Prototype Drug Flashcards
Amoxicillin
Broad spec; +/-, some anaerobic
oral, excreted renally
CWI
Beta-Lactamase Inhibitors
Agumentin (Clauvulanic acid + amoxicillin)
Unasyn (Sulbactam)
Zosyn (Tazobactam)
CWI
Agumentin: (Clauvulanic acid + amoxicillin)
covers gram +/- and some anaerobic organisms, beta-lactamase produced
AE: hypersensitivity, diarrhea
CWI
Cephalosporins
similar to penicillin so allergies
CWI
Cephalexin (Keflex)
Mainly active against gram + (skin flora)
AE: nausea, vomiting, diarrhea
CWI
1st gen
Ceftriaxone
IV or IM, some +/- coverage great CNS penetration AE: hypersensitivity, may increase bleeding tendencies Contra: avoid in neonates for billi CWI 3rd gen
Doxycycline
gram +/-, mycoplasma pneumniae, chlamydia, tick borne
AE: photo-toxicity, tooth discoloration, C. diff
DI: binds to cations (avoid milk), oral contraceptives
bacteriostatic broad
PSI
Azithromycin
reversibly binds to 50s ribosomonal subunits inhibiting protein synthesis
can cover atypical organisms: mycoplasma, legionella, chlamydia
AE: N/V, abdominal pain, from risk of QT prolongation of EKG
Metronidazole
Protozoa, anaerobic bacteria
MOA: inhibits nucleic acid synthesis= cell death
DI: Ethanol: facial flushing, vomiting, tachycardia
AE: nausea, headache, metallic taste, hypersensitivity reactions
Bacteriocidal but fairly narrow spectrum
Fluconazole
MOA: inhibition of CYP450 used for candida AE: N, headache, rash, abdominal pain, DI: inhibition of CYP3A4 Fungistatic
unfractionated heparin
anticoagulant
binds to/enhance the effects of anti-thrombin>inactivation of thrombin & factor Xa
IV, SQ
AE: bleeding, heparin-induced thrombocytopenia
Enoxaprin (lovenox)
anticoagulant: lower molecular weight heparin
enhance the effects of anti-thrombin>inactivation of factor Xa
SQ
AE: bleeding, heparin-induced thrombocytopenia
no protein binding, more predictable bioavailability
Warfarin (coumadin)
anticoagulant: Vitamin K antagonist
inhibits synthesis of Vit K dependent clotting factors (VII, IX, X & thrombin)
AE: bleeding
Antidote: (Vitamin K), be careful of veg consumption
Dabigatran (pradaxa)
anticoagulant: direct thrombin inhibitor
AE: bleeding, GI effects (pain, nausea, dyspepsia)
Rivaroxaban (Xarelto)
anticoagulant: direct factor Xa inhibitor
AE: bleeding
Ferrous Sulfate
nutritional sup for iron deficiency anemia
AE: GI effects: nausea, heartburn, CONSTIPATION, and diarrhea, can turn stools dark green or black
Can be toxic in large doses: treat with deferoxamine
DI: reduced absorption if taken with antacids; increased absorption if given with vita C but also increases AE
Iron Dextran
parenteral iron preparation for iron deficiency anemia
AE: anaphylactic reactions, hypotension, circulatory failure, cardiac arrest
cyanocobalamin
Vitamin B12 product
helps activate folic acid?
AE: generally safe, may see hypokalemia due to erythrocyte production
PO, IM, SC, intransally (NEVER IV), must be deep IM/SC
Folic Acid
Nutritional sup, essential for DNA synthesis
important for early pregnancy: neural tube defects
PO or IV
Erythropoietin (Procrit)
Erthropoietic growth factor
SC or IV
stimulate RBC formation (renal disease, oncologic/hematologic)
Lisinpril (Zestril)
ACE inhibitor
shown to slow progression of kidney injury in diabetes pt
AE: persistant cough, hyperkalemia, teratogenic, angioedema
Losartan (Cozaar)
Angiotensin Receptor Blocker
does not cause ACE cough
AE: teratogenic, angioedema, hyperkalemia,
Amlodipine
Calcium Channel Blocker
dilates blood vessels
can cause a reflexive tachycardia
AE: peripheral edema (problem if already HF edema)
Hydralazine
Vasodilator
PO/ IV
AE: tachycardia, can cause SLE
Metroprolol (Lopressor)
Beta Adrenergic Blocker (sympatholytics)
decreased cardiac output, suppress reflex tachycardia, reduces release of renin
AE: bradycardia, heart block, bronchoconstriction (be careful with asthma)
Labetalol (Trandate)
Combination Beta & Alpha Blocker
decreased cardiac output, suppress reflex tachycardia, reduces release of renin
AE: bradycardia, heart block, bronchoconstriction (be careful with asthma)
Nitrofuratoin (Macrobid, Macrodantin)
Nitrofuran Antibiotic
some gram +/-
bacteriostatic but can be bactericidal at high does
Good for UTI (only therapeutic in the urine)
Metabolism inhibitor (folate antagonist); damages DNA
avoid in patients with decreased kidney function; good for pregnancy
AE: brown urine, GI disturbances (N/V/D), pulmonary reactions, peripheral neuropathy, hepatotoxicity
Trimethoprim/Sulfanethoxazole (Bactrium, Septra)
Sulfonamide Antibiotic (SS or DS)
Good for UTI; broad spectrum
Inhibitors of folate synthesis and reduction; bacteriostatic
DI: warfarin (increased bleeding)
AE: Hyperkalemia, thrombocytopenia, neutropenia, megaloblastic anemia, Kernicterus, renal dysfunction, hypersensitivity reactions (Stevens-Johnson)
sodium bicarbonate
electrolyte
uses: metabolic acidosis, hyperkalemia (doesn’t fix it/bandaid)
AE: can be caustic to the vasculature; can cause hypokalemia, Metabolic alkalosis
potassium chloride
common choice
IV and PO
for hypokalemia but don’t make them hyper
AE: GI: N/V/D, abdominal discomfort, esophagitis. give with food!
IV can cause local irritation and pain
Monitor serum K levels, signs of hyperkale, IV site
Contraindications: monitor in renal dysfunction, and other meds that increase K
magnesium sulfate
IV
replacement
Uses: hypomagnesemia, preeclampsia and eclampsia, migraines, status asthmaticus
Mag: activates IC enzymes
binds mRNA to the ribosomes
helps skeletal muscle contractility and blood coag.
calcium chloride
1g=3g of gluconate (more potent/ elemental Ca)
more caustic to the vasculature, admin centrally
if give too fast, kidneys will dump it
dextrose 50% injection
treatment for hyperkalemia with IR: shifts K back into cells (doesn’t get rid of it)
albuterol
Short acting B2 agonist
binds to B2 in lungs: bronchodilation
Binds to B2: activates adenylate cyclase which then stimulates production of cAMP
cAMP is used by the Na-K ATPase pump to move intracellularly
AE: tachycardia, only temp decrease in K
dextrose 50% injection
treatment for hyperkalemia with IR: shifts K back into cells (doesn’t get rid of it)
used for hypoglycemia and hyperkalemia
insulin, regular
treatment for hyperkalemia with D50%: shifts k back into cells (doesn’t get rid of it)
via NA-K ATPase pump in cell membrane
IV or SC, diabetes and hyperkalemia; essential for cellular uptake of glucose
monitor blood sugar
kayexalate
sodium polystyrene Resin that exchanges Na for K in the gut then you poop it out. PO or rectally takes a few hours- not for emergencies AE: intestinal necrosis and GI effects
