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Pharmacology > Chemotherapeutic Agents > Flashcards

Chemotherapeutic Agents Flashcards

1
Q

are used to destroy both organisms that invade the body (e.g., bacteria, viruses, parasites, protozoa, fungi) and abnormal cells within the body (e.g., neoplasms, cancers)

A

Chemotherapeutic drugs

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2
Q

organisms that invade the body

A

bacteria, viruses, parasites, protozoa, fungi

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3
Q

abnormal cells within the body

A

neoplasms, cancers

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4
Q

These drugs affect cells by altering cellular function or disrupting cellular integrity, causing cell death, or by preventing cellular reproduction, eventually leading to cell death.

A

Chemotherapeutic drugs

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5
Q

Chemotherapeutic drugs affect cells by

A

altering cellular function or disrupting cellular integrity, causing cell death, or by preventing cellular reproduction, eventually leading to cell death.

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6
Q

the basic structural unit of the body

A

Cell

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7
Q

Each cell has a ____________________________________________, which contains a variety of ______________

A

nucleus, a cell membrane, and cytoplasm; organelles

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8
Q

contains all genetic material necessary for cell reproduction and for the regulation of cellular production of proteins.

A

Nucleus

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9
Q

Nucleus contains a spherical mass called

A

nucleolus

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10
Q

sites of protein synthesis

A

ribosomes

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11
Q

Within this nucleolus are dense fibers and proteins that will eventually become _____________________

A

ribosomes

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12
Q

essential for cellular integrity and is equipped with many mechanisms for maintaining cell homeostasis.

A

Celll Membrane

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13
Q

mainly composed of proteins and lipids— phospholipids, glycolipids, and cholesterol

A

lipoprotein structure

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14
Q

a lipoprotein structure, mainly composed of

A

proteins and lipids— phospholipids, glycolipids, and cholesterol

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15
Q

power plants” within each cell that produce energy in the form of ATP,which allows the cell to function.

A

Mitochondria

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16
Q

membrane-covered organelles that contain specific digestive enzymes that can break down proteins, nucleic acids, carbohydrates, and lipids

A

Lysosomes

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17
Q

are responsible for digesting worn or damaged sections of a cell when the membrane ruptures and the cell dies.

A

Lysosomes

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18
Q

designed to target foreign organisms that have invaded and infected the body

A

ANTI-INFECTIVE AGENTS

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19
Q

ANTI-INFECTIVE AGENTS:
THERAPEUTIC ACTION

A
  • interfere with biosynthesis of the pathogen cell wall.
  • interfere with the steps involved in protein and DNA synthesis, functions necessary to maintain the cell and allow for cell division.
  • alter the permeability of the cell membrane to allow essential cellular components to leak out
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20
Q

ANTI-INFECTIVE ACTIVITY:

A
  • Bactericidal
  • Bacteriostatic
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21
Q

active against the infective microorganisms that they actually cause the death of the cells they affect.

A

Bactericidal

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22
Q

not as aggressive; they interfere with the ability of the cells to reproduce or divide

A

Bacteriostatic

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23
Q

a complex interaction among chemical mediators, leukocytes, lymphocytes, antibodies, and locally released enzymes and chemicals.

A

HUMAN IMMUNE RESPONSE

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24
Q

It is difficult to treat any infections for two reasons:

A
  1. Anti-infective drugs cannot totally eliminate the pathogen without causing severe toxicity in the host
  2. Patients do not have the immune response in place to deal with even a few invading organisms.
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25
Q

refers to the ability over time to adapt to an anti-infective drug and produce cells that are no longer affected by a particular drug.

A

RESISTANCE

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26
Q

Resistance can be

A

natural or acquired

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27
Q

ACQUIRING RESISTANCE:

A
  1. Producing an enzyme that deactivates the antimicrobial drug
    2 Changing cellular permeability to prevent the drug from entering the cell or altering transport systems.
  2. Altering binding sites on the membranes which then no longer accept.
  3. Producing a chemical that acts as an antagonist to the drug.
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28
Q

ANTI-INFECTIVE AGENTS
PURPOSE:

A
  • For Treatment of Systemic Infections.
  • identification of the correct pathogen and selection of a drug (sensitivity)
  • Combination Therapy
  • Prophylaxis
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29
Q

synergistic, which means that they are more powerful when given in combination

A

Combination Therapy

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30
Q

to prevent infections before they occur.

A

Prophylaxis

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31
Q

Inhibit protein synthesis

A

AMINOGLYCOSIDES

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32
Q

used to treat serious infections caused by susceptible strains of gram negative bacteria, including Pseudomonas aeruginosa, E. coli, Proteus species, the Klebsiella–Enterobacter– Serratia group, Citrobacter species, and Staphylococcus.

A

AMINOGLYCOSIDES

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33
Q

AMINOGLYCOSIDES is

A

Bactericidal

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34
Q

A. AMINOGLYCOSIDES
PHARMAKOKINETICS

A
  • poorly absorbed from the GI tract but rapidly absorbed after intramuscular (IM) injection. widely distributed throughout the body, cross the placenta and enter breast milk, and are excreted unchanged in the urine
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35
Q

AMINOGLYCOSIDES
CONTRAINDICATIONS/ CAUTIONS:

A

Allergy
Hepatic disease
Renal disease
Preexisting Hear loss
Herpes/ Mycobacterial Infection
Myasthenia gravis or parkinsonism
Lactation

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36
Q

AMINOGLYCOSIDES
ADVERSE EFFECTS:

A
  • Black box warning alerting health care professionals to the serious risk of: ototoxicity and nephrotoxicity.
  • GI effects include nausea, vomiting, diarrhea, weight loss, stomatitis, and hepatic toxicity.
  • Cardiac effects can include palpitations, hypotension, and hypertension
  • Hypersensitivity reactions include purpura, rash, urticaria, and exfoliative dermatitis.
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37
Q

AMINOGLYCOSIDES
Observe for :

A

OTOTOXICITY
NEPHROTOXICITY

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38
Q

are a relatively new class of broad-spectrum antibiotics

A

CARBAPENEMS

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39
Q

used to treat serious infections caused by susceptible strains of S. pneumoniae, Haemophilus infl uenzae, Moraxella catarrhalis, S. aureus, Streptococcus pyogenes, E. coli and others.

A

CARBAPENEMS

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40
Q

indicated for treating serious intra-abdominal, urinary tract, skin and skin structure, bone and joint, and gynecological infect

A

CARBAPENEMS

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41
Q

First drug of Class

A

Meropenem

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42
Q

CARBAPENEMS
PHARMAKOKINETICS

A
  • Rapidly absorbed if given IM
  • They are widely distributed throughout the body, although it is not known whether they cross the placenta or enter breast milk.
  • excreted unchanged in the urine
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43
Q

CARBAPENEMS
CONTRAINDICATIONS/ CAUTIONS:

A
  • allergy to any of the carbanems or beta-lactams
  • seizure disorders
  • meningitis
  • lactation
  • Use caution during pregnancy
  • Ertapenem is not recommended for use in patients younger than 18 years of age.
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44
Q

CARBAPENEMS
ADVERSE EFFECTS:

A
  • GI tract can limit the use of carbapenems in some patients.
  • Pseudomembranous colitis, Clostridium difficile diarrhea
    nausea and vomiting can lead to serious dehydration and
    electrolyte imbalances.
  • Superinfections can occur with any of the carbapenems.
  • CNS effects can include headache, dizziness, and altered mental state.
  • Seizures
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45
Q

CARBAPENEMS
Monitor the patient regularly for signs of:

A
  • pseudomembranous colitis
  • severe diarrhea,
  • superinfections
  • confusion and seizures
  • phlebitis
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46
Q

basically interfere with the cell wall–building ability of bacteria when they divide

A

CEPHALOSPORINS

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47
Q

are largely effective against the same gram-positive bacteria that are affected by penicillin G, as well as the gram-negative bacteria P. mirabilis, E. coli, and K. pneumoniae (use the letters PEcK as a mnemonic

A

First-generation cephalosporins

48
Q

are effective against the previously mentioned strains, as well as H. influenzae, Enterobacter aerogenes, and Neisseria species (remember HENPeCK)

A

Second-generation cephalosporins

49
Q

which are effeCtive against all of the previously mentioned strains relatively weak against gram-positive bacteria but are more potent against the gram-negative bacilli, as well as against Serratia marcescens (remember HENPeCKS).

A

Third-generation cephalosporins

50
Q

cephalosporins are in development. The first drug of this group, cefepime (Maxipime), is active against gram-negative and gram-positive organ isms, including cephalosporin-resistant staphylococci and P. aeruginosa.

A

Fourth-generation cephalosporins

51
Q

CEPHALOSPORINS
PHARMAKOKINETICS

A
  • are well absorbed from the GI tract
  • others are absorbed well after IM injection or IV administration
  • are primarily metabolized in the liver and excreted in the urine.
  • These drugs cross the placenta and enter breast milk.
52
Q

CEPHALOSPORINS
CONTRAINDICATIONS/ CAUTIONS:

A
  • allergies to cephalosporins or penicillins
  • Use with caution in patients with hepatic or renal impairment
  • use with caution in pregnant or lactating patients
53
Q

CEPHALOSPORINS
ADVERSE EFFECTS:

A
  • GI tract and include nausea, vomiting, diarrhea, anorexia, abdominal pain, and flatulence. Pseudomembranous colitis
  • CNS symptoms include headache, dizziness, lethargy, and paresthesias.
  • Nephrotoxicity
  • Hepatotoxicity
  • Superinfection
54
Q

CEPHALOSPORINS
Monitor the patient regularly for signs:

A

Nephrotoxicity
Hepatotoxicity
Superinfection
Diarrhea

55
Q

They interfere with the action of DNA enzymes necessary for the growth and reproduction of the bacteria.

A

FLUOROQUINOLONES

56
Q

are indicated for treating infections caused by susceptible strains of gram-negative bacteria, including E. coli, P. mirabilis, K. pneumoniae, etc.

A

FLUOROQUINOLONES

57
Q

FLUOROQUINOLONES
PHARMAKOKINETICS

A
  • are absorbed from the GI tract, metabolized in the liver, and excreted in the urine and feces.
  • drugs are widely distributed in the body and cross the placenta and enter breast milk
58
Q

FLUOROQUINOLONES
CONTRAINDICATIONS/ CAUTIONS:

A
  • allergy to fluoroquinolones
  • pregnancy
  • Use with caution in the presence of renal dysfunction
59
Q

FLUOROQUINOLONES
ADVERSE EFFECTS:

A
  • most common are headache, dizziness, insomnia, and depression
  • GI effects include nausea, vomiting, diarrhea, and dry mouth
  • Box Warning was added to all drugs in this class in 2009 reporting the risk of tendinitis and tendon rupture.
  • immunological effects include bone marrow depression
    fever, rash, and photosensitivity
60
Q

FLUOROQUINOLONES
Monitor the patient for :

A

CNS: headache, dizziness, tinnitus,confusion, mental depression
GI upsets
bone marrow depression
PHOTOTOXICITY/ PHOTOSENSITIVITY
HEPATOTOXICITY
NEPHROTOXICITY

61
Q

bactericidal effects by interfering with the ability of susceptible bacteria to build their cell walls when they are dividing.

A

PENICILLINS

62
Q

drugs prevent from biosynthesizing the framework of the cell wall, and the bacteria with weakened cell walls swell and then burst from osmotic pressure within the cell.

A

PENICILLINS

63
Q

are indicated for the treatment of streptococcal infections, including pharyngitis, tonsillitis, and others.

A

PENICILLINS

64
Q

At high doses, these drugs are also used to treat meningococcal meningitis.

A

PENICILLINS

65
Q

PENICILLINS
PHARMAKOKINETICS

A
  • rapidly absorbed from the GI tract, reaching peak levels
  • sensitive to the gastric acid levels in the stomach and should be taken on an empty stomach to ensure adequate absorption.
  • excreted unchanged in the urine
  • enter breast milk
66
Q

PENICILLINS
CONTRAINDICATIONS/ CAUTIONS:

A
  • allergy to penicillin and cephalosporins
  • pregnancy
  • Use with caution in the presence of renal disease
67
Q

PENICILLINS
ADVERSE EFFECTS:

A
  • Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, glossitis, stomatitis, gastritis, sore mouth, and furry tongue.
  • Superinfections, including yeast infections
  • Pain and inflammation at the injection site
  • Hypersensitivity reactions may include rash, fever, wheezing, and, with repeated exposure, anaphylaxis
68
Q

work by inhibiting protein synthesis in a wide range of bacteria, leading to the inability of the bacteria to multiply

A

TETRACYCLINES

69
Q

indicated for treatment of infections caused by Rickettsiae, Mycoplasma pneumoniae, Borrelia recurrentis, H. infl uenzae, Haemophilus ducreyi, Pasteurella pestis, ETC.

A

TETRACYCLINES

70
Q

TETRACYCLINES
PHARMAKOKINETICS

A

-absorbed adequately, but not completely, from the GI tract.
Absorption is affected by food, iron, calcium, and other drugs in the stomach.
- cross the placenta and pass into breast milk

71
Q

TETRACYCLINES
CONTRAINDICATIONS/ CAUTIONS:

A
  • allergy to tetracyclines or to tartrazine
  • pregnancy and lactation
  • ophthalmic preparation: patients who have fungal, mycobacterial, or viral ocular infections
  • used with caution in children younger than 8 years of age
72
Q

TETRACYCLINES
ADVERSE EFFECTS:

A
  • direct irritation of the GI tract and include nausea, vomiting, diarrhea, abdominal pain, glossitis, and dysphagia.
  • Fatal hepatotoxicity related to the drug’s irritating effect on the liver
  • Skeletal effects involve damage to the teeth and bones.
  • Dermatological effects include photosensitivity and rash.
  • Superinfections
  • Local effects, such as pain and stinging with topical or ocular application
  • Hypersensitivity reactions
73
Q

the group of bacteria that contain the pathogens that cause tuberculosis and leprosy.

A

Mycobacteria

74
Q

Mycobacteria
the group of bacteria that contain the pathogens that cause tuberculosis and leprosy.
cause serious infectious diseases:

A

Mycobacterium tuberculosis - PTB
Mycobacterium leprae- LEPROSY OR HANSEN’S DISEASE
Mycobacterium avium-intracellulare -mycobacterium avium complex in AIDS

75
Q

ANTITUBERCULOSIS DRUGS
Treatment duration:

A

6 months to 2 years

76
Q

ANTITUBERCULOSIS DRUGS
First-line drugs :

A
  • isoniazid (Nydrazid)
  • rifampin (Rifadin)
  • pyrazinamide (generic)
  • ethambutol (Myambutol)
  • streptomycin (generic),
  • rifapentine (Priftin).
77
Q

ANTITUBERCULOSIS DRUGS
Second-line drugs :

A
  • ethionamide (Trecator-SC),
  • capreomycin (Capastat),
  • cycloserine (Seromycin)
  • rifabutin (Mycobutin).
78
Q

the mainstay of leprosy treatment

A

Dapsone (generic)

79
Q

inhibits folate synthesis

A

Dapsone (generic)

80
Q

used for treatment of P. carinii pneumonia in AIDS patients

A

Dapsone (generic)

81
Q

Dapsone (generic)
Adverse Effects

A
  • CNS effects, such as neuritis, dizziness, headache, malaise,
    drowsiness, and hallucinations.
  • irritating to the GI tract, causing nausea, vomiting, anorexia,
    stomach upset, and abdominal pain.
82
Q

ANTIMYCOBACTERIALS
PHARMAKOKINETICS

A
  • Well absorbed from the GI tract.
  • metabolized in the liver and excreted in the urine
  • cross the placenta and pass into breast milk
83
Q

Inhibits the synthesis of mycolic acids and acts to kill actively growing organisms in the extracellular environment

A

Isoniazid

84
Q

Inhibits the growth of dormant organisms in the macrophages and caseating granulomas

A

Isoniazid

85
Q

Is active only during cell division and is used in combination with other antitubercular medications

A

Isoniazid

86
Q

Isoniazid
Side and adverse effects

A

a. Hypersensitivity reactions
b. Peripheral neuritis
c. Neurotoxicity
d. Hepatotoxicity and hepatitis; increased liver function test levels
e. Pyridoxine deficiency
f. Irritation at injection site with intramuscular administration
g. Nausea and vomiting
h . Dry mouth
i. Dizziness
k. Vision changes

87
Q

Isoniazid
Contraindications and cautions

A

a. Contraindicated in clients with hypersensitivity or with acute liver disease
b. Use with caution in clients with chronic liver disease, alcoholism, or renal
impairment.
c. Use with caution in clients taking hepatotoxic medications because the risk for
hepatotoxic ity increases.
d. Alcohol increases the risk of hepatotoxicity.
e. May increase the risk of toxicity of carbamazepine and phenytoin
g. May decrease ketoconazole concentrations

88
Q

Inhibits bacterial RNA synthesis

A

Rifampicin

89
Q

Binds to DNA-dependent RNA polymerase and blocks
RNA transcription

A

Rifampicin

90
Q

Used with at least 1 other antitubercular medication

A

Rifampicin

91
Q

Rifampicin
Contraindications and cautions

A

a. Contraindicated in clients with hypersensitivity
b. Used with caution in clients with hepatic dysfunction or alcoholism
c. Use of alcohol or hepatotoxic medications may increase the risk of hepatotoxicity.
d. Decreases the effects of several medications, including oral anticoagulants, oral
hypoglycemics, chloramphenicol, digoxin, disopyramide phosphate, mexiletine, quinidine polygalacturonate, fluconazole, methadone hydrochloride, phenytoin, and
verapamil hydrochloride

92
Q

Rifampicin
Side and adverse effects

A

a. Hypersensitivity reaction, including fever, chills, shivering, headache, muscle and bone pain, and dyspnea.
b. Heartburn, nausea, vomiting, diarrhea
c. Red-orange–colored body secretions
d. Vision changes
e. Hepatotoxicity and hepatitis
f. Increased uric acid levels
g. Blood dyscrasias
h. Colitis

93
Q

Interferes with cell metabolism and multiplication by inhibiting 1 or more metabolites in susceptible organisms

A

Ethambutol

94
Q

Inhibits bacterial RNA synthesis and is active only during
cell division

A

Ethambutol

95
Q

Slow-acting and must be used with other bac tericidal
agents

A

Ethambutol

96
Q

Ethambutol
Contraindications and cautions

A

a. Contraindicated in clients with hypersensitivity or optic neuritis and in children younger than 13 years
b. Used with caution in clients with renal dysfunction, gout, ocular defects, diabetic retinopathy, cataracts, or ocular inflammatory conditions
c. Used with caution in clients taking neurotoxic medications because the risk for neurotoxicity increases

97
Q

Ethambutol
Side and adverse effects

A

a. Hypersensitivity reactions
b. Anorexia, nausea, vomiting
c. Dizziness
d. Malaise
e. Mental confusion
f. Joint pain
g. Dermatitis
h. Optic neuritis
i. Peripheral neuritis
j. Thrombocytopenia
k. Increased uric acid levels

98
Q

Aminoglycosides Drugs

A

amikacin
gentamicin
kanamycin
neomycin
streptomysic
tobramysin

99
Q

Treatment of serious gram-negative infections

A

amikacin (Amikin)

100
Q

Treatment of Pseudomonas infections and a wide variety of gram-negative infections

A

gentamicin (Garamycin)

101
Q

Treatment of hepatic coma and to decrease gastrointestinal (Gl) normal flora

A

kanamycin (Kantrex)

102
Q

Suppression of Gl normal flora preoperatively; treatment of hepatic coma; topical treatment of skin wounds

A

neomycin (Mycifradin)

103
Q

Fourth drug in combination therapy regimen for treatment of tuberculosis;

A

streptomycin (generic)

104
Q

Short-term IV or IM treatment of serious infec-tions; ocular infections caused by susceptible bacteria; nebulizer management of cystic fibrosis and P. aeruginosa infections

A

tobramycin (TOBI, Tobrex)

105
Q

Carbapenems Drugs

A

doripenem
ertapenem
imipenem-cilastatin
meropenem

106
Q

Treatment of complicated intra-abdominal infections or complicated UTis, including pyelonephritis, caused by susceptible bacteria

A

doripenem

107
Q

Treatment of community-acquired pneumonia, complicated genitourinary infections, acute pelvic infections, complicated intra-abdominal infections, skin and skin-structure

A

ertapenem

108
Q

Treatment of serious respiratory, intra-abdominal, urinary tract, gynecological, bone and joint, skin and skin-structure infections; septicemia, endocarditis, bone and joint infections, and polymicrobic infections

A

imipenem-cilastatin

109
Q

Treatment of bacterial meningitis, complicated skin and skin-structure infections, intra-abdominal infections

A

meropenem

110
Q

Treatment of bacterial meningitis, complicated skin and skin-structure infections, intra-abdominal infections

A

meropenem

111
Q

FIRST-GENERATION CEPHALOSPORINS

A

cefadroxil
cefazolin
cephalexin

112
Q

SECOND-GENERATION CEPHALOSPORINS

A

cefaclor
cefoxitin
cefprozil
cefuroxime

113
Q

THIRD-GENERATION CEPHALOSPORINS

A

cefdinir
cefotaxime
cefpodoxime
ceftazidime
ceftibuten
ceftizoxime
ceftriaxone

114
Q

FOURTH-GENERATION CEPHALOSPORINS

A

cefditoren
cefepime
ceftaroline

115
Q

Floroquinolones Drugs

A

ciprofloxacin
gemifloxacin
levoflaxacin
mixofloxcin
norflocaxin
ofloxacin

Pharmacology (24 decks)

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