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Reproductive > Pharm > Flashcards

Pharm Flashcards

1
Q

What is the DOC for Primary Syphilis: Treponema palladium infections?

A

Benzathine Pen G

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2
Q

DOC for Chlamydia infection?

A

Azithromycin

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3
Q

DOC for Gonococcal infection?

A

Ceftriaxone

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4
Q

What is the DOC for Trichomniasis?

A

Metronidazole

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5
Q

What is the DOC for Bacterial vaginosis?

A

Metronidazole

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6
Q

Bioavailability of Acyclovir is dependent on?

A

DOSE
Higher dose= lower BA
Lower dose= Higher BA

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7
Q

MOA: competitively inhibits viral DNA poly by competing with Deoxyguanosine triphosphate for incorporation into viral DNA?

A

Acyclovir
Famciclovir
Valacyclovir

Do NOT cause chain termination

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8
Q

What drug is de-acetylated into penicyclovir its active metabolite?

A

Famciclovir

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9
Q

What are the AE for Acyclovir?

A

Neurotoxic= Seizures
Renal failure= insoluble @ high doses
Pt must HYDRATE

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10
Q

What is the function of “Benzathine” preparation of Pen G for Syphilis tx?

A

IM to all for Drug depot and slow release

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11
Q

Poor CSF penetration
Rapid renal elimination via tubular excretion
Hypersensitivity?

A

Pen G

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12
Q

DOC and preparation for Congenital syphilis?

A

Aqueous crystalline Pen G

Procaine Pen G

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13
Q

What is a Jarisch- Herxheimer rxn?

A

Chills, fever, headache, myalgias, arthralgias and more prominent Syphilitic lesions following Penicillin G administration
Caused by Release of Spirochete antigens and host rxn
DO NOT discontinue Pen G

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14
Q

What drug is given for symptomatic relief of Jarisch Herxheimer rxn?

A

Aspirin

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15
Q

MOA of Azithromycin?

A

Binds 50s ribosomal subunit: bacteriostatic

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16
Q

MOA of Doxycycline?

A

Binds 30s subunit: Bacteriostatic

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17
Q

MOA of Levofloxacin?

A

Inhibit DNA gyrase (topo II) in G-; CIDAL

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18
Q

MOA of Ofloxacin?

A

Inhibits topo IV in G+: CIDAL

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19
Q

AE of Azithromycin?

A

GI

Vaginitis

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20
Q

AE of Doxycycline?

A

GI
Hepatic damage
Photosensitivity
Teratogen (D)

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21
Q

AE of Erythromycin?

A

GI
Inhibits CYP3A4
Cholestatic jaundice

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22
Q

AE of Floxacins?

A

Taste disturbance
BBW: tendonitis/ rupture + muscle weakness
Avoid with Myasthenia gravis

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23
Q

Ceprofloxacin is CI in?

A

Pregnancy and lactation

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24
Q

MOA of Ciprofloxacin?

A

Bacteriocida beta lactam: binds PBPs causing cell lysis

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25
Q

What Antibiotic inhibits CYP1A2?

A

Cipro

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26
Q

Antibiotics with LONG t1/2, extensive tissue uptake & slow release, Mostly eliminated in Stool?

A

Azithromycin

Doxy

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27
Q

Antibiotics with SHORT t1/2, Base form readily inactivated by gastric acid. Estolate preps are stable and are liberated into base upon absorption from upper Intestine, Mostly eliminated in stool?

A

Erythromycin

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28
Q

Antibiotics with Medium t1/2 that is Prolonged in RENAL dysfunction?

A

FLoxacins

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29
Q

Associated with hypertrophic pyloric stenosis in neonatal exposure?

A

Erythromycin

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30
Q

What antibiotic is distributed to tissues, bodily fluids, secretions, Renal elimination, does NOT cross placenta, but may get into Breast milk causing infant diarrhea, candidiasis, skin Rash>

A

Amoxicillin

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31
Q

MOA of Ceftraixone?

A

Bacteriocidal Beta lactam: binds PBP causing cell lysis

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32
Q

MOA of cipro?

A

Bactiocidal
G-= inhibits TOPO II
G+= Inhibits TOPO IV

Widely distributed Esp Genital fluids

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33
Q

Elimination route for Ceftriaxone?

A

Urine by GF

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34
Q

Elimination of Cipro?

A

Hepatic metabolism to active metabolite
Renal elimination 2/3
Stool 1/3

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35
Q

AE of cetixime?

A

Diarrhea + GI
Increase Clotting Time
False + urine Glucose in Diabetic pts

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36
Q

MOA of Metronidazole and Tinidazole?

A

Amebicidal, Bactericidal, Trichomonocidal
Unionize drug taken up by anaerobes= reduced to its active metabolite= Disrupts DNA Helical Structure,
INHIBITS nucleic acid synthesis
Equally effective agains dividing vs non dividing

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37
Q

Widely distributed, Extensive hepatic metabolism, Renal Elimination (Discolors urine)
Inhibits CYP2C9?

A

Metronidazole

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38
Q

Widely distributed, Extensive CYP3A4 metabolism with renal Elimination (discoloring urine)?

A

Tinidazole

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39
Q

AE of Metronidazole and Tinidazole?

A

Avoid pregnancy and breastfeeding
Candidiasis
DISULFIRAM like effect
2nd malignancies

40
Q

AE of Clindamycin?

A

Intravaginal use only in 1st trimester
Can cause: low birth weight, premies, neonatal infection,
Excreted in breast milk
GI: diarrhea

41
Q

Conazoles MOA?

A

Block ergosterol synthesis through 14-alpha demethylase (CYP that converts Lanosterol-> ergosterol)

42
Q

Azole that is widely distributed and has RENAl elimination, inhibits CYP2C9?

A

Fluconazole

43
Q

AE of Azoles?

A

Teratogen: high doses= abdominal wall defects, cleft palate
Avoid in 1st trimester
Weaken Latex condoms or diaphragms

44
Q

What are Gardasil and Cervarix made from?

A

Recombinant L1 proteins= HPV capsid antigen

45
Q

What is the HPV quadrivalent vaccine?

A

Gardasil (6, 11, 16, 18)

46
Q

What is the Bivalent HPV vaccine?

A

Cervarix (16, 18)

47
Q

MOA of Podofilox?

A

plant derived mitotic spindle inhibitor blocking microtubular activity in Keratinocytes

48
Q

MOA of imiquimod?

A

Modifies immune response

Activates immune cells through Toll-like Receptor 7 = increases cytokines and immune cells

49
Q

MOA of SInecatechins?

A

Green tea extract antioxidant

pain and discomfort at application site

50
Q

What are the aromatase inhibitors?

A

Anastrozole
Exemestane
Letrozole

51
Q

What are the SERDs & SERMs?

A

Rolaxifene
Tamoxifene
Toremifene
Fulvestrant

52
Q

What is Goserelin?

A

GnRH agonist

53
Q

What are the HER-2/neu Antibodies?

A

Pertuzumab
Trastuzumab
Ado-Trastuzumab
Emtasine

54
Q

What is the TKI indicated for Tx of breast cancer?

A

Lapatinib

55
Q

What is the mTOR inhibitor indicated for Breast/endometrial cancer?

A

Everolimus

56
Q

What are the clinical features that warrant genetic testing for BRCA 1/2 mutations?

A

Early-onset breast cancer (<50)
Ovarian, fallopian tube, primary peritoneal cancer
Individuals with two or more primary breast cancers or breast and ovarian cancer
Male breast cancer
Two or more individuals in family with breast/ovarian cancer
Ashkenazi Jewish ancestry

57
Q

What Tx are recommended for premenopausal women with breast Cancer?

A

GnRH agonists/antagonists

Surgical excision

58
Q

Tx for postmenopausal women with breast cancer?

A

SERM
SERD
Aromatase inhibitors

59
Q

What is the reason that estrogen sensitivity in Tumors decreases?

A

Estrogen receptors can activate nuclear gene expression or act with Growth factor receptors
*tumors tend to direct ER towards anther route of actions

60
Q

MOA: selective estrogen receptor downregulator?

A

Fulvestrant

61
Q

ER+ metastatic BC in postmenopausal women with progression. Pure antagonist, no Estrogenic actions?

A

Fulvestrant

62
Q

What is the precise MOA of Fulvestant?

A

Impairs DImerization
increased turnover
Disrupted nuclear localization
degradation–> decreases ER levels

63
Q

What are the AE for Fulvestrant?

A 
PM symptoms
Nausea
Asthenia
Pain
Vasodilation (hot flashes)
Headache
64
Q

ER agonist/antagonist depending on location of ER subtypes. + on bone and - on mammary glands?

A

Tamoxifene

Rolaxifene

65
Q

Causes decreased bone metabolism
Decreased serum LDL, cholesterol, increases Apolipoprotein-A1
Retinal Degeneration
Teratogen

A

Tamoxifene

Rolaxifene

66
Q

What drug has BBW for endometrial hypertrophy, vaginal bleeding, endometrial cancer?

A

Tamoxifene

67
Q

What drugs have BBW for Thromboembolic disease, (DVT or PE). stroke?

A

Tamoxifene

Rolaxifene

68
Q

This drug is CYP3A4 metabolized
Teratogenic
Prolongs QT
Avoid w/ Hx of Endometrial hyperplasia + Thromboembolic disease?

A

Toremifene

69
Q

AE of Torimemfene that is different from Tamoxifene?

A

Prolongs QT

70
Q

Which drug is CYP2D6 metabolized?

A

Tamoxifene= into 4(OH) tamoxifene + Enoxifene both more active that parent drug

71
Q

What is CYP19A1?

A

Aromatase

72
Q

What is the steroidal Aromatase inhibitor?

A

Exemestane

73
Q

What is the difference btwn steroidal and Nonsteroidal Aromatase inhibitors?

A 
Non-steroidal= Reversible 
Steroidal = Non-reversible
74
Q

AE of Aromatase inhibitors?

A 
Arthralgia
Cataracts
Diarrhea
Hot flashes
Nausea
Hair thinning
75
Q

ASCO recommends that all PM women with hormone receptor + early breast cancer receive adjuvant therapy with what?

A

Aromatase inhibitors with Tamoxifene

76
Q

MOA of Pertuzumab?

A

Binds EC domain and PREVENTS lignad dependent Dimerization

77
Q

MOA of Trastuzumab?

A

Bonds the Juxtaglomerular Region of EC domain of HER-2

78
Q

What is the Extra MOA for Ado-Trastuzumab?

A

Interferes with Microtubules

79
Q

AE of Pertuzumab?

A

Decreased LVEF
Neutropenia
Leukopenia
Teratogenic

80
Q

AE of Trastuzumab?

A

Cardiomyopathy/ HF
Renal Failure
Hepatotoxic
Pneumonia and respiratory failure

81
Q

What are the BBW for Pertuzumab?

A

Pregnancy

82
Q

BBW for Trastuzumab?

A 
Cardiomyopathy
Infusion Rxn
Pregnancy 
respiratory distress syndrome
Respiratory insufficiency
83
Q

BBW for Ado-Trastuzumab?

A

Heart failure
Hepatic disease
Pregnancy
Ventricular Dysfunction

84
Q

What is the Metabolism of Lipatinib?

A

Extensive CYP3A 4&5

*Liver disease= increased Drug concentrations

85
Q

Drug causes Elevated LFTs so routine Liver monitoring is required?

A

Lapatinib

86
Q

AE of Lapatinib?

A 
GI toxic
Aneaia
Thrombocytopenia
Hand- Foot syndrome 
Rash pain
Headache/backache
INterstial lung disease/ pneumonitis
QT prolongation
87
Q

Which drugs prolong QT interval?

A

Lapatinib

Toremifene

88
Q

What drug is associated with initial Transient disease flare (bone pain, hypercalcemia, Breast enlargement or tenderness)?

A

Goserelin

89
Q

AE of Goserelin?

A 
Hypo-estrognic actions:
Amenorrhea
Hot flashes
decreased libido
Vaginal dryness
Emotional liability 
Depression
Gynecomastia 
Osteopenia/osteoporosis
90
Q

What is the function of mTOR?

A

Central regulator of cell proliferation
Angiogenesis
Cell Metabolism

91
Q

MOA of Everolimus?

A

mTOR inhibitor

92
Q

AE of Everolimus?

A 
Opportunistic infections 
Neoplasia
Lymphoma 
SCC
non-infectious Pneumonitis (can be fatal)
HYPER everything
93
Q

Drugs used in Endometrial cancer?

A

Medroxyprogesterone

Megestrol

94
Q

MOA for Medroxyprogesterone?

A

Progestin contraceptive

bonds progestin receptor and blocks GnRH release

95
Q

AE of Medroxyprogesterone?

A

Amenorrhea
Edema
Anorexia
Weakness

96
Q

MOA of Megestrol?

A

Synthetic oral Progestin – Suppresses pituitary LH release and enhances estrogen degradation
Promotes diff/maintenance of Endometrial tissue

97
Q

AE of Megestrol?

A 
Wght gain (increased appetite)
Hot flashes
sweating 
lethargy 
Tumor Flare + Hypercalcemia + 
Thromboembolisms

Reproductive (6 decks)

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