Pharmacology Exam 1 drugs // Cramberry: Create & study flash cards online

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Penicillin G Mech of action Weaken bacterial cell wall-- cell death

Penicillin G Side effects Allergy/anaphlyaxis; renal impairment; hyperkalemia; dysrhythmias

Penicillin G Therapeutic use Gram + bacteria; preferred for gram + bacilli; drug if choice for syphilis; prophylaxis of bacterial endocarditis

Penicillin G-- Pt teaching don't take with aminoglycosides!!

Ampicillin-- Therapeutic Use useful against infections caused by Enterococcus faecalis, Proteus mirabilis, E. coli, Salmonella, Shigella, and H. influenzae

Ampicillin--key side effects rash and diarrhea; decreases efficacy of oral contraceptives; for those w/renal impairment, dosage should be reduced

Amoxicillin-- Why is it better than ampicillin? less diarrhea than ampicillin b/c less amoxicillin remains unabsorbed in the intestine

Ticarcillin--therapeutic use primary indication is infection w/ P. aeruginosa (usually combined w/aminoglycoside)

Ticarcillin--side effects sodium overload; bleeding

Piperacillin--therapeutic use (think ticarcillin) active against P. aeruginosa (its principal target)

ALL PENICILLINS--Mechanism of action Weaken the bacterial wall causing cell lysis!!

These 2 drugs are active against P. aeruginosa Ticarcillin & Piperacillin

This drug is used for prophylaxis of bacterial endocarditis Penicillin G

This drug causes sodium overload and bleeding Ticarcillin

Don't take this drug with aminoglycosides...or else!! Penicillin G

ALL cephalosporins-- Mechanism of Action Weaken bacterial cell wall--cell lysis!!!

First generation cephalosporins (Cefazolin) are highly active against... Gram (+) bacteria

This generation of cephalosporins is highly active against gram-negative aerobes.. third generation (ceftriaxone)

Side effects for Cephalosporins allergic/hypersensitivity/anaphylaxis; bleeding; thrombophlebitis; pain w/IM injection; cross allergy to penicillins; associated w/pseudomembraneous colitis

Pt teaching for Cephalosporins instruct client to observe for & to report signs of allergic rxn (rash, hives, etc); use caution if used w/other drugs that promote bleeding; no alcohol!; pt must complete full course of therapy; take with food; store oral cephalosporins in fridge

Therapeutic uses for second generation Cephalosporins (Cefotetan) certain prototypes used against pneumonia caused by Haemophilus influenzae, Klebsiella, pneumonococci, and staph; abdominal and pelvic infections

Monobactams--Mechanism of action Weaken bacterial cell wall--cell lysis!

Aztreonam--Therapeutic uses active only against gram-negative aerobic bacteria; highly resistant to beta-lactamases

T or F: Vancomycin is a tetracycline FALSE-- Vancomycin is a beta lactam!

Aztreonam- Side effects Generally well tolerated; pain & thrombophlebitis @ site of injection

Drug that is a Monobactam Aztreonam

Imipenem- Therapeutic use gram-positive cocci, gram-negative cocci, gram-negative bacilli, & anaerobic bacteria; urinary tract infections

Imipenem is under this category of beta lactams Carbapenems

Imipenem- Side effects /hypersensitivity; GI symptoms (diarrhea, vomiting, etc); suprainfection

Vancomycin-- Mechanism of action Weaken bacterial cell wall--cell lysis!

Vancomycin- therapeutic use reserved for serious infections; drug of choice for MRSA or Staph. epidermis; alternative to penicillins and cephalosporins to treat severe infections (remember: so 'no' to 'vanco')

Vancomycin- Key side effects Ototoxicity; infusion rxn (rashes, flushing, etc); thrombophlebitis

Aztreonam- mechanism of action Weakening of bacterial cell wall- cell dies!!! x.x

Mechanism of action for Doxycycline Bacteriostatic inhibitor of protein synthesis (doesn't kill cell; just slows it down)

Doxycycline-therapeutic uses first line drug for Lyme disease, anthrax, chlamydial infections, and sexually acquired proctitis; topical formulation used for periodontal disease; low-dose oral formulation used for acne

Doxycycline- key side effects GI irritation; yellow/brown tooth discoloration &/or hypoplasia of teeth enamel; suprainfection; hepatotoxicity; renal toxicity; photosensivity

This drug is a tetracycline Doxycycline!

Can doxycycline be taken with food? Yes

Tigecycline- therapeutic use intra-abdominal infections & complicated skin infections that need broad empiric coverage

Tigecycline- mechanism of action Bacteriostatic inhibitor of protein synthesis

Tigecycline- key side effects nausea; vomiting; photosensitivity; may stain developing teeth; suprainfection

Tigecycline is a drug under the category of _____. Glycylcyclines

Therapeutic uses of Erythromycin infections in clients w/penicillin allergy; pneumonia caused by Legionnaire’s Disease, whooping cough; treatment of choice for diphtheria

Erythromycin- key side effects GI discomfort; Thrombophlebitis; QT prolongation and sudden cardiac death

Erythromycin- mechanism of action bacteriostatic inhibitor of protein synthesis

Erythromycin, Azithromycin, & Clarithromycin are all.... Macrolides!

Therapeutic uses for Azithromycin respiratory tract infections; cholera; chancroid; otitis media; uncomplicated infections of the skin; disseminated M. avium complex disease; infections caused by Chlamydia trachomatis (drug of choice)

Key side effects for Azithromycin diarrhea; nausea; abdominal pain

This drug must NOT be taken with aluminum or magnesium containing antacids Azithromycin

Clarithromycin- mechanism of action Bacteriostatic inhibitor of protein synthesis (doesn't kill cell; just slows it down)

Clarithromycin- therapeutic effects (similar to azithromycin) respiratory tract infections; uncomplicated infections of the skin; prevention of disseminated Mycobacterium avium complex infections in pts w/ advanced HIV; used for H. pylori infections & as substitute for penicillin G in allergy patients

Clarithromycin- key side effects diarrhea; nausea; distorted taste; may prolong QT interval; can inhibit hepatic metabolism of warfarin, carbamazepine, and theophylline, dosages of these drugs may need to be reduced

This drug is the only Ketolide Telethromycin

Therapeutic uses for Telethromycin similar to that of macrolides, w/one important exception: significant activity against Strep. pneumoniae that are penicillin & macrolide resistant; also pneumonia caused by M. catarrhalis, Chlamydia pneumoniae or Mycoplasma pneumoniae

Key side effects of Telethromycin severe injury to the liver; GI disturbances (diarrhea, nausea, vomiting, and loose stools); in pts w/myasthenia gravis, makes muscle weakness worse (contraindicated); visual disturbances; prolong the QT interval

Therapeutic uses for Clindamycin effective against gram-positive cocci, widely used for penicillin alternative; drug used primarily for anaerobic infections outside the CNS (doesn’t cross BBB); drug of choice for severe group A streptococcal infection and for gas gangrene; preferred drug for abdominal & pelvic infections cause by B. fragilis

Key side effects of clindamycin antibiotic-associated pseudomembraneous colitis (AAPMC), cause is suprainfection of the bowel with C. difficile, an anaerobic gram(+) bacillus; diarrhea; abdominal pain; fever; leukocytosis; stools often contain mucus and blood; hypersensitivity rxns; hepatotoxicity; blood dyscrasias (rare)

T or F: Clindamycin weakens bacterial cell wall. FALSE--Clindamycin inhibits protein synthesis.

Linezolid- Therapeutic uses vancomycin-resistant enterococci (VRE); MRSA

Side effects of Linezolid diarrhea; nausea; headache; reversible myelosuppression; neuropathy (rare)

T or F: Linezolid inhibits protein synthesis. TRUE!!

Chloramphenicol- Mechanism of action Bacteriostatic Inhibitor of protein synthesis

T or F: Chloramphenicol is widely used today. FALSE- Use of Cloramphenicol dropped drastically after it was found it caused fatal aplastic anemia.

Chloramphenicol- therapeutic uses only used for life-threatening infections for which safer drugs are contraindicated or ineffective

Side effects of Chloramphenicol Gray syndrome; reversible bone marrow suppression; aplastic anemia; GI effects; neurologic effects

ALL Aminoglycosides-- Mechanism of action Bactericidal Inhibitors of Protein Synthesis

Therapeutic uses of Gentamycin used primarily to treat serious infxns caused by aerobic gram(-) bacilli; primary targets are Pseudomonas aeruginosa @ the Enterobacteriaceae; can be combined w/ Vancomycin or penicillin to treat serious infections caused by certain gram(+) cocci (Enterococcus species, some streptococci, and Staph. aureus)

Ciprofloxacin- mechanism of action bactericidal as a result of inhibition of the enzyme necessary for DNA replication

ciprofloxacin is a _______ flouroquinolone

Ciprofloxacin-- therapeutic uses infections of the respiratory tract, urinary tract, GI tract, bones, joints, skin, and soft tissues; preferred drug for preventing anthrax in people who have inhaled anthrax spores; pediatric uses are treatment of complicated urinary tract and kidney infections cause by E. coli, and postexposure tx of inhalational anthrax

Ciprofloxacin- key side effects Achilles tendon rupture; GI rxns; CNS effects (dizziness, headache, etc); suprainfection (thrush, vaginal yst infxn); risk of phototoxicity

Ciprofloxacin- pt teaching instruct pts to wear protection when outdoors; pts should refrain from exercise due to tendon rupture; complete full prescribed course of therapy

Which drug should you caution patients to wear protection when outdoors? Ciprofloxacin

Mechanism of action of Flouroquinolones Bactericidal as a result of inhibition of the enzyme necessary for DNA replication

This drug is a flouroquinolone ciprofloxacin

Gentamycin, Tobramycin, and Amikacin are all... aminoglycosides

Mechanism of all aminoglycosides! Bactericidal inhibitors of protein synthesis!

A patient taking amikacin would need to be monitored for this key sid effect.. otoxicity

Rifampin--mechanism of action suppresses RNA synthesis, and consequently protein synthesis (disrupt DNA fxn)

Rifampin- therapeutic uses tuberculosis; drug of choice for pulmonary TB and disseminated disease; leprosy (bactericidal to M. leprae)

Side effects of Sulfamethoxazole/Trimethoprim-- (SMZ)/(TMP) hypersensitivity including Stevens-Johnson syndrome; blood dyscrasias; crystalluria; kernicterus

Side effects of Sulfonamides and Sulfamethoxazole/Trimethoprim Kernictus & Crystalluria