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AANP Class - Leik, Sarah Michell, MedMastery, & Other > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Antibiotics…what are commonly treated with antibiotics

A

Strep, whooping cough, urinary tract infections, some skin infections/abscesses, otitis media/middle (maybe), sinusitis (maybe), bronchitis (maybe), pneumonia (maybe)

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2
Q

Antibiotics: Four Mechanisms of Action

A

1) inhibit of folate synthesis
2) Inhibition of DNA replication/synthesis
3) inhibition of protein synthesis
4) inhibition of cell wall synthesis

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3
Q

What drugs inhibit folate synthesis?

A

SulFOnamide (think FOlate)

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4
Q

What drugs inhibit DNA replication?

A

FluoroQUINolones (think QUIN as identical copies of DNA and eliminating them)

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5
Q

Inhibit Protein Synthesis =
MALT

A

Macrolides
Amnioglycosides
Linocosamides
Tetracyclines

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6
Q

These drug classes inhibit wall synthesis…

A

Cephalosporins
Penicillins
Carbapenems
Glycopeptides

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7
Q

What are the natural penicillins and what do they cover?

A

Penicillins

  • gram positive coverage for syphilis (Penicillin G/injectable), strep pharyngitis, dental infections, rheumatic fever
  • Penicillin G (IM/IV)
  • Penicillin V (oral)
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8
Q

What are the penicillinase resistant drugs and what do they cover?

A

Penicillinase Resistant

  • gram positive
  • coverage for MSSA, STAPH aureus
  • MSSA stands for meticillin sensitive staphylococcus aureus, often referred to as staph, staph aureus and often lives in the nose and on the skin
  • nafcillin
  • oxacillin
  • dicloxacillin
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9
Q

What are the Amino-Penicillins and what do they cover

A

Amino-Penicillin

  • gram positive and gram negative
  • covers acute otitis media, strep pharyngitis, listeria, part of H.pylori group of 3 (amoxicillin, omeprazole, rifabutin)
  • amoxicillin (oral)
  • ampicillin (IV/IM)
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10
Q

What are the beta-lactamase inhibitor penicillins?

A

Bacteria acquired resistance by developing a beta-lactamases, thus this drug class was developed
- gram positive, gram negative, anaerobes

  • covers acute sinusitis, animal & human bites, aspiration pneumonia
  • clavulanate “shield”
  • sulbactam “shield”

Amoxicillin-Clavulanate (Augmentin)
Ampicillin-Sulbactam (Unasyn)

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11
Q

This antibiotic covers
gram positive cocci: Streptococci

A

Penicillin G and mostly known for treating syphilis

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12
Q

These antibiotics cover
gram positive cocci: MSSA and Streptococci

A

Anti-Staph Penicillins: Naficillin/Oxacillin

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13
Q

These antibiotics cover
- gram positive cocci: Streptococci
- gram negative bacilli: E. coli, P. mirabilis
- gram negative cocci: N. meningitis

A

Aminopenicillins: Ampicillin/Amoxicillin

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14
Q

These antibiotics cover
- gram positive cocci Streptococci and MSSA
- gram negative bacilli: E. coli, P. mirabilis, klebsiella

A

1st Generation Cephalosporin: Cefazolin, cephalexin

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15
Q

These antibiotics cover
- gram positive cocci: Streptococci, MSSA,
- gram negative bacilli: E. coli, P. mirabilis, klebsiella
- anaerobes

A

2nd Generation Cephalosporin: Cephotetan, Cefoxitin

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16
Q

These antibiotics cover
- gram positive cocci: Streptococci, MSSA
- gram negative bacilli: E. coli, P. mirabilis, klebsiella, ESCAPPM
- gram negative cocci: N. gonorrhoeae, N. meningitis?

A

2nd Generation Cephalosporin: Ceftriaxone

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17
Q

These antibiotics cover
- gram positive cocci: Streptococci
- gram negative bacilli: E. coli, P. mirabilis, klebsiella,
- pseudomonas

A

3rd Generation Cephalosporin: Ceftazidime

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18
Q

These antibiotics cover
- gram positive cocci: Streptococci, MSSA
- gram negative bacilli: E. coli, P. mirabilis, klebsiella, Pseudomonas, ESCAPPM
- gram negative cocci: N. gonorrhoeae, N. meningitis

A

4th Generation Cephalosporin: Cefepime

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19
Q

These antibiotics cover
- gram positive cocci: Streptococci and MSSA
- gram negative bacilli: E. coli, P. mirabilis, klebsiella
- anaerobes

A

Aminopenicillins with beta-lactamase inhibitors:
- Amoxicillin + Clavulanate (Augmentin)
- Ampicillin + Sulbactam (Unasyn)

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20
Q

These antibiotics cover
- gram positive cocci: Streptococci, MSSA
- gram negative bacilli: E. coli, P. mirabilis, kleibsiella, Pseudomonas, ESCAPPM
- gram negative cocci: N. meningitis
- anaerobes

A

Aminopenicillins with beta-lactamase inhibitors: Piperacillin + Taxobactam (Zosyn)

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21
Q

These antibiotics cover
- gram positive cocci: Streptococci, MSSA,
- gram negative bacilli: E. coli, and P. mirabilis, klebsiella, ESCAPPM
- gram negative cocci: N. gonorrhoeae, N. meningitis
- anaerobes

A

Monobactams: Ertapenem

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22
Q

These antibiotics cover
- gram positive cocci: Streptococci, MSSA
- gram negative bacilli: E. coli, P. mirabilis, klebsiella, Pseudomonas, ESCAPPM
- gram negative cocci: N. gonorrhoeae, N. meningitis, - anaerobes

A

Monobactams: Imipenem, Meropenem

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23
Q

These antibiotics cover
- gram positive cocci: MSSA
- gram negative bacilli: E. coli, P. mirabilis, klebsiella, Pseudomonas, ESCAPPM
- gram negative cocci: N. gonorrhoeae, N. meningitis

A

Quinolones: Ciprofloxacin

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24
Q

These antibiotics cover
- gram positive cocci: MSSA, Streptococci
- gram negative bacilli: E. coli, P. mirabilis, klebsiella, Pseudomonas, ESCAPPM
- gram negative cocci: N. gonorrhoeae, N. meningitis

A

Quinolones: Levofoxacin

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25
Q

These antibiotics cover
- gram positive cocci: MSSA, Streptococci
- gram negative bacilli: E. coli, P. mirabilis, klebsiella, ESCAPPM
- gram negative cocci: N. gonorrhoeae, N. meningitis
- anaerobes
- atypicals

A

Quinolones: Moxifloxacin

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26
Q

These antibiotics cover
- gram negative bacilli: E. coli, and P. mirabilis, keibsiella, Pseudomonas, ESCAPPM

A

Aminoglyosides: Gent/Tobra/Amikacin

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27
Q

These antibiotics cover
- gram positive cocci: Streptococci, MRSA, MSSA
- anaerobes

A

Lincosamide: Clindamycin

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28
Q

These antibiotics cover
- gram positive cocci: Streptococci, MSSA
- gram negative cocci: N. meningitis

A

Macrolides: Azithromycin

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29
Q

These antibiotics cover
- gram positive cocci: Streptococci
- gram negative bacili: E. coli
- gram negative cocci: N. meningitis

A

Tetracyclines: Doxycycline

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30
Q

These antibiotics cover
- gram positive cocci: Streptococci, MRSA, MSSA

A

Glycopeptides: Vancomycin

31
Q

These antibiotics cover
- gram positive cocci: MRSA, MSSA, Streptococci
- gram negative bacilli: E. coli, P. mirabilis, klebsiella, ESCAPPM
- gram negative cocci: N. meningitis

A

Antimetabolite:
TMP/SMX = trimethoprim-sulfamethozaole (Bactrim)

32
Q

These antibiotics cover anaerobes

A

Nitromidazoles: Metronidazole

33
Q

Patient needs furosemide (sulfa drug and loop diuretic) and but has a sulfa allergy

A

Ethacrynic Acid is a loop diuretic but is not a sulfa drug

34
Q

Diuretics and Calcium Side Effects

A

HYPER calcemia (thiazides)
HYPO calcemia (loops)
Think “Loops Lose” (calcium)

35
Q

Diuretics - Thiazide and Loop - Other Side Effects

A

Worsen gout and hyperuricemia (thiazides)
Can cause ototoxicity (loops)

36
Q

Drugs causing nephrotoxicity

A

Amnioglycoside
Drugs: gentamicin, amikacin, neomycin, tobramycin

37
Q

Patient with dilated cardiomyopathy (seen in heart failure) should not have

A

1) Alcohol

2) Doxorubincin/Danorubicin - chemotherapy (treat with dexrazoxane)
Drugs: Lipodox, Doxil

38
Q

Drugs that give bright orange bodily secretions

A

Rifampin

39
Q

Drug that causes red man syndrome and What does red man syndrome look like?

A

Vancomycin

Red man syndrome rash is flushing reaction with pruritus, an erythematous rash that involves the face, neck, and upper torso

40
Q

Drug that causes Grey Baby Syndrome and What does Grey Bay Syndrome look like?

A

Chloramphemicol (antibiotic)

Grey Baby Syndrome experiences sudden drop in BP resulting in grey skin, nails, lips blue, abdominal distention, irritability, vomitting, diarrhea, loss of appetite, leading to hemodynamic collapse, flaccidity, cyanosis, hypotension, death in neonates

41
Q

What do you have to monitor with clozapine? How often should I get the lab work?

A

Think monitor your CBC CLOZly!

Monitor CBC for severe neutropenia - absolute neutrophil count (ANC) less than 500 / uL.

Agranulocytosis a ANC less than 100 neutrophils / uL (microliter)

Enroll in REMS program and monitor ANC every week for 6 weeks, then every other week for 6 months, then monthly

42
Q

What drugs may induce lupus (Anti-HiSTONE Ab)

A

Hydralazine
Isoniazid
Procainamide
Methyldopa
Quinidine

hiSTONED on drugs

43
Q

What may give a dry cough and angioedema?

A

ACE inhibitors (switch to ARBs)
Mechanism: Bradykinin Buildup

44
Q

Hemorrhagic Cystitis

A

Cyclophosphamide (chemotherapy drug)

Treat with Mesna aka Mesnex to decrease the risk of bleeding from bladder

45
Q

What drug can cause cartilage damage in children?

A

Fluoroquinolones
Ciprofloxacin
Gemifloxacin
Levoflaxicin
Moxifloxacin
Norfloxacin
Ofloxacin

46
Q

What drug causes bone or tooth damage? Who do we not give these to?

A

Tetracyclines
Doxycycline
Minocycline

Pediatrics and Pregnant women

47
Q

What drugs can cause a prolonged QT Syndrome?

A

1) Azithromycin

2) Class Ia Anti-arrhythmic: fast sodium channel blockers that prolong the action potential
- procainamide
- quinidine
- lidocaine
- mexiletine

3) Class Ic Anti-Arrhythmics: fast sodium channel blocker that has no effect on the action potential
- flecainide
- encainide
- propafenone

4) Class III Anti-Arrhythmics: potassium channel blockers
- amiodarone
- sotalol
- dofeitlide
- ibutilide

48
Q

What is G6P deficiency and which drugs should be avoided?

A

Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is a condition that red blood cells breaks down in response to certain medications

Quinidine
Sulfonamides
Isoniazid

49
Q

Tuberculosis Drugs and what to watch out for

A

RIPE ONGO

Rifampin - Orange secretions
Isoniazid - Neuropathy, B6 deficiency, Drug induced lupus, hemolysis
Pyrazinamide - Gout
Ethambutol - Optic Neuritis

50
Q

Penicillins - Amoxicillin
pregnancy and infant safe

What can I treat?

A

Pneumonia (in certain cases)
Otitis Media
Syphilis (PCN G IM)
Group A Strep Throat
Group B via pregnancy via IV
Sinusitis

51
Q

Penicillins - Amoxicillin/Clauvulanate (Augmentin)
pregnancy and infant safe

What can I treat?

A

Second-line otitis media (treatment failure with amoxicillin or recent antibiotic use)

Sinusitis - this drug penetrates the sinus cavity

52
Q

Penicillins - Dicloxacillin
pregnancy and infant safe

What can I treat?

A

Mastitis

Second line for mastitis could be clindamycin or macrolides

53
Q

Macrolides
ends in -mycin

What Can Macrolides Treat?

A

Pneumonia (in certain cases)

Azithromycin (Z-pack) can be used for Pertussis (it only helps for no further spread)

Clarithromycin (Biaxin) can be used for part of the H. Pylori treatment guidelines but a common side effects is GI upset

54
Q

Sulfonamides - trimethoprim/sulfamethoxazole (Bactrim)
have sulfa

A

Urinary Tract Infections
Purulent Cellulitis (MRSA Bactrim, Clinda, Doxy)
Pneumocystis jirovecii pneumonia prophylaxis in AIDS patients
Below the waist skin complaints

55
Q

Stevens-Johnson Syndrome

A

reaction people can have when they take sulfonamide antibiotics, but can also occur with other medications too

starts with flu-like symptoms, then a painful, bleeding, peeling rash erupts on the entire body

56
Q

Cephalosporins have “ceph” or “cef” in the name
- pregnancy safe
- ok if patient has PCN allergy that is not anaphylactic

A

Skin Complaints
Post-Operative Wounds

57
Q

Fluoroquinolones ends in -floxacin

A

Respiratory fluoroquinolones such as levofloxacin (Levaquin) for those with pneumonia if they have respiratory co-morbidities or recent antibiotic use

Ciprofloxacin (Cipro)
- Urinary Tract Infections
- Diverticulitis
- Travelers Diarrhea

black box = Achilles Tendon Rupture
Heel Pain = MEDICAL EMERGENCY

58
Q

Tetracyclines ends in -cycline
avoid in pregnancy except for Rocky Mountain Spotted Fever

A

Rocky Mountain Spotted Fever
Lyme Disease
Purulent Cellulitis (BCD)
Pneumonia (if the criteria is met)

59
Q

Vancomycin Vancocin

A

MRSA
* Worried about nephro and otoxicity
* Red Man Syndrome can occur which can be pre-treated prior to administering this drug

60
Q

Nitrofurantoin - Macrobid

A

Urinary Tract Infections
◦ Safest for women in the second trimester

61
Q

Clindamycin Cleocin

A

Used for more serious infections, like purulent infections
High risk for superinfection (or suprainfection)
CDIFF
2nd line option for mastitis

62
Q

Metronidazole

A

Trichomoniasis
- It’s tricky tricky tricky…think metronidazole treats trich
Bacterial vaginitis
Used in treatment of H. Pylori

Side Effects
◦ GI upset
◦ Metallic taste
◦ Disulfiram-Like reactions such as nausea, vomiting, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and general hangover-like symptoms

63
Q

Sinusitis Pneumonic
AUGust Colds

A

AUGust Colds
AUGmentin or Cephlasporins

64
Q

Strep Throat Pneumonic
Strip in the PM

A

Strip in the PM
Penicillins or Macrolides

65
Q

Purulent Cellulitis Pneumonic
Mrs “A” - BCD

A

Mrs “A” - BCD
Usually caused by MRSA
Bactrim
Clindamycin
Doxycycline

66
Q

Dog and Cat Bites Pneumonic

A
  • Dog Bitten = AUGMENTIN

Extra question…how long after a dog or cat bite do we suture this? WE DO NOT

67
Q

Pregnancy Safe Antibiotics - Pneumonic
CAMP

A

CAMP
* Cephalosporins
* Amoxicillin
* Macrolides/Macrobid
* Penicillins

68
Q

Pneumonia - MAD Lung

A

No respiratory comorbidities and no recent antibiotic use:
MAD
* Macrolides
* Amoxicillin
* Doxycycline

  • But, if we have recent antibiotic use OR respiratory comorbidity
    LUNG
  • Levofloxacin (heavy) hitter
    ◦ Respiratory Fluoroquinolones
  • Macrolide + Augmentin
69
Q

H. Pylori
Triple & Quad Therapy

A
  • Triple Therapy (CAP)
    ◦ Clarithromycin + Amoxil + PPI
    ◦ Can cause flagyl if PCN allergy
  • Quadruple Therapy
    ◦ Treat My Belly Pain
    ◦ Tetracycline + Metronidazole + Bismuth + PPI
70
Q

STI Antibiotics
Cuties All Get Cooties To be Freaky, Sneaky, and Playful

A

Chlamydia = Azithromycin
Gonorrhea = Ceftriaxone
Trich = Flagyl
Syphilis = Penicillin G

71
Q

Otitis External = Swimmer’s Ear

A
  • Bacteria that causes this is pseudomonas
  • Heavy hitter meds needed for pseudomonas
  • Ofloxacin drops (can also add cortisporin drops)
72
Q

Interactions with Wafarin Therapy that can Increase INR
NO PREGNANT PATIENTS

A

Glucocorticoids: Methylprednisolone, prednisone
SSRIs & SNRIs: Fluoxetine, sertraline, duloxetine, fluvoxamine, venlafaxine
Fluoroquinolones: Ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin
Macrolides: Azithromycin, clarithromycin, erythromycin
Penicillins: Amoxicillin, amoxicillin-clavulanate
Azole Antifungals: Fluconazole, miconazole
Statins: Fluvastatin, lovastatin, rosuvastatin, simvastatin
Other medications: Tramadol, fenofibrate, trimethoprim-sulfamethoxazole

73
Q

CHA2DS 2 -VASc score is a tool that will help determine whether a patient needs anticoagulation therapy for stroke risk

A

C (congestive heart failure history = 1)
H (hypertension history = 1)
A (age >75 years = 2; age 65-74 = 1; <65 = 0)
D (diabetes history = 1)
S (stroke/transient ischemic attack [TIA]/thrombolic embolism = 1)
V (vascular disease history including prior myocardial infarction, peripheral artery disease, aortic plaque = 1)
A (age 65–74 years = 1)
S (sex: female gender = 1; male gender = 0)

Score of 0 is low risk. Score of 2 or more requires anticoagulation, some physicians will treat patients with a score of 1

74
Q

Name Direct Acting Anticoagulants (DOACs) are the first-line agents for nonvalvular AF

A

dabigatran (Pradaxa)
rivaroxaban (Xarelto)
endoxaban (Savaysa)
apixaban (Eliquis)

AANP Class - Leik, Sarah Michell, MedMastery, & Other (20 decks)

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