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FA Antibiotics Flashcards

1
Q

Penicillin G

A

IV

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2
Q

Penicillin V

A

Oral

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3
Q

Penicillin MOA

A

Bind PBPs, inhibit transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes

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4
Q

Penicillin Clinical Use

A

SASS: S. pneumo, Actinomyces, S. pyogenes, Syphilis
Generally: Bactericidal for GramPos/Neg cocci, GramPos rods, spirochetes

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5
Q

Penicillin Toxicity

A

HS, hemolytic anemia

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6
Q

Penicillin Resistance

A

Beta-lactamase cleavage of beta-lactam ring

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7
Q

Aminopenicillin Drugs

A

Amoxicillin, Ampicillin

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8
Q

Aminopenicillin MOA

A 
Bind PBPs, inhibit transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes
Wider spectrum (AMPed up penicillins)
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9
Q

Aminopenicillin Clinical Use

A

Wider spectrum –> HHELLPS kill enterococi: H. flu, H. pylori, E. coli, Listeria, Proteus, Shigella, Salmonella, enterococci

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10
Q

Aminopenicillin with better oral bioavailability

A

AmOxicillin

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11
Q

Aminopenicillin Toxicity

A

HS, Amp Rash, Pseudomembranous Colitis

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12
Q

Aminopenicillin Resistance

A

Beta-lactamase cleavage of beta-lactam ring

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13
Q

Penicillinase-Resistant Penicillin Drugs

A

Dicloxacillin, Nafcillin, Oxacillin, Methicillin

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14
Q

Penicillinase-Resistant Penicillin MOA

A

Bind PBPs, inhibit transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes
Narrower-spectrum
Bulky R-group prevents beta-lactamase access to ring

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15
Q

Penicillinase-Resistant Penicillin Clinical Use

A

S. aureus (not MRSA)

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16
Q

Antipseudomonal Penicillin Drugs

A

Ticarcillin, Piperacillin (+ beta-lactamase inhibitor)

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17
Q

Antipseudomonal Penicillin MOA

A

Bind PBPs, inhibit transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes
Extended spectrum
Susceptible to beta-lactamases

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18
Q

Antipseudomonal Penicillin Clinical Use

A

Pseudomonas, GramNeg Rods

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19
Q

Antipseudomonal Penicillin Toxicity

A

HS

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20
Q

Beta-lactamase inhibitors

A

Clavulanic Acid, Sulbactam, Tazobactam

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21
Q

Cephalosporin MOA

A

Bind PBPs, inhibit transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes
Less susceptible to beta-lactamases
Bactericidal

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22
Q

Cephalosporin Toxicity

A

HS, autoimmune hemolytic anemia, disulfiram-like rxn w/EtOH, Vit K deficiency
Cross-reactive w/penicillins
Increase nephrotoxicity of Aminoglycosides

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23
Q

Cephalosporin Resistance

A

structural change in PBPs (transpeptidases)

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24
Q

These drugs can cause a disulfiram-like reaction with alcohol

A

Metronidazole, Cephalosporins

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25
Q

1st Gen Cephalosporin Drugs

A

Lin, Lex: Cefazolin, Cefalexin

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26
Q

1st Gen Cephalosporin Clinical Use

A

PEcK: Proteus, E. coli, Klebsiella

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27
Q

2nd Gen Cephalosporin Drugs

A

Fake Fox Fur: Cefaclor, Cefoxitin, Cefuroxime

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28
Q

2nd Gen Cephalosporin Clinical Use

A

HEN PEcKS: H. flu, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia

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29
Q

3rd Gen Cephalosporin Drugs

A

Tri, Tax, Taz: Ceftriaxone, Cefotaxime, Ceftazidime

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30
Q

3rd Gen Cephalosporin Clinical Use

A

Triax: Meningitis, Gonorrhea, disseminated Lyme
Taz: Pseudomonas

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31
Q

4th Gen Cephalosporin Drugs

A

Cefepime

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32
Q

4th Gen Cephalosporin Clinical Use

A

Pseudomonas, GramNeg, additional GramPos activity

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33
Q

5th Gen Cephalosporin Drugs

A

Ceftaroline

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34
Q

5th Gen Cephalosporin Clinical Use

A

MRSA, broad GramPos and GramNeg coverage (not Pseudomonas)

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35
Q

These antibiotics are relatively safe in pregnancy

A

Beta-lactams, Azithromycin, Clindamycin, Metronidazole

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36
Q

These antibiotics can be used against Pseudomonas

A

Aminoglycosides (GNATS), Aztreonam, Carbapenems, Cefepime, Ceftazidime, Fluoroquinolones, Ticarcillin/Piperacillin, Colistin and Ploymixin B (MDR Strains)

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37
Q

Carbapenem Drugs

A

Imipenem, Meropenem, Ertapenem, Doripenem

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38
Q

Carbapenem MOA

A

Bind PBPs, inhibit transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes
Broad spectrum
Beta-lactamase resistant
Imipenem always + cilistatin to reduce inactivation by dihydropeptidase I in renal tubules

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39
Q

Carbapenem Clinical Use

A

GramPos Cocci, GramNeg Rods, Anaerobes

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40
Q

Imipenem always adminstered with what, and why?

A

Cilastatin to reduce inactivation by dihydropeptidase I in renal tubules

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41
Q

These drugs can be given to a pt w/penicillin allergy

A

Monobactams, Macrolides, Clindamycin

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42
Q

Carbapenem Toxicity

A

CNS toxicity (seizures), GI distress, skin rash

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43
Q

Monobactam drugs

A

Aztreonam

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44
Q

Monobactam MOA

A

Bind PBP3, inhibit transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes
Less susceptible to beta-lactamases
Synergistic w/aminoglycosides
No cross-allergicity w/penicillins

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45
Q

Monobactam Clinical Use

A

GramNeg rods ONLY

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46
Q

These drugs can be used in pts w/renal insufficiency instead of aminoglycosides

A

Monobactams (Aztreonam)

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47
Q

These drugs are less susceptible to beta-lactamases

A

Monobactams,

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48
Q

These drugs are beta-lactamase resistant

A

Carbapenems, Vancomycin, Cephalosporins, Penicillinase-Resistant Penicillins

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49
Q

These drugs should be administered with beta-lactamase inhibitors

A

Penicillin, Aminopenicillins, Antipseudomonal Penicillins

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50
Q

Monobactam Toxicity

A

usually nontoxic; occasional GI upset

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51
Q

Vancomycin MOA

A

binds D-ala-D-ala to inhibit cell wall elongation
Bactericidal
Beta-lactamase resistant

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52
Q

Vancomycin Clinical Use

A

MRSA, Staph epi, Enterococcus, C. diff

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53
Q

Vancomycin Toxicity

A

“Red Man’s NOT in the Van”: Red Man Syndrome (antihistamines), Nephrotoxicity, Ototoxicity, Thrombophlebitis

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54
Q

Vancomycin Resistance

A

amino acid modification of D-ala-D-ala to D-ala-D-lac

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55
Q

This carbapenem has decreased risk of seizures and is stable to dihydropeptidase I in renal tubules

A

Merepenem

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56
Q

These bugs are NOT covered by Cephalosporins

A

LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA (except 5th gen), Enterococci

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57
Q

These drugs bind to 30S subunit to inhibit protein synthesis

A

“Ami has 30 Tetras”: Aminoglycosides, Tetracyclines

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58
Q

These drugs bind to 50S subunit to inhibit protein synthesis

A

“CCEL at 50”: Chloramphenicol, Clindamycin, Erythromycin (Macrolides), Linezolid

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59
Q

Aminoglycoside Drugs

A

GNATS: Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

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60
Q

Aminoglycoside MOA

A

Bind 30S subunit –> misreading of mRNA, blockage of translocation
Bacteriocidal
Require O2 for uptake (Amin”O2”glycosides)

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61
Q

Aminoglycoside Clinical Use

A

Severe GramNeg Rod infxns (Ami”NOT”glycoside)
Synergistic w/Beta-lactams
Bowel sterilization for Sx (neomycin)

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62
Q

These drugs are synergistic w/Beta-lactams

A

Aminoglycosides

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63
Q

This drug is used for bowel sterilization pre-Sx

A

Neomycin

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64
Q

This aminoglycoside is hepatically excreted

A

Amikacin

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65
Q

Aminoglycoside Toxicity

A

“caNNOT kill anaerobes:” Nephrotoxicity, NMJ blockade, Ototoxicity (esp. w/loop diuretics), Teratogen

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66
Q

Aminoglycoside mnemonic

A

Mean GNATS caNNOT kill anaerobes

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67
Q

Aminoglycoside Resistance

A

Bacterial tranferase enzymes inactivate via APA: Adenylation, Phosphorylation, Adenylation

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68
Q

Tetracycline Drugs

A

Tetracycline, Doxycycline, Minocycline, Demeclocycline, Tygecycline

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69
Q

Tetracycline MOA

A

T’s: Bind to 30S (Thirty) subunit –> prevent tRNA attachment
Accumulate intracellularly
Limited CNS penetration
Ca2+, Mg2+, Fe2+ decrease absorption in gut

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70
Q

This tetracycline is hepatically eliminated

A

Doxycycline

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71
Q

This tetracycline is commonly used for acne

A

Minocycline

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72
Q

This tetracycline can be used as a diuretic in SIADH

A

Demeclocycline

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73
Q

These products inhibit tetracycline absorption

A

Ca2+, Mg2+, Fe2+

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74
Q

Tetracycline Clinical Use

A

Borrelia burgdorferi, M. pneumoniae, Rickettsia, Chlamydia, acne

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75
Q

Tetracycline Toxicity

A

Tummy (GI distress), can’t get Taller (inhibition of bone growth in kids), Tooth discoloration, Teratogenic

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76
Q

Tetracycline Resistance

A

decreased uptake or increased efflux via plasmid-encoded transport pumps

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77
Q

Chloramphenicol MOA

A

Blocks peptidyltransferase at 50S subunit

Bacteriostatic

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78
Q

Chloramphenicol Clinical Use

A

Meningitis (H. flu, N. meningitidis, S, pneumo), Rocky Mtn Spotted Fever (Rickettsia)

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79
Q

Chloramphenicol Toxicity

A

Dose-dependent anemia, dose-independent aplastic anemia, gray baby syndrome

80
Q

What is gray baby syndrome and what causes it?

A

Chloramphenicol –> Vomiting, Ashen gray skin color, Limp body tone, HypOtension, Cyanosis, Hypothermia, Cardiovascular collapse

81
Q

Chloramphenicol Resistance

A

Plasmid-encoded acetyltransferase inactivates drug

82
Q

Clindamycin mnemonic

A

Clindamycin Cleans Up Anaerobes (anaerobic infxns above diaphragm)

83
Q

Clindamycin MOA

A 
Blocks translocation (peptide transfer) at 50S subunit
Bacteriostatic
84
Q

Clindamycin Clinical Use

A

Anaerobic infxns (Bacteroides, C. perfringens) in aspiration pneumonia, lung abscesses, oral infxns; invasive Strep pyogenes infxn

85
Q

Clindamycin Toxicity

A

Pseudomembranous colitis from superinfxn (C. diff overgrowth) (primary cause), fever, diarrhea

86
Q

Oxazolidinone Drugs

87
Q

Linezolid MOA

A

Binds 50S subunit and blocks Initiation Complex formation

88
Q

Linezolid Clinical Use

A

GramPos, incl. MRSA and VRE

89
Q

Linezolid Toxicity

A

Bone marrow suppression (esp thrombocytopenia), peripheral neuropathy, serotonin syndrome

90
Q

What is serotonin syndrome and what antibiotic causes it?

A

Linezolid –> excessive accumulation of serotonin –> symptoms can range from mild (shivering and diarrhea) to severe (muscle rigidity, fever and seizures)

91
Q

These drugs can suppress bone marrow

A

Linezolid, TMP

92
Q

Linezolid Resistance

A

rRNA point mutation

93
Q

Macrolide Drugs

A

ACE: Azithromycin, Clarithromycin, Erythromycin

94
Q

Macrolide MOA

A

Binds to 23S rRNA of 50S subunit –> blocks translocation (macro”slide”)
Bacteriostatic

95
Q

Macrolide Clinical Use

A

Atypical pneumonia (Mycoplasma, Chlamydia, Legionella), STIs (Chlamydia), GramPos Cocci (Strep in pts w/penicillin allergy), B. pertussis

96
Q

Macrolide Toxicity

A

MACRO: Increased GI Motility, Arrhythmia from prolonged QT interval, acute Cholestatic hepatitis, Rash, eOsiniphilia
Increases serum conc of theophyllines and oral anticoagulants
Erythro and Clarithro inhibit P450

97
Q

Macrolide Resistance

A

Methylation of 23S rRNA-binding site

98
Q

Trimethoprim MOA

A

Inhibits bacterial Dihydrofolate Reductase (folate synthesis)
Bacteriostatic

99
Q

Trimethoprim Clinical Use

A

Used w/SMX to cause sequential block of folate synthesis (bactericidal) – UTIs, Shigella, Salmonella, Pneumo jirovecii, Pneumonia Rx and prophylaxis, toxoplasmosis prophylaxis

100
Q

Trimethoprim Toxicity

A

Treats Marrow Poorly: Megaloblastic anemia, leukopenia, granulocytopenia (alleviate w/folinic acid)

101
Q

Sulfonamide MOA

A

PABA metabolites inhibit dihydropterate synthase (folate synthesis)
Bacteriostatic

102
Q

Sulfonamide Clinical Use

A

GramPos, GramNeg, Nocardia, Chlamydia, simple UTI (triple sulfas or SMX)

103
Q

Sulfonamide Toxicity

A

HS, Hemolysis in G6PDH Def, Nephrotoxicity (tubulointerstitial nephritis), Photosensitivity, Kernicterus in infants, displaces other drugs from albumin (warfarin), Stevens-Johnson Syndrome

104
Q

Sulfonamide Resistance

A

Altered enzyme, decreased uptake, or increased PABA synthesis

105
Q

TMP-SMX Toxicity

A

Stevens-Johnson Syndrome (mostly SMX)

106
Q

TMP-SMX MOA

A

Sequential inhibition of folate synthesis

107
Q

TMP-SMX Clinical Use

A

PUSS: Pneumo jirovecii, UTIs, Shigella, Salmonella

108
Q

Fluoroquinolone Drugs

A

Ciprofloxacin, Levofloxacin, Moxifloxacin

109
Q

Fluoroquinolone MOA

A

inhibit DNA Topoisomerase I (DNA Gyrase) and DNA Topoisomerase IV
Bactericidal
Cannot be taken w/antacids

110
Q

These antibiotics cannot be taken with antacids

A

Fluoroquinolones, Tetracyclines

111
Q

Fluoroquinolone Clinical Use

A

GramNeg Rods in urinary and GI tracts; Pseudomonas, Atypical pneumonia (Levo, Moxi), Neisseria, some GramPos organisms

112
Q

Fluoroquinolone Toxicity

A

Superinfection, Tendon Rupture, GI upset, may prolong QT interval, skin rash, headache, dizziness
C/I in pregnancy, nursing, kids under 18 (cartilage damage)
“Quinolones hurt attachments to Bones”

113
Q

Fluoroquinolone Resistance

A

Chromosome-encoded mutation in DNA gyrase; plasmid-mediated resistance; efflux pumps

114
Q

Daptomycin MOA

A

Lipopeptide that disrupts cell membrane of GramPos cocci

115
Q

Daptomycin Clinical Use

A

S. aureus skin infxns (esp. MRSA), bacteremia, endocarditis, VRE – NOT used for pneumonia (inactivated by surfactant)

116
Q

Daptomycin toxicity

A

Myopathy, rhabdomyolysis

117
Q

Metronidazole MOA

A

Forms toxic free radical metabolites that damage bacterial DNA
Bactericidal, antiprotozoal

118
Q

Metronidazole Clinical Use

A

GET GAP on the Underground Metro: anaerobes below diaphragm: Giardia, Entamoeba, Trichomonas, Gardenerella, Anaerobes (Bacteroides, C. diff), H. Pylori (w/PPI and Clarithromycin)

119
Q

These 2 antibiotics are used in “triple therapy” w/PPI to treat H. pylori

A

Clarithromycin, Metronidazole

120
Q

Metronidazole Toxicity

A

Disulfiram-like rxn w/EtOH, headache, dysgeusia

121
Q

Disulfiram-like reaction

A

severe flushing, tachycardia, hypotension

122
Q

These antibiotics should be avoided in pregnancy

A

SAFe Children Take Really Good Care: Sulfonamides, Aminoglycosides, Fluoroquinolones, Clarithromycin, Tetracyclines, Ribavirin (antiviral), Griseofulvin (antifungal), Chloramphenicol

123
Q

post-antibiotic effect

A

persistent suppression of bacterial growth after a brief exposure (1 or 2 hours) of bacteria to an antibiotic even in the absence of host defense mechanisms

124
Q

this antibiotic exhibits post-antibiotic effect

A

Azithromycin

125
Q

These drugs can be used against MRSA

A

Vancomycin, Linezolid, Daptomycin, Tigecycline, Ceftaroline

126
Q

These drugs can be used against VRE

A

Linezolid, Tigecycline, Daptomycin

127
Q

These drugs can be used against anaerobes

A

Clindamycin (above diaphragm), Metronidazole (below diaphragm), Tigecycline, Cefoxitine, Zosyn (Piperacillin + Tazobactam), Respiratory Fluoroquinolones (Moxi > Levo), Carbapenems

128
Q

These drugs can be used against Atypical Pneumonia (Legionella, Mycoplasma, Chlamydia)

A

Macrolides, Tetracyclines, Moxifloxacin, Levofloxacin

129
Q

These drugs can be used for UTIs

A

TMP-SMX, Fluoroquinolones, Fosfomycin (if the others don’t work)

130
Q

These drugs can be used for outdoor diseases (Borrelia Lyme Disease/Ricksietta Rocky Mtn/Y. pestis Plague)

A

Tetracyclines, Ceftriaxone (Lyme)

131
Q

These drugs can be used for Chlamydia

A

Macrolides

132
Q

These drugs can be used for Syphilis

A

Penicillin G

133
Q

These drugs can be used for Gonorrhea

A

Ceftriaxone

134
Q

These drugs can be used for MDR Pseudomonas

A

Polymixins B/E (Colistin)

135
Q

These drugs can be used for Hepatic encephalopathy

136
Q

These drugs can be used for Anthrax

A

Doxycycline, Fluoroquinolones

137
Q

These drugs can cause pseudomembranous colitis (superinfxn)

A

Clindamycin, Tetracyclines, Aminopenicillins (Treat w/Vanco, Metronidazole)

138
Q

These drugs can cause ototoxicity

A

Aminoglycosides (esp w/loop diuretics), Vancomycin

139
Q

These drugs can cause myopathy

A

Daptomycin

140
Q

These drugs can cause tendon rupture and cartilage damage

A

Fluoroquinolones

141
Q

These drugs are motilin agonists that can cause severe diarrhea

A

Macrolides (ACE)

142
Q

These drugs can cause NMJ blockade

A

Aminoglycosides (GNATS)

143
Q

These drugs can cause seizures

A

Carbapenems, Isoniazid

144
Q

This drug can cause Red Man Syndrome

A

Vancomycin

145
Q

These drugs can cause bone marrow suppression

A

TMP, Linezolid

146
Q

These drugs can cause kernicterus

A

Sulfonamides

147
Q

These drugs can cause hemolysis in G6PDH deficiency

A

Sulfonamides

148
Q

These drugs can cause Vit B6 deficiency / peripheral neuropathy

149
Q

These drugs can cause Vit K deficiency

A

Cephalosporins

150
Q

These drugs can cause nephrotoxicity

A

Aminoglycosides, Vancomycin, Sulfonamides

151
Q

These drugs can cause optic neuropathy / red-green colorblindness

A

Ethambutol (“Eye”-thambutol)

152
Q

These drugs can cause megaloblastic anemia

A

Trimethoprim

153
Q

These drugs can cause red-orange body fluids

154
Q

These drugs can cause hyperuricemia

A

Pyrazinamide

155
Q

These drugs can cause aplastic anemia

A

Chloramphenicol

156
Q

These drugs can cause hepatotoxicity

A

Isoniazid, Pyrazinamide

157
Q

These drugs can cause acute cholestatic hepatitis

A

Erythromycin

158
Q

These drugs are P450 2C9 inhibitors

A

Sulfonamides, Metronidazole

159
Q

These drugs are P450 2C9 inducers

160
Q

These drugs are P450 inhibitors

A

Isoniazid, Clarithromycin and Erythromycin (NOT Azithromycin), Ciprofloxacin

161
Q

Rifampin MOA

A

Inhibits DNA-dependent RNA Polymerase

162
Q

Rifampin Clinical Use

A

Mycobacterium tuberculosis; delay resistance to Dapsone in leprosy; prophylaxis for close contacts of kids with HiB meningitis

163
Q

Rifampin Toxicity

A

Minor hepatotoxicity, P450 inducer (drug interaxns), Red-Orange body fluids

164
Q

Rifamycin Drugs

A

Rifampin, Rifabutin

165
Q

Which rifamycin is preferred in HIV and why?

A

Rifabutin b/c less P450 stimulation

166
Q

Rifampin Resistance

A

Mutations reduce drug binding to RNA Pol

Monotherapy rapidly leads to resistance

167
Q

4 R’s of Rifampin

A

DNA-dependent RNA Polymerase
Ramps up P450
Red-orange body fluids
Rapid Resistance when used alone

168
Q

These drugs are used for active TB

A

RIPE for treatment: Rifampin, INH, Pyrazinamide, Ethambutol

169
Q

These drugs are used for latent TB

A

Rifampin, INH

170
Q

Isoniazid MOA

A

decrease Mycolic Acid synthesis

requires bacterial KatG (catalase-peroxidase) for activation

171
Q

Isoniazid Clinical Use

A

Mycobacterium tuberculosis – only agent used as solo prophylaxis

172
Q

This drug is the only agent used as solo prophylaxis against TB

173
Q

Isoniazid Toxicity

A

Neurotoxicity (B6 deficiency – peripheral neuropathy – treat w/pyridoxine), hepatotoxicity

174
Q

Isoniazid Resistance

A

Mutations causing underexpression of KatG

175
Q

Pyrazinamide MOA

A

Uncertain – somehow converted to active cpd pyrazinoic acid

176
Q

Pyrazinamide Clinical Use

A

Mycobacterium tuberculosis

177
Q

Pyrazinamide Toxicity

A

Hyperuricemia, hepatotoxicity

178
Q

Ethambutol MOA

A

inhibits arabinosyltransferase –> decreases carbohydrate polymerization of cell wall

179
Q

Ethambutol Clinical Use

A

Mycobacterium tuberculosis

180
Q

Ethambutol Toxicity

A

Optic neuropathy, Red-Green colorblindness (“Eye”-thambutol)

181
Q

This drug is used as prophylaxis for endocarditis, Sx/dental procedures

A

Amoxicillin

182
Q

This drug is used as prophylaxis for gonorrhea

A

Ceftriaxone

183
Q

This drug is used as prophylaxis for recurrent UTIs

184
Q

This drug is used as prophylaxis for meningococcal exposure

A

Ceftriaxone, Ciprofloxacin, or Rifampin

185
Q

This drug is used as prophylaxis for pregant women w/Group B Strep

A

Penicillin G

186
Q

This drug is used as prophylaxis for gonorrheal conjunctivitis in newborn

A

Erythromycin ointment

187
Q

This drug is used as prophylaxis for post-Sx Staph aureus infxn

188
Q

This drug is used as prophylaxis for Strep pharyngitis in kids w/Hx Rheumatic Fever

A

Benzathine Penicillin G or Oral Penicillin V

189
Q

This drug is used as prophylaxis for syphilis

A

Benzathine Penicillin G

190
Q

What gene is implicated in MRSA strains?

A

MecA codes for new PBP2a

191
Q

Which carbapenem has best activity against Pseudomonas?

192
Q

What drug can be used to treat C. diff?

A

ORAL Vancomycin, Metronidazole

193
Q

Which tetracycline is used for antibiotic-resistant infections?

A

Tygecycline (broad spectrum)

194
Q

Antibiotic for Staph skin infxn?

A

Mupirocin (can also eliminate nasal carriage)

195
Q

These drugs These agents may compete with penicillin for renal tubular secretion, prolonging the half-life of penicillin

A

Aspirin, furosemide, indomethacin, sulfonamides, thiazide diuretics

M2 - Pharm (10 decks)

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