Midterm 3 structure

Question 1

Answer 1

Methadone

Question 2

Answer 2

Ceftaroline Fosamil Acetate

• Effective against gram + and -
• Exhibit Activity against MRSA
• Bacterial Cell wall synthesis inhibitor

Question 3

Answer 3

Fludrocortisone

Mineralocorticoids

Question 4

Answer 4

Prednisolone

• Glucocorticoid
• Regulate glucose metabolism
• Anti-inflammatory activity
• Glucose sparing effect

Question 5

Answer 5

Prednisone

Question 6

Answer 6

Ciprofloxacin

• Quinolone : inhibit DNA synthesis by promoting cleavage of bacterial DNA in the DNA gyrase
• Effective against gram - (inhibition of DNA gyrase) and gram + (inhibition of DNA type 4 topoisomerase)
• conc dependent killing + PAE / Bactericidal Activity
• used with caution in patients with epilepsy/seizures
• Photosensitivity; rash; tendonitis; prolong QT; Chelation with antacids
• Not safe for children/pregnant women (CAT.C)

Question 7

Answer 7

Tigecycline

• Glycylcycline
• Inhibits protein synthesis
• IV only
• Cat. D
• Teeth staining in children less than 8 yrs

Question 8

Answer 8

Naproxen

• NSAID
• Non-Selective Cox inhibitors - slightly selective for COX 1
• Analgesic, Antipyretic, Anti-inflammatory
• Longer duration of action than Ibuprofen

Question 9

Answer 9

Hydrocodone

Question 10

Answer 10

Sulfamethoxazole

• Competitive inhibitor of PABA
• Antimetabolite -> prevent folate synthesis
• Synergistic with trimethoprim
• Gram + and - ive
• MRSA

Question 11

Answer 11

Daptomycin

• Lipopeptide
• Binds to bacterial membrane by a Ca++ dependent mechanism –> depolarization, K efflux & cell death
• Not for treatment of pneumonia
• Skeletal muscle myalgia & weakness
• Cleared renally
• Concentration-dependent Killing
• active against vancomycin resistant strains of enterococci and staphylococci.

Question 12

Answer 12

Vancomycin

• Glycopepetide
• Inhibits Cell Wall Synthesis by binding to the D-Ala-D-Ala terminus of nascent peptidoglycan
• Nephortoxicity & ototoxicity (when combined with aminoglycosides)
• Skin rash
• Redman Syndrome if rapid IV infusion
• Gram +

Question 13

Answer 13

Naloxone

• pure antagonist
• Antagonists at mu & kappa receptors
• Treat opioid overdose
• Rescue agent for respirator depression

Question 14

Answer 14

Meperidine

• Agonist - pure phenylpiperidine
• Metabolized to normeperidine, which may cause seizures at high plasma levels
• SS when usd with SSRIs
• Hyperpyrexic coma when used with MAO inhibitors (Linezolid)

Question 15

Answer 15

Gentamycin

• Aminoglycosides - bacteria origin
• Gram - aerobic bacteria
• Renal Clearane
• Synergistic with beta-lactams or vacomycin against gram +
• Oto and Nephro-toxicity
• Bacterial protein Synthesis (binding to the 30S Ribosomal subunit)

Question 16

Answer 16

Cephalexin

• 1st gen Cephalosporin
• Impaired cell wall synthesis
• Treat skin and soft tissue infection ; UTI
• Time dependent Killing
• DDI alcohol : disulfiram
• DDI Probenecid –> Tubular secretion
• Should not be used with pts who has penicillin allergies

Question 17

Answer 17

Capecitabine ( Xeloda)

Question 18

Answer 18

Oxycodone

• Agonist - Pure Phenanthrenes
• Genetic in certain hepatic enzymes (CYP 2D6)
• Strong Agonist ( mu receptor)
• Heptatic Metabolism
• Toxicities : Respiratory depression, constipation, addiction liability

Question 19

Answer 19

Oxymorphone

• Strong Agonist ( mu receptor)
• Heptatic Metabolism
• Toxicities : Respiratory depression, constipation, addiction liability

Question 20

Answer 20

Meropenem

• Carbapenems (IV)
• Low susceptibility to Beta-Lactamase
• Gram + and - Anaerobic ; slightly greater activity against gram - aerobic
• Prevent cell wall synthesis by binding and inhibiting cell wall transpeptidases
• Less likely to cause seizures than Imipenem

Question 21

Answer 21

Auranofin

DMARD (gold complex)

Question 22

Answer 22

Oxaprozin

• NSAID
• Highly photosensitive

Question 23

Answer 23

Aztreonam

• Monolactam - for patients with penicillin allergies
• Synergistic with aminoglycosides
• IV only
• Prevents bacterial cell wall synthesis by binding to and inhibiting cell wall transpeptidases (bind to PBP)
• Eliminated via renal tubular secretion (half life is prolonged in renal failure)
• Works against gram - aerobes; No activity against gram + or anaerobes

Question 24

Answer 24

Clindamycin (Lincosamide)

• anaerobic antibiotic and gram + aerobic antibiotic; not effective against gram - aerobes
• activity against many MRSA.
• drug and metabolites are eliminated by biliary and renal excretion.
• Prevents bacterial protein synthesis by binding to the 50S ribosomal subunit
• Skin and soft tissue infections, anaerobic infections
• Toxicity: Gastrointestinal upset, difficile colitis.
• Undergoes hepatic metabolism
• Semisynthetic - bacteriostatic

Question 25

Answer 25

Cefamandole

• Second Gen Cephalosporins
• Works against anaerobes; extended gram - aerobes
• treats Sinus, ear, and respiratory infections cause by H. influenzae or M.Catarrhalis

Question 26

Answer 26

Metronidazole

• Nitroimidazole
• Disrupt Electron transport (MoA)
• Bactericial against anaerobic
• Used infections caused by C.Difficile Colitis; can be used for moderate MRSA
• GI upsets, Metallic taste, Neuropathy
• DDI with alcohol : Disulfiram like rxns