Top 200 drugs

  1. Principles of Disease
    • Pathogen location
    • Patient age and disease complications (COPD+pneumonia)
    • Serious infections caused by other infections
  2. Supportive Therapy
    antipyretics (Tylenol), analgesics, nutrition, respiratory care (pneumonias), and fluid hydration should always be included
  3. S-P-E-D-S
    • Sensitivity of pathogen
    • Penetration to affected site
    • Empiric therapy - first 48-72 hours
    • Duration of therapy
    • Supportive therapy
  4. Effective for upper respiratory tract infections, skin and soft tissue, and urinary tract infections

    (ex. otis media, sinusitis, pharyngitis)
    ...many antibiotics
  5. Effective for lower respiratory tract infections...
    • Macrolides- azithromycin, clarithromycin
    • Fluoroquinolones- ciprofloxacin, levofloxacin, monifloxacin
    • 3rd Generation Cephalosporin- Cefdinir
    • Extended Spectrum Penicillin- amoxicillin, clavulanate
  6. Effective for chlamydia, Rocky Mt spotted fever, Q fever, typhus fever, Lyme's disease, plaque, tularemia...
    • Tetracyclines- deoxycycline, minocycline;
    • also Azithromycin

    (single 1 gram dose)
  7. Not useful for UTIs...
    • Tetracyclines: all
    • Macrolides: all
    • Fluoroquinolones: Moxifloxacin (Avelox, Vigamox)
    • Nitroimidazole: Metronidazole (Flagyl)
  8. Useful for UTIs and complicated pyelonephritis...
    Other fluoroquinolones (ciprofloxacin, levofloxacin/Levaquin)
  9. Effective for osteomeylitis, tuberculosis (mycobacteria), and anthrax...
    Ciprofloxacin and levofloxacin (Cipro and Levaquin)

    (both are fluoroquinolones)
  10. Two for the 3-4 meds used to treat H. pylori GI infection and ulcers...
    amoxicillin and metronidazole

    (Amoxil/Trimox, and Flagyl)
  11. Metronidazole (Flagyl) covers...
    anaerobic only, no gram-positive (staph, strep) or gram-negative aerobes (E. coli, klebsiella, pseudomonas)
  12. Metronidazole is used for...
    • AAPC (antibiotic-associated pseudomembranous colitis caused by Clostridium difficile
    • trichomonas
    • giardia
    • vaginosis
    • pelvic inflammatory disease caused by anaerobic bacteria
    • H. pylori-related ulcers (in combo)
  13. ADRs - Anti-infectives: GI and skin
    GI: nausea, bomiting, diarrhea, stomach cramping

    • Skin:¬†hypersensitivity reactions - rash, hives, itching
    • photosensitivity (fluoroquinolone tetracyclines, sulfonamides)
    • hyperpigmentation (minocycline)
  14. Used to treat AAPC - antibiotic-associated psuedomembranous colitis with C. difficile...
    metronidazole (Flagyl)
  15. CNS ADRs
    1. Quinolones:
    2. Tetracyclines:
    3. Penicillins and metronidazole
    • 1. confusion, agitation, anxiety (rare)
    • 2. dizziness, lightheadedness
    • 3.¬†seizures with very high doses
  16. ADRs - Musculature
    Floroquinolones may cause tendonitis and tendon rupture

    (ciprofloxacin, levofloxacin, moxifloxacin)
  17. ADRs - Pediatrics
    • Tetracyclines cause tooth discoloration
    • Fluoroquinolones cause joint abnormalities - usually contraindicated pregnancy through age 18!!!
    • Sulfonamides cause kernicterus (extreem jaundice, brain damage) pregnancy-2months
  18. Drug Interactions
    • Antacids reduce absorbtion
    • Divalent cations (incl. dairy, supplements, antacids) reduce absorbtion and effectiveness of oral tetracyclines and fluoroquinolones (Mg, Ca, Zn, Fe)
    • Separate dosing of binding agents (Kaopectate, Sucralfate, Chlorestyramine)
  19. Contraceptives...
    Antibiotics may reduce effectiveness
  20. Interactions: Warfarin
    • Clarithromycin and fluconazole can reduce p-450 metabolism of warfarin, increasing bleeding risk
    • Monitor INRs, modify dose as needed
  21. Alcohol contact warning...
    metronidazole produces disulfiram-reaction (severe vomiting) with even trace contact with alcohol
  22. Good lung penetration...
    penicillins and cephalosporins - good

    aminoglycosides - poor
  23. macrolides
    azithromycin, clarithromycin
  24. fluoroquinolones
    • ciprofloxacin
    • levofloxacin
    • moxifloxacin
  25. 3rd Gen cephalosporin
    cefdinir (Omnicef)
  26. tetracyclines
    • doxycycline
    • minocycline
  27. covers only gram-negative anaerobes...
    metronidazole (Flagyl)
  28. Treat AAPC with...
    oral metronidazole
Card Set
Top 200 drugs
Top 200 drugs q2 antiinfective factoids classes use