Week 3 Pharm

Bacteriostatic Agent Classes

Tetracyclines, Macrolides, Lincosamides, Sulfonamide Derivatives, Oxazolidinones

Generic Tetracycline Meds

Doxycycline, Minocycline

MOA of Tetracyclines

Binds to 30S Ribosomal Subunit which inhibits protein synthesis.

Contraindications for Tetracyclines

Pregnancy, Liver or Renal impairment, Myasthenia Gravis, use of oral retinoids

Side and Adverse effects of Tetracyclines

Photosensitivity, Permanent Discoloration of teeth in Children.

Medication-Induced Lupus Erythematosus

Hepatoxicity, Intracranial Hypertension, Esophageal Ulceration

Generic Macrolide Meds

Erythromycin, Clarithromycin, Azithromycin (ZPAC)

Indications of use for Macolides

Respiratory Tract Infections, Community Acquired Pneumonia, also when Pt is allergic to Penicillin’s

Contraindications for Macrolides

Hypersensitivity, Prolonged QT Interval

Side and Adverse Effects of Macrolides

Ototoxicity can develop with high does or prolonged use

GI side effects

Generic Lincosamide Meds

Clindamycin

Contraindications of Lincosamides

Hx of Pseudomembranous Colitis, Ulcerative Colitis, Hypersensitivity

Side and Adverse Effects

Pseudomembranous Colitis, C-Diff associated Diarrhea, Hepatoxicity, Blood Dyscrasias

GI distress

Generic Sulfonamide Derivatives Meds

Sulfamethoxazole-Trimethoprim, (TMP-SMX), Bactrim

MOA of Sulfonamide Derivatives

Blocks Bacterial Folate Synthesis, Inhibits dihydropteroate synthase

Indications to use Sulfonamide Derivatives

Simple UTIs, Acute Otitis Media, Traveler’s Diarrhea, Shigellosis

Contraindications for Sulfonamide Derivatives

Sulfa Allergy, Pregnancy, G6PD Deficiency

Liver Damage, Renal Insufficiency

Side and Adverse effects of Sulfonamide Derivatives

Photosensitivity

Stevens-Johnson Syndrome (life threatening skin and mucous medication reaction)

GI disturbances

Anemia

Hepatotoxicity, Renal Failure

Generic Oxazolidinones Meds

Linezolid

MOA of Oxazolidinones

Inhibits Bacterial Protein Synthesis by binding to 50S ribosomal Subunit

Contraindications for Oxazolidinones

Concurrent MAOI use

Tyramine Rich Food

Hypersensitivity

Side and Adverse effects of Oxazolidinones

Myelosuppression, Peripheral neuropathy, Serotonin Syndrome, Lactic Acidosis

Elevated Pancreatic Enzymes, Elevated Liver Function Tests

GI Issues

Chloramphenicol Effects on body and Indication for use

Crosses Blood Brain Barrier

Severe Typhoid Fever

Contraindication of Chloramphenicol

Acute Porphyria (Buildup of porphyrin needed to make Hgb)

Neonates

Side and Adverse Effects of Chloramphenicol

Bone Marrow Suppression, Aplastic Anemia, Ototoxicity, Metabolic Acidosis

Client Education for Bacteriostatic Agents

Stress the Importance of Completing the full course of Antibiotics

Classes of Bactericidal Medications

Aminoglycosides, Beta-Lactams, Fluoroquinolones, Glycopeptides, Lipoglycopeptides, Cyclic Lipopeptides, Nitroimidazoles

Generic Aminoglycosides Medication

Gentamicin

MOA of Aminoglycosides

Inhibits bacterial protein synthesis by binding to 30S ribosomal Subunit

Indications to use Aminoglycosides

Very Strong Infections, Sepsis, Septic Shock

Contraindications for Aminoglycosides

Myasthenia Gravis

Hypersensitivity

Side and Adverse Effects of Aminoglycosides

Nephrotoxicity, Ototoxicity

GI issues

Generic Beta-Lactam Medications

Penicillins, Cephalosporins, Carbapenems

Contraindications for Beta-Lactams

Hx of Anaphylactic reaction to Penicillins

Hx of Seizures or CNS disorders

Side and Adverse effects of Beta-Lactams

Serious Hypersensitivity

Immune-mediated hemolytic Anemia-Cephalosporins

Seizures-Carbapenems

Generic Fluoroquinolones Meds

Ciprofloxacin, Levofloxacin

Contraindications for Fluoroquinolones

Hx of tendon Disorders

Prolonged QT Interval

Hypersensitivity

Side and Adverse effects of fluoroquinolones

Tendinitis/Tendon Rupture

QT Prolongation

Generic Glycopeptides Med

Vancomycin

Indications for use for Glycopeptides

MRSA, Cellulitis, Hospital Acquired Pneumonia

MOA of Glycopeptides

Inhibits Bacterial Cell wall synthesis by preventing cross linking of Peptidoglycan chains

Side and Adverse Effects of Glycopeptides

Vancomycin Flushing Syndrome (Red Man Syndrome) with rapid IV infusion

Nephrotoxicity and Ototoxicity

Generic Lipoglycopeptide Med

Telavancin

Contraindications for Lipoglycopeptides

Severe Renal Impairment

Hypersensitivity

Side and Adverse Effects for Lipoglycopeptides

Foamy urine, Taste Disturbances, Flushing, Itching

Nephrotoxicity and Ototoxicity

Generic Cyclic Lipopeptide Name

Daptomycin

Side and Adverse Effects of Cyclic Lipopeptides

Myalgia/Muscle Pain, Myopathy, Rhabdomyolysis

Generic Nitroimidazole Meds

Metronidazole, Flagyl

Contraindications for Nitroimidazole

Pregnancy, Alcohol Consumption within the past 72 Hours

Side and Adverse Effects of Nitroimidazole

Metallic Taste, Darkening of Urine, Peripheral Neuropathy, Seizures

Leukopenia, Thrombocytopenia

Medications of RIPE Therapy

Rifamycin, Isoniazid, Pyrazinamide, Ethambutol

Side and Adverse Effects of Rifamycin

Orange/Red Discoloration of Body Fluids

Hepatotoxicity, Blood Dyscrasias

Flulike Syndrome

Side and Adverse Effects of Isoniazid

Abdominal Pain, Dark Urine, Fatigue

Hepatotoxicity, Peripheral Neuropathy

Contraindications for Pyrazinamide

Severe hepatic impairment, Acute Gout, Hypersensitivity

Side and Adverse Effects for Pyrazinamide

Joint Pain (Arthralgia)

Hepatotoxicity, Hyperuricemia, Gout, Photosensitivity

Contraindications for Ethambutol

Optic Neuritis, Inability to report visual Changes

Side and Adverse Effects of Ethambutol

Optic Neuritis, Peripheral Neuropathy

Changes in visual Acuity or Color Perception

Antiseptics for UTI

Nitrofurantoin

Contraindications for Nitrofuratoin

Severe Renal Impairment (Creatinine Clearance less than 60 mL/min)

Infants

Side and Adverse effect for Nitrofuratoin

Oulmonary Toxicity, hepatotoxicity, Hemolytic Anemia, Medication-Induced Lupus Erythematosus

Medications for Influenza Virus

M2 Proton Channel Agonists, Neuraminidase Inhibitors, Polymerase Acidic Endonuclease Inhibitors

Generic Name and MOA for M2 Proton Channel Antagonists

Amantadine

Treatment for Influenza A

MOA: Prevents virus from making copies of itself by clocking M2 Proton channel

Generic Names and MOA of Neuraminidase Inhibitors

Oseltamivir, peramivir, Zanamivir

Treatment for influenza A and B

MOA: Binds to Neuraminidase on Influenza Virus, prevents creation of viral envelope

Generic Name and MOA of Polymerase Acidic Endonuclease Inhibitors

Baloxavir Marboxil

Treatment for Influenza A and B

MOA: Inhibits viral polymerase endonuclease activity and viral replication

Client Teaching for Influenza Meds

Start meds within 48 Hrs of symptoms arising

Classes of COVID-19 Medications

Protease Inhibitors, Nucleoside Analogues

Generic Name and Contraindications for Protease Inhibitors

Nirmatrelvir/Ritonavir (Paxlovid)

GFR less than 30 mL/min , History of Liver Problems, HIV

Generic Name and Contraindications for Nucleoside Analogues

Remdesivir

GFR less than 30 mL/min, Hypersensitivity

Generic names of Herpes Virus Medications

Acyclovir, Famciclovir, Valacyclovir

Client teaching of Herpes Virus

Can be passed through Sexual Contact

Acyclovir can cause Thrombocyopenic Purpura (dots on skin)

Buccal Medications are available

Classes of Hepatitis C Medication

NS5A Inhibitors, NS5B Polymersase Inhibitors, Second-Generation Protease Inhibitors

Contraindications of Heptitis C Meds

GFR less than 30 mL/min

End Stage Renal Disease

Hx of Hepatic Decompensation, Hepatic Impairment

Client Teaching of Hep C Meds

Amiodarone with Sofosbuvir can cause Severe Bradycardia

Beta-Blocker Meds ( -olol ), can Cause Severe Bradycardia

Classes of HIV Medications

Viral entry Inhibitors, Enzyme Inhibitors, Protease Inhibitors, Antiretroviral Therapies

Generic Name, MOA, and Adverse Effects of Viral Entry Inhibitors

CCR5 Inhibitors (Maraviroc)

MOA: Targets CCR5 Receptors on surface of CD4 Cell

Cirrhosis and Liver Failure

Generic Enzyme Inhibitors Meds

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) , (Zidovudine)

MOA of NRTI

Inhibits Reverse Transcriptase

Adverse Effects of Zidovudine

Lactic Acidosis, Severe Heptaomegaly with Steatosis

Generic Protease Inhibitor Name

Ritonavir (PI)

MOA of PI

Blocks action of Protease, an enzyme needed for HIV Replication

Side Effects and Adverse Effects of PI

Abdominal Pain, Altered Taste, Anorexia, Atypical thinking

Fat Redistribution, Hyperlipidemia, Hyperglycemia

Generic Antiretroviral Therapies Name

Integrase Strand Transfer Inhibitor (INSTI) (Cabotegravir)MOA

MOA of INSTI

Prescribed for Pre-Exposure Prohylaxis (PrEP), Blocks action of Enzyme integrase to keep HIV from replicating

Lowers Risk of Sexually Acquired HIV

Contraindications for INSTI

Hypersensitivity

Unknown or Positive HIV Status

Side and Adverse effects of INSTI

Rash, Redness, Pain at Injection Site, Problems sleeping

Hepatoxicity, increased risk for upper respiratory tract infection, Suicidal Ideation