Exam 1B: Dr. Bagwell Flashcards by Ian bicol

This is a low cost alternative antibiotic in children > 2 months and PCN allergic.

Sulfonamides

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This drug binds to the beta subunit of mycobacteria DNA-dependent RNA polymerase and inhibits RNA synthesis.

Rifampin

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Metabolism of INH is highly variable and dependent on ____.

acetylator status

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Block box warning for Fluoroquinolones.

Avoid in < 18 y.o; can cause tendon rupture/ tendonitis; potential for bone development problems

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Vancomycin Adverse reactions (3)

Ototoxicity 2. Nephrotoxicity 3. Red Man syndrome

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These organisms grow slowly and are relatively resistant to drugs that are largely dependent on how rapidly cells are dividing.

Mycobacteria They have the ability to go into dormant state

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Drug used as TB preventive therapy

INH

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Tamiflu needs to be taken within _____ onset of flu symptoms.

1st 48 hours

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Lab test you need to monitor in patients taking Flagyl

CBC (leukopenia)

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This is used for severe gram + infections such as MRSA resistant to first line antibiotics

Glycopeptides (Vancomycin)

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This drug blocks folic acid synthesis

sulfonamides

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mebendazole may cause ____

transient neutropenia

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What do you need to monitor in patients taking cephalosporins (2)

Diarrhea (C.Diff) 2. Renal function

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Lincosamides are the first line antibiotics in special populations such as ___

children and pregnant moms

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Diagnostic test to watch for in patients taking Moxifloxacin (avelox), a fluoroquinolone?

ECG (Aflutter)

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Fluoroquinoles interfere with ________ required for the synthesis of _______.

bacterial enzymes ….. bacterial DNA

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Mycobacteria have a ______ cell wall relatively impermeable to many drugs.

lipid-rich

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6 Causes of drug resistance (raid-me)

Recent use of Antibiotics 2. Age: 65 3. Immunosuppression 4. Day care center attendance 5. Multiple medical comorbidities 6. Exposure to young children

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For roundworms, hookworms, and whipworms, stool samples are obtained before and ______ after treatment for proof of cure.

1 -3 weeks

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Name 2 antifungals which are active against yeast and dermatophytes.

Naftifine (Naftin) 2. Terbinafine (Lamisil)

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this drug is converted to acyclovir after oral administration.

Valacyclovir

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Varicella: Antivirals should be started within ___.

24 hours of outbreak

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Anti-influenza B. (Inhaled)

Zanamivir (relenza) 4-17% absorbed

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These tetracyclines are used for treatment of acne

doxycycline minocycline

Valtrex may cause ____ (2) in immunocompromised patients.

1. Thrombocytopenic purpura (CHECK PLATELET) 2. Hemolytic uremic syndrome

Macrolides adverse reactions include urticaria, eczema, and \_\_\_\_\_.

stevens-johnson syndrome

This is the drug of choice for community acquired PNA (mycoplasma)

Macrolides

Antimycobacterials (2) which inhibit synthesis of mycolic acids

INH and ethambutol

Monitoring needed for patients taking sulfonamides (3)

1. WBC (longterm users) 2.C/S for UTI: 9/10 pts are already resistant 3. CXR: Cough in Macrobid use

T/F: Rifampin is an inducer of CYP450 enzyme

true

Ethambutol inhibits synthesis of \_\_\_\_\_\_, an essential component of mycobacteria cell wall.

arabinogalactan

This is the first line therapy for MRSA

Lincosamides (e.g. Clinda)

Common adverse reaction of metronidazole

metallic taste

This is the drug of choice for H. pylori infections

Clarithromycin (Macrolides)

It decreases absorption of tetracyclines.

Milk and Calcium

4 drug therapy used in Active TB

INH, ethambutol, Pyrazinamide, Rifampin

Intestinal parasites are treated with (2)

1. mebendazole (vermex) 2. Pyrantel (Pin-x)

Cephalosporins inhibit ______ in the bacterial cell wall.

mucopeptide synthesis

Macrolides are potent inhibitors of \_\_\_\_

CYP 450 3A4

FYI: Antimycobacterials: resistance develops rapidly to mono therapy. Cross resistance with INH and ethionamide

This drug is effective against amebiasis, trichomoniasis, giadiasis.

Tinidazole

Alcohol should be avoided in patients taking flagyl or tinidazole due to

disulfiram-like reactions (N/V)

Anti-influenza A drugs (3). Given orally

1. Amantadine (symmetrel) 2. Rimantadine (Flumadine) 3. Oseltamivir (Tamiflu)

Ivermectin may cause \_\_\_

Mazzotti reaction (swollen and tender lymph nodes, fever, tachycardia, hypotension, etc)

This antihelmentic should not be taken if pregnant and backup contraception should be used for 1 month after taking.

Albendazole

This drug may inhibit acetyl coenzymes.

Nitrofurantoin (Macrobid)

Sulfonamides (bacterium, nitofurantoin) should be avoided in patients with \_\_\_\_.

G6PD deficiency (Abnormal X chromosome gene; leads to hemolytic anemia)

FYI: Clindamycin is given 4x/ day therefore there is a high risk for non-compliance

This type of antibiotic inhibits RNA dependent protein synthesis

Macrolides

Clinical Indications for cephalosporins (4)

1. Strep pharyngitis 2. Acute otitis media 3. Chlamydia/ gonorrhea 4. Community-acquired PNA

Fluoroquinolones are clinical indicated for what type of PNA?

PCN resistant s. pneumoniae

Clinical Use/ Indications of Lincosamides

1. MRSA 2. Dental Infections 3. Infections in PCN allergic pts

Lab test monitoring if your patient is on fluroquinolones like levaquin?

ALT/AST, BUN/ Crea (Hepatic and renal tests)

\_\_\_\_\_ have greater activity against gram negative bacteria due to enhanced ability to penetrate the outer membrane organisms.

Aminopenicillins

Lab monitoring, q 3-4 months, for patients taking Ketoconazole (3)

1. AST, ALT 2. Alkaline phosphatase 3. Bilirubin

Macrolides need to be monitored for altered response to concurrent medications metabolized by \_\_\_\_\_.

CYP 450 3A and 2C9

Name 4 combination drugs of B-lactam + B-lactamase Inhibitors

1. Zosyn 2. Unasyn 3. Augmentin 4. Timentin

This drug treats both parasitic and bacterial infections.

Metronidazole (avoid in 1st rimester of pregnancy)

Monitoring for TB drugs

DOT (directly observed therapy)

When macrocodes are combined with STATIN, it increases the risk for \_\_\_\_.

myopathy

Black box warning for Tetracyclines

Don't prescribe in lactating, pregnant women or children s growth.

This is the first line therapy for chlamydia.

tetracyclines

Fluoroquinolones can have a delayed onset of tendon rupture/ tendonitis. How many days after administration?

120 days to months after administration

This anti fungal has the fewest drug interactions.

Fluconazole (Diflucan)

Macrolides are well absorbed from the \_\_\_

duodenum

Tissue parasites are treated with (3)

1. Mebendazole (vermex) 2. Albendazole (albenza) 3. Ivermectin (Stormectol)

Adverse reaction to PCN includes diarrhea. What drug, when combined with PCN, increases the risk of diarrhea?

Clavulanic acid (augmenting)

Example of a lincosamide

Clindamycin (Cleocin)

PCN allergic reactions occur within ______ minutes of administration.

2 - 30 minutes

Shingles: Antivirals should be started within \_\_\_.

3 days of outbreak

This drug binds reversibly to the 30S subunit of the bacterial ribosome.

Tetracyclines