Exam 1 drugs Flashcards

1
Q

Penicillins (oral and IV)

A
Pen VK
Amoxicillin
Amoxicillin-clavulanate
Dicloxacillin
Nafcillin
Penicillin G
Piperacillin/tazobactam
Ampicillin/sulbactam
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2
Q

Pen VK

A

Veetids
Children: 25-75 mg/kg/day in divided doses q6-8h
Adults: 125-500mg PO q6-8h

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3
Q

Amoxicillin

A

Amoxil
Children: 25-50 mg/kg/day in divided doses q8h
Adults: 250-500mg PO q8-12h

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4
Q

Amoxicillin-clavulanate

A

Augmentin
Children (<40kg): 20-45 mg/kg/day in divided doses 2-3 times daily
Adults: 500mg q8-12h or 875mg q12h or 2g q12h

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5
Q

Dicloxacillin

A

125-500mg q6h

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6
Q

Nafcillin sodium load

A

66mg Na+/g nafcillin

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7
Q

Piperacillin-tazobactam sodium load

A

Zosyn

54-64mg Na+/g piperacillin

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8
Q

Ampicillin-sulbactam sodium load

A

Unasyn

115mg Na+/1.5g of combo product

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9
Q

Cephalosporins (oral and IV)

A
Cephalexin
Cefaclor
Ceftriaxone
Cefepime
Cefazolin
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10
Q

Cephalexin

A

Keflex
1st generation
Children: 25-100 mg/kg/day in divided doses q6-8h (max 4g/day)
Adults: 250-1000mg q6h or 500mg q12h (max 4g/day)

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11
Q

Cefaclor

A

Ceclor
2nd generation
Children: 20-40 mg/kg/day divided q8-12h
Adults: 250-500mg q8h (500mg q12h for ER)

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12
Q

Ceftriaxone

A

Rocephin
3rd generation
IV or IM
Children: 50-100 mg/kg/day in 1-2 divided doses q12-24h
Adults: 1-2g q12-24h
max IV daily dose in renal impairment: 2g/day

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13
Q

Cefepime

A
Maxipime
4th generation
Usually IV
Children: 50mg/kg/dose q8-12h
Adults: 1-2g q8-12h

83mg NA/g cefepime

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14
Q

Cefazolin

A

Keflex/Ancef
IV
48mg Na+/g cefazolin

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15
Q

Protein synthesis inhibitors

A

aminoglycosides
tetracyclines
macrolides
clindamycin

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16
Q

Beta Lactams

A

penicillins

cephalosporins

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17
Q

Aminoglycosides

A
gentamycin
tobramycin
neomycin
amikacin
binds to 30S ribosomal subunit
bactericidal and concentration dependent
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18
Q

Gentamycin

A

IV or IM dosing

2-5mg/kg/day in divided doses q8h

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19
Q

Tetracyclines

A

doxycycline (Vibramycin/Adoxa)
minocycline (Minocin)
demeclocycline

binds to 30S ribosomal subunit
bacteriostatic
time dependent

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20
Q

Doxycycline

A

Vibramycin/Adoxa
Oral: IR and ER forms
100-200mg/day in 1-2 divided doses

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21
Q

Macrolides

A

azithromycin, erythromycin (EES 400, Ery-Tab), clarithromycin (Biaxin), fidaxomicin (Dificid)
Bind to 50S ribosome subunit
bacteriostatic

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22
Q

Azithromycin

A

Zithromax

Oral: 1-2g as single dose, 500mg daily, or 500mg on day 1 then 250mg on day 2-5

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23
Q

Clindamycin

A
Cleocin
Lincosamide
Binds to 50S ribosome subunit
Bacteriostatic
Time-dependent

Oral: Children: 8-40mg/kg/day PO in 3-4 divided doses
Adults: 150-450mg PO q6h
IV: Children: 20-40 mg/kg/day in 3-4 divided doses
Adults: 600-2700 mg/day in 2-4 divided doses

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24
Q

Metronidazole

A
Flagyl
Bactericidal
Concentration dependent
Oral and IV forms
250-750mg q8h
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25
Q

Sulfamethoxazole - Trimethoprim

A

Bactrim
Bactericidal
Concentration dependent
Oral: Bactrim DS: 160mg TMP/800mg SMX: 1 tab PO q12h
Bactrim SS: 80mg TMP/400mg SMX: 2 tab PO q12h
IV: 80mg TMP/400mg SMX

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26
Q

Nitrofurantoin

A
Macrobid/Macrodantin
Bactericidal
Concentration dependent
Macrodantin: 50-100mg PO q6h
Macrobid: 100mg PO BID
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27
Q

Fluoroquinolones

A

Ciprofloxacin, Levofloxacin, Moxifloxacin
Bactericidal
Concentration dependent

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28
Q

Ciprofloxacin

A

Cipro
PO: 500-750mg q12h
IV: 400mg q12h

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29
Q

Levofloxacin

A

Levaquin

PO or IV: 250-750mg q24h

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30
Q

Moxifloxacin

A

Avelox

PO or IV: 400mg q24h

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31
Q

Vancomycin

A

IV antibiotic

“Red Man Syndrome”

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32
Q

Daptomycin

A

Cubicin/Cubicin RF

IV antibiotic

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33
Q

IV antivirals

A

Acyclovir
Ganciclovir
Cidofovir

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34
Q

Acyclovir

A

Zovirax
IV antiviral
Infuse over 1 hour to reduce the risk of renal tubular damage
Ensure patient maintains adequate hydration

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35
Q

Ganciclovir

A

Cytovene
IV antiviral
Hazardous agent

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36
Q

Cidofovir

A

Vistide
IV antiviral
Hazardous agent

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37
Q

IV antifungals

A

Eichinocandins
Fluconazole
Voriconazole

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38
Q

Voriconazole

A

Vfend
IV antifungal
Monitor electrolytes (K+)
Hazardous agent

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39
Q

Fluconazole

A

Diflucan
IV antifungal
Don’t use if cloudy or precipitated
Hazardous agent

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40
Q

Eichinocandins

A

Micafungin (Mycamine)
Caspofungin (Cancidas)
Anidulafungin (Eraxis)
Infuse slowly and use a central catheter is infusing high doses

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41
Q

Vaughan-William Class 1A agents

A

Disopyramide
Quinidine
Procainamide

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42
Q

Disopyramide

A
Norpace
ventricular arrhythmias
IR: 100-150mg PO q6h
CR: 200-300mg PO q12h
Take on empty stomach
Beers list
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43
Q

Quinidine

A
A-fib/flutter, ventricular arrhythmias
Gluconate (ER): 648mg PO q8h
Sulfate: IR: 200-400mg PO q6h
ER: 300mg PO q8-12h
gluconate and sulfate forms aren't interchangeable
Dose adjust CrCl<10
Low Na+ diet and food increase rate and extent of absorption
Fruit juice/vit C can increase clearance
44
Q

Procainamide

A
ventricular arrhythmias
LD: 500-600mg IV over 25-30 mins
MD: 2-6mg/min by CI
Long term ADR: drug induced lupus erythematosus like syndrome
Active metabolite --> class III agent
45
Q

Vaughan-William Class IB agents

A

lidocaine
mexitetine
higher amounts of CNS AEs

46
Q

Lidocaine

A

Xylocaine
VF/pulseless VT, hemodynamic monomorphic VT
Usual regimen: 1-1.5mg/kg bolus
refractory VF or pulseless VT: 0.5-0.75 mg/kg bolus every 5-10 mins
CI: 1-4mg/min
TDM: avoid levels >5mcg/ml b/c of CNS toxicity

47
Q

Mexiletine

A
Ventricular arrhythmias
Usual dose 200-300mg PO q8h
Max daily dose of 1.2g
Take w/ food 
Avoid meds/foods that increase urinary pH
48
Q

Vaughan-William Class IC agents

A

Flecainide
Propafenone

Supraventricular tachycardias
Dietary considerations for both agents

49
Q

Flecainide

A
Tambocor
Usual regimen: 50-100mg PO q12h
Max/day: 300-400mg
Clearance decreased by strict vegetarian diets
Milk interferes w/ absorption
50
Q

Propafenone

A

Rythmol
ER caps: 225mg PO q12h, may increase to max of 425mg q12h
IR tabs: 150mg PO q8h, may increase to max of 300mg q8h
Avoid grapefruit juice
negative inotrope/chronotrope -> use caution in patients receiving beta blockers

51
Q

Vaughan-William Class II

A

Beta blockers: propranolol and esmolol
autorhythmics cells: decrease SA/AV nose automaticity and conduction velocity
Contractile cells: MSA at high doses

52
Q

Propranolol

A

Inderal
30-320mg/day divided q6-8h max/day: 640mg
Non-selective bb
Can be used to treat arrhythmias caused by hyperthyroidism
high protein diet can increase bioavailability

53
Q

Esmolol

A

Brevibloc
CI: 500mcg/kg/min over 1 min, then 50mcg/kg/min max of 200mcg/kg/min
Good with tenuous bp/hr

54
Q

Vaughan-William Class III agents

A
Amiodarone
Dofetilide
Sotalol
K+ channel blockade
Prolongs QT interval
Atrial and ventricular arrhythmias
55
Q

Amiodarone

A

Cordarone/Pacerone
blocks all 4
classifications
Oral: 200-1600mg/day
IV: 150-300mg rapid bolus (no pulse = 300mg) then 1mg/min for 6hrs, then 0.5mg/min for 18hrs
Avoid grapefruit juice and lots of drug-drug interactions
Doesn’t prolong QT interval and safe in HF and coronary disease

56
Q

Sotalol

A

Betapace
80-160mg PO BID
Start in hospital b/c of life threatening ventricular tachycardia associated w/ QT prolongation
Adjust frequency w/ CrCl <60ml/min

57
Q

Dofetilide

A
Tikosyn
125-250mcg PO BID
Will cause QTc prolongation
Dose adjust w/ CrCl <60ml/min
Contraindicated w/ cimetidine, dolutegravir, HCTZ, itraconazole, ketoconazole, megestrol, prochlorperazine, trimethoprim, verapamil
58
Q

Vaughan-William Class IV agents

A

Non-DHP CCBs: verapamil, diltiazem

Inhibits slow inward current by L-type Ca++ channels in AV/SA node –> slows conduction and prolongs repolarization
Supraventricular dysrhythmias: A-fib/flutter, paroxysmal supraventricular tachycardia

59
Q

Verapamil

A

Calan
IV: 0.075mg/kg bolus over 2 mins then CI of 5mg/hr
Oral: 240-480mg daily in divided doses-TID
Adjust dose in hepatic/renal impairment

60
Q

Diltiazem

A

Dilacor, Cardizem
IV: 0.25mg/kg bolus over 2 mins then CI of 5-10 mg/hr (NTE 15mg/hr)
Oral: 30mg q6h or 120-360mg/day in divided doses or ER
Adjust dose in hepatic impairment

61
Q

Metformin

A
Glucophage, Glucophage XR, Glumetza
500mg PO BID titrating up to max of 2550mg/day
Weight neutral, take w/ food, no alcohol
D/c before contrast dye
monitor
Contraindicated in eGFR <30
Drug-drug interactions: ranolazine
62
Q

Sulfonureas

A

Glipizide
Glyburide
Glimepiride

Maintain consistent diet and take w/ breakfast
Weight gain
Sulfa allergy
G6PD deficiency

63
Q

Glipizide

A

Glucotrol, GLucotrol XL
5-20mg QD or BID
Take 30mins before meals
Avoid XL w/ GI obstructions

64
Q

Glyburide

A

Diabeta, Micronase
2.5-5mg QD or BID
take w/ food
Avoid in CKD or concomitant use w/ bosentan

65
Q

Glimepiride

A

Amaryl
1-4mg qd
take w/ breakfast/first main meal

66
Q

Meglitinides

A

Regaglinide
Nateglinide

Weight gain
Don’t use w/ sulfonureas

67
Q

Regaglinide

A
Prandin
0.5mg TID w/ meal
If meal is skipped - skip dose
Take 30mins or less before meal
Contraindicated w/ gemfibrozil
68
Q

Nateglinide

A

Starlix
60-120mg TID w/ meals
If meal is skipped - skip dose
Take 30mins or less before meal

69
Q

Alpha-glucosidase Inhibitors

A

Acarbose
Miglitol

Lots of GI AEs
Not recommended in patients w/ SCr >2mg/dL or CrCl <25
Avoid in chronic intestinal diseases

70
Q

Acarbose

A

Precose
25mg TID
Take w/ first bite of food

71
Q

Miglitol

A

Glyset
25mg TID
Take w/ first bite of food

72
Q

GLP-1 mimetics

A
Liraglutide
Exenatide
Albiglutide
Dulaglutide
Weight loss
Boxed warning: thyroid cancer
73
Q

Liraglutide

A

Victoza

1.8mg SQ once daily

74
Q

Exenatide

A

Byetta: 5-10mcg SQ once daily
Increases INR

Bydureon: 2mg SQ every week
must assemble

Both contraindicated in CrCL <30

75
Q

Albiglutide

A

Tanzeum
30-50mg SQ every week

Must dissolve first: 15mins for 30mg and 30mins for 50mg

76
Q

Dulaglutide

A

Trulicity

SQ every week

77
Q

DPP-4 inhibitors

A

Sitagliptin
Linagliptin
Alogliptin

Take w/ or w/o food
Weight neutral

78
Q

Sitagliptin

A

Januvia
100mg QD

renal adjustment
may increase digoxin levels

79
Q

Linagliptin

A

Tradjenta
5mg QD

CYP3A4 interactions

80
Q

Saxagliptin

A

Onglyza
2.5-5mg QD

renal adjustment
CYP3A4 interactions
Avoid in new/worsening HF

81
Q

Alogliptin

A

Nesina
25mg QD

Renal adjustment
Avoid in new/worsening HF

82
Q

SGLT-2 inhibitors

A

Cangliflozin
Dapagliflozin
Empagliflozin

Precautions: ketoacidosis, fractures, hyperkalemia, renal impairment
Contraindicated in CrCl <30
Weight loss
s/s decreased blood pressure
UTI/genital fungal infections are common
Increased LDLs
83
Q

Cangliflozin

A
Invokana
100mg QD
Take w/ first meal of the day
CYP3A4 substrate
Only use 300mg if CrCl >60ml/min
Increased risk of leg/foot amputation
84
Q

Dapagliflozin

A

Farxiga

5mg QD

85
Q

Empagliflozin

A

Jardiance
Decreased CV mortality and hospitalization due to HF in Type 2 DM w/ CVD
Dose adjust in eGFR <45

86
Q

Thiazolidinediones (TZDs)

A

Pioglitazone
Rosiglitazone

Precaution: edema, macular degeneration, bladder cancer, fractures
Contraindication: HF
Drug-drug interactions

87
Q

Pioglitazone

A

Actos
15mg QD

Decreased triglycerides
May reduce CVD

88
Q

Rosiglitazone

A

Avandia
4mg QD

Increased LDLs
Don’t start in patients w/ stable IHD

89
Q

Glucovance

A

glyburide + metformin

90
Q

Janumet/Janumet XR

A

sitagliptan + metformin

91
Q

Jentadueto/Jentadueto XR

A

Linagliptan + metformin

92
Q

Kombiglyze/Kombiglyze XR

A

Saxagliptan + metformin

93
Q

Invokamet

A

Canagliflozin + metformin

94
Q

Glyxambi

A

Empagliflozin + Linagliptan

95
Q

Duetact

A

Pioglitazone + glimepiride

96
Q

Rapid Acting Insulins

A

Insulin Aspart/Lispro/Glusine

All expire 28 days after opening

97
Q

Insulin Aspart

A
Novolog (Flexpen)
Onset: 10-20mins
Peak: 40-50mins
Duration: 3-5hrs
Give 5-10mins before meal
98
Q

Insulin Lispro

A
Humalog (Kwikpen)
Onset:15-30mins
Peak: 30mins - 2.5hrs
Duration: 3-5hrs
Give w/in 15mins of meal or immediately after
99
Q

Insulin Glulisine

A
Apidra (Solostar)
Onset:
Peak:
Duration:
Give w/in 15mins of a meal or w/in 20mins after starting a meal
100
Q

Short Acting/Intermediate Acting Insulins

A

Regular insulin
NPH
OTC

101
Q

Regular Insulin

A
Humulin R and Novolin R
Onset:
Peak:
Duration:
Give 30mins before a meal
Humulin R expires 28 days after opening
Novolin R expires 42 days after opening
102
Q

NPH

A
Humulin N (vials and pens) and Novolin N
Onset:
Peak:
Duration:
Cloudy appearance
Humulin N vials expire 28 days after opening
Humulin N pens expire 14 days after opening
Novolin N expires 42 days after opening
103
Q

Basal Insulin

A

Insulin Degludec, Detemir, Glargine

104
Q

Insulin Degludec

A
Tresiba Flextouch (U-100 and U-200)
Onset: 30-90mins
Duration: >24hrs
Dosed once daily
Expires 56 days after opening
105
Q

Insulin Detemir

A
Levemir (Flextouch)
Onset: 1-2hrs
Duration: up to 24hrs
Once or twice daily 12hrs apart
Expires 42 days after opening
106
Q

Insulin Glargine

A
Lantus (Solostar) U-100, Toujeo Solostar U-300
Onset: 1-2hrs
Duration: up to 24hrs
Acidic pH, cloudy appearance
Toujeo is more concentrated
Expires 28 days after opening