Pharm Exam 6 PSU 2026

Antibiotics

isoniazid

Antimycobacterial

rifampin

Antimycobacterial

ethambutol

Antimycobacterial

AE of isoniazid and ethambutol?

Peripheral neuropathy, hepatotoxicity, hyperglycemia

How are the adverse effects of isoniazid and ethambutol managed?

Vitamin B6

What side effect does rifampin cause?

Hepatotoxicity (red/orange color of bodily fluids)

What med does rifampin interact with?

Phenytoin

What does rifampin interact with?

Foods with tyramine (Increase risk of hepatotoxicity)

What do all anti-TB meds interact with

Hormonal contraceptives

Chloroquine

Antiparasitic

Hydroxychloroquine

Antiparasitic

What can antiparasitic like Hydroxychloroquine and chloroquine also treat?

Rheumatoid arthritis and lupus

AE of Hydroxychloroquine and chloroquine?

GI upset, headache, visual disturbances

Amphotericin B

Antifungal

Ketoconazole

Antifungal

fluconazole

Antifungal

AE of amphotericin B infusions?

Fever, chills, rigor, headache

How are AE of amphotericin B mitigated?

Pre treat with diphenhydramine and acetaminophen

Main AE of antifungals?

Bone marrow suppression, hepatotoxicity, nephrotoxicity, hypokalemia

Pt. teaching for oral nystatin?

Do not eat or drink for 30 mins after

TX of vaginal candidiasis?

Miconazole suppository or fluconazole oral

amantadine

Antiviral

Acyclovir

Antiviral

How do antiviral drugs work?

Alter viral reproduction (Do not cure but reduce symptoms)

What do acyclovir and valacyclovir treat?

Herpes simplex and herpes zoster

What does oseltamivir treat?

Influenza

What does ribavirin treat?

RSV

AE of topical and IV acyclovir?

Burning and itching at site
Phlebitis, extravasation, nephrotoxicity

Pt. teaching for antiviral use?

Increase fluid intake, start within 48 hours, take with food

How do antiretrovirals work?

Prevent virus from entering or inhibit enzymes needed for replication

What is HAART?

Highly active antiretroviral therapy

Pt. teaching for HAART

Take at same time each day, report any S/S, treatment is lifelong, practice safe sex

What is the main enzyme responsible for drug resistance in bacteria?

Beta-lactamase

Examples of bacterial superinfections?

C. Diff, candidiasis

What is the reason for giving penicillin with clavulanate

Clavulanate is a beta-lactamase inhibitor

Is amoxicillin broad or narrow spectrum

Broad

What class is piperacillin with tazobactam?

Antipseudomonal

AE of penicillin?

Hypersensitivity, renal impairment, hyperkalemia, dysrhythmias, hypernatremia

What does penicillin interact with?

Increase effect of warfarin
Decreases OC effectiveness
Deactivates aminoglycosides

Probenecid

Pt. teaching for penicillin?

Take with full glass of water or with food if GI upset occurs
Use alternative contraception

Cephalexin

1st gen cephalosporin

Cefaclor and cefotetan

2nd gen cephalosporin

Ceftriaxone

3rd gen cephalosprin

Cefepime

4th gen cephalosporin

Ceftaroline

5th gen cephalosporin

What population are cephalosporins avoided in?

Pts. with a anaphylactic reaction to penicillin

AE of cephalosporins?

Bleeding, thrombophlebitis, renal insufficiency, C.diff

Which cephalosporins may cause a disulfiram like reaction with alcohol?

Cefotetan and cefazolin

Pt. teaching for cephalosporins?

Take with food, avoid alcohol

imipenem-cilastatin

Carbapenems

What is imipenem-cilastatin used to treat?

Pneumonia, peritonitis, UTI

What is one unique quality of imipenem-cilastatin?

Broadest antibacterial action

AE of imipenem-cilastatin?

Cross-sensitivity to PCN and cephalosporins
Superinfection
Black furry tongue

Med interactions of imipenem-cilastatin?

decreases levels of valproic acid

What does aztreonam treat?

Tx of moderate to severe systemic infections and UTI

aztreonam

monobactam

Doxycycline

Tetracycline

AE of tetracyclines?

Tooth discoloration
Hepatotoxicity

Photosensitivity

Pt. teaching for doxycycline?

Wear sunscreen

Avoid in pregnancy and kids under 8
Avoid dairy

Avoid lying down after taking
Use alternative contraception

What can long term use of minocycline cause?

Bluish black/gray hyperpigmentation

What do aminoglycosides treat?

Gram negative bacteria

Gentamicin

Aminoglycoside

AE of aminoglycosides?

Ototoxicity

Nephrotoxicity

Erythromycin

Macrolide

azithromycin

Macrolide

What do macrolides like erythromycin and azithromycin treat?

Pertussis, chlamydia, strep

AE of macrolides like erythromycin and azithromycin?

Prolonged QT interval

Ototoxicity

Pt. teaching for erythromycin and azithromycin?

take erythromycin with food azithromycin without

Monitor PT/INR if taking warfarin

Use alternative contraception

Levofloxacin

Fluoroquinolone

ciprofloxacin

Fluoroquinolone

What do fluoroquinolones treat?

Severe infection

AE of ciprofloxacin and levofloxacin?

Tendonitis/ tendon rupture (especially in renal failure)
Limit caffeine
Photosensitivity

Use alternative contraception

When should fluoroquinolone use be cautioned?

Children under 18 and elderly

AE of SMZ-TMP

Crystalluria

Hyperkalemia
Kernicterus
Steven-Johnson syndrome
Hypoglycemia
Blood dyscrasias

S/S of steven Johnson syndrome?

Malaise, URI, fever, rash,

Pt. teaching for SMZ-TMP?

Take on empty stomach
Use alternative contraception
Report rash

Nitrofurantoin

Macrobid

What does nitrofurantoin treat?

UTI

AE for nitrofurantoin?

Can stain teeth and clothing

Turns urine rust colored

Can cause peripheral neuropathy
HA, drowsiness, dizziness

What population should nitrofurantoin be avoided in?

Pregnant women
Impaired kidney function

Phenazopyridine

Urinary tract analgesic

Pt. teaching for phenazopyridine?

Turns urine bright orange

Stains clothing

What is Vancomycin used to treat primariliy?

MRSA

AE of vancomycin?

Ototoxicity and nephrotoxicity
Red man syndrome

How is red man syndrome prevented with vancomycin use and what should you do if it occurs?

Pre treat with antihistamines and slow infusion if it occurs

What is metronidazole used to treat?

intra-abdominal and GYN infections

What is a major AE of metronidazole

Disulfiram reaction

What does clindamycin treat?

Very severe infection (ex. bone, skin, pneumonia, or in sepsis)

AE of clindamycin?

C. Diff

What class is nafcillin?

Antistaphylococcal

What labs to aminoglycosides like getnamicin require?

Peak and trough levels

When are peak and trough levels drawn?

Peak: 30 mins after IV completion
Trough: Before next admin

What should be done before administering acyclovir?

Hydrate pt.