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Pharm Exam 1 Flashcards

1
Q

What is CYP/Cytochrome P450?

A

Enzymes in the liver and gut wall that work together to process drugs

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2
Q

affinity

A

degree of attraction between drug and receptor

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3
Q

Antagonists

A

Prevent receptor activation by endogenous regulatory molecules and drugs

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4
Q

When patients are allergic to PCN what drug is used instead?

A

macrolides

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5
Q

Common receptors (9)

A

Cholinergic receptors
-nicotinic and muscarinic
Adrenergic
-Alpha 1&2 and Beta 1&2
Opiod
-Mu, kappa, delta

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6
Q

Cephalosporin interactions with other drugs

A

interferes with vitamin K so adjust blood thinners
use with aspirin and NSAIDs increased effect of platelet inhibition and leads to risk of bleeding
IM injections not recommended

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7
Q

Code of ethics

A

promote health
prevent illness
restore health
alleviate suffering

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8
Q

Mechanisms of actions of penicillins, cephalosporins, vancomycin, and imipenem?

A

inhibators of cell wall synthesis

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9
Q

General treatment for protozoa and helminths (and c diff)

A

metronidazole-flagyl

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10
Q

protein drug targets

A

membrane receptors
intracellular receptors
enzymes
ion channels
carriers or transporters

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11
Q

drugs that are synthetic/semisynthetic

A

most drugs

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12
Q

Impact of food on drug absorption

A

decreased absorption or rate of absorption (milk and tetracycline or fiber and digoxin)
increased absorption (high calorie meal and saquinavir)

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13
Q

extended-spectrum penicillins

A

carbenicillin and ticarcillin (interferes with platelet fx)
pseudomonas a. and klebsiella

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14
Q

examples of drugs that come from animals

A

hormones and heparin

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15
Q

How is cephalosporin eliminated?

A

kidneys

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16
Q

consequences of drug-drug interactions (3)

A

intensification of effects
reduction of effects
creation of a unique response

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17
Q

Properties of an ideal drug (3) plus 7

A

effective
safe
selective
reversible
predictable
easy to give
no interactions
low cost
stable chemically
simple generic name

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18
Q

drug interactions with fluoroquinolones

A

inhibit theophylline and warfarin
bind with antacids, calcium, iron, foods, and decrease bioavalability

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19
Q

What stage does penicillin work best in?

A

inflammatory phase of infection

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20
Q

non opportunistic fungi

A

coccidiodes, histoplasma, blastomyces

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21
Q

How does hepatic transformation affect drugs?

A

inactivation
change to active metabolite
activation of a pro drug to an active substance
activation to a toxic metabolite

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22
Q

what does miconazole treat

A

common OTC
tinea pedis, cutaneous candida, and other ringworms
given IV if allergic to amphotericin B

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23
Q

Agonists

A

molecules that activate receptors
affinity and high intrinsic activity
Dobutamine mimics NE at cardiac receptors
can make processes go faster or slower

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24
Q

What is the mechanism of action for fluoroquinolones

A

inhibition of DNA synthesis

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25
Beta lactamase inhibitors and their combos
clavulanic acid + amoxicillin or ticarcillin sulbactam + ampicillin tazobactam + piperacillin
26
Nystatin
treatment for oral thrush via lozenges
27
mechanism of action of macrolides and aminoglcosides
inhibitors of protein synthesis
28
antagonist
a drug which has affinity but no intrinsic activist. Binds to receptor and does not activate it and blocks other molecules. Beta-blockers and metoprolol
29
What happens in the pharmacodynamic phase?
drug receptor interaction
30
What are the two absorption routes?
Parenteral (outside intestines) or enteral (intestines)
31
CDiff/Pseudomembranous colitis process and treatment
destruction of normal flora allows c. diff to flourish C. Diff causes toxin that erodes cell lining of GI tract treated with metronidazole
32
mechanism of action for sulfonamides and trimethoprim
inhibits folic acid synthesis
33
Are macrolides bacteriocidal or bacteriorstatic
bacteriostatic
34
narrow spectrum w/ penicillinase resistance and what it works on
nafcillin and dicloxicillin staph aureus
35
drug
any chemical substance other than those required for normal sustenance which produces a biological effect
36
What is the main site of drug metabolism?
liver
37
3 basic mechanisms of drug-drug interactions (pharmacodynamic interactions)
at the same receptor: inhibitory at separate sites: potentative (stronger) (diazepam and morphine) or inhibitory (hydrochlorothiazide and spironlactone) combined toxicity should not be used together
38
What are 5 variables relating to drug distribution in the body?
1. blood flow to tissues 2. ability of drug to exit vascular system 3. body fat 4. protein binding 5. blood-brain barrier
39
what is the most common fluoroquinolones
ciprofloxin
40
Drugs that cause steven johnson syndrome
penicillins, sulfas, quinolones, phenytoin, carbamazepine, barbiturates, and lamictal
41
Mechanism of action of amphotericin
binds to ergosterol membrane of the fungus and pokes holes in it
42
VRSA
vancomycin resistant staph aureus
43
examples of drugs that come from microorganisms
some antibiotics
44
What happens in the pharmacokinetic phase?
absorption distribution metabolism excretion
45
pharmacology
study of drug or medicine
46
What is the spectrum and types of bacteria fluoroquinolones are good for?
broad spectrum bactericidal gram neg and some gram pos
47
drugs from genetic engineering
epogen and interferon
48
tolerance
a change in the responsiveness to drugs
49
What are the three steps of kidney excretion of drugs?
glomerular filtration passive re-absorption active secretion/transport
50
Induction at P450
Enhances metabolism of the drugs taken concurrently which prevents effectiveness of drug therapy Metabolized too fast to be effect
51
opportunistic fungi
cryptococcus, aspergillus, and candida
52
VISA
vancomycin insensitive staph aureus
53
erythromycin is the first line treatments for (3)
legionella pneumophila, whooping cough, and diphtheria
54
implication of sulfonamides and trimethoprim
crystalluria- H2o and cranberry juice toxic nephrosis from sulfur crystals anemia SJS allergy
55
toxicology
the study of adverse effects of drugs and other chemicals
56
therapeutic index
ratio between lethal dose (LD50) and effective dose (ED50), wider TI is better
57
relative potency
the amount of a drug that must be given to illicit a response
58
What happens in the pharmaceutical phase?
disintegration and dissolution of drug form drug becomes available for absorption
59
What are the three isoforms of CYP450 dedicated to metabolizing drugs?
CYP 1,2,3 CYP3A4- 50% of drug transformation CYP2D6- 30% CYP 1A2, 2C19, 2C9, and 2E1- 20%
60
What are 4 variables related to drug absorption?
route of administration blood flow to the site solubility of the drug (acid/base) concentration of the drug
61
MRSA
methicillin resistance staph aureus
62
side effects vs. adverse reactions
side effects are predictable; adverse reactions are unpredictable (anaphylaxis)
63
VRE
vancomycin resistant enterococcus faecaelis
64
Besides the kidneys, where can drugs be excreted?
lungs, sweat, saliva, mammary glands, and dialysis.
65
What are the three aminoglycosides and how are they administered
IV only amikacin gentamycin tobramycin
66
biologic half-life
rate of metabolism and excretion determines half life (time it takes to excrete 50% of the drug and for it to decrease by 50% in the body). Does not change with dose of drug.
67
mechanism of actions of the -azole antifungals
block the synthesis of sterol by inhibiting P450
68
Are macrolides broad or narrow spectrum?
broad
69
types of allergic reactions to PCN
immediate 2-30 mins, anaphylaxis accelerated 1-72 hours, weals and hives, rashes days to weeks, rashes
70
agonist
a drug which has affinity and intrinsic affinity A drug or substance that binds to a receptor inside a cell or on its surface and causes the same action as the substance that normally binds to the receptor. B-agonists and albuterol
71
Which bacteria are fluoroquinolones good for?
e.coli, klebsiella, salmonella, campylobacter jejuni, p. aeruginosa, h. flu, and anthrax spores
72
What are the major implications of aminoglycosides
ototoxic and nephrotoxic
73
pharmacotherapeutics
use of drugs to treat disease
74
pharmacokinetics
how the body interacts with the drug
75
5 "rights" plus an additional 5
1. right drug 2. right patient 3. right dose 4. right route 5. right time 6. right assessment 7. right documentation 8. right evaluation 9. right of patient to education 10. right of patient to reduce care
76
pharmacodynamics
how drug interacts with cells, tissues, and organs
77
maximal efficacy
the largest effect that a drug can produce
78
Adverse reactions for fluoroquinolones
insomnia, c diff, achilles tendon rupture in the elderly, steven johnson syndrome, QT prolongation.
79
three phases of drug interaction
1. pharmaceutical 2. pharmacokinetic -drug become available for action- 3. pharmacodynamic -effect of drug is seen-
80
What are the three ways the liver affects drugs in order to remove them from the body?
Increase H2O solubility for urine elimination Inactivates the chemical Coverts the chemical for elimination through the gut
81
broad spectrum penicillin and what it works on
ampicillin and amoxicillin H Flu, E coli, P mirabilis, neisseria, salmonella, shigella
82
signs and symptoms of a suprainfection related to penicillin use
darkened tongue, creamy vaginal discharge, watery diarrhea with cramping
83
How is amphotericin B administered
IV or intrathecally (spinal fluid)
84
What type of bacteria is vancomycin active against?
gram pos
85
efficacy
ability of a drug to initiate biologic activity as a result of binding to a given receptor
86
Shared adverse reactions of antimicrobial agents
antibiotic associated colitis allergic or hypersensitive reaction suprainfection
87
4 primary mechanisms of antibiotic resistance
descrease concentration of the drug at it's site of action alter the drug target molecule antagonist production drug inactivation
88
What are the two ways drugs exert their action?
Activate a series of cellular events creating a biological effect bind to receptors without stimulating them and block other chemicals from binding with the receptor
89
Uses for sulfonamides and trimethoprim
UTI pathogens such as e.coli, klebsiella, p. mirabilis. pneumocystis carinii pneumonia acute exacerbations of chronic bronchitis prostatitis and sinusitis
90
How are vancomycin and imipenem administered
IV only
91
Symptoms of SJS and type of hypersensitivity
type IV hypersensitivity flu like symptoms within two weeks of starting drug rash follows, followed by skin sloughing
92
MDR-TB
multi drug resistant TB
93
implications of amphotericin B
-fever and chills, give tylenol and antihistamine before giving -nephrotoxicity in 80% of patients -alveolar hemorrhage
94
drugs that come from minerals
calcium and iron
95
narrow spectrum penicillins and what they work on
penicillin G, V, or VK streptococcus and neisseria
96
what do penicillins interact with?
oral contraceptives, anti-coagulants, and aminoglycides
97
What is the main site for drug excretion?
kidneys
98
examples of drugs that come from plants
digitalis and atropine
99
Inhibition at P450
One drug blocks the enzymes that metabolize the other drugs leading to increased blood concentrations of unmetabolized drug (toxic)
100
which drug is the choice for all candida species
fluconazole
101
What parts of the body are fluoroquinolones good for and which aren't they?
good for lungs, prostate, and GU, bad for CSF
102
Spectrum and type of bacteria for aminoglycosides
narrow spectrum and gram negative
103
What generation of cephalosporins have CSF penetration?
3rd and 4th

Patho/Pharm (11 decks)

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