NURS 5334 Pharmacology Quiz 1

PCN drug-drug interactions - -aminoglycosides -bacteriostatic antibiotics -probenecid Cephalosporin Generation 1 - -cephalexin -cephazolin -cephadoxil Cephalosporin and PCN - Cross allergy w/PCN Carbapenems - not active against MRSA Vancomycin treats - gram positive Vancomycin AE - ototoxicity, nephrotoxicity, red man syndrome Vancomycin main danger - Hosp/vent. pneumonia in pt w/ Crcl less than 50 as it increases mortality Monobactams treats - gram negative aerobic Fosfomycin treats - enterococcus and Ecoli Aminoglycosides treat - gram negative bacilli Aminoglycosides adverse effects - ototoxicity and nephrotoxicity aminoglycosides peak and trough - Peak: 30 min after IV or IM Trough: divided- before next dose, daily-1 hr before next dose (value should be low: like zero) Sulfonamides MOA - inhibit folic acid synthesis UTI drugs - 1) TMP/SMZ and nitrofurantoin 2) levofloxacin & ciprofloxacin UTI in pregnancy - TMP/SMZ, Cipro, Levo, augmentin, cephalexin recurrent UTI prophylaxis - TMP Recurrent UTI other tx - SMZ 3 x week for 6 months; TMP or nitro at bedtime for 6 mos. Acute Bact Prostatitis Tx - Floxacins Tetracycline adverse effects - -Yellow/brown discoloration of teeth -hepatotoxicity -photosensitivity -GI -suprainfection/superinfection tetracycline absorption is impaired by - -magnesium laxative -antacids -Calcium -iron sup. -milk tetracycline treats - -lyme dx -anthrax -helicobacter pylori -mycoplasma Linezolid treats - VRE and MRSA Telithromycin BBW - muscle weakness w/myasthenia gravis Dalfopristin/Quinupristin BBW - reserve only for infection when not responding to vanco. to delay resistance Chloramphenicol BBW - fatal aplastic anemia Retapamulin and mupirocin tx - topical treatment for impetigo Mupirocin (topical) - MRSA in nostrils TB treatment - RIPE (rifampin, isoniazid, pyrazinamide, ethambutol); rifapentine and rifabutin TB treatment is effective when - no mycobacteria in sputum and no colonies present in culture TB second line injection drugs - Amikacin & Capreomycin MDR-TB - resistant to isoniazid and rifampin XDR-TB - resistant not only to isoniazid and rifampin but also to any fluoroquinolone and at least one of inject. second line drugs TB promoting resistance - Daily observed therapy (DOT), intermittent dosing (2-3 times/week) Tx of latent TB - INH (isoniazid) daily for 9 months OR INH + Rifampentin for 3 months TB Evaluation - 3 modes: -bacterial eval of sputum -clinical eval. -chest radiographs INH adverse effects - peripheral neuropathy (vit. b6, pyridoxine), hepatotoxicity, anemia, optic neuritis Rifampin adverse effects - -Causes discoloration of bodily fluids -GI -cutaneous rxn -hepatotoxic/hepatitis Rifampin drug interactions - -Induces P450; can hasten drug metabolism -Oral contraceptives -Warfarin -Drugs for HIV infection Levofloxacin, Moxifloxacin - -second line drugs for TB Levofloxacin, Moxifloxacin adverse effects - -GI -Tendon rupture Capreomycin Adverse Effects - nephrotoxicity and ototoxicity; BBW: disturbed balance Bedaquiline BBW - hepatotoxicity Fluroquinolones: Ciprofloxacin AE - -tendon rupture -GI -CNS -increased risk of CDI -BBW: myasthenia gravis ^ muscle weakness Fluroquinolones absortion reduced by - -aluminum antacid -magnesium antacid -iron & zinc salts -Sulcralfate -milk & dairy products Metronidazole BBW - has been shown to be carcinogenic in mice Fidaxomicin treats - diarrhea w/C. diff Bacitracin and Polymyxin B treats - Topical treatment for bacterial dx Amphotericin B BBW - infusion rxn & nephrotoxicity; only use in life threatening infection Itraconazole BBW - Don't give with HF or Ventricular disfunction Ketoconazole BBW - Fatal hepatic necrosis and ^ QT Flucocytosine BBW - Don't give to pts w/renal impairment Ringworm of the scalp - tinea capitis Ringworm of the feet - tinea pedis