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Pharm Ch 62

Classification of Meds

cross-sensitivity meds that share common actions and common adverse effects
anaphylactic reaction severe, total-body life-threatening adverse reactions that may result from the admin of any drug
FDA Preg Cat A a risk has not been doc during preg
FDA Preg Cat B animal studies have not shown a risk, but there is inadequate doc in humans, or animal studies have shown adverse effects, but this has not been demo. in humans
FDA Preg Cat C animal studies have shown adverse effects, but there are no adequate studies in humans, or the benefits to the preg woman may outweigh potential risks, or there are no adequate studies in humans or animals
FDA Preg Cat D there is evidence of human fetal risks, but the benefits may outweigh potential risks
FDA Preg Cat X abnormalities have been doc., the risk of use in preg women precludes the use of this med
True or False:A person can be allergic to a medicine at any time True, always look for signs of allergic reactions, including anaphylactic, life threatening situations. Also determine if they are taking OTC meds or herbal supp b/c many of these in combo with prescribed meds can cause serious undesired effects
certain meds, if taken with grapefruit juice can cause: toxicity,some should be taken with food or on an empty stomach
Drug-Drug interactions care must be taken when using two or more drugs:OTC, vitamins, & herbal supp.; variations from decreased effectiveness to overdose
Angelica and Chinese angelica (dong quai), cat’s claw, chamomile, chondroitin, feverfew, garlic, ginger, ginkgo, ginseng, goldenseal, grape seed extract, green tea leaf, horse chestnut seed, ledum tincture, turmeric May contribute to bleeding tendencies, particularly if combined with oral anticoagulants
Bee pollen, celery, coriander, dandelion root, fenugreek, garlic, ginseng, juniper berries, ma huang, Momordica charantia (Karela), xuan shen May cause problems in persons with diabetes
Ashwagandha, barberry, black cohosh root, burdock, cat’s claw, chamomile, dandelion root, false unicorn root, ginger, ginseng, licorice, nettle, octacosanol, schisandra, went rice May cause problems in pregnancy and/or lactation
Black cohosh root, chaste-tree berry, Chinese angelica (dong quai), ginseng, licorice, saw palmetto, St. John’s wort May have adverse reaction if taken with hormone replacements or hormonal contraceptives
Allspice, evening primrose May exacerbate seizure disorders
Chamomile, evening primrose, fish oil, ginkgo, ginseng, kava, ma huang, passionflower vine, psyllium (may block lithium), St. John’s wort, thyme, valerian, yohimbe May interact or cause overdose with antidepressants or other psychiatric medications
antibiotic is one type of anti-infective, is a chemical compound used specifically to treat bacterial infections.
antibiotic It is a product of living cells formed naturally by other living cells (e.g., bacteria, yeasts, or molds) or is produced semisynthetically in a laboratory.
antibiotic Although living cells produce antibiotics, the term “antibiotic” may also be used to mean any medication that acts as an antimicrobial agent.
Antibiotics are classified as: broad-spectrum: if they are effective against many organisms
Antibiotics are classified as: narrow-spectrum: or specific if they are effective against only a few microorganisms
bacteriostatic Antibiotics that retard the growth of bacteria are called
bactericidal Antibiotics that kill bacteria
Controlled release (CR): drug slowly released over a period of time
Delayed release (DR): medication will begin to take effect after a period of time
Extended release (ER): drug released over a longer period of time
Immediate release (IR): drug released immediately after being taken
Sustained release (SR): drug released over a period of time
factors must be considered for an antibiotic to be effective soluble in water & diffuse readily into the body tissues, shouldn't cause an adverse/allergic reaction, shouldn't affect the normal flora, and well absorbed by the GI tract, and should not be an antagonist to other antibiotics
If an antibiotic is used indiscriminately, particularly for minor ailments, or is administered improperly: certain pathogens may mutate or build a tolerance to it. Eventually, the antibiotic’s action is rendered ineffective against that particular microorganism and the microorganism is termed resistant to the antibiotic.
Some clients, who have a particular problem with frequent “strep” infections or a history of rheumatic fever take a small daily prophylactic (preventive) dose of oral penicillin,dosage schedule generally does not build up resistant strains of streptococcus and generally does not have side effects
culture and sensitivity (C&S) test to determine the specific microorganism causing an infection and the medication to which the organism is most sensitive
Cultures may be obtained from: blood, stool, sputum, pus, wound drainage (exudate), urine, or drainage from mucous membranes
To ensure the accuracy of test results, antibiotic therapy should not start until after the specimen for C&S is obtained and forwarded to the laboratory for analysis. Rationale: If antibiotic therapy begins before the specimen is secured, the numbers and types of bacteria present in the specimen could be reduced, which may result in inappropriate, and perhaps ineffective, antibiotic selection.
most effective and widely used antibiotics penicillins, cephalosporins, tetracyclines, aminoglycosides, macrolides, and sulfonamides
Penicillin (PCN) derived from a specific mold, inhibits the growth of susceptible bacteria. It is also bactericidal in sufficiently high concentrations or blood levels, most effective against gram-positive organisms: streptococci, staphylococci, and pneumococci, also a
PCN excreted rapidly in the urine and is remarkably free of toxic effects
PCN is ineffective against the tubercle bacillus, all viruses, and the organisms causing typhoid fever and, therefore, is a fairly narrow-spectrum antibiotic
PCN The oral route is the easiest and safest way to administer PCN and is usually effective for all but the most severe infections
PCN The oral route is the easiest and safest way to administer PCN and is usually effective for all but the most severe infections
PCN pregnancy category B drug
PCN serious adverse effects, such as hives, a skin rash, fever, dyspnea, or unusual bleeding, in milder PCN reactions, symptoms may be delayed and may occur 5 to 14 days after admin
Cephalosporins originally derived from a mold. Because cephalosporins are structurally similar to PCN, clients receiving cephalosporin therapy should be asked about previous sensitivity to PCN
cephalosporins are divided into three groups: first, second, and third generations
wide spectrum effective against more pathogens
Cephalosporins bactericidal. They are produced semisynthetically and are active against gram-positive cocci, including PCN-resistant staphylococci, and gram-negative bacteria, including Escherichia coli, Proteus mirabilis, and Klebsiella species.
Cephalosporins Adverse effects include GI symptoms such as flatulence (excessive intestinal gas) and diarrhea. Some cephalosporins can cause more serious adverse effects, such as bone marrow depression. As with any drug, allergic reactions are possible
Cephalosporins preg cat b,If the client drinks alcohol while taking a cephalosporin, severe nausea and vomiting are likely.
Tetracyclines (TCN) broad-spectrum antibiotics effective against a wide variety of organisms, including Rickettsia, Chlamydia, and Mycoplasma. They are sometimes used in clients who are allergic to penicillin
TCN are well absorbed orally,the presence of food and some dairy products (especially milk) in the stomach decreases oral absorption.
TCN To promote GI absorption, clients should receive tetracyclines on an empty stomach at least 1 hour before or 2 to 3 hours after eating.
TCN The presence of iron, calcium, magnesium, or aluminum in the stomach influences tetracycline absorption,shouldn't take antacids such as Gelusil, Maalox, Mylanta, Tums, or Milk of Magnesia.
TCN Oral calcium supplements will also inhibit absorption and should be taken at least 1 hour before or 3 hours after taking tetracyclines
TCN Side effects usually involve the GI system—nausea, vomiting, or diarrhea. Intestinal infections or digestive difficulties are possible because tetracyclines also may kill the normal flora found in the digestive tract
TCN Photosensitivity (sensitivity to light) may develop. Adverse reactions include skin rash, burning eyes, and vaginal or anal itching.
TCN pregnancy category D, cause a brownish discoloration of the enamel in developing teeth and are contraindicated for pregnant women and for children who do not yet have their permanent teeth
Aminoglycosides potent bactericidal antibiotics. They are active against many aerobic gram-negative organisms, particularly those causing urinary tract infections, meningitis, and life-threatening septicemias (generalized sepsis or infection throughout the body)
Aminoglycosides the medication of choice for hospital-acquired (nosocomial) gram-negative infections,also used pre-op in some clients who are scheduled for surgery of the GI tract, b/c the action of these meds reduces the number of normal bacterial flora found there.
Aminoglycosides can have toxic effects, namely ototoxicity and nephrotoxicity. Preg cat c
Ototoxicity caused by damage to the eighth cranial nerve, is manifested by dizziness, tinnitus, and gradual hearing loss that can occur even several days after the medication has been stopped.
Nephrotoxicity (kidney damage) is manifested by blood and protein in the urine
Macrolide antibiotics narrow-spectrum bacteriostatic agents. Macrolides include azithromycin (Zithromax, “Z-Pack”), clarithromycin (Biaxin), dirithromycin (Dynabac), and erythromycin (Erythrocin)
Macrolide antibiotics effective against most microorganisms that are sensitive to PCN and are used to treat respiratory tract infections in clients who are allergic to PCN
Macrolide antibiotics usually administered orally; erythromycin also may be administered parenterally. Adverse reactions include skin rashes, abdominal pain, nausea, and cramping. Macrolides are pregnancy category B agents
Macrolide antibiotics Azithromycin oral suspension and erythromycin should be given 1 hour before or 2 to 3 hours after a meal. Clarithromycin and dirithromycin should be taken with food.
Sulfonamides sulfa drugs) are used as antimicrobial agents, chiefly because of their low cost and effectiveness in treating common bacterial infections. They are bacteriostatic agents, requiring normal body processes to eradicate infection
Sulfonamides use of specific sulfonamides often indicated in the following conditions:chancroid, trachoma, toxoplasmosis, uncomplicated urinary tract infections,specific cases of malaria, meningococcal meningitis, Haemophilus influenzae infections of the middle ear
Sulfonamides an alternative to PCN for PCN-sensitive clients with rheumatic fever
Sulfonamides prescribed with PCN or erythromycin in conditions such as otitis media. Other sulfonamides are specific for other disorders. In other words, not all sulfonamides are appropriate for all disorders
Encourage clients taking sulfonamides to drink large amounts of fluids, to dilute the urine Rationale: Sulfa drugs are excreted via the kidneys and tend to form crystals in the urine, which causes kidney irritation and possible kidney stone formation. The intake of large amounts of fluid will minimize the possibility of crystal formation.
Sulfonamides adverse reactions including nausea, vomiting, diarrhea,electrolyte imbalance, cyanosis, or jaundice
Sulfamethoxazole/trimethoprim (Bactrim, Bactrim DS) a combination drug often considered the medication of choice for urinary tract infections. As with all other medications of this type, Bactrim should not be given to infants younger than 2 months.
Sulfamethoxazole/trimethoprim This medication is not the medication of choice for streptococcal infections or infections of the upper respiratory tract.
Symptoms of a serious reaction to clindamycin (Cleocin) include diarrhea with liquid feces and shreds of intestinal lining. Although rare, this reaction can be fatal, especially in children or older adults. Therefore, a client who is receiving clindamycin must report any diarrhea at once
Created by: jedwards087