Drug quiz 1: (#1-29) Anti-infectives Brand/Generic COMMUNITY

Flagyl, Flagyl ER

metronidazole [PO] (antibacterial, antiprotozoal)

Contraindications: Pregnancy, use of alcohol ro proplyene glycol-containing products (disulfram rxn)

BBW: POSSIBLY CARCINOGENIC

Side Effects: Metalic tase, darkened urine

Drug Interactions: issue with warfarin

Notes: Take with food

Metrogel,

Metrocream

metronidazole [topical] (antibacterial, antiprotozoal)

Counseling same as Flagyl

Nuvessa

Vandazole

metronidazole [vaginal] (antibacterial, antiprotozoal)

Counseling same as Flagyl

Diflucan

fluconazole (Azole derivative, antifungal agent)

Common Use: yeast infection

Warnings: Hepatotoxicity, QT prolongation

Side Effects: hair loss, headache, rash

Drug Interactions: CYP450 inhibitor (lots of drug interactions)

Nizoral

ketoconazole (Imidazole antifungal agent)

Common Use: Topically

Warnings: Severe hepatotoxicity, QT prolongation

Side Effects: Same has Diflucan

Drug Interactions: CYP450 Inhib

Nystop {topical}

Mycostatin {PO}

nystatin (Antifungal agent)

Common Use: localized Candidia infections (Thrush)

Notes: Shake well before use; swish and swallow

Lamisil

terbinafine (Antifungal agent, topical)

Common Use: Dermatophytes (topical)

Dosage forms: Tablet, topical

Warnings: Hepatotoxicity

Side Effects: Headache, elevated LFTs, rash, pruritis

Notes: For nail bed infections

Zovirax

acyclovir (Antiviral agent)

Common Use: Many Herpes (chicken pox, cold sore, shingles)

Warnings: Caution in renally impaired, geriatics

Notes: DOES NOT CURE Herpes; use proper sexual protection to stop spread

Valtrex

valacyclovir (Antiviral agent)

Common Use: Same as acyclovir; prodrug version of acyclovir

Warnings: Same as acylcovir

Notes: DOES NOT CURE herpes

Keflex

cephalexin (Cephalosporin antibiotic, 1st generation)

Common use: Skin infections, strep throat:

Warnings: Cross-sensitivitiy with penicllin allergy

Side Effects: GI upset, diarrhea

Notes: 250-500 mg PO Q6-12H

Ceftin

cefuroxime axetil (Cephalosporin antibiotic, 2nd generation)

Common Use: Acute otitis media

Warnings: Cross sensitiivty with penicllin allergy

Drug Interactions: Separate by 2 hours from antacids

Omnicef

cefdinir (Cephalosporin antibiotic, 3rd generation)

Common Use: Acute otitis media

Warnings/Side Effects: same as cephalexin

Cipro

ciprofloxacin (Fluoroquinolone antibiotic)

Common Use: Antipseudomonal

Contraindications: Tendon rupture; neuropathy; caution in patients taking CNS meds;can cause seizures

Warnings: QT prolongation; hypo/hyperglycemia, photosensitivity

Notes: Oral susp. - shake, avoid sun exposure; avoid in pregnant/breastfeeding women

Levaquin

levofloxacin (Fluoroquinolone antibiotic)

Common Use: Same as cipro

Contraindications: Tendon rupture; neuropathy; caution in patients taking CNS meds;can cause seizures

Warnings: QT prolongation; hypo/hyperglycemia, photosensitivity

Notes: Respiratory cipro

Avelox

moxifloxacin (Fluoroquinolone antibiotic)

Common Use: Same as cipro (antipseudomonal)

Contraindications: Tendon rupture; neuropathy; caution in patients taking CNS meds;can cause seizures

Warnings: QT prolongation; hypo/hyperglycemia, photosensitivity

Notes: Only fluoroquinolone that cant be used for UTI

Zithromax, Z-Pack

azithromycin (Macrolide antibiotic)

Common Use: Respiratory tract infections, COPD, Chlamydia, bad traveler’s diarrhea

Warnings: QT prolongation, hepatotoxicity (patients with liver diesease)

Side Effects: GI upset, cramping, tase perversion

Drug Interactions: fewer drug ineractions than other macrolides

Dosing: Z-Pak - 500 mg on day 1, 250 mg on days 1-5

Biaxin

clarithromycin (Macrolide antibiotic)

Common Use: H. pylori treatment

Contraindications: Don’t take with simvastatin or lovastatin

Warnings: QT prolongation, hepatotoxicity (liver diesease patients)

Side Effects: GI upset, taste perversion

Clindagel, Cleocin, Cleocin T

clindamycin (Lincosamide antibiotic)

Common Use: Purulent/non-purulent skin infections, B-lactam alternative for dental abcesses; for C. difficle

Side Effects: Nasuea, vomiting, diarrhea

Notes: Colitis

Dosage forms: topical, inj., capsule, susp.

Macrobid, Macrodantin

nitrofurantoin (Nitrofuran antibiotic)

Common Use: Uncomplicated UTI

Contraindications: Renal impairment

Warnings: Hemolyctic anemia

Side Effects: GI upset

Dosing: MacroBID is 100 mg BID for 5 days

Amoxil

amoxicillin (Penicillin antibiotic)

Common Use: First-line treatmnet for acute otitis media

Contraindications: Severe renal impairment, dont use ER formula

Warnings: Seizures (when not adjusted), GI upset, diarrhea, rash

Dosage form: capsule, tablet, susp.

Notes: Avoid in patients with B-lactam allergy

Augmentin

amoxicillin/clavulanate (Penicillin antibiotic)

Common Use: First-line treatmnet for acute otitis media and bacterial sinitis

Contraindications: Severe renal impairment, dont use ER formula

Side Effects: Seizures (when not adjusted), GI upset, diarrhea, rash

Dosage form: tablet, susp.

Notes: Lower dose of clavulanate for less diarrhea; avoid in patients with B-lactam allergy

Pen-Vee K

penicillin V potassium (Penicillin antibiotic)

Common Use: First-line treatmnet for strep and nonpurulent skin infections

Contraindications: Severe renal impairment

Side Effects: Seizures (when not adjusted), GI upset, diarrhea, rash

Dosage form: tablet, susp.

Notes: Take on empty stomach; Avoid in patients with B-lactam allergy

Septra, Septra DS,

Bactrim, Bactrim DS

sulfamethoxazole/ trimethoprim (Sulfonamide antibiotic)Common Use: First-line treatmnet for acute otitis media

Common Use: CA-MRSA skin infections, UTI

Contraindications: Sulfa allergy, avoid in pregnancy

Warnings: Skin reactions in G6PD defic.

Side Effects: Photosensivitity, elevated K levels, crystaluria

Dosing: Dose based on trimethoprim component

Doryx

Oracea

Vibramycin

doxycycline (Tetracycline antibiotic)

Common use: Lyme + Rocky Mountain Spotted Fever

Warnings: Children under 8, pregnant, breastfeeding; permenant teeth discoloration

Side effects: N/V/D

Interactions: Separate from antacids

Notes: Sit upright for 30 min after dose to prevent esophageal irritation

Minocin

minocycline (Tetracycline antibiotic)

Common Indications: CA-MRSA skin infections, acne

Warnings: Children under 8, pregnant, breastfeeding; permenant teeth discoloration

Side Affects: N/V/D

Drug interactions: Separate from antacids

Notes: Sit upright for 30 min after dose to prevent esophageal irritation

Bactroban

mupirocin (Topical antibiotic)

Common unse: Elimination of MRSA colonization on nare

Side Effects: Headache, localized irritation

Tamiflu

oseltamivir (Antiviral against influenza)

Side Effects: Headache, N/V/D, abdominal pain

Dosing: Treatment >12 years old; 75 mg BID x 5 days; pediatrics is weight based

Notes: Best when used within 48 hours of symptoms show

Plaquenil

Hydroxychloroquine ( aminoquinoline (antimalarial), disease modifying antirheumatic (DMARD)

Common use: Rheumatoid arthitis, Lupus

Warnings: can cause irreversible retinopathy, myopthay, cardiomyopathy

Side Effects: N/V/D, abdomninal pain, rash, pruritis, headache

Notes: Causes hemolysis in G6PD defic. patients

Peridex,

PerioGard

chlorhexidine gluconate (antibacterial oral rinse)

Common use: Gingivitis, periodontitis

Side Effects: teeth discoloration, mouth irritation, dysgeusia

Counseling points: Swish and spit 15 mL BID

Descovy

Emtricitabine + tenofovir alafenamide (Nucleoside reverse transcriptase inhibitor (NRTI)

Common use: HIV PrEP; post-treatment exacerbation of acute Hep B

Warnings: IRIS, lactic acidosis, renal toxcity, hepatomegaly

Side effects: Hyperlipedmea, weight gain, renal impairment, decrease in bone density, hyperpigmentation of feet (emitricitabine)

Drug Interactions: LOTS of drug ineractions

Conseling points: DOESN’T CURE HIV, continue safe sex to stop spread

Biktarvy

bictegravir + emtricitabine + Tenofovir alafenamide

(Integrase inhibitor + nucleoside reverse transcriptase inhibitor (NTRI)

Common use: HIV PrEP; post-treatment exacerbation of acute Hep B

Warnings: IRIS, lactic acidosis, renal toxcity, hepatomegaly

Side effects: weight gain, increase in serum creatinine, renal impairment, decrease in bone density, hyperpigmentation of feet (emitricitabine), avoid with cations (bictegravir)

Drug Interactions: LOTS of drug ineractions, significant

Conseling points: DOESN’T CURE HIV, continue safe sex to stop spread

QD

every day

BID

twice a day

TID

three times a day

QID

four times a day

PO

by mouth; orally

PRN

as needed (for)

AM

Morning; before noon

HS

at bedtime

Q

every