Pharm II Meds Midterm

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Pharm II Meds Midterm
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  1. Actigall
    • Gallstone-Solubilizing Agent: Urosdiol
    • reduces cholesterol content of bile, emulsifies bile salts
    • used for small, non calcified stones (see on US but not x-ray)
  2. Allylamines
    • Lamisil
    • new class on antifungals
    • also Butenafine, Terbinafine
  3. Amikacin
    • Aminoglycoside
    • broadest spectrum
    • least vulnerable to inactivation by bacterial enzymes
    • reserved for when other things really dont work
    • SE: nephrotoxic, ototoxic
  4. Amoxicillin
    • Broad Spectrum: Aminopenicillin
    • Tx: H. Pylori, Otitis media
    • best in neutral pH
    • better absorbed & fewer SE than ampicillin
    • PO only
  5. Ampicillin
    • Broad Spectrum: Aminopenicillin
    • Primarily IV, can be PO
    • generally not tolerated very well
  6. Amphogel, Alternagel
    • Antacid: Aluminum Hydroxide
    • use in pts w renal failure
    • Can also bring down phos levels - binds w PO4
    • avoid in HTN, FH - has high Na+
    • SE: constipation, inc CO2 production
  7. Amphotericin B
    • Antifungal
    • Tx: systemic mycoses
    • Broad spectrum, resistance is rare
    • highly toxic, difficult for pt - binds to ergosterol in cell membrane, humans have sterols in membrane also
    • fungicidal or fungistatic depending on conc
    • no PO, IV - 6-8 weeks, may be up to 3-4 months to finish
    • dont know how its excreted, stays in body for long time
    • SE: phlebitis, fever, chills, rigors (demerol or Dantrolene), N, HA, nephrotoxic in all (BUN & Creat up), hypokalemia (related to kidney)
    • SE start 1-3 hours after, pretreat w Tylenol/Aspirin and Benadryl
    • Interactions: nephrotoxic meds, Flucytosine (synergistic, can be used to lower dose of Ampho B)
    • rotate site, infuse slowly, alternate day dosing
  8. Antivert
    • Anticholinergic/Antihistamine: Meclizine
    • Tx: Motion Sickness
    • SE: Sedation, anticholinergic effects
  9. Augmentin
    • Amoxicillin + Clavulanic Acid (Beta-Lactam Inhibitor)
    • PO
    • more diarrhea than just amoxicillin
  10. Azithromycin
    • Macrolide Antibiotic: Zithromax, Z-pack
    • very specific dosing
    • take w or w/o food, not w antacids
    • newer - stronger, longer-half life = may be done taking before everything clears up
    • Tx: mycobacterium avium complex prophylaxis
  11. Aztreonam
    • Monobactam Antibiotic
    • Tx: gram neg aerobes only, very specific use, may need ID consult
    • can give w PCN allergy
    • affects cell wall but not beta-lactamase sensitive
  12. Azulfadine
    • 5-aminosalicylic acid derivate: Sulfasalazine
    • Tx: IBD
    • suppresses inflammation
    • SE: from Sulfa (photosensitivity, dec granulocytes, N, rash), less if given as enema
    • Contraindications: sulfa or aspirin allergy
  13. Bismuth
    • pepto Bismol
    • treatment of H. Pylori
    • antimicrobial agents that is local in GI tract
    • diarrhea, turns tongue and stool black
  14. Carafate
    • Sucralfate: Mucosal Protectant
    • aluminum salt & sulfated sucrose
    • acts locally like a BandAid, take PO and goes to place
    • Does not neutralize or reduce acid
    • SE: Constipation and reduced absorption of meds absorbed in stomach
  15. Cardura
    • Alpha1 Adrenergic Blocker: doxazosin
    • Tx: BPH
    • relax smooth muscle in prostate capsule, prostatic urethra and bladder neck
    • SE: dec BP, especially if on bp med, nitro, viagra
    • lifelong
  16. Castor Oil
    • stimulant laxative
    • works in small intestine
    • PO
    • not really used any more except sometime in emergencies to clear bowel before surgery
  17. Cefazolin
    • Cephalosporin Antibiotic - 1st Gen
    • Affects cell wall
  18. Ceftazadime
    • Cephalosporin Antibiotic - 3rd Gen
    • Affects cell wall
  19. Ceftriaxone
    • Cephalosporin Antibiotic - 3rd Gen
    • Affects cell wall
  20. Chlorampenicol
    • Broad spectrum, also kills normal flora
    • IV only
    • SE: bone marrow suppression, Gray syndrome, Aplastic anemia
    • only used if safer agent not avail
    • Grey syndrome: in newborns bc kidney and liver are immature, trouble clearing med - CV collapse and even death
    • can cross into placenta and breast milk
  21. Cinobac
    • Cinoxacin
    • Urinary Tract Antiseptic
  22. Cipro
    • Fluoroquinolone: Ciprofloxacin
    • broad spectrum, inhibits DNA gyrase
    • Tx: anthrax, UTI, prostatitis, pneumonia...
    • SE: GI, CNS (HA), tendon rupture, suprainrection (ex candida)
    • Drug and food interactions in PO only: Al and MG antacids, Fe and Zinc salts, dairy, Sucralfate
  23. Citrucel
    • Bulk Forming Laxative: methylcellulose
    • also used in tx of diarrhea, absorbs fecal water
  24. Clarithromycin
    • Macrolide Antibiotic: Biaxin
    • Tx: H. Pylori, Mycobacterium avium Complex prophylaxis
    • distortion of taste, nausea, diarrhea
    • extended release must be taken w meal
    • newer - stronger, longer half-life = may be done taking before everything is cleared up
  25. Clindamycin
    • Lincosamide Antibiotic
    • Tx: anaerobic infections outside CNS, acne
    • IV, PO, topical (vaginal)
    • SE: Pseudomembranous Colitis, rapid admin can cause EKG changes and hypotension
    • PO - take w full glass of H2O
  26. Colace
    • Surfactant Laxative: Docusate
    • stool softner
    • facilitates addition of fat & water over a few days
    • prophylactic
    • give w full glass of water, important to drink enough
  27. Compazine
    • Anti-emetic/Dopamine Antagonist: Prochloroperazine
    • Phenothiazine
    • EPS and sleepy due to dopamine blockade at chemoreceptor site(cant drive home)
    • very cheap but bad SE
    • PO, IM, IV, suppository
    • make sure they have call bell bc EPS will scare them
  28. Cytotec
    • Misoprostol: Antisecretory agent
    • synthetic form of prostaglandin
    • Tx: prevention of NSAID induced Gastric ulcers (not duodenal)
    • Promotes secretion of bicarb, mucus and blood flow and reduces secretion of acid
    • SE: Diarrhea, abd pain, utrine contractions, spotting & dysmenorrhea (Category X)
  29. Dapsone
    • Antimycobacterial
    • Tx: Leprosy
    • SE: GI, HA, rash, usually well tolerated tho
    • blocks synthesis of folic acid
    • Bactericidal, related to sulfonamides
    • used in combo w rifampin & clofazimine
  30. Dicloxacillin
    • PCNase resistant
    • narrow spectrum
    • MRSA resistant
  31. Doxycycline
    • Long Acting Tetracycline Antibiotic: Vibramycin
    • Tx: Lyme, Chlamydia, Malaria prophylaxis
    • longer half-life, better absorbed than tetracycline, can take w meal
  32. Dramamine
    • Anticholinergic/Antihistamine: Dimenhydrinate
    • Tx: Motion Sickness
    • Decs neural stimulation on neural pathway btwn inner ear and VC
    • SE: anticholinergic effects
  33. Dulcolax
    • Stimulant & Irritant Laxative: Bisacodyl
    • suppositories work in 15-60 mins
  34. Erythromycin
    • Macrolide Antibiotic
    • Tx: Better in Gram +, gastroparesis (separate effect)
    • PO, IV, topical (eye ointment)
    • alternate for PCN allergy
    • SE: Gi upset (common), Suprainfection, QT prolongation (rare)
    • Food generally decs absorption
  35. Ethambutol
    • Antimycobacterial
    • Tx: TB, active Mycobacterium avium
    • bacteristatic
    • SE: optic neuritis, allergy, hyperuricemia, GI discomfort
  36. Flomax
    • Alpha1 Adrenergic Blocker: tamsulosin
    • Tx: BPH
    • relax smooth muscle in prostate capsule, prostatic urethra and bladder neck
    • SE: dec BP less likely bc selective to prostate
  37. Flutamide
    • Androgen Receptor Blocker: Eulexin
    • Tx: Prostate CA
    • blocks testosterone, really only works for ~2 yrs
    • SE: gynecomastia, N/V/D, liver toxicity
    • combined w surgical or chem castration
  38. Folic Acid
    • Water Sol
    • Deficiency: megaloblastic anemia, neural tube defects
    • No neurologic effect
    • common in alcoholics
    • excess really doesnt cause a problem
  39. Furadantin
    • Nitrofurantoin
    • Urinary Tract Antiseptic
  40. Gentamicin
    • Aminoglycoside Antibiotic
    • Tx: serious gram - aerobic infections
    • not effective on anaerobic
    • can b used in empiric tx, but mostly specific tx
    • IM or intrathecal, PO (only for GI)
    • SE: neprotoxic, ototoxic, neuromuscular blockade (not common) - high peaks not dangerous, just high trough - monitor peak and trough
    • can be given daily (better, only draw trough) or 2-3 smaller doses (both)
    • serum levels vary greatly btwn pts, not just on ht/wt
    • Caution: using other nepro- or ototoxic meds
    • used in combo w PCN bc it breaks down cell wall but dont run through same IC
  41. Glycerine
    • suppository laxative
    • gentle, safe in infants and children
    • just softens stool, no stimulant effect
    • helps re-establish bowel patterns after abuse
  42. GoLYTELY
    • polyethylene Glycol-Electrolyte Solutions
    • isometric w body fluids: no fluid or electrolyte loss
    • Use: diagnostic procedure prep
    • drink 4L in 2-3 hours
    • safe in pts w dehydration
    • yellow, Gatorade like color
  43. Griseofulvin
    • Tx: dermatophytic infections
    • deposited in keratin precursor cells, newly formed keratin is resistant to fungal infections
    • 3-8 weeks for skin
    • 2-3 months for palms
    • up to 1 yr+ for nails
  44. Hydrocortisone
    • Corticosteroid
    • Tx: IBD
    • IV
  45. Imipenem
    • Carbapenem Antibiotic
    • IM or IV only
    • admin w Cilastin to inc urine excretion
    • PCN allergy cross sensitivity
    • affects cell wall
  46. Immodium
    • Antidiarrheal: Loperamide
    • Tx: gastroenteritis (acute or chronic diarrhea)
    • chem related to opioids but cant get high - dont need atropine so less SE
    • Slows motility
  47. Imuran
    • Immunomodulator: Azathioprine
    • Tx: refractory IBD
    • onset may be up to 6 months
    • SE: pancreatitis, bone marrow suppression, can be hepato- and nephrotoxic
    • monitor CBC
  48. INH
    • Isoniazid, Laniazid
    • Antituberculis/Antimycobacterial
    • primary agent, bactericidal
    • SE: peripheral neuropathy (Vit B6), hepatotoxic, optic neuritis, anemia
  49. Iron
    • Ferrous Sulfate
    • Deficiency: microcystic, hypochromic anemia (pale, tired, SOB, weakness)
    • Can be caused by chronic blood loss, pregnancy, also in infancy & early childhood
    • SE: GI (N/V, constipation, dark/green stool), Anaphylaxis w parenteral(usually do small skin test)
    • children at greatest risk of toxicity
    • better absorption btwn meals but food decs GI irritation, Vit C promotes absorption
    • can stain teeth
  50. Ivermectin
    • Stromectol
    • Tx: mites and lice
    • causes paralysis, disrupts nerve and muscle function
    • single dose, off label
    • still need to use comb to remove eggs
  51. Ketoconazole
    • Tx: systemic and superficial mycoses, less severe
    • less toxic, but less effective than Ampho B
    • Broad Spectrum, fungistatic & Fungicidal
    • inhibits synthesis of ergosterol
    • SE: N/V, hepatotoxic, effects sex hormone
    • Interactions: meds that inc gastric pH, inhibit cytochrome P450 enzymes, rifampin
  52. Lactulose
    • synthetic disaccharide of galactose & fructose
    • metabolized: by bacteria into acids & CO2, draws H2O into stool
    • tx: hepatic encephalopathy - acid draws ammonia in
    • cant b digested and is poorly absorbed
    • soft formed stool in 1-3 days
    • SE: cramping and flatulence
  53. Lamodil
    • Antidiarrheal: Diphenoxylate HCL w Atropine
    • opioid w atropine to deter abuse, can get morphine like high if you take alot, but very bad SE
    • Schedule V
    • SE: anticholinergic effects, opioid effects (CNS depression, constipation)
    • Drug interaction: MAOIs
    • Contraindications: infectious diarrhea, obstructed jaundice, under 2 years
  54. Lotronex
    • IBS: Alosetron
    • for women only
    • Risk management program: Fatal GI effects (obstructions, ischemia, perforations)
    • reduces urgency and freq of BMs
  55. Lupron
    • Leuprolide
    • Gonadotropin-Releasing Hormone Agonist
    • suppresses testosterone prod
    • SE: hot flashes, impotence, loss of libido, osteoporosis in men
    • chemical castration
  56. Maalox
    • Antacid
    • combination of aluminum (constipating) and magnesium (diarrhea) to balance out
  57. Malathion
    • Ovide
    • Organophosphate cholinesterase inhibitor
    • 0.5%lotion
    • Tx: lice and their ova
    • apply to hair, let air dry
    • flammable - high alcohol content
    • still need to use comb to remove eggs
  58. Mandelamine
    • Methenamine
    • Urinary Tract Antiseptic
  59. Marinol
    • Antiemetic/Cannabinoid: Dronabinol
    • Tx: N/V associated w chemo, appetite stimulant in AIDS, dementia
    • SE: dissociation, dysphoria
    • Caution: in cardiac pts - can drop bp and have palpations
    • Schedule III
    • Slow onset of action
  60. Mesalamine
    • 5-aminosalicylic acid derivate: Asacol or Pentasa
    • Tx: IBD
    • similar to sulfasalazine but w/o sulfa part, so less SE
    • Contraindication: aspirin allergy
  61. Metamucil
    • Bulk Forming Laxative: Psyllium
    • Unlabeled use: cholesterol lowering agent
  62. Methylprednisolone
    • Corticosteroid
    • Tx: IBD
    • PO, IV
  63. Metronidazole
    • Antiprotozoal: Flagyl, Metizol, Protostat
    • Tx: H. Pylori, Pseudomembranous Colitis, intestinal amebiasis, giardiasis, T. vaginalis
    • Broad spectrum, high resistance
    • Pro drug - need anaerobic enviro (our cells are aerobicc)
    • SE: N/V, HA, dry mouth, metallic taste, stomatitis, diarrhea, insomnia, vertigo, weakness, darkening of urine
    • Interactions: disulfiram, inhibits inactivation of warfarin, incs levels of Phenytoin, lithium, fluorouricil, Cyclosporin, Tacrolimus, binds w Cholesyramine (2 hours btwn), drugs that effect CYP3A4
    • Caution: in renal pts, dont use in 1st tri, caution after, dont use in CNS pts
  64. Milk of Magnesia
    • Antacid: Magnesium Hydroxide
    • Osmotic Laxative
    • generally more for constipation
    • SE: diarrhea, substantial fluid and electrolyte loss
    • Caution in pts w renal failure & HF, can inc mag level
    • Avoid w undiagnosed abd pain
    • Incs effect of sulfonylureas, quinidine & dicumarol
  65. Mineral Oil
    • Emollient or Lubricant laxative
    • excessive oral admin decs absorption of fat sol vits
    • poorly absorbed
    • not really used much anymore, was used in "healthy" chips
  66. Nafcillin
    • PCNase resistant
    • narrow spectrum
    • MRSA resistant
  67. NegGram
    • Nalidixic acid
    • Urinary Tract Antiseptic
  68. Neomycin
    • Aminoglycoside
    • highest risk for toxicity
    • PO, topically, NOT IV
    • Tx: suppress bowel flore before surgery
  69. Nystatin
    • polyene antibiotic
    • Tx: candidiasis only
    • PO (pill or suspension) & topical (powder)
  70. Orlistat
    • Lipase Inhibitor: Xenical
    • Tx: obesity
    • reduces absorption of dietary fats
    • must be obese (BMI 30) or overwt (27) w related health problems/CV risk factors
    • Contraindications: malabsorption syndrome, cholestasis, caution w kidney stones, delayed bladder emptying
    • SE: oily fecal incontinence, dec absorption of fat sol vitamins
  71. Oxacillin
    • PCNase resistant
    • narrow spectrum
    • MRSA resistant
  72. Pancrelipase
    • lipase, protease & amylse
    • enteric coated - dont cut or crush
    • Contraindications: hypersensitivities to porcine proteins, acute or chronic flares (will be NPO)
    • give w a meal or snack
    • Pancreatin - same action and indication but less conc
    • monitor albumin, prealbumin, pancreatic enzymes
  73. PCN G
    • Forms: Potassium PCN, Procaine PCN, Benzathine PCN - salts dissociate to release PCN G
    • Dont give PO, only K can be given IV
    • Distribution: inflammation incs penetration into CSF, joints and eye
    • not metabolized, so make sure no kidney problems
    • SE: allergy, pain at site, neurotoxicity w high blood levels, hyperkalemia w lg Iv doses
    • Interactions: Aminoglycosides inactivated when they are mixed - separate admin!
  74. PCN V
    • PCN VK, Pen-Vee K
    • PO only - usually w meal to reduce GI SE
    • Tx: dental work/issues, strep...
  75. Pepcid
    • Famotidine: H2 Receptor antagonist
    • does not inhibit hepat drug metabolizing enzymes
    • Same uses and SE as Zantac
  76. Pepto Bismol
    • Bismuth Subsalicylate
    • Antidiarrheal
    • antimicrobial effects in GI, reduces inflammation, soothes bowel, ins H2O absorption
    • SE: discoloration of tongue and stool
    • Contraindications: aspirin allergy, kids (Reye's), IBD (bursting)
  77. Lindane
    • Kwell, G-well
    • Tx: scabies, lice, pruritis (min effect)
    • causes seizure in parasite, can in pt too, esp if hx of seizure
    • SE: eye and mucus membrane irritation, seizure
    • Contraindication: Seizure d/o, elderly, less than 110 lbs
    • Caution: open sores, psoriasis, atopic dermatitis
  78. Permethrin
    • Nix, Elimite, Acticin
    • 1% liquid
    • Tx: scabies and lice
    • causes paralysis of insect
    • SE: not many - itching/burning
    • for scabies: apply to entire body (massage in), leave overnight, shower in morning
    • For lice: wash hair before, apply, leave 10 days, can retreat in 7
    • resistance in 5%
  79. Phenergan
    • Anti-emetic/Dopamine Antagonist: Promethazine
    • Phenothiazine
    • EPS and sleepy due to dopamine blockade at chemoreceptor site(cant drive home)
    • very cheap but bad SE
    • PO, IM, IV, suppository
    • make sure they have call bell bc EPS will scare them
    • Phenergan extravassation - necrosis,
    • death, finger and hand amputation – need to be very careful giving IV, some hospitals have pulled it, - if giving dilute it w NSS, only use a very good site, stay to watch it go in
  80. Piperacillin
    • Extended Spectrum: Antipseudomonal PCN
    • IV
    • PCNase sensitive
  81. Prednisone
    • Corticosteroid
    • Tx: IBD
    • PO
  82. Prilosec
    • omeprazole - PPI
    • Tx: GERD, PUD, Zollinger-Ellison, Dyspepsia
    • newer and more effective in dec gastric acid than H2 blockers
  83. Proscar
    • 5-alpha-reductase inhibitor: Finasteride
    • Tx: urinary symptoms of BPH
    • inc effect w inc enlargement
    • decs prostate size
    • SE: gynecomastia, dec libido, dec ejaculate volume
    • effects begin in 6-12 mo
    • indefinite tx, prostate will re-enlarge
    • monitor PSA, should go down
    • preg X = cant donate blood for certain period
  84. Pyrazinamide
    • Antimycobacterial
    • Tx: TB
    • Bactericidal
    • SE: hepatotoxic, photosensitivity
  85. Reglan
    • antiemetic/prokinetic agent: metoclopromide
    • Tx: N/V related to gastroparesis, GERD, psot-op, chemo
    • sensitizes tissue to acetylcholine, incs peristalsis & gastric emptying, Dopamine antagonist
    • SE: CNS depression, EPS, Diarrhea
  86. Rifampin
    • Antimycobacterial: Rifadin
    • Tx: TB, Leprosy, H flu, Legionella
    • SE: hepatitis, body fluid discoloration (red), optic neuritis
    • Interactions: cytochrome P450 meds (coumadin, contraceptives, HIV meds - incs metab
    • consult eye dr about contacts bc body fluids
  87. Scopolamine
    • Anticholinergic/Muscarinic Antagonist
    • Tx: Motion Sickness
    • SE: dry mouth, blurred vision, drowsiness (anticholinergic effects)
    • patch and pill
    • dec neural stimulation on pathway btwn inner ear and vomiting center
  88. Senokot
    • Stimulant Laxative: Anthraquinones
    • herbal source
    • change in urine color to dark yellow
    • red/brown pill
  89. Sodium Bicarbonate
    • Antacid
    • not an agent of choice
    • can make body pH rise
    • avoid Na+ load in pts w hx of HTN & HF
  90. Synercid
    • Streptgramin Antibiotic: Quinupristin/Dalfopristin (always come together in set ratio)
    • Tx: MRSA, VRE - require ID approval
    • Caution: pts w dec hepat func - monitor liver enzymes, bilirubin
    • Interactions: saline, heparin (flush line w D5W)
    • metabolized by liver
    • monitor for thrombophlebitis (flush line regularly)
  91. Tagamet
    • Cimetidine
    • PO, IM, IV
    • H2 Receptor Antagonist
    • treatment of PUD, GERD, Zollinger-Ellison Syndrome, Dyspepsia, prevention of aspiration pneumonitis
    • Blocks Histamine (messenger) at receptor site, histamine causes inc gastric acid prod. from parietal cells
    • Dont really use any more bc bad SE: antiandrogenic confusion (esp in elderly), inhibits hepatic drug metabolizing
    • Dont take w Antacids
  92. Terazosin
    • Alpha1 Adrenergic Blocker: Hytrin
    • Tx: BPH
    • relax smooth muscle in prostate capsule, prostatic urethra and bladder neck
    • SE: dec BP, especially if on bp med, nitro, viagra
    • lifelong
  93. Tetracycline
    • Tx: H. Pylori, acne
    • SE: stains teeth, photosensitivity, GI irritation, suprainfection
    • PO, topical
    • Contraindicated: pregnancy, breastfeeding, under 8
    • Take on empty stomach, space 2 hours from Ca, Fe, MG-form non-absorbable compounds)
  94. Thiamin
    • Vit B1 - Water Sol
    • Deficiency: Wernicke-Korsakoff syndrome (CNS effects), common in alcoholics
    • Wernicke-Korsakoff requires IV replacement
  95. Ticarcillin
    • Extended Spectrum: Antipseudomonal PCN
    • IV
    • PCNase sensitive
  96. Timentin
    • Ticaricillin + Clavulanic acid (Beta-Lactamase Inhibitor)
    • IV
  97. Tobramycin
    • Aminoglycoside
    • same interactions and SE as gentamicin
  98. Trimethroprim
    • Suppresses synthesis of DNA, RNA, and protein (more sensitive to bacterial cells)
    • Bactericidal or Bacteriosatic
    • SE: rash, itching, GI upset, but generally well tolerated
    • not recommended druing preg (exacerbates folate deficiency)
  99. TMP-SMZ
    • Trimethoprim-Sulfamethoxazole: Bactrim, Cotrim, Spetra (comes pre-mixed 1:5)
    • Tx: broad spectrum of Gram - and +, UTI, otitis media, bronchitis, pneumonia-PCP, Shigellosis, community MRSA
    • Action: inhibits production of nucleic acids and proteins
    • very effective and low resistance bc working at 2 points of protein synthesis process
    • PO or IV, well distributed
    • SE: N/V, rash, sulfonamide reactions, sulfa allergy, GI upset (common)
    • dose based on TMP component
    • Interactions: Coumadin, Phenytoin, Sulfonylureas (intensifies)
  100. TUMS
    • Antacid: Calcium Carbonate
    • SE: acid rebound, constipation, eructation due to inc CO2 production
  101. Unasyn
    • Ampicillin + Sulbactam (Beta-Lactamase Inhibitor)
    • IV
  102. Vancomycin
    • Tx: MRSA, pseudomembranous colitis, gram + infections
    • Safe in PCN allergy
    • SE: redman/neck syndrome, ototoxic, nephrotoxic
    • monitor peak, trough, and infusion time
    • IV, PO (only for GI) - cant be IM
    • Redman: flushed, anxious - directly related to infusion time
  103. Viagra
    • Sildenafil
    • PDE5 inhibitor
    • also Cialis, Levitra (prolongs QT)
    • Tx: ED
    • Selective inhibition
    • PRN! 1/day, works for whole day
    • SE: hypotension, Priapism, MI, Sudden death, HA, flushing, dyspepsia, nonartereic ischemic optic neuropathy
    • augments effects of nitric oxide resulting in inc blood flow
    • most insurance wont cover
    • Interactions: nitrates, alpha1 antagonists, hepatic pathway, high fat foods delay absorption
    • make sure they're able to tolerate activity
  104. Vit A
    • Fat Sol
    • Deficiency: night blindness
    • Toxicity: birth defects, liver injury, bone related D/Os
    • Teratogenic:
    • From: anything that is orange, fish, meats, dairy
  105. Vit B6
    • Pyridoxine - Water Soluble
    • Deficiency: peripheral neuritis - common in alchohilcs and pts on INH
    • Interactions: interferes w Levodopa
  106. Vit B12
    • Cyanocobalamin - Water Sol
    • Deficiency: Megaloblastic anemia, parasthesias that can progress to permanent neurologic changes
    • Generally from impaired absorption (lack of intrinsic factor), also from celiac and gastric surgery
    • May require life long monthly IM
  107. Vit D
    • Fat Sol
    • Deficiency: rickets/osteomalacia
    • Toxicity: hypercalcemia
    • From: sun, fortified foods, not many foods naturally have it
    • incs Ca absorption
  108. Vit E
    • Fat sol
    • Deficiency: neurologic effects - rare, except malabsorption syndromes
    • Toxicity: risk of bleeding at very high doses
  109. Vit C
    • Water Sol
    • Deficiency: Scurvy - bone and tooth development, bleeding from gums, loose teeth
    • From: citrus fruits
    • involved in production of collagen
  110. Vit K
    • Fat Sol
    • Deficiency: bleeding tendency
    • Toxicity: its not really stores so its hard to reach toxic levels
    • Uses: in neonates, warfarin OD
    • PO, IV (risk of hypersensitivity)
    • causes blood clotting, Coumadin blocks it
    • From: green leafy veggies, synthesized by bacteria in GI
  111. Zantac
    • Ranitidine - H2 Receptor Antagonist
    • more powerful than tagamet w fewer SE and drug interactions: no antiandrogenic effects, doesnt cross BBB, weak inhibitor of hepat drug metab enzymes
    • antacids can dec absorption
    • Uses: GERD, PUD, Zollinger-Ellison, Dyspepsia
  112. Zofran
    • 5-HT3 receptor antagonist: ondansetron
    • very good, not just for Ca tx
    • comes PO, IV and dissolving tab
  113. Zosyn
    • Piperacillin + Tazobactam (Beta-Lactamase Inhibitor)
    • IV
  114. Zyvox
    • Oxazolidinone Antibiotic: Linezolid
    • Tx: MRSA and VRE - require ID approval, $5,000 bottle of wine
    • SE: Myelosuppression, N/V, Diarrhea, headache
    • Interactions: MAOI and Sympathomimetics (HTN crisis), SSRI (serotonin syndrome
    • IV or PO
  115. Proton Pump Inhibitors
    • Prevacid, Protonix, Nexium, Aciphex
    • 1st 3 can be IV, all others PO
    • -prazole
    • Nexium metabolizes slower than Prilosec
    • prevent production of acid itself
    • take ac and 2 hours pc, do not crush/chew, needs to reach duodenum
    • 4-8 weeks recommended use to promote healing bc dec acid can lead to inc gastrin (neg feedback), can cause Ca

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