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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
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
Quinolones: Moxifloxacin
26
These antibiotics cover - gram negative bacilli: E. coli, and P. mirabilis, keibsiella, Pseudomonas, ESCAPPM
Aminoglyosides: Gent/Tobra/Amikacin
27
These antibiotics cover - gram positive cocci: Streptococci, MRSA, MSSA - anaerobes
Lincosamide: Clindamycin
28
These antibiotics cover - gram positive cocci: Streptococci, MSSA - gram negative cocci: N. meningitis
Macrolides: Azithromycin
29
These antibiotics cover - gram positive cocci: Streptococci - gram negative bacili: E. coli - gram negative cocci: N. meningitis
Tetracyclines: Doxycycline
30
These antibiotics cover - gram positive cocci: Streptococci, MRSA, MSSA
Glycopeptides: Vancomycin
31
These antibiotics cover - gram positive cocci: MRSA, MSSA, Streptococci - gram negative bacilli: E. coli, P. mirabilis, klebsiella, ESCAPPM - gram negative cocci: N. meningitis
Antimetabolite: TMP/SMX = trimethoprim-sulfamethozaole (Bactrim)
32
These antibiotics cover anaerobes
Nitromidazoles: Metronidazole
33
Patient needs furosemide (sulfa drug and loop diuretic) and but has a sulfa allergy
Ethacrynic Acid is a loop diuretic but is not a sulfa drug
34
Diuretics and Calcium Side Effects
HYPER calcemia (thiazides) HYPO calcemia (loops) Think "Loops Lose" (calcium)
35
Diuretics - Thiazide and Loop - Other Side Effects
Worsen gout and hyperuricemia (thiazides) Can cause ototoxicity (loops)
36
Drugs causing nephrotoxicity
Amnioglycoside Drugs: gentamicin, amikacin, neomycin, tobramycin
37
Patient with dilated cardiomyopathy (seen in heart failure) should not have
1) Alcohol 2) Doxorubincin/Danorubicin - chemotherapy (treat with dexrazoxane) Drugs: Lipodox, Doxil
38
Drugs that give bright orange bodily secretions
Rifampin
39
Drug that causes red man syndrome and What does red man syndrome look like?
Vancomycin Red man syndrome rash is flushing reaction with pruritus, an erythematous rash that involves the face, neck, and upper torso
40
Drug that causes Grey Baby Syndrome and What does Grey Bay Syndrome look like?
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
What do you have to monitor with clozapine? How often should I get the lab work?
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
What drugs may induce lupus (Anti-HiSTONE Ab)
Hydralazine Isoniazid Procainamide Methyldopa Quinidine hiSTONED on drugs
43
What may give a dry cough and angioedema?
ACE inhibitors (switch to ARBs) Mechanism: Bradykinin Buildup
44
Hemorrhagic Cystitis
Cyclophosphamide (chemotherapy drug) Treat with Mesna aka Mesnex to decrease the risk of bleeding from bladder
45
What drug can cause cartilage damage in children?
Fluoroquinolones Ciprofloxacin Gemifloxacin Levoflaxicin Moxifloxacin Norfloxacin Ofloxacin
46
What drug causes bone or tooth damage? Who do we not give these to?
Tetracyclines Doxycycline Minocycline Pediatrics and Pregnant women
47
What drugs can cause a prolonged QT Syndrome?
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
What is G6P deficiency and which drugs should be avoided?
Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is a condition that red blood cells breaks down in response to certain medications Quinidine Sulfonamides Isoniazid
49
Tuberculosis Drugs and what to watch out for
RIPE ONGO Rifampin - Orange secretions Isoniazid - Neuropathy, B6 deficiency, Drug induced lupus, hemolysis Pyrazinamide - Gout Ethambutol - Optic Neuritis
50
Penicillins - Amoxicillin pregnancy and infant safe What can I treat?
Pneumonia (in certain cases) Otitis Media Syphilis (PCN G IM) Group A Strep Throat Group B via pregnancy via IV Sinusitis
51
Penicillins - Amoxicillin/Clauvulanate (Augmentin) pregnancy and infant safe What can I treat?
Second-line otitis media (treatment failure with amoxicillin or recent antibiotic use) Sinusitis - this drug penetrates the sinus cavity
52
Penicillins - Dicloxacillin pregnancy and infant safe What can I treat?
Mastitis Second line for mastitis could be clindamycin or macrolides
53
Macrolides ends in -mycin What Can Macrolides Treat?
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
Sulfonamides - trimethoprim/sulfamethoxazole (Bactrim) have sulfa
Urinary Tract Infections Purulent Cellulitis (MRSA Bactrim, Clinda, Doxy) Pneumocystis jirovecii pneumonia prophylaxis in AIDS patients Below the waist skin complaints
55
Stevens-Johnson Syndrome
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
Cephalosporins have “ceph” or “cef” in the name - pregnancy safe - ok if patient has PCN allergy that is not anaphylactic
Skin Complaints Post-Operative Wounds
57
Fluoroquinolones ends in -floxacin
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
Tetracyclines ends in -cycline avoid in pregnancy except for Rocky Mountain Spotted Fever
Rocky Mountain Spotted Fever Lyme Disease Purulent Cellulitis (BCD) Pneumonia (if the criteria is met)
59
Vancomycin Vancocin
MRSA * Worried about nephro and otoxicity * Red Man Syndrome can occur which can be pre-treated prior to administering this drug
60
Nitrofurantoin - Macrobid
Urinary Tract Infections ◦ Safest for women in the second trimester
61
Clindamycin Cleocin
Used for more serious infections, like purulent infections High risk for superinfection (or suprainfection) CDIFF 2nd line option for mastitis
62
Metronidazole
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
Sinusitis Pneumonic AUGust Colds
AUGust Colds AUGmentin or Cephlasporins
64
Strep Throat Pneumonic Strip in the PM
Strip in the PM Penicillins or Macrolides
65
Purulent Cellulitis Pneumonic Mrs “A” - BCD
Mrs “A” - BCD Usually caused by MRSA Bactrim Clindamycin Doxycycline
66
Dog and Cat Bites Pneumonic
* Dog Bitten = AUGMENTIN Extra question…how long after a dog or cat bite do we suture this? WE DO NOT
67
Pregnancy Safe Antibiotics - Pneumonic CAMP
CAMP * Cephalosporins * Amoxicillin * Macrolides/Macrobid * Penicillins
68
Pneumonia - MAD Lung
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
H. Pylori Triple & Quad Therapy
* Triple Therapy (CAP) ◦ Clarithromycin + Amoxil + PPI ◦ Can cause flagyl if PCN allergy * Quadruple Therapy ◦ Treat My Belly Pain ◦ Tetracycline + Metronidazole + Bismuth + PPI
70
STI Antibiotics Cuties All Get Cooties To be Freaky, Sneaky, and Playful
Chlamydia = Azithromycin Gonorrhea = Ceftriaxone Trich = Flagyl Syphilis = Penicillin G
71
Otitis External = Swimmer’s Ear
* Bacteria that causes this is pseudomonas * Heavy hitter meds needed for pseudomonas * Ofloxacin drops (can also add cortisporin drops)
72
Interactions with Wafarin Therapy that can Increase INR NO PREGNANT PATIENTS
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
CHA2DS 2 -VASc score is a tool that will help determine whether a patient needs anticoagulation therapy for stroke risk
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
Name Direct Acting Anticoagulants (DOACs) are the first-line agents for nonvalvular AF
dabigatran (Pradaxa) rivaroxaban (Xarelto) endoxaban (Savaysa) apixaban (Eliquis)

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

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