Personal Pharm Cards Flashcards
What drugs are indicated for patient with acute gout attack
NSAID
Colchicine
corticosteroids/glucocorticoids (injection preferred)
^after NSAID failure
what drugs are indicated for preventative/chronic management of gout
- Xanthine oxidase inhibitors
- allupurinol, febuxostat
- probenecid
^reduce the urice acid level in the body
MOA of colchicine
microtubule inhibition by binding to tubulin –> white blood cell migration and phagocytosis is inhibited
colchicine adverse effects
GI:
N/V/D –> d/t loss of GI epithelium turnover which promotes BM
abdominal pain
what are the xanthine inhibitors
- allopurinol –> competitive inhibitor (mn: PURE competition)
- febuxostat –> non-competitive inhibitor
side effects of allopurinol
for this reason, many patients don’t tolerate it well. febuxostat is used as a second line of tx for patients who don’t tolerate allopurinol
what co-administration needs to be given with the XO inhibitors
cochicine because the changing ration of uric acid in the blood due to the XO inhibitors can cause acute gout attacks which colchicine will supress
MOA of allopurinol and febuxostat
Can we give patients aspirin for pain control of gout attack?
NO, not at normal dosages
it is dose dependent, see image
what are the best NSAIDs for gout?
sulindac, naproxen, indomethacin
probenecid side effects and administration precautions
Give with colchicine if acute setting
don’t use if renal problems
increased risk for developing uric acid kidney stones d/t increased secretion
Adverse Effects: GI irritation, rash, aplastic anemia; don’t give if pt has sulfa allergey
MOA of probenicid
whats its indication
blocks reabsorption of uric acid in proximal tubule –> increased excretion
indicated for gout
What DMARD is this based on the MOA shown
what’s its indication
leflunamide
what is the indication for prescribing leflunamide
RA, if the patient fails Methotrexate
what DMARD acts by inhibiting calcineurin?
what’s its indication
cyclosporin
indication and MOA of cyclophosphamide
indication: RA
MOA:
Staining features/virulence factors of Staphylococcus aureus
- gram positive
- beta hemolytic
- coagulase positive (differentiates s. aureus and s. epidermidis)
- catalase positive –> converts H2O2 to water and oxygen (differentiates it from strep)
- ferments mannitol
- contains alpha toxin and beta toxin
^pretty much all positives (mn: Aureas does All the Areas)
*** the other key thing that differentiates it from strep is that it is arranged in clusters rather than chains
Food poisoning due to staphylococcal enterotoxin is characterized
by a short incubation period ___-___ hours
1-8 hours
True/False:
Coagulase-positive staphylococci are considered
pathogenic for humans
TRUE
treatment for penicillin G- resistant S. aureus
Penicillin G-resistant S. aureus strains from clinical
infections always produce penicillinase. They
constitute >95% of S. aureus isolates in communities in
the United States.
• They are often susceptible to β-lactamase-resistant
penicillins, cephalosporins, or vancomycin.
• Vancomycin-resistant strains are rare.
GAS (strep. pyogenes) virulence factors
- bacterial capsule is responsible for evasion of phagocytosis.
- protein F is required for adherence to the host cell
- Streptokinase lysis clots and helps invasion into tissues.
- C-5 peptidase lyses complement complexes evading the complement component of the immune system
- Streptococcal pyogenic exotoxin is responsible for generating fever and immunomodulation
what are the 5 types of typhus infections and what was their causative agent
- Rocky Mountain spotted fever –> tickborne,
- scrub typhus, –> mite-borne
- rickettetsialpox, –> mite-borne
- endemic typhus, spread by a body louse
- murine endemic typhus spread by a flea.
what is the abx treatment for rickettsiae infection causing typhus?
tetracycline/docycycline
what is the basic differentiating factor between staph aureus and strep pyogenes ( in terms of structure)
are are the two most likely late sequelae of streptococcal pyogenes infections
- rheumatic fever
- glomerular nephritis
which organism is most usually responsible for toxic shock syndrome
Staph
the ___________ lab test differentiates between staph aureus from non pathogenic staphylococci
Coagulase test
sulfa drug rxn
what rare but strange MSK side effect can occur with taking fluoroquinalones
achilles tendon tear/rupture or swelling
Answer: DHFR and DHPS
what is an MAO
Monoamine oxidase
MAOI = drug that inhibites monoamine oxidase
*assoc with serotonin syndrome
answer: bacteroides fragilis
multivalent cations
drugs to avoid right before or after taking Calcium/tums etc: fluoroquinalones and tetracyclines
T/F: metronidazole only works on anaerobes
TRUE
esp c diff, b frag, H pylori
what drug to use to treat necrotizing fascitis
clindamycin (with penicillin G)
what are pediculocides
drugs that kill pediculus humanus (lice) of the head (capitis) and body (corporis)
Patient with anal itching presents. no other symptoms. microscopu of a the area shows this. What’s the diagnosis?
enterobius (pinworm) which is in the nematode family
what is ascaris
giant intestinal roundworm
causes intestinal pain, constipation (high pitched bowel sounds)
tx: mebendazole
mebendazole - what is it used to treat?
intestinal nematodes and tapeworms
what drugs are used to treat tapeworms
niclosamid, praziquantel, albendazole (or mebendazole)
praziquantel treats _______and _________
tapeworms (cestodes) and flukes (trematodes)
how does niclosamide work?
transport chain uncoupler
how does ivermectin work?
Glu Cl- channel agonistm
ivermectin treats
threadworm, dog heartowrm, wuchereria (elephantiasis), lice
limitation of treatment of lice with benzyl alcohol?
it only kills adult lice
what is “rid” OTC shampoo?
contain pyrethrins (from chrysanthemom flower), which kill lice via Na+ channel blockers
which drugs kill lice eggs and adults?
malathion
spinosad
ketoconazole
an antigunal medication
MOA: blocks ergosterol synthesis by inhibiting 17,20 lyase
AE: decrease in testosterone (p/w gynecomastia in men)
off label use: Cushing’s syndrome (b/c it also blocks upstream enzymes req. for cortisol synth.)
which drug can mimic effects of hypercortisolism
fludrocortisone
