2026 tips Pharm Final-HESI: Comprehensive Review of
Medications and Their Uses UTHealth N3540
Pharmacotherapeutics
,KIM
1. Epinephrine (Epi-pen) – know its use and how to use it.
○ • Epinephrine – beta-1, beta-2; alpha-1 (high doses) - Adrenergic agonists.
○ Treats severe allergic reactions (anaphylaxis) or sudden asthma attacks. It may
also be used to treat low blood pressure and slow heart rate
○ Administer epinephrine injection into middle of outer thigh, CAN be over
clothing, hold pen in place for 3 seconds after injection. (each epi-pen device
cannot be refilled or reused.
2. Antibiotics: (penicillins; cephalosporins; macrolides;fluoroquinolones – interactions
and adverse effects;
Macrolides: (alternative option for patients with penicillin allergy)
Adverse effects include: HEPATOTOXICITY and may cause QT prolongation
Erythromycin
Azithromycin
Clarithromycin
GI SIDE EFFECTS
Adverse effects: Hepatotoxicity (report): fatigue, elevated liver function tests, dark urine,
pale stools, jaundice
May cause QT prolongation (report) – cardiac arrhythmias (torsades de pointes)
Penicillin: major adverse effect- allergic reaction (hypersensitivity) urticaria, pruritus,
anaphylaxis, c difficile diarrhea (need to stop medication and report)
CROSS SENSITIVITY TO CEPHALOSPORINS
Cephalosporins: patients allergic to penicillin should not receive this, adverse effects
include: hypersensitivity, urticaria, pruritus
** antacids and iron decrease effectiveness of drug, may reduce efficacy of oral
contraceptives, do not take with alcohol
They cross the blood brain barrier to treat meningitis
Cephalexin (Keflex)
Cefazolin (Ancef)
2nd gen:
Cefaclor (Ceclor)
Cefprozil (Cefzil)
Cefoxitin (Mefoxin)
Cefuroxime (Ceftin)
, Fluoroquinolones: FDA BLACK BOX WARNING- tendinitis and tendon rupture,
CANNOT take with dairy products or antacids (must administer interacting products 2
hours before or 2 hours after antibiotic)
May cause QT prolongation and PHOTOSENSITIVITY , monitor for C. difficile
infection
Avoid drugs (macrolides, beta blockers) that prolong QT intervals.
Ciprofloxacin (Cipro) – UTI
Levofloxacin (Levaquin)
Moxifloxacin (Avelox)
Gemifloxacin (Factive)
Delafloxacin (Baxdela)
aminoglycosides – names, toxicities;
amikaCIN, gentamiCIN, tobramyCIN
Very potent antibiotics with serious toxicities, (ototoxicity and nephrotoxicity) do not
give drug if creatinine >1.2
tetracyclines – contraindications, teaching, warnings;
Do not use in PREGNANCY OR LACTATION, do not give to children under the age of
8 years old because tooth discoloration will occur if the drug binds to the calcium in the teeth
***Do not take with iron preparations, antacids, or dairy products , can cause
photosensitivity, may reduce efficacy of oral contraceptives, superinfections may occur, take
medication WITH 6 to 8 oz of water. Can cause photosensitivity.
sulfa antibiotic – use, monitoring
Sulfonamide: uses: treatment of UTIs, staphylococcus infections
a/e: SJS (assess cbc, report sore throat, fever, signs of infection), agranulocytosis,
hemolytic anemia, thrombocytopenia (when taken for an extended time frame, periodic
blood tests should be performed)
*photosensitivity can occur
Allergic reaction “sulfa allergy”: usually a delayed reaction w/ rash
Sulfasalazine: use: IBDs
Monitor and report signs of agranulocytosis (fever, sore throat, signs of infection)
thrombocytopenia (bruising, nose bleeds, bleeding gums) or any unusual weakness and
fatigue due to anemia
*periodic blood tests to monitor WBC, RBS, and platelet counts
, 3. Superinfections. What are superinfections?
A new infection that occurs because of antibiotic (destruction of normal flora) can
present as thrush and sore mouth, vaginal yeast infection, pseudomembranous colitis, C.
difficile (requires stool specimen)
4. -AZOLE medications. Monitoring/adverse effects.
(antifungal drugs) - adverse effects: (hepatotoxic) monitor for elevated liver function
tests, avoid alcohol, do not take with antacids at the same time, (antacids can reduce the
absorption of azoles)
Metronidazole
Can result in increased levels of many other drugs bc it Inhibit cytochrome P-450 drug
metabolizing enzymes
“DON’T DRINK ON THE METRO”
5. Anti-fungal: Terbinafine. Uses, adverse effects/monitoring.
(used for nail fungal infection) requires 3-6 months of treatment; liver failure may occur,
need to monitor liver function; avoid alcohol
*monitor for dark urine, clay-colored stool, jaundice
(contraindications: hepatic impairment and alcoholism)
6. Oseltamivir – uses, nursing.
Used for prophylaxis and treatment of influenza infection
Should be given within 2 DAYS of symptom onset and hydration is important as drugs
are excreted in urine
7. Acyclovir – when it is used.
herpesvirus - drug of choice for treatment of initial and recurrent episodes, used to
suppress replication of HSV-1-2, VZV
8. Interferons, hepatitis C combination therapy. Monitoring.
(interferons) Adverse effects: depression/ suicidal ideation- notify hepatotoxicity :
myelosuppression (check cbc with LFTs)
Medications and Their Uses UTHealth N3540
Pharmacotherapeutics
,KIM
1. Epinephrine (Epi-pen) – know its use and how to use it.
○ • Epinephrine – beta-1, beta-2; alpha-1 (high doses) - Adrenergic agonists.
○ Treats severe allergic reactions (anaphylaxis) or sudden asthma attacks. It may
also be used to treat low blood pressure and slow heart rate
○ Administer epinephrine injection into middle of outer thigh, CAN be over
clothing, hold pen in place for 3 seconds after injection. (each epi-pen device
cannot be refilled or reused.
2. Antibiotics: (penicillins; cephalosporins; macrolides;fluoroquinolones – interactions
and adverse effects;
Macrolides: (alternative option for patients with penicillin allergy)
Adverse effects include: HEPATOTOXICITY and may cause QT prolongation
Erythromycin
Azithromycin
Clarithromycin
GI SIDE EFFECTS
Adverse effects: Hepatotoxicity (report): fatigue, elevated liver function tests, dark urine,
pale stools, jaundice
May cause QT prolongation (report) – cardiac arrhythmias (torsades de pointes)
Penicillin: major adverse effect- allergic reaction (hypersensitivity) urticaria, pruritus,
anaphylaxis, c difficile diarrhea (need to stop medication and report)
CROSS SENSITIVITY TO CEPHALOSPORINS
Cephalosporins: patients allergic to penicillin should not receive this, adverse effects
include: hypersensitivity, urticaria, pruritus
** antacids and iron decrease effectiveness of drug, may reduce efficacy of oral
contraceptives, do not take with alcohol
They cross the blood brain barrier to treat meningitis
Cephalexin (Keflex)
Cefazolin (Ancef)
2nd gen:
Cefaclor (Ceclor)
Cefprozil (Cefzil)
Cefoxitin (Mefoxin)
Cefuroxime (Ceftin)
, Fluoroquinolones: FDA BLACK BOX WARNING- tendinitis and tendon rupture,
CANNOT take with dairy products or antacids (must administer interacting products 2
hours before or 2 hours after antibiotic)
May cause QT prolongation and PHOTOSENSITIVITY , monitor for C. difficile
infection
Avoid drugs (macrolides, beta blockers) that prolong QT intervals.
Ciprofloxacin (Cipro) – UTI
Levofloxacin (Levaquin)
Moxifloxacin (Avelox)
Gemifloxacin (Factive)
Delafloxacin (Baxdela)
aminoglycosides – names, toxicities;
amikaCIN, gentamiCIN, tobramyCIN
Very potent antibiotics with serious toxicities, (ototoxicity and nephrotoxicity) do not
give drug if creatinine >1.2
tetracyclines – contraindications, teaching, warnings;
Do not use in PREGNANCY OR LACTATION, do not give to children under the age of
8 years old because tooth discoloration will occur if the drug binds to the calcium in the teeth
***Do not take with iron preparations, antacids, or dairy products , can cause
photosensitivity, may reduce efficacy of oral contraceptives, superinfections may occur, take
medication WITH 6 to 8 oz of water. Can cause photosensitivity.
sulfa antibiotic – use, monitoring
Sulfonamide: uses: treatment of UTIs, staphylococcus infections
a/e: SJS (assess cbc, report sore throat, fever, signs of infection), agranulocytosis,
hemolytic anemia, thrombocytopenia (when taken for an extended time frame, periodic
blood tests should be performed)
*photosensitivity can occur
Allergic reaction “sulfa allergy”: usually a delayed reaction w/ rash
Sulfasalazine: use: IBDs
Monitor and report signs of agranulocytosis (fever, sore throat, signs of infection)
thrombocytopenia (bruising, nose bleeds, bleeding gums) or any unusual weakness and
fatigue due to anemia
*periodic blood tests to monitor WBC, RBS, and platelet counts
, 3. Superinfections. What are superinfections?
A new infection that occurs because of antibiotic (destruction of normal flora) can
present as thrush and sore mouth, vaginal yeast infection, pseudomembranous colitis, C.
difficile (requires stool specimen)
4. -AZOLE medications. Monitoring/adverse effects.
(antifungal drugs) - adverse effects: (hepatotoxic) monitor for elevated liver function
tests, avoid alcohol, do not take with antacids at the same time, (antacids can reduce the
absorption of azoles)
Metronidazole
Can result in increased levels of many other drugs bc it Inhibit cytochrome P-450 drug
metabolizing enzymes
“DON’T DRINK ON THE METRO”
5. Anti-fungal: Terbinafine. Uses, adverse effects/monitoring.
(used for nail fungal infection) requires 3-6 months of treatment; liver failure may occur,
need to monitor liver function; avoid alcohol
*monitor for dark urine, clay-colored stool, jaundice
(contraindications: hepatic impairment and alcoholism)
6. Oseltamivir – uses, nursing.
Used for prophylaxis and treatment of influenza infection
Should be given within 2 DAYS of symptom onset and hydration is important as drugs
are excreted in urine
7. Acyclovir – when it is used.
herpesvirus - drug of choice for treatment of initial and recurrent episodes, used to
suppress replication of HSV-1-2, VZV
8. Interferons, hepatitis C combination therapy. Monitoring.
(interferons) Adverse effects: depression/ suicidal ideation- notify hepatotoxicity :
myelosuppression (check cbc with LFTs)
