Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharma > Major Classes of Antibiotics > Flashcards

Major Classes of Antibiotics Flashcards

1
Q

Group of powerful antibiotics used to
treat serious infections caused by
gram-negative aerobic bacilli

A

Aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

amikacin, gentamicin, kanamycin,
neomycin, streptomycin, tobramycin

A

Aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Therapeutic Actions and Indications for Aminoglycosides.

A
  • Inhibit protein synthesis in susceptible strains of gram-negative bacteria
  • Irreversibly bind to a unit of a bacteria ribosome. Leading to misreading of a genetic code and cell
    death
  • Treat serious infections caused by susceptible strains of gram-negative bacteria (Pseudomonas
    auruginosa, E. coli, Proteus species, Kleibsiella Enterobacter-Serratia group, Citrobacter Species,
    and Staphylococcus aureus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pharmacokinetics of Aminoglycosides

A

Are poorly absorbed from the GI tract but rapidly absorbed after intramuscular (IM) injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Contraindications and Cautions for Aminoglycosides

A
  • Known allergy; Renal or hepatic disease; Preexisting hearing loss; Active herpes or mycobacterial infection; Myasthenia gravis or parkinsonism; Lactation
  • Do not use for longer than 7 to 10 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Adverse effects of Aminoglycosides

A
  • CNS: Ototoxicity (deafness, vestibular paralysis), confusion, depression, disorientation, and numbness, tingling, and weakness
  • Nephrotoxicity
  • GI effects: nausea, vomiting, diarrhea, weight loss, stomatitis, and hepatic toxicity
  • Cardiac: palpitations, hypotension, and hypertension
  • Hypersentivity: purpura, rash, urticarial, and exfoliative dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinically important drug-drug interactions for Aminoglycosides

A
  • Synergistic bactericidal effect when given with penicillin,
    cephalosporins, or ticarcillin
  • Avoid combining with diuretics, anesthetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  • Are relatively new class of broad-spectrum antibiotics effective against gram-positive and gram-negative bacteria
  • meropenem, diropenem, ertapenem, imipenemclistatin
A

Carbapenems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Therapeutic Actions and Indications for Carbapenems

A
  • Bactericidal
  • Inhibit cell membrane synthesis in susceptible bacteria, leading to
    cell death
  • Treat serious infections caused by susceptible strains of S. pneumoniae,Haemophilus influenzae, Moraxella catarrhalis, S.
    aureus, Streptococcus pyogenes, E. coli, Peptostreptococcus,
    Klebsiella pneumoniae, Clostridium clostridiiforme, Eubacterium
    lentum, Bacteroides fragilis, Bacteroides distasonis, Bacteroides
    ovatus, Bacteroides thetaiotamicron,, Bacteroides uniformis,
    Proteus mirabilis, P. aeruginosa, Acinetobacter baumannii,
    Streptococcus agalactiae, Porphyromonas asaccharolytica,
    Prevotella bivia
  • Indicated for treatment of serious intra-abdominal, urinary tract, skin
    and skin structure, bone and joint and gynecological infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pharmacokinetics of Carbapenems

A

Rapidly absorbed if given IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  • Contraindications and cautions of Carbapenems
A
  • Known allergy; seizure disorders; meningitis; lactation
  • Not for use in patients younger than 18 years old (ertapenem)
  • Used with caution in patients with inflammatory bowel disorders (meropenem)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Adverse effects of Carbapenems

A
  • GI: pseudomembranous colitis, Clostridium difficile diarrhea, and nausea and vomiting
  • Superinfections
  • CNS: headache, dizziness, and altered mental
    state
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinically important drug-drug interactions for Carbapenems

A
  • Not used with Valproic acid
  • Avoid using imipenem with vganciclovir
  • Avoid using meropenem with probenecid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What major class of Antibiotic has 4 generations?

A

Cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  • Effective against gram-positive bacteria that are affected by penicillin G, as well as the gram-negative
    bacteria P. mirabilis, E. coli, and K. pneumoniae
  • cefadroxil, cefazolin, cephalexin
A

First generation of Cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • Effective against previously mentioned strain as well
    as H. influenza, Enterobacter aerogenes, and Neisseria species
  • cefaclor, cefoxitin, cefprozil, cefuroxime
A

Second generation of Cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  • Effective against all of the previously mentioned strains, as well as gram-negative bacilli Serratia marcescens
  • cefdinir, cefotaxime, ceftibuten, ceftizoxime, ceftriaxone
A

Third generation cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  • active against gram-negative and gram-positive organisms including cephalosporin resistant staphylococci
    and P. aeruginosa
  • cefditoren, ceftaroline, cefipime
A

Fourth generation cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Therapeutic Actions and Indications for
Cephalosporins

A
  • Bactericidal and bacteriostatic
  • Interfere with cell wall-building ability of bacteria when they divide, that is, they prevent the bacteria from
    biosynthesizing the framework of their call walls. The bacteria with weakened cell walls swell and burst as a
    result of osmotic pressure within the cell.
  • Indicated for the treatment of infections caused by susceptible bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pharmacokinetics of: Cephalosporins

A

Well absorbed from the GI tract, some IM or IV administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Contraindications and Cautions for: Cephalosporins

A

Pharmacokinetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Adverse effects of: Cephalosporins

A
  • GI: nausea, vomiting, diarrhea, anorexia, abdominal pain, and flatulence, pseudomembranous colitis, bloody diarrhea or abdominal pain
  • CNS: headache, dizziness, lethargy, and paresthesias
  • Nephrotoxicity, superinfections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinically important drug-drug interactions for: Cephalosporins

A
  • Cephalosporins and aminoglycosides increases risk for nephrotoxicity (check BUN and creatinine levels)
  • May increase bleeding if given with anticoagulants
  • Avoid alcohol for 72 hours after discontinuing the drug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Therapeutic Actions and Indications for: Fluoroquinolones

A
  • interfere with the action of DNA enzymes necessary for the growth and reproduction of the bacteria leading to cell death
  • indicated for treating infections caused by susceptible strains of gram-negative bacteria, including E. coli, P.
    mirabilis, K. pneumoniae, Enterobacter cloacae, Proteus vulgaris, Proteus rettgeri, Morganella morganii, M. catarrhalis, H. infl uenzae, H.
    parainfluenzae, P. eruginosa, Citrobacter freundii, S. aureus, Staphylococcus epidermidis, some Neisseria gonorrhoeae, and group D streptococci infections
    frequently include urinary tract, respiratory tract, and
    skin infections
  • anthrax infection, typhoid fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pharmacokinetics of: Fluoroquinolones

A

Absorbed in the GI tract, metabolized in the liver, and excreted in the urine and feces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Contraindications and Cautions for: Fluoroquinolones

A
  • Known allergy; pregnant and lactating
    patients
  • Caution with renal dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Adverse effects of: Fluoroquinolones

A
  • CNS: Headache, dizziness, insomnia, and depression
  • GI: nausea, vomiting, diarrhea, and dry mouth
  • Tendinitis and Tendon rupture
  • Immune: bone marrow depression
  • Others: fever, rash, and photosensitivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Clinically important drug-drug interactions for: Fluoroquinolones

A
  • Decreased with iron salts, sucralfate, mineral supplements, or antacids
  • Cardiac reactions: quinidine, procainamide, amiodarone, sotalol, erythromycin, terfenadine,
    pentamidine, tricyclics, phenothiazines)
  • Increased theophylline levels if taken together
  • Increased tendonitis and tendon rupture with corticosteroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

was the first antibiotic introduced for clinical use.

A

Penicillin and Penicillinase Resistant antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

He used Penicillium molds to produce the original penicillin in the 1920s.

A

Sir Alexander Fleming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

penicillin G benzathine, penicillin G potassium, penicillin G procaine, penicillin V, amoxicillin,
and ampicillin

A

Penicillin and Penicillinase Resistant antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Therapeutic Actions and Indications for: Penicillin and Penicillinase Resistant antibiotics

A
  • Produce bactericidal effects by interfering with the ability of susceptible bacteria to build their cell
    walls when they are dividing
  • indicated for the treatment of streptococcal infections, including pharyngitis, tonsillitis, scarlet
    fever, and endocarditis; pneumococcal infections; staphylococcal infections; fusospirochetal infections; ratbite fever; diphtheria; anthrax; syphilis; and uncomplicated gonococcal infections,
    meningococcal meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pharmacokinetics of: Penicillin and Penicillinase Resistant antibiotics

A
  • rapidly absorbed from the GI tract, reaching peak levels in 1 hour. They are sensitive to the gastric acid levels in the stomach and should be taken on
    an empty stomach to ensure adequate absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Contraindications and Cautions for: Penicillin and Penicillinase Resistant antibiotics

A
  • Known allergy
  • Caution with renal dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Adverse effects of: Penicillin and Penicillinase Resistant antibiotics

A
  • GI: nausea, vomiting, diarrhea, abdominal pain, glossitis, stomatitis, gastritis, sore mouth, and furry
    tongue
  • Hypersensitivity: fever, rash, wheezing and anaphylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Clinically important drug-drug interactions for: Penicillin and Penicillinase Resistant antibiotics

A
  • Decreased with tetracycline
  • Inactivation of aminoglycosides if given together
36
Q
  • Drugs that inhibit folic acid synthesis
  • sulfadiazine, sulfasalazine, cotrimoxazole
A

Sulfonamides

37
Q

Therapeutic Actions and Indications for: Sulfonamides

A
  • competitively block paraaminobenzoic acid to prevent the synthesis of folic acid in susceptible bacteria that synthesize their own folates for the
    production of RNA and DNA
  • gram-negative and gram-positive bacteria such as Chlamydia trachomatis and Nocardia and some strains of H. influenzae, E. coli, and P. mirabilis
  • treatment for UTIs and trachoma, nocardiosis,
    STD’s
38
Q

Pharmacokinetics of: Sulfonamides

A

absorbed from the GI tract, metabolized in the liver, and excreted in the urine.

39
Q

Contraindications and Cautions for: Sulfonamides

A
  • Known allergy, pregnancy and lactation
  • Caution with renal disease or history of kidney stones
40
Q

Adverse effects of: Sulfonamides

A
  • GI: nausea, vomiting, diarrhea, abdominal pain, anorexia, stomatitis, and hepatic injury
  • Renal: crystalluria, hematuria, and proteinuria, nephrotic syndrome, toxic nephrosis
  • CNS: headache, dizziness, vertigo, ataxia, convulsions, and depression
  • Bone marrow depression
  • Dermatologic: photosensitivity and rash
41
Q

Clinically important drug-drug interactions for: Sulfonamides

A
  • tolbutamide, tolazamide, glyburide, glipizide, or chlorpropamide increases hypoglycemia
  • cyclosporine increases nephrotoxicity
42
Q
  • were developed as semisyntheticantibiotics
    based on the structure of a common soil mold. They are composed of four rings, thus its name.
  • tetracycline, demeclocycline, doxycycline, minocycline
A

Tetracycline

43
Q

Therapeutic Actions and Indications for: Tetracycline

A
  • work by inhibiting protein synthesis in a wide range of bacteria,
    leading to the inability of the bacteria to multiply
  • infections caused by Rickettsiae, Mycoplasma pneumoniae,
    Borrelia recurrentis, H. influenzae, Haemophilus ducreyi,Pasteurella
    pestis, Pasteurella tularensis, Bartonella bacilliformis, Bacteroides
    species, Vibrio comma, Vibrio fetus, Brucella species, E. coli, E.
    aerogenes, Shigella species, Acinetobacter calcoaceticus,
    Klebsiella species, Diplococcus pneumoniae, and S. aureus;
    against agents that cause psittacosis, ornithosis, ymphogranuloma
    venereum, and granuloma inguinale; when penicillin is
    contraindicated in susceptible infections; and for treatment of acne
    and uncomplicated GU infections caused by C. trachomatis
  • adjunct to protozoal infections
44
Q

Pharmacokinetics of: Tetracycline

A
  • absorbed adequately, but not completely, from the GI tract. Their absorption is affected by food, iron,
    calcium, and other drugs in the stomach.
  • concentrated in the liver and excreted unchanged in the urine
45
Q

Contraindications and Cautions for: Tetracycline

A
  • Known allergy, pregnancy and lactation
  • Ophthalmic preparation is contraindicated in patients with fungal, mycobacterial, or viral ocular
    infections
  • Used with cautions in children below 8 years old, hepatic or renal dysfunction
46
Q

Adverse effects of: Tetracycline

A
  • GI: nausea, vomiting, diarrhea, abdominal pain, glossitis, and dysphagia
  • Fatal hepatotoxicity
  • Skeletal: damage to teeth and bones
  • Dermatologic: photosensitivity and rash
47
Q

Clinically important drug-drug interactions for: Tetracycline

A
  • Decrease effectiveness of penicillin G and oral contraceptives
  • Increased digoxin toxicity
  • Decreased absorption with from combination with calcium salts, magnesium salts, bismuth salts,
    iron, urinary alkalinizers, and charcoal
48
Q

Clinically important drug-food interactions

A

Administer on an empty stomach

48
Q

the group of bacteria that contain the pathogens that cause tuberculosis and leprosy are classified on the basis of their ability to hold a stain even in
the presence of a “destaining” agent such as acid. Because of this property, they are called “acidfast” bacteria.

A

Mycobacteria

49
Q

What type of Antibiotic is against Mycobacteria? And is also a Antituberculosis Drug.

A

Antimycobacterials

50
Q

Tuberculosis can lead to serious damage in the lungs, the GU tract, bones, and the meninges.
Because M. tuberculosis is so slowly growing, the treatment must be continued for (answer).

A

6 months to 2
years

51
Q

First line of Antimycobacterials

A

soniazid, rifampin, pyrazinamide,
ethambutol, streptomycin, rifapentine

52
Q

Second line of Antimycobacterials

A

ethionamide, capreomycin,
cycloserine, and rifabutin

53
Q

Pharmacokinetics of: Antimycobacterials

A

Generally well absorbed from the GI tract. These drugs, given orally, are metabolized in the liver and excreted in the urine.

54
Q

Contraindications and Cautions for: Antimycobacterials

A

Known allergy, hepatic and renal failure,
pregnancy

55
Q

Adverse effects of: Antimycobacterials

A
  • CNS: neuritis, dizziness, headache, malaise, drowsiness, and hallucinations
  • GI: nausea, vomiting, anorexia, stomach upset, and abdominal pain
  • Rifampin, rifabutin, and rifapentine: discoloration of body fluids- orange-tinge (urine, sweat, tears)
56
Q

Clinically important drug-drug interactions for: Antimycobacterials

A
  • Increased toxic liver reaction with INH and rifampin
  • Increased metabolism and decreased drug effectiveness with quinidine, metoprolol, propranolol, corticosteroids, oral contraceptives,
    oral anticoagulants, oral antidiabetic agents, digoxin, theophylline, methadone, phenytoin, verapamil, cyclosporine, or ketoconazole in
    combination with rifampin or rifabutin
57
Q
  • Was first introduced in 2004
  • Telithromycin
A

Ketolides

57
Q

Therapeutic Actions and Indications for: Ketolides

A
  • block protein synthesis within susceptible bacteria, leading to cell death
  • effective against S. pneumoniae, including certain multidrug-resistant strains, H. influenzae, M.
    catarrhalis, Chlamydophila pneumoniae, and M.pneumoniae
58
Q

Pharmacokinetics of: Ketolides

A

Rapidly absorbed through the GI tract, reaching peak levels in 1 hour

59
Q

Contraindications and Cautions for: Ketolides

A
  • Known allergy
  • with known congenital prolonged QT interval, bradycardia, or any proarrhythmic condition such as hypokalemia with concurrent use of pimozide, cardiac antiarrhythmics,
    simvastatin, atorvastatin, or lovastatin and with myasthenia gravis
  • Use with caution with renal or hepatic impairment, pregnancy and lactating
60
Q

Adverse effects of: Ketolides

A
  • GI: nausea, vomiting, taste alterations and the potential for pseudomembranous colitis
  • Hypersensitivity: anaphylaxis
61
Q

Clinically important drug-drug interactions for: Ketolides

A
  • Serious adverse effects with pimozide,
    simvastatin, lovastatin, or atorvastatine
  • Increased serum level of digoxin and metoprolol
  • Decreased serum levels with rifampin, phenytoin, carbamazepine, or phenobarbital
  • Increase GI toxicity with theophylline
62
Q
  • similar to the macrolides but are more toxic
  • clindamycin, lincomycin
A

Lincosamides

63
Q

Therapeutic Actions and Indications for: Lincosamides

A

react at almost the same site in bacterial protein synthesis and are effective against the same strains of bacteria

64
Q

Contraindications and Cautions for: Lincosamides

A

Use with caution with renal or hepatic impairment, pregnancy and lactating

64
Q

Pharmacokinetics of: Lincosamides

A

rapidly absorbed from the GI tract or from IM injections and are metabolized in the liver and excreted in the urine and feces

65
Q

Adverse effects of: Lincosamides

A
  • GI: fatal pseudomembranous colitis
  • Pain, skin infections, and bone marrow depression
66
Q
  • First introduced in 2010
  • televancin
A

Lipoglycopeptides

67
Q

Therapeutic Actions and Indications for: Lipoglycopeptides

A

They inhibit bacterial cell wall synthesis by interfering with the polymerization and crosslinking of peptidoglycans. They bind to the bacterial membrane and disrupt the membrane barrier function causing bacterial cell death

68
Q

Pharmacokinetics of: Lipoglycopeptides

A
  • Available as an IV drug only
69
Q

Contraindications and Cautions for: Lipoglycopeptides

A
  • Known allergy, pregnancy and lactation
70
Q

Adverse effects of: Lipoglycopeptides

A
  • GI: nausea, vomiting, taste alterations, diarrhea, loss of appetite, and risk of C. difficile diarrhea
  • Nephrotoxicity: foamy urine
  • Rapid infusion can cause red man syndrome: flushing, sweating, and hypotension
71
Q

Clinically important drug-drug interactions for: Lipoglycopeptides

A

Arrhythmias if combined with other drugs known to prolong QT interval

72
Q
  • are antibiotics that interfere with protein synthesis in susceptible bacteria
  • erythromycin, azithromycin, clarithromycin, dirithromycin
A

Macrolides

73
Q

Therapeutic Actions and Indications for: Macrolides

A

may be bactericidal or bacteriostatic, exert their effect by binding to the bacterial cell membrane and changing protein function. This action can
prevent the cell from dividing or cause cell death, depending on the sensitivity of the bacteria and the concentration of the drug.

acute infections caused by susceptible strains of S. pneumoniae, M. pneumoniae, Listeria monocytogenes, and Legionella pneumophila; infections caused by group A betahemolytic streptococci; pelvic inflammatory disease caused by N. gonorrhoeae; upper respiratory tract infections caused by H. influenzae (with sulfonamides); infections caused by
Corynebacterium diphtheriae and Corynebacterium minutissimum (with antitoxin); intestinal amebiasis; and
infections caused by C. trachomatis.

  • Prophylaxis for endocarditis before dental procedures in high-risk patients with valvular heart disease who are allergic to penicillin
  • Topical macrolides are indicated for the treatment of ocular infections caused by susceptible organisms and for acne vulgaris, and they may also be used prophylactically against infection in minor skin abrasions and for the treatment of skin infections caused by
    sensitive organisms.
74
Q

Pharmacokinetics of: Macrolides

A

These drugs are absorbed in the GI tract. Erythromycin is metabolized in the liver, with excretion mainly in the bile to feces. Azithromycin
and clarithromycin are mainly excreted unchanged in the urine. Dirithromycin is excreted through the
feces.

75
Q

Dirithromycin is excreted through the
(answer). .

A

Feces

76
Q

Contraindications and Cautions for: Macrolides

A
  • Known allergy and lactation
  • Ocular preparations are contraindicated for viral fungal, or mycobacterial infections of the eye
  • Use with caution in patients with hepatic dysfunction and in those with renal disease
77
Q

Clinically important drug-drug interactions for: Macrolides

A
  • Increased digoxin levels when taken together
  • Increased effects with anticoagulants,
    theophylline, carbamazepine, or corticosteroids
    and cyclosporine
77
Q

Adverse effects of: Macrolides

A
  • GI: abdominal cramping, anorexia, diarrhea, vomiting, and pseudomembranous colitis
  • Neurological: confusion, abnormal thinking, and uncontrolled emotions
  • Hypersensitivity: rash and anaphylaxis
78
Q

Clinically important drug-food interaction: Macrolides

A

Should be taken on an empty stomach

79
Q

Aztreonam

A

Monobactam Antibiotics

80
Q

Therapeutic Actions and Indications for: Monobactam Antibiotics

A
  • disrupts bacterial cell wall synthesis, which promotes leakage of
    cellular contents and cell death in susceptible bacteria
  • indicated for the treatment of urinary tract, skin, intra-abdominal, and gynecological infections, as well as septicemia caused by susceptible bacteria, including E. coli, Enterobacter,
    Serratia,Proteus, Salmonella, Providencia, Pseudomonas,
    Citrobacter, Haemophilus, Neisseria, and Klebsiella.
81
Q

Pharmacokinetics of: Monobactam Antibiotics

A

IV and IM use only and reaches peak effect levels in 1 to 1.5 hours

82
Q

Contraindications and Cautions for: Monobactam Antibiotics

A
  • Known allergy, pregnancy and lactation
  • Renal or hepatic dysfunction
83
Q

Adverse effects of: Monobactam Antibiotics

A
  • GI: nausea, GI upset, vomiting, and diarrhea
  • Hepatic enzyme elevation, inflammation, phlebitis, and discomfort at injection sites
84
Q

Clinically important drug-drug interactions for: Monobactam Antibiotics

A
  • Incompatible with nafcillin, cephradine, and metronidazole

Pharma (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions