Drugs 1-29 Flashcards
1
Q
metronidazole
A
- Common Indications: bacterial vaginosis, trichomoniasis, etc.
- BBW: Possibly carcinogenic based on animal data
- Contraindications: Pregnancy (1st trimester), use of alcohol or propylene glycol-containing products during treatment or within 3 days of treatment discontinuation (disulfiram reaction)
- Side Effects: Metallic taste, darkened urine, nausea
- Drug Interactions: Can increase INR in patients taking warfarin (weak CYP2C9 inhibitor)
- Notes: Take IR tablets with food to decrease GI upset.
2
Q
fluconazole
A
- Common Indications: Yeast infections (ex. oral, esophageal, vaginal), nail bed infections (onychomycosis), oral thrush, oral candidasis
- Warnings: Hepatotoxicity, not recommended in pregnancy
- Side effects: Elevated LFTs, QT prolongation, rash/pruritis, headache, hair loss
- Drug Interactions: CYP450 inhibitor - a lot of drug interactions
- Notes: Vaginal candidiasis dose - 150 mg PO x 1 dose, renal dose adjustment required
3
Q
ketoconazole
A
- Common Indications: Mainly used topically
- BBW: Severe hepatotoxicity (has led to transplant and/or death), QT prolongation, oral use is considered last-line for antifungal therapy
- Side Effects: Same as fluconazole
- Drug Interactions: CYP450 inhibitor - a lot of drug interactions
- Notes: Shampoo can cause altered hair texture
4
Q
nystatin
A
- Common Indications: Mild, localized Candida infections (ex. Thrush)
- Dosage forms: Suspension, tablet
- Suspension Counseling Points: Shake well before using; Swish in the mouth and retain for as long as possible (seven minutes) before swallowing
5
Q
terbinafine
A
- Common Indications: Dermatophytes (nail bed infection)
- Dosage Forms: Tablet & topical
- Warnings: Hepatotoxicity
- Side Effects: Headache, elevated LFTs, skin rash, pruritus
- Notes: For nail bed infection treatment, may take several months after treatment continuation to see benefit due to the time it takes for nails to grow
6
Q
acyclovir
A
- Common Indications: Herpes simplex virus, varicella zoster virus (chicken pox), herpes zoster (shingles) herpes simplex labialis (cold sores)
- Dosage Forms: Capsule, tablet, buccal tablet, suspension, injection, topical
- Warnings: Caution in renal impairment, geriatrics, concomitant nephrotoxic medications
- Dosing for Herpes labialis: Apply topically 5 times daily for 4 days (can be used on genital sores)
- Dosing for Herpes zoster: 800 mg PO 5x daily for 7 or 10 days
- Counseling: Does not cure herpes infections - use proper contraception methods during sexual intercourse to avoid transmission; start treatment within 24 hours of symptom onset, maintain adequate hydration
7
Q
valacyclovir
A
- Common Indications: Same as acyclovir; valacyclovir is a pro-drug of acyclovir, it is more expensive but less frequent dosing, may be a beneficial in patients with poor adherence
- Dosage Forms: Tablet
- Warnings: Same as acyclovir
- Dosing for Herpes Zoster: 1 gram PO TID for 7 days
- Counseling: Does not cure herpes infections - use proper contraception methods during sexual intercourse to avoid transmission; start treatment within 24 hours of symptom onset, maintain adequate hydration
8
Q
cephalexin
A
- Common Indications: Skin infections (MSSA), strep throat
- Warnings: Cross-sensitivity with penicillin allergy
- Side Effects: GI upset, diarrhea, serious skin reactions (SJS/TEN)
- Dosing: 250-500 mg PO Q6-12H
9
Q
cefuroxime axetil
A
- Common Indications: Acute otitis media, community-acquired pneumonia (CAP)
- Warnings/Side Effects: Same as cephalexin
- Drug Interactions: Separate by 2 hours from short-acting antacids; avoid PPIs & H2RAs
10
Q
cefdinir
A
- Common Indications: Acute otitis media
- Warnings/Side Effects: Same as cephalexin
11
Q
ciprofloxacin
A
- Common Indications: Antipseudomonal (pneumonia)
- BBW: Tendon inflammation &/or rupture; peripheral neuropathy; CNS effects (seizures), use caution in patients with CNS disorders or are taking seizure-causing medications
- Warnings: QT prolongation (moxifloxacin > levofloxacin > ciprofloxacin); hypo/hyperglycemia; psychiatric disturbances; photosensitivity
- Counseling: Oral suspension - shake vigorously for 15 seconds before each dose; avoid sun exposure; separate from polyvalent cations; monitor blood glucose; avoid in pregnancy/breastfeeding
12
Q
levofloxacin
A
- Common Indications: “Respiratory fluoroquinolone”
The rest is the same as ciprofloxacin
13
Q
moxifloxacin
A
- Common Indications: Only fluoroquinolone that cannot be used for UTI
The rest is the same as ciprofloxacin
14
Q
azithromycin
A
- Common Indications: Community-acquired respiratory tract infections, COPD exacerbations, Chlamydia (in pregnant patients), severe traveler’s diarrhea
- Warnings/Precautions: QT prolongation (erythromycin > azithromycin > clarithromycin); hepatotoxicity (use caution in patients with liver disease)
- Side Effects: GI upset (diarrhea, abdominal pain, cramping), taste perversion
- Drug Interactions: Fewer drug interactions than other macrolides
- Dosing: Z-Pak - 500 mg on day 1, 250 mg on days 2-5
15
Q
clarithromycin
A
- Common Indications: H. pylori treatment regimens
- Contraindications: Contraindicated to take with simvastatin or lovastatin
- Warnings/Precautions: QT prolongation, hepatotoxicity (use caution in patients with liver disease), Use caution in patients with coronary artery disease
- Side Effects: GI upset (diarrhea, abdominal pain, cramping), taste perversion
- Drug Interactions: Use caution with other QT prolonging drugs, Simvastatin and lovastatin are contraindicated (due to increased risk of muscle toxicity)
