antibiotics/ respiratory

theophylline - xanthrine derivative

uses: long term mangement of chronic asthma/COPD

MOA: relaxes bronchial smooth muscle, decreases airway response to bronchoconstriction triggers NOT A RESCUE MED

S/E: n/v, nervousness, insomnia, CNS stimulation, narrow therapeutic window (10-20mg/ml)

education: avoid caffeine, increase hydration, avoid respiratory irritants, scheduled blood-level monitoring

penicillins - penicillin v, penicillin g, amoxicillin, piperacillin, tazobactam

uses: strepocococcal, pneumococcal, some staphylococcal infections

MOA: bactericidial

S/E: gi upset, rash, edema, anaphylaxis, superinfection, allergen to cephlaporin, coagulation change, high potassium'

education: take as directed, finish entire prescription, report persistent diarrhea, rash, swelling, difficulty breathing

priority: allergy history + anaphylaxis + cross sensitivity

cephlasporins: cephalexin, cefalozin, cefprozil, ceftriaxone, cefepine

uses: skine, bone, genitourinary, respiratory infection, otitis media infections

MOA: bactericidial

S/E: gi upset, allergen to penicillin, coagulation problems, renal impairment, superinfection

monitor: Labs: BUN/creatintine, s/s of bleeding

education: report rash/allergy, s/s of superinfection, avoid alcohol

carbepenems - imipenem

uses: serious/life threatening infections, multidrug restitant, gram positive, gram negative infections

MOA: bactericidal, broad spectrum antibiotic

S/E: gi upset, allergic reaction (penicillin/cephlasporin), superinfection, use caution with seizure disorders and renal impairment

education: report rash/allergy, persistant diarrhea, s/s of superinfection

monobactum - aztreonam

uses: primarily gram negative —> pseudomonas

MOA: bactericidal, narrow spectrum antibiotic

S/E: gi upset, rash/skin infection, allergic reaction. superinfection

education: report rash/allergic reaction, severe diarrhea, monitor signs of superinfection

sulfonamides- trimethoprim-sulfamethoxazole (TMP-SMX)

uses: UTI, otitis media, some respiratory infections, travelers diarrhea

MOA: bacteriostatic, broad spectrum

S/E: allergic reaction, rash, crystalluria, decreased kidney function, bleeding risk

monitor: BUN/creatintine, platelet count

education: finish entire prescription, increase hydration, sunscreen, report rash/fever/sore throat/mouth sores

fluroquinolones - levofloxacin

uses: pneumonia, complicated UTI, complicated skin infections

MOA: inhibits DNA replication

S/E: tendonitis/tendon rupture, peripheral neuropathy, CNS effect, photsensitivity, increased muscle weakness with myasthia gravis

education: finish entire prescription, increase hydration, seperate from antacids, calcium, iron, zinc, report tendon pain/numbness/tingling/weakness/mood changes immediately

macrolides- erythomycin/ azithromycin

uses: respiratory infections, otits media, pelvic inflammation infections, chlamydia

MOA: bactericidal/bacteriostatic - syngerrgistic

S/E: gi upset, liver toxicity, photosensitivty, QT prolongation, dysryhthimas

monitor: liver function

education: take as directed, sun protection, report chest pain, palpations, jaundice

antiviral- acylovir

uses: herpes, chickenpox, shingles

MOA: inhibits DNA replication, slows viral replication

S/E: nephrotoxicty, renal impairments, gi upset fatigue, decreased seizure threshold

monitor: BUN/creatintine, GFR, hydration

education: take exactly as directed, maintain hydration, allow periods of rest

antiviral- oseltamivir/tamiflu

uses: treatment of influenza, preventive exposure

MOA: blocks release of new virus from infected cells, slows viral reproduction

S/E: gi upset, skin hypersensitivty

education: take exactly as described, rest/maintain hydration, does not replace flu vaccine

antiviral - adefovir

uses: chronic hepatitis

MOA: decreases hepatitis viral replication

S/E: nephrotoxicity, lactic acidosis, severe hepatomegally, severe hepatitis exacerbation

monitor: kidney and liver function

education: do not stop abruptly, long term therapy, continue liver monitoring after stopping

antiretroviral- lamivudine/zidovudine

uses: HIV treatment

MOA: blocks viral replication, helps control HIV

S/E: renal impairment, lactic acidosis, severe heptamegaly, pancreatitis

monitor: kidney function, urine output

education: take as prescribed, medication adherence is important, report s/s of pancreatitis, fatigue may occur

antifungals - clotrimazole/fluconazole/nystatin/terbinafine/amphotericin B

uses: fungal/yeast infections, oral thrush, skin infection, athletes foot, ringworm, systemic fungal infection

MOA: damages fungal cells, prevents fungal growth

S/E: skin irritation/ rash, liver toxicity, kidney toxicity, electrolytes

education: take as prescribed, report rash/fever/severe diarrhea/abdominal pain, increased toxicity risk for amphotercin B

antimalaria- chloroquine

uses: prevention of malaria

MOA: disrupts processes necessary for parasite development

S/E: vision/hearing changes, gi upset, renal impairment, sign of toxicity: headache, drowsiness, n/v, visual disturbances, cardiovascular collapse

education: take as prescribed, take with food if gi upset, reduce mosquito exposure

antiprotozoals - metronidazole/metrogel

uses: bacterial vaginosis, trichomoniasis, giardia, anaerobic bacterial infections

MOA: interferes with microogranisms ability to survive/reproduce

S/E: seizures, peripheral neuropathy, psychotic reactions, liver toxicity

need to know: may be given topically, vaginal, PO, IV, IV doses are over 30-60min

education: avoid alcohol, take as prescribed, urine become darker, partner requires STI treatment

antihelminthic- mebendazole

uses: roundworm/ hookworms/ parastic worm infections

MOA: disrupts parasite metabolism and structure

S/E: gi upset, loss of appetite, bone marrow supression with prolonged therapy

education: take as prescribed, good hygiene prevents reinfection, wash bedding/towels/clothes

antimycobacterial - isoniazid

uses: tuberculosis

MOA: inhibit growth/destroy mycobacteria

S/E: liver toxicity, gi upset, peripheral neuropathy

education: treatment lasts many months, strict adherence, avoid alcohol, vitamin B6 supplement, alternate contraceptive,

glycopeptides - vancomyocin

uses: serious gram positive infections —> MRSA, C.Diff

MOA: inhibits bacterial cell wall synthesis

S/E: nephrotoxicity, ototoxicity, redman syndrome, C Diff

education: report tinnitus, hearing loss, vertigo, rash, worsening infection

diphenhydramine/ certizine

uses: allergy symptoms, cold symptoms

MOA: block histamine at H1 receptors

1st generation: anticholenergic, paradoxical SNC stimulation in kids

2n generation: less sedating, headache, n/v, fatigue

education: take as directed, no alcohol and CNS depression, caution driving if drowsy

dextromethorphan

uses: non-productive cough interferring with rest/sleep

MOA: suppresses cough reflex, decrease sensitivity of cough centers/receptor

S/E: n/v, drowsiness, rash, difficulty brearthing hallucination, disassociation (high doses)

education: maintain hydration, avoid cough, irritants, alcohol/cns depressants, caution with MAOi’s

pseudophedrine

uses: nasal congestion

MOA: alpha 1 agonist, constricts blood vessels in nasal tissues, decreases swelling congestion

S/E: increased HR, dysrhythimias, increased BP, nervousness, insomnia, HA, dizziness

education: no MAOI, no double doses, use with caution for high blood pressure, cardiac diease, glaucoma, diabetes

benzonatae

uses: cough associated with respiratory illness

MOA: decreased sensitivty of cough receptors, quiets irriating cough receptors

S/E: n/v, rash, constipation, drowsy, dizzy, HA, dry mouth, respiratory depression at high doses

education: swallow whole, no alcohol and cns depression

codenine/guaifenesin

uses: both suppress cough, loosen mucus

MOA:

• codenine - suppresses cough reflex

• guaifenesin- thins/loosens mucous

S/E: sedation, respiratory depression, constipation, n/v, urinary retention, abuse/dependence

education: no alcohol/cns depression, lowest effective dose for shortest duration possible

guaifenesin

uses: productive cough, thick respiratory cough, thick respiratory secretions

MOA: thins/loosens mucus, makes secrections easier to cough up

S/E: n/v, headache, rash, drowsy

education: increase fluids, no respiratory irritaints, no alchohol, cns depressant, encourage deep breathing/coughing

albuterol/salmetrol

uses:

• SABA - albuterol

• LABA - salmeterol

MOA: stimulates beta 2 receptors, relaxes bronchial smooth muscle, opens airway

S/E: tremor, tachycardia, dysrhythmias, cns stimulation

education: prime inhaler, assess RR, o2, sat, lung sounds before/after administration

fluticasone

uses: asthma prevention, nasal inflammation and allegies

S/E: hoarseness, sore throat, oral candidiasi, dry nasal passages, nose bleeds

education: not a rescue medication, rinse mouth after use

ipratropium/tiotripium

uses: maintence, asthma, COPD, chronic bronchitis

• ipratropium - short acting

• tiotripium - long acting

MOA: blocks actylcholine, relaxes bronchial smooth muscle, opens airways

S/E: cant spit, cant shit, cant piss, cant see

education: take as directed, no maximum dose, report swelling, avoid MOAI

not a rescue medication

predinsone/ methylprednisone

uses: severe asthma/allergic conditions, acute COPD exacerbation

S/E: high blood sugar, weight gain (long term), high BP, high sodium, low potassium, delayed wound healing

education: do not stop abruptly after long term use, blocking immune system from working

montelukast

uses: long term asthma control, excersise induced, allergic rhinnitis

MOA: blocks receptors, decrease air way inflammation

S/E: headache, cough/nasal congestion, nausea, liver toxicity, mental health changes

education: same time each day, 2hrs before exercise, do not stop with out notifying provider

not a rescue med, 3-7 day for full effect