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Pharm 1 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Tetracycline static or cidal, broad or narrow, general use

A

Bacteriostatic
First broad spectrum
Used for years against acne vulgaris

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2
Q

Tetracycline (food interactions)

A

Don’t take it with Mg, Al, antacids, or milk products containing calcium and iron (they bind preventing absorption)

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3
Q

Doxycycline (11 Side effects)

A

N/V/D, rash, flatulence, abd discomfort, H/A, photosensitivity, pruritus, heartburn, color vision changes

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4
Q

Tetracycline (preg category and 3 side/adverse effects)

A

Doxycycline category D
Teratogenic during 1st and 3rd trimesters, stains teeth
Nephrotoxicity when taken with other nephrotoxic drugs
Makes oral contraceptives less effective

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5
Q

Doxycycline 4 contraindications and 4 caution

A

Hypersensitivity, pregnancy, severe hepatic or renal disease
Caution: Renal and hepatic dysfunction, ETOH, and hypokalemia

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6
Q

Doxycycline drug-lab-food interactions

A

May increase effects of digoxin, decreased absorption with antacids, iron, and zinc
Decrease effects of BCP

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7
Q

Doxycycline adverse effects

A

Superinfections, severe photosensitivity
Life threatening: Blood dyscrasias, hepatotoxicity, intracranial HTN, pseudomembranous colitis

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8
Q

Doxycycline (routes, absorption, distribution, half life, excretion)

A

PO and IV
100% absorbed
90% distributed
14-24 hours
Urine and bile

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9
Q

Azithromycin (use, form)

A

Drug of choice for legionnaire’s disease
For patients with a PCN allergy, resp infections, gonorrhea, and skin infections
Z-pack, has loading dose

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10
Q

Azithromycin pregnancy category, 1 contraindication, 3 caution

A

Category B
Contraindications: Hypersensitivity
Caution: hepatic and renal dysfunction, lactation

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11
Q

Azithromycin side effects (9)

A

Anorexia, N/V/D, rash, pruritus, headache, vertigo, weakness

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12
Q

Azithromycin 5 adverse reactions and 2 life threatening

A

Superinfections, vaginitis, stomatitis, urticaria, hearing loss
Hepatotoxicity and anaphylaxis

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13
Q

Azithromycin drug interactions

A

Increased effect of digoxin, carbamazepine, theophylline, cyclosporin, warfarin
Decreased effect of PCNs clindamycin

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14
Q

Azithromycin routes, half life, excretion

A

PO, IV
68 hours
Excreted in bile and small amounts in urine

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15
Q

Sulfonamides (static or cidal, fun fact, general use, 3 things it treats, and who uses it)

A

Static
Oldest antibacterial agent used to combat infection
Used for UTIs-90% effective against E.coli
Also treats meningitis, chlamydia, and toxoplasma gondii
PCN allergy pts

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16
Q

Sulfonamides (2 forms and what is the cream used for)

A

PO (bactrim) or cream (Silvadene)- used for wound healing, post-op, cauterizations

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17
Q

Bactrim pregnancy category and contraindications

A

C/D
Don’t use during 3rd trimester
Severe renal or hepatic disease, hypersensitive to sulfonamides

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18
Q

Bactrim side effects and adverse effects

A

Side: N/V/D/A, rash, stomatitis, fatigue, depression, H/A, vertigo, photosensitivity, crystalluria (drink water)
Adverse: Leukopenia, thrombocytopenia, increased bone marrow depression, hemolytic anemia, Stevens-Johnson, renal failure

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19
Q

Bactrim routes, absorption, distribution, half-life, excretion

A

PO/IV
Well absorbed
50-65%, crosses placenta
8-12 hours
Excretes in urine as it metabolites

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20
Q

Cephalosporin (static or cidal, what is resistant to it, how it works, organization)

A

Cidal
MRSA
Beta-lactam, inhibits bacterial enzyme necessary for cell wall synthesis.
5 generations

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21
Q

1st generation (name, use, preg category, contra)

A

Cefazolin
For resp and urinary skin infections, surgical prophylaxis, bone and joint interactions, genital infections, and endocarditis
B
Hypersensitivity

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22
Q

Cephalosporins side and adverse effects and drug interactions

A

Anaphylaxis, dysgeusia, GI distress, C.diff, increased bleeding, seizures, nephrotoxicity, stevens-johnson, elevated hepatic enzymes
Alcohol may cause disulfiram-like reaction, flushing, dizziness, H/A, N/V, muscular cramps. Uricosurics decrease excretion

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23
Q

Cefazolin Side effects, adverse effects, and drug interactions

A

Anorexia, N/V/D, rash, abd cramps, and fever
Adverse: superinfections, urticaria, seizures, anaphylaxis
interactions: increased toxicity with loop diuretics, aminoglycosides, vanco. Decreased with tetracycline and erythromycin

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24
Q

2nd generation cephalosporin

A

cefaclor

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25
Q

What is cefaclor used for

A

Resp, urinary, skin infections, surgical prophylaxis, ear infections, gyn and colorectal surgery, PID, and intra-abdominal infections

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26
Q

cefaclor preg category, contra, caution

A

B
Hypersensitivity to cephalosporins
Hypersensitive to PCN, renal disease, lactation

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27
Q

Cefaclor side effects, adverse, and drug interactions

A

Anorexia, N/V/D, rash, pruritus, headache, vertigo, weakness
Adverse: Superinfection, urticaria, renal failure
Interactions: Increased toxicity with loop diuretics, aminoglycosides, vanco. Decreased with tetracycline and erythromycin

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28
Q

Cefazolin route, distribution, half life, excretion

A

IM, IV
85%
1.5-2.5 hours
70% excreted unchanged in urine

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29
Q

Cefaclor route, distribution, half life, excretion

A

PO
25%
0.5-1 hour
60-80% excreted unchanged in urine

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30
Q

Third generation cephalosporins (resistant to, effectiveness and spectrum, and example)

A

Resistant to beta-lactamases
Same effectiveness but further spectrum against gram -
Ceftriaxone (rocephin)

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31
Q

Fourth generation cephalosporins

A

Greater spectrum and stability against breakdown by beta-lactamase
Highly resistant
Not surgical prophylaxis
Sepsis, severe infections, female reproductive tract
Cefepime

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32
Q

Fifth generation cephalosporins

A

First active against resistant gram + like MRSA, VRSA, and VISA

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33
Q

Phenazopyridine (why it’s taken, side effects)

A

Relieves pain, burning, frequency, urgency
Headache, dizziness, GI distress, contact lens and urine discoloration, skin pigmentation

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34
Q

Bethanechol (what does it do, se/ar, contra)

A

Increase bladder tone of detrusor muscle
Neurogenic bladder (self-catheter) urinary retention
GI distress, abd cramps, headache, dizziness
Contraindication: peptic ulcer

35
Q

Oxybutynin (what is it, used for, se and ar, contra)

A

antispasmodic
Use for neurogenic or overactive bladder
Se and ar: drowsiness, dizziness, headache, blurred vision, insomnia, urinary retention, dry mouth, GI distress, constipation
Contra: Avoid in glaucoma, GI, or urinary obstruction

36
Q

4 urinary antiseptics and where drug action occurs

A

Nitrofurantoin
Methanamine
Fluoroquinolones (Cipro)
Trimethoprim (Bactrim)
Drug action is in renal tubule and bladder

37
Q

Nitrofurantoin (Macrodantin) route, absorption, distribution, half life, excretion

A

PO
Well absorbed in the GI tract, enhanced with food
20-60%, crosses placenta and excreted in breast milk
20 min
In urine, small amounts in bile

38
Q

ADPIE of nitrofurantoin

A

Assessment: Assess patient for UTI (vitals)
Monitor urine C&S
Diagnosis: Pain, acute related to inflammation. Infection or risk for it
Planning: Pt will be free of S&S of UTI within 10 days (abx)
Interventions: Monitor output and specific gravity
Obtain urine culture to identify organism before drug therapy (But before C&S, broad spectrum can be used)
Advise pt to avoid antacids
Inform pt to increase fluid intake and have food with abx
Evaluation

39
Q

Fluoroquinolones (use, side and adverse effects)

A

Treats lower UTIs
Headache, dizziness, visual impairment, GI distress, tendinitis, tendon rupture, peripheral neuropathy, seizures, C. diff (bleach, soap and water)

40
Q

Vancomycin (important, dilution, drug of choice for ____, ____ is resistant against it, used against what)

A

DON’T PUSH!! RED MANS
1g in 200mL of normal saline or RL
Drug of choice for MRSA, VRSA is resistant
Used against S. Aureus and in cardiac surgical prophylaxis for those with PCN allergy, C. diff, severe infection, septicemia, bone, skin, and lower resp tract infections

41
Q

Why is TMP-SMZ given and what does it treat

A

1 part trimethoprim to 5 parts sulfamethoxazole (synergistic)
Used for UTI, otitis media, bronchitis, pneumonia, rheumatic fever, burns

42
Q

Flagyl (used for what, avoid what and what will it cause)

A

Used to treat disorders of GI, serious gram -, intestinal amebiasis, trichomoniasis, IBD, anaerobic infections, bacterial vaginosis, prophylaxis in colorectal surgery, H-pylori
Avoid ETOH for 48 hours after treatment
Causes disulfiram reaction (facial flushing, severe H/A, tachy, palpitations, hypotension, dyspnea, sweating, slurred speech, abdominal cramps, N/V

43
Q

Rifampin (side effects, pt teaching, and use)

A

Turns soft contacts and urine orange
Used against TB

44
Q

Fluconazole effective against what, use

A

Effective against candidiasis (systemic and superficial)
Used in topical preparations to treat candidiasis and tinea
Increases permeability of fungal cell membrane

45
Q

Fluconazole (preg category, contra, caution)

A

C
Hypersensitivity
Caution: pregnancy

46
Q

ketoconazole side/adverse effects, drug-lab-food

A

Adverse: none known
Side: N/V/D/A, H/A, stomach cramps
hepatotoxicity when taken with echinacea
Increases PT when taking warfarin and hypoglycemia when taken with oral sulfonylureas

47
Q

Fluconazole routes, absorption, distribution, half life, elimination

A

PO, IV, and vaginal
Well absorbed in GI
12%
20-50 hours
Excreted in urine

48
Q

Influenza

A

Highly contagious viral infection
Dec-march
A: Mod to severe infection
B: Mild illness in children
C: Rare in humans
Abrupt onset, fever and then other symptoms

49
Q

2 drugs for influenza A prophylaxis

A

Amantadine (symmetrel) and rimantadine (Flumadine) HCL

50
Q

2 antivirals for flu

A

Oseltamivir phosphate (Tamiflu) and Zanamivir (Relenza)
Both inhibit replication of virus if given within 48h of symptoms

51
Q

INH (mode of action, use, preg category, contra)

A

Inhibition of bacterial cell wall synthesis
Prophylactic measure against TB
C
Severe renal or hepatic disease, ETOH, diabetic retinopathy

52
Q

INH side effects, adverse, life threatening, drug-lab-food

A

Side: N/V/C, drowsiness, tremors, rash, blurred vision, photosensitivity, tinnitus, dizziness, dry mouth
Only one to cause constipation!
Adverse: psychotic behavior, peripheral neuropathy, Vt b6 deficiency
Life threatening: dyscrasias, thrombocytopenia, seizures, agranulocytosis, hepatotoxicity
Drug: increased effect with ETOH, decreased GI absorption with antacids

53
Q

INH routes, absorption, distribution, half life, excretion, important

A

PO and IM
Well absorbed
10%
1-4 hours by the liver
75% excreted by urine
Onset of action and peak are the same (0.5 hrs and 1-2 hours)
Monitor LFTs!

54
Q

Polyenes (example, routes, use)

A

Nystatin
PO or topical, suspension, cream, ointment, vaginal tablets
Poorly absorbed in GI, oral given for intestinal candidiasis
Swish and swallow common

55
Q

Gentamicin (preg category, contra, caution)

A

Preg category C
Contra: Hypersensitivity, severe renal disease, pregnancy, breastfeeding
Caution: renal disease, heart failure, older adults, neonates

56
Q

Gentamicin (side/adverse effects, life threatening, Drug interactions)

A

Side: N/V/D/A, rash, visual disturbances, tremors, tinnitus, pruritus, muscle cramps, photosensitivity
Adverse: Oliguria, urticaria, palpitations, superinfection
Life threatening: Ototoxicity, nephrotoxicity, thrombocytopenia, liver damage
Drug: increased risk of ototoxicity with loop diuretics, increased of nephrotoxicity with furosemide, vancomycin

57
Q

Helminth infection

A

Intesting, lymphatic system, blood vessels, and liver
Developmental delays and disability in children
Enter the human host via contaminated foods, insect bites, or direct penetration
Tapeworms enter the intestines via contaminated food-pork, beef, fish, and dwarf tapeworms
Complications: GI obstruction, brain and CNS impairment, larvae move to lungs and liver and cause cysts which can rupture

58
Q

Most common anthelmintic, side/adverse reactions

A

Ivermectin
Side: GI distress, dizziness, weakness, headache, and drowsiness
Adverse: Dizziness, weakness, H/A, drowsiness

59
Q

Symptoms of TB

A

anorexia, cough, sputum production, fever, night sweats, weight loss, and + Sputum.

60
Q

Isoniazid

A

Bactericidal drug that inhibits tubercule wall synthesis and blocks Vt B6 which is used for intracellular enzyme production

61
Q

Prophylactic anti TB therapy (3) and who shouldnt prophylax

A

Individuals who have been in close contact with TB
Individuals who test positive for TB and who seroconvert
Do not prophylax pts with liver disease

62
Q

2 phases of TB regimen

A

First phase is 2 months
Second is 4-7 months

63
Q

6 Antiretroviral drugs

A

NRTIs
NNRTIs
PIs
Fusion (entry) inhibitors
CCR5 antagonists
INSTIs

64
Q

What do NRTIs do and they are used in combination with (2)?

A

block reverse transcriptase enzyme needed for viral replication
Mostly used as a primary NRTI with a combination of lamivudine or emtricitabine (dual combo)

65
Q

Zidovudine (use, preg category, caution)

A

NRTI
Management of clients with HIV, prevents maternal-fetal transmission
C
Caution: Bone marrow compromise, renal and hepatic dysfunction, decreased hepatic blood flow

66
Q

Zidovudine side, adverse, and drug-food-lab

A

Side: Numbness, tingling, burning and pain in lower ext, abd pain, rash, GI intolerance (improve within the first 2 weeks), fever, H/A, difficulty swallowing
Adverse: Arthralgia, insomnia, confusion, mental changes, bluish bands on fingernails, N/V, anemia, neutropenia, seizures, lactic acidosis, peripheral neuropathy, myopathy, pancreatitis, and lipoatrophy
Drug: Should be taken with food if pregnant, used with Bactrim may increase neutropenia. May increase MCV

67
Q

Zidovudine mode of action, route, absorption, distribution, half life, excretion, fun fact

A

Inhibits viral enzyme reverse transcriptase, which is necessary for viral HIV replication
PO
66-70%
25-38% crosses BBB and placenta
60 min, extensive first-pass effect
63-95% in urine
EXPENSIVE!

68
Q

How do NNRTIs work and why are they good

A

they prevent viral replication by competing with binding of reverse transcriptase enzyme at active site!!
main advantage is to reserve a protease-inhibitor based therapy for future use

69
Q

Side/adverse effects of NNRTIs and disadvantages

A

Rash, N/D, dizziness, insomnia, neuropathy, liver failure
Dis: Prevalence of NNRTI resistant viral strains and low genetic barrier of NNRTIs for development of resistance

70
Q

Protease inhibitors (PI)

A

Leads to sustained viral suppression, improved immunologic function, and prolonged client survival
Inhibits protease activity causing formation and release of immature, defective and noninfectious
Unlike NRTIs and NNRTIs, PIs act at the end of the HIV virus
Each PI has its own unique characteristics based on clinical efficacy, side-effect profile, and pharmacokinetic properties.

71
Q

Fusion (entry) inhibitors (action, side effects, and allergic reactions)

A

Prevents HIV entry into healthy cells by inhibiting fusion of the virus into healthy cell membranes (didn’t get to the nucleus yet)
Rash, diarrhea, injection site reactions, anaphylaxis, fever, hypotension

72
Q

HAART

A

3 agents to slow or inhibit 3 HIV enzymes. Makes HIV chronic, not deadly
Failure to take combination therapy can lead to resistance
Aggressive prophylaxis and treatment of opportunistic infections are suggested

73
Q

Initial treatment of HIV (what does HAART consist of)

A

2 NRTIs and a NNRTI or PI

74
Q

ADPIE of antiretroviral therapy

A

Assessment: Assess readiness to learn and discern preferred method of instruction
Diagnosis: Health management, ineffective related to complex drug management (cocktail)
Fear related to stigma of HIV diagnosis
Planning: Pt will adhere to drug regimen and report any difficulties
Interventions: provide information on necessity of adhering to drug regimen and regular healthcare
Evaluation

75
Q

How can HIV be transmitted from mother to child (4)

A

Pregnancy, labor, delivery, breastfeeding

76
Q

ART diet

A

No raw eggs or fish

77
Q

BRAT diet

A

bananas, rice, applesauce, roast

78
Q

Drugs for PCN allergy

A

Macrolides, Lincosamides, Glycopeptides, Ketolides, Lipopeptides
Mostly erythromycin (macrolides)

79
Q

Azithromycin mode of action
Static or cidal

A

Inhibits steps of protein synthesis, static and cidal

80
Q

How do aminoglycosides act, what are they used against, and what is resistant against it

A

By inhibiting bacterial protein synthesis
Used against gram - bacteria (E. coli)
Some gram + cocci are resistant, so PCN or cephalosporins used (the sulfates)

81
Q

S/E and A/R of aminoglycosides

A

Ototoxicity and nephrotoxicity (check renal function, dose, and age)

82
Q

Drug interactions of aminoglycosides

A

Don’t give with PCN, increases effect
Take them several hours apart (different site, never piggyback)
The drug action of warfarin (anticoag) can increase with aminoglycosides

83
Q

Oldest antimicrobial

A

Sulfonamides

84
Q

5 Stevens-Johnson

A

Amoxicillin, vanco, levaquin, bactrim, nitrofurantoin

Pharm 1 (4 decks)

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