Exam #3 Pharm Flashcards
1
Q
B-lactams MOA
A
MOA: bind PBP (transpeptidase) inhibiting peptidoglycan wall synthesis
-bactericidal
2
Q
Penicillins overall side effects
A
- Hypersensitivity
- GI Distress (naseau, vomiting, diarrhea)
- Nephrotoxicity
- Neurotoxicity (seizures)
- Hematologic Toxicity (Drug induced hemolytic anemia)
3
Q
drugs of choice for syphilis and Actinomyces infections
A
Penicillin G/V
4
Q
Amp/Amox are given for? (organisms)
A
HHELPSS kill enterococci H inlfluenzae H pylori E coli Listeria Proteus Salmonella Shigella Enterococci
5
Q
Naficillin adverse effects
A
Leukpenia
inflammation of injection sight
6
Q
Oxacillin adverse effects
A
inc liver enzymes
7
Q
piperacillin-tazobactam has a synergistic nephrotoxic effect when paired w
A
vanomycin
8
Q
Piperacillin adverse effects
A
leukopenia
thrombocytopenia
hepatitis
9
Q
Ticarcillin adverse effects
A
- associated w CHF (high Na+)
- thrombocytopenia
- hypokalemia
10
Q
Piperacillin and Ticarcillin cover
A
pseudomonas
gram neg rods
11
Q
1st Gen cyclosporins covers
A
- gram + cocci
- PEcK (Proteus, E. coli, Klebsiella)
12
Q
2nd Gen cyclosporins cover
A
HENS PEcK
- H influenzae
- Enterobacter
- Neisseria
- Serratia
- (Proteus, E. coli, Klebsiella)
13
Q
Cefotetan adverse effect
A
Hematological toxicities
disulfiram = flushing
14
Q
workhorse of the cyclosporins?
A
3rd gen
15
Q
Which cyclosporins cover Pseudomonas and Gram - aerobes
A
Ceftazidime
Cefapime
16
Q
which cyclosporin can cover MRSA
A
ceftaroline
17
Q
Imipenem-cilastatin adverse effects
A
Seizures
18
Q
why is Cilastatin given w imipenem
A
prevents imipenem degradation by renal tubule brush border dehydropeptidase
19
Q
Reserved for use in resistant Gram negative rod infections and complicated polymicrobial infections
A
carbapenems
20
Q
what do you give if allergic to penicillins
A
monobactams (Aztreonam)
21
Q
monobactams (Aztreonam) adverse effects
A
neutropenia in children
22
Q
monobactams (Aztreonam) work against
A
gram - rods ONLY
pseudomonas
23
Q
vancomycin adverse effects
A
- Red Man Syndrome
- nephrotoxicity
- ototoxicity
24
Q
Vancomycin treats
A
MRSA
Staph epi
C. diff
Enterococci
25
Vancomycin MOA
blocks glycopeptide polymerization preventing bacterial wall synthesis
26
Daptomycin MOA
put pores in cell membrane leading to depolarization and cell death
27
Daptomycin adverse effects
Myopathy
| -dont give for pulmonary infections
28
Tetracyclines MOA
binds 30s subunit preventing tRNA from binding
| -bacteriostatic
29
Tetracyclines include
Demeclocycline
Minocycline
Deoxycycline
Tetracycline
30
tetracyclines adverse effects
- GI disturbances
- Deposition in bones and teeth
- Phototoxicity
- Vertigo
31
Demeclocycline is used for
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
32
minocycline adverse effect
skin pigmentation when used for long periods of time
33
Tigecycline MOA
Reversibly binding to 30s ribosome and inhibiting protein synthesis
-bacteriostatic
34
Aminoglyosides include
```
Amikacin
Gentamicin
Neomycin
Streptomycin
Tobramycin
```
35
Aminoglyosides MOA
Binds to and distorts 30s ribosomal subunit causing misreading and disrupting protein synthesis
36
what is the most effective way to gives Aminoglycoside
Single large dose
| -post-antibiotic effects where killing continues to occur after plasma level decline
37
Aminoglycoside adverse effects
Ototoxicity
Nephrotoxicity
Paralysis
Skin rash
38
Aminoglycosides cannot be given for
anaerobes
39
most active aminoglycoside against pseudomonas
Tobramycin
40
Macrolides MOA
Bind to 50s ribosomal subunit inhibition translocation
| -"macroslides"
41
Macrolide Adverse Effects
```
GI disturbances
Jaundice
Ototoxicity
Prolonged QT interval
Hepatotoxicity
P450 inhibitor
```
42
atypical pneumonia treatment
macrolides
43
STD treatment
macrolides
44
Prolonged QT drugs
macrolide
| fluoroquinolone
45
respiratory tract infections treatment
macrolides
46
what drugs shouldn't be given with colchicine
Clarithromycin
| Telithromycin
47
What shouldn't be given if patient has jaundice/hepatitis
macrolides
48
What drugs are BIG P450 inhibits
macrolides
49
Treatment of Clostridioides difficile infection
Fidaxomicin
| Vancomycin
50
Fidaxomicin MOA
inhibits RNA polymerase preventing protein synthesis
| -bactericidal
51
Clindamycin MOA
Bind to 50s ribosomal subunit inhibition translocation
| -bacteriostatic
52
Clindamycin adverse effect
can cause C. diff
53
inhibits bacterial toxin production
clindamycin
54
treats anaerobic infections above diaphragm
clindamycin
55
Linezolid MOA
Bind to 23s ribosomal subunit of 50s inhibiting formation of 70s initiation complex and protein synthesis
56
linezolid adverse effects
- serotonin syndrome
- bone marrow suppression (thrombocytopenia)
- peripheral neuropathy
- retinopathy
57
Chloramphenicol MOA
binds 50s subunit preventing amino acids from being transferred to peptide chain
58
Chloramphenicol adverse effects
- GRAY Syndrome
- aplastic anemia
- optic neuritis
59
STREPTOGRAMINS include
quinupristin
| dalfopristin
60
STREPTOGRAMINS are active against
penicillin-resistant pneumococci, methicillin-resistant (MRSA) and vancomycin-resistant staphylococci (VRSA), and resistant E faecium
61
STREPTOGRAMINS adverse effects
-arthralgia-myalgia syndrome
62
chlorampenicol is broken down by
hepatic glucuronosyltransferase
63
chlorampenicol is used for
meningitis
| rickettsia infections
64
SULFONAMIDES MOA
inhibit dihydropteroate synthase
65
trimethoprim MOA
inhibitor of dihydrofolate reductase
66
drug of choice for nocardia
antifolate
67
sulfamethoxazole adverse effects
```
Hypersensitivity
GI issues
Hematotoxicity
Nephrotoxicity
interact w warfarin and methotrexate
```
68
Trimethoprim adverse effects
- folate def. (pregnancy)
- megaloblastic anemia
- hyperkalemia
69
Fluoroquinolones MOA
- inhibit topoisomerase II (DNA gyrase)
- inhibit topoisomerase IV
**bactericidal
70
Steven Johnson Syndrome can by causes by
Trimethoprim
| Amp/Amox
71
... increase the plasma levels of theophylline and other methylxanthines, enhancing their toxicity
fluoroquinolone
72
fluoroquinolone adverse effects
- TENDON rupture
- prolonged QT interval
- GI distress
- headache
- seizures
- phototoxicity
73
major drugs used in tuberculosis
```
isoniazid (INH)
rifampin
ethambutol
pyrazinamide
streptomycin
```
74
isoniazid MOA
binds B-ketoacyl acid synthase preventing synthesis of mycolic acid
75
all RIPE drugs cause
hepatitis
76
isoniazid can inhibit the metabolism of
carbamazepine and phenytoin
77
isoniazid (INH) adverse effects
hepatitis
peripheral neuropathy
seizures
**INH Injure Neurons and Hepatocytes
78
rifampin MOA
blocks DNA-dependent RNA polymerase
79
single treatment for latent Tb
isoniazid
80
which drug do you not want to give to rapid acetylators
isoniazid
81
highly active against M. leprae
rifampin
82
rifampin adverse effects
hepatitis
orange sweat, urine, tears
P450 inducer
83
preferred for TB patients connected with HIV
rifabutin
84
PYRAZINAMIDE contraindications
gout
| hepatic damage
85
Ethambutol MOA
inhibits arabinosyl transferases involved in the synthesis of arabinogalactan preventing cell wall formation
86
ethambutol adverse effects
- optic neuritis
- VISUAL acuity and color discrimination
- uric acid retention
87
Mycobacterium avium complex treatment
Azithromycin/Clarithromycin
| ethambutol
88
Dapsone MOA
inhibits dihydropteroate synthase in the folate synthesis pathway
89
M. leprae treatment
Dapsone + rifampin
90
Dapsone Adverse Effects
hemolysis
methemoglobinemia
peripheral neuropathy
91
Prophylaxis and treatment of disseminated mycobacterial infections due to Mycobacterium avium complex (MAC)
Azithromycin
| Clarithromycin
92
Clofazimine use and adverse effects
Use: multibacillary leprosy in combination with other drugs
| Adverse effects: pink-brown-blackish skin discoloration
93
SABAs and LABAs side effect
tremors
94
LABAs names
salmeterol
formoterol
indacaterol
95
Asthma drugs that have milk hypersensitivities as contraindications
salmetrol
fluticasone
mometasone
96
LABAs mainly used for COPD
Indacaterol
97
Theophylline's MOAs
1. Inhibits PDE3 > PDE4 leading to reduced cAMP breakdown
2. Adenosine receptor blocker: preventing bronchoconstriction
3. Histone deacetylase activator: prevents transcription of inflammatory genes
98
Theophylline adverse effects
Narrow therapeutic index
Seizure
Arrhythmia
99
Ipratropium MOA (asthma drug)
inhibits muscarinic Ach receptor leading to dec parasympathetic system (bronchoconstriction and secretions)
100
Ipratropium adverse effect
dry mouth bc muscarinic antagonist
101
Corticosteroid names
Beclomethasone
Budesonide
Fluticasone
Mometasone
102
Corticosteroid MOAs
1. Controls rate of protein synthesis by binding glucocorticoid response elements (GRE)
2. Depress migration of polymorphonuclear leukocytes, fibroblasts
3. Reverses capillary permeability and lysosomal stabilization at the cellular level to prevent or control inflammation
103
Cromolyn MOA
inhibits mast cell degranulation (histamine, leukotrienes, and slow-reacting substance of anaphylaxis)
104
Cromolyn adverse effect
cough
105
Omalizumab MOA
monoclonal antibody that selectively binds to the Fc portion of human IgE preventing mast cell sensitization
Pharmacokinetics: 12-16 week onset
106
Montelukast MOA
selective antagonist of the cysteine leukotriene-1 receptor not allowing for inflammatory bronchoconstriction to occur
107
Montelukast adverse effect
Cough
| Elevated serum hepatic enzymes
108
Zileuton MOA
selective inhibition of 5-lipoxygenase preventing the formation of both LTB4 and cysteinyl leukotrienes
109
Zileuton adverse effect
Headaches
| Hepatotoxicity
110
Roflumilast MOA and indication
MOA: selectively inhibit PDE4 in the lungs leading to dec inflammation (unlike other PDE inhibitors which inc cAMP and bronchodilation)
COPD exclusively`
111
what to not give COPD patient s and why
- inhaled corticoid steriods
| - risk of bacterial pneumonia
112
Theophylline use in COPD
inc diaphragm contractility
113
Progression of meds for asthma
1. SABA
2. Low Dose ICS
3. Low Dose ICS + LABA
4. Medium Dose ICS + LABA
5. High Dose ICS + LABA
6. High Dose ICS + LABA + oral corticosteroid
114
#1 for CHF
Furosemide
115
#1 for HTN
hydrochlorothiazide
116
increase COX expression
Furosemide
117
Don't give for hyperglycemia and hyperlipidemia
hydrochlorothiazide
118
Metabolic acidosis causing diuretic
acetozalomide
| spironolactone
119
Metabolic alkalosis causing diuretic
furosemide
| hydrochlorothiazide
120
Acetazolamide indication
glaucoma
altitude sickness
enhance excretion of weak acid drugs
121
Furosemide electrolytes
dec Mg, Ca, K
122
Hydrochlorothiazide electrolytes
inc Ca
| dec K
123
sulfa drugs
furosemide
| hydrochlorothiazide
124
diuretic increase risk for gout
furosemide
125
ototoxic diuretic
furosemide
126
diuretic that inc lithium levels
furosemide
127
spironolactone adverse effects
gynecomastia
| renal failure
128
#1 for hyperaldosteronism
spironolactone
129
Liddles syndrome treatment
spironolactone
130
ENaC inhibitors
amiloride
| triamterene
131
emergency reduction of intracranial pressure treatment
mannitol
132
Mannitol adverse effects
CHF exacerbation
133
V2 only antagonist
tolvaptan
134
V1 and V2 antagonist
conivaptan
135
treat staph and E. coli UTIs
nitrofurantoin
136
treats complicated and uncomplicated UTIs
fosfomycin
137
Cryptococcus treatment
Amp B
| fluconazole
138
headache main side effect
Zileuton
| terbinafine
139
Amp B adverse effects
| MOA
fever/chills
| MOA: pores in cell wall
140
phototoxic
tetracyclines
| fluoroquines
141
p450 inducers
rifampin
| griseofulvin
142
P450 inhbitors
macrolides
streptogramins (Quinupristin-dalfopristin)
all azoles
143
can give for MRSA
```
vanco
dapto
linezolid
5th gen
clindamycin
```
144
hepatotoxic
macrolides
| voriconazole
145
post antibiotic effect
aminoglycosides
146
cilastin is given w
imipenem
147
tazobactam is given w
pipercillin
148
SJS
ampicillin
| amoxicillin
149
arthralgia/myalgia syndrome
quinipristin/dalfopristin
150
SIADH
demecyclin
151
paralysis
aminoglycosides
152
statins colchine theophylline
erythromycin
clarithromycin
azithromycin
telithromycin
153
glucoronocyltransferase
chlorophenicol
154
Nocardia treatment
TRM-SMX
155
hypokalemia
tigarcillin
156
hyperkalemia
trimethromine
157
dont use on scalp
ketoconazole
158
lysosomes
amp B
159
b glucans
fungins
160
BRC/ABL
imatinib
161
EGRF tyrosine kinase
Erlotinib
162
B-raf and cancer
Vemurafenib
| -melanoma
163
EGFR monoclonal antibody
Cetuximab
164
HER2
Trastuzumab
165
cardiotoxic monoclonal antibody
trastuzmab
166
Don’t give tizanidine w
Ciprofloxacin
167
Don’t give w porphyria
Griseofulvin
