Transcript Pharmtech Review Medications

Pharmtech Review Medications
All medications have a patent or trade name(s) and one generic
name
Information on drugs can be obtained from:
1. Drug topics Red Book: has prices, emergency info.,
clinical uses, product identification, mainly for
insurance reimbursement info.
2. Orange book: Used for approved drug clinical uses
3. Merck Index; for identifying chemicals
4. Physicians desk reference: book of the drug inserts
about dosing, generics and trade names, product
identifying, results of clinical trials and side effects
5. USP three volumes on approved uses of drugs, patient
information on drug, how to store a drug,
6. American Hospital Formulary Service Drug info; uses,
interactions, absorbtion and dosage of drugs.
Regulatory Agencies
• TJC (formerly known as The Joint Commission
on Accreditation of Healthcare. For controlling
quality care of hospitals, home health care
agencies, pharmacies, Sx centers, nursing
homes (inspection is voluntary)
• DEA: enforces the controlled subs. Act by
examining records, registering pharmacies
• FDA: Ensures quality of drugs and drug insert
information, their efficacy and and safety
• US Pharmacopeia: USP sets standards of
purity of drugs and foods and supplements
Antibiotics; Sulfonamides
• Bacteriostatic only: kill bacteria by blocking
reproduction only
• Usually for UTI’s and URI’s
• Side effects: photosensitiviy, kidney damage,
nausea
• Special considerations; avoid sunlight, drink a
lot of water to avoid kidney stones,
Gantricin, Septra, Bactrim,
Azulfadine
• Watch out for allergies to sulfa drugs,
photosensitivity, nausea
Examples of sulfonamides
• Sulfamethoxazole-trimethoprim brand name
is Bactrim or Septra
• Sulfadiazine Cream often used on diabetic
wounds (the silver cream)
• Sulfasalazine/Sulfoxazole brand name is
Gantrisin and Azulfidine
Gram Stain (quick in office ID of
type of bacteria and what it’s likely
sensitive to)
Penicillins
• Bacteriocidal; kill bacteria by preventing
formation of cell wall
• Used for abscesses, pneumonia, otitis media,
• Side effects: Allergies common, rash, asthsma,
anaphylaxis
• Take pens on empty stomach
• Last longer if refrigerated since it has a natural
source
Examples
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Amoxicillin: Brand Amoxil in cap or susp.
Ampicillin: Omnipen,
Cloxacillin;
Dicloxacillin: Dynapen
Cephalosporins
• Synthetic replacement of penicillins and are cidal
(break down cell wall production)
• Ten percent cross sensitivity to those with pen
allergy
• Broader spectrum than natural penicillins (kill
both gram positive and gram negative organisms
• Used a lot prior to sx as prophylactic
Examples of cephalosporins
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Cefaclor brand name ceclor
Defadroxil brand is Duricef
Cephalexin brand is Keflex (oral only)
Cefuroxime brand is Ceftin (IV or IM)
Tetracyclines
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Bacteriostatic; inhibit protein synthesis
Used for acne, broncitis, pneumonia
Side effects: photosensitivity
Never take with calcium containing foods for
calcium binds with the drug and is ineffective
• Causes yellowing of teeth in growing teeth
• Never given to pregnant females, teratogenic,
birth defects and kids under 9 yrs old
• Drug sensitive to light, tinted bottles and good at
room temp for 2 weeks only
Examples of tetracyclines
• Doxycycline: brand Vibramycin
• Minocycline: brand Minocin
• Tetracyline: brand Achromycin
Macrolide antibiotics
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Inhibit protein synthesis
Side effects; very upsetting to stomachs
Always take macrolids with food
Erythromycin was also developed, before
cephalosporins, as alternative to penicillins
and those allergic to pens.
Examples of macrolides
• Azithromycin brand is Zithromax
• Clarithromycin brand is Biaxin
• Also, Ilosone, EES, Erythrocin, E mycin are all
salts of erythromycin
Quinolones
• Interfere with DNA function and replication
killing bacteria (bacteriocidal)
• Used for serious bone and joint infections,
URIs and UTIs
• Side effects; nausea, dizziness
• Possible teratogenic effects (baby deformers)
• Photosensitivity in skin and drug is
photosensitive
Examples of quinolones
• Ciprofloxacin brand is Cipro (broad spectrum,
good alternative to penicillin allergic pts.)
• Levofloxacin brand Levaquin
• Oxafloxacin brand is Floxin
Aminoglycosides
• Block protein synthesis (bacteriocidal)
• For serious infections mainly
• Side effects; nephrotoxic,
ototoxic,tinnitus,permament deafness
Examples of aminoglycosides
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Amikacin brand is Amikin
Gentamicin brand is Garamycin
Neomycin brand is neosporin
Streptomycin brand is Streptomycin
Tobramycin brand is Nebcin
Miscellaneous antibiotics
• Clindamycin brand is Cleocin
• Inhibits protein synthesis
• Second line drug for serious bone infections
and penicillin allergic patients
• Causes bleeding of the intestines and
ulcerations of colon
Metronidazole (Flagyl)
• Used for Trichomonas of vagina and penile
urethra
• Never take with ethanol; works like Antabuse
Vancomycin (Vancocin)powerful
aminoglycoside; last line drug
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Only for very severe infections
Serious ototoxicity, neprhotoxicity
CDC has warnings out about this drug
Keep patient very hydrated to prevent serious
side effects.