Pharmtech Review Medications

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Pharmtech Review Medications
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All medications have a patent or trade name(s)
and one generic nameInformation 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.

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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

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Antibiotics Sulfonamides

• Bacteriostatic only kill bacteria by blocking
  reproduction only
• Usually for UTIs and URIs
• Side effects photosensitiviy, kidney damage,
  nausea
• Special considerations avoid sunlight, drink a
  lot of water to avoid kidney stones,

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Gantricin, Septra, Bactrim, Azulfadine

• Watch out for allergies to sulfa drugs,
  photosensitivity, nausea

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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

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Gram Stain (quick in office ID of type of
bacteria and what its likely sensitive to)
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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

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Examples

• Amoxicillin Brand Amoxil in cap or susp.
• Ampicillin Omnipen,
• Cloxacillin
• Dicloxacillin Dynapen

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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

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Examples of cephalosporins

• Cefaclor brand name ceclor
• Defadroxil brand is Duricef
• Cephalexin brand is Keflex (oral only)
• Cefuroxime brand is Ceftin (IV or IM)

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Tetracyclines

• 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

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Examples of tetracyclines

• Doxycycline brand Vibramycin
• Minocycline brand Minocin
• Tetracyline brand Achromycin

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Macrolide antibiotics

• 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.

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Examples of macrolides

• Azithromycin brand is Zithromax
• Clarithromycin brand is Biaxin
• Also, Ilosone, EES, Erythrocin, E mycin are all
  salts of erythromycin

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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

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Examples of quinolones

• Ciprofloxacin brand is Cipro (broad spectrum,
  good alternative to penicillin allergic pts.)
• Levofloxacin brand Levaquin
• Oxafloxacin brand is Floxin

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Aminoglycosides

• Block protein synthesis (bacteriocidal)
• For serious infections mainly
• Side effects nephrotoxic, ototoxic,tinnitus,perma
  ment deafness

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Examples of aminoglycosides

• Amikacin brand is Amikin
• Gentamicin brand is Garamycin
• Neomycin brand is neosporin
• Streptomycin brand is Streptomycin
• Tobramycin brand is Nebcin

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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

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Metronidazole (Flagyl)

• Used for Trichomonas of vagina and penile urethra
• Never take with ethanol works like Antabuse

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Vancomycin (Vancocin)powerful aminoglycoside
last line drug

• Only for very severe infections
• Serious ototoxicity, neprhotoxicity
• CDC has warnings out about this drug
• Keep patient very hydrated to prevent serious
  side effects.