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Pharm 1 Jack > Highlights for the Final > Flashcards

Highlights for the Final Flashcards

1
Q

What sort of drug will more readily cross plasma membranes?

A

small, non-ionized, lipid soluble drugs

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2
Q

therapeutic index (TI) is

A

a ratio of the dose of a drug that produces toxicity relative to the dose of the same drug that produces a clinically desired response. Looked at as an equation, this would be T.I. = LD50 / EC50…thus a measure of the drug’s safety. A large value indicates that there is a wide margin between an effective dose and a toxic dose.

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3
Q

Which drug class has a high potential for abuse?

A

Class II

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4
Q

Stage 2 HTN

A

160-179/100-109

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5
Q

Stage 3 HTN

A

>180/110

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6
Q

What catalyzes angiotensinogen to angiotensin I

A

renin, a proteolytic enzyme formed in the granules of juxtaglomerular cells

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7
Q

Angiotensin I goes to Angiotensin II by being cleaved by

A

ACE (angiotensin converting enzyme) which is found mostly in the lungs but also the kidneys and brain and elsewhere

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8
Q

most potent vasoconstrictor produced by the body

A

angiotensin II

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9
Q

how do thiazide diuretics work

A

increase sodium and water excretion into urine by inhibiting sodium and chloride reabsorption in the cortical thick ascending limb and early distal tubule

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10
Q

side effect on minerals when taking thiazide diuretics

A

can cause calcium and uric acid to be reabsorbed by proximal tubule in increased amounts…so serum levels of calcium and uric acid rise

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11
Q

Primary thiazide diuretic

A

hydrochlorthiazide (HCTZ)/hydrodiuril

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12
Q

what supplement is generally recommended when taking hydrochlorthiazide/hydrodiuril

A

potassium

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13
Q

patients with a sulfa allergy should not take these drugs because they contain a sulfonamide moiety

A

hydrochlorthiazide (HCTZ)/hydrodiuril and furosemide/lasix

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14
Q

main loop diuretic

A

furosemide/lasix

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15
Q

what do loop diuretics do

A

inhibit chloride reabsorption in the ascending loop of Henle by blocking the Na+/K+/Cl- co-transporter system

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16
Q

***Rank diuretics from strongest to weakest

A

***loop > thiazide > potassium sparing?

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17
Q

loop diuretics can increase the loss of

A

sodium, potassium, calcium, and magnesium

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18
Q

bioavailability is

A

fraction of administered drug that reaches systemic circulation in an unchanged form…(if 100 mg of a drug is taken orally and 70 mg of the drug is absorbed unchanged, then the bioavailability of that drug is 70%)

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19
Q

half life is

A

the amount of time required for the plasma concentration of a drug to decrease by 50% after discontinuation of a drug

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20
Q

the EC50 or effective concentration 50 is

A

the concentration or dosage of an agent which induces a specified clinical effect in 50% of the subjects to which the drug has been administered.

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21
Q

LD50 or lethal dose 50 is

A

the concentration or dosage of an agent or drug which causes death in 50% of the subjects to which that agent or drug has been administered.

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22
Q

efficacy refers to

A

the degree to which a drug is able to induce maximal therapeutic effects. Efficacy is a term often used to compare drugs of different classes.

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23
Q

drug class with no approved medical use

A

Class I

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24
Q

drug class with moderate potential for abuse

A

Class III

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25
Q

drug class with low potential for abuse

A

Class IV

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26
Q

drug class contraindicated in pregnancy

A

Class X

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27
Q

preferred diuretic for patients with renal disease and HTN emergencies

A

loop diuretics

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28
Q

what do potassium sparing diuretics do

A

increase sodium excretion and inhibit potassium secretion in the distal convoluted tubule

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29
Q

examples of disease states the potassium sparing diuretics should not be used with

A

severe renal insufficiency, poorly controlled DM, and multiple myeloma

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30
Q

drugs that can cause hyperkalemia

A

ACE inhibitors and Angiotensin II receptor blockers

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31
Q

primary potassium sparing diuretic

A

spironolactone/aldactone

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32
Q

diuretic that has anti-androgenic properties and is thus used to treat hirsutism and PCOS

A

spironolactone/aldactone

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33
Q

prototype B-blocker

A

propranolol/inderal

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34
Q

beta blocker that acts at both Beta 1 (heart) and Beta 2 (lungs)

A

propranolol/inderal

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35
Q

beta blocker that is selective (acts at Beta 1)

A

atenolol/tenormin

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36
Q

disadvantage of B-blockers include

A

high incidence of adverse CNS affects, sexual dysfunction in men/women, and bradycardia

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37
Q

contraindications of beta blockers include

A

certain cardiac conduction abnormalities, severe asthma, and severe COPD

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38
Q

drug where abrupt withdrawal can lead to rebound HTN and/or rebound tachycardia, probably due to up-regulation of beta receptors during treatment…can result in MI or stroke

A

beta blockers

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39
Q

overuse of a beta blocker can result in

A

bradycardia and heart block

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40
Q

treatment of choice to reverse bradycardic effects of a beta blocker is

A

glucagon

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41
Q

first line treatment of HTN in conventional clinical practice

A

ACE inhibitors and calcium channel blockers

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42
Q

treatment for acute asthmatic attacks that are unresponsive to other medications

A

epinephrine (adrenalin)

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43
Q

indication of epinephrine

A

emergent treatment of asthma, status asthmaticus, anaphylaxis

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44
Q

OTC preparation containing a very low dose of epinephrine

A

what is primatene mist

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45
Q

class of albuterol/ventolin, proventil

A

beta 2 agonist

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46
Q

long acting beta 2 agonist

A

class of salmeterol/severent

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47
Q

when are anticholinergic drugs typically indicated

A

generally not indicated for acute asthma attacks but rather for maintenance therapy in asthma patients who cannot tolerate treatment with a beta agonist

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48
Q

primary anticholinergic drug

A

ipratropium/atrovent

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49
Q

class of zafirlukast/accolate

A

leukotriene receptor antagonist

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50
Q

drug for prophylaxis and treatment of chronic asthma

A

zafirlukast/accolate

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51
Q

how do corticosteroids work

A

inhibition of phospholipase A2 blocks release of arachadonic acid, the precursor of the prostaglandins and leukotrienes from membrane bound phospholipids. Histamine release and kinin activity is also suppressed by glucocorticoids.

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52
Q

primary inhaled steroid

A

beclomethasone/beclovent, vanceril

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53
Q

indication of beclomethasone/beclovent

A

asthma not controlled by sympathomimetics (bronchodilators) alone

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54
Q

indication for prednisone/deltasone

A

COPD, worsening asthma

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55
Q

Abrupt withdrawal of prednisone or other drugs with corticosteroid properties may result in severe and potentially life threatening

A

hypofunction of the adrenal glands, also known as Addisonian crisis.

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56
Q

What’s significant about theophylline/theo-dur

A

bad TI, lethal dose is not far from effective dose

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57
Q

class of theophylline/theo-dur

A

xanthine or methylxanthine bronchodilators

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58
Q

class of codeine

A

narcotic analgesic and cough suppressant

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59
Q

MOA of codeine and dextromethorphan

A

suppresses the sensitivity of CNS cough centers in the medulla

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60
Q

Class of dextromethorphan

A

synthetic derivative of morphine

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61
Q

indication of dextromethorphan

A

cough suppression

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62
Q

MOA of diphenhydramine/benadryl

A

H1 receptor site blockage. The production and release of histamine is not blocked.

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63
Q

Does diphenhydramine/benadryl cross the BBB

A

yes

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64
Q

primary non-sedating antihistamine

A

loratadine/claritin

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65
Q

MOA of loratadine/claritin

A

H! receptor antagonist

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66
Q

Does loratadine/claritin

A

No

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67
Q

Mechanisms of varenicline/chantix

A

partial agonist of alpha 4/beta 2 nicotinic acetylcholine receptor sites`

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68
Q

side effects of varenicline/chantix

A

increasing reports of neuro-psychiatric symptoms that range from nightmares or insomnia to depression and suicidal ideations to increased agitation and rage

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69
Q

primary alpha blocker

A

prazosin/minipress (alpha 1)

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70
Q

indication of prazosin/minipress (alpha 1)

A

HTN, BPH

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71
Q

Drug class used as prophylaxis of migraine headache and for Raynaud’s syndrome

A

calcium channel blockers

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72
Q

calcium channel blockers should be used with more caution in patients with

A

Bradycardia or severe CHF

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73
Q

class of verapamil/isopten

A

calcium channel blocker

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74
Q

indication of verapamil/isopten

A

HTN, angina–especially vasospastic angina, CHF

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75
Q

long term use of calcium channel blockers is associated with increased risk for

A

breast cancer

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76
Q

ACE inhibitors reduce BP by

A

interfering with the generation of Angiotensin II from Angiotensin I…also inhibit the degradation of bradykinins, allowing for another mechanism by which peripheral vascular resistance can be reduced

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77
Q

what drug is considered least likely of the antihypertensive drugs to cause sexual dysfunction in males

A

ACE inhibitors

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78
Q

How do ACE inhibitors affect serum lipids, glucose or uric acid levels

A

They don’t affect them

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79
Q

ACE inhibitors can potentially increase serum

A

potassium

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80
Q

drug of choice for HTN patients with diabetes

A

ACE inhibitors

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81
Q

With ACE inhibitors, avoid concurrent use of

A

potassium sparing diuretic…but potassium wasting diuretics are quite commonly used in conjunction

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82
Q

drug class with the side effect of dry irritating cough

A

ACE inhibitors

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83
Q

Can you use ACE inhibitors during pregnancy

A

No

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84
Q

drug class with side effect of angioedema, life threatening when it involves the tongue and oropharyngeal area

A

ACE inhibitors

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85
Q

Primary ACE inhibitor

A

Lisinopril/Prinivil or Zestril

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86
Q

Do Angiotensin II receptor blockers cause cough and angioedema

A

Yes, although their potential to do so is less than ACE Inhibitors

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87
Q

Do Angiotensin II receptor blockers cause hyperkalemia?

A

Yes

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88
Q

primary Angiotensin II receptor blocker

A

Losartan/Cozaar

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89
Q

Can you take Losartan/Cozaar during pregnancy

A

Yes

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90
Q

example of a direct vasodilator

A

Minoxidil/Loniten

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91
Q

Minoxidil and Hydralazine is generally reserved for

A

severe hypertension, resistant to previous antihypertensive treatment attempts

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92
Q

What is the more potent direct vasodilator: Minoxidil or Hydralazine?

A

Minoxidil is more potent than Hydralazine but it is associated with more adverse effects, including potential for marked sodium and water retention and hirsutism

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93
Q

Drug that causes Hirsuitism

A

Minoxidil/Loniten

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94
Q

drug that causes drug induced lupus syndrome

A

Hydralazine

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95
Q

first drug FDA approved in new antihypertensive drug class known as direct renin inhibitors

A

Aliskiren (Tekturna)

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96
Q

drug that can cause angioedema

A

Aliskiren (Tekturna)

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97
Q

three main classes of drugs that have proven very effective in treating patients with stable angina pectoris

A

nitrates, beta blockers, calcium channel blockers

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98
Q

the treatment of choice to reverse the bradycardic effects of a beta blocker is

A

glucagon

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99
Q

Class of propranolol/inderal

A

non-selective beta blocker

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100
Q

drug used for panic attacks

A

propranolol/inderal

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101
Q

class of atenolol/tenormin

A

selective beta blocker

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102
Q

treatment of choice to reverse the symptomatic effects of bradycardia of a calcium channel blocker is

A

calcium gluconate…but glucagon can be given if calcium gluconate increases pulse rate

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103
Q

class of amlodopine/norvasc

A

calcium channel blocker

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104
Q

what do you do with someone with unstable angina

A

administer MONA = morphine, oxygen, nitrate, aspirin

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105
Q

how do you reverse morphine

A

naloxone

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106
Q

MOA for aspirin/ASA

A

Irreversibly inhibits cyclooxgenase enzyme. Inhibition of cyclooxgenase prevents the formation of thromboxane A2 and prostaglandins with resultant diminished platelet aggregation.

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107
Q

Drug w markedly increased risk for the development of Reye’s syndrome in children with fevers due to viral conditions such as mumps or chickenpox

A

aspirin/ASA

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108
Q

what can be used in patients who are intolerant or allergic to aspirin

A

ADP receptor antagonists

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109
Q

class of Clopidogrel/ Plavix

A

platelet aggregation inhibitor

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110
Q

what do Glycoprotein IIB/IIIA inhibitors do

A

prevent the binding of fibrinogen, thereby blocking platelet aggregation.

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111
Q

class of Abciximab/ ReoPro

A

glycoprotein IIB/IIIA inhibitor

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112
Q

how does regular weight heparin act as an anti-coagulant

A

Regular weight heparin acts as an anti-coagulant by binding to antithrombin III. The heparin-antithrombin III complex then binds to and inactivates activated factor X (Xa) and factor II (thrombin). Heparin ultimately acts to prevent conversion of fibrinogen to fibrin. Heparin does not actively lyse clots but is able to inhibit further thrombogenesis.

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113
Q

What reverses the effects of heparin

A

Protamine sulfate

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114
Q

how does low molecular weight heparin act

A

directly inactivates factor X (Xa) in the clotting cascade…proven to be as effect as regular weight Heparin but with fewer reported side effects

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115
Q

class of Enoxaparin/ Lovenox

A

low molecular weight heparin

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116
Q

MOA of Warfarin/Coumadin

A

Antagonizes vitamin K. This interferes with the synthesis of vitamin K dependent clotting factors (factors II, VII, IX, and X).

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117
Q

Anti-coagulant effects of Coumadin may be reversed with

A

Vit. K

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118
Q

Coumadin should not be used by

A

Pregnant women

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119
Q

class of Rivaroxaban/ Xarelto

A

anticoagulant

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120
Q

MOA of Rivaroxaban/Xarelto

A

direct inhibiton of factor Xa

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121
Q

class of streptokinase

A

Thrombolytic (clot buster)

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122
Q

Antidote to bleeding in the class of drugs known as “clot busters” (streptokinase)

A

Aminocaproic acid (Amicar) is a plasmin in-activator and antifibrinolytic. It is utilized for bleeding that occurs as a result of streptokinase and other agents in this class of drugs referred to as the “clot busters”.

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123
Q

anti-arrhythmic drug class Ia, Ib, Ic

A

sodium channel blockers

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124
Q

anti-arrhythmic drug class II

A

beta adrenergic receptor blockade

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125
Q

anti-arrhythmic drug class III

A

potassium channel blockade

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126
Q

anti-arrhythmic drug class IV

A

calcium channel blockade

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127
Q

class of Quinidine/Quinidex

A

anti-arrhythmic–Class Ia

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128
Q

MOA of Quinidine/Quinidex

A

sodium channel blocker

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129
Q

drug that causes Cinchonism

A

Quinidine/Quinidex

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130
Q

symptoms of cinchonism include

A

blurred vision, tinnitus, nausea, vomiting, headache, disoreintation and possible psychotic states

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131
Q

drug that may induce Torsade de Pointes

A

Quinidine/Quinidex

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132
Q

Class of Mexiletine/Mexitil

A

anti-arrhythmic Class Ib

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133
Q

MOA of Mexiletine/Mexitil

A

blocks open sodium channels

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134
Q

Class of Flecainide/ Tambocor

A

anti-arrhythmic Class Ic

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135
Q

drug to treat Wolff-Parkinson-White syndrome

A

Flecainide/ Tambocor

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136
Q

MOA of Flecainide/ Tambocor

A

sodium channel blocker

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137
Q

therapeutic index of Flecainide/ Tambocor

A

narrow

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138
Q

primary Class II/Beta Blocker

A

Atenolol/Tenormin

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139
Q

Primary Class III/K+ channel blocker

A

Amiodarone/ Cordarone

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140
Q

MOA of Amiodarone/ Cordarone

A

potassium channel blockade

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141
Q

drug that contains high levels of iodine

A

Amiodarone/ Cordarone

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142
Q

drug that causes Blue-gray coloring of skin can occur as a result of iodine deposition

A

Amiodarone/ Cordarone

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143
Q

primary Class IV/Ca++ channel blocker

A

Verapamil/ Calan, Isoptin

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144
Q

MOA of Verapamil/ Calan, Isoptin

A

calcium channel blockade

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145
Q

initial drug of choice for PSVT

A

Adenosine/ Adenocard

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146
Q

class of atropine

A

anti-arrhythmic

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147
Q

indication of atropine

A

cardiac use is in treatment of bradycardia

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148
Q

MOA of Atropine

A

anticholinergic agent - atropine is a competitive inhibitor of the muscarinic acetylcholine receptors thus it can be thought of as a parasympatholytic.

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149
Q

cardiac drugs which can be administered via an endotracheal tube (for absorption through the lungs)

A

Atropine, Lidocaine, and Epinephrine (ALE)

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150
Q

side effects of atropine

A

Blurred vision, dilated pupils, dry mouth and increased heart rate are usually among the first toxic effects of atropine

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151
Q

antidote for organophsophate poisoning

A

atropine

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152
Q

uses of atropine

A

cycloplegic to temporarily paralyze accommodation and as a mydriatic to dilate the pupils, diarrhea to decrease secretions and slow peristalsis, preoperatively to decrease bronchial and salivary secretions

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153
Q

classic symptoms of acute organophosphate poisoning

A

muscarinic in nature…SLUDGE: salivation, lacrimation, urination, diarrhea, gastric distress, emesis

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154
Q

Toxicity due to atropine results in

A

decreased secretions; flushed, dry, warm skin, visual changes and delirium with hallucinations…Dry as a bone, red as a beet, hot as a hare, blind as a bat, mad as a hatter.

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155
Q

specific antidote for atropine toxicity or tropane alkaloid toxicity is

A

physostigmine, a reversible acetylcholinesterase inhibitor.

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156
Q

Which has a longer half life and is now seldom used because of increased risks of toxicity: Digoxin or digitoxin?

A

Digitoxin…both have very low TI’s though

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157
Q

MOA of Digoxin

A

Inhibitors the Na+/K+ ATPase pump which serves to increase inward current of sodium followed by a greater influx of calcium. Cardiac contraction is enhanced by the increased concentration of intracellular calcium. Also increases renal perfusion.

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158
Q

drug that may cause characteristic flattening or even inversion of the T wave on EKG.

A

Digoxin/ Lanoxin

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159
Q

drug where you get blurred vision, double vision, flickering dots or flashes of light, halos may appear around objects

A

Digitalis

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160
Q

treatment of Digitalis intoxication

A

Digoxin-Fab fragments/ Digibind …they attach to Digoxin molecules and rapidly remove them from receptor sites

161
Q

Omega-3 fish oil available as a prescription drug

A

Lovaza

162
Q

class of Niacin/ Niaspan

A

Anti-hyperlipidemic/B vitamin

163
Q

drug where Intense flushing and pruritis is common.

A

Niacin/ Niaspan

164
Q

how can flushing and itching when taking Niacin/ Niaspan be minimized

A

ASA or NSAIDs taken 30 minutes to an hour before the niacin dose.

165
Q

Niacin/Niaspan is Contraindicated in patients with

A

poorly controlled DM, active liver disease or active peptic ulcer disease.

166
Q

safest form of niacin that is currently available

A

non-prescription Inositol hexaniacinate

167
Q

category of meds that decrease triglyceride production in the liver

A

fibric acid derivatives

168
Q

most commonly used fibric acid derivative

A

Gemfibrozil/Lopid

169
Q

noted contraindication for Gemfibrozil/Lopid

A

contraindicated in patients with pre-existing gallbladder disease and liver disease

170
Q

what do statins do

A

HMG-CoA reductase inhibitors

171
Q

drug class that can lead to rhabdomyolysis, the severe and rapid muscle breakdown which can lead to acute renal failure

A

statins

172
Q

statin drug that was recalled after multiple deaths from rhabdomyolysis

A

Cerivastatin/Baycol

173
Q

primary statin drug

A

Atorvastin/Lipitor

174
Q

Can Atorvastin/ Lipitor be used by pregnant women?

A

no, category X. Also contraindicated in breast feeding mothers as all statin drugs are.

175
Q

type of drug that binds cholesterol and forms insoluble complexes which are excreted in the feces

A

bile acid sequestrants

176
Q

bile acid sequestrants are often used in conjunction with

A

niacin

177
Q

primary bile acid sequestrant

A

cholestyramine/questran

178
Q

class of Ezetimibe/ Zetia

A

anti-hyperlipidemic - cholesterol absorption inhibitor

179
Q

MOA of Ezetimibe/ Zetia

A

inhibits intestinal absorption of cholesterol at the brush border

180
Q

examples of synthetic antimicrobial drugs

A

sulfonamides and Quinolones

181
Q

class of Sulfamethoxazole with Trimethoprim/ Bactrim

A

sulfonamide antibiotic in combination with an additional folic acid inhibitor

182
Q

MOA of Sulfamethoxazole with Trimethoprim/ Bactrim

A

interference with folic acid formation at a successive step to sulfonamides…synergistically inhibits two steps in folic acid synthesis

183
Q

two types of drugs that each affect folic acid production

A

trimethoprim and sulfonamides

184
Q

what part of folic acid production do sulfonamides affect

A

dihydropteroate synthetase

185
Q

what part of folic acid production does trimethoprim affect

A

dihydrofolate reductase

186
Q

Drug that causes Stevens Johnson syndrome (topical epidermal necrolysis)

A

Sulfamethoxazole with Trimethoprim/Bactrim

187
Q

penicillin typically treats infections caused by

A

susceptible Gram-positive organisms

188
Q

what type of antibiotic are penicillins

A

beta-lactam

189
Q

MOA of penicillin G

A

Beta lactam component binds to PBPs on bacteria and thereafter inhibits cross linking of components of bacterial cell wall.

190
Q

MOA of Amoxicillin/ Amoxil

A

Binds to penicillin binding protein and inhibits protein synthesis in the bacterial cell wall.

191
Q

antibiotic that can cause pseudomembranous colitis

A

Amoxicillin and clavulanate/Augmentin

192
Q

interesting thing about dose of Amoxicillin and clavulanate/Augmentin

A

two 250 mg Augmentin capsules will give you twice the clavulanate dose of one 500 mg Augmentin capsule.

193
Q

general action of cephalosporins

A

disrupt the synthesis of the peptidoglycan layer of bacterial cell walls, resulting in cytolysis and cell death

194
Q

First generation of Cephalosporins start with

A

Ceph-…later generations start with Cef-

195
Q

advantage of first generation cephalosporin

A

great gram + coverage but poor gram -

196
Q

advantage of third generation cephalosporin

A

great gram- coverage but poor gram+ coverage

197
Q

MOA of Cephalexin/Keflex

A

Similar to penicillin with inhibition of protein synthesis of the bacterial cell wall via beta lactam activity.

198
Q

Approximately 5%* of penicillin allergic patients will also be allergic to the

A

cephalosporin class of drugs.

199
Q

Macrolides tend to accumulate within

A

leukocytes and are therefore actually transported into the site of infection

200
Q

class of Erythromycin

A

macrolide antibiotic

201
Q

MOA of Erythromycin

A

inhibit protein synthesis by binding to 50 S bacterial ribosome

202
Q

Broad spectrum antibiotic that is generally bacteriostatic in low concentrations and bactericidal in high concentrations. May be used in penicillin allergic patients.

A

Erythromycin

203
Q

MOA of Azithromycin/ Zithromax

A

inhibit protein synthesis by binding to 50 S bacterial ribosome

204
Q

drug that should not be given with calcium supplements or with dairy products as they are chelated by the drug and will markedly diminish drug absorption and bioavailability

A

Tetracyclines

205
Q

drug that should not be used in infants and children younger than age 8 or 15 or in pregnant women because they can permanently stain teeth

A

Tetracyclines

206
Q

class of Tetracycline/ Sumycin

A

Tetracycline antibiotic

207
Q

MOA of Tetracycline/ Sumycin

A

inhibits bacterial protein synthesis by interfering with 30 S ribosome. Bacteriostatic rather than bactericidal.

208
Q

drug commonly used to treat acne and acne rosacea. Chlamydia. Lyme disease. Rocky Mountain Spotted Fever.

A

Tetracycline/ Sumycin

209
Q

Drug that chelates calcium ions. Accumulates in bone and teeth. Avoid taking this class of drugs with dairy products or calcium supplements.

A

Tetracycline/ Sumycin

210
Q

Gentamicin/ Garamycin class

A

aminoglycoside antibiotic

211
Q

MOA of Gentamicin/ Garamycin

A

Binds to 30 S and 50 S ribosomal subunits interfering with protein synthesis. Bactericidal.

212
Q

Potentially nephrotoxic and ototoxic antibiotic

A

Gentamicin/ Garamycin

213
Q

mechanism of Quinolones

A

inhibit bacterial DNA gyrase, thereby inhibiting DNA replication and transcription

214
Q

drug class with side effect of tendon damage or spontaneous tendon rupture

A

Quinolones

215
Q

class of Ciprofloxacin/Ciproxin

A

Quinolone antibiotic

216
Q

MOA of Ciprofloxacin/Ciproxin

A

Inhibits DNA gyrase, an enzyme responsible for properly uncoiling DNA during transcription.

217
Q

1st generation Quinolones have good coverage with

A

Gram - bacteria

218
Q

2nd generation Quinolones have good coverage with

A

Gram + bacteria

219
Q

Who should Ciprofloxacin/Ciproxin be avoided in

A

The Quinolones chelate calcium and can be deposited in cartilage, thus the use of oral or parenteral forms should be avoided in all children and infants and all pregnant and lactating females.

220
Q

Specific drug that is associated with increased risk for tendon injury (esp. Achilles tendon injury) in adults taking the drug and also reduces the metabolic breakdown of caffeine, thus prolonging the effects.

A

Ciprofloxacin/Ciproxin

221
Q

class of Metronidazole/ Flagyl

A

Imidazole class of antibiotics

222
Q

MOA of Metronidazole/ Flagyl

A

activated intermediates of the drug bind to DNA and inhibit further nucleic acid synthesis

223
Q

Drug that drinking alcohol can result in Disulfiram-like (aka Antabuse-like) reaction with nausea, vomiting, flushing, and tachycardia.

A

Metronidazole/Flagyl

224
Q

drug that interrupts the breakdown of alcohol

A

Metronidazole/Flagy

225
Q

MOA of Nitrofurantoin/ Macrobid

A

disrupts both DNA and RNA of bacteria which are sensitive to the drug.

226
Q

Drug with rare adverse effects include pulmonary fibrosis and drug-induced autoimmune hepatitis.

A

Nitrofurantoin/ Macrobid

227
Q

class of Clindamycin/Cleocin

A

lincosamide antibiotic

228
Q

MOA of Clindamycin/Cleocin

A

binds to 50 S ribosomal subunits of bacteria which acts to inhibit protein synthesis

229
Q

class of Vancomycin/ Vancocin

A

glycopeptide antibiotic

230
Q

MOA of Vancomycin/ Vancocin

A

Inhibits synthesis of bacterial cell wall phospholipids as well as inhibition of peptidoglycan polymerization at a site separate from the penicillin binding proteins sites utilized by beta lactam antibiotics.

231
Q

Are Clindamycin and Erythromycin related drugs?

A

No

232
Q

Drug associated with a complication reffered to as Red Man Syndrome or Red Neck Syndrome…characterized by intense facial flushing, diffuse erythema, and possible bullae formation and desquamation

A

Vancomycin/ Vancocin

233
Q

MOA of Rifampicin/Rifampin

A

Rifampicin inhibits DNA-dependent RNA polymerase in bacterial cells thus preventing transcription to RNA and subsequent translation to proteins.

234
Q

Antibiotic for treatment of traveler’s diarrhea

A

Rifaximin/Xifaxan

235
Q

Drug that turns urine and saliva orange

A

Rifampicin/Rifampin

236
Q

MOA of Mupirocin/Bactroban

A

selective binding to bacterial isoleucyl-tRNA synthetase, which halts the incorporation of isoleucine into bacterial proteins.

237
Q

topical drug to treat bacterial skin infections, such as IMPETIGO, boils, and folliculitis

A

Mupirocin/Bactroban

238
Q

MOA of Bacitracin

A

interferes with the transfer of cell wall precursors from the bacterial cell membrane to the cell wall.

239
Q

Class of Neomycin

A

aminoglycoside antibiotics

240
Q

How do aminoglycosides work

A

binding to the bacterial 30S ribosomal subunit, leaving the bacterium unable to synthesize proteins vital to its growth.

241
Q

Neomycin and other members of the aminoglycoside class are extremely effective in killing

A

Gram - bacteria

242
Q

MOA of Polymycin B

A

bind to the bacterial cell membrane and alters its structure, making it more permeable. Increased cell wall permeability results in marked water uptake by the bacterial cell and subsequent cell death.

243
Q

what drug class have a risk profile that is too great to be used for an infection like Strep throat

A

aminoglycosides

244
Q

class of Clotrimazole/ Lotrimin

A

antifungal

245
Q

MOA of Clotrimazole/ Lotrimin

A

binds to ergosterol molecules on the fungal cell membrane and causes membrane leakage during cell division

246
Q

class of Nystatin/ Mycostatin

A

antifungal, may be used both topically and systemically

247
Q

MOA of Nystatin/ Mycostatin

A

binds to ergosterol molecules on the fungal cell membrane and causes membrane leakage during cell division

248
Q

current drug of choice for onychomycosis

A

Terbinafine/ Lamisil

249
Q

Terbinafine/ Lamisil is mainly effective on group of fungi known as

A

dermatophytes

250
Q

class of Fluconazole/ Diflucan

A

antifungal, both topical and systemic

251
Q

MOA of Fluconazole/ Diflucan

A

inhibits fungal membrane synthesis

252
Q

anti-fungal that can be used as vaginal suppository for yeast vaginitis

A

Fluconazole/ Diflucan

253
Q

Can inhibit Fluconazole/ Diflucan can inhibit cytochrome enzyme systems responsible for metabolism of many drugs

A

Fluconazole/ Diflucan

254
Q

class of Amphotericin B/Amphocil

A

antimycotic

255
Q

MOA of Amphotericin B/Amphocil

A

binds to ergosterol molecules on the fungal cell membrane and disrupts membrane integrity, resulting in death of the fungal cell

256
Q

Drug with fevers and shaking chills are common. Pre-treatment with Benadryl, NSAIDs or Prednisone often used to mitigate the fever and chills.

A

Amphotericin B/Amphocil

257
Q

Isoniazid (INH) / Nitrazid class

A

antibiotic

258
Q

MOA of Isoniazid (INH) / Nitrazid

A

Isoniazid is a pro-drug and must be activated by bacterial catalase. The activated form of INH inhibits the synthesis of mycolic acid in the mycobacterial cell wall

259
Q

Drug that competes with an enzyme that is needed to produce pyridoxine

A

Isoniazid (INH) / Nitrazid

260
Q

peripheral neuropathy is a common side effect when using ____ and is caused by

A

when using Isoniazid and is caused by INH induced pyridoxine deficiency…so you should take B6 in conjunction

261
Q

class of Rifampin/ Rifadin

A

antibiotic

262
Q

MOA of Rifampin/ Rifadin

A

inhibits DNA-dependent RNA polymerase in bacterial cells thus preventing transcription of messenger RNA and subsequent translation to protein production

263
Q

Standard treatment of TB

A

Rifampin/Rifadin, Isoniazid (INH)/Nitrazid, Pyrazinamide/Pyrazinamide, Ethambutol/Myambutol

264
Q

drug that is a nicotinamide analog with an unknown mechanism of action

A

Pyrazinamide

265
Q

MOA of Ethambutol

A

inhibits mycolic acid synthesis in the mycobacterial cell wall

266
Q

Multi-drug resistant tuberculosis (MDR-TB) is defined as TB that is resistant to at least

A

Isoniazid and Rifampin

267
Q

acronym for CDC recommended empiric treatment of patient suspected of having MDR-TB

A

SHREZ MC

268
Q

7 drugs that make up SHREZ MC are

A

Streptomycin + Hydrazine + Rifampin + Ethambutol + pyraZinamide + Moxifloxacin (a fluoroquinolone) and Cycloserine (a broad spectrum antibiotic)

269
Q

how soon do you need to administer Oseltamivir/ Tamiflu for it to be effective

A

w/in 48 hours of symptoms

270
Q

MOA of Oseltamivir/ Tamiflu

A

neuramidase inihbitiion, preventiing virus from budding off from cell. Oseltamivir/ Tamiflu was first orally active neuraminidase inhibitor to be commercially developed.

271
Q

Zanamivir/ Relenza is not recommended in people with

A

history of asthma or COPD due to risk of serious bronchospasm

272
Q

MOA of Zanamivir/ Relenza

A

neuramidase inhibitor

273
Q

drug that is used as a treatment for the early stages of Parkinson’s disease

A

Amandatine/ Symmetrel…best used as short term therapy (6-12 months)…its an anti-viral that was recommended as prophylaxis for influenza

274
Q

primary drug for herpesvirus infection

A

Acyclovir/Zovirax

275
Q

class of Acyclovir/ Zovirax

A

antiviral

276
Q

MOA of Acyclovir/ Zovirax

A

guanosine analog that is incorporated into the virus DNA and inhibits further viral synthesis

277
Q

Does Acyclovir/ Zovirax actively cross the blood barrier?

A

Yes. It can be used to treat herpes meningitis and encephalitis.

278
Q

4 main categories of drugs used as treatment or prophylaxis against HIV

A

reverse transcriptase inhibitors (RTIs), protease inhibitors (PIs), fusion inhibitors, integrase inhibitors

279
Q

primary Nucleoside reverse transcriptase inhibitor

A

Zidovudine (AZT)/ Retrovir

280
Q

MOA of Zidovudine (AZT)/ Retrovir

A

pyrimidine analog that is incorporated into the viral DNA by reverse transcriptase. Incorporation into viral DNA terminates further replication

281
Q

____ inhibitors are currently used to treat HIV and Hep C

A

protease inhibitors

282
Q

primary protease inhibitor

A

Saquinavir/ Invirase

283
Q

MOA of Saquinavir/ Invirase

A

Protease enzyme inhibition prevents viral protein molecules from being cleaved into smaller fragments, which prevents both the replication of the virus within the cell and the release of mature viral particles from an infected cell.

284
Q

interferon alpha is for

A

Hep C

285
Q

Interferon Beta is for

A

relapsing multiple sclerosis

286
Q

interferon gamma is for

A

chronic granulomatous diseases

287
Q

indication of Interferon alpha

A

chronic hep B and C, genital warts due to HPV, Kaposi’s sarcoma and hairy cell leukemia

288
Q

MOA of Interferon alpha

A

Interferon is a naturally occurring glycoprotein that interferes with the ability of a virus to infect cells. Interferon appears to induce host cell enzymes that inhibit viral RNA translation and subsequent viral synthesis within the infected host cell.

289
Q

When treating hepatitis C, pegylated interferon is often administered with the drug

A

Ribavirin

290
Q

name the two recombinant protein vaccinations

A

Hep B and HPV

291
Q

Gardasil and Cervarix protect against what two types of HPV

A

HPV 16 and 18, 6 and 11

292
Q

substances added to boost the immune response to a vaccine

A

adjuvant

293
Q

examples of aluminum containing vaccines

A

Hep A, Hep B, and DTaP

294
Q

as of 2005 the only childhood vaccine in the US that still contained more than trace amounts of Thiomersal is

A

influenza vaccine

295
Q

what type of vaccine is Hib

A

conjugate

296
Q

what type of vaccine is Meningococcal

A

conjugate

297
Q

for people that are asplenic, revaccination at period intervals is recommended for what vaccine

A

pneumococcal vaccine…also recommended for nephrotic syndrome

298
Q

Psyllium/ Metamucil class

A

fiber laxative

299
Q

MOA of Psyllium/ Metamucil

A

contains soluble and insoluble fiber. adds bulk to stool as well as absorbing fluid into the feces to soften the stool

300
Q

“Drug” that can contain gluten if in wafer form

A

Psyllium/ Metamucil

301
Q

class of Docusate/ Colace

A

stool softener

302
Q

MOA of Docusate/ Colace

A

anionic surfactant

303
Q

class of Magnesium Hydroxide/ Milk of Magnesia

A

osmotic laxative, antacid

304
Q

Bisacodyl/ Dulcolax class

A

stimulative laxative

305
Q

MOA of Bisacodyl/ Dulcolax

A

increases intestinal motility

306
Q

class of Loperamide/ Imodium

A

antidiarrheal - analog of Meperidine

307
Q

MOA of Loperamide/ Imodium

A

diminished peristalsis due to activation of opiate receptors in GI tract. Loperamide is an opioid receptor agonist and acts on the u-opioid receptors in the myenteric plexus within the large intestines. It does not affect the central nervous system like other opioids. Dimished activity of the myenteric plexus decreases the motility of the circular and longitudinal smooth muscles of the intestinal wall. This increases the amount of time substances stay in the intestine, allowing for more water to be absorbed out of the fecal matter.

308
Q

class of Diphenoxylate with Atropine/ Lomotil

A

antidiarrheal

309
Q

MOA of Diphenoxylate with Atropine/ Lomotil

A

combination of morphine analog and acetylcholine inhibitor results in diminished peristalsis

310
Q

what antidiarrheal is generally no indicated beyond 48 hours

A

Diphenoxylate with Atropine/ Lomotil

311
Q

What is the active ingredient in Kaopectate

A

Bismuth subsalicylate (same as Pepto-Bismol). It was formerly kaolin clay (kaolinite) and pectin.

312
Q

moderate to severe N/V may require more potent agents that block

A

the 5-HT3 receptor sites

313
Q

Meclizine/ Antivert class

A

antiemetic, H1 blocker

314
Q

class of Metoclopramide/ Reglan

A

antiemetic/pro-kinetic

315
Q

MOA of Metoclopramide/ Reglan

A

dopamine 2 blocker and mixed serotonin 3 antagonist/serotonin 4 agonist

316
Q

class of Ondansetron/ Zofran

A

antiemetic

317
Q

MOA of Ondansetron/ Zofran

A

blockade of serotonin (5HT3) receptor sites results in significant anti-nausea effect

318
Q

what is an effective agent for severe nausea due to various chemotherapeutic agents (given approx. 30 min prior)

A

Ondansetron/ Zofran

319
Q

MOA of Emetic/ Syrup of Ipecac

A

stimulation of medullary chemoreceptor trigger zone and local irritant of GI tract

320
Q

Emetic/ Syrup of Ipecac is not given with

A

charcoal

321
Q

class of Calcium carbonate/ Tums

A

antacid

322
Q

MOA of Calcium carbonate/ Tums

A

neutralization of stomach acid, reducing mucosal irritation

323
Q

side effect of Calcium carbonate/ Tums

A

constipation

324
Q

class of Ranitidine/ Zantac

A

H2 Histamine receptor antagonist

325
Q

MOA of Ranitidine/ Zantac

A

blocks the action of histamine on parietal cells in the stomach, decreasing acid production by these cells

326
Q

class of Omeprazole/ Prilosec

A

Proton Pump Inhibitor

327
Q

Esomeprazole/ Nexium–what is it

A

single enantiomer form of Omeprazole that AstraZeneca made because they lost their patent

328
Q

rank least to most potent drug classes for stomach acid

A

antacid, H2 blocker, PPI

329
Q

therapy of choice for PUD

A

triple therapy for 7-14 days for PUD due to H Pylori

330
Q

antibiotics used in Triple Therapy for PUD

A

Amoxicillin, Erythromycin, Clarithromycin (Biaxin), Tetracycline or Metronidazole (Flagyl)…NOT Zithromax

331
Q

5-aminosalicylic acid (5-ASA), also called Mesalamine can be used to treat

A

inflammatory bowel disease

332
Q

class of 5-ASA/ Mesalamine

A

aminosalicylates

333
Q

MOA of 5-ASA/ Mesalamine

A

inhibition of leukotriene production, anti-prostaglandin and anti-oxidant effects

334
Q

5-ASA/ Mesalamine, is it more useful for Crohn’s or UC

A

far more useful for UC

335
Q

Who benefits more from antibiotics: Crohn’s or UC?

A

Patients with Crohn’s disease

336
Q

two of the most commonly used antibiotics for treating Crohn’s disease

A

Metronidazole/Flagyl and Ciprofloxacin/Ciprofloxin

337
Q

Budesonide/ Entocort is used to treat

A

mild to moderate Crohn’s disease

338
Q

Azthioprine/ Immuran class

A

immunomodulator

339
Q

MOA of Azthioprine/ Immuran

A

inhibits purine synthesis, resulting in an anti-proliferative effect and induction of apoptosis of T-cells

340
Q

Infliximib/ Remicade class

A

immunomodulator - TNF inhibitor

341
Q

MOA of Infliximib/ Remicade

A

inhibits the pro-inflammatory cytokine, TNF-alpha

342
Q

major side effect of Infliximib/ Remicade

A

drug induced lupus

343
Q

several medications are available to treat urge incontinence by

A

blocking acetylcholine action on the bladder and diminish detrusor muscle contraction

344
Q

class of Oxybutynin/ Ditropan

A

anticholinergic med

345
Q

MOA of Oxybutynin/ Ditropan

A

competitive antagonism of M3 subtype of the muscarinic acetylcholine receptor

346
Q

class of Tolterodine/ Detrol

A

anticholinergic med

347
Q

indication of Tolterodine/ Detrol

A

used to relieve frequent urination and inability to control urination due to urge incontinence

348
Q

MOA of Tolterodine/ Detrol

A

competitive antagonism of M2 and M3 subtypes of the muscarinic acetylcholine receptor

349
Q

Tolterodine/ Detrol and Oxybutynin/ Ditropan have potential interactions with

A

drugs metabolized by cytochrome P450

350
Q

class of Imipramine/ Tofranil

A

tricyclic antidepressant, mainly used in the treatment of clinical depression but is also used in cases of urge incontinence and enuresis

351
Q

MOA of Imipramine/ Tofranil

A

blocks reuptake of serotonin and norepinephrine and appears to diminish acetylcholine uptake in smooth muscle

352
Q

2 very important things about Imipramine/ Tofranil

A

black box warning about increased risk for suicidal ideation and suicide. Overdose can be fatal due to a heart block.

353
Q

drug used frequently for enuresis

A

Imipramine/ Tofranil

354
Q

two main medication for management of BPH are

A

alpha blockers and 5alpha-reductase inhibitors

355
Q

class of Tamsulosin/ Flomax

A

alpha 1 receptor antagonist

356
Q

MOA of Tamsulosin/ Flomax

A

smooth muscle relaxation via alpha adrenergic antagonism

357
Q

side effects of Tamsulosin/ Flomax

A

retrograde ejaculation

358
Q

class of Finasteride / Proscar

A

5 alpha-reductase inhibitor

359
Q

indication of Finasteride / Proscar

A

BPH

360
Q

MOA of Finasteride / Proscar

A

blocks conversion of testosterone to dihydrotestosterone

361
Q

Drug that is used for male pattern baldness and BPH

A

a lower dosage of Finasteride / Proscar

362
Q

Drug that women who are or who may become pregnant must not handle crushed or broken

A

Finasteride / Proscar

363
Q

the drug of choice for cystitis has been

A

TMP-Sulfa/Bactrim

364
Q

drug that changes urine to distinct dark orange or reddish color

A

Phenazopyridine/ Pyridium

365
Q

drug that has been known to permanently discolor contact lenses

A

Phenazopyridine/ Pyridium

366
Q

Drug that should be used with caution in people with Parkinson’s disease because, as a dopamine antagonist, it may worsen the condition

A

Metoclopramide/ Reglan

367
Q

dilution of epinephrine for anaphylaxis or status asthmaticus

A

1:1000 SQ or IM

368
Q

dilution of epinephrine for cardiac issues (i.e. life threatening bradycardia)

A

1:10,000 I.V.

369
Q

dilution of epinephrine for local injection when epinephrine is used along with an anesthetic agent (i.e. Lidocaine with epi)

A

1:50,000

370
Q

treatments for bacterial vaginosis

A

metronidazole or clindamycin

371
Q

treatments for cervicitis

A

azithromycin or doxycycline

372
Q

treatments for chlamydia in adults and adolescents

A

azithromycin and doxycycline

373
Q

treatment for chlamydia in pregnent people

A

azithromycin

374
Q

treatments for chlamydia in infants, children, and neonates

A

erythromycin and ethylsuccinate

375
Q

treatment for acute epididymitis likely caused by sexually transmitted CT and GC

A

ceftriaxone and doxycycline

376
Q

treatment for acute epididymitis likely caused by sexually transmitted CT and GC and enteric organisms (anal sex)

A

ceftriaxone, levofloxacin, ofloxacin

377
Q

acute epididymitis caused by enteric organisms

A

levofloxacin or ofloxacin

378
Q

treatments for genital herpes simplex

A

acylcovir or valacyclovir or famciclovir

379
Q

treatment for genital warts (HPV)

A

imiquimod or podofilox or sinecatechins or trichloroacetic acid or bichloroacetic acid

380
Q

treatments for gonoccocal infections in adults and adolescents

A

ceftriaxone or azithromycin

381
Q

treatment for pharyngeal gonorrhea

A

ceftriaxone or azithroycin

382
Q

gonococcal conjunctivitis

A

ceftriaxone plus azithromycin

383
Q

gonorrhea in children

A

ceftriaxone

384
Q

treatment for Lymphogranuloma venereum

A

doxycycline

385
Q

treatments for Nongonococcal Urethritis (NGU)

A

azithromycin or doxycycline

386
Q

treatments for Pediculosis Pubis

A

permethrin or pyrethrins with piperonyl butoxide

387
Q

treatments for Pelvic Inflammatory Disease

A

cefotetan plus doxycycline parenterally or IM: ceftriaxone with doxycycline

388
Q

treatment for Scabies

A

permethrin or ivermectin

389
Q

treatment for syphilis

A

benzathine penicillin G

390
Q

treatment for Trichomoniasis

A

metronidazole or tinidazole

391
Q

treatment for strep throat

A

penicillin or erythromycin if allergic

392
Q

treatment of acute otitis media

A

amoxicllin, cephalosporin, or azithromycin if allergic

393
Q

treatment for acute sinusitis

A

amoxil or a cephalosporin, erythromycin if allergic

394
Q

treatments for bronchitis

A

amoxil, tmp-sulfa, or azithromycin

395
Q

treatments for pneumonia

A

erythromycin or azithromycin, possibly quinolones

396
Q

treatment for cystitis

A

TMP-sulfa

397
Q

treatment for pyelonephritis

A

quinolones

398
Q

treatment of celluliis

A

TMP-sulfa or mupiocin (bactroban)

Pharm 1 Jack (8 decks)

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