DL - Final 5

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Author:
kyleannkelsey
ID:
302666
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DL - Final 5
Updated:
2015-05-13 12:10:31
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DL Final
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DL - Final
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DL - Final
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  1. What are the DDIs for Macrolides?
    Erythromycin, clarithromycin = CYP450 inhibitors
  2. What are the counseling pearls for Macrolides?
    • Finish entire prescription
    • May take with food to decrease stomach upset
    • Potential for drug-drug interactions: antiarrhythmics, cyclosporine, digoxin, theophylline, diltiazem, verapamil
  3. What are the AE of Fluoroquinolones?
    • Nausea, dyspepsia
    • Photosensitivity
    • Headache, dizziness, insomnia
    • Confusion, hallucinations (elderly, renal dysfunction)
    • Seizures (rare, dose-related)
    • QTc prolongation (dose-related) (Moxifloxacin, levofloxacin > ciprofloxacin)
    • Blood glucose fluctuations (hypo/hyperglycemia)
    • Arthralgias, Achilles tendon rupture (rare, elderly)
  4. What are the counseling pearls for Fluoroquinolones?
    • Do not take with calcium, iron, zinc, antacids, milk or multivitamins
    • Potential for drug-drug interactions: warfarin, theophylline, antiarrhythmics
    • Might want to caution any patient on warfarin about antibiotics because of changes in flora effect Vitamin K levels
    • May cause increased sensitivity to sunlight
    • Contact prescriber if tendon inflammation or pain develops
  5. What is the spectrum for Tetracyclines?
    • Large Range of Effect
    • Atypicals – Mycoplasma, Chlamydia, Legionella
    • T. pallidum, B. burgdoferi (Lyme disease), H. pylori
    • Streptococcus pneumoniae
    • CA-MRSA, P. acnes
  6. What are the common uses for Tetracyclines?
    • Community-acquired pneumonia
    • Bronchitis, sinusitis
    • Skin and soft tissue infections (CA-MRSA)
    • H. pylori eradication (tetracycline)
    • Chlamydia (doxycycline)
    • Tick borne diseases
    • Acne
  7. What are the AE for Tetracyclines?
    • Nausea, diarrhea, esophageal irritation
    • Photosensitivity
    • Tooth discoloration (children) -Avoid in pregnant women and children ≤ 8 years of age
    • Dizziness, vertigo (minocycline) – not really a problem with doxycycline
  8. What are the Counseling pearls for Tetracyclines?
    • Do not take with calcium, iron, zinc, antacids, milk or multivitamins
    • May cause increased sensitivity to sunlight – do not use tanning equipment
    • Take with a full glass of water, remain upright for 30 minutes - To prevent esophageal irritation
  9. What is the spectrum for Trimethoprim/Sulfamethoxazole?
    • MSSA, CA-MRSA
    • E. coli, Salmonella, Shigella
    • Stenotrophomonas maltophilia
    • Pneumocystis jirovecii (PCP)
  10. What are the common uses for Bactrim?
    • PCP prophylaxis and treatment
    • Skin and soft tissue infections (CA-MRSA)
    • Urinary tract infections - Common
  11. What are the AE for Trimethoprim/Sulfamethoxazole?
    • Allergic or hypersensitivity reactions – More common than other classes - Rash, toxic epidermal necrolysis, Stevens-Johnson syndrome
    • Photosensitivity
    • Bone marrow suppression (high doses) – tends to take a long time for this to develop
    • Crystalluria, hyperkalemia

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