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1st Semester Final > 1st Semester Final Drug Cards > Flashcards

1st Semester Final Drug Cards Flashcards

Drugs are bad, mmmk?

1
Q

CLASS: B-lactam antibiotics mechanism of action and subclasses (4 of em)

A
  • Disrupt cell wall to allow for water to flood in and cause the cell to burst
  • PCNs, cephalosporins, carbapenums, and monobactam
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2
Q

SUBCLASS: PCN mech of action and what is it most active against?

A

Bind to penicillin binding proteins and cause inhibition of transpeptidases and activation of autolysins, primarily active against gram +

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3
Q

Most common ADR to PCN

A

Allergic rxn anaphylaxis, 7% approx

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4
Q

DRUG: PenG activity

A
  • Gram + bacteria except for highly resistant ones
  • Some gram neg including niesseria, also DOC for syphilis
  • relatively narrow spectrum
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5
Q

DRUG: PenG administration

A

4 diff salts, none activated PO

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6
Q

DRUG: PenV how is it different from PenG?

A

Only diff is that it is immune to gastric acid so the go to standard for oral therapy

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7
Q

DRUGS: Nafcillin, oxacillin, dicloxacillin are most active against what?

A

Very narrow, only penicillinase producing strains of S. aureus and S. epidermidis

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8
Q

Name the 2 aminopenicillins

A

Ampicillin and amoxicillin

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9
Q

SUBCLASS: PCN, list the drugs (8 of em)

A
  • PenG
  • PenV
  • Nafcillin
  • oxacillin
  • dicloxacillin
  • ampicillin
  • amoxicillin
  • Piperacillin
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10
Q

DRUGS: ampicillin and amoxicillin are most active against what?

A

Most gram pos and some gram neg including enteric bacilli

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11
Q

Amoxicilin rash

A

Nonallergic maculopapular rash that appears with use and isn’t serious

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12
Q

Name the 3 methicilins (how do you remember them?)

A

Nafcilin
oxacilin
dicloxacilin
(NOD)

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13
Q

DRUG: Piperacillin is most active against what? How do you remember it?

A

Pseudomonas (think P), most gram + and some other gram -

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14
Q

SUBCLASS: cephalosporins mech of action and what is their spectrum?

A

Same as PCN, bind PBP’s and disrupt cell wall synthesis and activate autolysins, their spectrum is variant upon the generation

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15
Q

SUBCLASS: Name the 5 cephalosporin generations and their activity levels, what are the 2 trends important to knowing?

A

1) Cephalexin - highly active on gram + not so much -, rarely DOC its expensive and other things are more effective (Keflex - can be used for UTI)
2) Cefoxitin - highly active on gram + and more gram -
3) Cefazidime OR ceftriaxone - highly active on gram + and - and psuedomonas, can penetrate CSF
4) Cefipime - broad spectrum, highly resistant to B lactamase
5) Ceftaroline - can treat MRSA

Activity on gram - increases further down generations but gram + activity decreases as you go down

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16
Q

Common ADR’s for cephalosporins

A
  • Maculopapular rash
  • cross reactivity with penicillin
  • alcohol intolerance (disulfam like reaction)
  • Ca2+ precipitate formation
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17
Q

SUBCLASS: carbapenams mech of action and what is it active against?

A

-Bind PBP 1 and 2 cause weakening of bacterial cell wall with lysis and death, broad spectrum many gram + and -

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18
Q

SUBCLASS: carbapenams, list the drugs (4 of em) how do you remember them?

A
  • Imipenam
  • Meropenam
  • Ertapenam
  • Dorpipenam

(IMED)

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19
Q

DRUGS: Imipenam/Meropenam/ertapenam/dorpipenam spectrum, 1 significant ADR

A

Very broad (in fact most broad of any antimicrobial) mixed infections gram + and - most reactive against anaerobes, seizures in elderly

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20
Q

SUBCLASS/DRUG: Monobactam (Aztreonam) mech of action and what is it most active against?

A

Interferes with PBP3 to prevent synthesis of bacterial cell wall highly resistant to B lactamases, Narrow, only aerobic gram neg including

  • H. influenzae
  • P. aeruginosa
  • Enterbacteriacieae
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21
Q

SUBCLASS/DRUG; aztreonam ADR

A

psueudomembranous colitis suprainfection

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22
Q

CLASS: Vanco and friends mech of action and what is it most active against? What are the drugs (4)

A
  • Inhibit cell wall syntehsis WITHOUT using the PBP interaction, not a B lactam
  • Mostly gram + highly resistant in serious infections such as MRSA, Cdiff and strep
  • Vancomycin, teicoplanin, fofsomycin, televancin
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23
Q

DRUG: Vancomycin 3 big ADRs

A
  • ototoxicity
  • renal failure
  • red man syndrome (potentially itchy, red rash not super dangerous but uncomfortable should stop treatment and take some antihistamines)
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24
Q

DRUG: Teicoplanin differences from Vanco

A

Similar action and structure to vanco but devoid of any ADR’s, used in vanco resistant cases

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25
Q

DRUG: Fofsomycin differences from vanco

A

Used to treat uncomplicated UTI’s specifically, used in vanco resistant cases

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26
Q

DRUG: televancin differences from vanco

A

Used to treat complex skin disturbances, has side effect of taste disturbance and foamy urine, used in vanco resistant cases

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27
Q

CLASS: Aminoglycoside mech of action and what is it most active against? List them (4)

A

Dirsupt bacterial protein synthesis by binding 30 s ribosomal unit after active transport across cell membrane via Oxygen dependent process, spectrum is narrowed to only gram negative aerobic bacilli, includes gentamycin, tobramycin, amikacin, and neomycin

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28
Q

CLASS: Aminoglycosides common 3 ADRS

A
  • kidney damage
  • inner ear damage
  • neuromuscular blockage (flaccid paralysis)
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29
Q

DRUG: gentamycin is commonly used for what purpose?

A

Alongside vanco or B lactam to treat severe infections

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30
Q

DRUG: tobramycin is commonly used as what?

A

A topical eye treatment

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31
Q

DRUG: amikacin has 2 outstanding features. What are they?

A
  • broadest spectrum of the aminoglycosides

- best resistance to inactivation by bacterial enzymes

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32
Q

DRUG: Neomycin is used for what purpose?

A

Pre-surgical suppression of bowel flora

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33
Q

CLASS: Bacteriostatic inhibitors of protein synthesis mech of action and list the 8 subclasses/drugs included (remember: Tony Tiger must chuck cocks down quivering ladies rectal masses)

A

Inhibit growth and replication, do not kill bacteria, include

  • tetracyclines
  • Tigecycline
  • macrolides
  • clindamycin
  • chloramphenicol
  • dalfopristin/quinipristin
  • Linezolid
  • Retamulin/mupirocin
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34
Q

SUBCLASS: Tetracyclines mech of action and what are they most active against?

A 
Bind 30s ribosome preventing protein synthesis, actively transported into cell via energy dependent process only present in bacterial cells
Broad spectrum including a lot of key ones
-Rickettsial diseases
-Chlamydia trachomatis 
-Brucella 
-Cholera 
-Mycoplasma pneumoniae 
-borelia burgdorferi 
-H pylori 
-antrahx
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35
Q

SUBCLASS: Tetracyclines, 3 common uses of them and 4 common ADR’s

A

1) acne
2) peptic ulcers
3) peridontal disease

Photosensitivty, bone and teeth discoloration, suprainfection, fanconi syndrome (if expired, fanconi syndrome where excess excretion by kidney and eventually renal failure

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36
Q

SUBCLASS: Tetracycline absorption considerations (2 ways to administer and one has some problems)? List the 4 tetracyclines

A
  • Form chelates in gut with metal ions, often used topically
  • tetracycline
  • doxycycline
  • minocycline
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37
Q

DRUG: Tetracycline key fact

A

-short acting, cannot take with food (chelates)

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38
Q

DRUG: doxycycline key fact

A

-long acting, cannot take with food (chelates)

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39
Q

DRUG: minocycline key fact

A

-Long acting, can take with food

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40
Q

SUBCLASS: Macrolides mech of action, what are they active against? Name the 3 of them (how do you remember it?)

A

Bind 50S ribosome subunit to prevent protein synthesis, broad spectrum antibiotic on gram + and - to extent

  • Azithromycin
  • Clarithromycin
  • Erythromycin ((ACE!))
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41
Q

DRUG: erythromycin 3 ADRs

A
  • Ototoxicity
  • Suprainfection
  • prolonged QT syndrome
  • nausea and diahrrhea
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42
Q

DRUG: Clarythromycin 3 ADR, what is the significant difference between that and erythromycin

A
  • ototoxicity
  • suprainfection
  • prolonged QT syndrome

it is 2-4x more active than erythromycin

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43
Q

SUBCLASS/DRUG: Clindamycin mech of action, what is it most active against? What is a big ADR with this?

A

Binds the 50S subunit to prevent protein synthesis, anaerobic GI gram -, pseudomembranous colitis suprainfection is the big one ADR

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44
Q

SUBCLASS/DRUG: chloramphenicol mech of action, what is it most active against (also note a specific disease)? What are 2 big ADRs with this?

A

Inhibition of the 50S ribosome to prevent protein synthesis, broad spectrum last resort often for bacterial meningitis and typhoid, 2 big ADR’s are pancytopenia and grey baby syndrome (builds up toxic metabolites causing generalized malaise and death)

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45
Q

SUBCLASS/DRUGS: (synercid) Dalflopristin/Quinipristin mech of action, what is it active against? What are 2 ADR’s associated with this?

A

Streptogamins that together become bactericidal, specific spectrum for VRE and MRSA, 2 ADR’s are hepatotoxicity and thrombophlebitis

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46
Q

SUBCLASS/DRUG: Linezolid mech of action, what is it active against? What is the big ADR associated with this?

A

Binds 23s portion of 50s subuinit of ribosome, cross resistance therefore unlikely, specific for VRE and MRSA, myelosuppression is the big ADR

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47
Q

SUBCLASS/DRUG: Tigecycline is identical to ____, just _____

A

Tetracyclines, just newer

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48
Q

SUBCLASS/DRUGS: Retapamulin/mupirocin use (2 things)

A

Topical antibiotics against impetigo and for recurrent MRSA skin infections

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49
Q

CLASS: Fluorquinolones mech of action, what is it active against? List all of them (2)

A

Enter bacterium by passive diffusion and inhibit replication of baterial DNA by inhibiting bacterial DNA gyrase and toposiomerase IV, active against complex most gram -, some gram + including MRSA but poor activity against anaerobes

1) ciprofloxacin
2) Moxifloxacin

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50
Q

DRUG: Augmentin is composed of what two components? What function does this serve?

A
  • Amoxacillin and clavulanic acid

- it gives the goods of penicillin and overcomes resistance from B lactamases

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51
Q

Probenicid function

A

Supplement prolongation of PCN’s and cephalosporins in the body so they aren’t excreted so quickly

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52
Q

Keflex can be given this way to prevent UTI’s in women who are prone to them….

A

Prophylactically

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53
Q

Often lyme disease is treated with what?

A

Doxycycline

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54
Q

While on erythromycin, what needs to be monitored? what is erythromycin specifically effective against?

A

Liver and ECG in long term use, legionella, diptheria and strep throat

55
Q

What is azithromycin is most effective against…. what is difference between this and erythromycin

A

….mycoplasm….it is less effective than erythromycin

56
Q

What is a Zpac dosing?

A

500 mg azithromycin day 1, followed by 250mg days 2-5

57
Q

DOC for bacteroides particularly of the fragilis variety

A

Clindamycin

58
Q

CLASS: Sulfonamides mech of action, what are they most active against? What is it the DOC of?

A

Bacteriostatic thru inhibiting folic acid synthesis on PABA enzymes (prevents DNA and RNA production), many gram + but have resistance, DOC for UTI

59
Q

CLASS: Sulfonamides 5 ADR’s

A
  • Hemolysis
  • G6P deficiency
  • kernicterus (neurotoxic bilirubin buildup)
  • don’t use in pregnancy
  • can cause steven johnson syndrome (painful rash that becomes blisters)
60
Q

Bactrim is composed of these 2 components and state their function, what does bactrim treat?

A
  • Trimethoprim (inhibits folic acid for gram - and treats uncomplicated UTI)
  • sulfamethoxazole (mix it with to make bactrim)

UTI’s and otitis media

61
Q

CLASS: Sulfonamides, list the main drug

A

Bactrim (TMP-SMX)

62
Q

Bactrim is used for what 3 organisms?

A
  • MRSA
  • e coli
  • klebsiella
63
Q

CLASS: Fluorquinolones 3 ADRs

A
  • tendon rupture (DO NOT GIVE TO KIDS)
  • photosensitivity
  • may worsen myasthenia gravis
64
Q

DRUG: Ciprofloxacin is most active against ___, and is used frequently for these 3 items

A

gram -, pylenephritis, UTI, gastroenteritis

65
Q

DRUG: Moxifloxacin is most active against ___, and is frequently used for these 2 items

A

gram +, CAP or UTI

66
Q

DRUG: Metronidazole (flagyl) mech of action and what is it most active against? What 4 things is it the DOC for? How about its 2 ADR’s? Can i ask you even more questions?

A
  • Taken up passively, converted to active form in anaerobic bacteria, break up DNA helical structure
  • Protozoa (giardia) or anaerobic bacteria, DOC for Cdiff, amoeba, and trichomonas vaginalis, and BV
  • darkening of urine and neurologic effect
67
Q

List the 4 big TB and leprosy drugs and the acronym to remember them? What is the ADR?

A 
Rifampin - required
isoniazid - required 
pyrazinamide
ethambutol
RIPE

Red orange body fluids such as sweat

68
Q

DRUG: Ampho B mech of action, what does it treat, what are the 2 ADR’s? What group of people is this often given to?

A
  • Bind ergosterol and disrupt fungal cell membrane by making it leak intracellular content especially K+
  • Broad for fungi such as histoplasma, cryptococcus, candida, DOC for most systemic mycoses in life threatening fungal infections especially
  • renal toxicity or infusion related thrombphlebitis
  • immunocompromised
69
Q

DRUG: What is ketoconazole is administered how?

A

oral and topical

70
Q

DRUG: Fluconazole (diflucan) is used for this disease

A

vulvovaginal candidiasis

71
Q

DRUG: Voriconazole is used for this disease

A

aspergillis infections

72
Q

DRUG: Flucytosine mech of action, usage, and ADR’s

A
  • Taken up by cell and converted via cytosine deaminase to 5-fluorouracil that then disrupts DNA and RNA synthesis (only in organisms that have cytosine deaminase, humans and many fungi do not)
  • almost always used with ampho B
  • Causes myelosuppression
73
Q

CLASS: Azoles mech of action and ADR? What are they used as an alternative to?

A
  • decreases synthesis of ergosterols
  • inhibit hepatic p450 enzymes increasing plasma levels of many drugs
  • Ampho B
74
Q

6 options for MRSA and their general indications

A
  • vanco (hospital acquired)
  • doxy (community acquired)
  • mupirocen (repeated skin infections or decolonization of the nose)
  • linezolid (its good alternative)
  • Bactrim (its also good alternative)
  • ceftalorine (its good alternative)
75
Q

Griseofulvin treats ___ thru the mechanism of ____

A

tinea capitis by implanting into the keratin of cells

76
Q

What 4 things are treated well by mebendazole?

A

trichonella spiralis, ascariasis (roundworms), N. (americanus), and pinworm (E. vermicularis)

77
Q

Treatment for schistosomiasis and T. solium (tapeworm)?

A

praziquantel

78
Q

HCV treatment of choice (3 things)

A

Ribavirin and interferon alpha and simprovir

79
Q

HIV treatments should include

A

3 active meds and 2 inactive meds ritanovir and colblstat

80
Q

3 drugs that treat mycoplasma

A

erythromycin, doxy, clindamycin

81
Q

UTI prophylaxis drugs (2)

A

Keflen and bactrim

82
Q

DOC for HSVII and varicella-zoster and CMV, what is its mech of action

A

Acyclovir, inhibits DNA replication

83
Q

Staph sapryticous causes….

A

….UTI’s in young women

84
Q

Olsetamivir is used in treatment of the…

A

….influenza A AND B

85
Q

Levofloxacin is more effective against….

A

gram+ staph or strep

86
Q

DRUG: fluorquinolones mech of action

A

Enter bacterium by passive diffusion and inhibit replication of baterial DNA by inhibiting bacterial DNA gyrase and toposiomerase IV

87
Q

DRUG: bacitracin is used to treat what? How is it typically administered? What can you combine it with?

A

Group A hemolytic strep, topically, polymixin B

88
Q

Azoles are often given as an alternative to….

A

….ampho B

89
Q

Clotrimazole is used to treat 3 areas….

A

….candida of skin, mouth and vag and tinea cruris (jock itch, dermatophytes)

90
Q

Nystatin is used to treat….

A

….candida glaborata

91
Q

Itraconazole is used to treat….

A

….histoplasmosis

92
Q

Scabies is treated with…

A

permthrin

93
Q

Cryptococcus is treated with…

A

….ampho B and flucytosine

94
Q

Aspergillosis is often seen in this group of people and manifests this way. How is it treated?

A

Farmer’s working with hay, balls in the lungs. Treated with ampho B or itraconazole

95
Q

Triple therapy regimen

A

Original standard of care for HepC until DAA development, includes pegylated interferon alfa (notorious for causing damage to host cell), protease inhibitor (simeprovir is specific for hepC), and ribavirin

96
Q

Interferon alpha ADRs (3)

A
  • Flu like symptoms
  • Mental health
  • alopecia
97
Q

Harvoni

A

Two PO antiviral agents used as a popular combination to treat HCV today

98
Q

HIV Medications

A

1) protease inhibitors
2) reverse transcriptase inhibitors
3) fusion entry inhibitors
4) nucleoside analogs
5) integrase inhibitors

99
Q

What drug can you not give to patietns with G6P deficiency

A

Bactrim or any sulfa drugs

100
Q

Treatment for HSVI topically during recurrent infections and mech of action

A

pencyclovir/denovir, inhibits DNA polymerase

101
Q

Valcyclovir is the prodrug of….

A

acyclovir

102
Q

Gancyclovir is often given for….

A

CMV

103
Q

DRUG: Clomid function

A

PCOS and infertility

104
Q

Progesterone only birth control for….

A

….post partum or breast feeding mother

105
Q

Progesterone only is contraindicated for acne because….

A

…it causes acne

106
Q

Bleeding during the 2nd half of a cycle indicates you need….

A

…more progesterone

107
Q

Too much nausea and vomiting indicates what about progestoerone and estrogen?

A

…Too high estrogen or too little progesterone

108
Q

Bleeding during the 1st half of a cycle indicates you need….

A

….more estrogen

109
Q

The ratio of LH to FSH is ___ is patients in PCOS

A

High

110
Q

Depo provera, what type of birth control is it and how long does it take to return to fertility?

A

Injectable progesterone only birth control that is not long acting (only 3 months) can take 12 to 18 months to return to fertility

111
Q

In a patient who wants to be pregant but they have PCOS, you give 2 drugs

A

1) metformin

2) clomid

112
Q

Terezol function

A

Treat candida tropicalis

113
Q

Treatment for lichen planus

A

corticosteroids

114
Q

IUD’s help prevent ____ cancer

A

endometrial

115
Q

Treatments for PMS

A
  • NSAIDS
  • Antidepressents
  • Oral contraceptives
116
Q

Fibrocystic breast changes are ___ and mobile.

Fibroadenoma is ____ and mobiel

A

Tender, nontender

117
Q

Tamoxifen is a…

A

….antiestrogen

118
Q

Mastodynia treatment

A
  • oral contraceptives
  • nsaids
  • prolactin antagonist
119
Q

Nuva ring

A

Short acting IUD given once a month

120
Q

Premarin

A

For postmenopausal dyspareunia

121
Q

Estrace

A

Specific estrogen cream for atrophic vaginitis

122
Q

2 drug Treatment of patients suspected to have gonorrhea or chlamydia

A
  • doxy or azithromycin

- ceftriaxone

123
Q

Acute prostatitis manifests as…. Chronic prostatitis manifests as….

A

….Red hot, tender prostate upon examination.

….a boggy, minimally tender prostate

124
Q

Acute prostatitis is seen in younger sexually active men. What do you treat them with? If septic you would give what?

A

Bactrim or cipro

IV gentamycin and ampicililin

125
Q

DOC for primary syphillis and tertiary (latent and neuro) syphillis

A

Benzathine PCN (primary or latent) aqueous crystaline in the neuro form

126
Q

alpha blocker treatment for BPH

A

Relaxes the neck of the bladder

127
Q

Avodart/proscar are ___ and they function to treat what disease?

A

5 a reducase inhibitors, treat BPH

128
Q

You would give exogenous testosterone for the following reasons

A
  • loss of libido
  • osteoperosis
  • high triglycerides

NOT for ED

129
Q

Urethritis is most likely caused by a ____ in males. Therefore you treat with this.

A

STI (gonorrhea or chlamydia)

Azithromycin and doxy

130
Q

Macrobid (nitrofurantoin)

A

A drug that can prevent and treat UTI’s

131
Q

If younger than 35, you will receive ___ and ____ for epididymitis. If you are older, then you will received ____ or _____

A

Ceftriaxone and doxy

Cipro or bactrim

132
Q

Viagra, levitra, cialis mech of action

A

Increase blood flow to the penis by increasing nitric oxide metabolites and inhibit phosphodiesterase activity that decreases it to allow for longer erections

133
Q

Cannot give nitroglycerin along with this group of drugs. Speaking of which, what is nitroglycerin given for?

A

Viagra/levitra/cialis because you increase the nitric oxide metabolites to dangerous levels, nitroglycerin helps chest pain from CAD

134
Q

2 classes of drugs that can cause ED

A
  • antidepressants

- anti hypertensives

1st Semester Final (45 decks)

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