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Therapeutics 5 Kappa Epsilon > 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
what drugs are lincosamides
Clindamyacin
26
what drugs are Nitromidazoles
metronidazole
27
different b/w minocycline and teglecycline
tegecycline = glycylamindo moiety added to position 9
28
what are the two main major mechanisms of resistance for tetracyclines
tetracycline specific efflux pumps | decrease access to ribosome via ribosomal protection proteins
29
which -cycline is usually resistant to the 2 major resistance mechanisms
tigecycline (resistance seen when multi drug efflux pu,p)
30
what two things does Tigecycline NOT cover
Pseduomonas!! | Proteus
31
what drugs cause QT prolongation
FQs Macrolides Telavancin
32
what drugs notably cause thrombophlebitis
vanco Macrolides synercid
33
what drugs causes myopathy
synercid | daptomyocin
34
what drug cause acute eosinophilic pneumnoa
daptomyocin (aka why dont use in pneumonia)
35
what drugs cause peripheral neuropathy
Linezolid FQs Metronidazole
36
what drugs have an alcohol reaction
metronidazole | cefotetan (NMTT side chain)
37
what drugs should not be used in pregnancy
``` SMZ-TMP Lipoglycopeptides (black box: Telavancin) Metronidazole FQs Tetracyclines ```
38
what drugs have CYP interactions
Synercid | Macrolides (not azithromycin)
39
what drugs go into the CSF
``` ALL PCNs Cephs: parenteral cefuroxine/3rd/4th gen Meropenem Aztreonam Vancy SMZ-TMP Linezolid Metronidazole ```
40
what drugs are chelators
FQs | Tetracyclines
41
ADEs of tetracyclines
Nausea/Vomiting Photosensitivity Pregnancy risk (teeth color weirdness)
42
explain the MOA of SMZ-TMP
PABA --> Dihydrofolic acid --> Tetrahydrofolic acid --> Purines (U) --> Thymine -- > DNA SMZ inhibits 1st step and TMP inhibits 2nd step
43
SMZ-TMP does not cover ______ or _____
not pseudomonas | NO anaerobes
44
SMZ-TMP is DOC for what
pneumocystis carinii/jirovecci
45
ADEs of SMZ-TMP
hypersensitivity Pregnancy - billirubin issue Renal insufficiency/hyperkalemia/crystalluria
46
``` Polymyxins: Cover only one of the following - which one? Gram + Gram - or Anaerobes ```
ONLY gram - | only target organism is Pseudomonas
47
what Gram - bugs do POLYMYXINS not cover
proteus providencia serratia (bruella, burkholderia)
48
dosing for Polymyxins -- use what weight for parenteral dosing
IBW (aka LBW)
49
Clindamycin: Distribution | Gets into ______ but not ____
bone - yes | CSF - no
50
Clindamycin: Renal or Liver?
liver!!
51
ADEs of clindamycin
C.Diff inducer!! | Hepatoxicity
52
``` Metronidazole: Cover only one of the following - which one? Gram + Gram - or Anaerobes ```
only anaerobes | target wise: BDA and C.diff only!
53
Metronidazole: | into CSF?
yes!
54
ADEs of metronidazole?
metallic taste peripheral neuropathy Pregnancy caution - teratogenic (disulfiram and warfarin)
55
Disinfectant, Sterilant, or Antiseptic? | Chlorhexidine
antiseptic
56
Disinfectant, Sterilant, or Antiseptic? | Povidone-Iodine
antiseptic
57
Disinfectant, Sterilant, or Antiseptic? | iodine
antiseptic
58
Disinfectant, Sterilant, or Antiseptic? | Bleach
disinfectant
59
Disinfectant, Sterilant, or Antiseptic? | halazone
disinfect (for water)
60
Disinfectant, Sterilant, or Antiseptic? | NaDCC
disinfectant (for water and better than halazone)
61
Disinfectant, Sterilant, or Antiseptic? | Phenols
disinfect
62
Disinfectant, Sterilant, or Antiseptic? | Quaternary Ammonium Compounds
used ONLY for Gram + bugs | THUS do not use as antiseptic bc could cause infections if used as antiseptic...
63
Disinfectant, Sterilant, or Antiseptic? | Aldehydes
Sterilant | carcinogenic
64
Disinfectant, Sterilant, or Antiseptic? | Peroxygen compounds
disinfectants/sterilants
65
Disinfectant, Sterilant, or Antiseptic? | Ethylene oxide
EXPLOSIVE! Sterilant so tiny it get through packaging
66
Disinfectant, Sterilant, or Antiseptic? | heavy metals
disinfectant
67
Methylparaben /Propyl paraben cover what
yeasts and molds
68
Definition - Disinfectant?
kills every but spores (on inanimate objects)
69
Definition - Sterilant?
kills everything even spores (inanimate objects)
70
Definition - Antiseptic
use on living tissues

Therapeutics 5 Kappa Epsilon (27 decks)

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