Common Drugs and Facts

Symptoms of Anaphylaxis

Itching, flushing, hives, face swelling, wheezing, profuse sweating, dropping bp, shock, death

How to treat anaphylaxis?

Epinephrine, Hydrocortisone, CPR

What are the 7 major classes of Antibiotics?

Penicillins, Cephalosporins, Tetracyclines, Macrolides, Aminoglycosides, Sulfonamides, Floroquinolonies

Which drugs are bactreriocidal and how does it work?

Penicillin, Cephalosporin, Vancomycin
Inhibits cell wall synthesis

Which drugs are bacteriostatic and how does it work?

Tetracyclines, Macrolides, Aminoglycosides
Inhibits protein synthesis

Which drugs are used for serious sepsis?

Carboapenems, monobactams

What enzyme is produced in penicillin resistant strains of antibiotics?

betalactamase

Name the two most common penicillin antibiotics

Ampicillin, Amoxicillin

Name two suicide substrates

Clavulanate, Sulbactam

What is the rate at which allergy to penicillin has a cross-reactivity with penicillin?

~10%

Penicillin

What is used as early treatment of syphillis

1st Gen Cephalosporins tx

skin, soft tissue infections, UTIs

2nd Gen Cephalosporins tx

Strep pneumoniae, the flu

3rd Gen cephalospoirins tx

Pneumonia, Meningitis, Gonorrhea

Advantage of Cephalosporins vs Penicillins

Cephalosporins treat wider range of bacterial infections

What are the most common side effects of antibiotics?

Nausea, vomiting, diarrhea, rash, photosensitivity

Naming: Penicillins

-illin

Naming: Cephalosporins

cef-/ceph-

Naming: Tetracyclines

-cycline

What are the toxicities of tetracyclines

GI disturbances, superinfections, tooth/bone deposition, expired may cause nephrotoxicity, should be taken alone on empty stomach

What are the toxicities of aminoglycosides?

long half-life, GI upset, ototoxicity, nephrotoxicity, hepatic dysfunction - CYP450 inhibitor

Name a common Aminoglycoside

Gentamycin

What can Tetracyclines treat?

Rickettsias, chlamydia, traveler's diarrhea

Name the most common Macrolide

Azythromycin

Mostly, what do macrolides treat? Hint: generalized system(s)

respiratory and skin infections

Toxicities of Aminoglycosides

Reversible nephrotoxicity - cratinine clearance must be monitored strictly, irreversible ototoxicity, temporary neuroms blockage
Not often used for these reasons

Aminoglycosides treat:

strictly treat gram negative sepsis

Mechanism of Sulfonamides

Inhibit folic acid activity

Side effects of Sulfonamides

NVD, Rash, Stephen Johnson's Syndrome
May cause kidney stones - prevent with lots of fluids

Mechanism of (floro)Quinilones

DNA gyrase inhibitor which create the double helix of DNA structure

Side effects of (Floro)Quinilones

spontaneous tendon ruptures
not recommended for use pt's >16yr

Naming: (Floro)Quinilones

-floxacin

Uses for clindamycin

Acne, Alt to penicillin in dental prphylax, anaerobic pneumonia, bone infections, bowel infections, female genital infections, intra-abdom infections

What severely adverse side effect can metronidazole or clindmycin have?

Nosocomial infection - Clostridium Difficile
immediately stop if have diarrhea w/in 24 hrs

What does metronidazole treat?

Anaerobic bacteria and protozoa infection

What are specific side effects for metronidazole?

metallic taste in mouth, highly bitter, excess tongue fur, not taken with alcohol - may cause severe GI upset

Virus Multiplication Phase 1

absorption, penetration, and uncoating as the virus enters the host cell and sheds its protective coating

Virus Multiplication Phase 2

Synthesis of viral components

Virus Multiplication Phase 3

Assembly and release of the virus which can destroy or permanently change the cell

Hep B and C treated by

interferons
B: and lamivudine
C: and ribavirin

MOA for HIV

NRTI, non-NRTI, Protease Inhibitors, Viral Fusion Hinhibitors

Preferred Regimen of HAART

(1) Protease inhibitor, (1) NRTI combo

Alternative Regimen of HAART

(2) NRTI combo (1) RTI - nevirapine or delavidrine

How to monitor for HIV

monitor RNA levels - if does not fall 10x by week 8 change drug regimen and use 2-3 new agents. Change if CD4s fall or condition deteriorates

Following HAART guidelines, when is anitviral therapy administered

initiated at CD4 count <350
recommended at CD4 count between 350-500

What is the treatment regimen for TB

Mos 1-2: IRPE
Mos 3-6: IR

What kinds of patients are at risk of fungal infections?

diabetes pts and pts who use steroids

What are the two most commonly prescribed anti-fungals?

Ketoconozole, Itraconazole

Metronidazole

used for pre-op surgery prep

Nitrofurantion

Used to treat UTI's - creates formaldehyde in urine as an antibiotic

Drugs used for GI worms

Albendzole, Mebendazole, Thiambendazole, Pyrantel Pamoate