Pharm Flashcards
1
Q
Treatment for Pseudomonas
A
pipercillin; aminoglycosides; ceftAZadime; Cipro
2
Q
Treatment for C. Dif
A
metronidazole
3
Q
Treatment for MRSA
A
Vancomycin; linezolid
4
Q
Treatment for Strep. Penumo (PNM)
A
cetriaxone –> levofloxin (drug resistant);
5
Q
Treatment for Staph cellulitis
A
dicoloxicillin (pus, circular)
6
Q
Treatment for Strep cellulitis
A
penicillins (red lines)
7
Q
Treatment for Strep throat
A
penicillins
8
Q
Treatment for Sinusitis
A
amoxiciliin - helps kill entercocci
9
Q
Treatment for pre-surgical wound care
A
1st gen ceph (cefazolin)
10
Q
Treatment for gonorrhea
A
ceftriaxone
11
Q
empirical treatment of meningitis
A
3rd generation ceph
12
Q
Treatment for VRE/ VRSA
A
daptomycin (gram + only)
13
Q
Treatment for gram - sepsis (severe infection)
A
gentamycin
14
Q
Treatment for intracellular bacteria
A
doxycycline
15
Q
Treatment for chlamydia
A
doxycycline
16
Q
Treatment for anerobes above diaphragm
A
clindamycin (aspiration pnm)
17
Q
Treatment for anerobes below diaphragm
A
metroniadazole
18
Q
Treatment for PCP, toxo
A
bactrin
19
Q
Treatment for complicated UTI
A
ceftriaxone; cipro (E. Coli)
20
Q
Treatment for listeria
A
ampicillin
21
Q
Treatment for uncomplicated UTI
A
bactrin
22
Q
SE aminoglycosides
A
ATN
23
Q
SE Tetracyclin
A
photosensitivity; teeth discoloration`
24
Q
Take imipenum with
A
cilastin
25
SE imipenem
seizures (meropenem less)
26
GBS prophylatic
amoxicillin
27
PBP2b resistant to
PCN and 1st and 2nd generation
28
PBP2b found in ____ bacteria
s. penumo (used 3rd generation)
29
SE Vancomycin
Red man syndrome (pre-treat anti-histamines)
| Nephrotoxicity, Ototoxcicity (dose-dep), Thrombophlebitis
30
PBP2x resistance to and found in ____ bacteria
all b-lactams; MRSA
31
Requires o2 for uptake
aminoglycosides
32
SE macrolids
Torsades
33
SE sulfonamides
hemolytic anemia with G6PD deficient; kernicterus in infants
34
SE Trimethroprim
hyperkalemia; granulocytopenia
35
SE Metronidazole
Disulfiram like reaction
36
cephalosporins don't cover
LAME - listeria, Atypiclas, MRSA, enterococci
37
Treatment for Enterococci
Amoxicillin
38
Causes rash when given to someone with EBV
ampicillin
39
Azotram cover
gram neg rods only (pseudomonas)
40
Treatment for Atypical pneumonia
Macrolids (Mycoplasm; chlamydia, legionella) --azirthromycin
41
good penetration into bone
clindamycin (s. aureus osteomylitis)
42
Treatment for pseudomonas in CF patients
Colistin
43
Treatment for Strep infections in patients allergic to penicillin
macrolids (azirthromycin)
44
SE Torsades (x2)
floroquinolones (twisting topo) and macrolids
45
SE: neuromuscular blockade
Gentamycin
46
Chloramphenicol severe side effect that restricts its use
aplastic anemia (rare); bone marrow suprression (common); GRAY BABY syndrome due to the baby's inability to conjugate the drug for elimination leading to high serum concentrations
47
Nifurtimox effective against
Trypanosomaisis
48
Treatment for Amebiasis and Leishmanaisas DOC
Metronidazole
49
Cannot be taken with milk
tetracycline -- ca2+ chelates it
50
Ototoxic drugs
Gentamicin, tobramycin, vancomyacin (dose dependent toxicity, not idiosyncratic or allergic reaction)
51
Which has better oral bioavaliability? Ampicillin or amoxicillin?
Amoxicillin
52
Treatment for Fungal meningitis
fluconazole
53
H2 blocker that inhibits p450
cimetidine
54
causes rebound hyperacidity
cimeditine (also p450 inhibitor) and antiacids
55
which causes constipation and which cases diarrhea? Aluminum and Magnesium compounds
Aluminum = constipation
Magnesium = laxative
Calcium carbonate also causes constipation as a side effect of its action as an antiacid
56
What do you have to avoid taking PPI's with and therefore take them in the morning before meals?
Omeprazole etc. because it is activated by acid (so don't want to inhibit acids...)
Will heal H2 blocker refractory ulcers (more effective than antihistamines)
57
Of the PPI's which has the least drug interactions and no p450 blockade?
Pantoprazole
58
Use specifically to treat NSAID induced ulcers
Misoprostol (PGE analog)
59
Promotility drug used to treat GERD?
Metoclopramide - peripheral DA antagonist increases forward flow into duodenum via enhanced fundus/antral contractions
CI in bowel obstruction
60
Meclizine
1st gen antihistamine H1 blocker and muscarninc receptor blocker used for motion sickness, nausea etc in PREGNANT women (diphendyramine H1 also used)
61
S.E. of this promotility drug = pseudo-parkinsonism like movements (dystonia, resting tremor, rigidity, bradykinesia)
Metoclopramide (DA antagonsim)
62
May cause black stool, used to treat PUD
Bismuth salts (pepto)
63
Drug used for exacerbations in UC
Sulfasalazine (anti-inflam; 5-ASA)
64
Which has more side effects Sulfasalazine or Olsalazine and why?
Sulfasalazine b/c one of the is metabolites Sulfapyridine which produces all the SE --> olsalazine doesn't have this metabolite`
65
Infliximab is a monoclonal antibody against? used for?
TNF-alpha; UC and Chrone's chronically (IV monthly)
66
MOA of ondansetron?
decrease vagal stimulation; serotonin antagonists
67
Colloids and pectins used to treat diarrhea
Metamucil and Kaopectate
68
```
As you age, higher or lower VD:
Hyrdrophilic drugs?
Drugs that bind to muscle?
Hydrophobic drugs? (ex?)
Drugs that bind to protein? (ex's?)
```
lower VD b/c lower body water
Lower VD b/c lower lean body mass
Higher VD b/c increased fat stores (ex. diazepam)
Higher percentage of drug unbound (active) b/c decreased plasma protein (albumin) --> warfarin, barbiturates, phenytoin, carbemexapine
69
Drugs metabolized by phase 1 or phase 2 metabolism preferred in older patients?
In general phase 2 pathway. This pathway convert drugs to inactive metabolites that do not accumulate. Phase 1 sometimes converts to more active drug or less active compound, however still active so effects are harder to predict. (therefore don't like benzo b/c metabolite from phase 1 reaction last a long time)
70
Does serum creatinine reflect GFR/ creatinine clearance in older patients?
no, b/c older patients have lower lean muscle mass and therefore lower creatinine production --> but w/ decreased GFR it may appear to be a normal amount in serum.
71
Drug-drug interactions in older adults:
1. benzo + ? = sedation and falls
2. CCB + diuretic = ?
3. Digitalis + ? = bradycardia or arrhythmia
4. ACE I + diuretic = ?
1. antidepressents or antipyschotics
2. hyoptension and orthostasis
3. anti-arrhythmic
4. hyoptension and hypokalemia
72
which effect goes away faster: inhibitors of p450 or inducers? why?
inhibitors - they are simply sitting on the site of action of p450 and therefore once the drug goes through its half life (or four half lifes for the whole drug concentration to clear) the effect will dissappear.
73
MOA of inducers of p450
inducers turn on transcription factors that upregulate p450. Therefore there is a lag time before the effect occurs. In addition, that also means it takes longer for the effect to go away --> for the transcription factors to down regulate.
INCREASE THE ACTUAL AMOUNT OF THE p450 ENZYME
74
p450 is involved in what type of drug metabolism in the liver?
phase 1, oxidizes drugs. makes hydrophobic drugs more hydrophilic for excretion in urine. Also can activate drugs if it is a prodrug.
75
Def: Pharmacodynamics
biochem and physiolgical effects of drugs on the body. Relationship between drug concentration and effect. Ex. drug-drug interactions through RECEPTORS of action directly.
76
Def: Pharmokinetics
what the body does to the drug. Absorption, distribution, chemical changes (metabolism) and excretion of the drug. This is the place were p450 enzyme comes in.
77
Drug used as colonoscopy prep?
Magnesium citrate is the drug most often used. Osmotic cathartic agents are the drugs used to clean the G.I. tract before colonoscopy exams.
78
Bisacodyl is a
stimulant cathartic.
79
Can you use a suicide inhibitor for strep pneumo?
NO! b/c its resistance is based on a PBP change (2b) and therefore an inhibitor of beta lactamse will not help
80
Caspofungin used for
invasive asspergillios or candida. Echinocandins
81
Anti-fungals that inhibit p450 (x4)
fluconazole, Ketoconazole, itraconazole, terbinafine
82
Which anti-fungals are polyenes and what is there use?
Amphotericin B & Nystatin. Used for serious systemic mycoses. Nystatin = swish and swollow candida infections.
83
Treatment for cryptococcal meningitis
Amph B w/ flucytosine
84
Which anti-fungals are allylamines? What do they treat?
Terbinafine - treat topical dermatophytes esp nail infections
85
Which anti-fungal is a cell wall synthesis inhibitor?
Echinocandins - caspofungin --> inhibits synthesis of B-glucan
86
What two antifungals are best for onychomycosis?
Caspofungin and Griseofulvin (deposits in keratin containing tissues)
87
Which HAART medication can cause radiolucent finidngs in the kidney?
Indinavir - can form percipitates if patient doesn't stay hydrated.
88
Which NRTI can cause pancreatitis?
Didanosine
89
Which NNRTI's are contraindicated in pregnancy?
Delavirdine and efavirenz
90
Which HIV drug causes lipodystrophy syndrome?
Protease inhibitors. Look slike cushing syndrome
91
Metoclopramide is rx in what situation?
Gastroparesis, post surgery or in a diabetic. Or as an antiemetic
92
What is metoclopramide's major side effects?
Parkinson like effects.
93
MOA of metoclopramide?
D2 receptor antagnoist. Increases resting tone, contractility and LES tone.
94
Use of Prochlorperazine and major side effect?
anti-emetic works on the chemo receptor trigger zone. torticollis.
95
Use of atropine sulfate?
relax small bowel smooth muscle, and decrease GI motility. Helps in diarrhea. (anti-cholinergic)
96
3 opioid agnosits used to treat diarrhea?
Loperamide (immodium), diphenoxylate, codeine
97
psyllium seed (metamucil)
methycellulose
sodium carboxymethylcellulose
USED FOR?
bulk forming (pull in water) for constipation
98
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castor oil
cascara sagrada
senna extract
disacodyl
phenolphthalein (ex lax)
USED FOR?
```
irritant/ stimulant for constipation
99
```
magnesium cirtate solution
magnesium sulfate
milk of magnesia
sodium phosphate (colonscopy)
lactulose (liver failure pts)
USED FOR?
```
osmotic cathartics for constipation
100
mineral oil
dioctyl sodium sulfo-succinate
USED FOR?
stool softeners or lubricants
