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O fluoroquinolones including levaquin are associated

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oFluoroquinolones, including LEVAQUIN®, are associated with an increased risk oftendinitis and tendon rupturein all ages. This risk is increased in patients over 60years, in patients taking corticosteroids, and in patients with kidney, heart orlung transplants.oAnaphylactic and allergic skin reactions, serious, occasionally fatal, may occurafer first doseoAgranulocytosis, thrombocytopenia, and renal toxicities may occur afer multipledosesoSevere, and sometimes fatal, hepatoxicity has been reported.oCentral nervous system effects, includingconvulsions, anxiety, confusion,depression, and insomnia may occur afer the first dose. Use with caution inpatients with known or suspected disorders that may predispose them toseizures or lower the seizure thresholdoClostridium difficile-associated colitis: evaluate if diarrhea occursoPeripheral neuropathy: discontinue if symptoms occur in order to preventirreversibilityLIPOPEPTIDES-New category, bactericidal-Mechanism of Action– inhibits protein, DNA, and RNA synthesis-Uses:oComplicated skin infectionsoSepticemia due to Staphylococcus aureus infectionsoInfective endocarditis due to MRSA-Example/Prototype:Daptomycin (Cubicin)-Side effects –oHypo/hypertension, anemia, numbness, tingling, dizziness, insomnia,pain/burning in urination, N/V-Adverse Effects:oElevated creatine kinase (rhabdomyolysis) esp. when given with statinsoUnexplained myopathy, neuropathyoHypo/hyperkalemia, hyperglycemiaoPleural effusion-Drug Interactionstoxicity with tobramycin, increased bleeding with warfarinSULFONAMIDES-Bacteriostatic, first isolated from coal tar in 1900s, produced in 1935 to treat pneumonia-Usefulness ↓ due to drug resistance, discovery of PCN, used in patients allergic to PCN-Mechanism of Action –inhibit formation of folic acid in bacterial cells which is essentialfor bacterial growth-Uses –UTI, gram (-) infections, prostatitis, respiratory infections, burn wounds (topical),meningococcal meningitis, newborn eye prophylaxis, chlamydia, and toxoplasmosis-Prototype –Trimethoprim-sulfamethoxazole [TMP-SMZ] (Bactrim, Septra)-Trimethoprim:urinary tract anti-infective-Trimethoprim-sulfamethoxazole[TMP-SMZ] (Bactrim, Septra)oSynergistic effectoBoth drugs together in one compound cause bacterial resistance to developmuch more slowly38
PHARM SP 2019 EXAM 2KEY: [yellow highlight = contraindications] [blue highlight = nursing considerations] [red text = interactions/adverse effectsto monitor] / [green highlight = prototype]Uses:urinary, intestinal, and lower respiratory tract infections; otitismedia; prostatitis; and gonorrhea; used to preventPneumocystis cariniipneumoniain patients with AIDS-Side Effects and Adverse ReactionsoModerate rashes, anorexia, nausea, vomiting and diarrhea, stomatitis,crystalluria, and photosensitivityoAgranulocytosis, aplastic anemiaoHypoglycemiaoSevere skin reactionSteven Johnson’s Syndrome: a rash of round lesions aboutan inch across arises on the face, trunk, arms and legs, and soles of the feet, butusually not the scalpo

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estrogen, Anabolic steroid

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