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)
16
Q
clindamycin
A
- Common Indications: Purulent and non-purulent skin infections, beta-lactam alternative for dental abscesses, surgical prophylaxis & infective endocarditis prophylaxis
- BBW: Colitis (C. difficile)
- Side Effects: Nausea, vomiting, diarrhea (N/V/D)
- Dosage Forms: Topical, injection, capsule, suspension
17
Q
nitrofurantoin
A
- Common Indications: Drug of choice for uncomplicated UTI (cystitis only)
- Contraindications: Renal impairment (CrCl < 60 mL/min)
- Warnings: Hemolytic anemia
- Side Effects: GI upset (take with food), brown urine discoloration (harmless)
- Dosing: Macrobid is 100 mg BID for 5 days
18
Q
amoxicillin
A
- Common Indications: First-line treatment for acute otitis media; prophylaxis for infective endocarditis prior to dental procedures
- Contraindications: Severe renal impairment (CrCl < 30 mL/min) - do not use extended release formulation
- Side Effects: Seizures (with accumulation when not renally adjusted), GI upset, diarrhea, rash, hemolytic anemia
- Dosage Forms: Tablet, capsule, chewable, suspension
- Notes: Avoid in patients with beta-lactam allergy
19
Q
amoxicillin/clavulanate
A
- Common Indications: First-line treatment for acute otitis media & bacterial sinusitis (if antibiotics are indicated)
- Contraindications: Severe renal impairment (CrCl < 30 mL/min) - do not use extended release formulation or 875 mg strength
- Side Effects: Same as amoxicillin
- Dosage Forms: Tablet, chewable, suspension
- Notes: Use lowest dose of clavulanate to decrease diarrhea; avoid in patients with beta-lactam allergy
20
Q
penicillin V potassium
A
- Common Indications: First-line treatment for strep throat and nonpurulent skin infections (no abscess)
- Contraindications: Severe renal impairment (CrCl < 30 mL/min)
- Side Effects: Same as amoxicillin
- Dosage Forms: Tablet, suspension
- Notes: Take on an empty stomach
21
Q
sulfamethoxazole/trimethoprim
A
- Common Indications: CA-MRSA skin infections, UTI, Pneumocystis pneumonia (PCP)
- Dosing: Dose based on the trimethoprim (TMP) component; SMX:TMP ratio = 5:1
- Contraindications: Sulfa allergy
- Warnings: Skin reactions (SJS/TEN, thrombotic thrombocytopenic purpura) G6PD deficiency (hemolysis risk)
- Side Effects: Photosensitivity, elevated K levels, hemolytic anemia, crystalluria
- Counseling: Avoid in pregnancy and sulfa allergy; take with a full glass of water
22
Q
doxycycline
A
- Common Indications: First-line treatment for Lyme disease and Rocky Mountain Spotted Fever, community acquired pneumonia, COPD exacerbations, bacterial sinusitis, chlamydia, acne, CA-MRSA skin infections
- Contraindications:
- Warnings/Precautions: Caution in children <8 years old, pregnancy, and breastfeeding (permanent teeth discoloration)
- Side Effects: Nausea, vomiting, diarrhea, photosensitivity
- Drug Interactions: Separate from antacids and polyvalent cations (at least 1-2 hours before or 4 hours after the chelating drug)
- Counseling: Sit upright for at least 30 minutes after the dose to prevent esophageal irritation, take with at least 8 oz of water
23
Q
minocycline
A
- Common Indications: CA-MRSA skin infections, acne
- Warnings/Precautions: Caution in children <8 years old, pregnancy, and breastfeeding (permanent teeth discoloration); drug induced lupus erythematosus (DILE)
- Side Effects: Nausea, vomiting, diarrhea, photosensitivity
- Drug Interactions: Same as doxycycline
24
Q
mupirocin
A
- Common Indications: Elimination of MRSA colonization of the nares
- Side Effects: Headache, burning, localized irritation, rhinitis, pharyngitis
25
Q
oseltamivir
A
- Common Indications: Influenza
- Dosage Forms: capsule, suspension
- Warnings/Precautions: Neuropsychiatric events, serious skin reactions (SJS/TEN), anaphylaxis
- Side Effects: Headache, nausea, vomiting, diarrhea, abdominal pain
- Dosing: Treatment >12 years old: 75 mg BID x 5 days. Prophylaxis >12 years old: 75 mg QD x 10 days. Pediatrics: weight based.
- Notes:Most effective when started within 48 hours of symptom onset
26
Q
hydroxycholoroquine
A
- Common Indications: Rheumatoid arthritis, Lupus
- Warnings/Precautions: Can cause irreversible retinopathy, myopathy and neuropathy, cardiomyopathy, QT prolongation
- Side Effects: Nausea, vomiting, diarrhea, abdominal pain, rash, pruritis, headache, vision changes (dose related), bone marrow suppression, hepatotoxicity
- Notes: Causes hemolysis in patients with G6PD deficiency
27
Q
chlorhexidine gluconate
A
- Common Indications: Gingivitis, periodontitis
- Side Effects: Dental discoloration, dysgeusia, mouth irritation
- Counseling points: Swish and spit 15 mL BID
28
Q
emitricitabine + tenofovir alafenamide
A
- Common Indications: HIV PrEP
- BBW: Post-treament exacerbation of acute Hepatitis B; Risk of drug resistance with use for pre-exposure prophylaxis
- Warnings/Precautions: immune reconstitution syndrome (IRIS); lactic acidosis; renal toxicity (TAF less severe than TDF); hepatomegaly
- Side Effects: Hyperlipidemia; Weight gain, renal impairment, decrease in bone mineral density (TAF); Nausea, diarrhea, Hyperpigmentation of the palms of the hands or soles of the feet (emtricitabine)
- Drug Interactions: Check for drug interactions!
- Counseling points: Do not stop taking or skip doses of HIV medications without speaking to your doctor. This medication does not cure HIV - use safe sex practices and do not share needles.
29
Q
bictegravir +emitracitabine + tenofovir alafenamide
A
- Common Indications: HIV Treatment
- BBW: Post-treament exacerbation of acute Hepatitis B
- Warnings/Precautions: immune reconstitution syndrome (IRIS); lactic acidosis
- Side Effects: Weight gain, increase in serum creatinine, N/V; renal impairment (TAF); Avoid with multivalent cations (bictegravir); Hyperpigmentation of the palms of the hands or soles of the feet (emtricitabine)
- Drug Interactions: Check for drug interactions! Significant!
- Counseling points: Do not stop taking or skip doses of HIV medications without speaking to your doctor. This medication does not cure HIV - use safe sex practices and do not share needles.
