Notes Flashcards by RICHARD TREAT

Prodrugs have a long half life because

you’re waiting for it to break down and become active

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Agonist- activates the receptor.
Antagonist- blocks the effects of the receptor.
Partials-

in the middle

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Supratherapuetic means the level is

too high

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Steady state-

what goes in is the same as what goes out

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P-glycoprotein inhibitors include
v____ and g____
Drugs that can become toxic when given with a P-glycoprotein inhibitor
___ and ___

Verapamil, grapefruit juice

make these ones toxic

Digoxin, cyclosporine

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Live vaccines are contraindicated for

pregnant women and immunosuppressed patient and kids under 1 year old

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Why do you need multiple doses of inactivated vaccines

they’re dead so they can’t replicate on their own

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For our purposes we are not counting ___ as an NSAID

aspirin

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Tdap for pregnant women

give single dose of Tdap for every pregnancy at 27 to 36 weeks.

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If patient is at risk of becoming preg, check for titers for

rubella and varicella

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Contraindication for MMR-

severe immunodeficiency and pregnancy

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Mumps and rubella have no

post exposure prophylaxis

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___ and ___ have no post exposure prophylaxis

Mumps and rubella

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zoster (shingles) indicated for all adults

over 60 without contraindications

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___(___) indicated for all adults over 60 without contraindications

zoster (shingles)

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if you get the shingles vaccine too young,

it might not cover you for your whole life. So if you get it not until 60 than you’re probably covered for the rest of your life.

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besides aspirin all other NSAIDS cause

fluid retention

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tylenol max daily dose is

3 grams, in the hospital it’s 4

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2 main causes of GI bleeds are

h. Pylori and nsaids/aspirin

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Sodium bicarb is an antacid. What’s good about it, and what should you watch out for

its good because it gives quick relief

Old people should look out for fluid retention especially if they have heart failure

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What should you know about calcium carbonate as an antacid

It’s safe for pregnancy but be careful with renal patients because too much calcium can build up

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magnesium hydroxide or aluminum hydroxide given together so you don’t have

diarrhea

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Cimetidine, an H2 blocker, is very potent but

not used much anymore because it has many interactions.

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Talk about the structure of PPIs

PPIs are not stable.

They are pro drugs, they are encapsulated so they don’t break down right away.

Have short half lives, but not short duration of action.

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When do you take a PPI

You want to take them on an empty stomach so they are more effective. when stomach is empty you have less acid though, which is bad, you want acid so that the drug can work. So what we do is give it an hour before a meal, that way you’ll then have some acid.

How long until a PPI is effective

3-4 days

don't take Bismuth subsalicylate with

warfarin

If you have h pylori, you might use a ___, then start an abx

PPI to stop the acid

Fungal infections: Be careful with foot infections if they are

immunocomprised or severely DM because it could possibly be something more serious

When you hear Candida, think of a___, n___

azoles, nyastatins

How do you decide between a cream or powder?

Depends on location. If a dry area, use ointment, moist area use powder

T. Unguium- ___ anti fungal is optimal.

systemic

___ administration of penicillin is needed for STDs and Strep

When prescribing Abx, the first and second questions you ask are

allergies, renal function

Major drug interaction to watch out for with women using abx is

birth control

Cefotetan can cause bleeding and disulpheran like actions which is

a med given to alcoholics which causes a violent reaction

Because tetracyclines are don't really get into the blood, they're not so good for bacteriemia, but they can get to hard to reach places like

bone marrow

Macrolides can be given for a shorter amount of time because

they stay in the tissues

If you have a kid that has a cough and doesnt go away from the regular meds, they might have

mycoplasma

the 3 atypical organisms-

legionella (elderly and young kids), mycoplasma (young kids), chlamydia

Aminoglycosides are usually this, but not usually that

usually given IV, not usually monotherapy

Unlike Vancomycin, Aminoglycosides work by

concentration dependent killing

How is the doing schedule of beta lactams different from the dosing of aminoglycosides

beta lactams need a steady level, whereas aminoglycosides are better as just one big hit against the kidneys

With abx, We want the trough to be very low, because

that means your body had time to clear it and its safe to give the next dose.

While we know that aminoglycosides cause ear problems, more specifically amikacin causes ___ and the other two cause

Amikacin- auditory | Gentamicin, tobramycin- vestibular

bactram, watch out for __ allergy

sulfa (because bactram is TMP-Sulfanomide)

z-pack is aka

azithromycin

First choice for sinusitis or a dog bite (don't over think it)

augmentin

If they have a pen allergy and you're in doubt, choose

doxycycline

Uncomplicated UTI refers to who?

healthy female, Complicated UTI- everyone else

Number one cause of UTI is

E coli

Pyelonephirtis is serious enough that you should

go to the hospital

Nitrofurantoin is underused, its good for uncomplicated cystitis. Definitely don’t use for ____ because it won’t reach that tissue.

Pyelonephirtis

Remember not to use bactram at these two times

1 week of pregnancy, 3rd trimester

what is good and what's bad about Linezolid

Good because it comes PO and IV. Bad thing is is causes blood issues like decrease platelets also its bacteriostatic

Dalbavancin is special because you only need it

once a week via IV

v_____- dosed by actual body weight, unless you’re severely obese, in which case you use adjusted

Vancomycin

Vancomycin- dosed by actual body weight, unless you’re

severely obese, in which case you use adjusted

Vancomycin- dosed by actual body weight, unless you’re severely obese, in which case you use ____

adjusted

When they say muscarinic, think

anticholinergic

sama stands for

short acting muscarinic agent

Mild COPD treatment

SABA

Moderate COPD treatment

SABA plus abx/corticosteroid

0 to 1 regular exacerbations and low MRC/CAT scores

SABA

0 to 1 regular exacerbations and high MRC/CAT scores

LABA or LAMA

2 or more regular exacerbations/1 or more serious exacerbation and low MRC/CAT scores

LAMA

2 or more regular exacerbations/1 or more serious exacerbation and high MRC/CAT scores

LAMA LAMA and LABA LABA and ICS