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Pharmacology > Micro drugs > Flashcards

Micro drugs Flashcards

1
Q

MOA: Inhibition of peptidoglycan cross-linking and therefore cell wall synthesis (7)

A 
PCN
Methicillin
Ampicillin
Piperacillin
Cephalosporins
aztreonam
imipenem
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2
Q

Inhibits peptidoglycan synthesis

A

Bacitracin

Vancomycin

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3
Q

Blocks DNA topoisomerase

A

Flouroquinolones

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4
Q

Inhibits folic acid synthesis and therefore bacteria nucleotide synthesis

A

Sulfonamides

trimethoprim

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5
Q

Damages bacteria DNA

A

Metronidazole

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6
Q

Blocks bacteria mRNA synthesis

A

Rifampin

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7
Q

Blocks protein synthesis at the 30S ribosomal subunit

A

Tetracyclines

Aminoglycosides

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8
Q

Blocks protein synthesis at the 50S ribosomal subunit(5)

A 
chloramphenicoa\l
macrolides
Clindamycin
Linezolid
Streptogramins
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9
Q

List the 3 drugs that inhibit beta lactamase activity?

What is so special about them?

A

Clavulanic acid
Sulbactam
Tazobactam

They should be added to PCNs that are not resistant to beta lactamases

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10
Q

PCN (G) and V are used the following organisms

A 
Gram positives
       Strep pneumo
        Strep pyogenes
        Actinomyces
N. Meningititis
Syphillis--Troponema pallidum
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11
Q

List PCNs that are penicillinase resistant (Hint NOD)

What is one unique toxicity associated wit NOD?

What other drugs(non PCN) are penicillinase resistant?

A

Nafcillin
Oxacillin
Dicloxacillin

Interstitial nephritis

Aztreonam

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12
Q

Which particular organism is the penicillinase resistant PCNs used for

A

Staph aureus except for MRSA

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13
Q

What is one the particular side effect of Ampicillin—think in relation to another type of bacteria problem

what is the other toxicity

A

Pseudomenbranous colitis
aka c-Diff

Ampicillin Rash

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14
Q

Ampicillin and Amoxicillin are used for these organisms (7)

A 
H.Influenza
E.coli
Listeria monocytogenes
Proteus mirabilis
salmonella
shigella
enterococci

HELPSS Enterococci

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15
Q

What common toxicity is common to the PCNs

A

Hypersensitivity reactions

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16
Q

Ticarcillin and Piperacillin are known to work well for this bacteria

What other group can they cover

A

Pseudomonas

Gram negative rods

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17
Q

Name the organisms that are not covered by cephalosporins

A 
LAME
Listeria
Atypicals---Chlamydia and mycoplasma
MRSA
Enterococci
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18
Q

What is the one cephalosporin that can cover MRSA

A

Ceftaroline

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19
Q

1st generation cephalosporins

A

Cefazolin Az and alexin are 1st

Cephalexin

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20
Q

2nd generation cephalosporins

A

Cefoxitin
Cefaclor
cefuoxime

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21
Q

3rd generation cephalosporins

A

Ceftriaxone
Cefotaxime
ceftazidime

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22
Q

4th generation cephalosporins

A

cefepime

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23
Q

What three organisms are the 1st generation cephalosporins used for?

A

PEK
Proteus mirabilis
E.Coli
Klebsiella

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24
Q

What is used prior to surg to prevent S.aureus wound infections

A

Cefazolin

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25
Q

2nd generation cephalosporins are good for? (6)

A 
HENS PEK
H.Influenza
Enterobacter aerogenes
Neisseria
Serratia marcescens

Proteus mirabilis
E.Coli
Klebsiella

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26
Q

What are the 3rd generation generally used for?

A

Serious Gram negs

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27
Q

Ceftriazone is especially for these two

A

Meningitis

gonorrhea

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28
Q

Ceftazidime is especially for

A

Pseudomonas

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29
Q

Hypersensitivity
Nephrotoxicity with aminoglycosides
Vit K deficiency

A

cephalosporin toxicities

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30
Q

Under what conditions would you use aztreonam

A

Only for Gram negative rods in pts with
PCN allergy
Renal insufficiency

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31
Q

What drug is always given with imipenem

A

cilastatin

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32
Q

Why cilastatin given with imipenem (MOA)

A

Imipenem will otherwise be inactivated in the renal tubules–inhibits renal dehydropeptidase

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33
Q

GI distress
sezuires
skin rash

A

Carbapenem

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34
Q

Vancomycin inhibits peptidoglycan synthesis by binding to what portion

A

D-ala D-ala portion of cell wall precursors

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35
Q

How do bugs gain resistance to vancomycin

A

amino acid change from D-ala D-ala to D-ala D-lac

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36
Q

Gram positives
MRSA
C.diff
enterococci

A

Vancomycin

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37
Q 
Nephrotoxicity
ototoxicity
thrombophlebitis
Flushing
(Flushing is NOT cute)
A

Toxicities for vancomycin

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38
Q

What two drugs especially cause pseudomembraneous colitis?

A

Ampicillin

clindamycin

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39
Q

Treatment for c-diff

A

vancomycin

metronidazole

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40
Q

Prophylactic drug to avoid M.avium-intracellulare disease in AIDs pts

A

Azithromycin

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41
Q

Treatment for Lapramatous Leprosy

A

Dapsone, Rifampin, and clofazimine

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42
Q

Treatment for Tuberculoid Laprosy

A

Dapsone and Rifampin

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43
Q

Treatment for N.meningitis

A

PCN G and Ceftriaxone

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44
Q

Prophylaxis for N.meningitis

A

Rifampin
ciprofloxacin
or ceftriaxone
also for meningitis from H.flu

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45
Q

N.gonorrhea treatment

A

ceftriaxone
plus
Azithromycin and doxycycline(chlamydia)

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46
Q

Treatment for psuedomonas

A

Aminoglycosides

plus extended course Pipercillin/ticarcillin

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47
Q

treatment for lyme disease (Borrelia Burgdoferi)

A

Ceftriaxone

Doxycycline

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48
Q

Treatment for Rickettsial and vector-borne diseases

A

Doxycyline

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49
Q

Treatment for Chlamydiae

A

Azithromycin or doxycycline

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50
Q

Prophylactic treatment to prevent pneumonia caused by RSV virus in premature children

A

Palivizumab

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51
Q

List five aminoglycosides

A 
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
(GNATS)
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52
Q

Specific mechanism of aminoglycosides

A

Inhibits the formation of the initiation complex which= misreading of the mrna

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53
Q

Why are amynoglycosides ineffective against anerobes?

A

Because they require O2 for uptake

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54
Q

Neomycin is used for?

A

Bowel surgery

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55
Q

Aminoglycosides are typically used for?

A

Serious Gran neg rods

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56
Q

Aminoglycosides toxicities

A

Nephrotoxicity (esp with cephalosporin)
Neuromuscular block
ototoxicity
teratogen

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57
Q

Name the tetracyclines

A

tetracycline
doxycycline
minocycline
Demeclocycline

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58
Q

Which tetracycline is used as an ADH antagonist for use in SIADH

A

Demeclocyline

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59
Q

What is the specific MOA of tetracycline?

A

Prevents the attachment of amino-acyl-tRNA after binding to 30S ribosome

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60
Q

Tetracyclines are used for

A

Borrelia Burgdoferi
Mycoplasma pneumoniae
Rickettsia
chlamydia

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61
Q

Why are tetracylines especially effective against chlamydia and rickettsia?

A

They have the ability to accumulate intracellularly

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62
Q

side effects of tetracyclines

A

Photosensitivity
Discoloration of teeth in kids
inhibition of bone growth in kids
teratogen

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63
Q

List macrolides

A

erythromycine
azithromycin
clarithromycine

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64
Q

Macrolides specific MOA

A

Blocks translocation (23) of 50S subunit

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65
Q

Macrolides are used for

A

Pneumonia from atypicals( Mycoplasm/legionella/chlamydia)
Chlamydia STD
gram+ cocci inPCN allergy

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66
Q

Macrolides toxicities

A 
Motility issues
Arrythmia--QT
Cholestatic hepatitis--acute
rash
eOsinophils
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67
Q

Macrolides increase serum concentration of

A

theophyllines

oral anticoagulants

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68
Q

Treatment for Toxoplasmosis

A

Sulfadiazine + pyrimethamine

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69
Q

Psuedomonas drugs

A 
Ticercillin/pipercillin
ceftazidime and cefepime
ciprofloaxacin and levofloxacin
imipenem and meropenem
Amikacin/gentamycin/tobramycin
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70
Q

Specific MOA of chloramphenicol

A

blocks peptidytransferase at the 50S subunit

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71
Q

Chloramphenicol toxicities

A

Anemia
Aplastic anemia
grey baby syndrome

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72
Q

Blocks peptide transfer at the 50S subunit

A

clindamycin

73
Q

What is used to treat anaerobes above the diaphragm

What is used to treat anaerobes below the diaphragm

A

clindamycin

metronidazole

74
Q

Clindamycin is used for?

A

Anaerobes above the diaphragm
Anaerobe infections in aspiration pneumonia or lung abscess
oral infections with Anaerobe

75
Q

Clindamycin toxities

A

c. Diff
Fever
diarrhea

76
Q

Side effect of omeprazole

A

v. cholera infection

77
Q

List the sulfonamides

A

Sulfamethoxazole
sulfisoxazole
sulfadiazine

78
Q

Inhibited by sulfonamides

A

dihydropteroate synthase

79
Q

Sulfonamides toxicities (6)

A 
G6PD deficiency hemolysis
nephrotoxicity
photosensitivity
kernicterus in  infants
Warfarin displacement from albumin
hypersensitivity rxn
80
Q

Trimethoprim inhibits

A

dihydrofolate reductase

81
Q

Trimethoprim toxicities

A

Megaloblastic anemia
leukopenia
granulocytopenia
TMP treats marrow poorly

82
Q

TMP-SMx are combined to treat the following

A

UTIs
Shigella
Salmonella
Pneumocystis jiroveci

83
Q

How would you recognize that a drug is a fluoroquinolone

A

Floxacin

84
Q

Fluroquinolones are contraindicated in?

Why?

A

Preg
children

Damage to cartilage

85
Q

Less common toxicities associated with fluroquinolones

A

Tendonitis
Tendon rupture
leg cramps
myalgia

86
Q

Superinfections, rash, headache, and dizziness

A

common toxicities of fluroquinolones

87
Q

How does metronidazole damage DNA

A

By forming free radicals

88
Q

Metronidazole are used for

A 
Anerobes below the diaphragm
           c-diff and bacteroides
Giardia
Entamoeba
Trichomonas
Gardenerella vaginalis
89
Q

Metronidazole toxicities

A

Metallic taste
HA
Disulfiram-like reaction with etoh

90
Q

M.tuberculosis treatment

A

Rifampin
isoniazid
pyrazinamide
ethambutol

91
Q

TB prophylaxis

A

isoniazid

92
Q

M.avium-intercellulare treatment

A

Rifampin
azithromycin
ethambutol
streptomycin

93
Q

Isoniazid MOA

A

Decreased the synthesis of mycolic acid

94
Q

What does isoniazid need in order to be active

A

conversion into its active form by bacterial catalase peroxidase

95
Q

Isoniazid toxicities

A

Neurotoxicity

Hepatotoxicity

96
Q

Give this to prevent Isoniazid neurotoxicity and lupus

A

pyridoxine

97
Q

Rifampin specific MOA

A

Inhibits DNA-dependent RNA polymerase

98
Q

Rifampin toxicities

A

P-450
orange body fluids
Minor hepatotoxicity

99
Q

Should Rifampin be used alone?

if not why?

A

No

Rapid resistance

100
Q

Pyrazinamide’s acidic product is good for

A

Acidic pH of phagolysosomes where TB engulfed macrophages are found

101
Q

Pyrazinamide Toxicities

A

hepatotoxicity

hyperurecemia

102
Q

Ethambutol MOA

A

Decreases carbohydrate polymerization of mycobacterium cell wall

103
Q

Ethambutol toxicity

A

Red-green color blindness

104
Q

Prophylaxis against gonococcal or chlamydial conjuctivitis in newborn

A

Erythromycin ointment

105
Q

Prohylaxis for a child with prior rheumatic fever

A

oral PCN

106
Q

GBS prophylaxis in preg

A

Ampicillin

107
Q

Prophylaxis against endocarditis with surgical/dental stuff

A

PCNs

108
Q

Prophylaxis in a pt with h/o recurrent UTIs

A

TMP-SMX

109
Q

Prophylaxis for syphillis

A

BENZATHINE PCN G

110
Q

HIV prophylaxis to prevent Toxoplasmosis ann Pneumocystis pneumonia (CD4<100)

A

TMP-SMX

111
Q

Treatment for vancomycin resistant enterococci

A

Linezolid and streptogramins

112
Q

What two groups of antifungals inhibit membrane function

A

Amphotericin B

Nystatin

113
Q

What antifungal messes with nucleic acid synthesis

A

5-Flucytosine

114
Q

What antifungals mess with Lanosterol synthesis?

A

Naftifine

Terbinafine

115
Q

What antifungals mess with ergosterol synthesis

A

Azoles

116
Q

What antifungals mess with cell wall synthesis

A

the Fungins–

117
Q

Amphotericin B MOA

A

Binds ergosterol and forms pores in the membrane for electrolytes

118
Q

Amphotericin B is used

A

Serious systemic mycosis

119
Q

Amphotericin B toxicities

A 
Shake and bake
hypoTN
nephrotoxicity
arrythmias
anemia
IV phlebitis
120
Q

How is Nystatin used and why?

Give an Ex

A

Topically because it is too toxic to be be used systemically

Swish ans swallow for thrush treament

121
Q

Specific MOA for the azoles

A

Inhibits the P-450 enzymes that converts Ianosterol to ergosterol

122
Q

Fluconazole is used for

A

chronic suppression of cryptococcal meningitis in AIDS pts and candida in all pts

123
Q

itraconizole is used for

A

Blastomyces, coccidoiides, histoplasmosis

124
Q

Azoles toxicities

A

Testosterone syn inhibition—>gynecomastia

p450 inhibition—->liver dysfunction

125
Q

How exactly does 5-Flucytosine mess with nucleic acid synthesis

A

Conversion to 5-fluorouracil by cytosine deaminase

126
Q

Flucytosine toxicity

A

Bone marrow suppression

127
Q

The fungins–capofungin and micafungin MOA

A

inhibits synthesis of Beta-glucan

128
Q

Capofungin and Micafungin toxicities

A

Flushing (histamine)

GI upset

129
Q

The Fungins are used for

A

Invasive aspergillosis and candida

130
Q

Terbinafine/naftifine MOA

Used to treat

A

Inhibit fungal enzyme squalene epoxidase

fungal infections of the fingers and toe nails

131
Q

Griseofulvin used for

A

treatment of superficial fungal infections like tinea.

Disrupts mitosis

132
Q

Antiprotozoan theraoy for trypanosoma brucei

A

Suramin and melarsorprol

133
Q

Antiprotozoan therapy for t.cruzi

A

Nifurtinox

134
Q

Antitprotozoan therapy for leishmaniasis

A

Sodium stibogluconate

135
Q

Methronidazole has both

A

bacteria and antiprotozoal ability

136
Q

Chloroquine MOA

A

inhibits the detoxification of heme into hemozoin—heme is toxic to plasmodia

137
Q

Chloroquine used not be used for

A

P.falciparum because of resistance

138
Q

How does P.falciparum gain resistance

A

membrane pump that decreases the intracellular conc of the drug

139
Q

P.falcipurum should be treated instead with

A

Atovaquone/proguanil

140
Q

Use this for life threatening malaria

A

Quinidine

141
Q

Chloroquine toxicity

A

retinopathy

142
Q

Praziquantal is used against

A

Flukes like schistosoma

143
Q

Test for this before giving quinidine

A

G6PD deficiency

144
Q

For vivax/ovale malaria,add this

A

primaquine

to prevent relapse

145
Q

Neuroaminidase inhibitor

Effect=

A

Zanamivir and oseltamivir

decrease the the release of progeny virus

146
Q

Ribavirin is used for

A

RSV, Chronic HCV

147
Q

Ribavirin MOA

A

Guanosine analog that competitively inhibits IMP dehydrogenase and Decreases guanine nucleotides syn

148
Q

Ribavirin toxicities

A

Teratogen

hemolytic anemia

149
Q

Acyclovir used for

A

HSV–lesions and encephalitis

VSV–primary

150
Q

VSV zoster

A

Famciclovir

151
Q

Acyclovir MOA

A

Guanosin analog that preferentially inhibits viral DNA polymerase by chain termination

152
Q

Acyclovir need to be monphosphorylated by

A

HSV/VSV thymidine kinase

153
Q

Ganciclovir is used for

A

CMV

154
Q

Ganciclover MOA

A

Guanosine anolog that preferentially inhibits viral DNA polymerase

155
Q

Ganciclover is monophosporylated by

A

CMV viral kinase

156
Q

Ganciclover toxicities

A

Leukopenia
Neutropenia
Thrombocytopenia
renal toxicity

157
Q

Compare Ganciclover and acyclover in terms of toxicity

A

Ganciclover is much more toxic to us than acyclovir

158
Q

Foscarnet and cidofovir are used when

A

CMV retinitis in immunocom when ganciclover fails

acyclovir resistant HSV

159
Q

Foscarnet MOA

A

A pyrofosphate analog that binds to the pyrophosphate-binding site of viral DNA polymerase

160
Q

How is Forcarnet and cidofovir ‘s MOA different from that of ganciclover and acyclovir

A

It does not have to be activate by viral kinase

161
Q

This combination is used for HAAAT in HIV pts to prevent resistance

A

2 NRTIs
+
1NNRTI or 1 protease inhibitor or 1 integrase inhibitor

162
Q

MOA of protease inhibitors

A

They prevent cleavage of the big polypeptide into their functioning parts and thus prevent maturation of new virions

163
Q

How to recognize protease inhibitors

A

Navir

164
Q

Protease inhibitor toxicities

A

Hyperglycemia
lipodystrophy
Nepropathy/hematuria

165
Q

MOA of NRTIs

A

competively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain

166
Q

List NRTIs(7)

A 
Tenofovir
Abacavir
Stavudine
zidovudine
Lamivudine
Emtricitabine
Didanosine
167
Q

Which NRTIs does not have to be activated

A

Tenofovir

168
Q

Zidovudine is used for

A

which is used in preg to reduce fetal transmission and as general prophylaxis

169
Q

NRTIs and NNRTIs toxicity

A 
Bone marrow suppression
Peripheral neuropathy
Lactic acidosis
rash
anemia
170
Q

List NNRTIs

A

Nevirapine
Efavirenz
Delavirdine

171
Q

MOA of NNRTIs

A

Bind at a different site to reverse transcriptase

172
Q

Raltegravir is a

A

Intergrase inhibitor that inhibits HIV genome integration into host cell chromosome

173
Q

Raltegravir toxicity

A

Hypercholesterolemia

174
Q

Interferon therapy blocks

A

replication of RNA and DNA

175
Q

IFN-alpha use

A

Chronic Hep B and C

Kaposi’s sarcoma

176
Q

IFN-beta use

A

MS

177
Q

IFN-gamma use

A

NADPH oxidase deficiency

178
Q

Interferon toxicity

A

Neutropenia and myopathy

179
Q

Take Really Good Care= Children SAF stands for

A 
Drugs not to use during preg
Tetracycline--teeth and bone
Ribavirin--teratogen
Griseofulvin---teratogen
Chloramphenicol---grey babe
Clarithromycin---embryotoxic
Sulfonamides--Kernicterus
Aminoglycosides--ototoxicity
fluroquinolones--cartilage damage

Pharmacology (13 decks)

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