DOC pharm ninja 2 Flashcards
DOC for invasive asperlligosis
MOA:
AE:
Voriconazole
MOA: inhibit 14 alpha-sterol demethylase (CYP)–> blocks conversion of Ianosterol to ergosterol–> disruption of membrane function and increased permeability.
AE: Transient visual distubance
DOC- candida and most coccidoides
MOA:
AE:
Fluconazole
MOA: inhibit 14 alpha-sterol demethylase (CYP)–> blocks conversion of Ianosterol to ergosterol–> disruption of membrane function and increased permeability.
AE: Transient visual distubance
DOC for emesis due to motion sickness
MOA:
AE:
scopolamine
class: Anti-M
MOA:
AE:
DOC for closure of ductus arteriosusMOA:
AE:
Indomethacin
DOC for in OA and pregnancy but is not antiplateletI or anti-inflammatory
MOA:
AE:
ACETOMENOPHEN
DOC for gout
MOA:
AE:
Indomethacin
DOC first DMARD prescribed for mild moderate and severe RA.
also CI in pregnancy.
MOA:
AE:
Methotrexate
DOC for trigeminal neuralgia
MOA:
AE:
carbamezapine
Analgesic Adjunctive agent for pain management
- has pure glucocorticoid activity–> less adverse effects.
MOA:
AE:
dexamethasone
DOC for surgical prophylaxis against gram +vet infection because it has a long half life. [staph and strep on skin can infect the incision].
MOA:
AE:
cephalozolin
DOC for enterobacter infection and extended spectrum B-lactamase producing gram -ve’s.
MOA:
AE:
Carbapenems:
Impenem
Meropenem
DOC for:
- gonorhea [assume all gonorrhea is PCN resistant]
- Meningitis [ampicillin resistant H. Influenzae]
- Meningitis prophylaxis
- Lyme disease with CNS and joint infections otherwise use doxycycline
MOA:
AE:
Cephalosporin:
Ceftriaxone
DOC for: - Chlamydia - M. pneumoniae - Lyme disease w/out CNS joint involvement - Rickettsia [RMSF] - cholera - anthrax prophylaxis MOA: AE:
Tetracyclines:
- Doxycycline
- Minocycline
- Tetracycline
DOC for empiric tx of infective endocarditis
MOA:
AE:
GENTAMICIN for empiric Tx of infective endocarditis w/ vancomycin or PCN Aminoglycosides: GNATS - GENTAMICIN - Neomycin - Amikacin - Tobramycin - Streptomycin
DOC for plague
MOA:
AE:
Aminoglycoside: streptomycin
MOA: Irreversible binding to 30S ribosome
AE: - Serious toxicity –> S shorten regimen [5d]
- Nephrotoxic [ATN] Ototoxic
- Neuromuscular blockade [contraindicated in Myasthenia Gravis]
- Pregnancy –> Cat D
- Teratogen
DOC for pertussis
MOA:
AE:
Macrolide: Erythromycin MOA: reversible binding to 50S ribosome AE: QT prolongation - Inhibits CYP450 [except azithromycin] - GI effects [motilin] - cholestatic hepatitis
DOC for C.difficile
Metronidazole
MOA: - forms cytotoxic products under anaerobic conditions.
- Interferrs w/ nucleic acid synthesis [reductive bioactivation of its nitro group by ferredoxin]
AE: - Dark urine
- Disulfiram-like reaction [avoid alcohol]
- Avoid in 1st trimester–>unknown safety
C. diff Colitis
Common cause?
treatment?
Most common cause:
Clindamycin
Ampicillin, Amoxicillin Cephalosporins Fluoroquinolones
Treatment: Oral Metronidazole = DOC
Oral Vancomycin
Fidaxomicin [↓recurrence]
Surgical prophylaxis [SP]
in PCN allergic patients?
DOC’s
Car
Vancomycin or clindamycin are usually the DOC’s Cardiothoracic → Vancomycin plus aztreonam
Colorectal → ciprofloxacin + metronidazole or clindamycin
Syphilis and UTI’s in pregnancy
What do you do in a allergic pregnancy?
What side effect may develop and what do you do?
DOC for syphilis not matter what the stage is PCN G and is the only drug with documented efficacy during pregnancy If a pregnant patient is allergic to PCN G, she should undergo desensitization rather than use any other drug.
May develop a JarischWHerxheimer reaction → fever, chills, myalgia, tachycardia… It is not an allergic reaction and the drug should be continued [Pretreatment with prednisolone may help] UTI Tx [E. coli] → Cotrimoxazole, Cipro, Nitrofurantoin, or Amoxicillin+clavulanic acid Pregnant and have UTI → PCN or cephalosporins [however, ceftriaxone can cause kernicterus] or nitrofurantoin
1st Line DOC in HIV pt’s due to Mycobacterium TB
Rifabutin → DOC in HIV pt’s due to less CYP450 effects
ACYCLOVIR
DOC for HSV encephalitis Can be used for prophylaxis in the immunocompromised
GANCYCLOVIR
DOC for CMV retinitis and prophylaxis
TRIFLURIDINE
DOC: HSV keratoconjunctivitis and recurrent epithelial keratitis
Treatment of Pneumocystis PNA
Cotrimoxazole [TMP-SMX]
Flucanazole
DOC → candida & most coccidioides
- Maintenance therapy or prophylaxis for cryptococcal meningitis [after initial Tx with amphotericin B]
Voriconazole
DOC for invasive aspergillosis Similar spectrum to itraconazole
METRONIDAZOLE
DOC for invasive amebiasis in combination with a luminal agent [alternative treatment includes tetracycline] G. Lamblia, T. vaginalis, H. pylori, C. diff Anaerobic cocci & gram –ve bacilli
Diloxanide Furoate
DOC for asymptomatic amebiasis or in combination with metronidazole for moderate to severe infections
Ivermectin
DOC for: Onchocerca volvulus [river blindness] CLM Strongyloides
Diethylcarbamazine
DOC for lymphatic filariasis, loiasis and tropical eosinophilia
Praziquantel
whats the DOC for cysticercosis?
DOC for Schistosomiasis Trematode: C. sinensis, P. westermani Cestode: D. latum, T. solium & saginata [albendazole is the DOC for cysticercosis → T. solium larva]
Bithionol
DOC for sheep liver fluke [fasciola hepatica] Alternative treatment for pulmonary paragonimiasis
Trimethoprim-sulfamethoxazole [TMP-SMX] (CTRAMEXAZOLE)
DOC: P. JIROVEJI
TOXOPLASMA
CHLOROQUINE
DOC for treatment and prophylaxis of vivax and ovale [non]falciparum, or uncomplicated falciparum] Highly effective against blood schizonts but not against liver parasites
Quinidine and Quinine
DOC for severe falciparum disease May need to combine with doxycycline Highly effective against blood schizonts but not against liver parasites.
Primaquine
DOC for eradication of dormant liver form of vivax and ovale Chemoprophylaxis for all strains
