Miscellaneous Facts Flashcards
drugs with pregnancy category B
penicilin G cefazolin erythromycin nitrofurantoin amphotericin B deoxycholate nystatin
drugs with pregnancy category C
vancomycin
cipro
TMP-SMZ
fluconazole
drugs with pregnancy category D
tetracycline
gentamicin
antifungals
nystatin
fluconzaole
amphotericin B
urinary antiseptics
nitrofurantoin
trimethoprim-sulfamethoxazole TMP-SMZ
fluoroquinolones
Ciprofloxacin DNA replication
aminoglycosides
gentamicin
macrolide
erythromycin
bacterial cell wall inhibitors
vancomycin
carbapenems
cefazolin
penicillin G
bacterial protein synthesis inhibitors
gentamicin
erythromycin
tetracycline
black box warning: red man syndrome, ototoxicity, nephrotoxicity
vancomycin
black box warning: discoloration of the teeth
tetracycline
black box warning: cardiotoxicity w/ risk for torsades de pointes
erythromycin
black box warning: ototoxicity, nephrotoxicity
gentamicin
black box warning: tendonitis and tendon rupture
Cipro
black box warning: Stevens-Johnson syndrome
trimethoprim-sulfamethoxazole TMP-SMZ, fluconazole
black box warning: cardiac arrest, ototoxicity, nephrotoxicity
amphotericin B and gentamicin/vancomycin for oto and nephro only
anti-infective drug classes that antagonize or inhibit penicillin
aminoglycosides and tetracyclines
increases anticoagulant effect of warfarin
cefazolin, tetracycline, erythromycin, Cipro, fluconazole
food can reduce absorption by 50%
tetracyclines
administer w/ full glass of water on empty stomach
tetracycline, Cipro, erythromycin (unless enteric coated), TMP-SMZ (might be ok w/ food)
avoid use w/ fluconazole and grapefruit juice
erythromycin
don’t give immediately before sleep
tetracyline
hearing loss, vertigo and dizziness
erythromycin
narrow spectrum for serious systemic gram-negative infections given parenterally
aminoglycosides (but also some gram-positive MRSA in gentamicin)
broad spectrum usually PO
tetracycline
photosensitivity
gentamicin, tetracycline, Cipro, TMP-SMZ
no antacids, calcium supplements, iron products or laxatives w/ magnesium
tetracycline
3 ways drugs block bacterial DNA replication
1) inhibit synthesis of precursor bases 2) interact w/ or bind to DNA, preventing uncoiling 3)bind to enzymes of replication, stopping formation of new strand
cartilage, GI, cardio, CNS, photo and hepato toxic
Cipro
avoid with caffeine, antacids, magnesium, aluminum, iron or zinc sulfate, sucralfate and calcium-fortified juices
cipro
may enhance effects of oral anticoagulants
TMP-SMZ
avoid w/ fluoroquinolones and antacids w/ magnesium
Nitrofurantoin
pulmonary toxicity
Nitrofurantoin
5 mechanisms of action for antifungals
1) inhibition of nucleic acid synthesis 2) disruption of membrane integrity (3) disruption of microtubule formation 4) inhibition of glucan synthesis 5) inhibition of ergosterol synthesis
polyene drug class
Amphotericin B, Nystatin
don’t use if BUN > 40 mg/dL or creatinine > 3 mg/dL
Amphotericin B
hypokalemia a common problem
amphotericin B
nausea and vomiting in 10 to 20% of patients administered PO
fluconazole
bind to sterols in fungal cell membrane
nystatin
premedicate w/ antipyretics, antihistamines, antiemetics and corticosteroids
amphotericin B
give with food or milk
nitrofurantoin
