1. Exam 4: Brief Medication Review

2. Antibacterial MedicationPharmaco- therapeutics Pharmaco- dynamics Main Side or Adverse Effects Penicillin (Amoxicillin) Gram Positive Bacterial infections Narrow spectrum Beta-lactamase – attacks cell wall of bacteria Allergic Reaction GI upset Cephalexin (Keflex) Bacterial infections 4 generations Cephalosporin – also beta lactamase and ruptures bacteria cell wall GI upset H/A, Dizzy, Lethargy Cross-allergy with penicillin Ciprofloxacin (Cipro) Quinolone/Fluro- quinilone effective against aerobic gram pos. and neg. bacteria Inhibits bacterial cell DNA- gyrase, an enzyme needed by bacteria to reproduce GI upset, H/A, Restlessness Crystallized urine Arthropathy (joints) Contraindicated in pregnancy and lactation Vancomycin (Vancocin) Septicemia, Endocarditis, C. Diff., Bone infections Alters cell wall permeability of gram positive bacteria Highly toxic: Ototoxic Nephrotoxic Azithromycin (Zithromax) Erythromycin Legionaires disease, pneumonia, other Inhibits RNA protein synthesis in bacteria GI upset Hives, rash Interstitial nephritis

3. Mycobacterial MedicationPharmaco- therapeutics Pharmaco- dynamics Main Side or Adverse Effects Isoniazid (INH)Tuberculosis infections Disrupts the synthesis of the TB bacterium cell wall Risk: Hepatotoxicity Risk: Peripheral neuropathy Risk: Encephalopathy Contraindicated in hepatitis, cirrhosis or other liver disease Lots of drug interactions including alcohol Give on an empty stomach RifampinTuberculosis infections Leprosy Blocks RNA transcription in bacterial cell protein Fever, chills, headache Fatigue Turns all bodily secretions (urine, tears) orange to red-orange Risk: Hepatotoxicity Risk: Nephrotoxicity

4. Urinary Tract Infections MedicationPharmaco- therapeutics Pharmaco- dynamics Main Side or Adverse Effects Trimethoprim/ sulfamethosazole (Bactrim DS, Septra) Urinary tract infections, Traveler’s diarrhea, other infections Inhibit bacterial folate synthesis. Bacteriostatic - not bacteriocidal. N/V, Diarrhea Rare: Anemia Drink lots of water when taking and with administration (at least a full glass) Nitrofurantoin (Macrodantin, Macrobid) UTI’sBelieved to interfere with several bacterial enzyme systems Rapidly excreted Contraindicated in patients with renal disease Phenazopyridine (Pyridium) Pain associated with UTI’s Unknown. Excreted in the urine and has a topical anesthetic effect. Turns the urine reddish- orange Rash, itching Headache GI upset

5. Antifungal/Antiparasitic & Dermatology MedicationPharmaco- therapeutics Pharmaco- dynamics Main Side or Adverse Effects TetracyclineAcne Vulgaris, other infections Broad spectrum against both gram positive and gram negative bacteria but bacteriostatic – not bacteriocidal Photosensitivity Multiple food interactions Tooth staining Contraindicated in pregnancy, lactation Amphotericin B (Fungizone) Systemic fungal or protozoal infections, brain or meninges Binds to sterols in fungal cell membranes Contraindicated in anemia and abnormal electrolytes Risk: Nephrotoxicity, Low potassium/calcium/ magnesium and chloride Metronidazole (Flagyl) Trichomoniasis, amebiasis, giardiasis, C.Diff Other suspected fungal or protozoal diseases Inhibits DNA synthesis in anaerobic organisms and bacteria N/V, Dry mouth Altered sense of taste Anorexia GI upset/Abdominal pain Contraindicated in the presence of alcohol (wait at least 1 day after medication before drinking alcohol)

6. Immunity MedicationPharmaco- therapeutics Pharmaco- dynamics Main Side or Adverse Effects MethotrexateRheumatoid arthritis Some cancers Inhibits the replication and function of T- lymphocytes that produce cytokines. Pregnancy Category X Rash, H/A, N/V, rash, Stomach inflammation, Hair loss (alopecia) Platelet suppression (thrombocytopenia); Bone marrow suppression (Aplastic anemia); WBC suppression (Neutropenia) Interferon alpha-2b Hepatitis C Some cancers Stimulates cytokine production which promotes immune system responses Flu-like symptoms: body aches, low grade fever, headaches, etc. EchinaceaMild viral illnesses Promotes immune system responses Counteracts immune-suppression drugs Can trigger hay fever

7. Antiviral and Retroviral MedicationPharmaco- therapeutics Pharmaco- dynamics Main Side or Adverse Effects Oseltamivir (Tamiflu) Influenza Type A & B H5N1, H1N1 Appears to inhibit the release of viruses from infected cells reducing spread N/V Insomnia, Vertigo Bronchitis Works best when given within 48-hours of symptoms appearing Acyclovir (Zovirax) Herpes zoster (Chicken Pox, Shingles) Herpes Simplex Type 1 (Cold Sores) Herpes Simplex Type 2 (Genital) Becomes incorporated into the viral DNA and stops its synthesis Dizziness N/V, Abdominal pain, Anorexia Risk: Seizures, Confusion, Nephrotoxicity Oral: Drink lots of water IV: Infuse over 60 minutes Zidovudine (AZT, Retrovir) Human Immuno- deficiency virus, Epstein Barr, Hepatitis B Inhibit reverse transcriptase, an enzyme critical to HIV reproduction Headache, sleepiness GI upset Risk: Seizures and Blood disorders esp. anemia