General Pharmacology Flashcards
What are the 2 classes and 1 individual drug that inhibit cell wall synthesis?
Penicillins, cephalosporins, and Bacitracin
Which class of antibiotics alter the 30S subunit and 50S subunit, respectively?
30S»Aminoglycosides & Tetracyclines
50S»Chloramphenicol, Macrolides, and Clindamycin
Sulfamethoxazole + Trimethoprim =?
Bactrim (used for MRSA)
Sulfadiazine + Pyrimethamine = ?
Toxoplasmosis treatment
Which enzymes do Fluoroquinolones inhibit?
DNA gyrase + Topoisomerase IV
What is the mechanism of action of Penicillins & Cephalosporins?
Inhibit cell wall synthesis by inhibiting transpeptidase
Is Bacitracin bactericidal or bacteriostatic?
Bactericidal agent
Does Bacitracin target gram + or - bacteria?
What is it used to treat?
Gram + only. Comes in ointment form..used to treat Blepharitis
What antibiotics are found in Polysporin?
Bacitracin (gram + coverage) + Polymyxin B (gram - coverage)
Which drug is the drug of choice for MSSA? (methicillin-sensitive Staphylococcal infections)
Dicloxacillin
Which bacteria do Cephalosporins target? from 1st to 4th generations?
1st and 2nd gen are more gram +, while 3rd and 4th more effective against gram (-).
What is Cephalexin?
prescribed for skin infections caused by gram (+) bacteria including dacroadenitis, dacryocystitis, and pre-septal cellulitis
IV ceftriaxone is the treatment of choice for _______________ and ______________.
- Gonococcal conjunctivitis
2. Orbital cellulitis
What treatment is used for corneal ulcers?
Fortified Gentamicin with fortified Cefazolin
Topical ophthalmic aminoglycosides are notorious for causing ______________.
Superficial puntate keratitis
In which conditions can Doxycycline be used to treat?
- Meibomianitis»decreases the release of irritating free fatty acids and alters the configuration of oil glands
- Acne Rosacea
- chlamydial ocular infections (trachoma, adult inclusion conjunctivitis)
- recurrent corneal erosions
What are the adverse effects of Tetracyclines?
pseudotumor cerebri, bone growth retardation, and discoloring of teeth
What are 2 side effects of Minocycline?
- Blue sclera
2. Pigmented cysts of the conjunctiva
Oral Azithromycin (Z-pack) is commonly prescribed for which disease?
- Chlamydial infections (ex. trachoma, inclusion conjunctivitis)
Topical Azithromycin (Azasite) is used to treat which diseases?
- Bacterial conjunctivitis (BID X 2 days, then QD x 5 days)
2. Blepharitis
Topical ophthalmic erythromycin ointment is commonly used prophylactically for preventing which disease in newborns?
- Gonococcal ophthalmia neonatorum
Which bacteria are targeted when Lincomycin and Clindamycin are prescribed?
- MRSA
2. Anaerobic infections
What other drugs, besides Lincomycin & Clindamycin are used to treat MRSA?
- Bactrim (Trimethoprim + Sulfamethoxazole)
2. Doxycycline
If MRSA is suspected in the skin around orbit, what drugs can be used to treat it?
Doxycycline & Bactrim
If MRSA is suspected in the eye, what drugs can be used to treat it?
Polytrim + Besivance
Which bacteria did 1st generation Fluoroquinolones target?
targeted more gram (-)
|»_space;4th generation target more gram (+), but are still potent against gram (-)
What is one adverse side effect of taking ORAL Fluoroquinolones?
TENDINITIS
Which Antibiotics are Bacteriostatic agents?
- Tetracyclines
- Trimethoprim
- Erythromycin
Which Antibiotics are Bactericidal agents?
- Penicillins
- Bacitracin
- Aminoglycosides
- Cephalosporins
- Fluoroquinolones
What are the 4 drugs used for TB treatment?
- Ethambutol
- Rifampin
- Isoniazid
- Pyrazinamide
What is the main adverse effect of Rifampin and Isoniazid?
What is another side effect of Isoniazid?
HEPATOTOXICITY
> > Pyridoxine (Vit. B6) deficiency
What is the main adverse effect of Ethambutol?
Optic neuritis
What are the routes of transmission for Hepatitis A through E?
A. oral/fecal B. blood/body fluids C. blood/body fluids D. blood/body fluids E. oral/fecal
What is the most common side effect of Hepatitis C therapy (Ribavirin)?
Conjunctivitis
What are the common side effects of Ribavirin?
Remember the name: R: Retinal detachment I: Ischemia (CWS) B: Bleeding (hemorrhages) AV: Arterial and Venous occlusions iriN: Optic Neuritis
When can Viroptic be used?
Used to treat Herpes Simplex Keratitis
»inhibits DNA polymerase
»corneal toxicity b/c of thimerasol
How does Ganciclovir differ from Viroptic?
Ganciclovir has BAK preservative, while Viroptic contains thimerosal
Which corneal disease and retinal disease, respectively is treated with Zirgan (Ganciclovir)?
- HSV keratitis
- CMV retinitis
> > Foscavir can be used for CMV retinitis if Zirgan fails.
What is the MOA for Natamycin, Amphotericin B, and Nystatin?
bind to ergosterol and form pores within the fungal cell membrane
What is the MOA of Ketoconazole?
What is it used for?
Inhibits Ergosterol synthesis
> > Used for treatment of SEVERE fungal corneal ulcers
What is the MOA of Greseofulvin?
Inhibits fungal mitosis by interfering with Microtubule formation.
Which 2 drugs are combined to treat Toxoplasmosis?
Sulfadiazine + Pyremethamine
The initial sign of bull’s eye maculopathy is ____________ within the macula.
RPE mottling
What are the 2 main MOA’s for Chloroquine?
- builds up heme that is toxic to Plasmodium parasite from Malaria
- Inhibits phospholipase A
What is Lindane (Kwell) used to treat?
Treats Pubic lice
What roles do COX 1 and COX 2 play, respectively?
- COX 1»syntheside prostaglandins that mediate inflammation.
- COX 2»synthesize prostaglandins that inhibit gastric secretions
Which systemic conditions use Hydroxychoroquine (Plaquenil) for treatment?
Lupus, RA, and Malaria
For which conditions can Triamcinolone (Kenalog) be used to treat?
- Diabetic macular edema
- Graves
- Intermediate and resolving post. uveitis
- Chalazia
- Irvine-Gass CME and all other macular edemas
What are ocular side effects from taking Indomethacin (NSAID)?
whorl keratopathy and pigmentary retinopathy
NSAIDS are contraindicated in which patients?
Heart disease patients
What is the only Ester based steroid in the market today?
Lotemax (Loteprednol)
What are the 4 main Indirect cholinergic Agonists?
Edrophonium, Echothiophate, Pyridostigmine, and Neostigmine
What is the MOA of Donepezil?
It is a CNS acetylcholinesterase inhibitor (indirect cholinergic agonist)
Which 1st generation H1 blockers are cholinergic antagonists?
Diphenhydramine, brompheniramine, chlorpheniramine, and promethazine
Which antipsychotics are Cholinergic Antagonists?
Chlorpromazine, and Thioridazine
Which antidepressants are Cholinergic Antagonists?
TCA’s (amitriptyline, imipramine) and MAOI’s
Which systemic B-drug is the only long-acting B2 agonist?
Salmeterol
–is NOT to be used for a rescue inhaler!
What are the main systemic alpha-1 antagonists?
Tamsulosin, Terazosin, and Prazosin
What are the main systemic beta-1 specific antagonists?
Atenolol, and metoprolol
What is the MOA of Pseudoephedrine (Sudafed)?
Non-specific alpha and beta adrenergic receptor agonist
What are some adverse effects of Sudafed?
Tachycardia, Bronchoconstriciton, Nervousness, Agitation, Diplopia, and Blurred Vision
»avoid giving to patients taking MAOI’s and pts. with elevated IOP
What are the side effects of H1 systemic anti-histamines?
> > 1st gen. have CNS penetration»as well as anti-cholinergic effects like Mydriasis, dry eyes, dry mouth, and tachycardia
(2nd generation H1 anti-histamines have LESS CNS penetration)
What is the MOA of systemic H2 blockers?
Prevents histamine stimulation of gastric acid secretion by blocking H2 receptors on gastric parietal cells
What is the MOA Proton pump inhibitors?
Inhibits H+/K+ ATPase pumps
–1st line therapy for peptic ulcer disease and GERD
What are the 3 main Short-Acting B2 Agonists?
- Albuterol
- Metaproterenol (no longer prescribed for asthma)
- Isoproterenol (no longer prescribed for asthma)
- -Beware of IOP elevation in glaucoma patients
What is MOA of Acetylcysteine? What can it be used to treat?
- A mucolytic agent that breaks disulfide bonds in proteins of mucus
- Prescribed QID for filamentary keratitis
