Antimicrobials (TB) and anemia drugs Flashcards
Isoniazid (INH) MOA
disrupts cell wall synthesis
Isoniazid SE
Peripheral neuropathy, hepatotx, optic neuritis/visual prob, hyperglycemia; BLACK BOX–HEPATITIS
Isoniazid NC
- PO
- monitor liver enzymes
- avoid antacids–dec drug abs
- inc CNS and hepatotox when taken with rifampin
- can inc fx phenytoin
- give with vit B6 for black box
Rifampin MOA
Inhibit pro synth via attack hydrocarbon ring structure
Rifampin SE
Hepatitis, hematological dx, red-brown discolored urine and fluids
Rifampin NC
- be careful when give with isonizid
- CYP inducer (dec effect beta block, benzos, cyclopsorins, anticaogs, antidaibetics, phenytoin, theophylline)
- may need higher doses of these (not CI)
- PO or IV
First line drugs for TB
isoniazid and rifampin
Ethambutol MOA
Diffuse into mycobacteria and suppress RNA synth which index pro synthesis
Ethambutol SE
blindness, retrobulbar neuritis
Ethambutol NC
- Only PO
- give with INH and rifampin
- not for kids under 13 age
Pyrazinamide MOA
Inhibit lipid and nucleic acid synth
Pyrazinamide SE
hepatotoxicity, hyperuricemia
Pyrazinamide NC
- used with other meds
- CI with gout and hyperuricemia
- PO
- not for preg
Streptomycin class
Aminoglycosides
Streptomycin MOA
interfere with pro synth and cause faulty proteins
Streptomycin SE
Ototox, nephrotoxic, blood dyscrasias
Streptomycin NC
- IM only (daily)
- can inc bleeding (careful with anticoags)
Ferrous sulfate, ferrous gluconate, iron dextran indications
Tx and prevent IDA, treat blood loss
Ferrous sulfate, ferrous gluconate, iron dextran SE
GI–nausea, heartburn, constipation, metallic taste, stain teeth (straw), fatal iron tox OD (in kids, liver fail), leading cause poison death in kids; black or dark green stool, malodorous
ferrous sulfate and ferrous gluconate NC
- ferrous–oral
- iron dextran–parenteral
- dec abs with antacids–don’t take with antacids or Ca supps
- inc abs with vit C
- not great abs
- deferoxamine drug tx iron tox (chelate the iron to form compound excreted in stool)
- often in mutivit or supp (preg)
- stain teeth
Iron dextran NC
- parenteral iron
- give test dose
- BLACK BOX–epi available bc can cause allergic rxn (anaphylaxis)
- IM form–stains so ztrack
cyanocobalamin indications
Low b12, pernicious anemia, bariatric surgery pt need 1 mg daily, surgery with stomach removed, pt with severe def or neuro sx
cyanocobalamin SE and NC
- well tolerated, pain or red at site
- IM, not IV
- weekly inject then gradually to monthly
- supplement with diet
Folic acid supplements SE and NC
- well tolerated
- supp with diet
- tablets 1-5mg
- OTC recc dose 400 mcg
Epoetin alpha class and MOA
Erythropoietin stim agent; Stim erythropoiesis; inc hgb and reticulocyte counts
Epoetin alpha indications
Only index when hgb under 10g/dL unless on dialysis; CKD
Epoetin alpha SE
HTN, serious CV events (inc H&H), can progress certain cancers, injection site prob, bone pain, HA; BLACK BOX for freezing it, mixing with other meds
Epoetin NC
- IV and IVP, and SQ
- BLACK BOX when given over 10g bc clotting risk
- weekly monitor
- don’t want hgb over 11
- CI in uncontrolled HTN bc epogen may worsen high BP
Hgb levels can rise in 2 weeks
Antidote for iton
Deferoxamine–chelating agent
