infectious disease 2

what class is clindamycin

lincosamide

what class is nitrofurantoin

nitrofuran

what class is metronidazole

nitroimidazole

what class is fluconazole

azole antifungal

what class is acyclovir and valacyclovir

guanosine nucleoside analog

what class is oseltamavir

neuraminidase inhibitor

what class is benzonatate

antitussive

what class is codeine-guaifenesin

antitussive/expectorant combo

clindamycin brand name

cleocin

clindamycin formulations

capsules, solution for inj, granules for oral solution, topical pledget, topical gel, topical lotion, topical solution, topical foam, vaginal cream, vaginal suppositories

clindamycin indications

bacterial infections: oral skin and abdominal infections, topical for bacterial vaginosis or acne, prevention of infections during dental procedures

clindamycin mechanism of action

reversibly binds 50s subunit → inhibits bacterial protein synthesis

clindamycin common adverse effects

N/V/D, abdominal pain, rash

clindamycin serious adverse effects

C diff colitis, increased liver function tests, erythema multiforme, SJS, TEN, agranulocytosis

clindamycin boxed warnings

possible severe colitis which might result in fatality

clindamycin contraindications

Hx of hypersensitivity to clindamycin

clindamycin general counseling points

finish all, store appropriately, stop taking if reaction develops, may cause N/V/D or rash, report severe diarrhea (Cdiff), take with a full glass of water

clindamycin topical counseling point

may cause dryness or skin irritation

clindamycin vaginal form counseling

may decrease effectiveness of barrier contraceptives, use another form of birth control up to 5 days following treatment

nitrofurantoin brand name

capsules (microdantin), monohydrate capsules (macrobid)

nitrofurantoin formulations

capsules, monohydrate capsules, oral suspension

nitrofurantoin indications

bacterial infections: urinary tract infections

nitrofurantoin mechanism of action

inhibits cell wall synthesis— interferes with carbohydrate metabolism by inhibition of acetyl CoA

nitrofurantoin common adverse effects

N/V/D, loss of appetite, rash, headache, urine/tear discoloration (orange/brown)

nitrofurantoin serious adverse effects

hepatotoxicity, hemolytic anemia, peripheral neuropathy, pulmonary fibrosis

nitrofurantoin contraindications

CrCl <60 mL/min, pregnancy at term, hepatic dysfunction at previous use, hypersensitivity

nitrofurantoin counseling points

finish all, store appropriately, stop taking if reaction develops, may cause N/V/D or rash, report severe diarrhea, may cause dark or discolored urine, report difficulty breathing if taking for more than 6 months, take with food

metronidazole brand name

flagyl

metronidazole formulations

tablets and capsules, ER tablets, topical cream, topical gel, topical lotion, vaginal gel, injectable solution

metronidazole indications

bacterial and protozoal infections: bacterial vaginosis, trichomoniasis, giardiasis, amebiasis, Cdiff infection

metronidazole mechanism of action

cytotoxic reduced form causes breakage in helical DNA structure → protein breakage and cell death

metronidazole common adverse effects

N/V/D, abnormal taste, yeast infection, vaginitis, headache, dizziness, jarisch herxheimer reaction, rash

metronidazole serious adverse effects

SJS, TEN, seizures, neuropathies, aseptic meningitis, ototoxicity

metronidazole boxed warnings

carcinogenic in mice and rats

metronidazole contraindications

use of disulfiram in the past two weeks, use of alcohol containing products during therapy or within 72 hours of dicontinuation, 1st trimester pregnancy (DNA breakage)

metronidazole general counseling points

finish all, store appropriately, stop taking if reaction develops, may cause N/V/D or rash, report severe diarrhea, may cause metallic taste, report abnormal nerve sensations, AVOID ALCOHOL

metronidazole topical form counseling

may cause dryness/skin irritation, avoid contact with eyes

metronidazole vaginal form counseling

may cause yeast infection, may cause itching and increased menstrual cramping

fluconazole brand name

diflucan

fluconazole formulations

tablets, powder for suspension, solution for inj

fluconazole indications

fungal or yeast infection: vaginal yeast infections

fluconazole mechanism of action

decreases ergosterol synthesis and inhibits cell membrane formation

fluconazole common adverse effects

N/V, headache

fluconazole serious adverse effects

QT prolongation, torsades de pointes, SJS, TEN, agranulocytosis, anaphylaxis, seizures

fluconazole contraindications

concomitant use with drugs metabolized by CYP3A4 that are know to prolong QT interval, concomitant use with terfenadine in patients receiving multiple fluconazole doses greater/equal to 400mg, hypersensitivity

fluconazole counseling

may cause N/V, store appropriately, may cause headache, report severe rashes, report feelings of abnormal heart rate

acyclovir brand name

zovirax

valacyclovir brand name

valtrex

acyclovir formulations

capsules, tablets, oral suspension, solution for inj, topical cream, topical ointment, buccal tablet

valacyclovir formulation

tablet only

acyclovir/valacyclovir indications

viral infections: herpes zoster (shingles), recurrent herpes simplex labialis (fever blisters), genital herpes simplexa

acyclovir/valacyclovir mechanism of action

synthetic purine nucleoside: competitively inhibits viral DNA poly, incorporates into and terminates DNA chain, inactivates viral DNA poly

acyclovir/valacyclovir common adverse effects

N/V/D, headache, malaise, contact dermatitis (topical)

acyclovir/valacyclovir serious adverse effects

thrombocytopenic purpura/hemolytic uremic syndrome, neutropenia, increased LFTs, increased SCr

acyclovir/valacyclovir contraindications

hypersensitivity to previouse use, hypersensitivity to milk protein

acyclovir/valacyclovir oral counseling

drink plenty of water to avoid renal complications, may cause N/V/D, store suspension, elderly patients may experience dizziness/confusion/somnolence

acyclovir/valacyclovir topical counseling

may cause burning/itching/dryness, only use on external part of lips and face, use rubber glove with application to avoid transmission

oseltamivir brand name

tamiflu

oseltamivir formulations

capsules, powder for oral suspension

oseltamivir indications

treatment and prophylaxis of influenza virus A/B

oseltamivir mechanism of action

inhibits viral neuraminidase which affects release of viral particles

oseltamivir common adverse effects

N/V/D, abdominal pain

oseltamivir serious adverse effects

abnormal behavior, delirium, seizures, GI hemorrhage, SJS, TEN

oseltamivir counseling

finish all, N/V/D, report abnormal behavior/signs of delirium/hallucinations, take with food to minimize stomach irritation, skip missed dose if next dose is in 2 hours, store suspension, begin treatment within 2 days of symptoms, begin prophylaxis within 2 days of exposure, capsules can be opened and mixed with sweet syrups/solutions

benzonatate brand names

tessalon perles

benzonatate formulations

capsules

benzonatate indication

cough

benzonatate mechanism of actions

anesthetizes stretch or cough receptors of vagal afferent fibers located in alveoli, may also inhibit transmission of cough reflex at medulla

benzonatate common adverse effects

nausea, numbness of throat and tongue if capsules are broken or chewed, dizziness, headache, sedation

benzonatate counseling

may cause dizziness or sedation, headache, do not break/crush/chew

antitussive/expectorant combo brand name

robitussin AC

codeine-gauifenesin formulation

solution, syrup, tablet

codeine-guaifenesin indications

cough

codeine-gauifenesin mechanism

codeine— suppresses cough reflex in cough center of medulla

gauifenesin— thins bronchial secretions and increases sputum volume

coedine-gauifenesin common adverse effects

N/V, constipation, sedation

codeine-gauifenesin serious adverse effects

respiratory depression, orthostatic hypotension, syncope, seizures

codeine-guaifenesin contraindications

hypersensitivity, asthma, pediatric patients having tonsillectomy or adenoidectomy

codeine-guaifenesin counseling

may cause sedation, do not drive or engage in other activities requiring mental alertness while taking, rise slowly from seated position, may cause N/V and constipation, avoid use with alcohol