Functions of Peripheral Adrenergic Receptor Subtypes Functions of Peripheral Cholinergic Receptor Subtypes
Receptor Receptor
Subtype Location Response to Receptor Activation Subtype Location Response to Receptor Activation
Alpha1 Eye Mydriasis—wide eyed with fear Nicotinicn All autonomic nervous system Stimulation of parasympathetic and
Arterioles (skin, viscera, mucous Constriction ganglia and the adrenal medulla sympathetic postganglionic nerves and
membranes) release of epinephrine from the adrenal
Veins Constriction medulla
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Sex organs, male Ejaculation Nicotinicm Neuromuscular junction Contraction of skeletal muscle
Bladder neck and prostatic capsule Contraction Muscarinic All parasympathetic target organs:
Alpha2 Presynaptic nerve terminals Inhibition of transmitter release—decreases Eye Miosis
sympathetic nervous system (SNS) out- Heart Decreased rate
flow to the blood vessels and heart Lung Constriction of bronchi
Beta1 Heart Increased rate, force of contraction, and AV Promotion of secretions
conduction velocity
Bladder Voiding
Kidney Renin release—RAS
GI tract Salivation
Beta2 Arterioles (heart, lung, and Dilation
skeletal mucle) Increases gastric secretions, intestinal
Bronchi Dilation tone, and motility
Uterus Relaxation Defecation
Liver Glycogenolysis Sweat glands Generalized sweating
Skeletal muscle Enhanced contraction, glycogenolysis Sex organs Erection
Dopamine Kidney Dilation of kidney vasculature Blood vessels Vasodilation
-zepam, -zolam Benzodiazepine (BZD) diazepam, alprazolam -prazole Protein pump inhibitor–acid reducer omeprazole
-pril Angiotensin-converting enzyme (ACE) inhibitor lisinopril -cillin Penicillin antibiotic amoxicillin
-artan Angiotensin-receptor blocker (ARB) candesartan -cef, -ceph Cephalosporin antibiotic cefazolin
-dipine Calcium channel blocker amlodipine -cycline Tetracycline antibiotic tetracycline
-statin Lipid-lowering drug atorvastatin -floxacin Fluoroquinolone antibiotic levofloxacin
-ase, -plase Thrombolytic alteplase -thromycin Macrolide antibiotic azithromycin
-parin Anticoagulant enoxaparin -micin, -mycin Aminoglycoside antibiotic gentamycin
-sone Corticosteroid prednisone -azole Antifungal itraconazole
-dronate Bisphosphonate for osteoporosis alendronate
Continued
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Postoperative urinary retention
Adverse Effects
Hypotension
Bradycardia, dysrhythmias
Bronchoconstriction
GI effects
ATROPINE ATROPINE
Muscarinic Antagonist (Anticholinergic)
Muscarinic Antagonist (Anticholinergic)
Blocks muscarinic receptors
Increases heart rate
Decreases salivary, bronchial, sweat, and acid-secreting cell secretions
Relaxes bronchial smooth muscles
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Myasthenia gravis
Reversal of neuromuscular blockade in postoperative patients
Adverse Effects
Excessive glandular secretions, increased GI motility
Urinary urgency, bradycardia, sweating, and miosis
Cholinergic crisis—treat with atropine
SUCCINYLCHOLINE SUCCINYLCHOLINE
Depolarizing Neuromuscular Blocker
Depolarizing Neuromuscular Blocker
Causes paralysis of muscle by preventing repolarization
Uses
Muscle relaxation during endotracheal intubation
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Treatment of nasal congestion
Delay of anesthetic absorption
Dilation of the pupil for ocular exam
Adverse Effects
Hypertension
Necrosis
EPINEPHRINE EPINEPHRINE
Adrenergic Agonist (Catecholamine)
Adrenergic Agonist (Catecholamine)
Activates all four adrenergic receptors—alpha1, alpha2, beta1, and beta2
Pupil dilation, arterial and venous vasoconstriction
Increases heart rate and force of contraction
Bronchial dilation, glycogenolysis, enhanced muscle contraction
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Uses
Cardiac arrest, heart failure, and anaphylactic shock
AV heart block and asthma
Delays absorption of local anesthetic and controls superficial bleeding
Reduces nasal congestion
Dilates pupil for eye procedures
Adverse Effects
Hypertension, tachycardia, and dysrhythmias
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Angina, necrosis following extravasation
Hyperglycemia in diabetic patients
PROPRANOLOL (INDERAL) PROPRANOLOL (INDERAL)
Adrenergic Antagonist
Adrenergic Antagonist Noncardioselective Beta Blocker
Noncardioselective Beta Blocker
Blocks beta1 and beta2 receptors
Reduces heart rate, decreases force of ventricular contraction
Decreases conduction through AV node, decreases cardiac output
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Suppresses renin, bronchoconstriction
Uses
Angina, hypertension, cardiac dysrhythmias
Myocardial infarction, heart failure, hyperthyroidism, glaucoma
Adverse Effects
Bradycardia, reduced cardiac output, AV heart block
Rebound cardiac excitation, bronchoconstriction
Inhibition of glycogenolysis, CNS effects
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Not used in patients with asthma or diabetes
Suppresses renin
Does not block beta2 receptors (no bronchoconstriction)
Not likely to inhibit glycogenolysis
Preferred for patients with asthma or diabetes
Uses
Hypertension, angina pectoris, heart failure
Adverse Effects
Bradycardia, reduction of cardiac output, AV heart block
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Rebound cardiac excitation following abrupt withdrawal
PRAZOSIN (MINIPRESS) PRAZOSIN (MINIPRESS)
Adrenergic Antagonist
Adrenergic Antagonist Alpha blocker
Alpha Blocker
Blocks alpha1 receptors
Dilates arteries and veins
Relaxes smooth muscle in the bladder neck and prostatic capsule
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Uses
Hypertension
Benign prostatic hypertrophy
Adverse Effects
Orthostatic hypotension, reflex tachycardia
Inhibition of ejaculation
Nasal congestion
Use with sildenafil (Viagra), other drugs for erectile dysfunction, can
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. lead to hypotension
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Reduces symptoms of Parkinson’s disease
Adverse Effects
Effects take several months to develop
Loss of effect occurs over time
Nausea, vomiting, dyskinesias
Postural hypotension, psychosis
Dark sweat and urine, may activate melanoma
Uses
Alzheimer’s disease (AD)
Adverse Effects
Cholinergic effects
Nausea, vomiting, dyspepsia, diarrhea
Bradycardia, bronchoconstriction
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Epilepsy
Adverse Effects
Nystagmus, sedation, ataxia, diplopia
Cognitive impairment, gingival hyperplasia, hirsutism
Rash, fetal harm, bleeding tendencies in newborns
Narrow therapeutic range (10 to 20 mcg/mL)
Can decrease the effect of other drugs such as:
Oral contraceptives, warfarin, and glucocorticoids
Inject slowly, use normal saline flush
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Withdraw over a period of 6 to 8 weeks to avoid seizures
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Relief of pain
Adverse Effects
Respiratory depression, constipation
Orthostatic hypotension, urinary retention, miosis
Biliary colic, euphoria, sedation, cough suppression
Tolerance and physical dependence
Reversed with naloxone (Narcan)
Fold here
Uses
Migraine headache
Adverse Effects
Chest pressure, coronary vasospasm
Fetal harm
Fold here
Adverse Effects
Sedation, orthostatic hypotension, weight gain, dry mouth
Blurry vision, urinary retention, constipation, tachycardia
Galactorrhea, gynecomastia, amenorrhea, diabetes
Agranulocytosis, seizures
Low risk of extrapyramidal effects
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Antidepressants Depression, bipolar disorder, insomnia, and neuropathic pain
Adverse Effects
Orthostatic hypotension, sedation
Anticholinergic effects
Cardiotoxicity, seizures, hypomania
Many drug interactions
SSRIs preferred for treatment of depression
Adverse Effects
CNS stimulation, orthostatic hypotension
Hypertensive crisis from buildup of dietary tyramine
Many drug interactions
SSRIs preferred for treatment of depression
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Reduces euphoria, hyperactivity, and other symptoms
Preferred for patients with classic (euphoric) mania
Adverse Effects
Accumulates to toxic levels in the presence of a low sodium level
Lithium levels must be kept below 1.5 mEq/L
Blood levels drawn 12 hours after evening dose
Signs of toxicity include fine hand tremor, GI upset, thirst, polyuria, and
muscle weakness
Chronic use can lead to renal toxicity and hypothyroidism
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Pregnancy Risk Category D
Drug interactions occur with diuretics, NSAIDs, and anticholinergics
Adverse Effects
GI disturbances, weight gain
Rare thrombocytopenia, pancreatitis, liver failure
Target trough level is 50 to 125 mg/mL
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Adverse Effects
Headache, dizziness, double vision
Life-threatening rashes include Stevens-Johnson syndrome and
epidermal necrolysis
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Short-term management of insomnia
Adverse Effects
Daytime drowsiness, dizziness
Do not use with alcohol or other CNS depressants
BARBITURATES BARBITURATES
Thiopental (Pentothal)
CNS Depressants
Secobarbital (Seconal)
Phenobarbital Potentiate the actions of GABA (an inhibitory neurotransmitter)
Uses
CNS Depressants Insomnia
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Uses
Attention deficit/hyperactivity disorder (ADHD)
Narcolepsy
Adverse Effects
Insomnia, reduced appetite, palpitations, hypertension, angina,
dysrhythmias, psychosis
Abrupt discontinuation can lead to withdrawal reactions
Potential for abuse (Schedule II)
Sudden death
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
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Adverse Effects
Insomnia, growth suppression
Headache, abdominal pain, lethargy
Abuse potential (Schedule II)
Sudden death
Drug holidays recommended
Alcohol abuse
Adverse Effects
Nausea, vomiting, flushing, palpitations, headache
Sweating, blurry vision, hypotension, chest pain, shock
will occur with 7 mL of alcohol ingestion
Fold here
Uses
Rapid mobilization of fluid
Pulmonary edema resulting from heart failure or renal or liver disease
Especially useful in patients with renal insufficiency
Adverse Effects
Hypokalemia, hyponatremia, hypochloremia, dehydration, hypotension,
and ototoxicity
May cause dysrhythmias when used with digoxin (decreases potassium)
Treatment of hypertension
Mobilization of edema with mild heart failure, hepatic or renal disease
Adverse Effects
Hyponatremia, hypochloremia, dehydration
Hypokalemia and hypotension
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Hypertension and edema
Heart failure
Primary hyperaldosteronism
Adverse Effects
Endocrine effects such as:
Gynecomastia, menstrual irregularities, impotence, and hirsutism
Hyperkalemia
Fold here
Uses
Angiotensin II-Receptor Blockers (ARBs) Hypertension, heart failure, MI, and diabetic nephropathy
Prevention of MI, stroke, and death
Adverse Effects
Renal failure in patients with renal artery stenosis
Hypotension
Angioedema
Fetal injury
Does not cause cough or hyperkalemia
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
Fold here
Uses
Hypertension
Angina
Adverse Effects
Peripheral edema, flushing, dizziness, headache
Does not slow heart rate like nondihydropyridines
Uses
Heart failure and dysrhythmias
Adverse Effects
Anorexia, nausea and vomiting, fatigue
Visual disturbances (blurry vision, yellow tinge, halos)
Dysrhythmias
Digoxin toxicity (therapeutic level 0.5 to 0.8 ng/mL)
Hold if HR 60 BPM or K is low
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Inject slowly over 5 minutes
Give Digibind for digoxin overdose
AMIODARONE (CORDARONE) AMIODARONE (CORDARONE)
Antidysrhythmic
Antidysrhythmic Class III Potassium Channel Blocker
Class III Potassium Channel Blocker Delays repolarization
Reduces automaticity in the SA node, reduces contractility
Decreases conduction velocity in the AV node, ventricles, and
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His-Purkinje system
Uses
Recurrent ventricular fibrillation
Unstable ventricular tachycardia
Adverse Effects
Widening of the QRS complex
Prolongation of the PR and QT intervals
Pulmonary toxicities, sinus bradycardia, AV block, hypotension
Corneal microdeposits, optic neuropathy
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Hepatitis, thyroid dysfunction
Toxicities in pregnancy
Grapefruit juice increases levels to toxicity
Fold here
Uses
Atrial and ventricular dysrhythmias
Adverse Effects
Systemic lupus erythematous–like syndrome
Blood dyscrasias
QRS widening and prolongation
Accelerates repolarization
Uses
Short-term therapy for ventricular dysrhythmias
Adverse Effects
No significant impact on the ECG
Drowsiness, confusion, and paresthesias
Toxic doses may produce convulsions and respiratory arrest
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Decreases velocity of conduction through the AV node
Decreases myocardial contractility
Uses
Sinus tachycardia, severe recurrent ventricular tachycardia
Paroxysmal atrial tachycardia, hypertension
Adverse Effects
Prolongs PR interval on the ECG
Bradycardia, heart failure, AV block, and sinus arrest
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Bronchospasm in patients with asthma
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Dyslipidemia
Adverse Effects
Hepatotoxicity
Flushing, itching
Gastric upset, nausea, vomiting, diarrhea
May raise blood sugar in patients with diabetes
May increase incidence of gout
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Hypertriglyceridemia
Adverse Effects
Myopathy, liver injury
Rash, nausea, abdominal pain, diarrhea
Gallstone formation
Increases warfarin levels, leading to hemorrhage
Fold here
Uses
Angina, myocardial infarction
Adverse Effects
Headache, orthostatic hypotension
Reflex tachycardia
Use with sildenafil (Viagra), other drugs for erectile dysfunction may lead
to severe hypotension
Uses
Prevention of stroke and MI
Adverse Effects
Hemorrhage
Fold here
Acute coronary syndrome
Used during angioplasty
Adverse Effects
Intercranial hemorrhage, gastrointestinal bleeding
Hematuria, gingival bleeding
Thrombocytopenia
Anaphylaxis
Uses
Fold here
Prevents venous thrombosis
Used for pulmonary embolism, evolving stroke, DVT
Open heart surgery, MI, renal dialysis
Monitoring
Activated partial thromboplastin time (aPTT)
Normal aPTT 40 seconds; therapeutic level 60 to 80 seconds
Adverse Effects
Bleeding—antidote is protamine sulfate
Heparin-induced thrombocytopenia (HIT)
(Decreased platelet count 100,000 leads to thrombosis)
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
May be used during pregnancy
Fold here
Adverse Effects
Nausea, heartburn, bloating, constipation, diarrhea
Liquid iron preparation stains teeth
Toxic to children (lethal dose is 2 to 10 grams)
Adverse Effects
Hypokalemia
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Adverse Effects
Folic acid does not correct neurologic consequences
Will correct anemia, but may mask B12 deficiency
Always give folic acid with B12
Adverse Effects
Retention of sodium and water by kidney
Peripheral edema
Anemia, dyspnea, tachycardia
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Anemia due to AIDS treatment with AZT (zidovudine)
Anemia caused by chemotherapy
Adverse Effects
Hypertension
Increase in cardiovascular events
Red cell aplasia
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Type 2 diabetes
Adverse Effects
Hypoglycemia
Fetal harm
Uses
Type 2 diabetes
Adverse Effects
Decreased appetite, nausea, diarrhea, and weight loss
Lactic acidosis
Avoid in patients with renal or liver disease
Avoid in patients with ETOH abuse, infection, or CHF
Discontinue 48 hours prior to test with contrast media to avoid
lactic acidosis
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
ROSIGLITAZONE (AVANDIA) ROSIGLITAZONE (AVANDIA)
PIOGLITAZONE (ACTOS) Thiazolidinedione (TZD)
“Glitazone”
Thiazolidinediones (TZDs) Insulin Sensitizer
“Glitazones”
Increases insulin sensitivity
Insulin Sensitizers
Fold here
Uses
Type 2 diabetes
Adverse Effects
Fluid retention—caution in patients with CHF
Hepatotoxicity—monitor ALT
Uses
Type 2 diabetes
Adverse Effects
Flatulence, cramps, abdominal distention, diarrhea
Hypoglycemia, liver dysfunction
Fold here
Uses
Type 2 diabetes
Adverse Effects
Hypoglycemia
Administer 30 minutes before meal
GLUCAGON GLUCAGON
Hormone that increases plasma levels of glucose
Opposite effect of insulin
Uses
Treats hypoglycemia from insulin overdose
Used only if IV glucose is not available
Fold here
Fold here
Uses
Hypothyroidism
Adverse Effects
Thyrotoxicosis if dosage is excessive
Tachycardia, angina, nervousness, insomnia
Hyperthermia, sweating, and tremor
Increases warfarin levels
Takes about 1 month to reach plateau
Thyrotoxic crisis
Adverse Effects
Agranulocytosis, hypothyroidism, rash
Fetal harm
Fold here
Bursitis, osteoarthritis, anaphylaxis, asthma
Skin disorders, prevention of respiratory distress syndrome (RDS) in
preterm infants
Replacement therapy for patients with Addison’s disease
Adverse Effects
Adrenal insufficiency resulting from suppression of HPA axis
Glucose intolerance (increases blood sugar), osteoporosis, infection
Growth retardation, mood changes, cataracts, glaucoma
Peptic ulcer disease, iatrogenic Cushing’s syndrome
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
Erectile dysfunction
Adverse Effects
Hypotension, priapism, headache, and flushing
Visual changes
Use with nitrates and alpha blockers leads to hypotension
Fold here
Uses
Benign prostatic hypertrophy
Hypertension
Adverse Effects
Orthostatic hypotension, reflex tachycardia
Inhibition of ejaculation
Nasal congestion
Use with erectile dysfunction drugs may lead to hypotension
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
Fold here
Organ transplant
Adverse Effects
Nephrotoxicity, infection, hepatotoxicity, lymphomas
Hypertension, anaphylaxis, fetal harm
Fold here
Decreases flushing, itching, and secretion of mucus
Uses
Allergic rhinitis, urticaria, motion sickness, insomnia
Cold symptoms, mild transfusion reactions, allergic reactions
Adverse Effects
Sedation, confusion, nausea, and dry throat
Fold here
Reduces inflammation, pain, and fever
Uses
Pain, fever, inflammation
Prevention of thrombus in arteries
Prevents MI and stroke
Adverse Effects
Bleeding, gastric ulceration, renal impairment
Not used in children because of Reye’s syndrome
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Fetal harm, salicylism
Hypersensitivity in patients with allergies
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Minimal gastric, renal, and platelet effect
Uses
Osteoarthritis, rheumatoid arthritis, dysmenorrhea
Acute pain
Adverse Effects
Dyspepsia, mild renal impairment
Not used in patients with sulfonamide allergy
Premature closure of ductus arteriosus
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
Uses
Pain and fever
Preferred in children
No GI injury, no effect on platelets or kidneys
Adverse Effects
Toxic metabolite builds up in ETOH abusers
Hepatic necrosis can occur
Acetylcysteine (Mucomyst) given for overdose
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Reduces bronchial hyperactivity
Increases number and responsiveness of beta2 receptors
Uses
Asthma
Adverse Effects
Oropharyngeal candidiasis—rinse mouth after use
Minimal adrenal suppression and bone loss
Slows growth but does not reduce adult height
Copyright © 2007 by Saunders, an imprint of Elsevier Inc. Slight increased risk of cataracts and glaucoma
Uses
Asthma
Adverse Effects
Effect is delayed by 20 to 30 minutes
Not to be used as a rescue inhaler in an emergency
Tachycardia, angina, tremor, and leg cramps
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Reduces dosage of inhaled corticosteroid (ICS)
Uses
Asthma and allergic rhinitis
Adverse Effects
GI upset
Effect is delayed
THEOPHYLLINE THEOPHYLLINE
Methylxanthine
Methylxanthine Bronchodilator
Bronchodilator
Produces bronchodilation by relaxing bronchi
Uses
Fold here
Fold here
Uses
Asthma
Adverse Effects
Hyperglycemia, tachycardia, tremor
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Proton Pump Inhibitors (PPIs) Zollinger-Ellison syndrome
Adverse Effects
Headache, diarrhea, nausea, and vomiting
Fold here
Uses
Suppresses nausea caused by chemotherapy
Suppresses postoperative emesis and GERD
Adverse Effects
Sedation and diarrhea
Extrapyramidal reactions, especially in children
Fold here
Uses
Decreases nausea and vomiting due to:
Chemotherapy, radiation therapy, and anesthesia (postoperatively)
Adverse Effects
Headache, nausea, and dizziness
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Nausea
Adverse Effects
Sedation, blurry vision, urinary retention, dry mouth
Fold here
Treats infections caused by Staphylococcus aureus
Adverse Effects
Allergic reaction, GI effects
Thrombophlebitis, hypokalemia
Fold here
Gram-positive infections
Surgical prophylaxis
Adverse Effects
Allergic reaction
Bleeding tendencies
Thrombophlebitis
Antibiotic-associated pseudomembranous colitis (AAPMC)
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Active against gram-negative organisms
Adverse Effects
Allergic reaction
Bleeding tendencies
Thrombophlebitis
Antibiotic-associated pseudomembranous colitis (AAPMC)
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Chlamydia trachomatis, Mycoplasma pneumonia
Helicobacter pylori, anthrax, and Lyme disease
Acne, peptic ulcer disease, periodontal disease
Adverse Effects
GI irritation, suprainfection (AAPMC)
Discoloration of teeth (avoid in children 8 years old)
Hepatotoxicity, exacerbation of renal impairment
Photosensitivity, vestibular toxicity
ERYTHROMYCIN ERYTHROMYCIN
CLARITHROMYCIN (BIAXIN) Macrolide Antibiotic
AZITHROMYCIN (ZITHROMAX) Broad-Spectrum Antibiotic
DIRITHROMYCIN (DYNABAC)
TELITHROMYCIN (KETEK) Inhibits bacterial cell wall synthesis
Uses
Fold here
Macrolide Antibiotics Active against most gram-positive and some gram-negative organisms
Broad-Spectrum Antibiotics Treats atypicals such as Legionella pneumonia, pertussis, diphtheria, and
pneumonia caused by Mycoplasma pneumoniae
Can be used as an alternative to PCN in allergic individuals
Adverse Effects
GI effects, liver injury
Inhibitor of cytochrome P450
Increases levels of theophylline, carbamazepine, and some statins
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Bacteroides fragilis, Fusobacterium, Clostridium perfringens
Adverse Effects
Antibiotic-associated pseudomembranous colitis (AAPMC)
Diarrhea
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Urinary tract infections
Pneumonia caused by Pneumocystis carinii
Adverse Effects
Nausea, vomiting, rash, blood dyscrasias
Hypersensitivity reactions (Stevens-Johnson syndrome)
Not for use in patients with sulfa allergies
Avoid use in pregnant women near term
Avoid use in infants under the age of 2 months
Fold here
Infections caused by obligate anaerobic bacteria
Bacteroides, Clostridium difficile, Helicobacter pylori, Trichomonas
vaginalis, giardiasis
Used as prophylaxis in colorectal or abdominal surgery
Adverse Effects
Nausea, headache, dry mouth, metallic taste
Dark discoloration of urine
Disulfiram-like effect when used with alcohol
Increases warfarin levels
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
Antifungal Agents
Adverse Effects
Hepatotoxicity (monitor liver function tests [LFTs])
Decreases sex hormones
Don’t give with PPIs
Inhibits hepatic drug-metabolizing enzymes
Increases levels of warfarin, phenytoin, and some statins
Fold here
Dermatophytic infections of the skin, hair, and nails
Not active against Candida species or systemic mycoses
May take 3 to 8 weeks to respond
Adverse Effects
May decrease the effects of warfarin
Adverse Effects
IV administration can lead to phlebitis and nephrotoxicity
Infuse slowly over 1 hour and maintain hydration
Oral therapy may lead to nausea, vomiting, diarrhea
Headache and vertigo
Fold here
Adverse Effects
Flulike syndrome
Depression
Fatigue, hair loss, thyroid damage, heart damage
Bone marrow suppression
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Antiretroviral Drugs HIV infection
Adverse Effects
Anemia, neutropenia, lactic acidosis
Fold here
Adverse Effects
Hyperglycemia, diabetes, fat redistribution, hyperlipidemia
Increased bleeding in hemophiliac patients
Reduced bone mineral density
Elevation of serum transaminases
Can increase or decrease levels of other drugs
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