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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
What is cefaclor used for
Resp, urinary, skin infections, surgical prophylaxis, ear infections, gyn and colorectal surgery, PID, and intra-abdominal infections
26
cefaclor preg category, contra, caution
B Hypersensitivity to cephalosporins Hypersensitive to PCN, renal disease, lactation
27
Cefaclor side effects, adverse, and drug interactions
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
28
Cefazolin route, distribution, half life, excretion
IM, IV 85% 1.5-2.5 hours 70% excreted unchanged in urine
29
Cefaclor route, distribution, half life, excretion
PO 25% 0.5-1 hour 60-80% excreted unchanged in urine
30
Third generation cephalosporins (resistant to, effectiveness and spectrum, and example)
Resistant to beta-lactamases Same effectiveness but further spectrum against gram - Ceftriaxone (rocephin)
31
Fourth generation cephalosporins
Greater spectrum and stability against breakdown by beta-lactamase Highly resistant Not surgical prophylaxis Sepsis, severe infections, female reproductive tract Cefepime
32
Fifth generation cephalosporins
First active against resistant gram + like MRSA, VRSA, and VISA
33
Phenazopyridine (why it's taken, side effects)
Relieves pain, burning, frequency, urgency Headache, dizziness, GI distress, contact lens and urine discoloration, skin pigmentation
34
Bethanechol (what does it do, se/ar, contra)
Increase bladder tone of detrusor muscle Neurogenic bladder (self-catheter) urinary retention GI distress, abd cramps, headache, dizziness Contraindication: peptic ulcer
35
Oxybutynin (what is it, used for, se and ar, contra)
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
4 urinary antiseptics and where drug action occurs
Nitrofurantoin Methanamine Fluoroquinolones (Cipro) Trimethoprim (Bactrim) Drug action is in renal tubule and bladder
37
Nitrofurantoin (Macrodantin) route, absorption, distribution, half life, excretion
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
ADPIE of nitrofurantoin
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
Fluoroquinolones (use, side and adverse effects)
Treats lower UTIs Headache, dizziness, visual impairment, GI distress, tendinitis, tendon rupture, peripheral neuropathy, seizures, C. diff (bleach, soap and water)
40
Vancomycin (important, dilution, drug of choice for ____, ____ is resistant against it, used against what)
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
Why is TMP-SMZ given and what does it treat
1 part trimethoprim to 5 parts sulfamethoxazole (synergistic) Used for UTI, otitis media, bronchitis, pneumonia, rheumatic fever, burns
42
Flagyl (used for what, avoid what and what will it cause)
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
Rifampin (side effects, pt teaching, and use)
Turns soft contacts and urine orange Used against TB
44
Fluconazole effective against what, use
Effective against candidiasis (systemic and superficial) Used in topical preparations to treat candidiasis and tinea Increases permeability of fungal cell membrane
45
Fluconazole (preg category, contra, caution)
C Hypersensitivity Caution: pregnancy
46
ketoconazole side/adverse effects, drug-lab-food
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
Fluconazole routes, absorption, distribution, half life, elimination
PO, IV, and vaginal Well absorbed in GI 12% 20-50 hours Excreted in urine
48
Influenza
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
2 drugs for influenza A prophylaxis
Amantadine (symmetrel) and rimantadine (Flumadine) HCL
50
2 antivirals for flu
Oseltamivir phosphate (Tamiflu) and Zanamivir (Relenza) Both inhibit replication of virus if given within 48h of symptoms
51
INH (mode of action, use, preg category, contra)
Inhibition of bacterial cell wall synthesis Prophylactic measure against TB C Severe renal or hepatic disease, ETOH, diabetic retinopathy
52
INH side effects, adverse, life threatening, drug-lab-food
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
INH routes, absorption, distribution, half life, excretion, important
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
Polyenes (example, routes, use)
Nystatin PO or topical, suspension, cream, ointment, vaginal tablets Poorly absorbed in GI, oral given for intestinal candidiasis Swish and swallow common
55
Gentamicin (preg category, contra, caution)
Preg category C Contra: Hypersensitivity, severe renal disease, pregnancy, breastfeeding Caution: renal disease, heart failure, older adults, neonates
56
Gentamicin (side/adverse effects, life threatening, Drug interactions)
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
Helminth infection
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
Most common anthelmintic, side/adverse reactions
Ivermectin Side: GI distress, dizziness, weakness, headache, and drowsiness Adverse: Dizziness, weakness, H/A, drowsiness
59
Symptoms of TB
anorexia, cough, sputum production, fever, night sweats, weight loss, and + Sputum.
60
Isoniazid
Bactericidal drug that inhibits tubercule wall synthesis and blocks Vt B6 which is used for intracellular enzyme production
61
Prophylactic anti TB therapy (3) and who shouldnt prophylax
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
2 phases of TB regimen
First phase is 2 months Second is 4-7 months
63
6 Antiretroviral drugs
NRTIs NNRTIs PIs Fusion (entry) inhibitors CCR5 antagonists INSTIs
64
What do NRTIs do and they are used in combination with (2)?
block reverse transcriptase enzyme needed for viral replication Mostly used as a primary NRTI with a combination of lamivudine or emtricitabine (dual combo)
65
Zidovudine (use, preg category, caution)
NRTI Management of clients with HIV, prevents maternal-fetal transmission C Caution: Bone marrow compromise, renal and hepatic dysfunction, decreased hepatic blood flow
66
Zidovudine side, adverse, and drug-food-lab
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
Zidovudine mode of action, route, absorption, distribution, half life, excretion, fun fact
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
How do NNRTIs work and why are they good
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
Side/adverse effects of NNRTIs and disadvantages
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
Protease inhibitors (PI)
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
Fusion (entry) inhibitors (action, side effects, and allergic reactions)
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
HAART
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
Initial treatment of HIV (what does HAART consist of)
2 NRTIs and a NNRTI or PI
74
ADPIE of antiretroviral therapy
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
How can HIV be transmitted from mother to child (4)
Pregnancy, labor, delivery, breastfeeding
76
ART diet
No raw eggs or fish
77
BRAT diet
bananas, rice, applesauce, roast
78
Drugs for PCN allergy
Macrolides, Lincosamides, Glycopeptides, Ketolides, Lipopeptides Mostly erythromycin (macrolides)
79
Azithromycin mode of action Static or cidal
Inhibits steps of protein synthesis, static and cidal
80
How do aminoglycosides act, what are they used against, and what is resistant against it
By inhibiting bacterial protein synthesis Used against gram - bacteria (E. coli) Some gram + cocci are resistant, so PCN or cephalosporins used (the sulfates)
81
S/E and A/R of aminoglycosides
Ototoxicity and nephrotoxicity (check renal function, dose, and age)
82
Drug interactions of aminoglycosides
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
Oldest antimicrobial
Sulfonamides
84
5 Stevens-Johnson
Amoxicillin, vanco, levaquin, bactrim, nitrofurantoin

Pharm 1 (4 decks)

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