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KMK > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

MOA for Bacitracin

A

inhibits transfer of transpeptidase into growing bacterial cell wall

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2
Q

Drugs that inhibit protein synthesis by binding to 30S subunits

A

Aminoglycosides

Tetracyclines

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3
Q

Drugs that inhibit bacterial protein synthesis by binding to the 50S subunit

A

Chloramphenicol, macrolides, clindamycin

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4
Q

Drugs that inhibit folic acid synthesis

A

Sulfonamides

Trimethoprim and pyrimethamine

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5
Q

MOA for fluoroquinolones

A

inhibits DNA gyrase and topoisomerase IV

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6
Q

Side effects of oral antibiotics

A

GI effects (nausea, vomiting, bloating, decreased appetite, diarrhea)

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7
Q

MOA of penicillins and cephalsporins

A

inhibit cell wall synthesis by inhibiting transpeptidase

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8
Q

Bacitracin only effective against which bacteria & how would you prescribe it?

A

gram + , QD - TID for blepharitis

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9
Q

amoxicillin

A
  • MOA inhibits transpeptidase
  • better gram (-) coverage
  • NOT resistant to penicillinase
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10
Q

What does dicloxacillin and augmentin treat?

A

hordeola, preseptal cellulitis

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11
Q

Which drugs are penicillinase resistant?

A
  • oxacillin
  • dicloxacillin
  • cloxacillin
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12
Q

How is Augmentin prescribed?

A

500 mg , 875 mg, 1,000 mg tabs BID x 1 week

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13
Q

Dicloxacillin

A
  • best for methicillin-sensitive staph aureus (MSSA)

- NOT effective for staphylococcal strain (MRSA)

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14
Q

Adverse effects for penicillin

A
  • urticaria & anaphylaxis (IgE mediated type 1 reaction) to contact dermatitis (type 4)
  • render oral contraceptives ineffective
  • Stevens-Johnson syndrome in pts taking amoxicillin
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15
Q

Why are patients usually allergic to both cephalosporins & penicillins?

A

They both have beta-lactam ring
Cephalosporin - 6 ring
Penicillin - 5 ring

1% risk that the pt is allergic to BOTH

Contraindicated in pt with hx of IgE type 1 hypersensitivity rxn (urticaria & anaphylaxis)

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16
Q

Cephalosporins MOA

A

Inhibit transpeptidase

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17
Q

what is cephalexin used to tx for?

A

skin infections caused by gram + bacteria - dacryadenitis, dacryocystitis, and preseptal cellulitis - SHOULD NOT BE USED IN ISOLATION W/ MRSA

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18
Q

Dosage for cephalexin

A

250-500mg BID to QID for the tx of dacryocystitis, dacryadenitis, & preseptal cellulitis

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19
Q

What is ceftriaxone used to tx?

A

tx gonorrhea conjunctivitis & orbital cellulitis

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20
Q

Ceftriaxone dosage for gonococcal conjunctivitis corneal involving and noninvolving

A

Involving - IV every 12-24 hours for 3 days

Non-involving - single 1 gram IM injection

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21
Q

Ceftriaxone dosage for orbital cellulitis

A

1 gram IV qday x 1 week

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22
Q

Adverse effects for cephalosporins

A

destroy normal micrflora - alters absorption of vitamin K causing “thinning” of blood in pts taking warfarin (Vit K antagonist)

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23
Q

Gram coverage for cephalpsporins

A

1st gen: gram (+)
2nd gen: gram: some(-) & (+)
3rd gen: gram (-) & (+)

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24
Q

Gram coverage for aminoglycosides

A

gram + and -, better gram - coverage

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25
Q

List Aminoglycosides & MOA

A

TobraGent30

Gentamycin
Tobramycin

Inhibit binding of 30s ribosomal subunit

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26
Q

What is tobradex used to tx?

A

inflammation w/ bacterial infection (staph marginal keratitis, corneal infiltrates)

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27
Q

List Tetracyclines

A

Tetracycline
Doxycyline
Minocycline

28
Q

Contraindications for tetracylcines

A

pt with renal failure, children & pregnant pt

29
Q

MOA of tetracyclines

A

Binds to 30S subunit

30
Q

What does mincocyline tx? dosage?

A

low doses & long term tx of acne vulgaris

31
Q

What is doxycycline used to tx?

A
  • meibomianitis
  • Acne rosacea
  • Chlamydial conjunctivitis
  • RCE
32
Q

How long does epithelial basement membrane and hemidesmosomes formation take to heal?

A

approx 2 months

33
Q

SE for tetracyclines

A

Pseudotumor cerebri, bone growth retardation, discoloration of teeth

34
Q

SE for tetracyclines

A

Pseudotumor cerebri, bone growth retardation, discoloration of teeth

35
Q

Minocycline SE

A

blue sclera & pigmented cyst on the conjunctiva

36
Q

Which drugs block protein synthesis at the 50S ribosomal subunit?`

A

Chloramphenicol, macrolides (erythromycin, azithromycin) , lincomycin, & clindamycin

37
Q

MOA for chloramphenicol

A

inhibits bacterial protein synthesis by binding to 50S ribosomal subunit

  • effective against gram (+) and gram (-) bacteria
  • ointment or topical ophthalmic solution
38
Q

Adverse effects for chloramphenicol?

A

Topical ophthalmic use has caused fatal aplastic anemia

Extended therapy may result in optic neuritis

39
Q

Macrolides MOA

A

(erythromycin/azithromycin)

  • inhibits bacterial protein synthesis by binding to 50S ribosomal subunit
40
Q

Macrolides are usually prescribed for what?

A

Chlamydial infections (trachoma, AIC) b.c of its convenient 1 gram dose - take on an empty stomach or azithromycin can be rx as 4 250 mg capsules or as 2 500mg capsules

Z-Pak six 250mg capsules; 2 capsules are taken on the first day, then one capsule is taken each day for the remaining 4 days

Tri-Pak = 3 500mg capsules

Topical azithromycin (azasite): indicated for tx of bacterial conjunctivitis and blepharitis - a novel drug delivery system allows for prolonged drug contact time

Blepharitis = BID x 2 days, then QDay thereafter until sx resolve (often several months)

The recommended dosing for bacterial conjunctivitis is BID x 2 days, then QDay for 5 days

ERYTHROMYCIN

uncommonly prescribed for active bacterial infection due to poor resistance profile, Rx for prophylaxis of gonococcal opthalmia neonatorum

ORAL CLARITHROMYCIN prescribed for respiratory infections

41
Q

Azasite contains which preservative?

A

BAK - pts who wear CL are advised to discontinue CL wear during tx

42
Q

Lincomycin, clindamycin (Cleocin) MOA

A

inhibit bacterial protein synthesis by reversibly binding to 50S ribosubunit

43
Q

Lincomycin and clindamycin are used to tx what?``

A

MRSA (Methicillin resistant staph aureus) and anaerobic infections `

44
Q

What is recommended for the treatment of MRSA

A

“Bacteria Cant Decide”

Bactrim (trimethoprim & sulfmethoxazole)
Clindamycin
Doxcycyline

45
Q

Antibiotics that interfere with Bacterial DNA

A

Sulfonamides: Sulfisoxazole (Gantrisin), sulfacetamide (sulamyd), sulfamethoxazole (Gatanol), sulfadizine)

Trimethoprim (Primsol), pyrimethamine (Daraprim)

46
Q

Sulfonamides MOA

A
  • Inhibit dihydropteroate synthase (enzyme that converts PABA to dihydrofolic acid) as the first step of folic acid synthesis
  • these drugs are bacteriostatic agents that are prescribed to tx gram (+) and gram (-)
47
Q

What are sulfonamides used to tx?

A
  • Topical sulfisoxazole and sulfacetamide: prescribed for bleph and conjunctivitis but now RARELY used
48
Q

Sulfa topical side effects?

A

Most common side effects of ophthalmic administration include burning, stinging, contact dermatitis, and local photosensitization

49
Q

tx for toxoplasmosis

A

sulfadiazine is prescribed with pyrimethamine to treat toxoplasmosis

50
Q

Bactrim is a combination of which to medications?

A

sulfamethoxazole and trimethprim

51
Q

Oral sulfonamides side effects

A

can cause kernicterus in infants due to bilirubin accumulation within the brain (contraindicated during pregnancy); may induce myopic shift, in pt’s refractive error

Topical + oral sulfonamides can cause SJS

52
Q

What is Stevens-Johnson syndrome?

A

disease characterized by fever and lesions on the skin and mucous membranes that result in sloughing of the skin over 10% or less of the body surface area

Can cause conjunctival lesions in 85% of pts - ranging from mild conjunctival injection to sever conjunctival scarring

Commonly associated with meds (sulfonamides, including bactrim, amoxicillin, allopurinol) and infections

53
Q

Trimethoprim MOA

A

inhibit dihydrofolate reductase - an enzyme that converts dihydrofolic acid to tetrahydrofolic acid in the second step of folic acid synthesis

54
Q

Topical opthalmic trimethoprim

A

effective against gram + & - infections, but not effective against Pseudomonas

It is available in combination with polymyxin B (strong gram -) agent

Pyrimethamine can be given orally for ocular toxoplasmosis infections

55
Q

What does the Ocular TRUST study state?

A

trimethoprim & tobramycin (to a lesser extent) are the most potent topical ophthalmic antibiotics against MRSA; other studies have shown besifloxacin and vancomycin are also effective against MRSA

56
Q

Polytrim is dosage

A

QID for 5-7 days for bacterial conjunctivitis

57
Q

adverse effects of trimethoprim

A

bone marrow suppression, apalstic anemia, leukopenia, granulocytopenia. Pyrimethamine can have similar toxicity

“Trimethoprim = TMP = TREATS MARROW POORLY”

58
Q

DNA gyrase and topoisomerase blocers

A

fluroquinolones

2nd gen: ciprofloxacin (Coloxan, cipro), ofloxacin (oculoflox)
3rd gen: levofloxacin (Quixin)
4th gen: gatifloxacin (zymar), moxifloxacin (vigamox, avelox), besifloxacin (besivance)

59
Q

Fluoroquinoles MOA

A

inhibit bacterial DNA by inhibiting DNA gyrase and topoisomerase IV

60
Q

Fluoroquinolones are used to treat which conditions?

A

CL related corneal ulcers, corneal abrasions, and bacterial conjunctivitis

61
Q

Dosage of fluroquinolones for infectious corneal ulcers

A

Q15 mins for 1 hr, then Q1H tehreafter with daily follow up

62
Q

Fluoroquinoles dosage for corneal abrasions

A

corneal abrasions and corneal erosions: most often QID for prophylaxis

63
Q

Ciprofloxacin can treat which conditions?

A

prescribed for gram (-) urinary & GI infections

64
Q

Moxifloxacin

A

approved for tx of penumonia, sinusitis, intra-abdominal and skin infections

65
Q

Side effects for fluoroquinolones

A

“fluroquinoLONES can hurt the attachment to your BONES”

tendintis, contraindicated in pregnancy, children, and adolescents below the age of 18 due to damage in cartilage formation and inhibition of bone growth

66
Q

3rd and 4th gen fluoroquinolones have been formulated to improve effectiveness against gram __

A

+

KMK (18 decks)

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