Pharm Final Flashcards
Penicillin G
-Gram-positive bacterial infections, anaerobes, spirochetes
- Highly Protein Bound
- NO Penicillin/Cephalosporin allergies
-May not see the allergic reaction with first-time dose (usually with 2nd or 3rd dose) Bc B-cell antibodies take a minute to recognize and attack
Cefazolin
-Similar to penicillin: structure & activity (Considered beta-lactam ABX)
-PCN allergy = high risk of cephalosporin allergy
Tetracycline
- inhibit the growth of gram-positive and gram-negative bacteria, but do not kill
-Rickettsia species, Mycoplasma pneumoniae, and Chlamydia trachomatis, acne
-SE:Affects tooth development of kids from the fourth month of fetal development to 8 years old, Temporary and permanent discoloration of developing teeth, and Photosensitivity
-NC:Take on empty stomach either 1 hour before or 2 hours after any meal or other drugs to maximize absorption.
Ciprofloxacin
-Uncomplicated urinary tract infections(UTI), Anthrax, VAP, Typhoid, Plague
-Inhibits the relaxation of DNA and promotes the breakage of bacterial DNA
-SE: Athropathy(joint disease) which is Often irreversible, and Ppl under 18 years old(Achilles tendon rupture)
Sulfamethoxazole
-Uncomplicated UTIs, systemic infection
-Bactericidal-Folate antagonist, competes with para aminobenzoic acid (PABA);Med takes place of PABA, which starves the bacteria
-NC:Wear sunscreen bc more likely to get sunburns, Take 1-2 hours before/after meal with full glass of water to enhance med absorption
Vancomycin
-Eradicates most gram-positive pathogens
-Bacterial septicemia, endocarditis, bone and joint infections, MRSA
-Oral admin = C-Diff tx
-Bacteriocidal & Bacteriostatic(prevents growth)
-SE:Ototoxic, Nephrotoxic, “Red Man” syndrome, Flushing system = profound release of histamine = face beet red color
-Use is limited by ability to produce toxic effects in kidneys & 8th cranial nerve (inner ear)
-Used only when other ABX fail to resolve infection
Amphotericin B
-Progressive and potentially fatal systemic fungal or protozoal infections
-Binds to sterols in fungal cell membranes and ruptures the fungus
-SE: Amphoterrible(Nephrotoxicity(40% receiving IV drugs), Anemia, Electrolyte imbalances= Hypokalemia, Hypomagnesemia, Hypocalcemia)
Fluconazole
-Oral Candidiasis (thrush) & Candida vaginits
-Inhibit synthesis of ergosterol
-Better tolerated with less side effects
-Primarily given topically
Metronidazole
-Inhibits DNA synthesis agts anaerobic bacteria
-Truchomoniasis, Toxoplasmosis, Pneumocystisi Pneumonia, Amebiasis, Giardiasis
-C.Diff, antiparasitic, H.Pylori, antibacterial
-Caution with alchy and other sexual partners have to be treated at the same time
Acyclovir
-Decrease in flu-like symptoms
-Frequency of herpes-like flare-ups decrease
-SE: nephrotoxicity
- NC: Admin tablets/capsules with a full glass of water with/without food, Drink at least eight 8oz glasses of water/day, Emphasize that med does not cure disease; not effective against HIV, and Need an alarm to wake pts up to take doses
Omeprazole (Prilosec)
-Inhibits gastric acid production in proton pump of gastric parietal cells in last phase of production and antimicrobial for H.Pylori
-Heartburn, GERD, Peptic Ulcers, H.Pylori
-SE: Long-term use has led to cancer of the stomach(don’t have a higher level of acid anymore), osteoporosis, and malabsorption of Mg and Vit. D, and Increase C.Diff development
-NC:Given automatically in hospital to prevent stress ulcers, Cant just quit-> can lead to overproduction of stomach acid, Causes Warafin action to be increased(bleeding) and Clopidogrel to be decreased(clotting), Take 1 hr before meals and on empty stomach(They have to eat 1 hr after taking med and the med doesnt work well if taken after meal);If malnoourished-> pt. Will need more med bc it is highly protein bound
Famotidine (Pepcid)
-GERD, Duodenal & Gastric Ulcers
-Decrease acid secretion in stomach by blocking the effect of histamine at H2 receptors-> allowing GI ulcers to heal
-NC:Not as potent as PPI, Works best after meals, Smoking reverses effect, and If famotidine and antiacids are prescribe-> give them at least 2 hrs apart to prevent decrease absorption of Pepcid
Psyllium mucilloid (Metamucil)
-Bulk-forming fiber laxative
-Safest type of laxative
-Can be used to treat diarrhea
-Absorbs water to increase bulk & Pass through body undigested (no systemic effects)
-Distended bowel to initiate to initiate reflex bowel activity by Stimulates peristalsis
-Slow-acting (12-72 hours)
-NC: Can take every single day but Must be followed with a large amount of fluid; Chewed/dry powder form may cause esophageal obstruction and/or fecal impaction (bezoar) bc Insoluble lump in GI tract of anything that causes an obstruction
Diphenoxylate HCL
-Antidiarrheal
-Acts on intestinal smooth muscle by Slowing intestinal motility, allowing time for fluid reabsorption and better stool formation
-Synthetic narcotic with an anticholinergic(Dosage not high enough for pain relief and Take too much = anticholinergic effects)
-Alcohol, barbituates, tranquilizers (CNS Depressants)
-Rarely used in hospital;Antidote = Narcan
Prochlorperzaine (Compazine)
-N/V, hiccups
-Blocks the dopamine in chemoreceptor trigger zone in brain stem
-SE: Extrapyramidal symptoms and CNS Depression
(Restlessness, drowsiness, insomnia, headache, anxiety, and confusion) and Anticholinergic effects(dry mouth, urinary retention)
Ondansetron (Zofran)
-N/V associated with cancer or chemo
-Prevents the stimulation of type 3 serotonin receptors in Chemo Receptor Trigger Zone(brain stem and vagal nerves).
-SE: Serotonin syndrome, Prolong QT interval(telementary)
-Much safer than compazine/promazine and doesn’t cause much symptoms
Simethicone
-Decrease gas production
-Defoaming action that alters the surface tension of gas bubbles, makes one bigger gas bubble
-Should be given after meals and at bedtime to increase its effectiveness
Magnesium hydroxide
-Saline Laxative and Attract or retain water in the intestinal ume, resulting in an increased intraluminal pressure that stimulates peristalsis
-SE: Overactive bowel and fluid/electrolyte imbalances
- NO pts with ABD pain (will worsen), bowel obstruction
-NC:Drink glass of water after admin to prevent dehydration and to promote a more rapid effect, May cause dehydration and electrolyte imbalances, and Not used regularly
Docusate sodium- (Colace)
-Stool softener that should be used for prevention not treatment
-Permits mixing of fats and fluids with fecal mass -> making it easier to pass stool
-Does not stimulate peristalsis
-Takes a couple of days to work
Albuterol
-Bronchodilator; Beta agonist (sympathomimetic)
-Beta stimulation (SNS) = bronchial dilation + RR rate & depth
-SE: tachy, tremors, Tachycardia, Tremors, palpitations, anxiety, headache, insomnia, GI symptoms
What are the contraindications with albuterol?
-Beta blockers = Propranolol (Inderal)
-Limit caffeine intake
Amiodarone
-atrial fib/flutter and life-threatening ventricular arrhythmias
-Therapeutic level 0.8 - 2.8 mcg/ml
-Close ICU/CVP, telemetry(QT intervals) monitoring
What are side effects on amiodarone?
-Pulmonary Toxicity, arrhythmia exacerbation, liver disease, (skin turns gray/blue in sun),
What are the contraindications with amiodarone?
NO: Digoxin/Warfarin
Aspirin
-NSAID
-Inflammation, fever, pain, anti-platelet
-Pts have to be off aspirin for 5-7 days so their platelets can clot properly
-Don’t use aspirin unless its a super high fever
-GI issues = enteric coated ASA & will digest in small intestine instead
-Give with milk or food to decrease GI upset and taking it on an empty stomach does not cause ulcers
What are the side effects of Aspirin?
S/S: Reye’s syndrome in children ( no baby aspirin to kids)
What are the contraindications to Aspirin?
-Peptic Ulcer Disease, Bleeding DIsorders, Children with Viral illness
Atorvastatin
-Inhibits HMG0-COA reductase
- High 1st past effect + protein bound
-S/S: rhabdomyolysis, myopathies
-NO liver disease, pregnancy, grapefruit juice
- Monitor Liver enzymes + CPK(3 weeks, 1 month, then 6 months)
- Take in evening bc cholesterol is dumped in blood stream by midnight
Atropine
a. Anticholinergic effects (“Can’t see, pee, spit, shit” & mydriasis, peripheral vasodilation (red face)
b. Max dose= 3 mg IV total (leads to bowel ischemia)
c. NO Myasthenia Gravis
d. Antidote: Neostigmine
-0.5 mg Q5 min until HR increases
Beclomethasone
-Inhaled glucocorticoid steroid
-NO: immunosuppression; systemic fungal infection
a. Dilates bronchial tree bc it reaches the lower lung
b. Toxicity (HTN)
d. Longer-term use= child stunt growth
Benztropine
-Anticholinergic used in Parkinsons
-Drives heart rate up
- Can’t see, pee, shit, spit
-blocks (acetylcholine)
Bethanechol
-GI Hypoactivity, GERD, Dry mouth, urinary retention,(non-obstructive)
-Parasympathomimetic= Activates rest &
digest
a. NO BPH or obstructions, pulmonary issues bc it stiffens the lungs, Parkinson’s, bradycardia, anticholinergic, atropine, epi
b. Monitor for Cholinergic Crisis
D- diaphoresis and diarrhea
U-urinary frequency
M-miosis
B-bronchospasms
E-emesis
L-lacrimation
i. S- salivation
Catopril
ACE inhibitor= blocks angiotensin 2 in the lungs and causes build-up bradykinin= cough
b. S/S:1st dose syncope, non-productive cough, neutropenia, angioedema
c. NO Pregnancy
d. Cough = switch to Angiotensin receptor blockers (works directly on blood vessels, no bradykinin build-up