pharm

Question 1

What is the MOA of clindamycin?

Answer 1

Inhibits bacterial protein synthesis (primarily bacteriostatic) at the level of bacterial 50s ribosome.

Question 2

what are some uses for clindamycin?

Answer 2

(a) Often used to treat anaerobic infections but is effective for a variety of aerobic and anaerobic gram positive and gram negative bacteria.
(b) Can also be used to treat protozoa, like malaria.
(c) Useful in topically treating acne
(d) May also be useful in treating MRSA infections
(i) It is not the first choice for this as vancomycin is preferred.
(e) Monitor with prolonged therapy:
(i) CBC, liver and kidney function tests
(ii) Symptomatology (especially diarrhea because of high association with CDAD

Question 3

name 3 relevant ADR’s for Clindamycine

Answer 3

(a) Common: dry skin, morbilliform rash, GI upset (diarrhea, nausea); secondary infections (candida and CDAD)
(b) Serious: CDAD, hypersensitivity (TEN, SJS), agranulocytosis

Question 4

name 2 3rd generation cephalosporins

Answer 4

Ceftriaxone (3rd generation, broad spectrum)

( Ceftazidime (3rd generation, broad spectrum

Question 5

what is the MOA of vanco?

Answer 5

inhibits bacterial wall synthesis

Question 6

what is vanco used for?

Answer 6

CDAD, skin or lung infections, MRSA infections, infective endocarditis

Question 7

what is the mOA of TMP-SMX

Answer 7

folic acid antagonist

Question 8

what parameters should you consider when determining to give a PCA (patient controlled analgesia)

Answer 8

consider the patients age, weight, co-morbid conditions, level of pain, opioid tolerance, cognitive ability, and physical limitations

Question 9

what are the 4 opioid receptors?

Answer 9

(a) Mu: PEAR
(i) Physical dependence
(ii) Euphoria
(iii) Analgesia
(iv) Respiratory depression
(b) Kappa: SAM
(i) Sedation
(ii) Analgesia (spinal)
(iii) Miosis
(c) Delta: AREG
(i) Analgesia
(ii) Release of Growth Hormone
(d) Sigma: Do HaRM
(i) Dysphoria (opposite of euphoria)
(ii) Hallucination (both visual and auditory)
(iii) Respiratory and vasomotor stimulation
(iv) Mydriasis

Question 10

is CNS distribution of drugs uniform?

Answer 10

nope

Question 11

name the Receptor locations beginning with highest concentration to lowest
(i) Cerebral cortex

Answer 11

(i) Cerebral cortex
(ii) Amygdala
(iii) Septum
(iv) Thalamus
(v) Hypothalamus
(vi) Midbrain
(vii) Spinal cord

Question 12

what drug is approx 100 x more potent than morphine?

Answer 12

fentanyl ( sublimaze)

Question 13

how often are fentanyl patches replaced?

Answer 13

q 72 hours except in the elderly in which they may exceed the 72 hours

Question 14

what medx is • Same potency as morphine with similar withdrawal symptoms
• Not recommended for chronic pain relief

Answer 14

5. Meperidine (Demerol)