Pharm Unit Review

bethanechol

direct cholinomimetic

muscarinic receptor

ileus / urinary retension

pilocarpine

direct cholinomimetic

muscarinic receptor

glaucoma / Sjogren syndrome / CF sweat sample

methacholine

direct cholinomimetic

muscarinic receptor

can be degraded / screening tool for asthma

carbachol

direct cholinomimetic

muscarinic and nicotinic receptors

glaucoma / more potents / more side effects

edrophonium

anticholinesterases

quarternary amine

short acting / used to diagnose MG

pyridostigmine

anticholinesterases

quarternary amine

longest acting / used to treat MG

neostigmine

anticholinesterases

quarternary amine

reverses paralysis after anesthesia

donepezil

anticholinesterases

tertiary amine

used for Alzheimer's by increasing ACh in brain

rivastigmine

anticholinesterases

tertiary amine

used for Alzheimer's by increasing ACh in brain

physostigmine

anticholinesterases

tertiary amine

antidote for anticholinergic (atropine) overdose

atropine

antimuscarinic

tertiary amine

bradycardia / ACLS / inhibiting salivation and secretions

antidote for anticholinesterase poisoning

oxybutyin

antimuscarinic

tertiary amine

overactive bladder / decreases detrussor muscle spasms

scopolamine

antimuscarinic

tertiary amine

acts in vomiting part of brainstem / used for motion sickness / N/V after surgery

ipratropium

antimuscarinic

quarternary amine

short acting / bronchodilator / for COPD and asthma

tiotropium

antimuscarinic

quarternary amine

long acting / bronchodilator / for COPD and asthma

phenylephrine

alpha 1 agonist

nasal decongestant / for hypotension / induces mydriasis

clonidine

alpha 2 agonist

decreases norepinephrine release / decreases bp / treats ADHD

isoprenaline

non selective beta agonist (beta 1 and 2)

beta 1: increase hr, contractility, O2, energy demands

beat 2: vasodilation and lowers peripheral vascular resistance

used for bradycardia and heart block

albuterol

selective beta 2 agonist

short acting / bronchodilation / for COPD and asthma

salmeterol

selective beta 2 agonist

long acting / bronchodilation / for COPD and asthma

epinephrine (epi pen)

alpha and beta agonist / acts on alpha and beta receptors

alpa: vasoconstriction

beta: relaxing bronchioles

for anaphylaxis. severe asthma, ACLS, septic shock

phenoxybenzamine

non-selective alpha blocker / blocks alpha 1 and 2

irreversible non-competitive antagonist

for pheochromocytoma

phentolamine

non-selective alpha blocker / blocks alpha 1 and 2

reversible competitive antagonist

for pheochromocytoma (not as much)

can cause hypertensive crisis from MAOIs

doxazosin

selective alpa 1 blocker

lowers bp for HTN (not first line)

for urinary retention from BPH (benign prostatic hyperplasia)

terazosin

selective alpa 1 blocker

lowers bp for HTN (not first line)

for urinary retention from BPH (benign prostatic hyperplasia)

propranolol

non selective beta blocker (1st gen) / blocks beta 1 and 2

for HTN, CAD, tachycardia, angina pectoris, post MI, migraines (cross BBB)

DON’T use with COPD, asthma, and DM (if taking insulin)

atenolol

cardioselective beta blockers (2nd gen) / selective for beta 1

lowers bp and contractility / decreases renin release

for HTN, angina, post MI

SAFE for COPD, asthma, and DM

BUT, at high doses can affect beta 2

metoprolol tartate

cardioselective beta blockers (2nd gen) / selective for beta 1

lowers bp and contractility / decreases renin release

for HTN, angina, post MI

SAFE for COPD, asthma, and DM

BUT, at high doses can affect beta 2

labetalol

alpha beta blockers (3rd gen)

blocks alpha 1 receptors and beta 1 receptors in vessels

for HTN and PVD

has antioxidant properties / decreases free radical production

decreases thickening of blood vessels / decreases atherosclerosis

causes orthostatic hypotension

gentamicin

aminoglycosides

neomycin

aminoglycosides

amikacin

aminoglycosides

tobramycin

aminoglycosides

streptomycin

aminoglycosides

aminoglycosides

irreversibly bind to the 30S ribosomal subunit

requires O2 dependent cotransporter

gram negative aerobic bacteria

bacteriostatic in low concentrations / bactericidal in high concentrations

antimetabolites

interfere with the synthesis of DNA by inhibiting bacterial folate synthesis
gram positive and gram negative

sulfonamides

antimetabolite

inhibit dihydropteroate synthetase (DHPS)

preventing formation of dihydropteroic acid

silver sulfadiazine 1%

antimetabolite

topical only

sulfamethoxazole (SMX)

antimetabolite

trimethoprim (TMP)

antimetabolite

inhibits dihydrofolate reductase (DHFR)

preventing the formation of tetrahydrofolic acid

Trimethoprim / Sulfamethoxazole (TMP/SMX) (Bactrim) 

antimetabolite

blocks folate synthesis at two steps

both meds alone: bacteriostatic

combined: bactericidal

doxycycline

tetracycline

minocycline

tetracycline

tigecycline

tetracycline

tetracyclines

binds to the 30S ribosomal subunit

broad spec

gram negative, gram positive, and atypical

bacteriostatic

penicillin G

narrow spectrum

penicillin V

narrow spectrum

amoxicillin

broad spectrum

ampicillin

broad spectrum

piperacillin

extended spectrum

ticarcillin

extended spectrum

methicillin

very narrow spectrum

oxacillin

very narrow spectrum

nafcillin

very narrow spectrum

cloxacillin

very narrow spectrum

dicloxacillin

very narrow spectrum

narrow spectrum penicillin

common gram-positive bacteria, spirochetes

broad spectrum penicillins

gram positive and gram negative

can be used in pregnancy

extended spectrum penicillins

gram negative coverage

effective against pseudomonas

very narrow spectrum penicillins

gram positive and staphylococcus aureus

penicillins

inhibits cell wall synthesis in bacteria by binding to beta-lactam rung with PBP enzymes

bactericidal

cephalosporins

inhibits cell wall synthesis in bacteria by binding to beta-lactam rung with PBP enzymes

bactericidal

classified into generations by coverage and not age

cephalexin

first generation cephalosporin

cefazolin

first generation cephalosporin

first generation cephalosporin

gram postive bacteria and few gram negative bacteria that cause UTI

cefaclor

second generation cephalosporin

cefuroxime

second generation cephalosporin

cefoxitin

second generation cephalosporin

second generation cephalosporin

gram postive and gram negative

some anaerobic coverage

cefixime

third generation cephalosporin

ceftriaone

third generation cephalosporin

ceftazidime

third generation cephalosporin

third generation cephalosporin

broad spec

good gram negative coverage

cross BBB and treat bacterial meningitis

cefepime

fourth generation cephalosporin

fourth generation cephalosporin

effective against gram negative as (3rd) and gram positive as (1st)

treats pseudomonas

crosses BBB and can treat meningitis

ceftaroline

fifth generation cephalosporin

fifth generation cephalosporin

broad spec

can’t cross BBB

used for MRSA

5-Nitroimidazoles metronidazole

inhibit synthesis of DNA in bacteria and other organisms

must be reduced by protein ferredoxin

bactericidal

effective against many anaerobic bacteria and protozoans

narrow spectrum antibiotic

ciprofloxacin

second generation fluoroquinolone

oflaxacin

second generation fluoroquinolone

levofloxacin

third generation fluoroquinolone

moxifloxacin

third generation fluoroquinolone

fluoroquinolones

inhibit DNA replication by disabling DNA topoisomerase II (DNA gyrase) and DNA topoisomerase IV

broad spectrum antibiotics

bactericidal

very effective against Gram negative bacteria and certain mycobacteria (can be used for the treatment of tuberculosis)

chloramphenicol

inhibit protein synthesis

inhibits peptidyl transferase

prevents peptide bond formation between new amino acids and the polypeptide chain

broad spec / can cross BBB (treat meningitis)

gram negative and positive / aerobic and anaerobic

bacteriostatic

erythromycin

macrolide

inhibits cytochrome p450

first med given to newborns

azithromycin

macrolide

atypical coverage

clarithromycin

macrolide

renally dosed

inhibits cytochrome p450

macrolides

binds to the 50S ribosomal subunit

inhibits protein synthesis

effective against gram positive and gram negative

bacteriostatic

clindamycin

lincosamides

bind to the 50S ribosomal subunit

inhibits protein synthesis

bacteriostatic but bactericidal at high concentrations

broad spec

gram positive and anaerobic

MRSA

linezolid

oxazolidinones

binds to the 50S subunit of the ribosome

prevents it from combining with the 30S

inhibits protein synthesis

broad spec

effective against a wide variety of gram-positive bacteria

reserved for bacterial infections resistant to other antibiotics (MRSA and VRE)

bacteriostatic against enterococci and staphylococci with a short post-antibiotic effect

bactericidal against some streptococcal species

Bacitracin (BACiiM)

bactoprenol inhibitors

blocks bactoprenol phosphate

bacteria can't make new peptidoglycan

inhibits cell wall synthesis

narrow spec

few gram positive bacteria

bacteriostatic

imipenem/Cilastatin

carbapenems

meropenem

carbapenems

ertapenem

carbapenems

doripenem

carbapenems

carbapenems

bind to PBPs and inhibits cell wall synthesis

broad spec “Big Guns”

gram positive and gram negative and anaerobes

bactericidal

aztreonam

monobactam

resistant to beta lactamases

narrow spec

very effective against gram negative

INEFFECTIVE against gram positive

bactericidal

vancomycin

glycopeptide

telavancin

glycopeptide

teicoplanin

glycopeptide