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Pharmacotherapeutics for Advanced Nursing Practice, 1st. Ed., Demler & Rhoads, 2018/
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Pharmacotherapeutics for Advanced Nursing Practice, 1st. Ed., Demler & Rhoads, 2018 | Nurse Practitioner (NP) School Study Aid
Antibiotics Overview
- Cell Wall Inhibitors
- Cell Wall Inhibitors
- Penicillins
- Cephalosporins
- Monobactams
- Carbapenems (Imipenem & Meropenem)
- Beta-Lactamase Inhibitors
- Protein Synthesis Inhibitors
- Protein Synthesis Inhibitors
- Aminoglycosides
- Macrolides
- Clindamycin
- Tetracyclines
- Linezolid
- Chloramphenicol
- Other
- Fluoroquinolones
- Sulfonamides
4 mins
Aminoglycosides
- Drug Names
- Gentamicin
- Neomycin for Bowel Surgery Prep
- Amikacin
- Tobramycin
- Streptomycin
- Mechanism of Action
- Bactericidal
- Inhibit Formation of Initiation Complex
- Cause Misreading of mRNA
- Require O2 for Uptake
- Resistance
- Resistance by Transferase Enzymes
- Acetylation
- Phosphorylation
- Adenylation
- Indications
- Gram-Negative Rod Infections
- Synergistic with B-Lactam Antibiotics
- Side Effects
- Nephrotoxicity Especially When Used with Cephalosporins
- Ototoxicity Especially When Used with Loop Diuretics
- Teratogen
5 mins
Neomycin Sulfate
- Mechanism
- Aminoglycoside Antibiotic
- Indications
- Topical Infection
- Intestinal Surgery Prophylaxis
- Side Effects
- Ototoxicity
- Nephrotoxicity
- Rash
- Blood Dyscrasias
- Considerations
- GI Superinfection
2 mins
Cephalosporins Overview
- Mechanism of Action
- Beta lactam drug
- Inhibits cell wall synthesis
- Bactericidal
- Side Effects
- Hypersensitivity reactions
- Vitamin K Deficiency
- Disulfiram like reaction with Alcohol
- Increased Nephrotoxicity of Aminoglycosides
1 min
1st Generation Cephalosporin
- Drug Names
- Cefazolin
- Cephalexin
- Indications (PEcK Mnemonic)
- Proteus mirabilis
- E. coli
- Klebsiella
- Gram-Positive Cocci
1 min
2nd Generation Cephalosporin
- Drug Names
- Cefoxitin
- Cefaclor
- Cefuroxime
- Indications (PEcK HENS Mnemonic)
- Proteus mirabilis
- E. coli
- Klebsiella
- Gram-Positive Cocci
- Haemophilus influenzae
- Enterobacter
- Neisseria
- Serratia marcescens
2 mins
3rd Generation Cephalosporin
- Drug Names
- Cefotaxime
- Ceftriaxone
- Cefdinir
- Ceftazidime
- Pseudomonas
- Indications
- Serious Gram-Negative Bacteria Resistant to Other Beta-Lactams
1 min
4th Generation Cephalosporin
- Drug Name
- Cefepime
- Indications
- Increased Activity Against Gram-Positive Infections and Pseudomonas
29 secs
5th Generation Cephalosporin
- Mechanism
- Beta-Lactam
- Indications
- Resistant Bacteria
- Broad Spectrum Gram-Positive and Gram-Negative
- Drugs
- Ceftobiprole
- Has Pseudomonas Coverage
- Ceftaroline
- No Pseudomonas Coverage
1 min
Imipenem
- Mechanism
- Resistant to Beta-Lactamases
- Broad Spectrum
- Indications
- Anaerobes
- Gram-Negative Rods
- Gram-Positive Cocci
- Must Administer with Cilastatin
- Cilastatin is Inhibitor of Renal Dehydropeptidase I
- Side Effects
- Diarrhea
- Skin Rash
- Seizures
- Considerations
- Meropenem
- Stable to Dehydropeptidase I
- Reduced Risk of Seizures (Non-Seizure Causing)
2 mins
Aztreonam
- Monobactam
- Resistant to beta lactamases
- Binds to penicillin binding protein (PBP)
- Inhibit cell wall synthesis
- No Activity on Gram-Positives or Anaerobes
- Gram-Negative Rods
- Non allergenic to penicillin
- Synergistic with aminoglycosides
2 mins
Chloramphenicol
- Mechanism
- Bacteriostatic
- Inhibits 50S Peptidyltransferase Activity
- Indications
- Meningitis
- Rocky Mountain Spotted Fever in Pregnant Women
- Side Effects
- Anemia
- Aplastic Anemia
- Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
- Resistance Caused by Plasmid Encoded Acetyltransferase
2 mins
Macrolides
- Mechanism of Action
- Bacteriostatic
- Bind to 23S rRNA of 50S Subunit
- Inhibit Protein Synthesis by Blocking Translocation
- Macrolides
- Erythromycin
- Azithromycin
- Clarithromycin
- Indications
- Gram-Positive Cocci
- Atypical Pneumonia
- Chlamydia
- Considerations
- Resistance by Methylation of 23S rRNA Binding
2 mins
Penicillin
- Gram Positive
- Spirochetes
- Bind PBPs
- Block Transpeptidase Cross-linking of Cell Wall
- Activate Autolytic Enzymes
- Bactericidal
- Hypersensitivity Reactions
- Hemolytic Anemia
- Beta-lactamase Sensitive
2 mins
Ampicillin and Amoxicillin
- Mechanism
- Aminopenicillin
- Broad Spectrum Penicillin
- Indications
- Gram-Positive and Some Gram-Negative Infections
- Side Effects
- Rash
- Diarrhea
- Considerations
- No Effect Against Staph Aureus
- Often combined with Beta Lactamase Inhibitor
- Allergic Reaction
2 mins
Aminopenicillin Mechanisms
- Indications
- Broader Spectrum
- Drug Names
- Ampicillin
- Amoxicillin
- Mechanism and Characteristics
- Beta-Lactamase Sensitive
- Combine with Clavulanic Acid
- Side Effects
- Hypersensitivity Reactions
- Ampicillin Rash
- Pseudomembranous Colitis
2 mins
Aminopenicillin Uses
- Drug Names
- Ampicillin
- Amoxicillin
- Indications
- Shigella
- Haemophilus Influenzae
- Salmonella
- Listeria
- Enterococci
- Proteus Mirabilis
- E. Coli
1 min
Fluoroquinolones Antibiotics
- -floxacin
- Mechanism of Action
- Inhibits Topoisomerase II & IV
- Bactericidal
- Indications
- Gram-negative Rods
- Pneumonia
- Gastrointestinal Infections
- Urinary Tract Infection
- Genital Infections
- Drugs
- Levofloxacin
- Ciprofloxacin
- Has Pseudomonas Coverage
- Considerations
- Avoid Polyvalent Cations
3 mins
Fluoroquinolones Toxicities
- Diarrhea
- Skin Rash
- Headache
- Tendon Rupture in Adults
- Myalgias in Kids
- Damage to Cartilage
- Teratogen
- QT Prolongation
1 min
Silver Sulfadiazine (Silvadene) and Mafenide Acetate (Sulfamylon)
- Mechanism
- Topical Antimicrobial
- Indications
- Burns
- Open Wound Care
- Side Effects
- Mafenide
- Pain
- Acidosis
- Considerations
- Administer Analgesic Prior to Wound Care
1 min
Sulfonamides Mechanisms
- Bacteriostatic
- Gram-Positive
- Gram-Negative
- Nocardia
- Chlamydia
- PABA antimetabolites
- Inhibit dihydropteroate synthase
- Sulfamethoxazole
- Sulfisoxazole
- Sulfadiazine
1 min
Trimethoprim
- Mechanism of Action
- Bacteriostatic
- Inhibits Bacterial Dihydrofolate Reductase
- Causes Sequential Block of Folate Synthesis
- Used in Combination with Sulfamethoxazole
- Combination Used For Recurrent Urinary Tract Infections
- Indications
- Shigella
- Salmonella
- Pneumocystis Jiroveci Pneumonia
- Side Effects
- Decrease in Red and White Blood Cells
- Alleviated with Leucovorin Rescue
2 mins
Tetracycline Drug Names and Indications
- Drug Names
- Demeclocycline
- Minocycline
- Doxycycline
- Fecally Eliminated
- Can be Used in Renal Failure
- Indications
- Antidiuretic Hormone Antagonist
- Chlamydia
- Rickettsia
- Borrelia burgdorferi
- Helicobacter Pylori
- Mycoplasma Pneumonia
3 mins
Tigecycline (Tygacil)
- Mechanism Of Action
- Glycylcycline Antibiotic
- Binds 30S Subunit
- Inhibits Protein Synthesis
- Indications
- Severe Infections
- Broad Spectrum Coverage
- Anaerobic & Multidrug-Resistant Organisms
- Deep Tissue Penetration
- Side Effects
- GI Distress
- Severe Nausea and Vomiting
- Considerations
- 2nd Line Agent
3 mins
Daptomycin (Cubicin)
- Mechanism Of Action
- Lipopeptide Antibiotic
- Disrupts Cell Membrane
- Causes Rapid Depolarization
- Indication
- Gram-Positive Cocci
- MRSA
- Side Effects
- Myopathy
- Rhabdomyolysis
- Peripheral Neuropathy
- Considerations & Patient Education
- Inactivated by Surfactant
- Not Used (Avoid) for Pneumonia
3 mins
Vancomycin Mechanism
- Bacteriostatic and Bactericidal
- Gram-Positive
- Inhibits Cell Wall Mucopeptide
- Binds to D-ala D-ala
- Resistance with Change to D-ala D-lac
- Staphylococcus aureus
- Orally for Clostridium difficile
- Enterococci
2 mins
Vancomycin Side Effects & Toxicity
- Side Effects
- Thrombophlebitis
- Nephrotoxicity
- Ototoxicity
- Diffuse Flushing Called Red Man Syndrome
- Prevent with Antihistamine
- Prevent with Slow Infusion
2 mins
Clindamycin
- Mechanism of Action
- Bacteriostatic
- Binds 50S Ribosomal Subunit
- Blocks Translocation
- Indications
- Anaerobic Infections above the Diaphragm
- Aspiration Pneumonia
- Lung Abscess
- Side Effects
- Can Cause Pseudomembranous Colitis
1 min
Linezolid (Zyvox)
- Mechanism Of Action
- Oxazolidinone Antibiotic
- Binds 23S rRNA of 50S Subunit
- Inhibits Protein Synthesis
- Indication
- Gram-Positive Organisms
- MRSA
- VRE (Vancomycin Resistant Enterococci)
- Side Effects
- Bone Marrow Suppression
- Decreased Platelet Count
- Peripheral Neuropathy
- Lactic Acidosis
- Serotonin Syndrome
- Considerations & Patient Education
- Avoid Tyramine Containing Foods
4 mins
Rifampin
- Tuberculosis (TB)
- Blocks RNA Polymerization
- Haemophilus influenzae Type B
- Leprosy
- Meningitis
- P450 inducer
- Red-orange urine
55 secs
Terbinafine
- Indications
- Dermatophytosis
- Onychomycosis
- Mechanism
- Inhibits Squalene Epoxidase
- Side Effects
- Hepatotoxicity
- GI Distress
- Taste Disturbances
- Headache
2 mins
Azoles (Ketoconazole)
- "-azole" suffix
- Indications
- Local and Less Serious Systemic Mycosis
- Mechanism
- Inhibits Ergosterol Synthesis
- Inhibits P450
- Side Effects
- Liver Dysfunction
- Inhibition of Testosterone Synthesis
1 min
Amphotericin B
- Indications
- Systemic Mycosis
- Fungal Meningitis
- Last Resort for Protozoan infections
- Mechanism
- Polyene
- Binds Ergosterol
- Forms Membrane Pores
1 min
Nystatin
- Indications
- Candidiasis
- Vaginal
- Oral
- Cutaneous
- Mechanism
- Polyene
- Binds Ergosterol
- Forms Membrane Pores
- Topical form of Amphotericin B
- Side Effects
- Rash
1 min
Griseofulvin
- Mechanism
- Disrupts Microtubules in Mitosis
- Indications
- Antifungal for Superficial Infections
- Tinea and Ringworm
- Side Effects
- Teratogen
- P450 Inducer
- Confusion
- Headache
2 mins
Ethambutol
- Mechanism of Action
- Bacteriostatic
- Blocks Arabinosyltransferase
- Arabinosyltransferase Polymerizes Carbohydrates
- Carbohydrate Polymers Make Mycobacterium TB Cell Wall
- Side Effects
- Red/Green Color Blindness
- Reversible with Drug Discontinuation
40 secs
Isoniazid
- Indications
- Tuberculosis (TB)
- Mechanism of Action
- Requires Catalase Peroxidase
- Decreases Mycolic Acid Synthesis
- Fast vs Slow Acetylators
- Side Effects
- B6 Deficiency
- Neurotoxicity
- Hepatotoxicity
- Drug-induced Lupus
1 min
HIV Prophylaxis Medications
- CD4+ < 200
- TMP-SMX
- Pneumocystis Pneumonia
- CD4+ < 100 Susceptible to Toxoplasma Gondii
- CD4+ < 50
- Mycobacterium Avium and Intracellulare
- Azithromycin If Delayed Therapy
2 mins
NRTIs for HIV (Drug Names)
- Nucleoside Analog
- DEALSZ
- Didanosine (DDI)
- Emtricitabine (FTC)
- Abacavir (ABC)
- Lamivudine (3TC)
- Stavudine (d4T)
- Zidovudine (ZDV)
- Nucleotide Analog
- Tenofovir (TDF)
2 mins
NRTI Toxicity
- Bone Marrow Suppression
- Reverse with G-CSF and Erythropoietin
- Rash
- Neuropathy
- Anemia
- Pancreatitis
- Lactic Acidosis
1 min
Zanamivir (Relenza) and Oseltamivir (Tamiflu)
- Indications
- Influenza A and B
- Treatment and Prophylaxis
- Mechanism
- Inhibits Release of New Virus
- Inhibits Influenza Neuraminidase
1 min
Acyclovir (Zovirax)
- Mechanism
- Guanosine Analog
- Inhibits Viral Replication
- Thymidine Kinase Activation
- Indications
- Herpes Simplex Virus (HSV)
- Varicella Zoster Virus (VZV)
- Side Effects (Oral)
- Headache
- GI Distress
- Side Effects (IV)
- CNS Toxicity
- Nephrotoxicity (Crystalline Nephropathy)
- Considerations
- Prevents Recurrent Episodes
- Slow IV Infusion
2 mins
Ganciclovir
- Indications
- Cytomegalovirus (CMV)
- Immunocompromised
- Mechanism
- Guanosine Analog
- Disrupts DNA Synthesis
- Inhibits Viral DNA Polymerase
- Side Effects
- Hematologic Effects
- Nephrotoxicity
1 min
Foscarnet
- Indications
- CMV Retinitis
- Acyclovir-resistant HSV
- Mechanism
- Does Not Require Activation (by Viral Kinase)
- Inhibits Viral DNA Polymerase
- Pyrophosphate Analog
- Resistance through Mutated DNA Polymerase
- Side Effects
- Nephrotoxicity
- Electrolyte Abnormalities
- Hypokalemia
- Hypocalcemia
- Hypomagnesemia
2 mins
Metronidazole
- Mechanism of Action
- Bactericidal
- Forms Free Radical Toxic Metabolites
- Damages DNA
- Indications
- Giardia lamblia
- Entamoeba Histolytica
- Trichomonas
- Gardnerella
- Anaerobes
- Side Effects
- Metallic taste
- Disulfiram like Reaction with Alcohol
2 mins
Ascariasis Clinical Features and Management
- Early Clinical Manifestations
- Cough
- Eosinophilic Pneumonitis (Loffler Syndrome)
- Late Clinical Manifestations
- GI Upset
- Bowel or Biliary Obstruction
- Worms in Stool
- Diagnosis
- Stool Ova and Parasite Studies
- Management
- Albendazole
- Pyrantel Pamoate In Pregnancy
5 mins
