Extra Stuff Flashcards
What Drugs belong to the 1st generation of Cephalosporins and what are they used for?
- Cephalexin - commonly prescribed for outpatient use
2. Cefazolin - Surgical Prophlylaxsis
What are second gernerations Cephalosporins used for?
Mild Gram (-) and Intraabdominal Infections
What drugs belong to the 3rd generation of Cephalosporins?
- what are they used for?
- Ceftriaxone - treatment of STDs, Pediatric Meningitis
2. Cefepime - pseudomonal Infections
What are 4th generation Cephalosporins used for?
Nosocomial Infections
T or F: Cephalosporins are acid stable so you can take them without food.
True
What are Monobactams used for?
Treatment of Gram (-) rods
T or F: Ampicillin works better on gram (-) bacteria because its amino groups allow it to pass through the LPS layer
True
T or F: Mitronidazole is given as a pro-drug
True
What does binding to CD3 prevent?
- what drug does this?
- Prevents T cell activation
- Muranomab-OKT3 does this
What does Ab binding to CD80/86 prevent?
- what drug does this?
- Prevents T cell co-stimulation so T cell never becomes completely active - apoptosis follows
- Balatacept does this
What does Ab binding to CD25 do?
- what drug does this?
- Prevents clonal expansion
- Basiliximab does this
T or F: since both sirolimus and tacrolimus work on FKBP12, they both act to some extent on calcineurin
False, they both act on FKBP12 but only tacrolimus works on calcineurin, sirolimus only works on mTOR
Which of the cell-cycle inhibitors is specific to B and T cells?
- explain.
Mycophenolate mofetil is specific to B and T cells because it interrupts the synthesis of Guanosine from IMP. B and T cells lack a GMP salvage pathway so depleting GMP synthesis is particularly toxic to these cells.
Which of the cell cycle drugs might be contraindicated with patients that have gout. why?
- Contraindicated if they are taking Allopurinol
- Allopurinol blocks the salvage pathways of Purines, this inhibits the side metabolic route of AZATHIOPRINE which shifts the dose response curve to the left because more 6-MP (mercaptopurine) is being produced
Which immunosuppressive drugs may vary in their bioavailability from patient to patient? why?
- Sirolimus, Cyclosporine, Tacrolimus
- They are metabolized by CYP3A4
Why are so many drugs given during the maintenance phase of immunosuppressive therapy?
To prevent dose related toxicity (some drugs like sirolimus and cyclosporine are even synergistic)
What are the 2 general effects of Ab treatment?
- Block T Cell activation/Proliferation
- Activate complement and produced ADCC
Azoles prevent conversion of what to what by what?
Lanosterol to Ergosterol via blockage of p450 (extensive side affects from azoles related to their ability to affect human p450 isoforms e.g. CYP3A4)
What biochemical process causes the symptoms seen in an infusion reaction?
-Increases in PG synthesis
Which of the Anti fungals is uniquely eliminated in the urine?
Fluconazole
Which of the Anti-fungal drugs should you not use in the patients that a immunosuppressed? why?
Terbinafine because it causes transient lymphopenia and neutropenia (patients receiving this drug should have CBCs performed regularly)
Why does treatment with azole drugs have to last so long?
- its fungistatic, so ending treatment early would leave original cells in tact to reproduce when therapy was terminated
- This is associated with high Relapse Rate
