P2 Top 200 #1 Flashcards
1
Q
Acyclovir
A
Zovirax
2
Q
Acyclovir class
A
Viral DNA Polymerase Inhibitor
3
Q
Acyclovir FDA indications
A
1.) Genital herpes simplex, adults, initial episode
400mg po tid or 200mg po five times daily.
2.) Genital herpes simplex, adults, recurrent episode
400mg TID for 5 days pr 800mg BID for 5 days or 800mg TID for 2 days
3.) Genital herpes simplex, suppressive therapy, 400mg BID for up to 12 months
4.) Herpes zoster (shingles)- 800mg po 5 times daily for 7-10 days
5.) Varicella (chickenpox)- 800mg QID
4
Q
Acyclovir MOA
A
Competitively inhibits viral DNA synthesis by inactivation of viral DNA polymerase
5
Q
Acyclovir contraindications
A
Hypersensitivity to acyclovir or valacyclovir
6
Q
Acyclovir drug interactions
A
Phenytoin, fosphenytoin, valproic acid- decreased abosprtion and lower plasma concentration of phenytoin or valproic acid
Varicella vaccine, Zoster vaccine- decrease vaccine efficacy due to antagonism
7
Q
Acyclovir adverse reactions
A
Common-malaise
Less common- N/V, HA, diarrhea
Rare, but serious- severe hypersensitivity, renal failure, TTP
8
Q
Amoxicillin
A
Amoxil, Moxatag
9
Q
Amoxicillin class
A
beta-lactam antibiotic
10
Q
Amoxicillin common FDA indications
A
- ) Acute otitis media- 500-875mg po BID
- ) Lower respiratory tract infection- 1g po daily for 10 days
- ) Pharyngitis, tonsillitis- 775mg po daily x10 days
- ) Streptococcal pharyngitis- 1q po daily for 10 days
- ) Ear, nose, and throat infection, infection of skin and/or subcutaneous tissue, infection of genitourinary system- 500-875mg po Q 12 h for 10 days
- ) Helicobacter pylori GI tract infection- 1 g po BID with PPI
11
Q
Amoxicillin MOA
A
Semisynthetic penicillin derivative that inhibits the biosynthesis of bacterial cell wall mucopeptide. Typically active against streptococcus, enterococcus, staphylococcus, and enterobacteriaceae
12
Q
Amoxicillin drug interactions
A
Methotrexate- decreased methotrexate clearance
Venlafaxine- increased risk of serotonin syndrome
Warfarin- increased risk of bleeding
Typhoid and cholera vaccine- decreases vaccine efficacy
Sodium picosulfate- decreases therapeutic effect
13
Q
Amoxicillin AE
A
Common- Diarrhea, nausea
Less common- skin rash, HA, vomiting
Rare but serious- severe hypersensitivity, renal failure, hepatic failure, pancytopenia
14
Q
Amoxicillin/ Clavulanate
A
Augmentin
15
Q
Amoxicillin/ Clavulanate MOA
A
Penicillin derivative that works against streptococcus, enterococcus, staphylococcus, and enterobacteriaceae. Clavulanate protects amoxicillin from degradation by beta lactamases
16
Q
Amoxicillin/ Clavulanate class
A
beta-lactam antibiotic
17
Q
Amoxicillin/ Clavulanate FDA indications
A
- ) Acute otitis media
- ) Community acquired pneumonia
- ) Lower resp tract infection
- ) Sinusitis
18
Q
Amoxicillin/ Clavulanate contraindications
A
Penicillin allergy
ER products are contraindicated in patients in dialysis or with severe renal dysfunction
19
Q
Amoxicillin/Clavulanate drug-drug interactions
A
Methotrexate- decreased methotrexate clearance, avoid.
Venlafaxine- Serotonin syndrome- avoid.
Warfarin- bleeding
Typhoid vaccine, cholera vaccine-decreases vaccine efficacy
Sodium picosulfate- decreases therapeutic effect.
20
Q
Amoxicillin/ Clavulanate adverse reactions
A
Common- Nausea, diarrhea
Less common- Skin rash, vomiting, mycosis, cadidiasis
Rare, but serious- renal failure, hepatic failure, pancytopenia
21
Q
Azithromycin
A
Zithromax, Z-Pak
22
Q
Azithromycin class
A
Macrolide antibiotic
23
Q
Azithromycin FDA indications
A
- ) Acute infective exacerbation of COPD
- ) Bacterial sinusitis
- ) Chancrois, nongonoccocal cervicitis
- ) Community acquired pneumonia
- ) Gonorrhea
- ) Streptococcal pharyngitis
24
Q
Azithromycin MOA
A
Azithromycin binds to the 50S ribosomal subunit, thus interfering with microbial protein synthesis
25
Azithromycin drug interactions
Agents that prolong QTc interval and class III antiarrhythmics- Avoid
Statins- increased risk of rhabdo
Digoxin- Increased digoxin toxicity
Ergot alkaloids- contraindicated
nelfinavir- increased azithromycin concentrations
Warfarin- bleeding
Typhoid, cholera vaccine- decreased vaccine efficacy
Sodium picosulfate- decreased therapeutic effect
26
Azithromycin adverse reactions
Common- diarrhea, nausea, vomiting, abdominal pain
Less common- headache, elevates liver enzymes, flatulence
Rare, but serious- Steven-Johnson syndrome, severe hypersensitivity, myasthenia gravis, QTc prolongation, torsades de pointes, hepatitis
27
Cefdinir
Omnicef
28
Cefdinir class
3rd generation cephalosporin
29
Cefdinir MOA
3rd gen cephalosporin with activity against gram positive and negative bacteria including beta lactamase producing strains
30
Cefdinir FDA Indications
1. ) Acute otitis media, pharyngitis, tonsilitis
2. ) Bronchitis, acute, secondary bacterial infection
3. ) Community-acquired pneumonia
31
Cefdinir drug interactions
Antacids, iron, vitamins-decreased absorption, separate by 12 h
Typhoid vaccine, cholera vaccine- decreased vaccine efficacy
Sodium picosulfate- decreased therapeutic effect
32
Cefdinir adverse effects
Common- diarrhea
Less common- N/V, vaginitis, HA
Rare, but serious- increased liver enzymes
33
Cephalexin
Keflex
34
Cephalexin FDA Indications
1. ) Infection of skin and/or subcutaneous tissue
2. ) Osteomyelitis
3. ) Otitis media
4. ) Streptococcal pharyngitis
35
Cephalexin class
First generation Cephalosporin
36
Cephalexin MOA
inhibits bacterial wall synthesis of actively dividing cells by binding to penicillin binding proteins. Effective against most gram-positive organisms.
37
Cephalexin drug interactions
Cholestyramine- decreases absorption of cephalexin
Metformin- increased metformin toxicity
Typhoid vaccine, cholera vaccine- decreased vaccine efficacy
Sodium picosulfate- antibiotics may decrease therapeutic effects
38
Cephalexin adverse effects
Common-Nausea
Less common- Vomiting
Rare, but serious- Steven-Johnson syndrome, renal failure, severe hypersensitivity, anemia, neutropenia, seizure
39
Chlorhexidine
Peridex, Paroex, Hibiclens
40
Chlorhexidine class
Antibacterial cleansing agent
41
Chlorhexidine FDA Indications
1. ) Gingivitis
| 2. ) Skin or wound cleansing
42
Chlorhexidine MOA
Is an antiseptic and antimicrobial drug with bactericidal activity.
43
Chlorhexidine drug interactions
None
44
Chlorhexidine Adverse Effects
Common- mouth irrigation, tongue irritation, tooth aches and discolored teeth with oral rinse
Less common- GI irritation
45
Ciprofloxacin
Cipro, Cipro XR
46
Ciprofloxacin class
Fluroquinolone antibiotic
47
Ciprofloxacin FDA indications
1. ) Anthrax, postexposure prophylaxis
2. )Bacterial prostatitis
3. ) Bronchitis
4. ) UTI
48
Ciprofloxacin MOA
inhibits bacterial DNA gyrase. Highly active against aerobic, gram-neg bacilli
49
Ciprofloxacin BBW
Myasthenia gravis, tendon rupture and inflammation, peripheral neuropathy, CNS effects, cardiac, dermatologic, and hypersensitivity reactions, aortic dissection and rupture, hypoglycemia, mental health adverse effects
50
Ciprofloxacin drug interactions
Diabetic agents- hypoglycemia
Aluminum, calcium, magnesium antacids- decreased absorption of cipro by chelation
Corticosteroids- increased risk of tendon rupture
CYP1A2 substrates- increased substrate toxicity
Warfarin- increased risk of bleeding
P-glycoprotein inducers- reduces cipro efficacy
P-glycoprotein inhibitors- cipro toxicity
Typhoid and cholera vaccine- diminished vaccine effects
Sodium picosulfate- decreased therapeutic effect
51
Ciprofloxacin Adverse Effects
Common- Tooth discoloration in infants
Less common-N/V, rash, myalgia, arthralgia, tendinitis, HA
Rare, but serious- Steven-Johnson syndrome, renal failure, anemia, neutropenia, thrombocytopenia, seizure, cardiac effects, liver failure, myasthenia gravis, tendon rupture, renal failure, psychosis, QTc prolongation, peripheral neuropathy, CNS effects, severe cardiac, dermatologic and hypersensitivity reactions
52
Clindamycin
Cleocin
53
Clindamycin class
Lincosamide antibiotic
54
Clindamycin FDA Indications
1. ) Bacterial infectious disease
2. Infection of skin and/or subcutaneous infections
3. ) Infectious disease of abdomen
4. ) Lower respiratory tract infection
5. ) Pelvic inflammatory disease
6. ) Septicemia
55
Clindamycin MOA
inhibits bacterial protein synthesis by binding 50S ribosomal subunit, can be bacteriostatic or bactericidal
56
Clindamycin BBW
Colitis
57
Clindamycin Drug interactions
Atracurium and nondepolarizing muscle relaxants- Additive effects on muscle contractility
Erythromycin- Decreased abx efficacy
Typhoid and cholera vaccines- decreased vaccine effects
Sodium picosulfate- decreased effects
58
Clindamycin Adverse Effects
Common- Nausea
Less common- diarrhea, vomiting, rash
Rare, serious- QTc prolongation, steven-johnson syndrome, pseudomembranous colitis, esophagitis
59
Doxycycline
Vibramycin
60
Doxyxycline class
tetracycline antibiotic
61
Doxycycline FDA indications
1. ) Acinetobacter infection
2. ) Acne vulgaris
3. ) Gonorrhea
4. ) Staphylococcal infection
62
Doxycycline MOA
broad-spectrum bacteriostatic compound that inhibits protein synthesis at the 30S ribosomal subunit
63
Doxycycline Drug interactions
Retinoic acid derivatives- risk of increased intracranial pressure
Antacids- decreased absorption via binding
Digoxin- decreased metabolism of digoxin
Penicillin- decreased efficacy
Typhoid and cholera vaccines
sodium picosulfate
64
Doxycycline Adverse Effects
Common- Photosensitivity, tooth discoloration in children over 8
Less common-N/V, diarrhea
Rare, but serious- esophageal ulceration, hypersensitivity, hepatotoxicity, renal toxicity, clostridium difficle colitis, increased intracranial pressure, decreased growth in children
65
Fluconazole
Diflucan
66
Fluconazole class
imidazole antifungal
67
Fluconazole FDA Indications
1,) Candidal vulvovaginitis, uncomplicated and complicated
2. ) Cryptcpccal meningitis
3. ) Candidiasis, systemic
4. ) Oropharyngeal candidiasis
68
Fluconazole MOA
Inhibits the biosynthesis of ergosterol
69
Fluconazole drug interactions
Agents that increase QTc interval
Atorvastatin, HMG-CoA reductase inhibitors- increased risk of rhabdo
CYP2C19, CYP2C9, CYP3A4/5 substrates- increased substrate toxicity
Sulfonylureas- hypoglycemia
70
Fluconazole Adverse Effects
Common-none
Less common- HA
Rare, but serious- Steven-Johnson syndrome, arrhythmias (prolonged QTc, elevated LFTs, hypokalemia
71
Ketoconazole
Nizoral
72
Ketoconazole class
Imidazole antifungal
73
Ketoconazole FDA Indications
1. ) Candidiasis of skin
2. ) Dandruff
3. ) pityriasis versicolor
4. ) Seborrheic dermatitis
5. ) Tinea corporis
6. ) Tinea cruris
7. ) Tinea pedis
74
Ketoconazole MOA
Inhibits the biosynthesis of ergosterol
75
Ketoconazole drug interactions
None with topical formulation
76
Ketoconazole adverse reactions
Common- appilcation site rxn with foam
less common- dry skin, burning, stinging at site of application
Rare, but serious- Rash, hair loss
77
Levofloxacin
Levaquin
78
Levofloxacin class
Fluroquinolone antibiotic
79
Levofloxacin FDA Indications
1. ) Bacterial prostatitis
2. ) Bacterial sinusitis
3. ) Bronchitis
4. ) Community-acquired pneumonia
5. ) Infection of skin and/or subcutaneous tissue
6. ) Pyelonephritis, acute
80
Levofloxacin MOA
Inhibits bacterial DNA gyrase
81
Levofloxacin contraindications
Concurrent administration with tizanidine
82
Levofloxacin BBW
Myasthenia gravis, tendon inflammation and rupture, peripheral neuropathy, CNS effects, cardiac, dermatologic, and hypersensitivity reactions, aortic dissections and ruptures
83
Levofloxacin drug interactions
```
Antidiabetics- hypoglycemia
aluminum, calcium, iron- decreased absoprtion by chelation
Class III Antiarrhythmics or agents that effect QTc interval- additive potential for QTc prolongation
Cotricosteroids- tendon rupture
NSAIDs- seizuers
Warfarin- bleeding
Typhoid and cholera vaccine
Sodium picosulfate
```
84
Levofloxacin Adverse Reactions
Common-Photosensitivity
Less common- N/V, rash, myalgia, arthralgia, tendinitis, HA
Rare, but serious- Steven-Johnsons syndrome, renal failure, severe hypersensitivity, anemia, neutropenia, thrombocytopenia, seizure, cardiac arrest, cardiac arrhythmias, liver failure, tendon rupture, psychosis, glucose abnormalities, C. diff, peripheral neuropathy, CNS effects, severe cardiac and dermatologic hypersensitivity reactions
85
Metronidazole
Flagyl
86
Metronidazole class
nitroimidazole antibiotic
87
Metronidazole FDA Indications
1. ) Abscess, anaerobic
2. ) Amebic dysentery, acute
3. ) Bacaterial vaginosis
4. ) Trichomoniasis (for pt and partner)
88
Metronidazole MOA
bactericidal against nearly all obligate anaerobic bacteria
89
Metronidazole contraindications
1st trimester of pregnancy
90
Metronidazole BBW
Carcinogenic
91
Metronidazole drug interactions
antiarrhythmic agents, TCAs- increased risk of QT prolongation and other cardiac events
Amprenavir- increased propylene glycol toxicity
CYP3A4/5 substrates- increases substrate toxicity
Cholestyramine- decreased absorption of metronidazole
Disulfiram- increased CNS toxicity and disulfiram rxns
Typhoid vaccine and cholera vaccine
Sodium picosulfate Warfarin
92
Metronidazole adverse reactions
Common-HA, nausea
Less common- Diarrhea, dizziness, neuropathy, abnormal taste
Rare, serious- severe hypersensitivity, seizures, ototoxicity, clinically insignificant dark urine, steven-johnson syndrome, neutropenia, thrombocytopenia
93
Minocycline
Minocin
94
Minocycline class
Tetracycline antibiotic
95
Minocycline MOA
Inhibit protein synthesis at the 30S ribosomal subunit
96
Minocycline drug interactions
Retinoic acid derivatives (tretinoin, acitrecin)- increased intracranial pressure
Aluminum, calcium, magnesium, iron-decreased absorption via binding
Ethinyl estradiol and other estrogen-based BC- decreases BC efficacy
Digoxin- Inhibits digoxin metabolism
Thyphoid vaccine, cholera vaccine, sodium picosulfate
penicillin
warfarin
97
Minocycline adverse reactions
Common-dizziness, vertigo, tooth discoloration in children under 8, headache
Less common- N/V, fatigue, pruritis, uticaria
Rare, serious- hypersenstitivity, hepatotoxicity, renal toxicity, C.diff increased intracranial pressure, decreased growth in children, tissue hyperpigmentation
98
Mupirocin
Bactroban
99
Mupirocin FDA indications
1. ) Impetigo
2. ) Secondary skin infections
3. ) Eradication of nasal colonization of MRSA
100
Mupirocin drug class
Topical antibacterial
101
Mupirocin MOA
Inhibits bacterial protein synthesis by reversibly and specifically binding to bacterial RNA synthetase
102
Mupirocin drug interactions
None
103
Mupirocin adverse reactions
Common- none
Less common- HA, pruritus, burning at application site, stinging sensation, rhinitis
Rare, but serious- C. diff diarrhea
104
Nitrofurantoin
Macrodantin, Macrobid
105
Nitrofurantoin class
Nitrofuran antibiotic
106
Nitrofurantion FDA Indications
1,) UTI
| 2,) UTI prophylaxis
107
Nitrofurantoin MOA
inactivates ribosomes and is bactericidal in urine
108
Nitrofurantoin contraindications
Use in neonates or pregnant patients at term due to risk of hemolytic anemia, anuria, or oliguria
109
Nitrofurantoin drug interactions
Fluconazole- risk of hepatic and pulmonary toxicity
typhoid and cholera vaccine, sodium picosulfate
Norfloxacin- antagonism effect
110
Nitrofurantoin adverse reactions
Common- Nausea, HA, discoloration of urine
Less common- Diarrhea, superinfection
Rare, but serious- hepatic failure, hemolytic anemia, interstitial lung disease
111
Nystatin (topical)
Nystop, Mycostatin, Nyamyc
112
Nystatin class
polyene antifungal
113
Nystatin FDA indications
Candidiasis of skin
114
Nystatin MOA
Binds to sterols in fungal cell walls
115
Nystatin drug interactions
None
116
Nystatin adverse effects
Less common- dry skin, irritation
| Rare, serious- rash, stevens-johnson syndrome
117
Oseltamivir
Tamiflu
118
Oseltamivir class
Neuraminidase inhibitor, antiviral
119
Oseltamivir FDA indications
1.) Influenza types A and B treatment and prophylaxis
120
Oseltamivir MOA
inhibits influenza neurominidase affecting release of viral particles
121
Oseltamivir drug interactions
None
122
Oseltamivir adverse effects
Common- N/V
Less Common- Diarrhea, elevated LFTs
Rare, serious- arrhythmias, anaphylaxis, stevens-johnson syndrome, seizures, delirium
123
Trimethoprim Sulfamethoxazole
Bactrim, Septra
124
Trimethoprim Sulfamethoxazole Class
sulfonamide antibiotic
125
Trimethoprim Sulfamethoxazole FDA Indications
1. ) Acute exacerbation of COPD
2. ) HIV infection
3. ) Travelers diarrhea
4. ) UTI
126
Trimethoprim Sulfamethoxazole contraindications
Children under 2 months, pregnant patients at term, megaloblastic anemia due to folate deficiency
127
Trimethoprim Sulfamethoxazole drug interactions
Antiarrhythmic agents, agents that prolong QTc interval
CYP2C8,2C9 substrates- increases substrate toxicity
Trimethoprim Sulfamethoxazole CYP3A4/5 and 2C9 inducers- reduces TMP efficacy
Trimethoprim Sulfamethoxazole CYP3A4/5 and 2C9 inhibitors- TMP toxicity
Typhoid and cholera vaccine, sodium picosulfate
Methotrexate- increases methotrexate toxicity
128
Trimethoprim Sulfamethoxazole Drug interactions
Common- diarrhea, nausea
less common- skin rash, urticaria
Rare, serious- serious hypersensitivity, renal failure, hepatic failure, pancytopenia, arrhythmias, stevens-johnson syndrome, hyperkalemia, hypoglycemia, hemolytic anemia
129
Valacyclovir
Valtrex
130
Valacyclovir class
DNA polymerase inhibitor
131
Valacyclovir FDA Indications
1,) Genital herpes
2. ) Herpes zoster
3. ) Varicella
4. ) Herpes labialis
132
Valacylovir MOA
prodrug of acyclovir
| Inhibits viral DNA synthesis by incorporation into viral DNA
133
Valacyclovir drug interactions
Phenytoin, fosphenytoin, valproic acid- decreased absorption of phenytoin
Foscarnet- increased chance of nephrotoxicity
134
Valacyclovir adverse reactions
Common- malaise, headache, increased LFTs
Less common- N/V, abdominal pain, rash
Rare, serious- renal failure, TTP
