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
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 +
3
Q
Most common ADR to PCN
A
Allergic rxn anaphylaxis, 7% approx
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
5
Q
DRUG: PenG administration
A
4 diff salts, none activated PO
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
7
Q
DRUGS: Nafcillin, oxacillin, dicloxacillin are most active against what?
A
Very narrow, only penicillinase producing strains of S. aureus and S. epidermidis
8
Q
Name the 2 aminopenicillins
A
Ampicillin and amoxicillin
9
Q
SUBCLASS: PCN, list the drugs (8 of em)
A
- PenG
- PenV
- Nafcillin
- oxacillin
- dicloxacillin
- ampicillin
- amoxicillin
- Piperacillin
10
Q
DRUGS: ampicillin and amoxicillin are most active against what?
A
Most gram pos and some gram neg including enteric bacilli
11
Q
Amoxicilin rash
A
Nonallergic maculopapular rash that appears with use and isn’t serious
12
Q
Name the 3 methicilins (how do you remember them?)
A
Nafcilin
oxacilin
dicloxacilin
(NOD)
13
Q
DRUG: Piperacillin is most active against what? How do you remember it?
A
Pseudomonas (think P), most gram + and some other gram -
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
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
16
Q
Common ADR’s for cephalosporins
A
- Maculopapular rash
- cross reactivity with penicillin
- alcohol intolerance (disulfam like reaction)
- Ca2+ precipitate formation
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 -
18
Q
SUBCLASS: carbapenams, list the drugs (4 of em) how do you remember them?
A
- Imipenam
- Meropenam
- Ertapenam
- Dorpipenam
(IMED)
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
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
21
Q
SUBCLASS/DRUG; aztreonam ADR
A
psueudomembranous colitis suprainfection
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
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)
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
25
DRUG: Fofsomycin differences from vanco
Used to treat uncomplicated UTI's specifically, used in vanco resistant cases
26
DRUG: televancin differences from vanco
Used to treat complex skin disturbances, has side effect of taste disturbance and foamy urine, used in vanco resistant cases
27
CLASS: Aminoglycoside mech of action and what is it most active against? List them (4)
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
28
CLASS: Aminoglycosides common 3 ADRS
- kidney damage
- inner ear damage
- neuromuscular blockage (flaccid paralysis)
29
DRUG: gentamycin is commonly used for what purpose?
Alongside vanco or B lactam to treat severe infections
30
DRUG: tobramycin is commonly used as what?
A topical eye treatment
31
DRUG: amikacin has 2 outstanding features. What are they?
- broadest spectrum of the aminoglycosides
| - best resistance to inactivation by bacterial enzymes
32
DRUG: Neomycin is used for what purpose?
Pre-surgical suppression of bowel flora
33
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)
Inhibit growth and replication, do not kill bacteria, include
- tetracyclines
- Tigecycline
- macrolides
- clindamycin
- chloramphenicol
- dalfopristin/quinipristin
- Linezolid
- Retamulin/mupirocin
34
SUBCLASS: Tetracyclines mech of action and what are they most active against?
```
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
```
35
SUBCLASS: Tetracyclines, 3 common uses of them and 4 common ADR's
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
36
SUBCLASS: Tetracycline absorption considerations (2 ways to administer and one has some problems)? List the 4 tetracyclines
- Form chelates in gut with metal ions, often used topically
- tetracycline
- doxycycline
- minocycline
37
DRUG: Tetracycline key fact
-short acting, cannot take with food (chelates)
38
DRUG: doxycycline key fact
-long acting, cannot take with food (chelates)
39
DRUG: minocycline key fact
-Long acting, can take with food
40
SUBCLASS: Macrolides mech of action, what are they active against? Name the 3 of them (how do you remember it?)
Bind 50S ribosome subunit to prevent protein synthesis, broad spectrum antibiotic on gram + and - to extent
- Azithromycin
- Clarithromycin
- Erythromycin ((ACE!))
41
DRUG: erythromycin 3 ADRs
- Ototoxicity
- Suprainfection
- prolonged QT syndrome
- nausea and diahrrhea
42
DRUG: Clarythromycin 3 ADR, what is the significant difference between that and erythromycin
- ototoxicity
- suprainfection
- prolonged QT syndrome
it is 2-4x more active than erythromycin
43
SUBCLASS/DRUG: Clindamycin mech of action, what is it most active against? What is a big ADR with this?
Binds the 50S subunit to prevent protein synthesis, anaerobic GI gram -, pseudomembranous colitis suprainfection is the big one ADR
44
SUBCLASS/DRUG: chloramphenicol mech of action, what is it most active against (also note a specific disease)? What are 2 big ADRs with this?
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)
45
SUBCLASS/DRUGS: (synercid) Dalflopristin/Quinipristin mech of action, what is it active against? What are 2 ADR's associated with this?
Streptogamins that together become bactericidal, specific spectrum for VRE and MRSA, 2 ADR's are hepatotoxicity and thrombophlebitis
46
SUBCLASS/DRUG: Linezolid mech of action, what is it active against? What is the big ADR associated with this?
Binds 23s portion of 50s subuinit of ribosome, cross resistance therefore unlikely, specific for VRE and MRSA, myelosuppression is the big ADR
47
SUBCLASS/DRUG: Tigecycline is identical to ____, just _____
Tetracyclines, just newer
48
SUBCLASS/DRUGS: Retapamulin/mupirocin use (2 things)
Topical antibiotics against impetigo and for recurrent MRSA skin infections
49
CLASS: Fluorquinolones mech of action, what is it active against? List all of them (2)
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
50
DRUG: Augmentin is composed of what two components? What function does this serve?
- Amoxacillin and clavulanic acid
| - it gives the goods of penicillin and overcomes resistance from B lactamases
51
Probenicid function
Supplement prolongation of PCN's and cephalosporins in the body so they aren't excreted so quickly
52
Keflex can be given this way to prevent UTI's in women who are prone to them....
Prophylactically
53
Often lyme disease is treated with what?
Doxycycline
54
While on erythromycin, what needs to be monitored? what is erythromycin specifically effective against?
Liver and ECG in long term use, legionella, diptheria and strep throat
55
What is azithromycin is most effective against.... what is difference between this and erythromycin
....mycoplasm....it is less effective than erythromycin
56
What is a Zpac dosing?
500 mg azithromycin day 1, followed by 250mg days 2-5
57
DOC for bacteroides particularly of the fragilis variety
Clindamycin
58
CLASS: Sulfonamides mech of action, what are they most active against? What is it the DOC of?
Bacteriostatic thru inhibiting folic acid synthesis on PABA enzymes (prevents DNA and RNA production), many gram + but have resistance, DOC for UTI
59
CLASS: Sulfonamides 5 ADR's
- Hemolysis
- G6P deficiency
- kernicterus (neurotoxic bilirubin buildup)
- don't use in pregnancy
- can cause steven johnson syndrome (painful rash that becomes blisters)
60
Bactrim is composed of these 2 components and state their function, what does bactrim treat?
- Trimethoprim (inhibits folic acid for gram - and treats uncomplicated UTI)
- sulfamethoxazole (mix it with to make bactrim)
UTI's and otitis media
61
CLASS: Sulfonamides, list the main drug
Bactrim (TMP-SMX)
62
Bactrim is used for what 3 organisms?
- MRSA
- e coli
- klebsiella
63
CLASS: Fluorquinolones 3 ADRs
- tendon rupture (DO NOT GIVE TO KIDS)
- photosensitivity
- may worsen myasthenia gravis
64
DRUG: Ciprofloxacin is most active against ___, and is used frequently for these 3 items
gram -, pylenephritis, UTI, gastroenteritis
65
DRUG: Moxifloxacin is most active against ___, and is frequently used for these 2 items
gram +, CAP or UTI
66
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?
- 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
List the 4 big TB and leprosy drugs and the acronym to remember them? What is the ADR?
```
Rifampin - required
isoniazid - required
pyrazinamide
ethambutol
RIPE
```
Red orange body fluids such as sweat
68
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?
- 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
DRUG: What is ketoconazole is administered how?
oral and topical
70
DRUG: Fluconazole (diflucan) is used for this disease
vulvovaginal candidiasis
71
DRUG: Voriconazole is used for this disease
aspergillis infections
72
DRUG: Flucytosine mech of action, usage, and ADR's
- 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
CLASS: Azoles mech of action and ADR? What are they used as an alternative to?
- decreases synthesis of ergosterols
- inhibit hepatic p450 enzymes increasing plasma levels of many drugs
- Ampho B
74
6 options for MRSA and their general indications
- 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
Griseofulvin treats ___ thru the mechanism of ____
tinea capitis by implanting into the keratin of cells
76
What 4 things are treated well by mebendazole?
trichonella spiralis, ascariasis (roundworms), N. (americanus), and pinworm (E. vermicularis)
77
Treatment for schistosomiasis and T. solium (tapeworm)?
praziquantel
78
HCV treatment of choice (3 things)
Ribavirin and interferon alpha and simprovir
79
HIV treatments should include
3 active meds and 2 inactive meds ritanovir and colblstat
80
3 drugs that treat mycoplasma
erythromycin, doxy, clindamycin
81
UTI prophylaxis drugs (2)
Keflen and bactrim
82
DOC for HSVII and varicella-zoster and CMV, what is its mech of action
Acyclovir, inhibits DNA replication
83
Staph sapryticous causes....
....UTI's in young women
84
Olsetamivir is used in treatment of the...
....influenza A AND B
85
Levofloxacin is more effective against....
gram+ staph or strep
86
DRUG: fluorquinolones mech of action
Enter bacterium by passive diffusion and inhibit replication of baterial DNA by inhibiting bacterial DNA gyrase and toposiomerase IV
87
DRUG: bacitracin is used to treat what? How is it typically administered? What can you combine it with?
Group A hemolytic strep, topically, polymixin B
88
Azoles are often given as an alternative to....
....ampho B
89
Clotrimazole is used to treat 3 areas....
....candida of skin, mouth and vag and tinea cruris (jock itch, dermatophytes)
90
Nystatin is used to treat....
....candida glaborata
91
Itraconazole is used to treat....
....histoplasmosis
92
Scabies is treated with...
permthrin
93
Cryptococcus is treated with...
....ampho B and flucytosine
94
Aspergillosis is often seen in this group of people and manifests this way. How is it treated?
Farmer's working with hay, balls in the lungs. Treated with ampho B or itraconazole
95
Triple therapy regimen
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
Interferon alpha ADRs (3)
- Flu like symptoms
- Mental health
- alopecia
97
Harvoni
Two PO antiviral agents used as a popular combination to treat HCV today
98
HIV Medications
1) protease inhibitors
2) reverse transcriptase inhibitors
3) fusion entry inhibitors
4) nucleoside analogs
5) integrase inhibitors
99
What drug can you not give to patietns with G6P deficiency
Bactrim or any sulfa drugs
100
Treatment for HSVI topically during recurrent infections and mech of action
pencyclovir/denovir, inhibits DNA polymerase
101
Valcyclovir is the prodrug of....
acyclovir
102
Gancyclovir is often given for....
CMV
103
DRUG: Clomid function
PCOS and infertility
104
Progesterone only birth control for....
....post partum or breast feeding mother
105
Progesterone only is contraindicated for acne because....
...it causes acne
106
Bleeding during the 2nd half of a cycle indicates you need....
...more progesterone
107
Too much nausea and vomiting indicates what about progestoerone and estrogen?
...Too high estrogen or too little progesterone
108
Bleeding during the 1st half of a cycle indicates you need....
....more estrogen
109
The ratio of LH to FSH is ___ is patients in PCOS
High
110
Depo provera, what type of birth control is it and how long does it take to return to fertility?
Injectable progesterone only birth control that is not long acting (only 3 months) can take 12 to 18 months to return to fertility
111
In a patient who wants to be pregant but they have PCOS, you give 2 drugs
1) metformin
| 2) clomid
112
Terezol function
Treat candida tropicalis
113
Treatment for lichen planus
corticosteroids
114
IUD's help prevent ____ cancer
endometrial
115
Treatments for PMS
- NSAIDS
- Antidepressents
- Oral contraceptives
116
Fibrocystic breast changes are ___ and mobile.
| Fibroadenoma is ____ and mobiel
Tender, nontender
117
Tamoxifen is a...
....antiestrogen
118
Mastodynia treatment
- oral contraceptives
- nsaids
- prolactin antagonist
119
Nuva ring
Short acting IUD given once a month
120
Premarin
For postmenopausal dyspareunia
121
Estrace
Specific estrogen cream for atrophic vaginitis
122
2 drug Treatment of patients suspected to have gonorrhea or chlamydia
- doxy or azithromycin
| - ceftriaxone
123
Acute prostatitis manifests as.... Chronic prostatitis manifests as....
....Red hot, tender prostate upon examination.
| ....a boggy, minimally tender prostate
124
Acute prostatitis is seen in younger sexually active men. What do you treat them with? If septic you would give what?
Bactrim or cipro
IV gentamycin and ampicililin
125
DOC for primary syphillis and tertiary (latent and neuro) syphillis
Benzathine PCN (primary or latent) aqueous crystaline in the neuro form
126
alpha blocker treatment for BPH
Relaxes the neck of the bladder
127
Avodart/proscar are ___ and they function to treat what disease?
5 a reducase inhibitors, treat BPH
128
You would give exogenous testosterone for the following reasons
- loss of libido
- osteoperosis
- high triglycerides
NOT for ED
129
Urethritis is most likely caused by a ____ in males. Therefore you treat with this.
STI (gonorrhea or chlamydia)
Azithromycin and doxy
130
Macrobid (nitrofurantoin)
A drug that can prevent and treat UTI's
131
If younger than 35, you will receive ___ and ____ for epididymitis. If you are older, then you will received ____ or _____
Ceftriaxone and doxy
| Cipro or bactrim
132
Viagra, levitra, cialis mech of action
Increase blood flow to the penis by increasing nitric oxide metabolites and inhibit phosphodiesterase activity that decreases it to allow for longer erections
133
Cannot give nitroglycerin along with this group of drugs. Speaking of which, what is nitroglycerin given for?
Viagra/levitra/cialis because you increase the nitric oxide metabolites to dangerous levels, nitroglycerin helps chest pain from CAD
134
2 classes of drugs that can cause ED
- antidepressants
| - anti hypertensives
