Pharmacy Technician Top 200 Week 1

Conditions of the Immune System

• Bacterial infections: Occur when the body’s immune system is unable to resist bacteria

• Multi-drug resistant infections: An infection caused by bacteria that is resistant to one or more drug classifications

• Pneumonia: An infection that causes acute inflammation in the airways of the lung, blocking them with thick mucus

• What is an example of a multi-drug-resistant infection? (Methicillin-resistant Staphylococcus aureus [MRSA])

Penicillins

• MOA: Prevent bacteria from forming a cell wall

• Indications: Abscesses, meningitis, otitis media, pneumonia, respiratory infections, prophylaxis

• Adverse reactions: Diarrhea, hives, rash, wheezing, anaphylaxis

• Contraindications: Hypersensitivity to β-lactams, seizure disorders, renal impairment

• Special considerations for penicillins include: Take on an empty stomach with water and avoid taking with colas or juices

Cephalosporins

• MOA: Prevent bacteria from forming a cell wall

• Indications: Dental work, heart and pacemaker procedures, orthopedic surgery, pneumonia, upper respiratory infections (URIs), and sinus infections

• Adverse reactions: Diarrhea, hives, rash, wheezing, anaphylaxis

• Contraindications: Hypersensitivity to penicillin, history of gastrointestinal (GI) problems, renal impairment

• Approximately 10% of the population may have a cross-sensitivity to penicillin

Tetracyclines 

• MOA: Inhibit protein synthesis in bacteria by binding ribosomes

• Indications: Acne, chronic bronchitis, Lyme disease, Rocky Mountain spotted fever, “walking” pneumonia, prophylaxis for traveler’s diarrhea

• Adverse reactions: GI, such as nausea and vomiting; photosensitivity to sunlight, resulting in rashes and sunburns

• Contraindications: Pregnancy, renal or hepatic impairment

• Special considerations: 

  • They should not be taken by pregnant women because of the possibility of dental birth defects

  • Taking expired tetracycline may result in toxicity and possibly death

• Tetracyclines should not be given to children under the age of 9

Macrolides

• MOA: Inhibit protein synthesis by interacting with ribosomes

• Indications: Pulmonary infections, Chlamydia, Haemophilus influenzae

• Adverse reactions: May cause GI distress

• Contraindications: Hepatic or renal impairment, QT prolongation

• The patient should take macrolides with food

• Clarithromycin may leave a metallic taste in one’s mouth

Quinolones

• MOA: Antagonize an enzyme required for DNA synthesis, causing DNA breakage and finally death

• Indications: Bone and joint infections, dental work, infectious diarrhea, URIs, and UTIs

• Adverse reactions: Nausea and vomiting, joint swelling, dizziness

• Contraindications: Myasthenia gravis, patients younger than 18 years of age, and patients older than 60 years of age

• Special consideration: Should not be given to pregnant women

• Antacids interfere with absorption and can cause phototoxicity

Antifungals

• Fungal infections: An infection caused by single-cell organisms that do not have chlorophyll, possess a cell wall, and reproduce by spores 

• MOA: Prevent synthesis of ergosterol and inhibit fungal cytochrome P450

• Adverse reactions: Liver toxicities may develop; therefore, liver function tests are recommended. GI distress may occur. Photosensitivity, rashes, and nausea are other common side effects

• Special considerations: 

  • Consuming a cola before taking itraconazole is recommended

  • Fatty meals should be taken with griseofulvin

• Fungus develops in individuals whose immune systems have been compromised by disease, drug therapy, or poor nutrition

• What is a tinea infection? (A fungal infection of the skin or feet)

• Antifungals may be used as either topical or systemic agents