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Therapeutics V Spring 2019 (P3 Spring) > Exam 2 - Cushman/Erdman (Drug Classes) CONTINUED > Flashcards

Exam 2 - Cushman/Erdman (Drug Classes) CONTINUED Flashcards

1
Q

Clindamycin is made from _________ (a naturally occuring abx)

A

from Lincomycin

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2
Q

Lincomycin –> clindamycin by adding

A

CHLORINE!! and Ph3P

Clindamycin has chlorine in its structure

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3
Q

Resistance in clindamycin is also seen in resistance of what drug class due to similar MOAs

A

macrolides

both bind to 50s ribosome

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4
Q

Clindamycin or Tetracyclines have the issues with Chelation?

A

Tetratcyclines

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5
Q

how to prevent chelation with tetracyclines?

A

take abx 1 - 2 hours before the multivalent metals

Dosage wise: package with EDTA - EDTA will chelate Ca2+!

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6
Q

Tetracyclines should be avoided in who because of the “teeth side effect”

A

kids! or pregnant women

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7
Q

how do tetracyclines affect teeth and what is the remaining effect

A

they chelate to Ca2+ during teeth formation leads to permanent gray/brown teeth

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8
Q

Tetracyclines used to have painful injections — this has been minimized how?

A

injectable formulations now have EDTA in it to chelate with the Ca2+ this way no insoluble Ca2+/tetracycline combos are administered

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9
Q

what two orgo reactions can occur to make tetracycline in active

A

epimerization and dehydration

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10
Q

which orgo reaction to tetracycline will create a toxic substance to the kidneys and what is that substance

A

dehydration will create “4-EpiANHYDROtetracycline” = v toxic to da kidneys

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11
Q

if a tetracycline lacks a _______ group there is no chance of forming the kidney toxic molecule of 4-epianhydrotetracycline

A

lack a 6-OH group

this beneficial adaption is seen in minocycline, doxycycline, tigecycline

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12
Q

which tetracycline has vestibular toxicities (vertigo, ataxia, nausea)
*these ADEs are not seen in other tetracyclines

A

minocycline

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13
Q

which tetracycline has a bunch of drug interactions (per cushman lecture)

A

Sarecycline

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14
Q

what are the Saracycline drug interactions

A

do not give with oral retinoids, antacids, iron preperations
can affect PCNs (make PCNs less effective)
dose reduce anticoags and PgP substrates

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15
Q

what is the really serious ADE with chloramphenicol

A

aplastic anemia

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16
Q

what are the 1st gen quinolones

A

Oxolinic acid

Nalidixic acid

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17
Q

what are the 2nd gen quinolones

A

Ciprofloxacin

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18
Q

what are the 3rd/4th gen quinolones

A

Levofloxacin, Moxifloxacin, Delafloxacin

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19
Q

what structure things differentiate 1st vs 2nd/3rd/4th gen quinolones

A

2/3/4 all have a -F group at pos. 6 and a ring with some nitrogen at pos. 7

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20
Q

what quinolone is a weirdo and has a side effect of hyperglycemia and hypoglycemia in diabetic pts

A

Gatifloxaxin

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21
Q

what drugs are tetracyclines

A

tetracycline
doxycycline
minocycline

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22
Q

what drugs are glycylcyclines

A

tigecycline

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23
Q

what drugs are sulfonamides

A

SMX-TMP

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24
Q

what drugs are polymycins

A

Colistin

Polymixin B

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25
Q

what drugs are lincosamides

A

Clindamyacin

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26
Q

what drugs are Nitromidazoles

A

metronidazole

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27
Q

different b/w minocycline and teglecycline

A

tegecycline = glycylamindo moiety added to position 9

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28
Q

what are the two main major mechanisms of resistance for tetracyclines

A

tetracycline specific efflux pumps

decrease access to ribosome via ribosomal protection proteins

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29
Q

which -cycline is usually resistant to the 2 major resistance mechanisms

A

tigecycline (resistance seen when multi drug efflux pu,p)

30
Q

what two things does Tigecycline NOT cover

A

Pseduomonas!!

Proteus

31
Q

what drugs cause QT prolongation

A

FQs
Macrolides
Telavancin

32
Q

what drugs notably cause thrombophlebitis

A

vanco
Macrolides
synercid

33
Q

what drugs causes myopathy

A

synercid

daptomyocin

34
Q

what drug cause acute eosinophilic pneumnoa

A

daptomyocin (aka why dont use in pneumonia)

35
Q

what drugs cause peripheral neuropathy

A

Linezolid
FQs
Metronidazole

36
Q

what drugs have an alcohol reaction

A

metronidazole

cefotetan (NMTT side chain)

37
Q

what drugs should not be used in pregnancy

A 
SMZ-TMP
Lipoglycopeptides (black box: Telavancin)
Metronidazole
FQs
Tetracyclines
38
Q

what drugs have CYP interactions

A

Synercid

Macrolides (not azithromycin)

39
Q

what drugs go into the CSF

A 
ALL PCNs
Cephs: parenteral cefuroxine/3rd/4th gen
Meropenem
Aztreonam
Vancy
SMZ-TMP
Linezolid
Metronidazole
40
Q

what drugs are chelators

A

FQs

Tetracyclines

41
Q

ADEs of tetracyclines

A

Nausea/Vomiting
Photosensitivity
Pregnancy risk (teeth color weirdness)

42
Q

explain the MOA of SMZ-TMP

A

PABA –> Dihydrofolic acid –> Tetrahydrofolic acid –> Purines (U) –> Thymine – > DNA

SMZ inhibits 1st step and TMP inhibits 2nd step

43
Q

SMZ-TMP does not cover ______ or _____

A

not pseudomonas

NO anaerobes

44
Q

SMZ-TMP is DOC for what

A

pneumocystis carinii/jirovecci

45
Q

ADEs of SMZ-TMP

A

hypersensitivity
Pregnancy - billirubin issue
Renal insufficiency/hyperkalemia/crystalluria

46
Q 
Polymyxins:
Cover only one of the following - which one?
Gram +
Gram -
or
Anaerobes
A

ONLY gram -

only target organism is Pseudomonas

47
Q

what Gram - bugs do POLYMYXINS not cover

A

proteus
providencia
serratia
(bruella, burkholderia)

48
Q

dosing for Polymyxins – use what weight for parenteral dosing

A

IBW (aka LBW)

49
Q

Clindamycin: Distribution

Gets into ______ but not ____

A

bone - yes

CSF - no

50
Q

Clindamycin: Renal or Liver?

51
Q

ADEs of clindamycin

A

C.Diff inducer!!

Hepatoxicity

52
Q 
Metronidazole:
Cover only one of the following - which one?
Gram +
Gram -
or
Anaerobes
A

only anaerobes

target wise: BDA and C.diff only!

53
Q

Metronidazole:

into CSF?

54
Q

ADEs of metronidazole?

A

metallic taste
peripheral neuropathy
Pregnancy caution - teratogenic
(disulfiram and warfarin)

55
Q

Disinfectant, Sterilant, or Antiseptic?

Chlorhexidine

A

antiseptic

56
Q

Disinfectant, Sterilant, or Antiseptic?

Povidone-Iodine

A

antiseptic

57
Q

Disinfectant, Sterilant, or Antiseptic?

iodine

A

antiseptic

58
Q

Disinfectant, Sterilant, or Antiseptic?

Bleach

A

disinfectant

59
Q

Disinfectant, Sterilant, or Antiseptic?

halazone

A

disinfect (for water)

60
Q

Disinfectant, Sterilant, or Antiseptic?

NaDCC

A

disinfectant (for water and better than halazone)

61
Q

Disinfectant, Sterilant, or Antiseptic?

Phenols

62
Q

Disinfectant, Sterilant, or Antiseptic?

Quaternary Ammonium Compounds

A

used ONLY for Gram + bugs

THUS do not use as antiseptic bc could cause infections if used as antiseptic…

63
Q

Disinfectant, Sterilant, or Antiseptic?

Aldehydes

A

Sterilant

carcinogenic

64
Q

Disinfectant, Sterilant, or Antiseptic?

Peroxygen compounds

A

disinfectants/sterilants

65
Q

Disinfectant, Sterilant, or Antiseptic?

Ethylene oxide

A

EXPLOSIVE!
Sterilant
so tiny it get through packaging

66
Q

Disinfectant, Sterilant, or Antiseptic?

heavy metals

A

disinfectant

67
Q

Methylparaben /Propyl paraben cover what

A

yeasts and molds

68
Q

Definition - Disinfectant?

A

kills every but spores (on inanimate objects)

69
Q

Definition - Sterilant?

A

kills everything even spores (inanimate objects)

70
Q

Definition - Antiseptic

A

use on living tissues

Therapeutics V Spring 2019 (P3 Spring) (27 decks)

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