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Pharmacology 2 > midterm > Flashcards

midterm Flashcards

1
Q

vWD

A

autosomal dominant, stabilizes factor VIII

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2
Q

desmopressin

A

procoagulent, like vasopressin, releases endogenous fVIII, vWF, plasminogen

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3
Q

aminocaproic acid, tranexamic acid

A

inhibits plasminogen from binding to fibrin, for surgeries on hemophiliac pt or large blood loss pt

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4
Q

vitamin K

A

procoagulant, warfarin antidote

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5
Q

protamine

A

procoagulant, heparin antidote

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6
Q

unfractionated heparin

A

anticoagulant, extracted from cow lung, pig intestines (so no animal allergies), tx of DVT, PE, and MI

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7
Q

enoxaparin, dalteparin

A

anticoagulant, LMWH

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8
Q

fondaparinux

A

like a LMWH, NO ANTIDOTE!

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9
Q

dabigatran

A

anticoag., no monitoring of INR/aPTT monitoring, idarucizimab is antidote

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10
Q

rivaroxaban and apixaban

A

anticoag., NO ANTIDOTE, no monitoring of INR/aPTT

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11
Q

warfarin

A

less consistent anticoag., LOTS of INXNS!, inhibits vit. K reductase, impactive by vit. K levels in liver, metabolized by CYP450 enzymes in liver, inxt with ABs, anti-fungals, NSAIDS, herbs, vit. K rich foods, must MONITOR INR/aPTT! antidote = vit. K

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12
Q

aspirin

A

platelet inhibitor, COX inhibitor

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13
Q

clopidogrel

A

platelet inhibitor, irreversible inhibition of P2Y12 receptor

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14
Q

use anticoagulants in dentistry?

A

NO!

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15
Q

safe INR for warfarin pts:

A

4.0 for simple OS, 3 for OS resulting in lots of blood loss

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16
Q

stop aspirin for OS?

A

Nope

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17
Q

who to consult before modifying anticoagulation therapy>

A

Prescribing physician or anticoag. clinic!

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18
Q

who has LPS

A

gram negative bacteria

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19
Q

who has thick cell wall

A

gram postitive bacteria

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20
Q

prevents cell growth or replication and limits spread of infection…

A

bacteriostatic

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21
Q

induces bacterial cell death

A

bactericidal

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22
Q

act on single or ltd group of bacteria, 1st choice

A

narrow spectrum, eg. isoniazid

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23
Q

effective against gram + and - bacteria

A

extended spectrum, ampicillin

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24
Q

active against wide variety of microbial species

A

broad spectrum, eg. tetracycline

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25
Q

what kills MRSA

A

NOT beta-lactam ABs, vancomyscin or ceftaroline preferred

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26
Q

acquired mechanism for beta-lactam resistance

A

bacteria produces beta-lactamases which hydrolyze beta-lactam ring!

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27
Q

clavulanic acid

A

beta lactamase inhibitor, given with amoxicillen –> AUGMENTIN

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28
Q

tazobactam

A

beta lactamase inhibitor, PIPERACILLIN

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29
Q

sulbactam

A

beta lactamase inhibitor, AMPICILLIN

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30
Q

narrow spectrum penicillins

A

Penicillin V and beta-lactamase resistant Dicloxacillin

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31
Q

extended spectrum penicillins

A

amoxicillin/clavaulanic acid, ampicillin/sulbactam, pipercillin/tazobactam

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32
Q

penicillin V

A

1st choice for tx of odontogenic infections, for moderate to severe gingivitis

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33
Q

Dicloxacillin

A

antistaphylococcal penicillin, rarely by dentists

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34
Q

Ampicillin with…

A

sulbactam

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35
Q

Amoxicillin with…

A

clavulanate

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36
Q

principle adverse effect of penicillins…

A

allergic rxn

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37
Q

1st gen. cephalosporins

A

cefazolin, cephalexin

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38
Q

2nd gen. cephalosporins

A

cefuroxime, cefprozil

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39
Q

3rd gen. cephalosporins

A

cefdinir, ceftriaxone –> penetrates CNS, both associate with c. dif. diarrhea

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40
Q

which cephalosporin penetrates CNS

A

ceftriaxone

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41
Q

4th gen. cephalosporin

A

cefepime –> beta lactamse resistant

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42
Q

5th gen. cephalosporin

A

ceftaroline –> MRSA

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43
Q

cephalosporins adverse rxns

A

allergic, not for pt with penicillin allergy bc cross hypersensitivity

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44
Q

drug ixn with cephalosporins

A

antacids, antihistamines, proton pump inhibitors, Fe supplements

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45
Q

monobactam

A

aztreonam –> IV for serious infectiosn

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46
Q

vancomycin

A

AB, inhibits cell wall synthesis, MRSA, S. pneumoniae, enterocolitis by C. dif., RED MAN SYNDROME!

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47
Q

Erythromycin, clarithromycin, azithromycin…

A

binds reversibly to 50s ribosomal subunit, bacteriostatic

48
Q

Adverse effects of erythromycin, clarithromycin, an azithromycin

A

GI tract
Ototoxic (erythromycin) –> reversible tinnitus
arrhythmia

49
Q

tx of H. pylori infections

A

clarithromycin

50
Q

Clindamycin…

A

good for penicillin-resistant bacteria acute orofacial infections
used as bacterial endocarditis prophylaxis in pts with penicillin allergy
can CAUSE C. diff infections!

51
Q

tetracycline/doxycycline

A

can cause permanent staining of teeth

52
Q

adverse effects of tetracyclines

A 
black furry tongue
nephrotoxic
hepatotoxic
not for kids under 8 yoa
not during pregancy
tooth discoloration
enamel hypoplasia
photosensitivity
superinfections (eg. C. albicans)
drug/food ixns
53
Q

drug/food ixns of tetracyclines

A 
dairy
Ca++
Mg++
Fe++
Al+++
antacids
54
Q

gentamicin

A

bactericidal aminoglycoside, serious Gram Negative infection

55
Q

adverse effects of aminoglycosides

A 
nephrotoxic
Ototoxic
poor oral absorption
poor CNS penetration
narrow therapeutic index
56
Q

Linezolid

A

oxazolidinone, tx of vancomycin-resistant E. faecium!

57
Q

Sulfamethoxazole, trimethoprim

A

bactericidal sulfonamides, prevent folic acid synthesis

58
Q

uses for sulfonamides

A 
respiratory
GI
UTI
not dentistry
(can cause anemias)
59
Q

Metronidazole

A 
bactericidal
anaerobes: C. diff.
H. pylori
parasitic infections
NOT effective against aerobes
!! used for JUVENILE / REFRACTORY PERIODONTITIS !!
disulfiram rxn when taken with ethanol
60
Q

Fluoroquinolones

A

ciprofloxacin, levofloxacin, moxiflocaxin
target DNA GYRASE in gnb
target TOPOISOMERASE IV in gpb
inhibits growth and DNA replication

61
Q

adverse rxns of fluroquinolones

A

photoxicity
tendon rupture
arrhythmia
NSAID ixn –> convulsive seizures!

62
Q

Isoniazid

A

tx of M. tuberculosis and M. kansasii

63
Q

Rifampin

A

inhibits bacterial DNA-dependent RNA polymerase

tx of ACTIVE TB

64
Q

common pathogens causing IE

A

viridans group streptococci (VGS)

Staph

65
Q

Cardiac conditions for which prophylaxis is recommended

A

unrepaired cyanotic CHD
completely repaired congineital heart defeft with prosthetic in FIRST 6 MONTHS AFTER PROCEDURE
repaired CHD with residual defects
cardiac transplant pt with valvulopathy

66
Q

how to administer AB prophylaxis for IE

A

single dose BEFORE procedure, or up to 2 hours after procedure if they forgot to take it before

67
Q

RNA viruses rely on…

A

…enzymes in the virion to synthesize mRNA for synthesis of viral proteins

68
Q

Amantadine

A

tx of influenza
inhibits fxn of M2 protein
prevents uncoating and release of viral RNA

69
Q

Osteltamivir, zanamivir

A

inhibits viral neuraminidase
blocking release of progeny virus from infectd host cells
TAMIFLU

70
Q

antiherpetic agents

A 
acyclovir
valacyclovir
ganciclovir
penciclovir
foscarnet
71
Q

antiherpetic agents not effective for treating CMV may be used for …

A

CMV prophylaxis in immune compromised pts

72
Q

chronic hepatitis infections throughout world

A

HBV and HCV

73
Q

NRTIs

A

treat HIV
require activation
!! TERATOGEN (efavirenz) NNRTI !!
zidovudine, lamivudine, emtricitabine, tenofovir

74
Q

Protease inhibitors

A

ritonavir
ritonavir + lopinavir (fixed dose combination)
use of PI + 2 NRTIs is synergistic

75
Q

Integrase Strand Inhibitors

A

Raltegravir, prevents HIV from multiplying in host

76
Q

to prevent HIV from becoming drug resistant usually they are …

A

combined into a single product

77
Q

typical anti-HIV regimen:

A

2 NNRTIs + PI or NRTI

78
Q

how to monitor HIV

A

viral load and CD4+ cell count every 2-8 weeks

79
Q

majority of HSV viral lesions treated by…

A

acyclovir

80
Q

penciclovir

A

tx of herpes labialis

81
Q

AIDS pt oral lesions

A

HPV
CMV
oral hairy leukoplakia

82
Q

characteristics of fungi

A

eukaryotic
cell membrane has ergosterol
cell wall has chitin

83
Q

fungal infection locations

A

superficial
subQ
systemic

84
Q

most common site of fungal infection

A

superficial

skin, nails, mucous membranes

85
Q

subcutaneous fungal infections

A

hair, nailbeds, skin

from puncture wounds with soil fungi

86
Q

systemic fungal infectiosn

A

various internal organs
immunocompromised pts at high risk
high mortality

87
Q

most common fungal infection orally

A

C. albicans

88
Q

class of antifungals used topically for superficial infectiosn

A

polyene

89
Q

amphotericin B

A

antifungal
detected for up to 4 wks in blood and 4-8 wks in urine after discontinuation of IV therapy
most toxic in use
REVERSIBLE ANEMIA

90
Q

Nystatin

A

antifungal

DRUG OF CHOICE FOR TX OF ORAL CANDIDA INFECTIONS

91
Q

Echinocandin antifungal

A

caspofungin
discrupts fungal cell wall
MC rxn –> phlebitis
Teratogenic

92
Q

Ketoconazole

A

ORAL AND TOPICAL FORMULATIONS
teratogenic
gynecomastia in men
mentrual irregularities in women

93
Q

Fluconazole

A

ORAL AND IV FORMULATIONS

EXCELLENT CNS PENETRATION (treat fungal meningitis)

94
Q

Clotrimazole troche

A

tx oropharyngeal candidasis in pts with AIDS

95
Q

Flucytosine

A

cytosine deaminase

ltd antifungal spectrum (candida and cryptococcus)

96
Q

Terbinafine

A

highly lipophilic and keratophilic antifungal

remains in skin and nails for up to 3 mos

97
Q

Griseofulvin

A

dermatophyte infections
CYP3A4 INDUCER !!
can reduce plasma cxn of warfarin, barbiturates, oral contraceptives

98
Q

MC type of oral fungal infection and txs

A 
Candidiasis
topical txs: clotrimazole oral troches
nystatin oral pastilles 
nystatin RINSE FOR PTS AT RISK FOR LIVER TOXICITY
Miconazole tablets
99
Q

systemic tx of oral candidiasis

A

oral therapy for AIDS
Ketoconazole (with topical nystatin)
Fluconazole

100
Q

IV tx of oral candidiasis

A

amphotericin B

w or wo flucytosine bc high drug toxicity

101
Q

tx of oral candidiasis with lichen planus

A

topical nystatin
or
clotrimazole with topical corticosteroid

102
Q

Histamine derived from

A

diet or bacteria in GIT, synthesized by mast cells

103
Q

histamine content of organs

A

highest in lung
skin
intestinal mucosa

104
Q

highest cxn of histamine in

A

mast cells
leukocytes
ENTEROCHROMAFFIN CELLS OF GIT

105
Q

tissue injury causes…

A

immediate release of histamine from mast cells

increase in vascular permeability

106
Q

allergic rxns cause…

A

histamine release

causing mild symptoms to severe symptoms

107
Q

H1 activation of histamines

A

increase in bronchiolar smooth muscle contraction

TARGET FOR ANTIHISTAMINES

108
Q

H2 activation of histamines

A

increase gastric acid secretion

TARGET FOR H2 BLOCKERS

109
Q

Histamine toxicity/shock treated by…

A

Epinephrine

110
Q

1st gen H1 antagonists

A

diphenhydramine, promethazine, meclizine

sedative, anti-nausea, xerostomia

111
Q

2nd gen H1 antagonists

A

loratadine, fexofenadine, cetirizine

do not cross BBB
less sedative

112
Q

H1 receptor antagonists ixt with H1 receptors on target cell and …

A

competively inhibit

can beovercome by increasing cxn of histamine

113
Q

are antihistamines used for anaphylactic shock or asthma?

A

no, EPI is

114
Q

do 1st gen H1 antihistamines reduce gastric acid secretion?

A

no, 2nd gen H1 do

115
Q

uses for antihistamines in dentistry

A

CNS actions, sedation

116
Q

H2 receptor antagonists include…

A

cimetidine, ranitidine, famotidine

117
Q

H2 receptor antagonists used for …

A

reduce gastric acid secretion
tx peptic ulcers
tx GERD

Pharmacology 2 (1 decks)

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