Pulmonary Meds shortened
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| Glucocorticoids | Vancenase, Flonase, Nasonex, Nasocort & Pulmicort
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| Leukotriene Modifiers | Singulair & Zyflo
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| Methylxanthines | theophylline
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| Beta 2 Adrenergic Agents | Xopenex, Albuterol, Serevent, Advair
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| Oral Anti-histamines | Benadryl, Tavist, Chlor-trimeton, Claritin, Zyrtec, Allegra, Clarinex
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| Decongestants | Sudafed, Dristan, Neo-synephrine
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| Anticholinergic | Spiriva & Atrovent
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| Coughing | Codeine, Dextromethopan, Mucinex & Mucomyst
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| Antifungal | Amphotericin B, Azoles (Diflucan, Sporanox, Vfend
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| Antimetabolites | Trimethoprim & Sulfonamides
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| Penicillins | Pipracil, Zolsyn, Augmentin, Penicillin G
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| Cephalosporins | Maxipime, Rocephine, Cefzil, Cefazolin
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| Carbapenems | Primaxin
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| Tetracyclines | Doxycycline & Tetracycline
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| Macrolides | Biaxin & Zithromax
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| Aminoglycosides | Gentamycin
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| Fluoroquinolones | Cipro & Levaquin
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| Azoles | Diflucan, Vfend, Sporanox
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| TB Meds | INH, Rifadin, PZA & myambutol
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| Chemo Agents | Taxol & Paraplatin
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| Vancenase, Pulmicort, Flovent/Flonase, Nasonex, Nasocort | Most effective antiasthma drug. S/E: with chronic use: adrenal suppression, bone loss, oropharyngeal candidiasis & dysphonia, hyperglycemia, displacement of fatty tissue, decreased healing
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| Nasonex & Nasocort | Intranasal. S/E: drying of nasal mucosa, burning/itching, sore throat, epistaxis, not as effective if nasal congestion is present
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| Zyflo | blocks leukotriene synthesis; used for adults and kids >12; hepatotoxic, monitor ALT, competes with theophylline, coumadin
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| Singulair | Leukotriene receptor blocker; used prophylactically & maintenance; prevention of exercise induced bronchospasm; relief of allergic rhinitis; not immediate or hepatotoxic
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| NasalCrom (Intranasal), Intal (Inhalation) | Effective for seasonal allergy attacks, and exercised induced bronchospasm, give 15 min before. Decreases bronchial inflammation, not a bronchodilator. Used prophylactically, not quick relief, no systemic effects, can be used instead of steroids
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| Theophylline | causes bronchodilation; narrow therapeutic range. Given PO. Wide variations in metabolic rates = therapeutic is 5-15, levels 20-25 cause nausea, vomiting, restlessness; >30 dysrhythmias (Vfib) and seizures. Avoid w/ caffeine. Not commonly used
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| Albuterol & Xopenx (short acting Beta 2 Adrenergic Agonist) | Given inhalation, immediate effect, peaks 30-60 mins, persist for 3-5 hrs. If used for exercise induced bronchospasm take 15 min before. S/E: increase HR, agina, tremor
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| Serevent (long acting Beta 2 Adrenergic Agonist) | Given PO or inhalation q12 hrs; not first choice for attack, not to be used alone - use w/ steroid. Onset begins 10-30 minutes
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| Advair | Combo Beta 2 Adrenergic Agonist
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| Chlor-Trimeton, Benadryl, Tavist (1st Generation oral antihistamines) | Relieves rhinorrhea, sneezing, nasal itching, but NOT congestion. Take on a regular basis. S/E: sedation, dry mouth, urinary hesitancy, constipation due to anticholinergic effects
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| Zyrtec, Allegra, Claritin, Clarinex (2nd Generation oral antihistamines) | Relieves rhinorrhea, sneezing, nasal itching but not congestion. Take on a regular basis. S/E: few, NO SEDATION
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| Neosynephrine, Sudafed, Dristan (Decongestants) | Decrease nasal congestion by vasoconstricting, shrinks swollen membranes. Used for allergic rhinitis to relieve stuffiness. S/E: rebound congestion, limit 3-5 day use, CNS excitation, restless, anxiety, watch cardiac patients
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| Sudafed | Can be converted to methamphetamine, must be kept behind counter
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| Atrovent | Onset 30 seconds, max 3 min. Lasts up to 6 hrs. S/E: dry mouth, irritation of pharynx, avoid if peanut allergy
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| Spiriva | Long acting, onset 30 minutes, peak 3 hrs, lasts 24 hrs. Given 1x daily. S/E: dry mouth, DPI, additive benefits w/ Beta 2
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| Codeine | Decreases frequency/intensity of cough; low dose, 1/10 of dose used for pain; potential for abuse
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| Dextromethophan | Non-opiod antitussive; taken at high doses can cause euphoria
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| Mucomyst | Given by inhalation; watch for bronchospasm, contains sulfur
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| Mucinex & Mucomyst | Expectorant stimulates flow of respiratory secretions, mucolytics breaks up mucus
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| Penicillin G | active against most gram + bacteria, most gram - are resistant. Given IM or IV, intra arterial injection can produce severe reactions (gangrene, necrosis) must AVOID
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| Pipracil | Broad spectrum, given IV, decrease dosing for impaired renal function.
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| Zosyn | Contains tazobactam which is a beta lactamase inhibitor (prevents the bacteria's beta lactase enzyme from breaking down the antibiotic which is piperacillin)
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| Augmentin | May be given orally; S/E: rash & diarrhea. Clavulanate is a beta lactamse inhibitor protecting the amoxocillin from the bacteria's beta lactamase enzymes
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| Cefazolin | Destroyed by beta lactamase enzymes; used for gram +. Binds to PCN binding proteins; has a beta lactam ring, bactericidal; most effective against bacteria undergoing cell division and growth. Given IV/IM
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| Cefzil & Ceftin | Less sensitive to beta lactamase enzymes. Does not reach CSF. Used for active infection; prophylactically w/ surgical patients
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| Rocephin & Maxipime | Highly resistant to beta lactamases. Reserved for active infections, strong antibiotics "BIG GUNS"
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| Cephalosporins | S/E: hypersensitivity reactions. Rash for several days after onset of use, risk for bleeding (interferes w/ Vit K metabolism), thrombophlebitis. Usually given IV/IM - eliminated by kidneys
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| Rocephin | Do not mix w/ calcium containing IVF/IVPB
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| Primaxin | Very broad spectrum, beta lactamase antibiotic given IV only. Binds to PCN binding proteins, resistant to many beta lactamases; penetrates gram - outer membrane. Penetrates CSF, elimination by renela. S/E: N/V, diarrhea, hypersensitivity
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| Vancomycin | Should be reserved for serious infections (CDIFF, MRSA, allergy to PCN). S/E: nephrotoxic, ototoxic (ringing in ears, hearing loss). Rapid infusion may cause "Red man syndrome". Do peaks & troughs
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| Azactam | Contains beta lactam ring. Binds to PCN binding proteins, NOT effective against anaerobes or gram + bacteria. S/E: pain & thrombophlebitis at injection site. Treats gram - aerobic bacteria. Given IM/IV
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| Tetracycline | Take on empty stomach, eliminated by kidneys, avoid w/ renal failure. Take w/ full glass of water, use straw/avoid contact w/ teeth. Treats: chlamydia, lymes diase, h pylori, acne
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| Doxycycline | Can take w/ food, eliminated by liver, OK to use w/ renal failure. S/E: discolors teeth. Treats: chlamydia, lyme's disease, h pylori, acne
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| Biaxin | Used for resp tract infections, h pylori, pertusis, whooping cough, diptheria, chlamydia, some pneumonia. S/E: GI Upset, QT prolongation
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| Zithromax | Treats respiratory infections, chlamydia, pertusis, whooping cough, diptheria, chlamydia, some pneumonia. Absorption increases w/ food.
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| Cleocin | Used for severe Group A strep infections. S/E: pseudomembranous colitis, CDIFF (profuse watery diarrhea, abdominal pain, fever, leukocytosis, stools positive for mucus and blood)
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| Zyvox | Used for VRE, MRSA, gram + bacteria. S/E: myelosuppression AKA decreases WBC, RBC, platelet
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| Gentamycin | Used for Aerobic gram - bacilli, cannot kill anaerobes, need O2 to transport medication across membrane. Given IV only, may give PO for bowel infection only. S/E: ototoxic, nephrotoxic, monitor peaks & troughs
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| Cipro & Levaquin | Used for respiratory, urinary, GI, bone, joints, skin & soft tissue infections. S/E: tendon (achilles) rupture, GI upset, candida of pharynx and vagina. CNS - dizziness, confusion. Absorption decreases w/ Al, Mg, Fe, Ca, dairy
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| Flagyl | Used for CDIFF, abdominal and vaginal surgery, h pylori. S/E: metallic taste, darkening of urine, nausea, headache, dry mouth. Avoid alcohol, may need to decrease alcohol
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| Amphotericin B | Active against broad spectrum fungi. Premedicate w/ Benadryl & tylenol, corticosteroids. Renal impairment occurs in almost all patients; avoid other nephrotoxic drugs, bone marrow suppression. BIG, DANGEROUS DRUG
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| Sporanox | Take with food, do not take w/ antacids. Broad spectrum anti-fungal
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| Diflucan, Vfend, Sporanox | Broad spectrum anti-fungals. Given PO. Used for blastomycosis, histoplasmosis, candidiasis. S/E: cardiosuppression and liver injury
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| Cancidas | Used for aspergillus or candida only. Given IV. S/E: phlebitis. Better tolerated than Ampho B
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| INH | Bactericidal to actively dividing organisms. Must be taken for 6 mos prefer 9. S/E: liver damage, peripheral neuropathy due to lowered vit B6
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| Rifadin | Bactericidal to TB. Take on empty stomach. S/E: Red,orange discoloration of urine, sweat, tears, saliva
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| PZA | Bactericiidal to TB, hepatotoxic, increases uric acid
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| Myambutol | Bacteriostatic, used to treat TB resistant to INH or Rifadin. S/E: optic neuritis (blurred vision, constriction of visual field, changes to color discrimination), inhibits uric acid excretion
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| Zovirax | Active only against herpes virus family (chicken pox, herpes, shingles).
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| Paraplatin | Used for small cell lung cancer. S/E: bone marrow suppression, nausea, vomiting. Nephrotoxic, watch for hearing loss
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| Taxol | Used for non small cell lung cancer. S/E: severe hypersensitivity infusion, bone marrow suppression, alopecia, bradycardia. Premedicate w/ Benadryl/corticosteroids.
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