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CPRII > PE/P HTN/PNA > Flashcards

PE/P HTN/PNA Flashcards

1
Q

AE associated w/ inhaling prostanoids?

A

cough

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2
Q

What color are arterial clots? What drugs used to tx?

A

WHITE (abundance of platelets)

platelet targeting drugs

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3
Q

What is PAH?

A

mean PAP >25 at rest & PCWP <15

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4
Q

What is pneumovax 23?

A

vax against broader range of Strep pneumo

NOT effective in kids<2yo

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5
Q

What is aztreonam?

A

monobactam active v G- bacterial

targets cell wall synthesis & can be used in pts w/ B lactam allergy

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6
Q

What occurs in pulmonary vasculature that increases resistance to flow?

A

remodeling

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7
Q

What is caused by drugs used to tx PAH?

A

vasodilatation

results in HA, flushing

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8
Q

Major AE w/ fluoroquinolone tx in young & old pts

A

tendon rupture

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9
Q

What is pathognomonic of PAH?

A

plexiform lesions

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10
Q

What are plexiform lesions?

A

bypass regions outside of plugged pulmonary arterioles that provide blood to multiple pulmonary capillaries

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11
Q

What are macrolides?

A

bacteriostatic drugs that bind to bacterial 50S to block peptide chain elongation

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12
Q

When are clot busters used?

A

used to tx PE in setting of hemodynamic instability

admin via peripheral vein

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13
Q

What is amoxicillin?

A

typical oral penicillin for combo tx of CAP

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14
Q

When is vancomycin used?

A

admin IV for MRSA

admin orally for resistant C diff infxns

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15
Q

Who does PAH classically affect?

A

young mom

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16
Q

What is gentamicin?

A

IV agent used to tx PNA in pts who cannot tolerate B lactams

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17
Q

What is indicative of R HF?

A

peripheral edema

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18
Q

What is super-infection?

A

occurs due to overgrowth of bacteria not susceptible to broad spectrum antibiotic

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19
Q

What is the CDC responsible for?

A

maintains database of bacterial resistance & issues guidelines on antibiotic stewardship

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20
Q

What metabolizes S-warfarin to 7-OH warfarin?

A

CYP2C9

increases warfarin potency 3-5x

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21
Q

What is endothelin?

A

exceptionally potent vasoconstrictor produced by endothelial cells

levels are + correlated w/ PAH

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22
Q

What is cefpodoxime?

A

orally active cephalosporin

pts w/ CAP allergic to penicillin

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23
Q

What is plasminogen?

A

enzyme that breaks down clots

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24
Q

What drug class is effective v Mycoplasma?

A

tetracyclines

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25
Q

Where must dabigatran be stored?

A

in a desiccator to avoid excess heat or cold b/c is unstable drug

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26
Q

What is prostacyclin?

A

made by endothelial cells from AA

promotes vascular relaxation, suppresses growth of vascular smooth m cells, inhibits platelet aggregation

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27
Q

What enzyme is inhibited by clavulanate, tazobactam, and sulbactam?

A

block bacterial enzyme Beta-lactamase

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28
Q

What is major AE w/ penicillins?

A

allergic rxns

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29
Q

What lab test monitors anticoagulant activity of heparin?

A

aPTT

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30
Q

What is cor pulmonale?

A

enlargement of R heart due to high blood pressure in pulmonary circulation

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31
Q

What is the tx of fat PE?

A

only SUPPORTIVE tx

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32
Q

What antibiotics should NOT be admin @ same time as bactericidal drugs?

A

bacteriostatic

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33
Q

What is sildenafil?

A

orally active PDE5 inhibitor

used to tx PAH

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34
Q

What syndrome is caused by infusing vancomycin too fast?

A

red man syndrome

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35
Q

What are sxs in PE?

A

chest pain, dyspnea, cough

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36
Q

What enzyme is inhibited by Linezolid?

A

inhibits MAO

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37
Q

When is dabigatran inferior to warfarin in inhibiting thromboembolism?

A

pts w/ mechanical heart valves

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38
Q

How is sensitivity of bacteria to an antibiotic measured?

A

disk diffusion test

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39
Q

Levels of what are high in PAH?

A

BNP

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40
Q

What is an IVC filter used for?

A

limit PE in pts who cannot use anticoagulant tx

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41
Q

What is MOA & use of aspirin?

A

irreversibly blocks synthesis of TXA2 by platelets

admin daily after discontinue of anticoagulation tx for VTE to prevent recurrence

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42
Q

What is an AE of tetracyclines & fluoroquinolones?

A

photosensitivity

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43
Q

What is AE assoc w/ prostanoids?

A

jaw pain

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44
Q

What is formed by tetracycline w/ Ca2+, Mg?

A

precipitate

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45
Q

What is concern of endothelin receptor antagonists in PAH tx?

A

teratogenesis in Fs

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46
Q

What is predictable for both fondaparinux & LMWH?

A

pharmacokinetics

can be admin @ home

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47
Q

What are aminoglycosides?

A

IV antibiotics w/ G- & G+ activity

48
Q

What are major AEs w/ aminoglycosides?

A

nephrotoxicity

ototoxicity

49
Q

What is rivaroxaban?

A

direct inhibitor of Factor X

inhibits generation of thrombin

50
Q

What is riociguat?

A

used to tx PAH by directly activating GC & stabilizes its interaction w/ NO

enhances cGMP production in vascular smooth m cells

51
Q

What type of PNA can follow viral PNA?

A

bacterial

52
Q

What is bosentan?

A

orally active non-selective blocker of endothelin receptors

alters conc of OCPs

53
Q

What is a chronic PE?

A

has eccentric location w/ recanalization & arterial webbing to bypass it

54
Q

What is selexipag?

A

orally active prostacyclin analog to tx PAH (esp in kids)

55
Q

What is an AE of PAH?

A

syncope

56
Q

What makes ampicillin & amoxicillin broad spectrum?

A

have activity v G- bacteria

57
Q

What is epoprostenol?

A

IV drug to tx PAH

continuous pump & t1/2 of 6 min

58
Q

What is ambrosentan?

A

orally active endothelin antagonist that selectively blocks ETa receptors to tx PAH

59
Q

What type of shock is caused by PE, cardiac tamponade or pneumothorax?

A

obstructive shock

60
Q

What is a fatal AE of bosentan?

A

hepatotoxicity

61
Q

What topoisomerase is targeted by respiratory fluoroquinolones?

A

topoi IV

62
Q

What is nifedipine?

A

CCB used in tx of pts w/ PAH & respond to vasopressor test

63
Q

What is heparin?

A

binds to antithrombin to inhibit Facto Xa & thrombin

64
Q

What does use of heparin increase risk of?

A

hematoma in brain or spinal cord

65
Q

What is dabigatran?

A

orally active & reversible direct inhibitor of thrombin

66
Q

What is linezolid?

A

anti-MRSA/VRE agent that can be used ORALLY to tx MRSA PNA

67
Q

What are signs of progressive pulm artery HTN?

A

blue lips
near syncope
swollen legs/ankles

68
Q

What is doxycycline?

A

tetracycline used for tx of CAP in combo w/ B-lactam

in pts who cannot tolerate macrolides

69
Q

What is MDR?

A

bacteria w/ nonsusceptibility to at least 1 agent in 3 different anti-microbial classes

70
Q

What are fluroquinolones?

A

broad-spectrum orally active drugs w/ activity v G- bacteria & some G+ bacteria

71
Q

What should you not mix penicillins with?

A

aminoglycosides

72
Q

What is cefepime?

A

IV 4th gen cephalosporin

greater ability to penetrate into G- bacteria

73
Q

What is clarithromycin?

A

add-on drug to B-lactams when tx PNA

less epigastric pain, blocks CYP450

74
Q

What is clindamycin?

A

past drug of choice for aspiration PNA

frequent cause of C diff colitis

75
Q

What does use of ventilator increase risk of?

A

increased risk of HAP (often due to MDR pathogen)

76
Q

What receptor contributes to PAH?

A

5HT receptor

77
Q

What are cephalosporins?

A

B-lactam containing antibiotics

78
Q

What is a mild AE of tadalafil, sildenafil or riociguat (esp when admin w/ a1 blocker)?

A

hypotension

79
Q

What is an early sign of PAH when assoc w/ physical activity?

A

dyspnea

80
Q

What is the antidote for heparin?

A

protamine

81
Q

What is cefditoren?

A

orally active cephalosporin used in pts w/ CAP w/ penicillin allergy

82
Q

What is an indication for alteplase?

A

acute & massive pulmonary embolism

83
Q

What is levofloxacin?

A

3rd gen respiratory fluoroquinolone

more G+ activity

84
Q

What is preferred tx of PE?

A

anti coagulation

also used in PAH to minimize in situ thrombosis

85
Q

What is ceftriaxone?

A

widely used 3rd gen IV cephalosporin

eliminated by LIVER

86
Q

What keeps platelets in inactivated state?

A

PGE2 (released by endothelial cells)

87
Q

What can be inserted in arteries or veins to improve blood flow?

A

stents

88
Q

What is iloprost?

A

prostacyclin analog

inhaled 6-9 times/day

89
Q

What is the status of fluoroquinolones in tx of CAP?

A

reserve status

to reduce appearance of tolerance

90
Q

What is azithromycin?

A

macrolide that does not block CYP450

slowly released @ bacteriostatic levels over several days

91
Q

What is andexanet alfa?

A

antidote for Factor Xa inhibitors (rivaroxaban, apixaban)

92
Q

What is treprostinil?

A

prostacyclin analog w/ longer 1/2 life

admin IV, subQ, inhalation, orally for tx PAH

93
Q

What is ending for drugs that fxn as tPA?

A

plase

94
Q

What is piperacillin?

A

extended spectrum w/ activity v Pseudo aeruginosa

95
Q

What is lefamulin?

A

pleuromutilin used to tx CAP when other agents do not work

96
Q

What is risk of cephalosporins?

A

bleeding

97
Q

What is argatraban?

A

admin IV for prophylaxis & tx of thrombosis in pts @ risk of HIT

98
Q

What is prevnar 13?

A

S pneumo vax admin to newborns & pts>65

99
Q

What are prostanoids?

A

drug class to tx PAH w/ more sxs

100
Q

What is tadalafil?

A

orally active PDE5 inhibitor to tx PAH

101
Q

What is an AE of tetracyclines?

A

turn developing teeth gray/brown

102
Q

What is erythromycin?

A

macrolide used instead of penicillin

103
Q

What is antidote for dabigatran?

A

idarucizumab

104
Q

What is macitentan?

A

non-selective endothelin receptor blocker

105
Q

What is life threat concern w/ IV prostanoid admin?

A

sepsis

106
Q

What is ipipenem?

A

carbapenem drug that targets bacterial cell wall synthesis

activity v many MDR bacteria

107
Q

What is blocked by B-lactam antibiotics?

A

cell wall synthesis

108
Q

What does heparin permanently inactivate?

A

thrombin

very rapidly limits extension of a clot

109
Q

What is the color of clots in venous side of circ?

A

RED (fibrin mesh)

110
Q

What enzyme is blocked by fluoroquinolones?

A

DNA gyrase

111
Q

What must be administered in tx of PAH?

A

OXYGEN (to maintain saturation >90%)

112
Q

What is route of admin for PDE5 inhibitors?

A

ORAL

113
Q

What is enoxaparin?

A

LMWH

inhibits factor Xa

114
Q

What is mnemonic for MDR bacteria of greatest concern?

A

ESKAPE

cause 80% of VAP

115
Q

What is alteplase?

A

glycoprotein that acts like human tPA

CPRII (4 decks)

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