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125 Cards in this Set
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penicillin G K
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Natural Penicillin
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Primarily used for streptococcal infections
dosed in million units except oral dosage form avoid potassium load in selected patients |
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penicillin G Na
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Natural Penicillin
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Primarily used for streptococcal infections
dosed in million units except oral dosage form avoid sodium load in selected patients |
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penicillin G procaine
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Natural Penicillin
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Primarily used for streptococcal infections
dosed in million units except oral dosage form allergy to procaine sometimes confused with pen allergy |
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penicillin G benzathine
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Natural Penicillin
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Primarily used for streptococcal infections
dosed in million units except oral dosage form used primarily for syphilis |
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penicillin VK
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Natural Penicillin
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oral dosage form (dosed in milligrams)
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amoxicillin
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Amoxil and various
Aminopenicillin |
better absorbed than ampicillin, caused less diarrhea
Indication: alternative for otitis media, URIs, UTI's, and some pneumonia |
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amoxicillin/clavulanate
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Augmentin
Aminopenicillin |
clavulanate is a beta-lactamase inhibitor
Indication: alternative for otitis media, URIs, UTI's, and some pneumonia |
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ampicillin
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Aminopenicillin
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diarrhea and rash are common
Indication: alternative for otitis media, URIs, UTI's, and some pneumonia |
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ampicillin/sulbactam
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Aminopenicillin
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sulbactam is a beta-lactamase inhibitor
Indication: alternative for otitis media, URIs, UTI's, and some pneumonia |
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nafcillin
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Semi-synthetic penicillins (anti-Staphylococcal)
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Some activity against other organisms
but used almost exclusively for activity against Staphylococci |
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oxacillin
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Semi-synthetic penicillins (anti-Staphylococcal)
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Some activity against other organisms
but used almost exclusively for activity against Staphylococci |
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dicloxacillin
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Semi-synthetic penicillins (anti-Staphylococcal)
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Some activity against other organisms
but used almost exclusively for activity against Staphylococci |
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piperacillin
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Extended-spectrum penicillins (anti-Pseudomonal)
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broad-spectrum including Pseudomonas
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piperacillin/tazobactam
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Extended-spectrum penicillins (anti-Pseudomonal)
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broad-spectrum including Pseudomonas
tazobactam is a beta-lactamase inhibitor |
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cefazolin
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1st generation cephalosporins
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Primarily used against strep and staph species
often used for surgical prophylaxis |
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cephalexin
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1st generation cephalosporins
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Primarily used against strep and staph species
often used for surgical prophylaxis |
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cefuroxime sodium
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2nd generation cephalosporins
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added activity against some Gram-neg organisms comapared to 1st generations
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cefoxitin
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2nd generation cephalosporins
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added activity against some Gram-neg organisms comapared to 1st generations
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ceftriaxone
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3rd generation cephalosporins
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added activity against some Gram-neg organisms comapared to 2nd generations
once-daily dosing |
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ceftazidime
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3rd generation cephalosporins
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added activity against some Gram-neg organisms comapared to 2nd generations
activity against Pseudomonas |
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cefepime
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4th generation cephalosporins
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called a 4th generation because of enhanced activity against some resistant Gram-neg organisms
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ceftaroline
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5th generation cephalosporin
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called a 5th generation because of enhanced activity against methicillin-resistant Staphylococcus aureus (MRSA) - discussed in class with agents for Gram-positive infections
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cefaclor
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Oral cephalosporins with an expanded spectrum
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You simply need to know that these are oral cephalosporins that cover more organisms than does cephalexin
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ceftibuten
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Oral cephalosporins with an expanded spectrum
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You simply need to know that these are oral cephalosporins that cover more organisms than does cephalexin
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cefdinir
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Oral cephalosporins with an expanded spectrum
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You simply need to know that these are oral cephalosporins that cover more organisms than does cephalexin
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cefditoren
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Oral cephalosporins with an expanded spectrum
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You simply need to know that these are oral cephalosporins that cover more organisms than does cephalexin
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cefuroxime axetil
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Oral cephalosporins with an expanded spectrum
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You simply need to know that these are oral cephalosporins that cover more organisms than does cephalexin
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cefixime
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Oral cephalosporins with an expanded spectrum
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You simply need to know that these are oral cephalosporins that cover more organisms than does cephalexin
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cefprozil
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Cefzil
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You simply need to know that these are oral cephalosporins that cover more organisms than does cephalexin
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aztreonam
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Monobactams
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usually no risk of an allergic reaction in penicillin-allergic patients
Active against Gm (-) rods including Pseudomonas PCN Allergy/Renal Dysfn. |
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imipenem/cilastatin
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Carbapenems
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broad-spectrum agents, increased chance of seizures
Indication: Intra-abdominal sepsis in ICU, Gm (-)/noscomial pneumonia, Febrile neutropenia |
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meropenem
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Carbapenems
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broad-spectrum agents, increased chance of seizures
Indication: Intra-abdominal sepsis in ICU, Gm (-)/noscomial pneumonia, Febrile neutropenia |
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ertapenem
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Carbapenems
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broad-spectrum agents, increased chance of seizures
used once daily, can be used for serious acquired community infections |
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doripenem
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Carbapenems
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broad-spectrum agents, increased chance of seizures
Indication: Intra-abdominal sepsis in ICU, Gm (-)/noscomial pneumonia, Febrile neutropenia |
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vancomycin
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Glycopeptides
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older antibiotic, resistance developing, VRE, VISA, VRSA
Used in Tx of MRSA and highly resistant Strep. species ADE: Fevers, chills, phlebitis, Red Man Syndrome, Ototoxicity, Nephrotoxicity at higher doses |
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linezolid
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Oxazolidinones
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bacteriostatic, often used for pneumonia, IV and oral, MAO inhibitor, drug interaction with SSRIs
ADE: Thrombocytopenia Community acquired pneumonia MRSA and VRE infections |
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daptomycin
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Lipopeptides
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bactericidal, often used in bacteremia and endocarditis, doesn't work in pneumonia (surfactant), increases CPK levels (muscle)
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tigecycline
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Glycylcyclines
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tetracycline derivative, activity against MRSA, VRE, anaerobes, some Gram-neg aerobes
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gentamicin
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Aminoglycosides
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ototoxicity and nephrotoxicity are the major limitations to use
Use: UTI, Pneumonia, Bacteremia/Sepsis, Empiric for neutropenia, Intra-abdominal infections, DM foot infections |
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tobramycin
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Aminoglycosides
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ototoxicity and nephrotoxicity are the major limitations to use
Use: UTI, Pneumonia, Bacteremia/Sepsis, Empiric for neutropenia, Intra-abdominal infections, DM foot infections |
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amikacin
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Aminoglycosides
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ototoxicity and nephrotoxicity are the major limitations to use
Use: UTI, Pneumonia, Bacteremia/Sepsis, Empiric for neutropenia, Intra-abdominal infections, DM foot infections |
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neomycin
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Aminoglycosides
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ototoxicity and nephrotoxicity are the major limitations to use
non-absorbable agent Use: UTI, Pneumonia, Bacteremia/Sepsis, Empiric for neutropenia, Intra-abdominal infections, DM foot infections |
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streptomycin
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Aminoglycosides
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ototoxicity and nephrotoxicity are the major limitations to use
used mainly for TB Use: UTI, Pneumonia, Bacteremia/Sepsis, Empiric for neutropenia, Intra-abdominal infections, DM foot infections |
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azithromycin
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Macrolides
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used primarily for respiratory infections
fewer GI sides effects than erythromycin; better activity |
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clarithromycin
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Macrolides
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used primarily for respiratory infections
fewer GI sides effects than erythromycin; better activity |
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erythromycin
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Macrolides
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used primarily for respiratory infections
GI side effects ADE: pts do not finish rx course, Jaundice, Ototoxicity at high doses, QT interval prolongation (torsades) DDI: CYP450 oxidation, inc. serum conc. of theophylline, warfarin, digoxin, etc. |
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ciprofloxacin
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Fluoroquinolones
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used for respiratory infections, UTIs, others,
complexation reactions with oral use (antacids, metal cations), QTc prolongation, tendon damage broad activity |
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levofloxacin
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Fluoroquinolones
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used for respiratory infections, UTIs, others,
complexation reactions with oral use, QTc prolongation, tendon damage broad activity |
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moxifloxacin
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Fluoroquinolones
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used for respiratory infections, UTIs, others,
complexation reactions with oral use, QTc prolongation, tendon damage Primarily Respiratory Infections |
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gemifloxacin
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Fluoroquinolones
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used for respiratory infections, UTIs, others,
complexation reactions with oral use, QTc prolongation, tendon damage Primarily Respiratory Infections |
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trimethoprim/sulfamethoxazole or cotrimoxazole
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Urinary anti-infectives
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antifolate/sulfa combination, skin reactions, drug interactions with protein bound sulfa, used for MRSA skin infections in addition to UTIs
ADE: Stevens Johnson Syndrome w/long acting sulfonamides Hepatitis, Blood dyscrasias, GI, Skin Rxns |
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nitrofurantoin
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Urinary anti-infectives
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poor systemic levels so used only for UTIs, pulmonary fibrosis, GI side effects
urine discoloration (brown) dose adjustment for renal pts CN in pts. w/ CrCl <40 G6PD deficiency monitor elderly |
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fosfomycin
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Urinary anti-infectives
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packet that must be mixed prior to use
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clindamycin
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Lincosamides
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older anti-anaerobic agent, used also for MRSA skin infections, may be more likely to cause C. diff colitis than some other agents
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doxycycline
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Tetracyclines
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used for a variety of infections including Rickettsial infections such as Rocky Mountain Spotted fever
most frequently used agent |
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minocycline
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Tetracyclines
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used for a variety of infections including Rickettsial infections such as Rocky Mountain Spotted fever
potent, but may cause dizziness |
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tetracycline HCl
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Tetracyclines
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used for a variety of infections including Rickettsial infections such as Rocky Mountain Spotted fever
not used as much anymore, others are used more frequently |
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colistin sulfate
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Polymixins
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nephrotoxicity is a limitation to use, being used now because of resistant Gram-negatives
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rifampin
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Rifamycins
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metabolic enzyme inducers
used in TB regimens and to add activity against Staph in combo regimens, drug interactions (inducer) |
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rifabutin
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Rifamycins
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metabolic enzyme inducers
fewer drug interactions than rifampin |
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metronidazole
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Misc.
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anti-anerobic activity, peripheral neruopathies, disulfiram reaction
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bacitracin
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Misc.
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mupirocin
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Misc.
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topical for elimination of nasal carriage of MRSA and for minor skin infections
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rifaximin
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Misc.
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for traveler's diarrhea and C. diff infections
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nitazoxanide
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Misc.
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for protozoal and helminthic infections/very promising for C. diff infections
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fidaxomicin
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Misc.
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Oral drug with superior sustained response against C. difficile infections when compared to vancomycin
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amphotericin B deoxycholate
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Polyenes
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broad-spectrum antifungal activity, bind ergosterol (toxicity thought to be related to binding cholesterol in humans
infusion-related toxicities and other longer term toxicities such as neprhotoxicity |
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amphotericin B lipid complex
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Lipid based amphotericin products
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designed to reduce the toxicity of amphotericin (especially nephrotoxicity)
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amphotericin B cholesteryl sulfate complex
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Lipid based amphotericin products
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designed to reduce the toxicity of amphotericin (especially nephrotoxicity)
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Liposomal amphotericin B
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Lipid based amphotericin products
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designed to reduce the toxicity of amphotericin (especially nephrotoxicity)
most frequently used of the lipid based amphotericin products because of range of indications |
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nystatin
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Lipid based amphotericin products
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designed to reduce the toxicity of amphotericin (especially nephrotoxicity)
topical use |
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fluconazole
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Azoles
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broad-spectrum antifungals, all are metabolic enzyme inhibitors to some extent, azole-resistant Candida becoming a problem
widely used for Candida infections |
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voriconazole
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Azoles
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broad-spectrum antifungals, all are metabolic enzyme inhibitors to some extent, azole-resistant Candida becoming a problem
advantage over fluconazole is activity against Aspergillus, has visual side effects |
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posaconazole
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Azoles
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broad-spectrum antifungals, all are metabolic enzyme inhibitors to some extent, azole-resistant Candida becoming a problem
slightly more potent than other azoles against Candida, may have fewer drug interactions |
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caspofungin
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Echinocandins
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Primarily used because they are active against azole-resistant Candida
aslo has an indication for treatment of Aspergillus infections, dosage adjustment with elevated Child-Pugh score |
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micafungin
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Echinocandins
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Primarily used because they are active against azole-resistant Candida
fewer drug interactions than caspofungin |
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anidulafungin
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Echinocandins
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Primarily used because they are active against azole-resistant Candida
fewer drug interactions than caspofungin |
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flucytosine
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Misc.
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used in combination for treatment of Cryptococcal meningitis, severe bone marrow toxicity, therapeutic drug monitoring usually done
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acyclovir
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Nucleosides used for Herpes Infections
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require metabolism to active triphosphates, have activity against other herpes viruses but usually used for herpes simplex
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valacyclovir
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Nucleosides used for Herpes Infections
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require metabolism to active triphosphates, have activity against other herpes viruses but usually used for herpes simplex
Prodrug of acyclovir |
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famciclovir
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Nucleosides used for Herpes Infections
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require metabolism to active triphosphates, have activity against other herpes viruses but usually used for herpes simplex
Prodrug of acyclovir |
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vidarabine
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For herpetic ophthmalmic infections
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Ointments and solutions used primarily for treatment of herpes simplex conjuntivitis and keratitis. All can cause irritation to the eye and patients may need to wear sunglasses because of photophobia
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idoxuridine
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For herpetic ophthmalmic infections
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Ointments and solutions used primarily for treatment of herpes simplex conjuntivitis and keratitis. All can cause irritation to the eye and patients may need to wear sunglasses because of photophobia
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trifluridine
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For herpetic ophthmalmic infections
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Ointments and solutions used primarily for treatment of herpes simplex conjuntivitis and keratitis. All can cause irritation to the eye and patients may need to wear sunglasses because of photophobia
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ganciclovir
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Primarily used for CMV Infections
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may cause myelosuppression
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valganciclovir
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Primarily used for CMV Infections
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Prodrug of ganciclovir, may cause myelosuppression
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cidofovir
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Primarily used for CMV Infections
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nephrotoxicity
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foscarnet
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Primarily used for CMV Infections
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does not need to be phosphorylated, may cause alterations in calcium and phosphate levels
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fomivirsen
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Primarily used for CMV Infections
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used for CMV retinitis
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amantadine
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Anti-influenza agents (earlier agents)
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active only against influenza A, CNS side effects
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rimantadine
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Anti-influenza agents (earlier agents)
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active only against influenza A, CNS side effects
more active and has fewer side effects than amantadine |
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zanamivir
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Anti-influenza agents--Neurominadase inhibitors
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inhibit release of newly formed virus from the infected cell surface, active against influenza A and B strains
given by inhaler |
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oseltamivir
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Anti-influenza agents--Neurominadase inhibitors
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inhibit release of newly formed virus from the infected cell surface, active against influenza A and B strains
given orally |
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interferon alfa
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Agents used primarily for hepatitis treatment
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other interferons made, but interferon alpha used for hepatitis, many adverse effects including neuropsychiatric effects
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Pegylated interferon alpha
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Agents used primarily for hepatitis treatment
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PEG added to slow the elimination so that fewer doses could be used, still has side effect profile of interferons, used with ribavirin in the treatment of hepatitis C
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ribavirin
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Agents used primarily for hepatitis treatment
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used in combo with pegylated interferon for treatment of hepatitis C, causes hemolytic anemia
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adefovir
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Agents used primarily for hepatitis treatment
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Primarily used for hepatitis B, causes nephrotoxicity
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lamivudine (3TC)
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Agents used primarily for hepatitis treatment
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Used also for HIV infection
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telaprivir
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Agents used primarily for hepatitis treatment
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a protease inhibitor, increased virologic response when added to peginterferon + ribavirin for treatment of Hep C
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bocepravir
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Agents used primarily for hepatitis treatment
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a protease inhibitor, increased virologic response when added to peginterferon + ribavirin for treatment of Hep C
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ribavirin
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Miscellaneous
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used by inhalation for treatment of respiratory syncytial virus (RSV), a infection usually seen in children
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zidovudine (AZT)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
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stavudine (D4T)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
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didanosine (DDI)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
contains buffer, so potentially decreased absorption of other agents that require acidic stomach pH |
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tenofovir disoproxil fumarate (TDF)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
produrg of tenofovir, tenofovir is actually a nucleotide analogue and does not require activation (phosphorylation) |
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zalcitabine (DDC)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
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emtricitabine (FTC)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
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lamivudine (3TC)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
also used to treat hepatitis |
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abacavir (ABC)
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Nucleoside reverse transcriptase inhibitors (NRTIs)
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competitive inhibitors of reverse transcriptase, competes with natural pyrimidines or purines, must be phosphorylated to generate active nucleotide analogues, cause lactic acidosis because of effects on mitochondria
increased blood levels with ethanol, do not rechallenge if patient experiences hypersensitivity reaction |
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neviripine (NVP)
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Non-nucleoside reverse transcriptase inhibitors (NRTIs)
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noncompettitive inhibitors of reverse transcriptase (diffferent site than with NRTIs), binds to enzyme and changes conformation, these drugs are not given alone, major side effects are rash, hepatotoxicity, and CNS side effects
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delavirdine (DLV)
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Non-nucleoside reverse transcriptase inhibitors (NRTIs)
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noncompettitive inhibitors of reverse transcriptase (diffferent site than with NRTIs), binds to enzyme and changes conformation, these drugs are not given alone, major side effects are rash, hepatotoxicity, and CNS side effects
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efavirenz (EFV)
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Non-nucleoside reverse transcriptase inhibitors (NRTIs)
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noncompettitive inhibitors of reverse transcriptase (diffferent site than with NRTIs), binds to enzyme and changes conformation, these drugs are not given alone, major side effects are rash, hepatotoxicity, and CNS side effects
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saquinavir (SQV)
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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ritonavir (RTV)
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
potent CYP3A4 inhibitor (this is used so that ritonavir can boost blood levels of other antiretrovirals |
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indinavir (IDV)
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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nelfinavir (NFV)
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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amprenavir (APV)
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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fosamprenavir (908)
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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atazanavir
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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tiprinavir
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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darunavir
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
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lopinavir
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Protease inhibitors
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prevents proteolytic cleavage of a final product necessary for assembly and release of the virus, all cause GI distress, potential for increased bleeding, insulin resistance, hyperlipidemias, altered distribution of fat, potentially hepatotoxicity, many CYP450 interactions (theyare metabolized that way and they are inhibitors (mainly 3A4 and 2D6)
ritonavir added to boost lopinavir |
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enfuvirtide
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Other Drugs for Treatment of HIV
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fusion inhibitor
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maraviroc
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Other Drugs for Treatment of HIV
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CCR5 receptor antagonist
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raltegravir
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Other Drugs for Treatment of HIV
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integrase strand inhibitor
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