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OU Practice Fall 2018 > ID ADE and counseling > Flashcards

ID ADE and counseling Flashcards

1
Q

PCN

A
  • Complete entire course of therapy
  • Drink ample fluids
  • Report persistent diarrhea (Concern for pseudomembranous colitis)
  • Pregnancy category B
  • ADE: nausea, diarrhea, HIVES, RASH
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2
Q

Veetids

A

• Take on empty stomach with water

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3
Q

Pfizerpen-G

A

• Pearls: Very short half-life, so must dose frequently or give by continuous infusion

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4
Q

Dicloxacillin

A

• Take on empty stomach with water

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5
Q

Nafcillin

A

• Pearls: Short half-life; q4h dosage interval, largely eliminated by the liver

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6
Q

Amoxil

A
  • Take extended release formulation within 1 hour of finishing a meal
  • Shake suspension well before use; may be mixed with formula, milk, fruit juice, or other cold drinks
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7
Q

Augmentin/XR/ES

A
  • Take with food to decrease GI effects
  • Drink water after chewable tablets
  • Augmentin ES suspension does not taste very good
  • ADE: diarrhea, hepatic dysfunction
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8
Q

Cephalosporins

A
  • Complete entire course of therapy
  • Drink ample fluids
  • Report persistent diarrhea (Concern for pseudomembranous colitis)
  • Pregnancy category B
  • ADE: Nausea, diarrhea, RASH
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9
Q

Ancef (cefazolin)

A

• Pearl: Good alternative to anti-staphylococcal penicillins (i.e. nafcillin), except in CNS infections

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10
Q

Keflex (cephalexin)

A

• Take on empty stomach

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11
Q

Ceftin (cefuroxime)

A
  • Take the suspension with food
  • Bitter taste
  • Tablets are without regard to meals
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12
Q

Omnicef (cefdinir)

A
  • Avoid antacids / iron within 2 hours

* ADE: Discolored stools (red)

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13
Q

Rocephin (ceftriaxone)

A
  • Pearls: Dosed once daily except for meningitis and enterococcal endocarditis (q12 hours), High biliary elimination, so no renal dose adjustment needed
  • ADE: Biliary sludging, Hyperbilirubinemia in infants / neonates
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14
Q

Maxipime (cefepime)

A

• Pearl: Often used as an alternative to piperacillintazobactam in cases of mild penicillin allergy when anti-pseudomonal activity is needed

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15
Q

Teflaro (ceftaroline)

A

• Dose adjust for CrCl < 50 ml/min

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16
Q

Carbapenems

A

• Will all need renal adjustments
• ADE: GI, rash, SEIZURES (imipenem greatest risk)
- Risk factors for seizures- renal impairment, CNS disease
• Pregnancy category B except for imipenem which is a category C

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17
Q

Primaxin (imipenem / cilastatin)

A
  • Renally adjust for CrCl < 90 mL/min
  • Cilastatin inhibits dehydropeptidase and keeps the toxic product from forming (imipenem gets metabolized to nephrotoxic product in the kidney by dehydropeptidase)
  • ADE: Most likely carbapenem to cause seizures
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18
Q

Invanz (ertapenem)

A
  • Renally adjust for CrCl <= 30 mL/min

* Once daily dosing convenient for home infusion therapy

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19
Q

Merrem (meropenem

A
  • Renally adjust for CrCl < 50 mL/min

* Pearl: Extended interval dosing (3 hour infusion) may be used for extremely resistant Gram (-) organisms

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20
Q

Macrolide

A

• Complete entire course of therapy
• Although erythromycin and azithromycin best absorbed on empty stomach, take with food or milk if GI upset
• Pregnancy category B
• ADE: GI UPSET, nausea, cramping, diarrhea, Rare hepatotoxicity (mostly telithromycin), QTc prolongation
- For QTc prolongation, Erythromycin (worst) > clarithromycin > azithromycin (least likely)

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21
Q

Erythromycin / Ery-tab

A
  • Food or milk if GI upset

* Swallow delayed release capsule and enteric coated tablet whole

22
Q

Biaxin / Biaxin XL (clarithromycin)

A
  • Take XL dosage form with food to increase absorption

* Regular tablets without regard to food

23
Q

Zithromax / Zmax (azithromycin)

A
  • Take without regard to meals

* Pearl: Biliary excretion / long half-life

24
Q

Ketek (telithromycin)

A
  • Report severe / persistent diarrhea or fainting

* ADE: diarrhea, nausea

25
Q

Fluoroquinolones

A

• Complete entire course of therapy
• Drink ample fluids to maintain urine flow
• Avoid antacids and iron products within hours prior to or after administration
• ADE: Nausea, diarrhea, headache, sun photosensitivity, QTc prolongation
- For QTc prolongation, Moxifloxacin (worst) > levofloxacin > ciprofloxacin (least)

26
Q

Baxdela (delafloxacin)

A
  • IV dose adjustment for CrCl < 30 mL/min

* No effects on QTc interval observed in study of 51 healthy subjects

27
Q

Tetracyclines

A
  • Take on empty stomach; food decreases absorption; can take with food if cannot tolerate taking it on an empty stomach
  • No antacids, iron or dairy within 2 hours
  • Avoid prolonged sunlight (except with minocycline)
  • Pregnancy category D (avoid unless benefit > risk)
  • ADE: Nausea, diarrhea, Photosensitivity (all except minocycline)
28
Q

Minocin (minocycline)

A

• ADE: can cause vertigo

29
Q

Bactrim

A
  • Empty stomach with ample water (especially to prevent crystalluria)
  • Avoid prolonged exposure to sunlight
  • ADE: Photosensitivity, acute kidney injury (crystalluria), diarrhea, rash, hyperkalemia
30
Q

Macrobid / Macrodantin (nitrofurantoin)

A
  • Take with food (increases absorption and helps with nausea)
  • May cause small incidence of urine discoloration (brown)
  • ADE: NAUSEA, diarrhea, headache
  • Rare: peripheral and optic neuropathy; hepatic rxns
31
Q

Monurol (fosfomycin)

A

• ADE: headache, dizziness, GI upset

32
Q

Flagyl (metronidazole)

A
  • Take with food or milk (to help with GI upset)
  • Avoid alcohol during and 24 hours after therapy
  • ADE: Nausea, diarrhea, cramping, metallic taste, seizure risk
33
Q

Metrogel-Vaginal (metronidazole)

A
  • Avoid intercourse during therapy
  • Avoid alcohol during and 24 hours after therapy
  • ADE: Candida superinfection
34
Q

Dificid (fidaxomicin)

A
  • Emphasize adherence (typically takes 10 days to see effect)
  • ADE: Nausea / GI discomfort
35
Q

Rifampin

A
  • Take 1 hour before or 2 hours after food (empty stomach)
  • Soft contact lenses may become permanently stained
  • ADE: Red / orange discoloration of secretions/urine, potential for hepatotoxicity
36
Q

Bactroban (mupirocin)

A
  • Apply small amount to affected area(s) but do not rub in
  • Do not use nasal ointment with other nasal medications
  • ADE: Topical irritation; nasal ointment may cause headache, rhinitis, congestion
37
Q

Vancocin (vancomycin)

A
  • ADE: Concern for nephro- and ototoxicity/phlebitis (IV)

* Monitor: Trough concentration 30 minutes before 4th dose

38
Q

Vibativ (telavancin)

A
  • Dose adjust for CrCl < 50 ml/min
  • ADE: Potential for nephrotoxicity/increase in serum creatinine
  • Infusion-related reactions similar to vancomycin
39
Q

Cubicin (daptomycin)

A
  • ADE: Myopathy / rhabdomyolysis
  • Monitor: for myopathy, Creatine kinase (CK) concentrations weekly
  • Pearl: Deactivated by pulmonary surfactant; therefore, CANNOT be used to treat pneumonia, Renal adjustments needed
40
Q

Cleocin (clindamycin)

A
  • Report diarrhea promptly to the physician
  • Take with a full glass of water
  • ADE: Nausea, abdominal pain, diarrhea
41
Q

Zyvox (linezolid)

A
  • ADE: Bone marrow suppression (> 2 weeks therapy), Peripheral and optic neuropathy (> 28 days therapy), Serotonin syndrome
  • Monitor: Weekly CBC if on extended duration of therapy
42
Q

Diflucan (fluconazole)

A

• ADE: nausea, hepatotoxicity, QTc prolongation

43
Q

Sporanox (itraconazole)

A
  • Take capsule / tablet with food and / or acidic beverage; avoid antacids
  • Take solution on an empty stomach
  • ADE: Nausea, rash, headache, edema, hepatotoxicity, QTc prolongation
44
Q

Ketoconazole

A
  • Take with food and/or acidic beverage; avoid antacids
  • Surveillance for hepatic adverse effects
  • ADE: nausea, skin irritation (if applied topically)
  • Monitor: LFT’s
  • Don’t bother learning dose on this one; will not test over it; we don’t use this often
45
Q

Nystatin

A
  • ADE: Local irritation, but generally well-tolerated

* DO know topical dosing for this

46
Q

Griseofulvin

A
  • Take with a fatty meal to increase absorption
  • Renal, hepatic and blood cell monitoring may be needed for prolonged therapy (leukopenia can happen over time)
  • ADE: Skin rash / urticaria, nausea, photosensitivity
47
Q

Lamisil (terbinafine)

A
  • Take with food
  • Monitor: for signs of liver dysfunction or rash
  • ADE: Diarrhea, dyspepsia; RASH (with oral use), Local irritation (topical)
48
Q

Zovirax (acyclovir)

A
  • Drink ample fluids

* ADE: Nausea, vomiting (oral administration), nephrotoxicity, CNS toxicity (seizure, confusion, etc)

49
Q

Valtrex (valacyclovir)

A
  • Drink ample fluids

* ADE: Headache, nausea, diarrhea, fatigue, CNS

50
Q

Famvir (famciclovir)

A
  • Drink ample fluids

* ADE: Headache, nausea, diarrhea, fatigue (causes headache and nausea more than the first two anti-virals)

51
Q

Tamiflu (oseltamivir)

A
  • Start within 2 days of symptom onset if used for treatment

* ADE: Nausea, vomiting, headache

52
Q

Natroba (spinosad)

A

• How to apply:
- For topical application only
- Shake suspension well
- Cover dry scalp and dry hair
- Leave on for 10 minutes then rinse thoroughly with warm water
- Observe for additional live lice after 7 days
- Adjunct lice management information applies
• ADE: Application site redness / irritation

OU Practice Fall 2018 (17 decks)

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