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Unit 6 > Pharm > Flashcards

Pharm Flashcards

1
Q

Treatment for Pseudomonas

A

pipercillin; aminoglycosides; ceftAZadime; Cipro

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2
Q

Treatment for C. Dif

A

metronidazole

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3
Q

Treatment for MRSA

A

Vancomycin; linezolid

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4
Q

Treatment for Strep. Penumo (PNM)

A

cetriaxone –> levofloxin (drug resistant);

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5
Q

Treatment for Staph cellulitis

A

dicoloxicillin (pus, circular)

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6
Q

Treatment for Strep cellulitis

A

penicillins (red lines)

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7
Q

Treatment for Strep throat

A

penicillins

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8
Q

Treatment for Sinusitis

A

amoxiciliin - helps kill entercocci

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9
Q

Treatment for pre-surgical wound care

A

1st gen ceph (cefazolin)

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10
Q

Treatment for gonorrhea

A

ceftriaxone

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11
Q

empirical treatment of meningitis

A

3rd generation ceph

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12
Q

Treatment for VRE/ VRSA

A

daptomycin (gram + only)

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13
Q

Treatment for gram - sepsis (severe infection)

A

gentamycin

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14
Q

Treatment for intracellular bacteria

A

doxycycline

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15
Q

Treatment for chlamydia

A

doxycycline

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16
Q

Treatment for anerobes above diaphragm

A

clindamycin (aspiration pnm)

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17
Q

Treatment for anerobes below diaphragm

A

metroniadazole

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18
Q

Treatment for PCP, toxo

A

bactrin

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19
Q

Treatment for complicated UTI

A

ceftriaxone; cipro (E. Coli)

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20
Q

Treatment for listeria

A

ampicillin

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21
Q

Treatment for uncomplicated UTI

A

bactrin

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22
Q

SE aminoglycosides

A

ATN

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23
Q

SE Tetracyclin

A

photosensitivity; teeth discoloration`

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24
Q

Take imipenum with

A

cilastin

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25
Q

SE imipenem

A

seizures (meropenem less)

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26
Q

GBS prophylatic

A

amoxicillin

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27
Q

PBP2b resistant to

A

PCN and 1st and 2nd generation

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28
Q

PBP2b found in ____ bacteria

A

s. penumo (used 3rd generation)

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29
Q

SE Vancomycin

A

Red man syndrome (pre-treat anti-histamines)

Nephrotoxicity, Ototoxcicity (dose-dep), Thrombophlebitis

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30
Q

PBP2x resistance to and found in ____ bacteria

A

all b-lactams; MRSA

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31
Q

Requires o2 for uptake

A

aminoglycosides

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32
Q

SE macrolids

A

Torsades

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33
Q

SE sulfonamides

A

hemolytic anemia with G6PD deficient; kernicterus in infants

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34
Q

SE Trimethroprim

A

hyperkalemia; granulocytopenia

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35
Q

SE Metronidazole

A

Disulfiram like reaction

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36
Q

cephalosporins don’t cover

A

LAME - listeria, Atypiclas, MRSA, enterococci

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37
Q

Treatment for Enterococci

A

Amoxicillin

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38
Q

Causes rash when given to someone with EBV

A

ampicillin

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39
Q

Azotram cover

A

gram neg rods only (pseudomonas)

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40
Q

Treatment for Atypical pneumonia

A

Macrolids (Mycoplasm; chlamydia, legionella) –azirthromycin

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41
Q

good penetration into bone

A

clindamycin (s. aureus osteomylitis)

42
Q

Treatment for pseudomonas in CF patients

A

Colistin

43
Q

Treatment for Strep infections in patients allergic to penicillin

A

macrolids (azirthromycin)

44
Q

SE Torsades (x2)

A

floroquinolones (twisting topo) and macrolids

45
Q

SE: neuromuscular blockade

A

Gentamycin

46
Q

Chloramphenicol severe side effect that restricts its use

A

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
Q

Nifurtimox effective against

A

Trypanosomaisis

48
Q

Treatment for Amebiasis and Leishmanaisas DOC

A

Metronidazole

49
Q

Cannot be taken with milk

A

tetracycline – ca2+ chelates it

50
Q

Ototoxic drugs

A

Gentamicin, tobramycin, vancomyacin (dose dependent toxicity, not idiosyncratic or allergic reaction)

51
Q

Which has better oral bioavaliability? Ampicillin or amoxicillin?

A

Amoxicillin

52
Q

Treatment for Fungal meningitis

A

fluconazole

53
Q

H2 blocker that inhibits p450

A

cimetidine

54
Q

causes rebound hyperacidity

A

cimeditine (also p450 inhibitor) and antiacids

55
Q

which causes constipation and which cases diarrhea? Aluminum and Magnesium compounds

A

Aluminum = constipation
Magnesium = laxative
Calcium carbonate also causes constipation as a side effect of its action as an antiacid

56
Q

What do you have to avoid taking PPI’s with and therefore take them in the morning before meals?

A

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
Q

Of the PPI’s which has the least drug interactions and no p450 blockade?

A

Pantoprazole

58
Q

Use specifically to treat NSAID induced ulcers

A

Misoprostol (PGE analog)

59
Q

Promotility drug used to treat GERD?

A

Metoclopramide - peripheral DA antagonist increases forward flow into duodenum via enhanced fundus/antral contractions
CI in bowel obstruction

60
Q

Meclizine

A

1st gen antihistamine H1 blocker and muscarninc receptor blocker used for motion sickness, nausea etc in PREGNANT women (diphendyramine H1 also used)

61
Q

S.E. of this promotility drug = pseudo-parkinsonism like movements (dystonia, resting tremor, rigidity, bradykinesia)

A

Metoclopramide (DA antagonsim)

62
Q

May cause black stool, used to treat PUD

A

Bismuth salts (pepto)

63
Q

Drug used for exacerbations in UC

A

Sulfasalazine (anti-inflam; 5-ASA)

64
Q

Which has more side effects Sulfasalazine or Olsalazine and why?

A

Sulfasalazine b/c one of the is metabolites Sulfapyridine which produces all the SE –> olsalazine doesn’t have this metabolite`

65
Q

Infliximab is a monoclonal antibody against? used for?

A

TNF-alpha; UC and Chrone’s chronically (IV monthly)

66
Q

MOA of ondansetron?

A

decrease vagal stimulation; serotonin antagonists

67
Q

Colloids and pectins used to treat diarrhea

A

Metamucil and Kaopectate

68
Q 
As you age, higher or lower VD:
Hyrdrophilic drugs?
Drugs that bind to muscle?
Hydrophobic drugs? (ex?)
Drugs that bind to protein? (ex's?)
A

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
Q

Drugs metabolized by phase 1 or phase 2 metabolism preferred in older patients?

A

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
Q

Does serum creatinine reflect GFR/ creatinine clearance in older patients?

A

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
Q

Drug-drug interactions in older adults:

  1. benzo + ? = sedation and falls
  2. CCB + diuretic = ?
  3. Digitalis + ? = bradycardia or arrhythmia
  4. ACE I + diuretic = ?
A
  1. antidepressents or antipyschotics
  2. hyoptension and orthostasis
  3. anti-arrhythmic
  4. hyoptension and hypokalemia
72
Q

which effect goes away faster: inhibitors of p450 or inducers? why?

A

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
Q

MOA of inducers of p450

A

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
Q

p450 is involved in what type of drug metabolism in the liver?

A

phase 1, oxidizes drugs. makes hydrophobic drugs more hydrophilic for excretion in urine. Also can activate drugs if it is a prodrug.

75
Q

Def: Pharmacodynamics

A

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
Q

Def: Pharmokinetics

A

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
Q

Drug used as colonoscopy prep?

A

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
Q

Bisacodyl is a

A

stimulant cathartic.

79
Q

Can you use a suicide inhibitor for strep pneumo?

A

NO! b/c its resistance is based on a PBP change (2b) and therefore an inhibitor of beta lactamse will not help

80
Q

Caspofungin used for

A

invasive asspergillios or candida. Echinocandins

81
Q

Anti-fungals that inhibit p450 (x4)

A

fluconazole, Ketoconazole, itraconazole, terbinafine

82
Q

Which anti-fungals are polyenes and what is there use?

A

Amphotericin B & Nystatin. Used for serious systemic mycoses. Nystatin = swish and swollow candida infections.

83
Q

Treatment for cryptococcal meningitis

A

Amph B w/ flucytosine

84
Q

Which anti-fungals are allylamines? What do they treat?

A

Terbinafine - treat topical dermatophytes esp nail infections

85
Q

Which anti-fungal is a cell wall synthesis inhibitor?

A

Echinocandins - caspofungin –> inhibits synthesis of B-glucan

86
Q

What two antifungals are best for onychomycosis?

A

Caspofungin and Griseofulvin (deposits in keratin containing tissues)

87
Q

Which HAART medication can cause radiolucent finidngs in the kidney?

A

Indinavir - can form percipitates if patient doesn’t stay hydrated.

88
Q

Which NRTI can cause pancreatitis?

A

Didanosine

89
Q

Which NNRTI’s are contraindicated in pregnancy?

A

Delavirdine and efavirenz

90
Q

Which HIV drug causes lipodystrophy syndrome?

A

Protease inhibitors. Look slike cushing syndrome

91
Q

Metoclopramide is rx in what situation?

A

Gastroparesis, post surgery or in a diabetic. Or as an antiemetic

92
Q

What is metoclopramide’s major side effects?

A

Parkinson like effects.

93
Q

MOA of metoclopramide?

A

D2 receptor antagnoist. Increases resting tone, contractility and LES tone.

94
Q

Use of Prochlorperazine and major side effect?

A

anti-emetic works on the chemo receptor trigger zone. torticollis.

95
Q

Use of atropine sulfate?

A

relax small bowel smooth muscle, and decrease GI motility. Helps in diarrhea. (anti-cholinergic)

96
Q

3 opioid agnosits used to treat diarrhea?

A

Loperamide (immodium), diphenoxylate, codeine

97
Q

psyllium seed (metamucil)
methycellulose
sodium carboxymethylcellulose
USED FOR?

A

bulk forming (pull in water) for constipation

98
Q 
castor oil
cascara sagrada
senna extract
disacodyl
phenolphthalein (ex lax)
USED FOR?
A

irritant/ stimulant for constipation

99
Q 
magnesium cirtate solution
magnesium sulfate
milk of magnesia
sodium phosphate (colonscopy)
lactulose (liver failure pts)
USED FOR?
A

osmotic cathartics for constipation

100
Q

mineral oil
dioctyl sodium sulfo-succinate
USED FOR?

A

stool softeners or lubricants

Unit 6 (4 decks)

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