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Assessment 13
Pharm - Anti-Microbials, Anti-fungals, Alternatives, Hematopoietics, Stimulants
143
Pharmacology
Professional
02/06/2011

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Term
Penicillin G
Definition
Anti-Microbial - cell wall synth - B-lactam - "Natural Pen";
Block cell wall-synth enzymes;
Parenteral admin;
Glomerular filtration, secretion;
Tx - G+ (staph, strep), GC, spirochetes (T. pallidum);
Res - B-lactamase (staph);
SE - RENAL IMPAIRMENT, rash, neurotoxic
Term
Penicillin V
Definition
Anti-Microbial - cell wall synth - B-lactam - "Natural Pen";
Block cell wall-synth enzymes;
Oral admin;
Glomerular filtration, secretion;
Tx - G+ (staph, strep), GC, spirochetes (T. pallidum);
Res - B-lactamase (staph);
SE - rash, neurotoxic
Term
Procaine Pen G
Definition
Anti-Microbial - cell wall synth - B-lactam;
Block cell wall-synth enzymes;
LONG LASTING PARENTERAL ADMIN - delayed absorption/release;
Glomerular filtration, secretion;
Use only in highly suscep. cases (Tx - G+ (staph, strep), GC, spirochetes (T. pallidum));
Res - B-lactamase (staph);
SE - rash, neurotoxic
Term
Benzathine Pen G (Bicilin)
Definition
Anti-Microbial - cell wall synth - B-lactam;
Block cell wall-synth enzymes;
LONGest LASTING PARENTERAL ADMIN - delayed absorption/release;
Glomerular filtration, secretion;
Use only in highly suscep. cases (Tx - G+ (staph, strep), GC, spirochetes (T. pallidum));
Res - B-lactamase (staph);
SE - rash, neurotoxic
Term
Methicillin
Definition
Anti-Microbial - cell wall synth - B-lactam;
Block cell wall-synth enzymes;
Parenteral admin;
Glomerular filtration, secretion;
SE - rash, neurotoxic
Term
Nafcillin (Unipen)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-staph";
Block cell wall-synth enzymes;
Parenteral admin;
Glomerular filtration, secretion;
Highly protein bound, acid stable;
Tx B-lactamase-producing staph;
SE - DEC ELECTROLYTES, rash, neurotoxic
Term
Oxacillin (Prostaphlin)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-staph";
Block cell wall-synth enzymes;
Oral or parenteral admin;
Glomerular filtration, secretion;
Highly protein bound, acid stable;
Tx B-lactamase-producing staph;
SE - rash, neurotoxic
Term
Cloxacillin (Tegopen)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-staph";
Block cell wall-synth enzymes;
Oral admin;
Glomerular filtration, secretion;
Highly protein bound, acid stable;
Tx B-lactamase-producing staph;
SE - rash, neurotoxic
Term
Dicloxacillin (Dynapen)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-staph";
Block cell wall-synth enzymes;
Oral admin;
Glomerular filtration, secretion;
Highly protein bound, acid stable;
Tx B-lactamase-producing staph;
SE - rash, neurotoxic
Term
Ampicillin (Omnipen)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Extended spectrum";
Block cell wall-synth enzymes;
Parenteral or oral admin;
Glomerular filtration, secretion;
Req supplement after dialysis;
Tx - [G+ and G- rods/bacilli] H. flu, E. coli;
Res - B-lactamase (G-);
SE - DELAYED RASH, DIARRHEA, PSEUDOMEMBRANOUS COLITIS, neurotoxic
Term
Amoxicillin (Amoxil)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Extended spectrum";
Block cell wall-synth enzymes;
Oral admin;
Glomerular filtration, secretion;
Req supplement after dialysis;
Tx - [G+ and G- rods/bacilli] H. flu, E. coli;
Res - B-lactamase (G-);
SE - DELAYED RASH, PSEUDOMEMBRANOUS COLITIS, neurotoxic
Term
Cyclacillin (Cyclapen)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Extended spectrum";
Block cell wall-synth enzymes;
Oral admin;
Glomerular filtration, secretion;
Tx - [G+ and G- rods/bacilli] H. flu, E. coli;
Res - B-lactamase (G-);
SE - rash, neurotoxic
Term
Carbenicillin (Geocillin)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-pseudomonal";
Block cell wall-synth enzymes;
Parenteral admin;
Glomerular filtration, secretion;
Tx - pseudo, H. flu (oft. combined with aminoglycoside);
Res - B-lactamase;
SE - rash, neurotoxic
Term
Mezlocillin (Mezlin)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-pseudomonal";
Block cell wall-synth enzymes;
Parenteral admin;
Glomerular filtration, secretion;
Tx - pseudo, H. flu (oft. combined with aminoglycoside);
Res - B-lactamase;
SE - rash, neurotoxic
Term
Ticarcillin (Ticar)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-pseudomonal";
Block cell wall-synth enzymes;
Parenteral admin;
Glomerular filtration, secretion;
Tx - pseudo, H. flu (oft. combined with aminoglycoside);
Res - B-lactamase;
SE - DEC ELECTROLYTES, rash, neurotoxic
Term
Piperacillin (Pipracil)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Anti-pseudomonal";
Block cell wall-synth enzymes;
Parenteral admin;
Glomerular filtration, secretion;
Req supplement after dialysis;
Tx - pseudo, H. flu (oft. combined with aminoglycoside);
Res - B-lactamase;
SE - DEC ELECTROLYTES (if hypoK), rash, neurotoxic
Term
Amoxicillin + clavulanic acid (Augmentin)
Definition
Anti-Microbial - cell wall synth - B-lactam;
Block cell wall-synth enzymes;
+ B-lactamase inhibitor;
Glomerular filtration, secretion;
Tx - resistant staph, anaerobes as URI;
SE - rash, neurotoxic
Term
Ampicillin + sulbactam (Unasyn)
Definition
Anti-Microbial - cell wall synth - B-lactam;
Block cell wall-synth enzymes;
+ B-lactamase inhibitor;
Glomerular filtration, secretion;
Tx - amp-res H. flu, Moraxella, Mixed G+/anaerobe (CAP)
SE - rash, neurotoxic
Term
Ticarcillin + clavulanic acid (Timentin)
Definition
Anti-Microbial - cell wall synth - B-lactam;
Block cell wall-synth enzymes;
+ B-lactamase inhibitor;
Glomerular filtration, secretion;
Tx - G- bacilli/anaerobes (B. fragilis);
SE - rash, neurotoxic
Term
Piperacillin + tazobactam (Zosyn)
Definition
Anti-Microbial - cell wall synth - B-lactam;
Block cell wall-synth enzymes;
+ B-lactamase inhibitor;
Glomerular filtration, secretion;
Tx - Mod to severe G- bacilli/anaerobes (B. fragilis);
SE - rash, neurotoxic
Term
Cefazolin (Ancef)
Definition
Anti-Microbial - cell wall synth - B-lactam - 1st Gen Cephalosporin;
Renal tubular secretion - inc [plasma] w/ probenecid;
Tx - G+ cocci, many G- bacilli (think ampicillin);
SE - hypersensitivity, phlebitis, IM pain, nephrotoxic, rare superinfections;
Term
Cephalexin (Keflex)
Definition
Anti-Microbial - cell wall synth - B-lactam - 1st Gen Cephalosporin;
ORAL ADMIN;
Renal tubular secretion - inc [plasma] w/ probenecid;
Tx - G+ cocci, many G- bacilli (think ampicillin);
SE - hypersensitivity, phlebitis, IM pain, nephrotoxic, rare superinfections;
Term
Cefoxitin (Mefoxin)
Definition
Anti-Microbial - cell wall synth - B-lactam - 2nd Gen Cephalosporin;
Renal tubular secretion - inc [plasma] w/ probenecid;
Tx - H. flu, B. fragilis;
SE - hypersensitivity, phlebitis, IM pain, nephrotoxic, rare superinfections;
Term
Cefuroxime (Ceftin)
Definition
Anti-Microbial - cell wall synth - B-lactam - 2nd Gen Cephalosporin;
Renal tubular secretion - inc [plasma] w/ probenecid;
Tx - H. flu, B. fragilis;
SE - hypersensitivity, phlebitis, IM pain, nephrotoxic, rare superinfections;
Term
Cefaclor (Ceclor)
Definition
Anti-Microbial - cell wall synth - B-lactam - 2nd Gen Cephalosporin;
ORAL ADMIN;
Renal tubular secretion - inc [plasma] w/ probenecid;
Tx - H. flu, B. fragilis;
SE - hypersensitivity, phlebitis, IM pain, nephrotoxic, rare superinfections;
Term
Cefotaxime (Claforan)
Definition
Anti-Microbial - cell wall synth - B-lactam - 3rd Gen Cephalosporin;
Renal tubular secretion - inc [plasma] w/ probenecid;
HIGHLY MET'D;
CROSSES BBB TO CSF;
Tx - [severe] enteric G-'s, B. fragilis, H. flu, Pseudo.;
SE - ENTEROBACTER SUPERINFECTIONS, hypersensitivity, phlebitis, IM pain, nephrotoxic;
Term
Ceftriaxone (Rocephin)
Definition
Anti-Microbial - cell wall synth - B-lactam - 3rd Gen Cephalosporin;
Renal tubular secretion - inc [plasma] w/ probenecid;
LONGEST T1/2, HIGHLY PROTEIN BOUND - Dialysis OK;
CROSSES BBB TO CSF;
Tx - [severe] enteric G-'s, B. fragilis, H. flu, Pseudo.;
SE - ENTEROBACTER SUPERINFECTIONS, hypersensitivity, phlebitis, IM pain, nephrotoxic;
Term
Ceftazidime (Fortaz)
Definition
Anti-Microbial - cell wall synth - B-lactam - 3rd Gen Cephalosporin;
Glomerular FILTRATION - NO INTERAXN w/ probenecid;
CROSSES BBB TO CSF;
Tx - [severe] enteric G-'s, B. fragilis, H. flu, Pseudo.;
SE - ENTEROBACTER SUPERINFECTIONS, hypersensitivity, phlebitis, IM pain, nephrotoxic;
Term
Cefpodoxime (Vantin)
Definition
Anti-Microbial - cell wall synth - B-lactam - 3rd Gen Cephalosporin;
ORAL ADMIN;
Renal tubular secretion - inc [plasma] w/ probenecid;
CROSSES BBB TO CSF;
Tx - [severe] enteric G-'s, B. fragilis, H. flu, Pseudo.;
SE - ENTEROBACTER SUPERINFECTIONS, hypersensitivity, phlebitis, IM pain, nephrotoxic;
Term
Cefepime (Maxipine)
Definition
Anti-Microbial - cell wall synth - B-lactam - 4th Gen Cephalosporin;
Renal tubular secretion - inc [plasma] w/ probenecid;
BROAD SPECTRUM - incl G+ w/ B-lactamase;
Tx - Pseudo, Klebsiella, E.coli;
SE - hypersensitivity, phlebitis, IM pain, nephrotoxic, rare superinfections;
Term
Imipenem + cilastatin (Primaxin)
Definition
Anti-Microbial - cell wall synth - B-lactam - Carbapenem;
BROADEST SPECTRUM CLASS - hydroxyethyl side chain = inc G- axn;
Enters inflamm meninges/CSF;
Glomerular filtration and secretion;
Tx - B-lactamase G- and G+, anaerobes, Pseudo, resistant Enterobacter's;
SE - seizures, nephrotox, CNS tox, allergic rxns
Term
Cilastatin
Definition
Given with Imipenem to prevent breakdown and decrease renal damage;
Term
Meropenem (Merrem)
Definition
Anti-Microbial - cell wall synth - B-lactam - Carbapenem;
BROADEST SPECTRUM CLASS - hydroxyethyl side chain = inc G- axn;
Enters inflamm meninges/CSF;
Tx - B-lactamase G- and G+, anaerobes, Pseudo, resistant Enterobacter's;
DEC EFX FOR G+ COCCI;
SE - (DEC)seizures, nephrotox, CNS tox, allergic rxns
Term
Ertapenem (Invanz)
Definition
Anti-Microbial - cell wall synth - B-lactam - Carbapenem;
BROADEST SPECTRUM CLASS - hydroxyethyl side chain = inc G- axn;
LONG T1/2;
Enters inflamm meninges/CSF;
Tx - B-lactamase G- and G+, anaerobes, Pseudo, resistant Enterobacter's;
DEC EFX FOR PSEUDO AND ACINETOBACTER;
SE - seizures, nephrotox, CNS tox, allergic rxns
Term
Aztreonam (Azactam)
Definition
Anti-Microbial - cell wall synth - B-lactam - "Monobactam";
Glomerular filtration and secretion;
Resistant to many B-lactamases;
Enters CSF;
NARROW SPECTRUM - G- BACILLI (use w/ broad spectrum);
TX - Pseudo.;
NO ALLERGIC RXN's;
SE - GI, skin;
Term
Vancomycin (Vancocin)
Definition
Anti-Microbial - cell wall synth;
Cidal effects w/ narrow spectrum;
Oral admin for mild GI infxns, parenteral for systemic;
Enters inflamm meninges/CSF;
Res - plasmid-mediated alteration in binding site;
Tx - DOC for MRSA, strep, enterococci, 2nd line for C. diff;
SE - synergistic nephtrotox, ototoxicity (w/ loops), Red Man Syndrome, dec [plasma] in multiple myeloma, GI, phlebitis
Term
Dalfopristin-Quinupristin (Synercid)
Definition
Anti-Microbial - Inh 50S ribosome - "Streptogramins";
Binds ribosome peptidyltransferase - blocks tRNA synthetase;
Static when separate, Cidal together;
IV admin;
Tx - staph and VRE (E. FAECIUM);
SE - inh CYP3A4, arthralgia, myalgia, inc conj. bili, thrombophlebitis
Term
Linezolid (Zyvox)
Definition
Anti-Microbial - Inh 50S ribosome;
Oral admin (100% bioavail), also parenteral;
Supplement after dialysis;
Res - pt mutations of 23s RNA ribosome binding site;
Tx - VRE (E. faecium and faecalis)[static], MRSA [static], strep [cidal];
SE - N/V, diarrhea, pseudomembranous colitis, inh MAO;
CI - PKU
Term
Daptomycin (Cubicin)
Definition
Anti-Microbial - cell MEMBRANE;
Alters charge of membrane in G+'s - Cidal;
IV admin once/day;
RARE RES, mech unknown;
Highly protein bound - interaxns;
Tx - resistant G+'s (VRE, MRSA), strep pyogenes;
SE - Muscle pain (inc [CPK])
Term
Tetracycline (Achromycin V)
Definition
Anti-Microbial - 30S ribosome;
Passive diffusion thru porin channels into cell - ribosome binding;
Abs (best in stomach) inh by multivalent cations - enters placenta, milk;
Res - slow, via dec influx & inc efflux;
Tx [BROAD] - MYCOPLASMA, CHLAMYDIA, RICKETTSIAE, SPIROCHETES, protozoa, lyme, acne, peridontal dz;
SE - TEETH discoloration, GI, avitaminosis, vertigo, photosens, liver tox, dec bone growth;
Term
Doxycycline (Vibramycin)
Definition
Anti-Microbial - 30S ribosome - "Tetracycline";
Passive diffusion thru porin channels into cell - ribosome binding;
Abs (best in stomach) inh by multivalent cations - enters placenta, milk;
Res - slow, via dec influx & inc efflux;
Tx [BROAD] - MYCOPLASMA, CHLAMYDIA, RICKETTSIAE, SPIROCHETES, protozoa, lyme, acne, peridontal dz;
SE - LIVER TOX, PHOTOSENS, TEETH discoloration, (LESS) GI, avitaminosis, vertigo, dec bone growth;
Term
Minocycline (Minocin)
Definition
Anti-Microbial - 30S ribosome - "Tetracycline";
Passive diffusion thru porin channels into cell - ribosome binding;
Abs (best in stomach) inh by multivalent cations - enters placenta, milk;
Res - slow, via dec influx & inc efflux;
Tx [BROAD] - prophylaxis for MENINGOCOCCUS, MYCOPLASMA, CHLAMYDIA, RICKETTSIAE, SPIROCHETES, protozoa, lyme, acne, peridontal dz;
SE - VERTIGO, ADULT TEETH discoloration, GI, avitaminosis, photosens, liver tox, dec bone growth;
Term
Demeclocycline (Declomycin)
Definition
Anti-Microbial - 30S ribosome - "Tetracycline";
Passive diffusion thru porin channels into cell - ribosome binding;
Abs (best in stomach) inh by multivalent cations - enters placenta, milk;
Res - slow, via dec influx & inc efflux;
Tx [BROAD] - MYCOPLASMA, CHLAMYDIA, RICKETTSIAE, SPIROCHETES, protozoa, lyme, acne, peridontal dz;
SE - PHOTOSENS, TEETH discoloration, GI, avitaminosis, vertigo, liver tox, dec bone growth;
Term
Tigcycline (Tygacyl)
Definition
Anti-Microbial - 30S ribosome;
Slow IV admin;
Little met, LONG t1/2;
Tx - [BROAD] G+, G-, anaerobes, MRSA;
SE - N/V, injection site pain, Tet-like teeth and bone efx, photosens, superinfection
Term
Erythromycin (Ilotycin)
Definition
Anti-Microbial - 50S ribosome - "Macrolide";
Oral admin, STATIC axn;
Res [cross-res w/ Clinda] - rapid - plasmid-mediated dec influx, target altered, and drug hydrolysis;
Tx - [NARROW, G+] LEGIONAIRE'S DOC, Pneumociocci, GAS, Listeria, Corynebacterium, Lyme;
SE - CYP450 inh, cholestatic hepatitis
Term
Clarithromycin (Biaxin)
Definition
Anti-Microbial - 50S ribosome - "Macrolide";
Oral admin, STATIC axn;
DEC GI EFX, INC ACID STABILITY, INC ABS;
Res [cross-res w/ Clinda] - rapid - plasmid-mediated dec influx, target altered, and drug hydrolysis;
Tx - [NARROW, G+] Erythro's plus MAC'S DOC, H.flu, strep, H.pylori, Ct, Moraxella;
SE - CYP450 inh, cholestatic hepatitis
Term
Azithromycin (Zithromax)
Definition
Anti-Microbial - 50S ribosome - "Macrolide";
Oral admin, STATIC axn;
LONG T1/2;
Res [cross-res w/ Clinda] - rapid - plasmid-mediated dec influx, target altered, and drug hydrolysis;
Tx - [NARROW, G+] DOC for LEGIONAIRE'S/MAC/CAMPYLOBACTER, H.flu, strep, Ct, Lyme;
SE - CYP450 inh, cholestatic hepatitis
Term
Telithromycin (Proteck)
Definition
Anti-Microbial - 50S ribosome - "Ketolide";
Binds 2 sites on the ribosome - HIGH AFFINITY;
Oral admin - conc in bronchi and lung;
Met by and inh's CYP3A4;
Res - low;
Tx - CAP - staph/strep/H.flu/ mycoplasma/Legionella, Ct;
SE - hepatotox, prolonged QT;
CI - MG
Term
Clindamycin (Cleocin)
Definition
Anti-Microbial - 50S ribosome - Sim. mech as macrolides;
Penetrates bone, not CSF;
Acid stable, slow resistance;
Tx - anerobes (B. FRAGILIS), G+, toxo, P. jiroveci;
SE - PSEUDOMEMBRANOUS COLITIS, GI, rash
Term
Gentamicin (Garamycin)
Definition
Anti-Microbial - 30s ribosome (irrev. dmg) - aminoglycoside;
Diffuse through outer porin channel, req energy from ETC for cytoplasmic memb;
Conc-dependent killing - use bolus dose (parenteral);
Enters inflamm meninges/CSF, renal cortex, inner ear;
Limited cross-res within class;
Tx - [severe aerobic G-] enterococcus endocarditis, MRSA, staph epi;
SE - ototoxicity (irrev.), nephrotox (PCT, renal cortex), neuromuscluar blockade, teratogen
Term
Tobramycin (Nebcin)
Definition
Anti-Microbial - 30s ribosome (irrev. dmg) - aminoglycoside;
Diffuse through outer porin channel, req energy from ETC for cytoplasmic memb;
Conc-dependent killing - use bolus dose (parenteral);
Enters inflamm meninges/CSF, renal cortex, inner ear;
Limited cross-res within class;
Tx - [severe aerobic G-] P. aeruginosa;
SE - ototoxicity (irrev.), nephrotox (PCT, renal cortex), neuromuscluar blockade, teratogen
Term
Amikacin (Amikin)
Definition
Anti-Microbial - 30s ribosome (irrev. dmg) - aminoglycoside;
Diffuse through outer porin channel, req energy from ETC for cytoplasmic memb;
Conc-dependent killing - use bolus dose (parenteral);
Enters inflamm meninges/CSF, renal cortex, inner ear;
Limited cross-res within class;
Tx - [resistant, severe aerobic G-] Klebsiella, Enterobacter, E.coli, 2nd-line TB!;
SE - ototoxicity (irrev.), nephrotox (PCT, renal cortex), neuromuscluar blockade, teratogen
Term
Chloramphenicol (AK-Chlor)
Definition
Anti-Microbial - 50s ribosome;
Static;
Enters CSF, placenta;
Inh CYP450;
Res - plasmid-mediated enzymatic acetylation, change cell wall, change ribosome;
Tx - [broad spec] H. flu meningitis, Salmonella, Bacteroides;
SE - myelosuppression (dose dependent rev./irrev.), gray baby syndrome (drug accumulation)
Term
Sulfamethoxazole (Gantanol)
Definition
Anti-Microbial - folic acid met;
Block use of PABA in folic acid synth;
Oral - rapidly absorbed;
Static alone;
Enter CSF, placenta, breastmilk;
Competes for albumin binding;
Tx - UTI;
SE - allergic rash, crystalline agg's in urinary tract, hematologic, hypersens, renal and liver tox
Term
Silver sulfadiazine (Silvadenea)
Definition
Anti-Microbial - folic acid met;
Block use of PABA in folic acid synth;
Topical/oral - rapidly absorbed;
Static alone;
Enter CSF, placenta, breastmilk;
Competes for albumin binding;
Tx - eye infxns;
SE - allergic rash, crystalline agg's in urinary tract, hematologic, hypersens, renal and liver tox
Term
Sulfasalazine (Azulfidine)
Definition
Anti-Microbial - folic acid met;
Block use of PABA in folic acid synth;
Oral - poorly absorbed;
Static alone;
Enter CSF, placenta, breastmilk;
Competes for albumin binding;
Tx - IBD;
SE - allergic rash, crystalline agg's in urinary tract, hematologic, hypersens, renal and liver tox
Term
Sulfisoxazole (Gantrisin)
Definition
Anti-Microbial - folic acid met;
Block use of PABA in folic acid synth;
Oral - rapidly absorbed;
Static alone;
Enter CSF, placenta, breastmilk;
Competes for albumin binding;
Tx - DOC for UTI;
SE - allergic rash, crystalline agg's in urinary tract, hematologic, hypersens, renal and liver tox
Term
Trimethoprim (Proloprim)
Definition
Anti-Microbial - folic acid met;
Selective for bacterial enz DHFR - prevents reduction of di- to tetra-hydrofolate;
Penetrates CSF, prostate, vaginal fluid;
Res - @ DHFR;
Term
Trimethoprim:Sulfamethoxazole (Bactrim)
Definition
Anti-Microbial - folic acid met;
Static alone, cidal together - 1:20 ratio;
Tx - UTI, URI, neisseria (GC,MC), H.flu, Legionella, P. jiroveci, nocardia;
SE - skin rash, hematological efx
Term
Ciprofloxacin (Cipro)
Definition
Anti-Microbial - DNA gyrase - 2nd gen fluoroquinolone;
Dec abs w/ multivalent cations in antacids;
Improved PK;
Inh CTP450;
Res - dec porin proteins, efflux, or binding site axn;
Tx - Hi G- systemic axn, intracellular bacteria;
SE - GI, dizzy, photosens, seizures, crystalluria;
CI - pregnancy, youth
Term
Ofloxacin (Floxin)
Definition
Anti-Microbial - DNA gyrase - 2nd gen fluoroquinolone;
Dec abs w/ multivalent cations in antacids;
Improved PK - good CSF penetration;
Inh CTP450;
Res - dec porin proteins, efflux, or binding site axn;
Tx - Hi G- systemic axn, intracellular bacteria;
SE - GI, dizzy, photosens, seizures, crystalluria;
CI - pregnancy, youth
Term
Enoxacin (Penetrex)
Definition
Anti-Microbial - DNA gyrase - 2nd gen fluoroquinolone;
Dec abs w/ multivalent cations in antacids;
Improved PK;
Inh CTP450;
Res - dec porin proteins, efflux, or binding site axn;
Tx - Hi G- systemic axn, intracellular bacteria;
SE - GI, dizzy, photosens, seizures, crystalluria;
CI - pregnancy, youth
Term
Levofloxacin (Levaquin)
Definition
Anti-Microbial - DNA gyrase - 3rd gen fluoroquinolone;
Dec abs w/ multivalent cations in antacids;
Res - dec porin proteins, efflux, or binding site axn;
Tx - Improved G+ axn, Broad G-, intracellular bacteria;
SE - GI, dizzy, photosens, seizures, crystalluria;
CI - pregnancy, youth
Term
Moxifloxacin (Avelox)
Definition
Anti-Microbial - DNA gyrase - 3rd gen fluoroquinolone;
Dec abs w/ multivalent cations in antacids;
Res - dec porin proteins, efflux, or binding site axn;
Tx - Improved G+ axn, Broad G-, intracellular bacteria;
SE - GI, dizzy, photosens, seizures, crystalluria, long QT;
CI - pregnancy, youth
Term
Gatifloxacin (Tequin)
Definition
Anti-Microbial - DNA gyrase - 3rd gen fluoroquinolone;
Dec abs w/ multivalent cations in antacids;
Res - dec porin proteins, efflux, or binding site axn;
Tx - Improved G+ axn, Broad G-, intracellular bacteria;
SE - GI, dizzy, photosens, seizures, crystalluria, long QT;
CI - pregnancy, youth
Term
Fosfomycin (Monurol)
Definition
Anti-Microbial - cell wall;
Inh PEP transferase - blocks formation of cell wall precursors - Cidal;
Oral admin - rapid abs - conc in urine;
Tx - simple UTI (G- or enterococci);
Expensive;
SE - diarrhea
Term
Amphotericin B (Amphocin)
Definition
Polyene Antifungal - cell membrane;
Binds ergosterol, forms pore - leak of K,Mg - Cidal efx;
IV admin - hi binding to beta-lipoprotein;
Res - in Candida;
Tx - [deep fungal in preg., systemics] Candida, Crypto, Aspergillus, Blasto;
SE - NEPHROTOX, fever, thrombophlebitis, hypersens, shock/hypoT;
Term
Flucystosine (Ancoban)
Definition
Antifungal;
Prodrug - inh thymidylate synth - inh DNA synth;
Cidal/static dep. on dose and organism;
Oral admin - Give with AmphB;
Res - dec permease, dec cytosine deaminase (no activation of drug);
Tx - [systemic mycoses] Candida meningitis
SE - hematological, colitis
Term
Fluconazole (Diflucan)
Definition
Antifungal - cell membrane;
Inh ergosterol synth;
Mild CYP450 inh;
PENETRATES CSF;
RENAL ELIM;
Res - rapid if used alone;
Tx - [broad] CANDIDA, Coccidio, Crypto;
SE - teratogenic, GI, rash
Term
Itraconazole (Sporanox)
Definition
Antifungal - cell membrane;
Inh ergosterol synth;
Moderate CYP450 inh;
Highly protein bound - Doesn't enter CSF;
HEPATIC ELIM;
Res - rapid if used alone;
Tx - [broad-er] BLASTO, Histo, 2nd line for Aspergillus;
SE - HEPATOTOX, GI, CHF, teratogenic
Term
Voriconazole (VFEND)
Definition
Antifungal - cell membrane;
Inh ergosterol synth;
Severe CYP450 inh;
Res - rapid if used alone;
Tx - [broad] Invasive Aspergillus, Scedosporium, Fusarium;
SE - VISUAL DISTURB, PHOTOSENS, HEPATOTOX, teratogenic
Term
Ketoconazole (Nizoral)
Definition
Antifungal - cell membrane;
Inh ergosterol synth;
Mild CYP450 inh;
Res - rapid if used alone;
Tx - [broad] yeasts, dermatophytes, systemic mycoses;
SE - DEC TESTOSTERONE, NO ADRENAL STERIODOGENESIS, teratogenic
Term
Caspofugin (Cancidar)
Definition
Antifungal - cell wall;
Inh alpha(1,3)D-glucan synthesis;
Long IV admin;
Slow met by hydrolysis, acetylation;
Tx - 3rd line for invasive aspergillus, candida;
SE - histamine sx, teratogen, hepatotox (inc ALT)
Term
Terbinafine (Lamasil)
Definition
Antifungal;
Inh squalene epoxidase - inh ergosterol synth;
Highly protein bound - Conc in keratin - hair and nails;
Oral or topical admin;
Tx - onychomyosal fungal infxns - nails;
SE - HA, GI, TASTE CHANGES, CHOLESTATIC HEPATITIS
Term
Griseofulvin (Fulvicin)
Definition
Antifungal;
Static - disrupts mitotic spindle;
Conc in keratin precursor cells;
CYP450 inducer;
Tx - dermatophytes;
SE - HA, GI, photosens;
Term
Isoniazid INH (Nydrazid)
Definition
Anti-mycobacterium - cell wall;
Blocks mycolic acid synth - cidal if rapid growth/ static if slow;
Oral admin;
Enters inflamm meninges/CSF, placenta, breastmilk;
Dec efx w/ anatacids, steroids - Met by acetylation;
Res - rapid, use in combo;
Tx - first line for TB;
SE - perhiperal neuropathy, hepatotox, B6 deficiency
Term
Rifampin (Rifadin)
Definition
Anti-mycobacterium;
Binds beta subunit of RNApol - cidal to intra/extracellular mycobacteria;
Oral admin - Enters CSF;
CYP450 inducer;
Inc lvls if take w/ probenecid;
Tx - TB (1st line), MRSA, mengingococcus, anti-leprosy;
SE - orange fluids, GI, fever, hepatotox
Term
Pyrazinamide PZA
Definition
Anti-mycobacterium;
Drug conv to acid - dec environmental pH;
Oral admin;
Dose-dep. Cidal/static;
Enters inflamm meninges/CSF;
Tx - [microbes in acidic lysosome/macrophage] first line TB;
SE - hepatotox, hyperuricemia, gout, arthralgia
Term
Ethambutol (Myambutol)
Definition
Anti-mycobacterium;
Oral admin - Dec abs w/ antacids (Al+++);
Static;
Enters placenta, breastmilk, inflamed meninges/CSF;
Slow resistance;
Tx - first line TB and MAC;
SE - optic neuritis, hyperuricemia, allergic
Term
Streptomycin
Definition
Anti-mycobacterium - aminoglycoside;
Targets ribosomes (30S);
IM admin;
Tx - first line TB;
SE - significant toxic profile;
Term
Cycloserine (Seromycin)
Definition
Anti-mycobacterium - cell wall;
Analog of D-alanine - blocks cell wall synth;
Dose-dep. cidal/static;
Oral admin;
No cross res;
Enters CSF, placenta, breastmilk;
Tx - Last line pulm/extra-pulm TB, MAC;
SE - HA, tremor, vertigo, psychosis, paranoid, seizures
Term
Capreomycin (Capastat)
Definition
Anti-mycobacterium;
Static;
IM admin;
Tx - last line TB;
SE - NEPHTROTOX;
Term
Kanamycin (Kantrex)
Definition
Anti-mycobacterium - aminoglycoside;
Targets ribosomes (30S);
IM admin;
Tx - 2nd-line TB;
SE - significant toxic profile;
Term
Ethionamide (Trecator)
Definition
Anti-mycobacterium;
Inh peptide synth;
Dose-dep. cidal/static;
Oral admin;
Enters CSF;
Tx - last line TB;
SE - GI, HEPATOTOX, THYROID
Term
Clofazimine (Lamprene)
Definition
Anti-mycobacterium;
Tx - 2nd-line for TB
Term
Paraaminosalicyclic acid
Definition
Anti-mycobacterium - folate synth;
Oral admin;
SE - significant toxic profile not in notes;
Term
Rifabutin
Definition
Anti-mycobacterium;
Tx - 2nd-line for MAC
Term
Anise
Definition
Herbal supplement - Natural coumarin derivative;
Interaxn w/ Rx anticoagulants
Term
Bitter Orange
Definition
Herbal supplement;
Contains synephrine, an alpha-1 agonist;
Inh CYP3A4;
SE - stroke, angina, ischemic colitis
Term
Borage
Definition
Herbal supplement;
'Tx' - RA, HTN;
Particularly pathogenic - hepatotox, carcinogenicity;
Term
Capiscum
Definition
Herbal supplement;
Causes hypocoagulability due to fibrolytic axn
Term
Celery
Definition
Herbal supplement - Natural coumarin derivative;
Interaxn w/ Rx anticoagulants
Term
Chamomile
Definition
Herbal supplement - Natural coumarin derivative;
Interaxn w/ Rx anticoagulants
Term
Chaparral
Definition
Herbal supplement;
'Tx' - tonic, arthritis, wt. loss;
SE - hepatotoxicity and carcinogenic
Term
Chromium
Definition
Mineral;
'Tx' - Enhances insulin action, carbohydrate fat and protein metabolism;
No proven effects;
SE - drug interaxns w/ β-blockers, steroids, insulin, nicotinic acid, NSAIDs
Term
Coenzyme Q10
Definition
Dietary supplement;
Potent antioxidant;
'Tx' - HTN, ischemic heart disease, prevention of statin-induced myopathy;
SE - poss warfarin interaxn due to VitK-like structure
Term
Cranberry juice
Definition
Supplement;
UTI adjunct to Tx/prophylaxis - may prevent bacteria from clinging to urothelium;
SE - GI, diarrhea
Term
Echinacea
Definition
Dietary Supplement;
'Tx' to give an Immune boost - no supporting evidence;
Thus antagonizes immunosuppressants;
Induces CYP3A4;
Inhibits CYP1A2 and intestinal 3A4
Term
Ephedra
Definition
Herbal supplement;
'Tx' for weight loss;
Cardiovascular tox - arrhythmias;
WITHDRAWN FROM MARKET
Term
Fenugreek
Definition
Herbal supplement - natural coumarin derivative;
Interaxn w/ Rx anticoagulants
Term
Garlic
Definition
Herbal supplement;
'Tx' - dec cholesterol;
SE - antiplatelet & prolonged bleeding
Term
Germander
Definition
Herbal supplement;
'Tx' for wt loss, general tonic;
SE - hepatotox
Term
Ginkgo Biloba
Definition
Herbal supplement;
'Tx' - preventing AD;
SE - anti-platelet,
Inh CYP1A2 and 2D6
Term
Ginseng
Definition
Herbal supplement;
Immune boost, CV benefits, dec LDL, dec [glucose];
Thus antagonizes immunosuppressants;
Other SE - prolonged bleeding, inh CYP2D6
Term
Glucosamine
Definition
Dietary supplement;
Substrate for articular cartilage;
Sulfate form > hydrochloride (not abs'd);
Mixed study results;
SE - few, may inc INR during warfarin tx
Term
Green Tea Extract
Definition
Herbal supplement;
'Tx' as anti-oxidant, anti-inflamm;
Stimulant axn - antagonize sedative Tx;
SE - hepatotox
Term
Kava-Kava
Definition
Herbal supplement;
'Tx' as a sleeping aid, anti-anxiety;
SE - hepatotox;
Term
Licorice
Definition
Herbal supplement;
'Tx' for peptic ulcers, flavor;
SE - pseudo-hyperaldosronism
Term
Meadowsweet
Definition
Herbal supplement - natural salicylate;
Interaxn w/ Rx anticoagulants
Term
Melatonin
Definition
Dietary supplement;
Used to regulate sleep/wake cycle after jet lag, etc.;
CYP1A2 met & Drug interactions (nifedipine);
SE - dec fertility, dec breast output
Term
Pomegranate juice
Definition
Dietary supplement;
'Tx' BPH, prostatic cancer;
SE - inc PSA doubling time (false info), inh CYP3A4, rhabdomyolysis (esp w/ statins)
Term
Poplar
Definition
Herbal supplement - natural salicylate;
Interaxn w/ Rx anticoagulants
Term
Red Clover
Definition
Herbal supplement - natural coumarin derivative;
Interaxn w/ Rx anticoagulants;
Estrogen-like axns - inc cancer risk
Term
Senna
Definition
Herbal supplement;
'Tx' as a laxative;
SE - hepatotox and carcinogenic
Term
St. John's Wort
Definition
Herbal supplement;
'Tx' - depression (good evidence);
Induces CYP3A4, 1A2, 2C9
Term
Vitamin supplements
Definition
Vit E&K - antagonize warfarin;
Vit A&D - GI and bone SEs;
Mixed study results
Term
Willowbark
Definition
Herbal supplement - natural salicylate;
Interaxn w/ Rx anticoagulants
Term
Zinc
Definition
Mineral supplement;
Imp. cofactor in enzymes, protein and carb metabolism;
Dec childhood diarrhea;
Healing of gastric ulcers;
Tx - sickle cell, acne, ADHD, Down's, herpes, hi cholesterol, plaques and gingivitis
Term
Erythropoietin (Epoetin alpha, darbepoetin alpha)
Definition
Hematopoietic Growth Factor;
Acts on progenitor cell receptor to inc RBC production (BFU-E and CFU-E);
IV or SC admin;
Tx - anemia assoc w/ AIDS, chemo, preemies, chronic inflamm dz's, renal failure;
SE - cardiotox, nephrotox
Term
Sagramostin (GM-CSF)
Definition
Myeloid Growth Factor;
Stimulates myelopoiesis of granulocytes and mono's;
Tx - iatrogenic neutropenia;
SE - granulocyte spike, bone pain, rash, flu-like
Term
Filgrastim (G-CSF)
Definition
Myeloid Growth Factor;
Stimulates myelopoiesis of granulocytes, etc.;
Tx - severe neutropenia;
SE - granulocyte spike, bone pain, rash
Term
Pegfilgrastim (Neulasta)
Definition
Myeloid Growth Factor;
Stimulates myelopoiesis of granulocytes, etc.;
Tx - severe neutropenia;
SE - granulocyte spike, bone pain, rash
Term
Thrombopoietin
Definition
Megakaryocyte Growth Factor;
Selective and rapid - inc platelets;
Tx - thrombocytopenia, especially associated with other anemias;
Term
Oprelvekin (Neumega)
Definition
Megakaryocyte Growth Factor;
Recombinant IL-11 which inc lymphoid and myeloid growth;
Tx - thrombocytopenia;
SE - fatigue, dizzy, dyspnea, arrhhythmia, edema
Term
Iron Ferrous Sulfate
Definition
Mineral Iron;
Oral admin;
Tx - DOC for iron deficiency anemia;
SE - heartburn, nausea, GI
Term
Iron Ferrous Gluconate
Definition
Mineral Iron;
Oral admin;
Tx - iron deficiency anemia;
SE - heartburn, nausea, GI
Term
Deferoxamine (Desferal)
Definition
Iron chelator;
Tx - iron poisoning, hereditary hemochromatosis
Term
Vit B12 (Cyanocobalamin and Hydroxycobalamin)
Definition
Vitamin;
Admin parenteral > oral;
Tx - B12 deficiency (megaloblastic - pernicious anemia)
Term
Folic Acid
Definition
Vitamin;
Oral or parenteral admin;
Use before preg thru breasfeeding;
Tx - specific deficiency (think prego, chemo, chronic EtOH, upper intestine dz);
Counteracts AED's
Term
Folinic Acid
Definition
Vitamin;
Derivative of tetrahydrofolate (THF);
Circumvents DHFR inh by methotrexate;
Potentiats 5-FU;
Use before preg thru breasfeeding;
Tx - specific deficiency (think prego, chemo, chronic EtOH, upper intestine dz);
Counteracts AED's
Term
Caffeine
Definition
Methylxanthine;
Adenosine receptor agonist - inc DA and NE release, PDE inhibition;
Rapid tolerance, mild withdrawal;
Not addicting - APA
Term
Amphetamine
Definition
CNS stimulant;
Indirect dopamine agonist - inc BP, wakefulness, alert, concentration, self-confidence, euphoria, physical perform., wt loss;
Psychological dependence;
Tx - obesity, narcolepsy, ADHD;
SE - arrhythmias, angina, HA, abuse (dopamine reward), neurotoxic, convulsions, cerebral hemorrhage, schizo.
Term
Dex-amphetamine (Dexedrine)
Definition
CNS stimulant;
Indirect dopamine agonist - inc BP, wakefulness, alert, concentration, self-confidence, euphoria, physical perform., wt loss;
Psychological dependence;
Tx - obesity, narcolepsy, ADHD;
SE - arrhythmias, angina, HA, abuse (dopamine reward), neurotoxic, convulsions, cerebral hemorrhage, schizo.
Term
Methamphetamine (Desoxyn)
Definition
CNS stimulant - dec peripheral efx;
Red phosphorous + ephedrine + iodine + lye;
Indirect dopamine agonist - inc BP, wakefulness, alert, concentration, self-confidence, euphoria, physical perform., wt loss;
SE - arrhythmias, angina, HA, abuse (dopamine reward), neurotoxic, convulsions, cerebral hemorrhage, schizo.
Term
Methhylphenidate (Concerta)
Definition
CNS stimulant - mild;
Indirect dopamine agonist - inc BP, wakefulness, alert, concentration, self-confidence, euphoria, physical perform., wt loss;
Tx - narcolepsy, ADHD;
SE - arrhythmias, angina, HA, abuse (dopamine reward), neurotoxic, convulsions, cerebral hemorrhage, schizo.
Term
Cocaine (-hydrochloride, Crack)
Definition
CNS stimulant;
Indirect dopamine agonist and dopamine reuptake inhibitor;
Inc HR, BP, arousal, alertness, euporhia (tolerance), performance, self-confidence;
Tx - vasoconstriction, local anesthesia;
SE - spasms, paranoia, irritability, violence, arrhythmias, Myo/Cerebral-ischemia, aortic dissection, dec libido, premature labor, seizures
Term
Mazindol
Definition
CNS stimulant;
Indirect dopamine agonist, NE reuptake inhibitor;
Tx - obesity;
SE - allergic, insomnia, palpitations, HTN, hallucinations, dry mouth, GI, impotence;
CI - HTN, CHF, arteriosclerosis, glaucoma;
Drug interaxns - MAOIs, TCAs, guanethidine
Term
Atomoxetine (Strattera)
Definition
Stimulant;
NE reuptake inh - NE agonist;
Tx - ADHD (esp adults);
Low abuse potential;
SE - anorexia, insomnia, inc HR/BP
Term
Phentermine (Adipex-P)
Definition
Stimulant;
Indirect NE and serotonin agonist;
Tx - short term for obesity;
Low abuse potential;
CI - atherosclerosis, HTN, hyperthyroid, CV dz, MAOIs
Term
Sibutramine (Meridia)
Definition
Stimulant;
DA, NE, serotonin reuptake inh;
Tx - obesity (<6 mo. use)
CI - MAOI, anorexia, HTN;
SE - serotonin syndrome, HTN
Term
Modafinil (Provigil)
Definition
Stimulant - unk mech;
No DA effect - no abuse;
Tx - narcolepsy;
Induces CYP450;
SE - HA for 1 week
Term
Ephedrine
Definition
Stimulant;
Inc release of DA and NE;
Tx - narcolepsy, bronchoconstriction, depression;
SE - HTN/inc HR, stroke, MI, insomnia, heat stroke, tachyphylaxis
Term
Strychnine
Definition
Stimulant - Pesticide and poison;
Glycine-R antagonist - disinhibition;
SE - convulstions, impaired respiration;
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