Module 2 Drug Flashcards Flashcards by Lindy Kirk

What are some examples of, and MOA for Penicillins?

PCN-β-lactam

Examples: Pen V and Pen G
        Broad-spectrum penicillins:
               Amoxicillin
               Ampicillin
               Augmentin
        Extended-spectrum
               Piperacillin
              Augmentin/Unasyn

MOA: Weaken the organism’s cell wall causing an excessive amount of water to be taken up and rupturing the cell wall, thus disrupting cell wall synthesis and promoting destruction.

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What are the Safety considerations/contraindications/D2D associated with Penicillins?

It is contraindicated in anyone with a history of type one allergic reaction to pcn.

Caution in patients with allergy to cephalosporin.

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What are some examples of 1st Gen Cephalosporins?

Cephalosporins: β-lactam

Examples: Duricef, Keflex

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What are the Safety considerations/contraindications/D2D associated with 1st Gen Cephalosporins?

Cross sensitivity if Type I PCN allergy

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What are some examples of 2nd Gen Cephalosporins?

2nd Gen Cephalosporins β-lactam

Examples: Cefzil, Ceftin

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What are some examples of 3rd Gen Cephalosporins?

3rd Gen Cephalosporins β-lactam

Examples: Rocephin, Omnicef

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What is the Mechanism of Action of all generations of cephalorporins?

Interferes with cell wall synthesis.

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What are some examples of 4th Gen Cephalosporins?

4th Gen Cephalosporins β-lactam

Examples: Cefepime

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What are some examples of, and MOA for Fluoroquinolones?

Examples: Ciprofloxin, Levaquin, Avelox/Factiva

MOA: Act by interfering with DNA gyrase which is the enzyme responsible for the stranding of bacterial DNA synthesis, as well as bacterial growth and replication. They are bactericidal.

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What are the Safety considerations/contraindications/D2D associated with Fluoroquinolones?

*Use with caution in underlying CNS pathology and renal impairment.

It should not be prescribed for patients with peripheral atherosclerotic vascular disease, hypertension, Marfan’s syndrome, and the elderly due to the increased risk of aortic aneurysm.
Potential for significant decreases in blood sugar and certain mental health side effects.
*QT prolongation

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What is the Black Box Warning associated with Fluroiquinolones?

Tendon Rupture?

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What patients cannot receive Flurouquinolones?

In general, it should not be used during pregnancy and lactation.

*Not for use in children under age 18.
Increase risk of C. diff

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What are some examples of, and MOA for Carbapenems?

Carbapenems β-lactam

Example: Imipenem

MOA: Weaken the cell wall

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What are the Safety considerations/contraindications/D2D associated with Carbapenems?

Parenteral administration is reserved for pts who cannot be treated with a narrower spectrum

It interacts with Valproate and can cause breakthrough seizures.

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What are some examples of, and MOA for Macrolides (Early and Later gen)?

Early Generation: Erythromycin
Later Generation: Azithromycin

MOA: Control the development or reproduction of bacteria and inhibit protein synthesis.

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What are the Safety considerations/contraindications/D2D associated with Macrolides?

*QT prolongation: Clarithromycin, erythromycin, and telithromycin; D2D with warfarin

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What are some examples of, and MOA for Tetracyclines?

Examples: Doxycycline, Minocycline

MOA: Obstruct the synthesis of protein by competing for the binding of the RNA ribosome to diminish the essential functions of growth and repair.

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What patients cannot receive Tetracyclines?

Tetracyclines contraindicated in pregnancy and for children under 8

Tetracycline breastfeeding See PLLR controversial in breastfeeding

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What are some examples of, and MOA for Sulfonamides?

Examples: Bactrim, Septra

MOA: Inhibition of folate metabolism

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What are the Safety considerations/contraindications/D2D associated with Sulfonamides?

Use with warfarin increases INR= bleeding

Hyperkalemia, especially if used with ACES, ARBS, elderly patients, or kidney disease.

SJS

What patients cannot receive Sulfonamides?

Pregnancy: should be avoided in both the first and third trimesters unless no other reasonable alternative is available.

Sulfonamides are contraindicated in infants who have either hyperbilirubinemia or G6PD deficiency.

What are some examples of, indications for, and MOA for Anti-anaerobic Agents?

Examples: Clindamycin, Cleocin

Indications: Anaerobics, Gr+, Gr-

MOA: Inhibits protein synthesis.

What is the Black Box Warning associated with Anti-anaerobic agents?

C. Difficile

What patients cannot receive Anti-anaerobic Agents (clindamycin)?

Clindamycin should be used during the first trimester of pregnancy only if clearly needed.
RBA breastfeeding

What are some examples of, indications for, and MOA for Anti-anaerobic Agents-Nitroimidazoles?

Example: Metronidazole(Flagyl) Indications: Treats anaerobic bacterial infections: Bacterial vaginosis, Trichomoniasis, Giardiasis, H. Pylori, C. difficile MOA: Inhibits protein synthesis by interacting with DNA and causing a loss of helical DNA structure and strand breakage.

What are the Safety considerations/contraindications/D2D associated with Anti-anaerobic Agents-Nitroimidazoles?

Do not use if has used disulfiram in the last two weeks.

What patients cannot receive Anti-anaerobic Agents-Nitroimidazoles?

Treat symptomatic BV in pregnancy- otherwise, RBA for pregnancy lactation

What are some examples of, indications for, and MOA for Anti-anaerobic Glycopeptides?

Example: Vancomycin Indications: Gr+ MOA: Inhibits cell wall synthesis

What are the Safety considerations/contraindications/D2D associated with Glycopeptides?

Reserved for serious infections. Renal toxicity (dose-dependent and do not co-administer with other renal drugs like NSAIDs, cyclosporin, aminoglycosides)

What patients cannot receive Oxazolidinones?

+ inhibits MAO | *don’t use with SSRIs

What are some Beta-Lactamase Inhibitors?

Clavulanic acid, Tazobactam, Sulbactam, Avicactam

What are some examples of, indications for, and MOA for Aminoglycosides?

Examples: Gentamycin, Tobramycin, Amikacin Indications: Serious infections, Aerobic Gr- MOA: Inhibits protein synthesis

What are the Safety considerations/contraindications/D2D associated with Aminoglycosides?

Serious toxicity to ears and kidneys

What is the Black Box Warning associated with Aminoglycosides?

Ototoxic, Neurotoxicity | Nephrotoxic

What are the indications for and MOA of Rifampin?

Indications: Anti TB, Gr-, Gr+, N. Meningitis, M. Leprae, MOA: Inhibits DNA-dependent RNA polymerase and suppresses RNA and protein synthesis

What are the Safety considerations/contraindications/D2D associated with Rifampin?

Hepatotoxicity *discolors urine Powerful inducer of MANY of the CYP pathways so many drug-to-drug interactions (Back up contraception!)

What patients cannot receive Rifampin?

Teratogenic in rodents. If given the last few weeks of pregnancy, postnatal hemorrhages in mother and infant. Pregnancy–Non Nursing Mothers Because of the potential for tumorigenicity shown for rifampin in animal studies, a decision should be made whether to discontinue nursing or discontinue the drug.

What patients cannot receive Nitrofurantoin, Macrodantin, or Microbid?

Contraindicated in pregnant patients at term (38-42 weeks) during labor and delivery or when the onset of labor is imminent. Contraindicated in neonates under one month of age.

What are the Safety considerations/contraindications/D2D associated with Nitrofurantoin, Macrodantin, or Microbid?

Acute pulmonary reactions | Possibility of hemolytic anemia due to immature erythrocyte enzyme systems

What are the indications for and MOA of Nitrofurantoin, Macrodantin, or Microbid?

Indication: Gr+ Gr- Pseudomonas Enterobacter, Klebsiella MOA: Damages bacteria DNA

What are the indications for and MOA of INH?

Treatment of TB Suppresses bacterial growth by inhibiting mycolic acid.

What are the Safety considerations/contraindications/D2D associated with INH?

Hepatoxicity *Monitor liver function. Do not give as a single agent for TB Peripheral neuropathy Supplement with B6

What is the Black Box Warning associated with INH?

Severe hepatitis, liver failure, death.

What are some examples of, indications for, and MOA for Oxazolidinones?

Example: Zovox Indications: Multidrug resistant Gr+, VRE, MRSA MOA: Bacteriostatic inhibitor of protein synthesis.

What are the Safety considerations/contraindications/D2D associated with Oxazolidinones?

This drug is held back for use for serious infections that are resistant.

What are the indications for and MOA of Acyclovir?

Indications: Active against members of herpesvirus family MOA: Inhibits viral replication by suppressing viral DNA.

What are the indications for and MOA of Valcyclovir (Prodrug of Acyclovir)?

Indications: Herpes labialis, Varicella, Genital herpes, Herpes zoster MOA: Inhibits viral replication by suppressing viral DNA.

What are the indications for and MOA of Famciclovir | (prodrug of penciclovir)?

Indications: Herpes zoster, Genital herpes MOA: Inhibition of DNA synthesis

What medication is NOT recommended for influenza?

Adamantanes (ex. Symmetrel)