Drugs

Question 1

Macrolides

Answer 1

PCN Substitute (can cause hearing loss) (can lead to C. diff / loose stools)

Question 2

Erythromycin (E-Mycin)

Answer 2

PCN Substitute: Macrolides. Has no extended half life.

Question 3

Azithromycin (Zithromax)

Answer 3

PCN Substitute: Macrolides. Has extended half life.

Question 4

Clarithromycin (Biaxin)

Answer 4

PCN Substitute: Macrolides. Has extended half life.

Question 5

Cephalosporins

Answer 5

Similar to PCN with its semi-synthetic beta-lactams, made in order to reduce the number of side effects. Bleeding chances, however, goes up with high doses. 10% cross sensitivity to PCN allergies.

Question 6

Lincosamide

Answer 6

PCN Substitute

Question 7

Clindamycin (Cleocin)

Answer 7

PCN Substitute: Lincosamide. For most gram +.

Question 8

Glycopeptide

Answer 8

PCN Substitute (bacteriocidal only) (gram + bacteria) (good against drug-resistant s. aureus) (used for cardiac surgery prophylaxis).

Question 9

Vancomycin

Answer 9

PCN Substitute: Glycopeptide. Can cause lose stool. Red man toxicity syndrome possibly if infusion too fast or too much. Steven Johnson’s. Ototoxicity possible.

Question 10

Televancin (Vibativ)

Answer 10

PCN Substitute: Glycopeptide. Once daily.

Question 11

Ototoxicity in…

Answer 11

• Vancomycin (maskable with Dramamine; potentiable with other drugs p11)
• Macrolides (hearing loss)
• Aminoglycosides

Question 12

Ketolides

Answer 12

PCN Substitute

Question 13

Telithromycin (Ketek)

Answer 13

PCN Subtitute: Ketolides. Only given for >18yo. Altered taste. Liver failure (w/ juandice)

Question 14

Tetracyclines

Answer 14

1. Miscellaneous Antiinfective Tetracyclines. Gram - and gram +. Used against acne, rosacea; resp, sti, skin infections. Diary products decrease effect. Teratogenic to 1st Trimester. Bluish teeth all life to 3rd Trimester.
2. A drug member called Tetracycline from the Tetracycline antibiotics family as well as a classification/family called Tetracycline. Tetracycline has trade name Sumycin. Short acting drug.

Question 15

Sumycin

Answer 15

Misc. Antiinfectives Tetracyclines’
Short acting drug, Tetracycline (Sumycin)

Aka Tetracyclines (Sumycin). Not to be confused with drug classification Tetracyclines (same spelling).

Question 16

Demeclocycline (Declomycin)

Answer 16

Misc. Antiinfectives Tetracyclines’

Intermediate-acting drug, Demeclocycline (Declomycin)

Question 17

Doxycycline Hyclate (Vibramycin)

Answer 17

Misc. Antiinfectives Tetracyclines’
Long-acting drug, Doxycycline Hyclate (Vibramycin)

Lots of GI effects. May drink milk to reduce GI effects even though milk decreases absorption for Tetracyclines in general.

But it is the only Tetracycline that doesn’t have its absorption lowered by high calcium.

Question 18

Glycylcycline

Answer 18

Misc. Antiinfective Glycylcycline

Question 19

Tigecycline (Tygacil)

Answer 19

Misc. Antiinfective Glycylcycline: Tigecycline (Tygacil). Warfarin (anticoagulant) will increase.

Question 20

Aminoglycosides

Answer 20

Misc. Antiinfective Aminoglycosides. Used against MRSA, Pseudomonas (they are gram -), and PID, and serious infections. Record Peaks and Troughs because of possible toxicity to kidney, liver, and heart (low K+). Octotoxicity possible, and its risk increases with ethacrynic acid loop diuretic

Is not given oral. No GI absorption. So administer IV/IM.

Aminoglycosides include:
Amikacin (Amikin)
Gentamicin (Garamycin)
Neomycin (Mycifradin)
Tobramycin (Nebcin)

Question 21

Amikacin (Amikin)

Answer 21

Misc. Antiinfective Aminoglycosides’ Amikacin (Amikin).

Question 22

Gentamicin (Garamycin)

Answer 22

Misc. Antiinfective Aminoglycosides’ Gentamicin (Garamycin). Epsecially record Peaks and Troughs.

Question 23

Fluoroquinolones

Answer 23

Misc. Antiinfective Fluoroquinolones. Primarily used for UTI and Pneumonia. Steven Johnson syndrome possible.

Fluoroquinolone drugs incl:
Cirpofloxacin HCl (Cipro)
Levofloxacin (Levaquin)
Ofloxacin (Floxin)
Moxifloxacin (Avelox)

~Note the “floxacin” but no clues in the trade names.

Question 24

Levofloxacin (Levaquin)

Answer 24

Misc. Antiinfective Fluoroquinolones’ Levofloxacin (Levaquin)

Absorption decrease with antacids and iron w/i 4 hrs

Question 25

Lipopeptides

Answer 25

Misc. Antiinfective Lipopeptides. Bacteriocidal only. S/E are either extremities or flip flops: potassium, glucose, bp. Other S/E: anemia, muscle breakdown (rhabdomyolysis) and pleural effusion. Warfarin goes up.

Incl. drug:
Daptomycin (Cubicin)

Question 26

Daptomycin (Cubicin)

Answer 26

Misc. Antiinfective Lipopeptides’ Daptomycin (Cubicin).

Question 27

Lipopetides vs Sulfonamides

Answer 27

• Lipopeptides are bacteriostatic (weaker, lipo constitutes). Targets gram + especially MRSA (S. aureus), but cannot completely kill them without other drugs concurrently.
• Sulfonamides are bacteriocidal (stronger, sulfur, R group integrity). Targets gram - and kill them off.

Question 28

Sulfonamides

Answer 28

Misc. Antiinfectives Sulfonamides. Often used for pt’s allergic to penicillin because it is chemically completely different. S/e are complex: prolonged used (2-4 weeks) lead to anemia, thrombocytopenia, neutropenia, AND the other category with agranulocytosis; liver and renal, crystalluria, sunglasses, hypoglycemic oral effect goes up, warfarin effect goes up.

Sulfonamide drugs incl:

• Sulfadiazine (Microsulfon) (Short-acting)
• Trimethoprim-sulfamethoxazole (Bactrim, Septra) (Intermediate-acting)
• Silver sulfadiazine (Silvadene) (Topical)

~Note the sulfa. But no clues in the trade names.

Question 29

Bactrim, Septra

Answer 29

Misc. Antiinfectives Sulfonamides’ -Trimethoprim-sulfamethoxazole (Bactrim, Septra) (Intermediate-acting)

Contraindicated in renal clients.