-Viruses

-Parasites

-Fungal Infections

-Nausea

-Vomiting

-Diarrhea

( Florastor is used to replenish the "good bacteria")

Overgrowth of another bacteria or organism, that will not be treated by the medication admisitered.

eg. Diarrhea, Oral Thrush, Yeast Infection

-Ototoxicity (Ear)

-Nephrotoxicity (Kidney)

-Hepatotoxicity (Liver)

-Skin Rash

-Shortness of Breath

-Fever

-Swelling

* If allergic reaction occurs, give epinephrine immediatley

-Cell Wall

-Protein Synthesis

-Folate Biosynthesis

-Nucleic Acid Synthesis

-Penicillins

-B-Lactamase Inhibitors

-Cepholosporins

-Vancomycin

-Bacteriocidal

-MOA: Inhibits the cell wall syntheses of the bacteria, therefore, causing a loss of the osmotic pressure, cell lysis, loss of nutrients, and finally cell death.

-Side Effects: Rash, Diarrhea

-Uses: Strep, Staph, Respiratory Infections, UTI, Otitis Media (ear infection)

Generation 1: Narrow Spectrum- PCN, G&V

Generation 2: Ampicillin, Amoxicillin

Generation 3: Carbenicillin, Ticarcillin

Generation 4: Widest Spectrum-Piperacillin, Mezlocillin

-Inhibits the enzyme penicillinase

-Clavulanate + Amoxicillin = Agumentin

Liquid may cause discoloration of teeth

-Sulbactam + Ampicillin =Unasyn

-Tazobactam + Piperacillin = Zosyn

-Bacteriocidal

-MOA: Inhibits the cell wall syntheses of the bacteria, therefore, causing a loss of the osmotic pressure, cell lysis, loss of nutrients, and finally cell death.

-Side Effects: IM very painful, nephrotoxicity with Gen-1

-Uses: Strep, Staph, Respiratory Infections, UTI, Otitis Media (ear infection)

Generation 1: Cefazolin, Cephalexin, Cefadroxil

Generation 2: Cefaclor

Generation 3: Cefixime, Ceftriaxone, Cefdinir

Generation 4: Cefepime

-Bacteriocidal

-MOA: Inhibits cell wall synthesis

-Uses: MRSA, Pseudomembranous Colitis

-Used as a Last Resort

-Side Effects: Ototoxicity, Nephrotoxicity, "Red Man Syndrome"

-Tetracylines

-Macrolides

-Telithromycin

-Aminoglycosides

-Lincomycin

-Bactroban (mupirocin)

-Chloramphenical

-Bacteriostatic

-MOA: Interferes with protein synthesis of bacteria by preventing the binding of transfer RNA to messenger RNA atthe ribosomal 30s subunit site

-Examples: Doxycycline, Minocycline, Tetracycline

-Uses: Acne, Lower Respiratory Infections, Chlamydia

1. Photosensitivity

2. Yellowing of teeth(not recommended for children under the age of 8)

3. Do not take with dairy products, antacids, and Fe+(iron) tabs

4. Nephrotoxicity & Hepatotoxicity

5. Superinfection

6.Preganancy Category D

7. May deposit in growing bone leading to depression of bone growth

-Bacteriostatic

-MOA: Inhibits protein synthesis by preventing the binding at the 50s subunit ribosomal site

-Examples: Erythromycin, Azithromycin, Clarithromycin

Uses: Gram + infections(Strep & Staph), Gram - infections(Moraxella & Neisseria), Chlamydia infections

-GI disturbances (Take with food)

-Z-Pak has shown an elevation in liver enzymes

-Biaxin has been shown to leave a metallic taste in mouth.

-Ketolide

-Use: Community aquired pneumonia

-Not used very often

-MOA: Inhibits bacterial protein sythesis by binding to two sites on the 50s ribosomal subunit

-Black Box Warning

-N/V/D

-Visual Disturbances(blurred vision)

-Once a day dosing for 5-7 days

-Enzyme Inhibitor (Stop taking "statins" if taking this medication)

-Bacteriostatic

-MOA: Drug binds to the bacteria, attatches to the ribosomes 30s and 50s subunit site irreversible and inhibits protein synthesis

Examples: Gentamycin, Neomycin, Tobramycin

-Uses: UTI, Before and after intestinal surgery, conjunctivitis, otitis media, bronchitis, staph infections, serious Gram - Bacilli

-Side Effects: Very high doses can result in neuromuscular blockade( Respiratory Paralysis), Ototoxicity, Nephrotoxicity

-Clindamycin (Cleocin)

-MOA: Binds to bacterial ribosome and suppresses protein synthesis

-Bacteriostatic

-Substitute for PCN allergy

-Uses: Skin and soft tissue infections

-Side Effects: diarrhea, pseudomembranous colitis cause by C-Diff

-MOA: Inhibits bacterial protein synthesis

-Bacteriocidal

-Used topically for skin infections caused by staph

-Rarely used in US or Europe

-MOA: Inhibits bacterial protein synthesis

-Uses: Bacterial septicemia, typhoid fever, meningitis

Side Effects: Grey Baby Syndrome(Abd distention, Circulatory collapse, Resp failure), Bone Marrow Depression (Anemia)

-Bacteriostatic

-MOA: Inhibits the synthesis of folic acid and thereby inhibiting growth

Uses: Burns, UTI,  Respiratory infections, PCP, Staph infx

-Examples: Silver sulfadiazine, Sulfacetamide, Sulfamethoxazole(main agent in Bactrim), Sulfasalazine

-Photosensitivity

-Rash

-Hyperkalemia

-Crystalluria

-Blood Disorders

-Fluroquinalones

-Anti-protozaonal Agents

-Bacteriocidal

-MOA: Inhibits DNA Gyrase, which is essential bacterial replication

-Uses: UTI, GI, Respiratory, and bone and joint, ear and eye infx

Examples: Ciprofloxacin, Levofloxacin, Monifloxacin, Ofloxacin

- HA

-Dizziness

-Photosensitivity

-Tendonitis

-QTc Prolongation

-Flagyl(metronidazole), Tindamax(tinidazole)

-MOA: Interferes with DNA

Uses: Bacterial and Protozoa infx

-Use: UTI due to it's antiseptic properties

-Counseling tip: Drink lots of water

Phenazopyridine(Pyridium)

-AZO

-Urinary tract anagensic

-Counseling tip: take with food, drink lots of water, will discolor urine

1. Metabolism of ABX

2. Change in ABX target site

3. Changes in Permeability

4. Efflux Mechanism (Pump)

5. Circumvent Pathway Blockade

- Systemic Infections- infection of the blood, bones, and lungs. Very serious. Common in hospital (neutropenic, immunocompromised, ICU Patients)

-Dermatophytic Infections- Infections of the keratinized tissue (hair, nails, skin). Caused by Tinea species.

-Candidiasis- Infection of mucous membrane. (Thrush, Vaginal Area)

-Amphotericin-B

-Azoles

-Echinocandins

-Griseofulvin

-Terbinafine

-Nystatin

MOA: binds to ergosterol and alters ther permeability of the cell causing nutrients and ions to leak out leading to cell destruction.

-Fungicidal

-Broadest spectrum

-Used for life threating mycotic infx

-infusion related toxicities(fever, chills, muscle spasms)

-Renal impairment

MOA: reduction of ergosterol synthesis by inhibition of fungal cytochrome P450 enzymes

-Examples: Diflucan(flucanazole) Nizoral (ketocanazole) Sporonox(itraconazole)

-Uses: Candida Species (yeast infx)

-Newest Class

-MOA: act at the level of the fungal cell wall by inhibiting the synthesis of β (1-3)-glucan

-Examples: Cancidas (caspofungin), Mycamine (micafungin), Eraxis(anidulafungin)

Uses: Candida infx (yeast infx)

-binds to infected keratinized tissue preventing the fungus from invading the healthy tissue

-Fungistatic

Inhibits squalene epoxidase--> fungal cell wall integrity lost

-Fungicidal

-Vaginal

-Miconazole (Monistat-7)

-Clotrimazole (Gyne-Lotrimin)(Mycelex-7)

-Athletes foot & Ringworm

-Clotrimazole (Lotrimin- AF)

-Terbinafine (Lamisil)

-Leading Killer on earth

-1.4 million ppl die every year

-Cause by Myocobacterium tuberculosis

-transmitted by droplets in the air from an infected person

-mainly infects lungs but also manifest in the spine brain and kidneys

-Isoniazid

-Rifampin

-Pyrazinamide

-Ethambutal

-treatment can last from 6 to 12 months

-Acyclovir

-Valacyclovir

-Famciclovir

-Human Immunodeficiency Virus

-Infects the helper T cells

-is a retro virus that reproduces RNA to DNA

-Modes of transportation: sexual contact, exposure to dirty needles, perinatal

AIDS

-Acquired Immunodeficency Syndrome

-Diagnosed when CD4+ helper cell count drops to less than 200 cells/mm3

-No Cure

-Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

              +Retrovir, Epivir, Ziagen, Emtriva

-Nonnucleotide Reverse Transcriptase Inhibitors(NNRTIs)

               +Sustiva, Viramune

-Protease Inhibitors

               +Norvir, Crixivan

-Fusion inhibitors

               +Fuzeon

-Integrase inhibitors

               +Isentress

-CCR5 antagonist

                +Selzentry

-Alkylating Agents

-Platinum Analogs

-Antimetabolites

-Natural Chemotherapy

-Antitumor Antibiotics

-Cyctotoxic antibiotics

MOA: Bind irreversibly with the nucleic acids. DNA unable to replicate and therefore can no longer synthesize proteins and other essential cell metabolites

5 different groups: Nitrogen Mustards (Cyclophosphmide), Ethylenemines (Altretamine), Alky Sulfonates (Busulfan), Nitrosoureas (Carmustine), Triazenes (Decarbazine)

-Cisplatin

-MOA: Not clear but exert their cytotoxic effect in the same manner as alkylating agents

-these agents inhibit or block some of the cells function or chemical reaction that is vital to cell growth and reproduction. 

-Folic Acid antagonist

           -Metotrexate(MTX)- DDI's with warfarin, PCN, NSAIDs, Omeprazole

Leucovorin- used to replenish Folic Acid

-Purine antagonist

           -Mercaptopurine(6MP)

-Pyrimidine antagonist

           -Fluorouracil (5-FU)

-Vinca alkaloids

-Vinblastine and Vincristine

-Podophyllotoxin

-Etoposide and teniposide

-Taxane derivatives

-Paclitaxel

-Camptothecins

-Irinotecan

-Benadryl

-Tagament or Zantac

-Anti-nausea meds

-Anthtracyclines

-Doxorubicin

-4 MOAs- Inhibits Top II, Bind to DNA, Formation of free radicals whick attack DNA, Alter cellular membranes.

-Dexrazoxan is used to protect against cardiomyopathy

-Bleomycin

-MOA: Interferes with DNA synthesis

-Pulmonary toxicity

-Tamoxifen(Nolvadex)

-used for breast cancer in men and women