TEST: Prescr Meds (Antibiotics) Flashcards
Isoniazid: names & use
Isoniazid (Isonicotinic acid hydrazine, INH, laniazid, nydrazid).
Antitubercular
Isoniazid: avoid
tyramine & histamine
Isoniazid: tyramine
Avoid Swiss or Cheshire cheeses, tuna, skipjack, and sardinella and tyramine containing foods as consumption may cause itching, redness, flushing and burning of the skin; tachycardia and palpitations; sweating, chills, and clammy feeling; headache and light-headedness; hypertension
Isoniazid: histamine
Avoid histamine containing foods (fermented foods, alcohol, cheese, dried fruits, anchovy, sardine) as adverse effects such as diarrhea, headache, hypotension, flushing, sweating, and itching may occur.
Isoniazid: B-6
•INH interferes w/ B-6 metabolism
•INH complexes with pyridoxal phosphate (PLP) the active coenzyme form of B-6, and the excretion of both is increased in the urine
Isoniazid: pyridoxial kinase
Pyridoxal kinase, the enzyme needed to convert pyridoxal to PLP (pyridoxal phosphate) is inhibited by INH
Isoniazid: PLP enzymes
INH competitively inhibits some PLP enzymes in the brain, such as gamma aminobutyric acid (GABA). Lack of GABA may cause seizures
Isoniazid: Prophylactic use
- Prophylactic use of pyridoxine hydrochloride (PN-HCL) supplements of 50-100 mg/day (some cases 400 mg/day) are recommended to decrease risk of peripheral neuropathy and mental changes.
- to control symptoms, use minimum dose vit B-6 since it promotes drug excretion.
Isoniazid: niacin
PLP converts tryptophan to niacin and cases of pellegra-like symptoms have been reported. 200-400 mg/day of niacin for one month generally results in remission of symptoms.
Isoniazid: vit B-12
•Vitamin B-12 deficiency has been reported with paresthesias, tingling, burning, and numbness of the hands and feet.
Isozianid: B vitamins
Slow acetylators, adolescents, malnourished, and diabetic pts are at increased risk of B vitamin deficiencies.
Prednisone (deltasone): type
Glucocorticoids [all end in -sone or -solone]
Glucocorticoids: use
- Immunosuppressive
- Antiinflammatory
- Hormone replacement for adrenocortical insufficiency
- Management of cerebral edema or acute spinal cord injury
- Adjunctive therapy for hypercalcemia
Glucocorticoids: herbs
•Betal nut may counteract med’s effects.
• ginseng may increase risk of toxicity.
•real licorice may increase blood med levels and high blood pressure.
Glucocorticoids: implications
- Most implications are for pts on long term therapy (not short-term) for immunosuppression or anti inflammation
- Side effects are increased at high dosages and in patients with hypoalbuminemia
Glucocorticoids: hyper/hypos
•Hypocalcemia and osteomalacia due to anti vitamin D activity. Rec Ca supp
•Hyperlipidemia
•Protein catabolism w/ muscle wasting & fat is redistributed to trunk of body
•Hyperphagia and weight gain
•Hyperglycemia. Wt management & control of carb and fat intake w/ increased protein intake may be needed
Ciprofloxacin (ciloxan, Cipro): type
fluoroquinolones.
all end in -cin.
Fluoroquinolones: use
Anti-infective, antibiotic
Fluoroquinolones: herbs
Cipro availability may be decreased by dandelion, fennel, and khat
Fluoroquinolones: zinc salts
also decrease absorption of these meds
tetracycline (panmycin): type & use
Tetracyclines
Anti-infective, antibiotic
Fluoroquinolones and Tetracyclines: implications
Calcium, magnesium, iron, and aluminum will form chelates with fluoroquinolones reducing the absorption of both the med and the mineral.
Fluoroquinolones and Tetracyclines: should not be taken
3 hrs before or 2 hrs after foods, medications, or supps containing divalent or trivalent cations or sodium bicarbonate
