Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 1 Jack > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Cardiac action potential phase 0

A

sodium channels open (Na+ in)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Phase I action potential

A

sodium channels close, potassium channels begin to open (K+) out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Phase II action potential

A

calcium and potassium channels open (Ca++ in and K+ out)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Phase III action potential

A

calcium channels close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Phase IV action potential

A

cells return to resting membrane potential (-70 mv)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

all anti-arrhythmic drugs are potentially

A

pro-arrhythmic as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

anti-arrhythmic drug class Ia, Ib, Ic

A

sodium channel blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

anti-arrhythmic drug class II

A

beta adrenergic receptor blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

anti-arrhythmic drug class III

A

potassium channel blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

anti-arrhythmic drug class IV

A

calcium channel blockade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what do anti-arrhythmic drug class Ia do

A

slow phase 0 depolarization, prolong action potential and slow conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what do anti-arrhythmic drug class Ib do

A

shorten phase 3 repolarization and decrease the duration of the action potential by blocking or inactivating sodium channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do anti-arrhythmic drug class Ic do

A

markedly slow phase 0 depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what do anti-arrhythmic drug class II do

A

diminish phase 4 depolarization, thus depressing automaticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what do anti-arrhythmic drug class III do

A

agents prolong phase 3 repolarization without altering phase 0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what do anti-arrhythmic drug class IV do

A

agents slow phase 4 depolarization and slow conduction particularly at the AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

class of Quinidine/Quinidex

A

anti-arrhythmic–Class Ia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Quinidine/Quinidex indication

A

A-flutter, A-fib, AV, and ventricular arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MOA of Quinidine/Quinidex

A

sodium channel blocker. diminished inward flow of sodium at phase 0 results in decreased automaticity and a lengthened refractory period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Char. of Quinidine/Quinidex

A

PO, IV. less commonly used because of significant adverse effect profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

side effects of Quinidine/Quinidex

A

potentially pro-arrhythmic, nausea, vomiting, diarrhea. Cinchonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

symptoms of cinchonism include

A

blurred vision, tinnitus, nausea, vomiting, headache, disoreintation and possible psychotic states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Quinidine/Quinidex may induce abnormal rhythm of ventricular tachycardia known as

A

Torsade de Pointes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Class of Mexiletine/Mexitil

A

anti-arrhythmic Class Ib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

indication of Mexiletine/Mexitil

A

ventricular arrhythmias, particularly recurrent v-tach after MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

MOA of Mexiletine/Mexitil

A

blocks open sodium channels and shortens phase 3 repolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Char. of Mexiletine/Mexitil

A

PO, IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

side effects of Mexiletine/Mexitil

A

drowsiness, confusion, potentially pro-arrhythmic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Class of Flecainide/ Tambocor

A

anti-arrhythmic Class Ic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

indication of Flecainide/ Tambocor

A

treatment of many types of supraventricular tachycardias, including Wolff-Parkinson-White syndrome, paroxysmal atrial fibrillation, paroxysmal supraventricular tachycardia and ventircular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

MOA of Flecainide/ Tambocor

A

sodium channel blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Char. of Flecainide/ Tambocor

A

PO, IV, narrow therapeutic index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

side effects of Flecainide/ Tambocor

A

potentially pro-arrhythmic. not indicated for patients with a history of MI or ventricular arrhythmia related to acute ischemic event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

primary Class II/Beta Blocker

A

Atenolol/Tenormin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

class of Atenolol/Tenormin

A

anti-arrhythmic Class II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

indication of Atenolol/Tenormin

A

tachyarrhythmias such as A-flutter, A-fib, atrioventricular and ventricular arrhythmias, paroxysmal supraventricular tachycardias, HTN, angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

MOA of Atenolol/Tenormin

A

beta 1 blockade reduces sympathetic effects on myocardium. reduced phase 4 depolarization and decreased automaticity in the SA node, AV node, and the Purkinje fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Char. of Atenolol/Tenormin

A

PO, IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

side effects of Atenolol/Tenormin

A

Bradycardia, hypotension, dizziness. Bronchoconstriction is possible but occurs less frequently in selective beta blockers. Depression, fatigue, impotency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Primary Class III/K+ channel blocker

A

Amiodarone/ Cordarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

class of Amiodarone/ Cordarone

A

anti-arrhythmic Class III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

indication for Amiodarone/ Cordarone

A

ventricular arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

MOA of Amiodarone/ Cordarone

A

potassium channel blockade. prolongs phase 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

char. of Amiodarone/ Cordarone

A

PO, IV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Amiodarone/ Cordarone contains high levels of

A

iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

side effects of Amiodarone/ Cordarone

A

Dizziness and light headedness. Pulmonary fibrosis possible. Blue-gray coloring of skin can occur as a result of iodine deposition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

primary Class IV/Ca++ channel blocker

A

Verapamil/ Calan, Isoptin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

class of Verapamil/ Calan, Isoptin

A

anti-arrhythmic Class IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

indication of Verapamil/ Calan, Isoptin

A

A-flutter, A-fib and paroxysmal supraventricular tachycardias, HTN, angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

MOA of Verapamil/ Calan, Isoptin

A

calcium channel blockade causes a slowing of phase 4 depolarization, resulting in slowed AV conduction. suppression of both SA and AV node activity often results in decreased heart rate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Char. of Verapamil/ Calan, Isoptin

A

PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

side effects of Verapamil/ Calan, Isoptin

A

dizziness, flushing, headaches, hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Adenosine/ Adenocard acts directly on the heart’s

A

sinus pacemaker cells and vagal nerve terminals to decrease chronotropic and ionotropic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Adenosine/ Adenocard is recommended as the initial drug of choice for

A

PSVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

class of Adenosine/ Adenocard

A

anti-arrhythmic-endeogenous nucleoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

indication of Adenosine/ Adenocard

A

abolishes acute paroxysmal supraventricular tachycardias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

MOA of Adenosine/ Adenocard

A

prolongs the refractory period and decreases automaticity in the AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Char. of Adenosine/ Adenocard

A

IV only. Duration of action is 15 seconds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

side effects of Adenosine/ Adenocard

A

low toxicity but often causes transient hypotension and chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

class of Atropine

A

anti-arrhythmic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

indication of Atropine

A

cardiac use is in treatment of bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

MOA of Atropine

A

anticholinergic agent - atropine is a competitive inhibitor of the muscarinic acetylcholine receptors thus it can be thought of as a parasympatholytic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Char. of Atropine

A

IV, PO. Can be also given via an endotracheal tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

side effects of Atropine

A

Blurred vision, dilated pupils, dry mouth and increased heart rate are usually among the first toxic effects of atropine. Use of atropine as a cardiac drug is generally confined to emergency treatment of life threatening bradycardia with hypotension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

by blocking the action of acetylcholine, atropine serves as an antidote for

A

poisoning by organophosphate containing insecticides and nerve gases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

topical atropine is used as a

A

cycloplegic to temporarily paralyze accommodation and as a mydriatic to dilate the pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

oral atropine can be used to treat

A

diarrhea as it decreases secretions and slows peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

given preoperatively, atropine decreases

A

bronchial and salivary secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

The classic symptoms in acute organophosphate poisoning are

A

muscarinic in nature…SLUDGE: salivation, lacrimation, urination, diarrhea, gastric distress, emesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Toxicity due to atropine results in

A

decreased secretions; flushed, dry, warm skin, visual changes and delirium with hallucinations…Dry as a bone, red as a beet, hot as a hare, blind as a bat, mad as a hatter.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

specific antidote for atropine toxicity or tropane alkaloid toxicity is

A

physostigmine, a reversible acetylcholinesterase inhibitor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

The two most common medications containing cardiac glycosides are

A

digoxin and digitoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Which has a longer half life and is now seldom used because of increased risks of toxicity: Digoxin or digitoxin?

A

Digitoxin…both has a very low TI though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Digoxin inhibits the Na+/K+ ATPase enzyme system and serves to

A

increase the inward flow current of sodium and calcium thereby increasing cardiac muscle contractility while also slowing conduction between atria and ventricles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

class of Digoxin/ Lanoxin

A

anti-arrhythmic - cardiac glycoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

indications of Digoxin/ Lanoxin

A

CHF. Slows ventricular response to atrial fibrillation and atrial flutter.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

MOA of Digoxin/ Lanoxin

A

Inhibitors the Na+/K+ ATPase pump which serves to increase inward current of sodium followed by a greater influx of calcium. Cardiac contraction is enhanced by the increased concentration of intracellular calcium. Also increases renal perfusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Char. of Digoxin/ Lanoxin

A

PO, 36 hour half life, may cause characteristic flattening or even inversion of the T wave on EKG.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Side effects of Digoxin/ Lanoxin

A

Digitalis intoxication – observed more frequently in patients with hypokalemia as may occur in patients on thiazides, lasix or other potassium wasting diuretics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Cardiac signs of Digitalis intoxication

A

arrhythmias, including bradycardia, partial or complete heart block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

GI signs of Digitalis intoxication

A

nausea, vomiting, anorexia and diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

CNS signs of Digitalis intoxication

A

drowsiness and fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

visual disturbances of Digitalis intoxication

A

blurred vision, double vision, flickering dots or flashes of light, halos may appear around objects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Treatment of digitalis intoxication is

A

Digoxin-Fab fragments/ Digibind …they attach to Digoxin molecules and rapidly remove them from receptor sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

most common organic molecule in the brain

A

cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

leading cause of death in the US

A

coronary artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Omega-3 fish oil available as a prescription drug

A

Lovaza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Five categories of cholesterol lowering agents

A

Niacin, Fibrates, HMG-CoA reductase inhibitors, bile acid binding resins, cholesterol absorption blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Side effects of Niacin/nicotinic acid

A

Pharmacologic use of niacin in doses of 3 grams or more has resulted in acute side effects of flushing, nausea, gastritis and headache. Longer term potential side effects of niacin toxicity include liver damage, retinal damage, gout and rhabdomyolysis (the rapid breakdown of skeletal muscle).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

class of Niacin/ Niaspan

A

Anti-hyperlipidemic/B vitamin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

indication of Niacin/ Niaspan

A

elevated total cholesterol, elevated VLDL, LDL, TG and low HDL levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

MOA of Niacin/ Niaspan

A

exact mechanism of action is not clear. Niacin appears to decrease VLDL synthesis in the liver while also increasing the clearance of VLDL in the plasma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Char. of Niacin/ Niaspan

A

PO. Intense flushing and pruritis is common.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

side effects of Niacin/ Niaspan

A

Less flushing and itching when ASA or NSAIDs taken 30 minutes to an hour before the niacin dose.
Follow LFTs to monitor for any possible hepatic damage. Also monitor glucose levels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Niacin/Niaspan is Contraindicated in patients with

A

poorly controlled DM, active liver disease or active peptic ulcer disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

safest form of niacin that is currently available

A

non-prescription Inositol hexaniacinate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

category of meds that decrease triglyceride production in the liver

A

fibric acid derivatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

most commonly used fibric acid derivative

A

Gemfibrozil/Lopid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

potential side effects of fibric acid derivatives

A

liver damage, gall stone formation, nausea, diarrhea, GI upset, rhabdomyolysis, and myalgias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

class of Gemfibrozil/Lopid

A

anti-hyperlipidemic, fibric acid derivative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

indication of Gemfibrozil/Lopid

A

elevated triglyceride levels, low HDL level, types IV and V hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

noted side effects for Gemfibrozil/Lopid

A

contraindicated in patients with pre-existing gallbladder disease and liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

HMG-CoA reductase inhibitors

A

statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

most common complaints from statins

A

muscle soreness and muscle weakness…less common are memory, cognitive dysfunction, and insomnia, abdominal pain, nausea, diarrhea, headache, erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

life-threatening side effect of statins

A

rhabdomyolysis, the severe and rapid muscle breakdown which can lead to acute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

what causes muscle soreness, muscle weakness, and frank rhabdomyolysis when using statins

A

decreased CoQ10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

contraindications to statins

A

heavy alcohol use, liver disease, unexplained elevation of liver enzymes, pregnancy, lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

statin drugs that was recalled after multiple deaths from rhabdomyolysis

A

Cerivastatin/Baycol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

primary statin drug

A

Atorvastin/Lipitor

110
Q

class of Atorvastin/ Lipitor

A

anti-hyperlipidemic, HMG-CoA reductase inhibitor

111
Q

indication of Atorvastin/ Lipitor

A

elevated total cholesterol, elevated LDL, low HDL levels. Indicated for symptomatic and non-symptomatic coronary artery disease

112
Q

side effects of Atorvastin/ Lipitor

A

muscle soreness and weakness. check CPK levels to assess for possible rhabdomyolysis when complaints of severe muscle pain are noted. may cause elevated liver enzymes. follow LFTs–prior to beginning therapy and at 6 weeks and 12 weeks. Plasma drug concentrations are significantly affected by concurrent liver disease.

113
Q

Can Atorvastin/ Lipitor be used by pregnant women?

A

no, category X. Also contraindicated in breast feeding mothers as all statin drugs are.

114
Q

type of drug that binds cholesterol and forms insoluble complexes which are excreted in the feces

A

bile acid sequestrants

115
Q

bile acid sequestrants are often used in conjunction with

A

niacin

116
Q

primary bile acid sequestrant

A

cholestyramine/questran

117
Q

class of Cholestyramine/ Questran

A

anti-hyperlipidemic, bile acid sequestrant

118
Q

indication of Cholestyramine/ Questran

A

elevated cholesterol, elevated LDL, can be used in patients with liver failure who have pruritis, as well as patients with increasing ammonia levels, patients with c. diff.

119
Q

MOA of Cholestyramine/ Questran

A

forms an insoluble complex with bile salts resulting in greater amounts of cholesterol being oxidized into bile acids and increased excretion of bile acids in stool

120
Q

side effects of Cholestyramine/ Questran

A

bloating, constipation, may interfere with absorption of fat soluble vitamins and folic acid. May delay the absorption of concomitant medications. The use of bile acid sequestrants has not been adequately studied in pregnant women and thus falls into category C. That being said, I personally recommend avoiding the use of this agent in both pregnancy and during lactation.

121
Q

The newest agents for the treatment of hypercholesterolemia act by

A

reducing the amount of cholesterol that is absorbed by the body.

122
Q

class of Ezetimibe/ Zetia

A

anti-hyperlipidemic - cholesterol absorption inhibitor

123
Q

ind. of Ezetimibe/ Zetia

A

elevated cholesterol, elevated LDL, elevated triglyceride and low HDL

124
Q

MOA of Ezetimibe/ Zetia

A

inhibits intestinal absorption of cholesterol at the brush border

125
Q

side effects of Ezetimibe/ Zetia

A

diarrhea, myalgias, arthralgias, abdominal pain. all statin concerns to be observed when Ezetimibe/ Zetia is used with a statin drug. Cautious use in pregnancy - Cat C.

126
Q

what is Vytorin

A

Category X drugs which combines the statin Simvastatin with Ezetimibe into a single fixed dose pill

127
Q

prescription fish oil

A

Lovaza

128
Q

meaning of cidal

A

ability to kill a microorganism

129
Q

meaning of static

A

ability of an agent to inhibit the proliferation of an organism

130
Q

examples of synthetic antimicrobial drugs

A

sulfonamides and Quinolones

131
Q

what is MIC

A

minimum inhibitory concentration

132
Q

what is MBC

A

minimum bactericidal concentration

133
Q

what is macrodilution testing

A

known amounts of bacteria are inoculated into a nutrient broth containing a dilutional series of antibiotic concentrations.

134
Q

conjugation

A

passage of genes from cell to cell allows for development of drug resistance to occur

135
Q

mutation

A

DNA of the microbe line is spontaneously modified

136
Q

transduction

A

bacteriophage carries modified DNA into the microbe to confer resistance

137
Q

what can inactivate some antimicrobials

A

pus (i.e. the aminoglycosides), hemoglobin in hematomas (i.e. the tetracyclines and penicillins), and the acidic environments of abscesses (i.e. the macrolides)

138
Q

all antimicrobial agents have a spectrum of potential adverse side-effects including but not limited to

A

hypersensitivity reactions, toxicity, development of additional infection or supra-infection

139
Q

class of Sulfamethoxazole/ Gantanol

A

sulfonamide antibiotic…he said he wont ask about this one in all likelihood

140
Q

MOA of Sulfamethoxazole/ Gantanol

A

competitive antagonists of paraaminobenzoic acid (PABA) which is used by bacteria in the synthesis of folic acid

141
Q

Char. of Sulfamethoxazole/ Gantanol

A

sensitive organisms are those that must synthesize their own folic acid. Broad spectrum antibiotic. Bacteriostatic. Distributed throughout all tissues of the body including the CSF.

142
Q

potential MOA of antimicrobials

A

inhibition of cell wall synthesis, increasing permeability of cell membrane, anti-metabolite action of a drug, inhibition of microbial DNA or RNA synthesis, inhibition of action of microbial ribosomal subunits

143
Q

ind. of Sulfamethoxazole/ Gantanol

A

UTIs, otitis media, bronchitis. has largely been replaced by Trimethoprim Sulfa which has a broader spectrum of activity.

144
Q

Side effects of Sulfamethoxazole/ Gantanol

A

GI - upset stomach, N/V. H/A, skin rashes, and marked photosensitization

145
Q

class of Sulfamethoxazole with Trimethoprim/ Bactrim

A

sulfonamide antibiotic in combination with an additional folic acid inhibitor

146
Q

MOA of Sulfamethoxazole with Trimethoprim/ Bactrim

A

interference with folic acid formation at a successive step to sulfonamides

147
Q

Char. of Sulfamethoxazole with Trimethoprim/ Bactrim

A

synergistically inhibits two steps in folic acid synthesis

148
Q

naturally derived antibiotic drug classes

A

penicillins, cephalosporins, macrolides, tetracyclines, aminoglycosides

149
Q

sensitivity is determined by several factors, including the ability of the antimicrobial agents to

A

reach the microorganism, bind to or enter the microorganism, interfere with a vital microbial function, remain chemically intact while acting upon the microorganism

150
Q

two types of drugs that each affect folic acid production

A

trimethoprim and sulfonamides

151
Q

what part of folic acid production do sulfonamides affect

A

dihydropteroate synthetase

152
Q

what part of folic acid production does trimethoprim affect

A

dihydrofolate reductase

153
Q

indications of Sulfamethoxazole with Trimethoprim/Bactrim

A

Urinary tract infections, Pneumocystis prophylaxis. Also for MRSA infections either empirically or proven by culture to be sensitive to TMP/ Sulfa.

154
Q

side effects of Sulfamethoxazole with Trimethoprim/Bactrim

A

Hypersensitivity is approximately 3x more common than with Sulfamethoxazole alone. Most hypersensitivity reactions involve skin reactions such as rash and photosensitivity. Megaloblastosis, leukopenia, and thrombocytopenia - characteristics of folate deficiency – are all potential adverse effects.

155
Q

major side effect of Sulfamethoxazole with Trimethoprim/Bactrim

A

Stevens Johnson syndrome (topical epidermal necrolysis

156
Q

penicillin typically treats infections caused by

A

susceptible Gram-positive organisms

157
Q

what type of antibiotic are penicillins

A

beta-lactam

158
Q

class of penicillin G

A

beta-lactam antibiotic

159
Q

MOA of penicillin G

A

Beta lactam component binds to PBPs on bacteria and thereafter inhibits cross linking of components of bacterial cell wall.

160
Q

indication of Penicillin G

A

Pen G is not used as frequently now as in the past but can still be effective against many Gram positive cocci such Streptococcus and some gram negatives such as Neisseria.

161
Q

Char. of Penicillin G (what is often added)

A

Procaine is often added to IM injections to diminish pain of injection. Procain and Benzathine also prolong the half-life of penicillin.

162
Q

Side effects of Penicillin G

A

penicillins have most common severe drug allergy but may not be true allergy response

163
Q

Amoxicillin/ Amoxil class

A

Penicillin derivative antibiotic containing a thiazoladine ring, a β lactam ring and side chains.

164
Q

MOA of Amoxicillin/ Amoxil

A

Binds to penicillin binding protein and inhibits protein synthesis in the bacterial cell wall.

165
Q

indications of Amoxicillin/Amoxil

A

Useful for urinary tract, ENT infections such as Strep throat and otitis media, lower respiratory, skin infections.

166
Q

side effects of Amoxicillin/Amoxil

A

penicillins have most common severe drug allergy but may not be true allergy response

167
Q

what causes resistance to Amoxicillin/Amoxil

A

Generally due to microorganisms ability to produce B-lactamase and/or modifications of the PBP sites

168
Q

Distribution of Amoxicillin/Amoxil

A

distributed widely in all tissues except in the CSF

169
Q 
class of Amoxicillin and 
clavulanate/Augmentin
A

penicillin derivative antibiotic containing Amoxil with clavulanic acid added to prevent B lactamase inhibition.

170
Q

MOA of Amoxicillin and

clavulanate/Augmentin

A

similar to Amoxil, binding to penicillin binding protein and inhibiting protein synthesis in the bacterial cell wall.

171
Q

side effects of Amoxicillin and

clavulanate/Augmentin

A

The most severe cause of antibiotic induced diarrhea is pseudomembranous colitis

172
Q

interesting thing about dose of Amoxicillin and

clavulanate/Augmentin

A

two 250 mg Augmentin capsules will give you twice the clavulanate dose of one 500 mg Augmentin capsule.

173
Q

general action of cephalosporins

A

disrupt the synthesis of the peptidoglycan layer of bacterial cell walls, resulting in cytolysis and cell death

174
Q

class of Cephalexin/Keflex

A

Cephalosporin antibiotic, first generation.

175
Q

First generation of Cephalosporins start with

A

Ceph-

176
Q

advantage of first generation cephalosporin

A

great gram + coverage but poor gram -

177
Q

later generation Cephalosporins start with

A

Cef

178
Q

advantage of third generation cephalosporin

A

great gram- coverage but poor gram+ coverage

179
Q

MOA of Cephalexin/Keflex

A

Similar to penicillin with inhibition of protein synthesis of the bacterial cell wall via beta lactam activity.

180
Q

Char. of Cephalexin/Keflex

A

Drug resistance generally occurs as a result of β-lactamase production or modifications of PBP.

181
Q

Indications of Cephalexin/Keflex

A

ENT infections, bronchitis, skin infections. Varies with the generation of cephalosporin. Prophylaxis in surgery. Alternative to penicillins in allergic patients.

182
Q

Side effects of Cephalexin/Keflex

A

Similar to penicillin. GI effects such as diarrhea. Yeast overgrowth. Approximately 5%* of penicillin allergic patients will also be allergic to the cephalosporin class of drugs.

183
Q

Macrolides tend to accumulate within

A

leukocytes and are therefore actually transported into the site of infection

184
Q

indication for Erythromycin

A

Erythromycin is often used to treat respiratory tract infections because it covers typical organisms such as streptococcus and has better coverage of atypical organisms (such as Mycoplasma and Legionella).
It is also used to treat Chlamydia, syphilis, and gonorrhea.

185
Q

class of Erythromycin

A

macrolide antibiotic

186
Q

MOA of Erythromycin

A

inhibit protein synthesis by binding to 50 S bacterial ribosome

187
Q

Char. of Erythromycin

A

Broad spectrum antibiotic that is generally bacteriostatic in low concentrations and bactericidal in high concentrations. May be used in penicillin allergic patients.

188
Q

Side effects of Erythromycin

A

GI distress with upset stomach and N/V are very common occurrences with Erythromycin, especially if the drug taken without food. Most tablets are enteric coated in an effort to diminish upset stomach.

189
Q

class of Azithromycin/ Zithromax

A

Macrolide antibiotic related to erythromycin, consisting of a many membered lactone ring

190
Q

MOA of Azithromycin/ Zithromax

A

inhibit protein synthesis by binding to 50 S bacterial ribosome

191
Q

Char. of Azithromycin/ Zithromax

A

Broad spectrum antibiotic that is generally bacteriostatic in low concentrations and bactericidal in high concentrations. Long half life (68 hours).

192
Q

Indication for Azithromycin/ Zithromax

A

Ear, nose and throat infections, sinusitis, bronchitis and pneumonia. Atypical infections such as Mycoplasma and Chlamydia infections. Long half-life and easy dosing schedule has made Zithromax one of most commonly used antibiotics.

193
Q

Side effects of Azithromycin/ Zithromax

A

Similar to erythromycin but with far less GI distress. Zithromax should still be taken with food to diminish adverse effects of upset stomach, nausea and vomiting. As with all antibiotics, bacterial and yeast overgrowth is possible.

194
Q

Tetracyclines should not be given concurrently with

A

calcium supplements or with dairy products as they are chelated by the drug and will markedly diminish drug absorption and bioavailability

195
Q

Tetracyclines should never be used in

A

infants and children younger than age 8 or 15 or in pregnant women because they can permanently stain teeth

196
Q

class of Tetracycline/ Sumycin

A

Tetracycline antibiotic

197
Q

MOA of Tetracycline/ Sumycin

A

inhibits bacterial protein synthesis by interfering with 30 S ribosome. Bacteriostatic rather than bactericidal.

198
Q

Indications for Tetracycline/ Sumycin

A

Effective in treating oral and respiratory infections caused by aerobic and anaerobic gram + and gram – organisms, killed by penicillins. Commonly used to treat acne and acne rosacea. Chlamydia. Lyme disease. Rocky Mountain Spotted Fever.

199
Q

Char. of Tetracycline/ Sumycin

A

chelates calcium ions. Accumulates in bone and teeth. Avoid taking this class of drugs with dairy products or calcium supplements.

200
Q

side effects of Tetracycline/ Sumycin

A

Irreversible staining of teeth. This drug and other tetracycline class drugs must be avoided in infants, children and early adolescents. GI distress. Photosensitivity.

201
Q

Gentamicin/ Garamycin class

A

aminoglycoside antibiotic

202
Q

MOA of Gentamicin/ Garamycin

A

Binds to 30 S and 50 S ribosomal subunits interfering with protein synthesis. Bactericidal.

203
Q

Indications of Gentamicin/ Garamycin

A

Primarily used to treat aerobic gram negative organisms. Useful in treating potentially life threatening infections such as meningitis, endocarditis or sepsis due to gram negative organisms. May also be used to treat Tuberculosis.

204
Q

Char. of Gentamicin/ Garamycin

A

No activity as an oral agent. Generally given IV when treating systemic infection. Often used with other antibiotics because of narrow spectrum of activity. Severe adverse effect profile. Used topically in the treatment of skin infections or infections of the eye.

205
Q

Side effects of Gentamicin/ Garamycin

A

Potentially nephrotoxic and ototoxic. These effects may be irreversible.

206
Q

mechanism of Quinolones

A

inhibit bacterial DNA gyrase, thereby inhibiting DNA replication and transcription

207
Q

main side effect of Quinolones

A

tendon damage or spontaneous tendon rupture…especially when concurrently using systemic corticosteroid such as prednisone

208
Q

class of Ciprofloxacin/Ciproxin

A

Quinolone antibiotic (synthetic)

209
Q

MOA of Ciprofloxacin/Ciproxin

A

Inhibits DNA gyrase, an enzyme responsible for properly uncoiling DNA during transcription.

210
Q

Quinolones are no longer indicated for

A

STI’s

211
Q

Indications for Ciprofloxacin/Ciproxin

A

Excellent coverage of many gram negative organisms and very good coverage for many gram positive organisms. Urinary tract, ENT, upper and lower respiratory tract infections. Anthrax - made “famous” (or infamous) by post 9/11 anthrax threats.

212
Q

1st generation Quinolones have good coverage with

A

Gram - bacteria

213
Q

2nd generation Quinolones have good coverage with

A

Gram + bacteria

214
Q

Who should Ciprofloxacin/Ciproxin be avoided in

A

The Quinolones chelate calcium and can be deposited in cartilage, thus the use of oral or parenteral forms should be avoided in all children and infants and all pregnant and lactating females.

215
Q

Side effects of Ciprofloxacin/Ciproxin

A

Not for use in children or pregnant females as it is taken up by bone and cartilage. Associated with increased risk for tendon injury (esp. Achilles tendon injury) in adults taking the drug. N/V, headache, insomnia, particularly in coffee drinkers. Ciproxin reduces the metabolic breakdown of caffeine, thus prolonging the effects.

216
Q

class of Metronidazole/ Flagyl

A

Imidazole class of antibiotics

217
Q

MOA of Metronidazole/ Flagyl

A

activated intermediates of the drug bind to DNA and inhibit further nucleic acid synthesis

218
Q

Indications for Metronidazole/Flagyl

A

Vaginitis due to Trichomonas vaginalis (protozoal) infection in both symptomatic patients as well as their asymptomatic sexual contacts and due to bacterial Gardnerella vaginal infection in symptomatic patients.
As part of a multi-drug regimen directed at eradication of Helicobacter pylori in peptic ulcer disease.

219
Q

Metronidazole is a ___-drug

A

pro-drug by virtue of the fact that the therapeutic action of the drug occurs after the drug has been taken up by sensitive organisms such as anaerobic gram negative bacteria or Protozoa.

220
Q

Side effects of Metronidazole/Flagyl

A

Common adverse drug reactions associated with oral Metronidazole therapy include: upset stomach, nausea, vomiting, and diarrhea. The sensation of a metallic taste in the mouth is another common complaint. Headaches. Thrush.

221
Q

If you drink alcohol while taking Metronidazole/Flagy, it can result in l

A

Disulfiram-like (aka Antabuse-like) reaction with nausea, vomiting, flushing, and tachycardia.

222
Q

How does Metronidazole interrupt the breakdown of alcohol

A

blocks the enzyme acetaldehyde dehydrogenase….blood alcohol will be far higher than usual so alcohol needs to be avoided till 24 hours after completion of treatment

223
Q

class of Nitrofurantoin/ Macrobid

A

Nitrofuran antibacterial agents

224
Q

indication of Nitrofurantoin/ Macrobid

A

lower urinary tract infections

225
Q

What drug can cover both a parasite (protozoa) and bacteria

A

Metronidazole/Flagy

226
Q

MOA of Nitrofurantoin/ Macrobid

A

disrupts both DNA and RNA of bacteria which are sensitive to the drug.

227
Q

Char. of Nitrofurantoin/ Macrobid

A

concentrated in the urine. Indicated for lower UTI’s but no for pyelonephritis. Considered safe for use in pregnancy prior to 38 wks of gestation. Resistance to other antibiotics has led to increased interest in Nitrofurantoin.

228
Q

side effects of Nitrofurantoin/ Macrobid

A

The most common side effects with Nitrofurantoin are nausea, vomiting, and diarrhea; less common reactions include fever and chills. Rare adverse effects include pulmonary fibrosis and drug-induced autoimmune hepatitis.

229
Q

Nitrofurantoin/ Macrobid is not recommended to us for

A

pyelonephritis

230
Q

class of Clindamycin/Cleocin

A

lincosamide antibiotic

231
Q

MOA of Clindamycin/Cleocin

A

binds to 50 S ribosomal subunits of bacteria which acts to inhibit protein synthesis

232
Q

common side effects of Clindamycin/Cleocin

A

GI upset, nausea, vomiting or diarrhea. Skin rashes, oral thrush and yeast vaginitis may occur. Pseudomembranous colitis from C. difficile overgrowth can occur.

233
Q

class of Vancomycin/ Vancocin

A

glycopeptide antibiotic

234
Q

indication of Vancomycin/ Vancocin

A

Infections by Gram-positive bacteria which are unresponsive to other less toxic antibiotics. These are often severe or even life threatening infections.

235
Q

MOA of Vancomycin/ Vancocin

A

Inhibits synthesis of bacterial cell wall phospholipids as well as inhibition of peptidoglycan polymerization at a site separate from the penicillin binding proteins sites utilized by beta lactam antibiotics.

236
Q

Vancomycin is used in the prophylaxis and treatment of

A

severe infections caused by Gram-positive bacteria…traditionally used as a last resort

237
Q

Are Clindamycin and Erythromycin related drugs?

A

No.

238
Q

what is the only indication for oral adminstration of Vancomycin

A

treatment of pseudomembranous colitis that is unresponsive to Metronidazole treatment or in cases in which there is a relapse of pseudomembranous colitis.

239
Q

side effects of Vancomycin/Vancocin

A

Vancomycin must be administered in a dilute solution over at least 60 minutes. This is to reduce the high incidence of pain at the infusion site and thrombophlebitis that is more likely to occur when the drug is more concentrated or when the delivery of the drug is too rapid.

240
Q

Go-to-drug for endocarditis and mrsa

A

Vancomycin/Vancocin

241
Q

associated complication with Vancomycin

A

associated with a complication reffered to as Red Man Syndrome or Red Neck Syndrome…characterized by intense facial flushing, diffuse erythema, and possible bullae formation and desquamation

242
Q

drug typically used to treat Mycobacterium infections, including tuberculosis and Hansen’s disease

A

Rifampicin/Rifampin

243
Q

Rifampicin is used as prophylactic therapy against

A

Neisseria meningitidis…also has role in treatment of MRSA

244
Q

MOA of Rifampicin/Rifampin

A

Rifampicin inhibits DNA-dependent RNA polymerase in bacterial cells thus preventing transcription to RNA and subsequent translation to proteins.

245
Q

Common side effects of Rifampicin

A

fever, GI disturbances and rash

246
Q

One of the most serious side effects of Rifampicin

A

hepatotoxicity and patients receiving Rifampicin should undergo baseline and frequent liver function tests to detect any signs of early liver damage.

247
Q

Rifaximin/Xifaxan has poor

A

bioavailability, meaning that very little of the drug will be absorbed into the blood stream when taken orally.

248
Q

Indication for Rifaximin/Xifaxan

A

treatment of traveler’s diarrhea, irritable bowel syndrome, small intestine overgrowth syndrome and hepatic encephalopathy.

249
Q

What does Rifampicin/Rifampin do to urine and tears?

A

turns them orange

250
Q

acceptable first line empiric choices for treating cellulitis

A

Clindamycin, a Cephalosporin or a Fluoroquinolone

251
Q

recommended monotherapy for presumed or confirmed cutaneous CA-MRSA infection

A

TMP-Sulfa DS

252
Q

drug of choice for SIBO

A

Rifaximin/Xifaxan

253
Q

Mupirocin/Bactroban is originally isolated from

A

Pseudomonas fluorescens

254
Q

MOA of Mupirocin/Bactroban

A

selective binding to bacterial isoleucyl-tRNA synthetase, which halts the incorporation of isoleucine into bacterial proteins.

255
Q

How is Mupirocin/Bactroban used

A

TOPICALLY and is primarily effective against Gram +

256
Q

Indication for Mupirocin/Bactroban

A

topical treatment for bacterial skin infections, such as impetigo, boils, and folliculitis. Mupirocin is also indicated for open wounds at risk for infection or after incision and drainage procedures of skin abscesses. Great success v. CA-MRSA too.

257
Q

Which drug has supplanted all other drugs for treating impetigo?

A

Mupirocin/Bactroban

258
Q

MOA of Bacitracin

A

interferes with the transfer of cell wall precursors from the bacterial cell membrane to the cell wall.

259
Q

What does Bacitracin target

A

Gram + bacteria

260
Q

Bacitracin is effective in treating

A

superficial infections of the skin and the eye.

261
Q

Class of Neomycin

A

aminoglycoside antibiotics

262
Q

How does aminoglycosides work

A

binding to the bacterial 30S ribosomal subunit, leaving the bacterium unable to synthesize proteins vital to its growth.

263
Q

Neomycin and other members of the aminoglycoside class are extremely effective in killing

A

Gram - bacteria

264
Q

Polymyxin B class

A

Poylmyxin group antibiotic

265
Q

MOA of Polymycin B

A

bind to the bacterial cell membrane and alters its structure, making it more permeable. Increased cell wall permeability results in marked water uptake by the bacterial cell and subsequent cell death.

266
Q

Polymycin is effective in treating

A

Gram - infections

267
Q

what drug has a risk profile that is too great to be used for an infection like Strep throat

A

aminoglycosides

268
Q

topical antibiotic that combines Bacitracin and Polymycin

A

Polysporin

269
Q

Neosporin contains

A

contains Bacitracin along with Neomycin and Polymyxin B, (hence, the term, ‘triple antibiotic’ ointment)

270
Q

topical antibiotics for superficial wounds

A

Polysporin and Neosporin

271
Q

Most common side effects of Polysporin/Neosporin

A

most commonly experienced side effect from the use of either topical Polysporin or Neosporin is skin irritation that may appear as redness, swelling, or a burning sensation. Hives may develop both at the site of application and elsewhere on the body. The most severe form of allergic response, anaphylaxis, can occur with symptoms such as difficulty swallowing and breathing.

Pharm 1 Jack (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions