Pharmtech Review Medications

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 uses3. Merck Index; for identifying chemicals4. 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.

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

Antibiotics; Sulfonamides

• Bacteriostatic only: kill bacteria by blocking reproduction only

• Usually for UTI’s and URI’s• Side effects: photosensitiviy, kidney damage,

nausea• Special considerations; avoid sunlight, drink a

lot of water to avoid kidney stones,

Gantricin, Septra, Bactrim, Azulfadine

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

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

Gram Stain (quick in office ID of type of bacteria and what it’s likely

sensitive to)

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

Examples

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

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

Examples of cephalosporins

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

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

Examples of tetracyclines

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

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.

Examples of macrolides

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

salts of erythromycin

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

Examples of quinolones

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

• Levofloxacin brand Levaquin• Oxafloxacin brand is Floxin

Aminoglycosides

• Block protein synthesis (bacteriocidal)• For serious infections mainly• Side effects; nephrotoxic,

ototoxic,tinnitus,permament deafness

Examples of aminoglycosides

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

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

Metronidazole (Flagyl)

• Used for Trichomonas of vagina and penile urethra

• Never take with ethanol; works like Antabuse

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.