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Exam 4 Drugs Flashcards

1
Q

What type of drug is prednisone?

A

Anti-inflammatory agent: Glucocorticoids

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2
Q

What type of drug is Zafirlukast?

A

Anti-inflammatory agent: Leukotriene Modifiers

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3
Q

What type of drug is Cromolyn?

A

Anti-inflammatory agent: Mast Cell Stabilizers

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4
Q

What type of drug is albuterol?

A

Bronchodilators: Beta2 agonists

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5
Q

What type of drug is Theophylline?

A

Bronchodilators: Methylxanthines

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6
Q

What type of drug is Atrovent?

A

Bronchodilators: Anticholinergics

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7
Q

What type of drug is Budesonide (Plumicort)?

A

Anti inflammatory drugs: Glucocorticoids

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8
Q

What type of drug is Fluticasone (Flovent)?

A

Anti inflammatory drugs: Glucocorticoids

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9
Q

Most effective anti-asthma drugs available for long term use

A

Glucocorticoids

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10
Q

Function of glucocorticoids

A

Reduce airway mucous production
Increase number of bronchial beta2 receptors
Increase beta2 receptor responsiveness to beta2 antagonists

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11
Q

How are glucocorticoids administered

A

Usually inhalation
IV for acute conditions
PO for long term preventative use

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12
Q

Mechanism of action of glucocorticoids

A

Suppress inflammation:
- Decrease synthesis/production & release of inflammatory mediators
- Decrease infiltration & activity of inflammatory cells
- Decrease edema of the airway mucosa

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13
Q

What are glucocorticoids used for?

A

Prophylaxis of chronic asthma and managing COPD

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14
Q

What should dosing of glucocorticoids be like?

A

Must be on a fixed schedule, not PRN

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15
Q

Adverse effects of PO glucocorticoids

A

Adverse effects are minor when taken acutely

Long term effects:
- Adrenal suppression
- Osteoporosis
- Hyperglycemia
- PUD

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16
Q

Adverse effects of inhaled glucocorticoids

A

If pt does not gargle after use:
- Oropharyngeal candidiasis
- Dysphonia hoarseness

Promotion of bone loss
Increased risk of cataracts
Increased risk of glaucoma

In children/adolescents: can slow growth

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17
Q

Action of leukotriene modifiers

A

Suppress effects of leukotrienes
(to prevent process of bronchoconstriction and inflammatory responses - such as edema and mucous secretion)

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18
Q

Most commonly used leukotriene modifier

A

*Montelukast (Singulair)

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19
Q

Other types of leukotriene modifiers

A

Zileuton (Zyflo)
Zafirlukast (Accolate)

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20
Q

Adverse effects of leukotriene modifiers

A

Neuropsychiatric effects:
- Depression
- Suicidal thinking
- Suicidal behavior

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21
Q

Most common type of mast cell stabilizer

A

Cromolyn

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22
Q

What is Cromolyn used for?

A

Prophylaxis, not quick relief of:
- Chronic asthma
- Exercise-induced bronchospasm
- Allergic rhinitis

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23
Q

Action of Cromolyn

A

*Suppresses bronchial inflammation (not a bronchodilator)

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24
Q

Routes for Cromolyn

A

Inhalation
Nebulizer
MDI

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25
Q

Adverse effects of Cromolyn

A

Cough
Bronchospasm

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26
Q

Safest of all anti asthma medications

A

Cromolyn

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27
Q

Used for symptomatic relief of asthma or COPD flare ups

A

Bronchodilators

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28
Q

Types of beta2 adrenergic agonist bronchodilators

A

Albuterol
Salmeterol
Terbutaline

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29
Q

What are beta2 adrenergic agonists most effective for?

A

Relief of acute bronchospasm
Prevention of exercise-induced bronchospasm

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30
Q

How are beta2 adrenergic agonists used for asthma?

A

For quick relief and long term control

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31
Q

Mechanism of action of beta2 adrenergic agonists

A

Activate beta2 receptors in smooth muscle of the lung
Promote *bronchodilation, relieving bronchospasm

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32
Q

Two types of beta2 adrenergic agonists

A

Short acting beta 2 agonists (SABAs)
Long acting beta 2 agonists (LABAs)

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33
Q

What are SABAs used for?

A

PRN for attacks

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34
Q

What are LABAs used for?

A

For long term control

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35
Q

Types of SABAs

A

Albuterol
Proventil

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36
Q

Adverse effects of SABAs

A

Tachycardia
Angina
Tremor

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37
Q

Types of LABAs

A

Acilidinium bromide (Tudorza)
Salmeterol (Serevent diskus)

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38
Q

Adverse effects of LABAs

A

May increase asthma (because of LABAs)

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39
Q

Adverse effects of inhaled beta2-adrenergic agonists

A

Tachycardia
Angina
Tremor

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40
Q

Adverse effects of oral beta2 adrenergic agonists

A

Angina pectoris
Tachydysrhythmias
Tremor

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41
Q

Prototype Methylxanthines

A

Theophylline

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42
Q

Therapeutic window for theophylline

A

10-20 mcg/mL

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43
Q

Other Methylxanthines

A

Aminophylline
Dyphylline

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44
Q

Brand names of glucocorticoid/LABA combinations

A

Advair
Symbicort

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45
Q

Prototype anticholinergic drug

A

Ipitropium (Atrovent)

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46
Q

Adverse effect of Ipratropium (Atrovent)

A

Dry mouth
Sore pharynx

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47
Q

Initial therapy for acute severe exacerbations of asthma

A

Oxygen
Systemic glucocorticoid
Nebulizer high dose SABA

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48
Q

Drugs used for exercise induced asthma

A

SABAs (first choice)
Or Cromolyn

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49
Q

Drugs used to manage stable COPD

A

Bronchodilators
Glucocorticoids
Phosphodiesterase 4 inhibitors

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50
Q

Drugs used to manage acute COPD

A

SABAs (inhaled)
Alone or with inhaled Anticholinergics

Systemic glucocorticoids
Antibiotics

Supplemental oxygen

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51
Q

Class that Aspirin belongs to

A

First generation NSAIDs

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52
Q

Action of aspirin

A

Nonselective inhibitor of cyclooxygenase

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53
Q

Uses of aspirin

A

Analgesic
Antipyretic
Anti inflammatory

Suppression of platelet aggregation
Protects from MI and stroke

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54
Q

Adverse effects of aspirin

A

GI upset
GI bleeding
Renal impairment
Salicylism
Reye’s syndrome
Risk during pregnancy
Hypersensitivity reaction

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55
Q

Drug interactions with aspirin

A

Anticoagulants
Glucocorticoids
Alcohol
Ibuprofen
ACE inhibitors and ARBs

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56
Q

Principle uses for non aspirin first generation NSAIDs

A

Rheumatoid arthritis
Osteoarthritis

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57
Q

Class for ibuprofen

A

First generation NSAID

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58
Q

How does ibuprofen work?

A

Inhibits cyclooxygenase

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59
Q

Functions of ibuprofen

A

Anti inflammatory
Analgesic
Antipyretic

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60
Q

Uses of ibuprofen

A

Fever
Mild to moderate pain
Arthritis

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61
Q

Adverse effects of ibuprofen

A

Risk of GI bleeding

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62
Q

Use for second generation NSAIDs

A

Suppression of inflammation and pain

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63
Q

Adverse effects of second generation NSAIDs

A

Lower risk for GI bleeding

Impaired renal function
Hypertension
Edema
*Increased risk for MI & stroke

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64
Q

What class does Celecoxib (Celebrex) belong to?

A

Second generation COX2 inhibitor

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65
Q

Uses for Celebrex

A

Osteoarthritis
Rheumatoid arthritis
Acute pain
Dysmenorrhea
Familial adenomatious polyposis

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66
Q

Adverse effects of Celebrex

A

GI ulceration
Renal impairment
Sulfonamide allergy
*Increased risk of stroke, MI)
*Contraindicated in pregnancy

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67
Q

Drug interactions of Celebrex

A

*Warfarin
Decrease effects of furosemide
Decrease effect of ACE inhibitors
Increase lithium levels
Levels may be increased by fluconazole

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68
Q

Therapeutic uses of acetaminophen

A

Analgesic
Antipyretic

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69
Q

Action of acetaminophen

A

Inhibits prostaglandins in CNS

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70
Q

Adverse effects of acetaminophen

A

Hepatotoxicity with overdose
Hepatic necorisis

71
Q

Treatment for overdose of acetaminophen

A

Acetylcysteine (Mucomyst)

72
Q

Drug interactions of acetaminophen

A

Alcohol
Warfarin

73
Q

Are penicillins Bactericidal or bacteriostatic?

A

Bactericidal

74
Q

How do penicillins work?

A

Weaken cell wall
Cause bacteria to take up excessive water and rupture

75
Q

Prototype penicillin

A

Penicillin G (Benzylpenicillin)

76
Q

Bacteria penicillin G is effective against

A

Gram positive
And some gram negative

77
Q

Adverse effects of penicillin G

A

Least toxic of all antibiotics
*Allergy

78
Q

Types of broad spectrum penicillins

A

Ampicillin (Principen)
Amoxicillin

79
Q

Adverse effects of broad spectrum penicillins

A

Rash
Diarrhea

80
Q

How can broad spectrum penicillins be administered

81
Q

Prototype for extended spectrum penicillins

A

Piperacillin

82
Q

Most widely used group of antibiotics

A

*Cephalosporins

83
Q

How are cephalosporins usually administered

A

Parenterally

84
Q

How do cephalosporins work?

A

Bind to penicillin-binding proteins (PBPs)
Disrupt cell wall synthesis
Cause cell lysis

85
Q

Difference between the generations of cephalosporins

A

Generations 3-5 can get into CSF and are stronger

86
Q

Medication for patient to take if they had a mild reaction to penicillin

A

1st generation cephalosporin

87
Q

Use of first generation cephalosporins

A

Prophylaxis against infection in surgical patients

88
Q

Use of second generation cephalosporins

A

Gram negative bacteria

89
Q

Use of third generation cephalosporins

A

*Meningitis (because can penetrate to CSF)

90
Q

Use of forth generation cephalosporins

A

Healthcare and hospital acquired pneumonias

91
Q

What are fifth generation cephalosporins used for?

92
Q

Drug interactions of cephalosporins

A

Probenecid
Alcohol
Drugs that promote bleeding
Calcium
Ceftriaxone

93
Q

Adverse effects of cephalosporins

A

Allergy - hypersensitivity, rash
Bleeding
Thrombophlebitis

94
Q

Class for Imipenem (Primaxin)

A

Carbapenems

95
Q

Class for Meropenem (Merrem IV)

A

Carbapenems

96
Q

Class for Ertapenem (Ivanz)

A

Carbapenems

97
Q

Prototype for carbapenems

A

Imipenem (Primaxin)

98
Q

Bacteria Imipenem is most effective against

A

Anaerobic bacteria

99
Q

Administration of Imipenem

100
Q

Adverse effects of Imipenem

A

GI interactions
Rash

101
Q

Action of vancomycin

A

Inhibits cell wall synthesis

102
Q

Uses for vancomycin

A

*Severe infections only
MRSA
Staphylococcus epidermidis
C diff

103
Q

Administration of vancomycin

A

IV (must be given slowly over 2 hours)

104
Q

Adverse effects of vancomycin

A

Renal failure
Ototoxicity
Red man syndrome
Thrombophlebitis
Thrombocytopenia
Allergy

105
Q

Class for Aztreonam (Azactam)

A

Monobactam

106
Q

How does Aztreonam (Azactam) work?

A

Binds to benicillin-binding protein 3

107
Q

What bacteria is Aztreonam effective against?

A

Narrow antimicrobial spectrum
Gram-negative aerobic bacteria only

108
Q

Administration of Aztreonam

A

Parenterally

109
Q

Class of telavancin (Vibativ)

A

Lipoglycoproteins

110
Q

Bacteria that Telavancin (Vibativ) is effective against

A

Gram positive

111
Q

Administration of Telavancin (Vibativ)

112
Q

Use of V+Telavancin (Vibativ)

A

Vent acquired pneumonia (VAP)
Skin infections

113
Q

Adverse effects of Telavancin (Vibativ)

A

Prolonged QT interval

114
Q

How do tetracyclines work?

A

Broad spectrum antibiotics
Inhibit protein synthesis

115
Q

Uses of tetracyclines

A

Acne
Rickettsial disease
Chlamydia
Brucellosis
Cholera
Mycoplasma pneumoniae
Lyme disease
Anthrax
Helicobacter pylori
PUD
Perio

116
Q

Adverse effects of tetracyclines

A

GI irritation
Effects of bone and teeth
Superinfection
Hepatotoxicity
Renal toxicity
Photosensitivity

117
Q

Food interactions with tetracyclines

A

Milk product
Calcium suppliments
Iron supplements
Magnesium containing laxatives
Most antacids

118
Q

What class does erythromycin belong to?

A

Macrolides

119
Q

How does erythromycin work?

A

Broad spectrum antibiotic
Inhibition of protein synthesis
Usually bacteriostatic but can be bactericidal

120
Q

Uses of erythromycin

A

If allergic to penicillin
Whooping cough
Acute diphtheria
Chlamydia
M. Pneumonia
Group A strep

121
Q

Adverse effects of erythromycin

A

GI issues (diarrhea)
QT prolongation and sudden cardiac death
Superinfection

122
Q

What class does clarithromycin (Biaxin) belong to?

A

Macrolides

123
Q

What class does Azithromycin (Zithromax) belong to?

A

Macrolides

124
Q

How does clindamycin (Cleocin) work?

A

Inhibits protein synthesis

125
Q

Bacteria Clindamycin is effective against

A

Most anaerobic bacteria (gram pos and neg)

126
Q

Uses of clindamycin

A

Only for certain anaerobic infections located outside of the CNS

127
Q

Adverse effects of clindamycin

A

Clostridium difficile - associated diarrhea (CDAD)
Hepatic toxicity
Blood dyscrasias
Diarrhea
Hypersensitivity reactions

128
Q

Which class does Linezolid (Zyvox) belong to?

A

Oxazolidinones

129
Q

Types of bacteria Linezolid (Zyvox) is affective against

A

Against multi drug-resistant gram positive pathogens
Aerobic and gram positive bacteria

130
Q

Examples of pathogens Linezolid (Zyvox) is effective against

131
Q

Side effects of Linezolid (Zyvox)

A

Diarrhea
Nausea and vomiting
Headache

132
Q

Drug interactions of Linezolid (Zyvox)

133
Q

Uses of Trimethoprim

A

*Acute and uncomplicated urinary tract infections

134
Q

Adverse effects of Trimethoprim

A

Hematologic effects
Hyperkalemia
Use in pregnancy and lactation

135
Q

Uses of trimethoprim-sulfamethoxazole

A

UTIs
Otitis media
Bronchitis
Shigellosis
Pneumonia
GI infection

136
Q

Brand names of trimethoprim-sulfamethoxazole

A

Bacteria
Septra

137
Q

Adverse effects of trimethoprim-sulfamethoxazole

A

GI: N&V
Rash
Hyperkalemia
Hypersensitivity reactions (Stevens-Johnson syndrome)
Blood dyscrasias
Kernicterus
Renal damage: crystalluria

138
Q

Most commonly used aminoglycosides

A

Gentamicin
Tobramycin
Amikacin

139
Q

Are aminoglycosides narrow or broad spectrum?
Bactericidal or bacteristatic?

A

Narrow
Bactericidal

140
Q

Use of aminoglycosides

A

Aerobic gram negative bacilli

141
Q

Adverse effects of aminoglycosides

A

*Nephrotoxicity
*Ototoxicity
Hypersensitivity reactions
Neuromuscular blockade
Blood dyscrasias
Rare, can cause paralysis or deadly respiratory depression

142
Q

Use of Gentamicin (Garamycin)

A

Used to treat serious infections caused by aerobic gram-negative bacilli
*Pseudomonas aeruginosa
*Escherichia coli

143
Q

Adverse effects of Gentamicin (Garamycin)

A

Nephrotoxicity
Ototoxicity

144
Q

What group of antibiotic are antibiotics in that end in -mycin?

A

Aminoglycosides

145
Q

What class does Ciprofloxacin belong to?

A

Fluoroquinolones

146
Q

Is Ciprofloxacin narrow or broad spectrum?

147
Q

Administration of Ciprofloxacin

148
Q

Types of bacterial that Ciprofloxacin is used for

A

Gram negative and some gram positive

149
Q

Uses of Ciprofloxacin

A

Drug of choice for anthrax
Respiratory infections
UTIs
GI infections
Bone, joint, skin, and soft tissue infections

150
Q

Adverse effects of Ciprofloxacin

A

GI: N&V, diarrhea, abdominal pain
CNS: dizziness, headache, restlessness, confusion, rarely seizures
*Tendon rupture
Photosensitivity
Candida infections: pharynx and vagina
Increased risk of c. Diff
*Contraindicated for adults over 60 yrs

151
Q

Adverse effects of Ciprofloxacin in older adults

A

Confusion
Somnolence
Psychosis
Visual disturbances
Myasthenia gravis

152
Q

Drug and food interactions of Ciprofloxacin

A

Cationic compounds reduce absorption:
Aluminum antacids
Magnesium antacids
Iron salts, zinc salts, sucralfate
Milk and dairy products

Elevates drug levels of:
Theophylline
Warfarin
Tinidazole

153
Q

Is metronidazole (Flagyl) Bactericidal or bacteristatic?

A

Bactericidal

154
Q

Uses of Metronidazole (Flagyl)

A

Protozoan infections
Infections caused by obligate anaerobes
H. Pylori
CDI

155
Q

Adverse effects of Metronidazole (Flagyl)

A

Neurotoxicity
Allergy
Superinfections

156
Q

Which class does Daptomycin (Cubicin) belong to?

A

Cylic lipopeptides

157
Q

What type of bacteria does Daptomycin (Cubicin) belong to?

A

Gram positive bacteria

158
Q

Use of Daptomycin (Cubicin)

A

Bloodstream infections caused by staph aureus (MRSA) and other skin infections caused by staph
Streptococcus

159
Q

Adverse effects of Daptomycin (Cubicin)

A

GI related
Headache
Rash
Myopathy

160
Q

What is Rifampin?

A

Broad spectrum drug mainly used to treat TB

161
Q

Class of Amphotericin B

A

Polyene antibiotics

162
Q

What is Amphotericin B used for?

A

Broad spectrum antifungal agent (also used against some Protozoa)

163
Q

Administration of Amphotericin B

A

IV
No oral admin

164
Q

Uses of Amphotericin B

A

Drug of choice for most systemic mycoses

165
Q

How does Amphotericin B work?

A

Binds to ergosterol in fungal cell membrane
Increases cell permeability
Cell leaks intracellular cations (esp potassium)
Is fungistatic or fungicidal

166
Q

Adverse effects of Amphotericin B

A

*Highly toxic - Infusion reactions
*Nephrotoxicity
Hypokalemia
Bone marrow suppression

167
Q

Symptoms of an infusion reaction when given Amphotericin B

A

Fever
Chills
Rigors
Nausea
Headache

168
Q

Dose of Amphotericin B that is likely to cause nephrotoxicity

169
Q

Contraindications for Amphotericin B

A

Nephrotoxic drugs (aminoglycosides, cyclosporines)
NSAIDs

170
Q

What should be monitored when giving Amphotericin B?

A

Serum creatinine every 3-4 days
Need to reduce dosage if >3.5mg/dL

Serum levels for hypokalemia

Hematocrit for bone marrow suppression (anemia)

171
Q

Which class does Itraconazole (Sporanox) belong to?

172
Q

Uses of Itraconazole (Sporanox)

A

Lower toxicity level (alternative to ampho B)
Used for systemic mycoses

173
Q

Side effects of Itraconazole (Sporanox)

A

Well tolerated in usual doses
Cardiosuppression (transient decrease in ventricular ejection fraction)
Liver damage
GI effects: nausea, vomiting, diarrhea
Can inhibit drug-metabolizing enzymes

174
Q

When taking Itraconazole (Sporanox), lab work needs to be monitored if also on which drugs?

A

Digoxin
Coumadin
Cyclosporin

Pharmacology (16 decks)

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