PHRM 822 Med List #1 - Antibiotics & Hormonal Contraceptives

general antibiotic counseling tips

Duration of therapy varies by medication and condition, patients should finish entire therapy even if they feel better

Most effective when taken at regularly scheduled intervals but don't have to wake up patient for doses

Many antibiotics cause GI upset

Signs of allergic reaction include itching, rash, hives, and difficulty breathing

doxycycline

Brand: Vibramycin, Adoxa, Monodox

Frequency: q12h

Indication: RTI, UTI, STI, acne, skin infections

Counseling: sun-sensitivity, take with food, do not take Al, Ca, Fe, Mg, or Zn 2 hours before/after, may decrease effectiveness of oral contraceptives

amoxicillin

Brand: Amoxil

Frequency: q8h, q12h

Indication: RTI, UTI, STI, ENT infection, skin infection

Counseling: contraindicated if penicillin allergy, may decrease effectiveness of oral contraceptives

cephalexin

Brand: Keflex

Frequency: q6h, q8h, q12h

Indication: RTI, UTI, ENT, skin infection, bone infection

Counseling: do not take Zn for 3 hours after, contraindicated if cephalosporin allergy, caution if penicillin allergy

azithromycin

Brand: Zithromax, Z-Pak, Tri-Pak

Frequency: q24h, Z-Pak: two 250mg tablets PO on day 1 and then one tablet days 2-5

Indication: RTI, STI, ENT infection, skin infection, eye infection

Counseling: do not take Al or Mg, take with food, QTc prolongation, contraindicated if macrolide allergy

ciprofloxacin

Brand: Cipro, Ciloxan

Frequency: q12h

Indication: STI, prostatitis, skin infection, bone infection, pneumonia, complicated UTI, RTI, abdominal infections

Counseling: QTc prolongation, do not take Ca or Fe 2 hours before/after, sun-sensitivity, caffeine-sensitivity, contraindicated if fluoroquinolone allergy

sulfamethoxazole/trimethoprim

Brand: Bactrim DS

Frequency: q12h

Indication: RTI, UTI, HIV-associated infections

Counseling: sun-sensitivity, take with 8 oz water, contraindicated if sulfa allergy

nitrofurantoin

Brand: Macrobid, Macrodantin

Frequency: q12h

Indication: UTI

Counseling: orange or brown urine expected, do not take Mg 2 hours before/after, take with food/milk to increase absorption

metronidazole

Brand: Flagyl

Frequency: q6h, q8h, q12h

Indication: abscess, GI infections, STI, vaginosis

Counseling: contraindicated if alcohol use during and 3 days after, metallic taste in mouth, headache

general estrogen/progestin counseling tips

Side effects: water retention, upset stomach/nausea, headache

Non-FDA uses: regulation of menstrual cycle, lessen menstrual flow, reduce painful menses

Miss a dose: take as soon as possible or with next days' dose, refer to package directions if 2 or more days missed

Ethinyl estradiol: increases risk of cardiovascular event, not recommended for those +35 years old, smoker, or history of stroke/blood clot

Tips: use additional non-drug form of contraceptive during the first week if OC not started day 1 of menses, take same time every day, may decrease the effectiveness of anticonvulsants or increase the chance of seizures

ethinyl estradiol/norgestimate

Brand: Ortho Tri-Cyclen, Tri-Sprintec, Tri-VyLibra

Frequency: one first phase tablet for 7 days, then one second phase tablet for 7 days, then one third phase tablet for 7 days, the one inactive tablet for 7 days

Indication: oral contraception, acne

Claim to fame: mimics natural menstrual cycle

ethinyl estradiol/norethindrone/ferrous fumarate

Brand: Loestrin Fe, Junel Fe, Microgestin Fe

Frequency: take one active tablet for 21 days, then one iron tablet daily for 7 days

Indication: oral contraception, acne

Claim to fame: replaces iron lost during menses

ethinyl estradiol/drospirenone

Brand: Yaz, Loryna, Jasmiel

Frequency: one active tablet for 24 days, the one inactive tablet for 4 days

Indication: oral contraception, acne, premenstrual dysphoric disorder

Claim to fame: 4 inactive days = shorter menstrual periods

Counseling: lessens the water retention/weight gain side effects of estrogen

ethinyl estradiol/norelgestromin

Brand: Xulane

Frequency: apple one new patch each week for 3 weeks, then week 4 is patch free

Indication: contraception

Counseling: same side effects as oral contraceptives but more common, adhesive may cause skin rash so rotate sites, do not cut patch, apply to butt, upper torso, stomach, or upper arm

ethinyl estradiol/etonogestrel

Brand: NuvaRing

Frequency: insert one ring into vagina on or before day 5 of cycle and leave in for 3 weeks, then remove on week 4 and discard

Indication: contraception

Counseling: if ring falls out rinse with cool water and re-insert within 3 hours, do not remove for intercourse, not a barrier

medroxyprogesterone

Brand: Depo-Provera

Frequency: 150 mg deep intramuscular injection in gluteal or deltoid muscle every 3 months

Indication: contraception, endometriosis pain, abnormal uterine bleeding, amenorrhea

Claim to fame: no estrogen

Counseling: nervousness, must be administered by healthcare professional, do not use for more than 2 years due to bone loss, spotting or absent menses may result

levonorgestrel

Brand: Plan B One-Step, EContra One-Step

Frequency: take 1 tablet PO as soon as possible within 72 hours of unprotected sex

Indication: emergency post-coital contraception

Counseling: fatigue, no evidence of interaction with antibiotics, will not terminate an existing pregnancy, spotting or changes in menses may result