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Pharm Exam 3 > ch. 75 > Flashcards

ch. 75 Flashcards

1
Q

are sulfonamides bacteriocidal or bacteriostatic

A

bacteriostatic

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2
Q

MOA solfonamides

A

Sulfonamides are structural analogs of PABA (component of folate) - suppress bacterial growth by inhibiting synthesis of tetrahydrofolate (derivative of folate). On the absence of folate the bacteria cant synthesize DNA, RNA, proteins

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3
Q

Sulfonamides are preferred drugs for

A

Acute UTIs - Bactrim

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4
Q

how do we make folate?

A

we dont, get it from our diet. Bacteria makes its own

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5
Q

Treat chlamydia

A

Azithromycin

doxycycline

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6
Q

used to treat ulcerative collitis

A

Sulfasalazine

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7
Q

Sulfonamides with rash of any sort or any reaction

A

stop immediately - high risk SJS

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8
Q

adverse effects of Sulfonamides in newborns

A

kernicterus

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9
Q

adverse effects of Sulfonamides

A 
blood dyscrasias
hypersensitivity
photosensitivity
avoid prolonged exposure to sunlight - sunburn
crystalluria
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10
Q

pt ed on how to take oral sulfonamides

A

drink 8-10 glasses of water or other non caffeinated fluids per day to decrease risk for crystalluria - can still have caffeine

report rash or tingling in mouth

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11
Q

hematologic effects of sulfonamides

A

G6PD def for blacks and people of mediterranean orgin. Red cell lysis can produce fever, pallor, jaundice (hemolytic anemia)

can cause agranulocytosis, leukopenia, thrombocytopenia and very rare aplastic anemia

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12
Q

kernicterus

A

disorder in newborns caused by deposition of bili in the brain. - neurotoxic and can cause severe neurologic deficits and even death.

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13
Q

Sulfonamides should not be given to infants younger than ___and not to pregnant pat after ___ weeks gestation

A

2 mos

32 weeks gestation

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14
Q

sulfonamides and breastfeeding

A

no

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15
Q

to minimize the risk for renal damage, adults should maintain a daily urine output of at least ____ mL

A

1200 (8-10 glasses of water a day)

crystalluria

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16
Q

sulfonamides are contraindicated for pt with creatinine clearance of

A

severe kidney disease

50% of dose if GFR is 15-30mL/min

17
Q

Drug interactions and sulfonamides

A

intensify effects of warfarin, phenytoin and sulfonylurea-type oral hypoglycemics (glipizide, glyburide)

18
Q

what food can you not take with Sulfadiazine

A

Vic C or acidifying drinks such as cranberry juice increase risk of crystalluria

19
Q

which med is for topical derm disorders

A

Topical Sulfacetamide

20
Q

sulfonamides and older adults

A

more likely to experience adverse effects - neutropenia, SJS/ TEN

21
Q

which is more likely to cause crystalluria

A

Sulfadiazine

22
Q

sulfacetamide should not be used by pt with history of severe hypersensitivity to

A

sulfonamides
sulfonylureas
thiazide or loop diuretics

23
Q

Trimethoprim inhibits

A

dihydrofolate reductase

24
Q

recurrent UTI treated with

A

Bactrim

25
Q

Pt ed trimethoprim

A 
early signs of blood dyscrasias 
-sore throat
-fever
-pallor
report any of these signs
26
Q

adverse effects trimethoprim

A 
itching
rash
epigastric distress
nausea
vomiting
glossitis
stomatitis
hyperkalemia
27
Q

potential effects of trimethoprim only if preexisting folic acid def

A

because of the pathway that trimethoprim works on

megaloblastic anemia
thrombocytopenia
neutropenia

28
Q

what populations would be ad increased risk for folic acid def

A

excessive alcohol intake
pregnant women
debilitated pt

29
Q

A pt on trimethoprim has sore throat, fever, pallor

what do you do

A

CBC
if sig reduction in counts - d/c trimethoprim
administer leucovorin - a reduced form of folic acid

30
Q

pt pop at high risk due to hyperkalemia while taking trimethoprim

A

trimethoprim suppresses renal excretion of k and can promote hyper K

Pt at greatest risk are those taking high doses
those with renal impairment
those taking other drugs that can elevate k - ACE, ARB, Potassium sparing diuretics, aldosterone antagonists, potassium supplements

31
Q

Hyperkalemia typically develops within ___ days of starting Trimethoprim

A

5

32
Q

Trimethoprim in pregnancy

A

no - folate- neural tube defects

33
Q

Trimethoprim in breastfeeding

A

no

34
Q

Bactrim (Trimethoprim/sulfamethoxazole) MOA

A

SMZ acts to inhibit incorporation of PABA into folate

TMP inhibits dihydrofolate reductase

35
Q

Bactrim used in

A 
UTIs
otitis media
bronchitis
shigellosis 
pneumonia from P.jirovecii
36
Q

CNS effects of Bactrim

A

headache, depression, hallucinations

37
Q

drug interactions for bactrim

A

warfarin
phenytoin
sulfonylurea - type oral hypoglycemics

intensify bone marrow suppression in pt receiving methotrexate

meds that also hyperk

38
Q

med for bordetella pertussis

A

erythromycin

39
Q

which has less microbial resistance

trimethoprim
Sulfonamide

A

trimethoprim

Pharm Exam 3 (19 decks)

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