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Pharmacology Exam 1 > Module 3 > Flashcards

Module 3 Flashcards

1
Q

What is the mechanism of action of penicillin?

A
  • cell wall synthesis inhibitors ( damaging cell wall to allow water to enter and destroy the organism);
  • bactericidal;
  • mostly gram-positive bacteria.
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2
Q

What is the mechanism of action of cephalosporins?

A
  • similar to pencillins;
  • cell wall synthesis inhibitors (damaging cell wall to allow water to enter and destroy the organism);
  • bactericidal;
  • mostly gram-negative bacteria; classified by 1st-5th generation drugs
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3
Q

What is the mechanism of action of carbapenems?

A
  • cell wall synthesis inhibitors ( damaging cell wall to allow water to enter and destroy the organism);
  • bactericidal;
  • the beta-lactam ring is very resistant to destruction by betalactamase.
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4
Q

What are the drugs in the penicillin class?

A

Penicillin G & V

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5
Q

What are the drugs in the cephalosporin class?

A

cefazolin (Ancef, Kefzol) cephalexin
(Keflex) (1st gens), cefixime (Suprax) (3rd gen), ceftaroline
(Teflaro), cefepime (Maxipime) (4th and 5th gens)

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6
Q

What drugs are in the beta-lactam antibiotic class?

A

penicillin, cephalosporin, monobactams, carbapenems; bactericidal

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7
Q

Describe the characteristics of the 1st gen cephalosporin.

A

First-generation cephalosporins are the most effective drugs in this class against gram-positive organisms including staphylococci and streptococci. They are sometimes drugs of choice for these organisms. Bacteria that produce beta-lactamase will usually be resistant to these drugs.

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8
Q

Describe the characteristics of the 2nd gen cephalosporins.

A

Second-generation cephalosporins are more potent, are more resistant to beta-lactamase, and exhibit a broader spectrum against gram-negative organisms than the first-generation drugs. The second generation agents have largely been replaced by third-generation cephalosporins.

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9
Q

Describe the characteristics of the 3rd gen cephalosporins.

A

Third-generation cephalosporins exhibit an even broader spectrum against gram-negative bacteria than the second-generation drugs.
They generally have a longer duration of action and are resistant to beta-lactamase.
These cephalosporins are sometimes drugs of choice against infections by Pseudomonas, Klebsiella, Neisseria, Salmonella, Proteus, and H. influenza.

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10
Q

Describe the characteristics of 4th and 5th gen cephalosporins.

A

Fourth- and fifth-generation cephalosporins are effective against organisms that have developed resistance to earlier cephalosporins.
Fourth-generation agents such as cefepime (Maxipime) are capable of entering the cerebrospinal fluid (CSF) to treat CNS infections.
The fifth-generation drugs such as ceftaroline (Teflaro) are designed to be effective against MRSA infections.

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11
Q

What example of drugs are the carbapenems?

A

Imipenem (Primaxin), ertapenem (Invanz), doripenem (Doribax), and meropenem (Merrem IV)

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12
Q

What is the mechanism of action of fluoroquinolones?

A

DNA synthesis inhibitors inhibiting two bacterial enzymes DNA gyrase and topoisomerase IV affecting replication and DNA repair.

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13
Q

What are the names of fluoroquinolones type of drugs?

A

“floxacin”; ciprofloxacin, levofloxacin, moxifloxacin

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14
Q

What type of bacteria is fluoroquinolones most effective with?

A
  • gram negative;

- bactericidal

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15
Q

What is the mechanism of action of sulfonamides?

A
  • folic acid inhibitors; suppress bacterial growth by inhibiting the synthesis of folic acid or folate;
  • bacteriostatic;
  • broad spectrum both positive and negative bacteria
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16
Q

What drug is commonly used to treat UTIs?

A

sulfamethoxazole-trimethoprim (Bactrim, Septra)

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17
Q

What is the mechanism of action of tetracyclines?

A
  • protein synthesis inhibitors; inhibiting bacterial protein synthesis by binding to the bacterial ribosome that slows microbial growth;
  • bacteriostatic;
  • one of the broadest spectrum drug class both effective in gram-negative and positive bacteria
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18
Q

What is the mechanism of action of macrolides?

A
  • protein synthesis inhibitors; inhibiting bacterial protein synthesis by binding to the bacterial ribosome that slows microbial growth;
  • low doses bacteriostatic; high dose bactericidal
  • mostly gram-positive bacteria
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19
Q

What is the mechanism of action of aminoglycosides?

A
  • protein synthesis inhibitors; inhibiting bacterial protein synthesis by binding to the bacterial ribosome that slows microbial growth;
  • bactericidal;
  • treatment of aerobic gram negative bacteria, mycobacteria, and some protozoans
  • clinical use limited due to ototoxicity and nephrotoxicity
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20
Q

What kind of drugs are the tetracyclines?

A

“cyclines” demeclocycline, doxycycline, minocycline, tegecycline

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21
Q

What kind of drugs are the macrolides?

A

“romycin” erythromycin, azithromycin, clarithromycin

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22
Q

Name 3 the aminoglycosides drugs?

A

gentamicin, tobramycin, streptomycin

23
Q

What is bacterial resistance?

A

when bacteria change in some way that reduces or eliminates the effectiveness of the antibiotic drug

24
Q

How does bacterial resistance occur?

A

1) genetic mutation such as enabling bacteria to produce enzymes that inactivate antibiotics (e.g., penicillin resistance occurred by bacteria producing enzyme called beta lactamases that cleaves off the beta lactam ring of penicillin to inactive the drug.
2) Acquiring resistance from another bacterium through simple mating process called conjugation that transfer genetic material.

25
Q

What is host flora and how it relates to bacterial infections?

A
  • (undergrowth) antibiotics destroy normal microorganism that serve antibacterial substances by competing with pathogenic organisms for space and nutrients. Removal of host flora by an antibiotic gives remaining microorganism an opportunity to grow, allowing for overgrowth of pathogenic microbes. As a result, superinfections could occur introducing new pathogens. Superinfections are a new infection caused by an organism different from the on causing the initial infection.
  • (overgrowth) host flora themselves can cause disease if allowed to proliferate without control or if they establish colonies in abnormal locations. For example, E coli is part of the host flora in the colon but can become a serious pathogen if it enters the urinary tract. Host flora may also become pathogenic if the patient’s immune system becomes suppressed called opportunistic infections.
26
Q

What are host factors in regards to bacterial infections?

A
  • immunocompromised: suppressed immune systems may require aggressive antibiotics or prophalysis treatment with bactericidal medications.
  • blood brain barrier-infections of the CNS are difficult to treat in that many drugs cannot cross the BBB.
  • tissue environment-injury or inflammation can cause tissue to become acidic or anaerobic and to have poor circulation or barriers like excessive pus formation or hematomas can block drugs from reaching their targets.
  • intracellular pathogens-mycobacterium tuberculosis, salmonella, toxoplama, and listeria may reside intracellularly and may be difficult to reach in high concentrations.
  • allergies to antibiotics
  • age-unable to metabolize or excrete antibiotics
  • pregnancy status-some antibiotics cross the placenta and cause birth defeats
  • genetics-some patients lack certain enzymes used to metabolize antibiotics.
27
Q

What is the most versatile group of antifungals and why?

A

The azole class is the largest and most versatile group of antifungals. These drugs have a broad spectrum and are used to treat nearly any systemic or superficial fungal infection.

28
Q

What are the names of antifungal drugs?

A

“azole” fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend).

29
Q

What is the mechanism of action of vancomycin?

A
  • inhibiting proper cell wall synthesis in Gram-positive bacteria;
  • treatment of MRSA
30
Q

What drugs are effective against staph infections?

A

Penicillinase-resistant penicillins (flucloxacillin, dicloxacillin) remain the antibiotics of choice for the management of serious methicillin-susceptible S. aureus (MSSA) infections, but first generation cephalosporins (cefazolin, cephalothin and cephalexin), clindamycin, lincomycin and erythromycin have important therapeutic roles in less serious MSSA infections such as skin and soft tissue infections or in patients with penicillin hypersensitivity, although cephalosporins are contra-indicated in patients with immediate penicillin hypersensitivity (urticaria, angioedema, bronchospasm or anaphylaxis).

31
Q 
What are the class of drugs for the treatment of vancomycin-resistant Enterococcus faecium
infections?
A
  • streptogramins

- Quinupristin/dalfopristin (Synercid)

32
Q

What is the most common protozoan disease and what drugs are used to treat it?

A
  • amebiasis

- metronidazole (Flagyl) and tinidazole (Tindamax)

33
Q

What is the most common parasite illness?

A
  • worldwide-ascariasis which is caused by the roundworm Ascaris lumbricoides
  • U.S.-enteriobiasis-pinworm Enterobius vermicularis
34
Q

What is the most common drugs to treat helminth (parasite) illnesses?

A

For ascariasis, oral mebendazole (Vermox)

For enterobiasis, albendazole (Albenza) or pyrantel (Antiminth)

35
Q

What does cholinergic agonists do?

A

Stimulate the parasympathetic nervous system (rest and digest)

36
Q

What does effects do parasympathetic division control?

A 
constricts pupil (miosis)
stimulates salivation
slows heart rate and contractility
constricts bronchioles
stimulates digestion
contracts bladder
stimulates erection & vaginal lubrication
37
Q

What does effects do sympathetic division control?

A 
dilates pupil (mydriasis)
inhibits salivation
accelerates heart rate and contractility
dilates bronchioles
inhibits digestion
stimulates release of glucose
secretes epinephrine and norepinephrine
relaxes bladder
stimulates ejaculation and orgasm
38
Q

What does cholinergic antagonists do?

A

blocks the parasympathetic nervous system (effects similar to SNS)

39
Q

What type of drugs are cholinergic agonists?

A

bethanechol (Urecholine) -direct acting parasympathomimetics: bind to cholinergic receptors

physostigmine (Antilirium) -cholinesterase inhibitors: inhibit the breakdown of Ach by inhibiting AchE

40
Q

What type of drugs are cholinergic antagonists?

A

Atropine muscarinic receptors to block effects (anticholinergic effects)

41
Q

What are the types of cholinergic antagonists?

A

muscarinic antagonist and nicotinic antagonist

  • their effects include: dilation of the pupils
    (mydriasis) , increase in heart rate, drying of glandular secretions, and relaxation of the bronchi (asthma treatment)
42
Q

Describe a seizure

A

clinical detactable sign of epilepsy, disturbance of electrical activity in the brain that may affect consciousness, motor activity, and sensation

43
Q

What are convulsions?

A

involuntary, violent spasms of large skeletal muscles of the face, neck, arms and legs.

44
Q

What is epilepsy?

A

neurological disorder, seizure disorder, two or more episodes of unprovoked seizures

45
Q

What are the classes of anti-seizure medications?

A
  • Drugs that potentiate GABA action: stimulate an influx of Cl- ions through the GABA receptor channel;
    • barbiturates: phenobarbital (Luminal) and
    • benzodiazepines: diazepam (Valium)
  • Drugs that suppress sodium influx
    • hydantoins: phenytoin (Dilantin)
    • phenytoin-related drugs: valproic acid (Depakene)
  • Drugs that suppress calcium influx
    • succinimides: ethosuximide (Zarontin)
  • Amino Acid compounds: keep positive ions fluxes balanced
    • taurine, acetazolamide (Diamox), lacosamide (Vimpat)
46
Q

Why is drug compliance important in pharmcotherapy of epilepsy and seizures?

A

It is important to take antiseizure medications as prescribed, at the same time everyday as abruptly stopping medications can cause withdrawal seizures. These medications need to be discontinued over a period of 6-12 weeks.

47
Q

What is the mechanism of action of central acting skeletal muscle relaxants?

A

increases circulating levels of norepinephrine (NE), blocking presynaptic uptake, alpha 2 adrenergic agonists

48
Q

What is a type of central acting skeletal muscle relaxant drug?

A

cyclobenzaprine (Flexeril)

49
Q

What is the contraindication of central acting skeletal muscle relaxants?

A

MI, dysrhythmias, hypothyroidism, severe cardiovascular disease

50
Q

What is the mechanism of action of direct-acting antispasmodics?

A

works at the level of the neuromuscular junction and skeletal muscles; interferes with release of calcium in skeletal muscles

51
Q

What is a type of antispasmodic drug?

A

dantrolene sodium (Dantrium)

52
Q

What are the contraindications of Dantrolene sodium (Dantrium)?

A

impaired cardiac, pulmonary or hepatic function

53
Q

What is the mechanism of action of skeletal muscle relaxants for short term procedures?

A

depolarizing blockers used for ECT and endotracheal intubation

54
Q

What are the precautions associated with succinylcholine?

A

Adverse effects include persistent paralysis in some patients, elevated blood levels of potassium, malignant hyperthermia, and postoperative muscle pain.

Pharmacology Exam 1 (3 decks)

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