Exam 2 Pharm Flashcards

1
Q

Tx for fungal infections

A

ketoconazole or fluconazole

amphotericin B for pregnancy

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2
Q

Tx for allergic pulmonary aspergillosis

A

corticosteroids

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3
Q

Tx for Pneumocystis jirvocei

A

TMP-SMX aka bactrim

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4
Q

Tx for Paragonimus westermani

A

praziquantal

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5
Q

Tx for strep pneumo

A

ampicillin

erythromycin/azithromycin

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6
Q

Tx for klebsiella

A

gentamicin

ciprofloxacin

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7
Q

Tx for chlamydophila pneumonia

A

erythromycin/azithromycin

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8
Q

Tx for bacillus anthracis

A

pencillin/doxycycline

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9
Q

Tx for yersinia pestis

A

streptomycin/gentamicin
tetracycline/doxycycline
chloramphenicol

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10
Q

Tx for TB

A

RIfampin
Isoniazid
Pyrazinamide
Ethambutol

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11
Q

Tx for nocardia

A

IV TMP-SMX

linezolid

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12
Q

Tx for diphtheria

A

penicillin

erythromycin

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13
Q

Tx for pertussis

A

erythromycin

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14
Q

Diphtheria prevention

A

DTaP-5 doses for children
Tdap-adults single dose
Td-10 yr booster
DT-no pertussis vaccine

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15
Q

MOA of fluoroquinolones

A

prevents topoisomerase II in gram (-) (gyrase)
prevents topoisomerase IV in gram (+) (separates)
bactericidal, blocks DNA synthesis

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16
Q

Types of resistance to fluoroquinolones

A

GyrA/GyrB pt mutation- decrease binding to DNA gyrase
ParC/ParE pt mutation-decrease topoisomerase IV binding
increased efflux/decreased influx
plasmid resistance (inhibits fluoroquinolones)

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17
Q

Fluoroquinolones for gram (-)

A

ciprofloxacin

levofloxacin

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18
Q

Fluoroquinolones for gram (+)

A

moxifloxacin

gemifloxacin

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19
Q

Fluoroquinolones for respiratory infections

A

levo/moxi/gemifloxacin

not ciprofloxacin

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20
Q

Fluroquinolones for anaerobic infection

A

moxifloxacin

21
Q

Metabolism of fluoroquinolones

A

cipro/levo/gemifloxacin by kidneys

moxifloxacin by liver

22
Q

Absorption of fluoroquinolones

A

inhibited by cations

forms complexes

23
Q

Fluoroquinolones for nosocomial pneumonia

A

ciprofloxacin

levofloxacin

24
Q

Fluoroquinolone for UTI

A
not moxifloxacin (liver metabolism)
cipro/levofloxacin
25
Q

Fluoroquinolones for skin infection

A

levo and moxifloxacin

26
Q

Adverse effects of fluroquinolones

A
QT prolongation
tendonitis/ruptured tendons (cartilage deg)
peripheral neuropathy (inhibits GABA in CNS)
photosensitivity
27
Q

MOA of macrolides

A

attaches to 50s subunit of ribosome
no protein synthesis
bacteriostatic
affinity for domain V of 23s RNA

28
Q

MOA of ketolides

A

binds 50s rRNA

binds domain V and domain II of 23s RNA

29
Q

Resistance to macrolides

A

decreased permeability/increased efflux (gram +)
methylation of binding site (erm gene, gram +)
hydrolyzation by esterases at lactone ring (ere gene)

30
Q

Absorption of macrolides

A

erythromycin is acid labile

others are acid stable

31
Q

Metabolism of macrolides

A

all by CYP3A4 except azithromycin
clarithromycin has some renal excretion
azithromycin has long t1/2

32
Q

Best macrolides for gram (+)

A

telithromycin/clarithromycin/erythromycin/azithromycin

in descending order of effectiveness

33
Q

Best macrolides for gram (-)

A

telithromycin/azithromycin/clarithromycin/erythromycin

in descending order of effectiveness

34
Q

Adverse effects of macrolides

A

QT prolongation
myasthenia gravis
liver failure (especially telithromycin)
ototoxicity (erythromycin)

35
Q

Drugs contraindicated with macrolides

A
theophylline
warfarin
CCB's
cyclosporine
digoxin
36
Q

MOA of linezolid

A

binds 50s rRNA
inhibits complex formation with fmet-tRNA/mRNA
bacteriostatic
no cross resistance

37
Q

Resistance to linezolid

A

mutation at binding site on 23s RNA

38
Q

Adverse effects of linezolid

A

thrombocytopenia

lactic acidosis

39
Q

Level I tx for strep pneumo

A

erythro/azithro/clarithromycin

40
Q

Level I tx for strep pneumo with comorbidities

A

respiratory fluoroquinolones OR

beta lactams + macrolides

41
Q

Level I tx for inpatient ICU-CAP

A

respiratory fluoroquinolones

42
Q

Tx for acute sinusitis

A

amoxicillin

TMP-SMX

43
Q

Tx for chronic sinusitis

A

clindamycin
cefazolin or cefuroxime + metronidazole
clarithromycin
fluoroquinolones

44
Q

Tx for pharyngitis

A

penicillin G Benzathine (intramuscular)

penicillin V

45
Q

Antibiotics for COPD

A

TMP-SMX
doxycycline
azithro/clarithromycin

46
Q

Tx for penicillin resistant strep pneumo

A

doxycycline
clindamycin
levofloxacin

47
Q

Tx for legionnaires disease

A

tigecycline
fluoroquinolones
azithromycin

48
Q

Tx for MRSA caused pneumonia

A

linezolid
vancomycin
tigecycline