Immune System Medications Flashcards
Need to Knows
- Classes: “mycin, cillin, micin, oxacin…”
- If allergic to penicillin, patient needs a new class to prevent anaphylaxis.
- All ABX get a culture and sensitivity test before starting therapy.
Aminopenicillins
Amoxicillin (Amoxil), Ampicillin (Unasyn), Amoxicillin/Clavulanate (Augmentin)
- Used for lower respiratory infection, sinus infection, pneumonia, ear infection, impetigo, skin infection, UTI, Peptic Ulcer (H. Pylori), GI/GU Infections
- Side effects: N/V/D, vaginitis, anemia, rash, abdominal pain, alkalosis, glossitis, fever
- Watch for penicillin allergy* (ANAPHYLAXIS)
- Can have oral, diaper, and/or vaginal candidiasis rash
- Watch for N/V/D
Extended-Spectrum Penicillins
Piperacillin/Tazobactam (Zosyn)
- Used for appendicitis, peritonitis, skin infections, GYN infections, community-acquired nosocomial pneumonia
- s/e: seizures (higher doses), drug induced hepatitis, bleeding, pain, superinfection
- Watch for anaphylaxis
- Obtain Hx before therapy initiates
- Notify HCP if fever or diarrhea occur (esp pus, mucus, or blood is in stool)
Potassium Clavulanate ER (Augmentin XR)
- Used for Lower RTI, sinus infection, pneumonia, ear infection, impetigo, skin infection, UTI
- Side effects:
Cyclosporine
Sandimmune, Neoral, Restasis
- Used to prevent/tx organ rejection, graft-vs-host disease in bone marrow and transplant clients. Tx RA and psoriasis, inflammatory dry eye.
- s/e: seizures, confusions, abdominal discomfort, F/E imbalances
- This medicine is used for a lifetime.
- Cosmetic changes (hirsutism, acne) may occur
- Don’t take St. John’s wort (interferes with anti rejection properties)
Immunomodulator
Pimecrolimus (Elidel)
- Used to tx atopic dermatitis
- s/e: headache, cough, redness/burning on application site
- Avoid Eyes; not for children <2 years
- Don’t apply occlusive dressing over site
Salicylate (ASA)
Aspirin (ASA)
- Used to treat inflammatory disorders, mild to mod pain, fever.
- s/e: epigastric distress, increase bleeding time, anemia, heartburn, nausea
- Take with food or milk
- Report tinnitus (Toxicity level reached)
- Don’t take with other NSAIDs
Antimetabolite
Methotrexate
- Used alone or with other tx modalities to tx carcinoma, leukemia, mycosis fungoides. Tx psoriasis and RA unresponsive to conventional therapy.
- s/e: headaches, anorexia, N/A, stomatitis
- Avoid alcohol (prevent GI Irritation), avoid vaccines without HCP advice
- Affects folic acid
Tumor Necrosis Factor Blockers
Adalimumab (Humira), Certolizumab Pegol (Cimzia), Golimumab (Simponi), Infliximab (Remicade), Etanercept (Enbrel)
- Used to dec progress of RA, juvenile arthritis, etc. Also used in Crohn’s and UC.
- s/e: headache, URTI, abdominal pain, injection site reactions, Infections
- Don’t receive live vaccines during therapy and avoid sick people.
- Notify HCP of URI or other infections
Synthetic Vitamin D₃ Analogue
Calcipotriene (Dovonex)
- Used to control skin cell development and production by acting as a synthetic form of Vit D
- s/e: itching, skin irritation, hypercalcemia, dry skin
- Apply a thin layer to affected skin 2x/day and rub in completely. Don’t cover.
- Regular lab tests done to monitor Ca+ concentrations
- Expect improvement in 2-8 weeks
Colony-stimulating Factors
Filgrastim (Neupogen), Sargramostim (Leukin), Pegfilgrastim (Neulasta)
- Used to accelerate bone marrow recovery after chemo or transplant. Management of severe chronic leukopenia.
- s/e: weakness, diarrhea, bone pain, myalgia, SVT
*Notify HCP of dyspnea or palpitations
Anti-Infective
Vancomycin (Vancocin)
- IV Use: Tx life-threatening infections (MRSA infections)
- PO Use: Tx of Staph enterocolitis, psuedomembraneous colitis from C. Diff
- s/e: hypotension, n/v, leukopenia, back and neck pain, superinfection
- Take oral form as directed
- Report tinnitus, rash, vertigo, hearing loss, flushing of skin, dizziness
- Admin IV over 60-90 mins to prevent “red-man syndrome”
Nonsteroidal Anti-Inflammatory Agents (NSAIDs)
Indomethacin, Ibuprofen, Naproxen, Ketorolac
- Used to tx mild to mod musculoskeletal pains or dysmenorrhea.
- S/e: GI Bleeding, hepatitis, drowsiness, constipation
- Take with food or milk and remain upright for 30 mins to dec irritation
- Alcohol increases irritation
- Report abdominal/stomach pain or black-red stools
- Wear sunscreen and protective clothing
Lincosamide Antibiotic
Clindamycin (Cleocin)
- Used to tx skin infections, RTI, septicemia, intra-abdominal infections, GYN infections, osteomyelitis
- s/e: dizziness, arrhythmias, hypotension, n/v/d
- Take medication until completed
- Notify HCP of diarrhea, abdominal cramping, fever, or bloody stools STAT
Aminoglycosides
Gentamicin, Amikacin, Tobramycin
- Used to tx serious gram-negative bacterial infections and staph caused infections from penicillins (contraindicated)
- Prevention of infective endocarditis. Used with other anti-infectives for TB
- s/e: Ototoxicity, nephrotoxicity, ataxia, vertigo
- Drink plenty of fluids
- Report tinnitus, vertigo, hearing loss, rash, dizziness, or difficulty urinating
Macrolides
Azithromycin (Zithromax), Clarithromycin (Biaxin), Erythromycin
- Used for mild to moderate Upper (Pharyngitis, Tonsillitis) and Lower Respiratory Infections (Pneumonia, MAC, exacerbation of COPD, Chlamydia)
- Used for bacterial STDs, ear infections, skin infections, GU infections, PUD
- Given PO or IV
- Side effects: Nausea, Diarrhea, Headache, Fatigue, Heartburn
- Watch for N/V/D, abdominal pain, superinfections
- Given in a 7 day dosage pack
- Report blood in stool
Fluoroquinolones
Ciprofloxacin (Cipro), Levofloxacin (Levaquin), Moxifloxacin (Avelox), Gemifloxacin (Factive), Ofloxacin
- Used (PO, IV) to tx UTI, GYN infections, skin infections, bone/joint infections, infectious diarrhea, typhoid fever.
- s/e: vaginitis, drowsiness, headache, abdominal pain, hyper/hypoglycemia
- Take medication as directed
- Drink plenty of fluids daily (prevent kidney stones)
- Don’t take with antacids
- May cause dizziness and drowsiness
- Use sunscreen and protective clothing
- Report rash, tendon pain or bloody stools*
Cephalosporins
- Used for Respiratory, GI/GU infections, Endocarditis, Meningitis
- Side effects: Rash, Anorexia, Hypersensitivity, GI Pain
- Contraindicated for Penicillin Allergy*
1st generation: For Gram Positive Staph/Strep. Examples: cefadroxil or cephalexin
2nd generation: For Gram-positive staph/strep and certain Gram-negative bacteria. Examples: cefuroxime, cefprozil, and cefaclor.
3rd generation: For Flu, Pneumonia, E.Coli. Examples: ceftriaxone and cefotaxime.
4th generation: Ex: Cefepime. Used for Gram-positive and Gram-negative bacteria.
5th generation: For MRSA, Penicillin-Resistant Strep, Ampicillin-susceptible and Enterococcus faecalis. Ex: Ceftaroline
*5th generation doesn’t work for Pseudomonas bacteria
Tetracyclines
Doxycycline, Minocycline, Tetracycline
- Used to treat various infections caused by unusual organisms. Tx of inhaled anthrax, gonorrhea, syphilis (penicillin allergy), acne.
- Prevents exacerbations of chronic bronchitis
-s/e: esophagitis, photosensitivity, rashes, superinfection
- Avoid antacids and dairy products.
- Women should use non-hormonal contraception
- Watch for s/s of yeast infection
