Midterm Flashcards
What are the two properties of an ideal drug?
Must work and must be safe
Is selectivity required for FDA approval?
No
What is pharmacokinetics defined as?
What the body does to a drug
What are the four components of pharmacokinetics?
Absorption, distribution, metabolism, excretion
What does pharmacodynamics mean?
What the drug does to the body
What is absorption defined as?
The movement of a drug from its administration site into the blood
What does the rate of absorption determine?
How soon the drug effects begin
What does the amount of drug absorbed determine?
The intensity of the drug response
What is a drugs half life?
The time required for the amount of drug in the body to decrease by 50%
How many half lives does it take for a drug to reach steady state?
4-5
How many half lives does it take for a drug to be eliminated from the body?
4-5
Do beta lactamase inhibitors have antibiotic activity?
No
What do beta lactamase inhibitors do?
Extend the activity of abx by de-activiting beta lactamase inhibition by bacteria
What is the only beta lactam that has no cross-reactivity with penicillin?
Aztreonam
What is a major side effect of daptomysin?
Rhabdo
Fluoroquinolones have black box warning for what two things?
Tendon rupture and myasthenia gravis
Which abx class can cause hypo and hyperglycemia?
Fluoroquinolones
Which class of abx prolongs QT?
Fluoroquinolones
Which abx causes a disulfiram effect when drunk with ETOH?
Flagyl
How long after taking the last dose of Flagyl can a pt drink ETOH?
48 hours
What medication class increases risk of CAP?
PPI
What is the duration of therapy for CAP?
Minimum of 5 days
What class of drugs increases risk of C. diff?
PPI
You need to test for HLAB5701 before starting what HIV drug?
Abacavir
Can a pt who tests positive for HLAB5701 be started on Abacavir?
No
What will happen if a pt who is positive for HLAB5701 is started on Abacavir?
Hypersensitivity rx
Does abacavir require dose adjustment for renal insufficiency?
No
There is an increased risk of adverse cardiovascular events in pts taking which HIV drug?
Abacavir
Which HIV drug will have its levels increased by ETOH?
Abacavir
What is the preferred initial ART for HIV?
Emtricitabine
What other virus is emtricitabine active against?
Hep B
What happens if you stop taking Hep B meds?
You can have a flare up of Hep B
Is emtricitabine active against Hep B?
Yes
Is Lamivudine active against Hep B?
Yes
What are the two most common side effects of efavarinz?
Vivid dreams and CNS effects
Which HIV agent has more CNS side effects, efavarinz or rilpivirine?
Efavarinz
Rilpivirine can only be given to pts with less than what viral load?
Less than 100,000 copies/mL
Is resistance testing required for all HIV medications?
Yes
What is salvage therapy?
Treatment for people who have already failed ART
What kind of environment does atazanavir require for absorption?
Acidic
What class of med should not be taken with atazanavir?
PPIs
How long after taking an H2 blocker can a pt take atazanavir?
10 hours
Protease inhibitors interact most with which drug class?
Statins
What is a major side effect of ibalizumab?
Immune reconstitution inflammatory syndrome
Which HIV med contains sulfa?
Darunavir
What is the only two agent HIV med approved for initial therapy?
Dovato
If a pt with HIV has Hep B as well, how many agents do they need to be on that are active against Hep B?
Two
How much time do you have to initiate post exposure HIV prophylaxis after exposure?
72 hours
Can you combine ACE and ARB for BP control?
No - too many risks
Nifedipine in large doses increases risk of what?
MI in pts with cardiovascular disease
What is considered a large dose of nifedipine?
Over 80mg/day
ACE/ARB should not be combined with which other anti-HTN?
Aliskiren
Can you give renin inhibitor with ACE or ARB?
No
Why should you not give renin inhibitor with ACE or ARB?
Increased risk of cardiovascular adverse events
What is the preferred initial agent for HTN in black pts?
Calcium channel blockers
How long to wait when switching from ACEi to ARNi and why?
36 hours to prevent angioedema
Can you give ACEi or ARNi if pt has hx of angioedema?
No
What percent of strokes are caused by afib?
15-20%
VKORCI and CYP2C9 affect dose variation of what drug?
Warfarin
Which DOAC needs to be stored in its original container?
Pradaxa
Which DOAC cannot be given in a pt with CrCl above 95?
Edoxaban
Pt must have 2 of what three factors to get a dose of Eliquis of 2.5 rather than 3?
Cr > 1.5, weight < 60kg, age 80
What is the only DOAC superior to Warfarin?
Eliquis
