Immune, Fungal, Cancer

Penicillin G

Pharm: Penicillin, cell wall inhibitorTherapeutic: antibacterial

Augmentin, Unasyn, Zosyn

Compound drugs consisting of a broad spectrum antibiotic and beta lactamase enzyme inhibitor --> inhibits beta lactamases

Cefazolin (Ancef, Kefzol)

Pharm: 1st gen cephalosporin, cell wall inhibitorTherapeutic: antibacterial

Tetracycline (Sumycin)

Pharm: Tetracycline, protein synthesis inhibitorTherapeutic: Antibacterial

Erythromycin (ERYC, Erythrocin)

Pharm: macrolide, protein synthesis inhibitorTherapeutic: Antibacterial

Gentamicin (Garamycin)

Pharm: aminoglycoside, protein synthesis inhibitorTherapeutic: antibacterial

Vancomycin

Pharm: GlycoproteinTherapeutic: Antibacterial

Ciprofloxacin (Cipro)

Pharm: Fluoroquinolone, bacterial DNA inhibitortherapeutic: antibacterial

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

Pharm: sulfonamide, FA inhibitorTherapeutic: antibacterial

Isoniazid (INH)

Pharm: mycotic inhibitorTherapeutic: antituberculosis

Amphotericin B (Fungizone)

Pharm: polyeneTherapeutic: antifungal (systemic)

Fluconazole (Diflucan)

Pharm: inhibitor of fungal cell membrane synthesisTherapeutic: antifungal

Nystatin (Mycostatin, Nystop)

Pharm: PolyeneTherapeutic: antifungal (superficial)

Chloroquine (Aralen)

Pharm: heme complexing agentTherapeutic: antimalarial

Metronidazole (Flagyl)

Pharm: nucleic acid synthesis disruptorTherapeutic: antibacterial + antiprotozoal

Zidovudine (Retrovir, AZT)

Pharm: NRTITherapeutic: Antiretroviral

Efavirenz (Sustiva)

Pharm: NNRTITherapeutic: Antiretroviral

Lopinavir w/ Ritonavir (Kaletra)

Pharm: protease inhibitorTherapeutic: Antiretroviral

Maraviroc (Selzentry)

Entry inhibitor - CRR5 antagonist

Dolutegravir (DTG, Tivicay)

Pharm: Integrase inhibitorTherapeutic: Antiviral

Acyclovir (Zovirax)

Pharm: Nucleoside analogTherapeutic: Antiherpes

Zanamivir (Relenza) and oseltamivir (Tamiflu)

Neuraminidase Inhibitor

Cyclophosphamide (Cytoxan)

Pharm: Alkylating agentTherapeutic: Antineoplastic

Methotrexate (MTX, Rheumatrex)

Pharm: antimetabolite, folic acid analogTherapeutic: Antineoplastic

Doxorubicin

Pharm: Antitumor antibioticTherapeutic: Antineoplastic

Vincristine (Oncovin)

Pharm: vinca alkaloid, natural productTherapeutic: antineoplastic

Tamoxifen

Pharm: Estrogen Receptor AntagonistTherapeutic: Antineoplastic

Penicillin G

MOA: Beta lactam ring inhibits bacterial cell wall synthesis

Augmentin, Unasyn, Zosyn

MOA: Overcomes resistance in bacteria that secrete b-lactamase

Cefazolin (Ancef, Kefzol)

MOA: Bactericidal, inhibits cell wall synthesis

Tetracycline (Sumycin)

MOA: Inhibits bacterial protein synthesis

Erythromycin (ERYC, Erythrocin)

MOA: Inhibits bacterial protein synthesis

Gentamicin (Garamycin)

MOA: Inhibits bacterial protein synthesis

Ciprofloxacin (Cipro)

MOA: Bactericidal - inhibits enzymes for bacterial DNA synthesis

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

MOA: Inhibit synthesis of folic acid/folate

Isoniazid (INH)

MOA: Inhibits mycolic acids

Amphotericin B (Fungizone)

MOA: Binds to ergosterol in fungal cell membrane causing them to become leaky impairing growth

Fluconazole (Diflucan)

MOA: Interferes with synthesis of ergosterol

Nystatin (Mycostatin, Nystop)

MOA: binds to ergosterol in fungal cell membrane allowing leakage of intracellular contents

Chloroquine (Aralen)

MOA: prevent metabolism of heme, which then builds to toxic levels within parasite

Metronidazole (Flagyl)

MOA: Acts as antiprotozoal drug that also has antibiotic activity against anaerobic bacteria

Zidovudine (Retrovir, AZT)

MOA: Virus mistakenly uses zidovudine as nucleoside, thus creating defective DNA strand, slows growth of HIV

Efavirenz (Sustiva)

MOA: Targets enzyme needed for reverse transcriptase; Binds directly to reverse transcriptase, disrupting enzyme's active site

Lopinavir w/ Ritonavir (Kaletra)

MOA: Inhibits HIV protease via chemical scissors

Maraviroc (Selzentry)

MOA: Blocks CCR5 - prevents binding and thus entry (CRR receptor is required)

Dolutegravir (DTG, Tivicay)

MOA: blocks stand transfer of retroviral DNA which interrupts HIV replication cycle

Acyclovir (Zovirax)

MOA: prevents viral DNA synthesis

Zanamivir (Relenza) and oseltamivir (Tamiflu)

MOA: Block neuraminidase

Cyclophosphamide (Cytoxan)

MOA: changes structure of DNA in cancer cells

Methotrexate (MTX, Rheumatrex)

MOA: disrupts cancer cell pathways, blocks folic acid synthesis

Doxorubicin

MOA: inhibits cell growth through cytotoxicity

Vincristine (Oncovin)

MOA: kills cancer cells in M- phase

Tamoxifen

MOA: blocks estrogen on breast cancer cells

Penicillin G

Indicated: Strep, Pneumonia, Staph

Augmentin, Unasyn, Zosyn

Indicated: Synergistic effect

Cefazolin (Ancef, Kefzol)

Indicated: gram + bacteria, respiratory tract infection, UTI, skin, biliary tract, bones, joints (NOT effective for MRSA)

Tetracycline (Sumycin)

Indicated: BS against gram + and - bacteria - Rocky mountain spotted fever, typhus, cholera, lyme disease, peptic ulcers from H.Pylori and chlamydial infections

Erythromycin (ERYC, Erythrocin)

Indicated: mostly gram + bacteria, gonorrhea, skin infections

Gentamicin (Garamycin)

Indicated: MRSA, severe UTI, respiratory, nervous, or GI infections, mostly gram - bacteria

Vancomycin

Indicated: C-diff, resistant staph aureus, surgical prophylaxis in PCN allergy pts with hx of MRSA

Ciprofloxacin (Cipro)

Indicated: UTI, pneumonia, skin, bone, and joint infections

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

Indicated: UTI, pneumocystis carinii in AIDs pts, lower respiratory tract infections, otitis media, prostatitis, gonorrhea

Isoniazid (INH)

Indicated: TB, chemoprophylaxis

Amphotericin B (Fungizone)

Indicated: systemic fungal infections

Fluconazole (Diflucan)

Indicated: fungal infections in CNS, bone, eyes, urinary tract, respiratory tract, prophylaxis of fungal infections in AIDS and immunosuppressed pts

Nystatin (Mycostatin, Nystop)

Indicated: Candida infections of intestines, vagina, skin, mouth

Chloroquine (Aralen)

Indicated: malaria treatment and prophylaxis, fever

Metronidazole (Flagyl)

Indicated: amebiasis (parasitic infection of the intestines/colon)

Zidovudine (Retrovir, AZT)

Indicated: Combo therapy for HIV

Efavirenz (Sustiva)

Indicated: Combo therapy for HIV

Lopinavir w/ Ritonavir (Kaletra)

Indicated: Combo therapy for HIV - preferred drug for initial treatment

Maraviroc (Selzentry)

Indicated: HIV

Dolutegravir (DTG, Tivicay)

Indicated: HIV

Acyclovir (Zovirax)

Indicated: Herpes

Zanamivir (Relenza) and oseltamivir (Tamiflu)

Indicated: Influenza n/v/d, HA, abdominal

Cyclophosphamide (Cytoxan)

Indicated: Hodgkin's lymphoma, multiple myeloma, breast and ovarian cancer

Methotrexate (MTX, Rheumatrex)

Indicated: choriocarcinoma, osteogenic sarcoma, leukemias, head & neck, breast, lung ca

Doxorubicin

Indicated: Solid tumors

Vincristine (Oncovin)

Indicated: Hodgkins and non-Hodgkin's lymphoma, bladder and breast ca

Tamoxifen

Indicated: reproductive related cancers

Penicillin G

S/E: n/v/d, hypersensitivity, allergies

Cefazolin (Ancef, Kefzol)

S/E: similar to PCN + superinfection and C-diff

Tetracycline (Sumycin)

S/E: n/v/d, abdominal cramp, gas, phototoxicity

Erythromycin (ERYC, Erythrocin)

S/E: superinfections, n/v/d, abdominal pain

Gentamicin (Garamycin)

S/E: rash, n/v, fatigue

Vancomycin

S/E: Red man syndrome, SJS, hearing loss, renal issues, phlebitis

Ciprofloxacin (Cipro)

S/E: n/v/d

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

S/E: Crystalluria

Isoniazid (INH)

S/E: Hepatotoxicity, neurotoxicity

Amphotericin B (Fungizone)

S/E: Phlebitis, nephrotoxicity, cardiac arrest, ototoxicity

Fluconazole (Diflucan)

S/E: mostly well tolerated, rare hepatotoxicity

Nystatin (Mycostatin, Nystop)

S/E: Topical: minor skin irritation, dermatitis. Oral: n/v/d

Chloroquine (Aralen)

S/E: CNS, cardiovascular toxicity, retinal toxicity

Metronidazole (Flagyl)

S/E: Metallic taste, rare myelosuppression

Zidovudine (Retrovir, AZT)

S/E: blood toxicity, anemia, neutropenia, anorexia, n/d, fatigue, generalized weakness

Efavirenz (Sustiva)

S/E: general well tolerated - but can see sleep disorders, delusions, dizziness, rash, hepatotoxicity

Lopinavir w/ Ritonavir (Kaletra)

S/E: n/v/d, dyspepsia, fatigue, HA - hyperglycemia, lipodystrophy, pancreatitis

Maraviroc (Selzentry)

S/E: cough, dizziness, rash, orthostatic hypotension, fever

Dolutegravir (DTG, Tivicay)

S/E: insomnia, fatigue, headache/hypersensitivity , hepatotoxicity, high triglycerides, neuropsychiatric events - depression, suicidal ideations, anxiety

Acyclovir (Zovirax)

S/E: nephro and neurotoxicity possible when IV

Zanamivir (Relenza) and oseltamivir (Tamiflu)

S/E: n/v/d, HA, abdominal pain, neuropsych, SJS, renal failure

Cyclophosphamide (Cytoxan)

S/E: myelosuppression, thrombocytopenia, n/v, anorexia, diarrhea, alopecia, hemorrhagic cystitis, n/v

Methotrexate (MTX, Rheumatrex)

S/E: myelosuppression, hemorrhage and bruising, low PLTs, n/v/d, GI ulcers and bleeding

Doxorubicin

S/E: red colored urine, cardiotoxicity , myelosuppression, low blood counts, n/v

Vincristine (Oncovin)

S/E: nervous system toxicity, paresthesia, peripheral neuropathy, muscular weakness, loss of neural reflexes, pain, paralytic ileus, constipation, alopecia, bronchospasm

Tamoxifen

S/E: less cytotoxic than other cancer drugs, n/v, hot flashes, fluid retention, vaginal discharge

Penicillin G

ROUTE OF ADMIN: IV, IM

Cefazolin (Ancef, Kefzol)

ROUTE OF ADMIN: IV, IM

Tetracycline (Sumycin)

ROUTE OF ADMIN: PO, topical, IM, IV

Erythromycin (ERYC, Erythrocin)

ROUTE OF ADMIN: PO, IV, rectal

Gentamicin (Garamycin)

ROUTE OF ADMIN: IV, IM

Ciprofloxacin (Cipro)

ROUTE OF ADMIN: PO, oral, IV, eye and ear drops

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

ROUTE OF ADMIN: PO, IV

Isoniazid (INH)

ROUTE OF ADMIN: PO, IM

Nystatin (Mycostatin, Nystop)

ROUTE OF ADMIN: PO, topical

Metronidazole (Flagyl)

ROUTE OF ADMIN: PO, IV

Acyclovir (Zovirax)

ROUTE OF ADMIN: Topical, PO, IV

Cyclophosphamide (Cytoxan)

ROUTE OF ADMIN: PO, IV

Penicillin G

CAUTIONS/CONTRAINDICATIONS: severe renal disease

Augmentin, Unasyn, Zosyn

CAUTIONS/CONTRAINDICATIONS: geriatrics or pt with renal impairment, may decrease effectiveness of PO contraceptives, acidic or grapefruit juice, don't mix with aminoglycoside

Cefazolin (Ancef, Kefzol)

CAUTIONS/CONTRAINDICATIONS: pts who are allergic to PCN

Tetracycline (Sumycin)

CAUTIONS/CONTRAINDICATIONS: Causes photosensitivity. Toxic to fetus - avoid pregnancy, dairy, iron, Mg, antacid

Erythromycin (ERYC, Erythrocin)

CAUTIONS/CONTRAINDICATIONS: antacids, bradycardia, hypokalemia, hypomagnesaemia, hepatic or renal dysfunction, lactation

Gentamicin (Garamycin)

CAUTIONS/CONTRAINDICATIONS: otoxic, nephrotoxic, neuromuscular blockade effects

Vancomycin

CAUTIONS/CONTRAINDICATIONS: otoxic, nephrotoxic, avoid Dramamine and renal excreted drugs

Ciprofloxacin (Cipro)

CAUTIONS/CONTRAINDICATIONS: antacids, mineral supplements

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

CAUTIONS/CONTRAINDICATIONS: severe renal and liver disease

Isoniazid (INH)

CAUTIONS/CONTRAINDICATIONS: alcohol, antacids, pts with severe hepatic disease

Amphotericin B (Fungizone)

CAUTIONS/CONTRAINDICATIONS: immunocompromised pts

Tamoxifen

CAUTIONS/CONTRAINDICATIONS: fertility sometimes affected

Fluconazole (Diflucan)

CAUTIONS/CONTRAINDICATIONS: alcohol

Nystatin (Mycostatin, Nystop)

CAUTIONS/CONTRAINDICATIONS: not use superficial antifungals intravaginally during pregnancy, caution with lactating pts

Metronidazole (Flagyl)

CAUTIONS/CONTRAINDICATIONS: 1st trimester of pregnancy, alcohol (disulfiram reaction)

Lopinavir w/ Ritonavir (Kaletra)

CAUTIONS/CONTRAINDICATIONS: No driving or hazardous activities, other drugs

Dolutegravir (DTG, Tivicay)

CAUTIONS/CONTRAINDICATIONS: pts with CDK and hepatic impairment

Cyclophosphamide (Cytoxan)

CAUTIONS/CONTRAINDICATIONS: Avoid sun&crowds, hepatic or renal impairment, steroid therapy, leukopenia, thrombocytopenia

Methotrexate (MTX, Rheumatrex)

CAUTIONS/CONTRAINDICATIONS: C/I in pregnancy and must avoid for at least 6 months after treatment, avoid sun, avoid inhaling particles

Penicillin G

NURSING CONSIDERATIONS: poor PO absorption

Augmentin, Unasyn, Zosyn

NURSING CONSIDERATIONS: Increase fluids

Cefazolin (Ancef, Kefzol)

NURSING CONSIDERATIONS: tx = 10 days, IV given over 30-35 mins, Cef (Ceph)-The Giant

Tetracycline (Sumycin)

NURSING CONSIDERATIONS: Full glass of H20, short half life requires 4x/day dosing, store away from light, monitor BUN/ALT/AST

Erythromycin (ERYC, Erythrocin)

NURSING CONSIDERATIONS: 5-7 day tx perio

Gentamicin (Garamycin)

NURSING CONSIDERATIONS: Monitor BUN, I&O, Cr, "I can't see, I can't hear, I can't pee", it's a "SIN" to give Gentamicin".

Vancomycin

NURSING CONSIDERATIONS: monitor peaks and troughs!

Ciprofloxacin (Cipro)

NURSING CONSIDERATIONS: Take with food

Trimethoprim-Sulfamethoxazole (TMP-SMZ)

NURSING CONSIDERATIONS: take with H20, monitor BUN and liver functions, drink plenty of H20

Isoniazid (INH)

NURSING CONSIDERATIONS: 6 months tx period (2 intensive, 4 continuation phase), multidrug therapy common, take on empty stomach 1 hr after or 2 hrs before meals, monitor liver enzymes, monitor for s/s of neurotoxicity, Rifampin - reddish orange body fluids

Amphotericin B (Fungizone)

NURSING CONSIDERATIONS: infuse slowly to prevent cardiac collapse, premedicate w/ APAP, corticosteroids, and/or antihistamine, HOLD if BUN >40 or Cr >3 . MUST Premedicate!"AmphoTERIcin causes TERror on the body", "AmphoTERrible

Fluconazole (Diflucan)

NURSING CONSIDERATIONS: Teach to report GI effects, high risk for dehydration and malnutrition, maintain food diary, monitor blood glucose in DM ptsFluconazole rhymes with ergosterol and "Fungus in your azole

Nystatin (Mycostatin, Nystop)

NURSING CONSIDERATIONS: For oral candidiasis: apply w/ swab to affected areas in infant. For adult with oral candidiasis: swish for at least 2 minutes

Chloroquine (Aralen)

NURSING CONSIDERATIONS: Can be given with food, resistance is common, used prophylactically two weeks prior and 4-6 after travel

Metronidazole (Flagyl)

NURSING CONSIDERATIONS: ER must be swallowed whole and on empty stomachIntoxicated guy punches you in stomach and yells "Die, disulfiram, Die!" --> tachy, SOB, flushing, nausea, headache. I raised my Flagyl flag to surrender

Zidovudine (Retrovir, AZT)

NURSING CONSIDERATIONS: 1st line drug in initial pharmacotherapy

Efavirenz (Sustiva)

NURSING CONSIDERATIONS: often given with another antiretroviral to reduce viral resistanceMonitor viral load, CD4, CBC, liver and renal profiles, and blood glucose levels, nutritional status. Assess for myelosuppression, nephrotoxicity, and SJS. Neutropenic precautions. Encourage strict compliance. "Structured Treatment Interruption" - Drugs may be periodically stopped to give immune system a chance to respond. AVOID crowds and sick people, and raw foods

...

NURSING CONSIDERATIONS: Teach pt to report fevers, s/s of hepatotoxicity; monitor lab work, Teach pt to report fevers, s/s of hepatotoxicity; monitor lab work, Monitor for nephrotoxicity, Encourage strong infection control measuresShort 1/2 life, PO 5x/day

Zanamivir (Relenza) and oseltamivir (Tamiflu)

NURSING CONSIDERATIONS: MUST start within 48 hrs of symptom onset - will shorten duration of symptoms by 2 days

Cyclophosphamide (Cytoxan)

NURSING CONSIDERATIONS: Hydrate! drink 2-3L of water/day+urinate frequently, IV hydration prior to tx, maintain nutrition, monitor RBC, WBC, PLT, strict infection control measures, blood dyscrasias, assess skin integrity, hearing loss, teach pt re: impact on fertility

Methotrexate (MTX, Rheumatrex)

NURSING CONSIDERATIONS: monitor photosensitivity, lung inflammation, good oral hygiene, monitor for extravasation, sun protective measure

Doxorubicin

NURSING CONSIDERATIONS: monitor for extravasation, s/s of cardiotoxicity, myelosuppression, secondary lesions 1-3 yrs later, access pregnancy/lactation status, Avoid skin exposure to drug(wear gloves, mask, apron)

Vincristine (Oncovin)

NURSING CONSIDERATIONS: Assess allergies,may produce acute bronchospasm and skin rashes, inquire if pregnant or breastfeeding, combating constipation, High fluid and fiber intake, Monitor BP, Observe patients for symptoms such as headache, dizziness, or syncope, May produce severe mental depression

Tamoxifen

NURSING CONSIDERATIONS: assess for pregnancy and breastfeeding, teach about development of cross gender sexual characteristics, offer support and be frank