PHARMACOLOGY MIDTERM Reviewer Denielle Genesis B. Camato
02272015
Anti- infectives Antibacterial Antitubercular Antifungal Antiviral
ANTIBACTERIAL
Penicillins Are bactericidal; they interfere with cell
wall synthesis by inhibiting biosynthesis of cell wall mucopeptides
Indicated for treatment of infections caused by –
Gram positive cocci Gram negative cocci Gram positive bacilli
Penicillin G Ampicillin Amoxicillin Augmentin Methicillin
Notes!Bactericidal – killBacteriostatic – preventAnti-infection – infectionAnti-inflammatory – inflammation
Cephalosporins Are bactericidal due to their ability to
inhibit mucopeptide synthesis in bacterial cell wall.
Indicated for treatment of infections caused by gram positive and negative organisms
1st generations 2nd generations 3rd generationsCefazolin Cefamandole CeftizoxineCephalexin Cefuroxime ceftriaxone
Aminoglycosides Are bactericidal agents that inhibits
proteins synthesis and lysing the cell envelope
Indicated for treatment of infections caused by gram negative enteric (GI disorders) bacilli Streptomycin Amikacin Neomycin Gentamicin
Macrolides Are bacteriostatic by inhibiting the
growth of microorganisms without causing a complete kill
Indicated for treatment of infections caused by gram positive and negative bacteria Erythromycin
Tetracyclines Protein synthesis inhibitor Used for treatment for UTI, chlamydia and
acne Tetracycline Methacycline Doxycycline
Quinolones Are bactericidal that interferes with DNA
replication Indicated for treatment of STDs caused by
gonorrhea or chlamydia Ciprofloxacin Ofloxacin Norfloxacin
Sulfonamides Interferes with the synthesis of
paraminobenzoic acid (required for the synthesis of folic acid in the bacteria)
Indicated for treatment of infections caused by gram positive and negative organisms Sulfacytine Sulfamethizole Sulfamethoxazole Trimethoprim Phenazopyridine Nitrofurantoin
Patient education on anti-infectives Unless directed otherwise, taking all
antibiotics with a full glass of water on empty stomach, at least one before meals or two hours after meals.
Not taken with fruit juice, anatacids and alcohol.
If side effects occur, discontinue and consult physician.
Immediately report rash, swelling or breathing difficulty to the physician.
Take at prescribed times to maintain blood levels.
Take entire prescription completely; not to discontinue when symptoms disappear.
Antitubercular agents Used to treat tuberculosis causes by
Mycobacterium tuberculosis Agents kill or inhibit the growth of
mycobacterial organisms Drugs are commonly used in combination
First line agents (RIPES) Rifampicin Isoniazid (INM) with
vitamins B6 (pyridoxine to prevent neuropathy)
Pyrazinamide Ethambutol Streptomycin
Patient Education Taking rifampicin on empty stomach for
maximum absorption or with food if nauseated
Taking prescribed medication for lengthy required period of time even though asymptomatic
Reporting side effects for possible dosage adjustment
Importance of frequent medical and laboratory tests
Red orange color urine, feces, sputum, sweat and tears with use of rifampicin
Avoidance of alcohol
Antifungal agents Bind to components of the fungal cell
membrane, leading to death of the fungal cell
Used to treat infections caused by fungi, whether systemic or local
Systemic antifungal Amphotericin B Ketoconazole Miconazole Fluconazole Topical antifungal Griseofulvin Nystatin Clotrimazole
Antiviral agents Enter the virus and prevent further
replication of the virus Indicated when an infections process is
due to virus Nucleosides Protease inhibitors Miscellaneous antiviral agents
Nucleosides Interfere with replication of HIV by inhibiting
the action of the enzyme reverse transcriptase
Prophylaxis after initial exposure to HIV Zidovudine Zalcitabine Didanosine Stavudine Lamivudine
Protease inhibitors Stop the activity of the HIV protease and
prevent the cleavage of viral polyproteins, thereby preventing viral maturation
Used to treat HIV in selected clients Saquinavir mesylate Crixivan Norvir
Miscellaneous antiviral agents Act by blocking replication of the virus
Acyclovir Famciclovir Ganciclovir Amantadine Rifantidine Ribavirin
Anti-Inflammatory drugs Arthritis Bursitis Spondylitis Gout Muscle strains/sprains
5 Cardinal signs of inflammation Redness (Rubor) Heat (Calor) Swelling (Tumor) Pain (Dolor) Limited mobility (Functio laesa)
NSAID (NON STEROIDAL ANTI-INFLAMMATORY DRUGS)
Non steroidal anti-inflammatory drug Action Inhibit synthesis of prostaglandins
(causes pain)
Non-selective (Traditional) NSAIDs Diclofenac VOLTAREN Ibuprofen ADVIL Indomethacin INDOCIN Ketorolac TORADOL Naproxen NAPROSYN Oxaprozin DAYPRO Sulindac CLINORIL
Partially Selective NSAIDs Etodolac LODINE Meloxicam MOBIC Nambutone RELAFEN
Selective COX-2 Inhibitor Celocoxib CELEBREX
Combinations Diclofenac/Misoprostol ARTHROTEC Lansoprazole/Naproxen PREVACID NAPRAPAC
Gout medication Colchicines ALLOPORINOL
Patient Education Administration with food to reduce
gastric irritation Increase food intake Caution with dosage Discontinue if there is unusual bleeding
(gums, stool, urine and bruising), epigastric pain or nausea, tinnitus, visual disturbances, weight gaining or edema and skin rash
03062015
CARDIAC DRUGS
Coronary Artery Disease (CAD)
Arteriosclerosis – Narrowing of coronary artery due to aging
Atherosclerosis – Narrowing due to Accumulator of fats, cholesterol, lipids
CARDIOVASCULAR DRUGS Cardiac Glycosides – indicated for
heart failureEx. Digoxin (Lanoxin) *Do not take if pulse is <60 >120 Digitalis toxicity 0.5-2.0 ng/mg
ANTIANGINAL AGENTS (chest pain) Nitrates
Isosorbide Dinitrite (Isordil) – Under the tongue (Sublingual)Isosorbide Mononitrate(Imdur) – OralBeta blockers – Action: Blocks the action of cathecolamines (Adrenaline)
Ex. Propanolol, Athenolol, MetoprololNitroglycerine – most common nitrates, IV, Sublingual, ointment, transdermal, oral
Action: it relaxes the muscle to promote vasodilation
Most common side effects; headache, hypotensionCalcium Channel Blockers – Action: Blocks calcium; leading to muscle dilation
*Antihypertensive drug
Myocardial ischemia - ( decrease Blood Supply)
- (decrease O2 supply)
CAD
Angina pectoris ( decrease Oxygen supply)
(Chest pain)
Myocardial infarction/heart attack – (necrosis of the myocardium)
Heart failure – inability of the heart to pump
Death
ANTIHYPERTENSIVE AGENTS*2 types:Primary – due to other diseasesEssential – aging
to lower angiotensin 1&2 120/80 Pre-hypertension
1) ACE inhibitors – Andiotensin Converting enzymes
2) Calcium Channel Blockers
3) Diuretics 5 types
Carbonic Anhydrase Inhibitors Loop diuretics – promotes excessive fluid; urine Potassium Sparring Diuretics Thiazides and Related Diuretics Osmotics
ANTIHYPOTENSIVE AGENT – increase blood pressureHypotensionShockCardiac arrest
ANTIDYSRRYTHMICSq Acts to restore a normal
cardiac rhythmq Indicated for atrial or
ventricular tachycardia or atrial fibrillation
q Monitor ECGq V-tachycardiaq Normal: 60-100 beats per
minuter 80 is the averager below 60 – bradyycardia
(slow heart rate)r above 100 – tachycardia
(fast heart rate)
LIPID LOWERING AGENTS
q lowers cholesterol levels
q hepatotoxic
ANTIPLATELET DRUGS
q decrease platelet aggregation/clumping
q inhibit thrombus formation
r thrombus – stationary
r embolus – wandering
ANTICOAGULANTS
q Prevent clot formation
q “blood thinner”
q COUMADIN
r Interfere with the action of vitamin K
r Oral
r Antidote vitamin K (promote synthesis of blood clotting)
q HEPARIN
r Inhibit the action of fibrin in clot formation
r Parental IV or SC
r Antidote PROTAMINE SULFATE
THROMBOLYTIC AGENTS
q Dissolves blood clots
q “clot busters”
q risk for hemorrhage
HEMORRHEOLOGIC AGENTS
q improves capillary blood flow by increasing RBC flexibility & decreasing blood viscosity
q Buerger’s disease
r Intermittent claudication caused by chronic occlusive arterial disease of the limbs
[ Cyelandilate (cyclan)
[ Isoxsuprine (vasodilan)
HEMOSTATIC AGENTS
q Used to control bleeding
rDGBCamato***end***
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