoxicillin/Clavulanate ratio?
Clavulin 250 tablets
Cephalexin
Keflex 250mg, 500mg tabs and caps, 125mg/5ml, 250mg/5ml suspension Q6H
shake well and refrigerate suspension, 10% better absorption without food
Cefuroxime
Ceftin 250mg, 500mg tab, 125mg/5ml susp
Shake well and refrigerate. Take with food.
PO Beta Lactams include
penicillin, amoxicillin, cloxacillin, amoxi/clav, cephalexin, cefuroxime
PO Beta Lactams side effects counselling
watch for allergic reactions like rashes, swelling, difficulty breathing
may cause stomach upset like nausea, vomiting, diarrhea, heartburn
Ciprofloxacin
Cipro 250, 500, 750, 1000 mg tabs, 500mg/5ml susp
Ok to take with meals involving dairy but ideally separate 2h before or 6h after any calcium supplements or fortified drinks. Otherwise can take with or without food.
Shake well & refrigerate suspension.
Moxifloxacin
400mg tabs once daily with or without food
Levofloxacin
250, 500, 750mg tabs once daily with or without food. Seperate 2h from calcium supplements.
Fluoroquinolone side effects
Cipro, Levo, Moxi
-avoid in pregnancy/breastfeeding
-C. diff diarrhea
-hypersensitivity - discontinue if rash
-photosensitivity - avoid UV exposure
-tendonitis in shoulder, hand or heel - if pain discontinue and rest and contact MD
-CNS: dizziness, suicidality in patients with depression, lower seizure threshold, neuropathy
-vision changes - discontinue and see ophthalmologist
-hypoglycemia - monitor and discontinue if low and contact MD
-QT prolongation - risk factors: antiarrhythmics, hypokalemia, bradycardia, heart disease
Fluoroquinolone counselling
Cipro, Levo, Moxi
Any heart conditions? diabetes? depression? pregnancy? breastfeeding?
Avoid sun exposure. Most common (approx 3%) side effects are nausea, headache, diarrhea, insomnia, dizziness. Avoid taking with antacids, calcium or iron supplements. (Moxi ok with calcium)
Monitor and discontinue if any unusual side effects like joint pain, rash, vision changes, chest pain.
Clarithromycin
Biaxin BID 250, 500 mg tabs, 125mg/5ml 250mg/5ml susp
XL extended release must be taken with food, otherwise may be with or without food.
Suspension: Shake well. DO NOT refrigerate.
Erythromycin
Eryc 250mg Q6H and 333mg Q8H delayed release caps
Take 2h before or after food, on empty stomach
Azithromycin
Zithromax 250mg, 600mg tabs, 100mg/5ml, 200mg/5ml susp
Take with or without food.
Suspension: Shake well and DO NOT refrigerate.
Macrolides side effects & counselling
Clarithromycin, Erythromycin, Azithromycin
-common side effects occur in <5%: cramping, nausea, vomiting, diarrhea, taste perversion, headache
-monitor for allergic reactions: rash, swelling, breathing difficulty(<1%)
-caution in pts w hepatic impairment, history of cholestatic juandice (monitor for yellowing), myesthenia gravis, QT prolongation risk factors (monitor for palpitations), many DDI
-not recommended in pregnancy or breastfeeding
-may use in children 6 months and older
Tetracycline
250mg tab QID
1h before or 2h after food
Doxycycline
Periostat 20mg tab for peridontitis - BID at least 1h before breakfast and dinner
Aprillon 40mg MR tab for rosacea, acne - QAM on empty stomach at least 1h before food
Doxytab or Doxycin 100mg tab/caps for infections, acne - OD-BID with or after food, with full glass of water, don’t lie down for 1-2h after
Minocycline
100mg, 200mg OD-BID
not significantly affected by food
Tetracyclines side effects & counselling
Tetra, Mino, Doxycycline - iron, antacids, dairy may impair absorption - separate 2h
-common s/e: diarrhea, nausea, throat irritation, dizziness (7%), photosensitvity /hyperpigmentation (wear sunscreen)
-d/c if rash/swelling, difficulty/pain swallowing, visual changes with headache (pseudomotor cerebri- HTN in brain), watery diarrhea (C.Diff), yeast infection
-contraindicated in children <8 y, pregnancy and lactation (stains teeth
Linezolid
Zyvoxam 600mg tab Q12H with or without food
-do not use with pseudoephedrine cold meds
-most common (10%) s/e: headache, nausea, diarrhea
-less common (1%) s/e: vomiting, taste disturbances, tongue discoloration, fungal infections (oral, vaginal)
-rare: hypertension, hypoglycemia/lactic acidosis, C Diff, myelosuppression (monitor if >2w duration), optic neuropathy (monitor for vision changes), serotonin syndrome (many DDI eg MAOI in past 2w)
Vancomycin
Vancocin 125mg, 250mg cap
-common: nausea, chills, hypotension
-rare: ototoxicity , nephrotoxicity, red man syndrome, TEN, allergic reactions
-not recommended in pregnancy/lactation
Clindamycin
Dalacin C 150mg, 300mg cap, 75mg/5ml susp
susp: shake well, do not refridgerate, stable for 14 days
-common (1-2%) s/e: diarrhea, rash, nausea, vomiting
-inform MD about any rash, diarrhea (high risk of C Diff)
-not recommended in pregnancy/lactation
Metronidazole
Flagyl 250mg, 500mg caps
-CI in hypothyroidism, neurological disorders…
-avoid alcohol during and 1 day after tx (may cause disulfiram reaction: flushing, vomiting, tachycardia)
-nausea, vomiting, diarrhea, reddish brown urine darkening, taste disturbances,
-inform MD if severe confusion, dizziness, hallucinations, visual disturbances
-d/c if allergic reaction (rash, swelling), hepatotoxicity (jaundice/yellowing), neuropathy, convulsions or stiff neck, fever, pancreatitis (severe abdominal pain, nausea)
-avoid in 1st trimester and during lactation
Rifampin
Rofact 150mg, 300mg caps
OD on empty stomach 1h before food
-common s/e: nausea, vomiting, diarrhea, orange discoloration of bodily fluids, headache, dizziness, difficulty concentrating, tiredness, menstrual changes
-d/c if C Diff (watery diarrhea), DRESS (rash), neuropathy, ataxia, thrombocytopenia (bruising), jaundice, anemia (SOB), leukopenia (fever)
HP Pack
Take all meds together before breakfast and dinner
OR
Take PPI before and ABX after food
AE:
Bismuth -stool darkening
Tetracycline-sun sensitivity
Metronidazole-DDI Alcohol
