Tetracyclines/Vancomycin
Patricia has been prescribed doxycycline for a Chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia’s education would include:
A. Use a back-up method of birth control (condom) until her next menses
B. Doxycycline may cause tendonitis and she should report any joint pain
C. Her partner will need treatment if her infection doesn’t clear with the doxycycline
D. Doxycycline is used for one dose treatment of STIs; take the whole prescription at once
A. Use a back-up method of birth control (condom) until her next menses
What generation of cephalosporin is Cephalexin (Keflex)?
What is an example of a common infection/organism this is prescribed for?
1st generation
skin infections
Staph aureus
What is the black-box warning for fluoroquinolones?
What age group is more at risk for this?
Risk of tendonitis or tendon rupture
elderly
What are some dose-related ADRs for macrolides?
N/V, ABD pain, cramping, diarrhea
Pattern: notice how they are all GI effects
This drug is first line therapy for treating dental infections. Name the specific drug.
clindamycin
What groups of people are tetracyclines contraindicated? Name three.
1. Pregnant women (class D)
2. Lactating women
3. Children less than 8 years old
What generation of cephalosporins are Cefaclor and Cefuroxime?
Name one infection these are used for.
2nd generation
Examples: Bacterial infections, pharyngitis, pneumonia, skin infections due to S. aureus or S. pyogenes, tonsillitis, or urinary tract infection. Acute exacerbation of chronic bronchitis. Impetigo. Otitis media
What is the most common GI adverse drug reaction for fluoroquinolones?
Pseudomembranous colitis
To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed:
A. Niacin (Vitamin B3)
B. Pyridoxine (Vitamin B6)
C. Riboflavin (Vitamin B2)
D.Thiamine (Vitamin B1)
B. Pyridoxine (Vitamin B6)
If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross-sensitivity to:
A. Loop diuretics
B. Sulfonylureas
C. Thiazide diuretics
D. All of the above
D. All of the above
Doxycycline is first line of therapy for these two organisms.
1. C. trachomatis
2. Ureaplasma urealyticum
Cephalosporins are what pregnancy category?
Category B
Name 5 clinical uses for fluoroquinolones
1. GU infections (complicated UTI, pyelonephritis, chronic bacterial prostatitis)
2. Community Acquired Pneumonia (Respiratory fluoroquinolones used as first-line therapy when comorbidities are present (Moxifloxacin, Gemifloxacin, Levofloxacin)
3. Chronic Bronchitis Exacerbation (for patients who do not respond to first-line therapy)
4. Skin, Tissue, & Bone Infections (PCN-resistant S. pneumoniae, skin infections, bone/joint infections)
5. Abdominal Infections (Complicated intraabdominal, infectious diarrhea)
When prescribing acyclovir, patients should be educated regarding:
A. High risk of developing diarrhea
B. Need to drink lots of fluids during treatment
C. Risk for life-threatening rash such as Stevens-Johnson
D. Eccentric dosing schedule
B. Need to drink lots of fluids during treatment
A patient is taking clindamycin (Cleocin) for an infection. What drug class is this?
What should the patient do if significant diarrhea develops? Explain your reasoning
clindamycin (Cleocin) is a lincosamide.
The patient should stop taking the medication if significant diarrhea.
Severe colitis is on the black box warning for this medication class and this may be what is happening to the patient.
What are common drug interactions with tetracyclines?
antacids, iron salts, magnesium containing products, zinc containing products
Cefdinir (Omnicef), Cefixime, Cefpodoxime, Ceftriaxone (Rocephin) are all examples of what generation of cephalosporins?
What types of infections these are used for?
3rd generation
Sinusitis, UTIs, STIs, CAP
Fluoroquinolones should not be used in these two groups of people?
1. Pregnancy
2. Children under 18 years old
Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:
A. Platelet count
B. BUN and creatinine
C. White blood cell count
D. AST, ALT, alkaline phosphatase, and bilirubin
D. AST, ALT, alkaline phosphatase, and bilirubin
What are first line drugs used to treat TB?
pyrazinamide [PZA]
rifampin [RIF, Rifadin, Rimactane]
isoniazid [INH]
streptomycin
ethambutol [EMB, Myambutol]
Remember: "surPRISE! you have tuberculosis!"
What are three common ADRs for patients taking vancomycin?
1. ototoxicity
2. nephrotoxicity
3. Red Man syndrome
What are the most common adverse drug reactions of cephalosporins? Name three
Allergies, Skin rash, Arthralgia, Coagulation abnormalities, fever, seizures, renal/hepatic failure
Give an example of drug used as first line therapy for CAP when co-morbidities are present.
Moxifloxacin, Gemifloxacin, Levofloxacin
When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include:
A. Metronidazole is safe in the first trimester of pregnancy
B. Consuming alcohol in any form may cause a severe reaction
C. Sexual partners need concurrent therapy
D. Headaches are a sign of a serious adverse reaction and need immediate evaluation
B. Consuming alcohol in any form may cause a severe reaction
What medication causes Mazzotti reaction?
What is medication used for?
What are signs and symptoms of Mazzotti reaction?
1. Ivermectin
2. Tissue nematodes (threadworms) and scabies
3. Fever, urticaria, swollen tender lymph nodes, tachycardia, hypotension, arthralgias, abdominal pains that starts within 7 days of treatment