Pharma Halo-halo 4

Question 1

MOA of loperamide

Answer 1

Agonist on peripheraly µ-opioid receptors

Question 2

Selective antagonist of the µ-opioid receptors

Answer 2

Methylnaltrexone bromide
-treatment of opioid-induced constipation
Alvimopan 🔥
-short term (≤7 days) use to shorten the period of post-op ileus in px who have undergone small/large bowel resection
-a/e: CV toxicity

Question 3

Addicting brother of loperamide

Answer 3

Diphenoxylate

Question 4

Contraindications of loperamide

Answer 4

Patients < 12 years old 📌 (katzung)
*patients < 2 y/o (statpearls)
Acute ulcerative colitis
(Reports of toxic megacolon)
Bloody diarrhea
Diarrhea associated with bacterial infection

Question 5

MOA of fluoroquinolones

Answer 5

Inhibits bacterial topoisomerase II (DNA gyrase and topoisomerase IV

DNA gyrase: relaxes positively supercoiled DNA
Topoisomerase IV: separates replicated chromosomal DNA into respective daughter cells

Question 6

Most active fluoroquinolne vs gram negative

Answer 6

Ciprofloxacin (especially Pseudomonas)

“C-domonas”

Question 7

Fluoroquinolones that lacks appreciable activity vs pseudomonas

Answer 7

Moxifloxacin

Question 8

DOC for prevention of anthrax

Answer 8

Ciprofloxacin

Question 9

DOC for tx of anthrax

Answer 9

Ciprolofxacin

Question 10

Fluoroquinolone that’s metabolized in the liver

Answer 10

Moxifloxacin

Question 11

Respiratory fluoroquinolones

Answer 11

Levofloxacin
Gemifloxacin
Moxifloxacin
Enhanced gram-positive activity and activity vs atypical pneuonia (chlamydiase, mycoplasma , legionella)

Question 12

A/e of fluoroquinonles

Answer 12

“Cartilages and Tendons”

Damages cartilage and cause arthropathy (in animal models) hence NOT used for <18y/o*
Tendinitis and tendon rupture in adults (rf: advanced age, renal insuf, concurrent steroid use)

*there’s growing consensus that fluoro may be used in children if needed
(Eg, for tx of pseudomonas infections in px w CF)

Question 13

A/e for tetracyclines

Answer 13

“BaTang FRaiL”

Bone deformity and growth inhibition
(not given to children < 8y/o)
Teeth fluorescence, discoloration, and enamel dysplasia

Fanconi syndrome
RTA
Liver impairment/necrosis

Question 14

MOA of praziquantel

Answer 14

Increases membrane permeability to calcium —> PARALYSIS

Question 15

MOA of pyrantel pamoate

Answer 15

Stimulates nicotinic receptors at NMJ of nematodes

Cuases depolarization-induced paralysis

Question 16

MOA of buspirone

Answer 16

5-HT1A agonist (partial)
-nonbenzodiazepine anxiolytic

D2 agonist

Question 17

remarks on moxifloxacin

Answer 17

1. 3rd gen
2. metabolized in the LIVER
3. NO activity vs pseudomonas

Question 18

First gen fluoroquinolones

Answer 18

nalidixic acid

cinoxacin

Question 19

2nd gen fluoroquinolones

Answer 19

“CLONE”

Ciprofloxacin
Lomefloxacin
Ofloxacin
Norfloxacin
Enoxacin

(AAFP)

Question 20

3rd gen fluoroquinolone

Answer 20

Gatifloxacin (ophthalmic only in US)
Gemifloxacin
Moxifloxacin
Levofloxacin
Sparfloxacin
(AAFP)

Question 21

4th gen fluorouuinolones

Answer 21

trovafloxacin

clinafloxacine

Question 22

5-HT1A partial agonist

Answer 22

buspirone