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POD Exam 2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Penicillin/Aminoglycosides

A

Increases the penetration of aminoglycosides since penicillin will break down cell walls

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2
Q

Postantibiotic Effect

A

Persistent effect of antibiotic effect on growth after only brief exposure to the drug

*Exhibited by aminoglycosides and fluoroquinolones

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3
Q

Prevents the cross linking of peptidoglycan by inhibiting transpeptidases

A

Penicillin / Cephalosporins / Carbapenems / Aztreonam

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4
Q

Inhibitor of peptidoglycan synthetase

A

Vancomycin

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5
Q

Inhibitors of 30s ribosome

A

Aminoglycosides

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6
Q

Inhibitors of peptidyl transferase

A

Chloramphenicols

*Decreased peptide bond formation

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7
Q

Inhibitors of 50s ribosome

A

Erythromycin / Clindamycin / Linomycin

“Macrolides”

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8
Q

Inhibits binding of aminoacyl tRNA to ribosome

A

Tetracyclines

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9
Q

Binds the 23s ribosome

A

Linezolid / Streptogramins

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10
Q

Cationic Detergents (Interference w/ cell membrane)

A

Polymixin B / Colistin

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11
Q

Inhibits DNAP

A

Rifampin

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12
Q

Inhibits action of DNA gyrase

A

Fluoroquinolones

*Inhibits the negative supercoiling of bacterial DNA

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13
Q

Inhibitors of lipid synthesis

A

Isoniazid

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14
Q

Inhibitors of folic acid synthesis

A

Sulfonamides / Trimethoprim

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15
Q

Reasons why you might start empiric coverage

A
  1. Site of infection is difficult to culture
    - Brain abscess, pneumonia, middle ear infxn
  2. Serious or life-threatening condition
  3. Empiric therapy- given as a broad treatment
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16
Q

Drugs that interfere w/ Warfarin

A

Bactrim & Erythromycin

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17
Q

Drugs that interfere w/ Theophylline

A

Ciprofloxacin

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18
Q

Drugs that interfere w/ SSRIs

A

Linezolid

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19
Q

What antibiotics do antacids interfere with?

A

FQNs and Tetracycline

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20
Q

Bactrim

A

Trimethoprim + Sulfamethoxazole

Treats Gram + (minus MRSA & VRE), ^PEK and CE, and Chlamydia, Cloroquine (R) malaria, Toxoplasmosis, and Pneumocystis carinii

Interactions: Warfarin => Potentiates effects causing excess clotting

Methotrexate => Increases free methotrexate in the blood

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21
Q

Which drugs inadequately reach the lungs?

A

Aminoglycosides

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22
Q

Abscesses and antibiotics

A

Must be drained before antibiotics can adequately do their job

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23
Q

“Piddly” Gram neg organisms

A

Haemophilus, Morganella, Moraxella, Shigella, Salmonella

Neisseria, Providencia

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24
Q

“Fence” Gram neg organisms

A

Proteus, E. Coli, Klebsiella

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25
Q

SPACE Gram neg organisms

A

Serratia

Pseudomonas

Acinetobacter

Citrobacter

Enterobacter

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26
Q

“Atypical” Orgs

A

Legionella

Mycoplasma

Chlamydia

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27
Q

Anerobic Gram neg organisms

A

Bacteroides

Clostridium

Peptostreptococcus

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28
Q

SPACE bug antibiotic coverage

A

Cell Wall Inhibitor + FQN OR Aminoglycoside

(Penicillin/Cephalosporin/Carbapenem)+ (Ciprofloxacin/Levofloxacin) OR (Gentramycin/Topramycin)

*Ace in the hole = Aztreonam

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29
Q

Penicillin General Structure

A
  1. Thiazolodine Ring (House)
  2. B-lactam ring (Garage)
  3. Acyl side group (chimney)
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30
Q

Targets of B-lactam antibiotics

A

PBPs

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31
Q

Cockroft-Gault Equation

A

(140-age)(Weight in kg)/([Creatinine])(72)

  • Must account for renal insufficiencies
  • If female, multiply by .85

Used to calculate renal excretion

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32
Q

Poor areas of penicillin distribution

A

Insoluble in lipid

=>CNS, Brain, Prostate

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33
Q

Adverse effects of penicillin

A

Allergic rxn =>Maculopapular rash

Interstitial nephritis (especially w/ methicillin)

Pseudomembranous colitis

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34
Q

Anti-staphylococcal penicillins

A

Methicillin, Oxacillin, Nafcillin

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35
Q

Aminopenicillins

A

Ampicillin / Amoxicillin

  • Amino group allows for penetration into cell walls
  • Treats strep, proteus, entero, salmonella, shigella, haemophilus
  • Drug of choice for Enterococcus
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36
Q

Carboxypenicillins

A

Carbenicillin / Ticaricillin

  • Has increased permeability to cell walls
  • Works against PIDDLYs, SPACE, and Strep
  • Can be causes dysfunctional platelets; Ticarcillin has high Na+ content
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37
Q

Ticarcillin hazards

A

Dangerous for CHF patients due to the high Na+ content

  • Can also cause platelet dysfunction
  • Replace w/ piperacillin
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38
Q

Augmentin

A

Amoxicillin + Clavulonic Acid

=>B-lactamase inhibitor adds Staphylococcus and anaerobe coverage

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39
Q

Timentin

A

Ticarcillin + Clavulonic Acid

=>B-lactamase inhibitor adds Staph and anaerobes to the spectrum

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40
Q

Cephalosporin Structure

A
  1. Dihydrothiazine ring (House)
  2. B-lactam ring (Garage)
  3. Acyl Side Chain (Chimney)
    * Cephalosporins have TWO R-groups; one on the acyl side chain and one on the dihydrothiazine ring

R1= Spectrum of Activity

R2= Stabilizer; increases t^1/2

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41
Q

Cephalosporin Distribution

A

Well-distributed; oral form is completely absorbed by the GI tract

  • CSF penetration is extra efficacious w/ inflammation
  • Usually use 4x Ceftriaxone
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42
Q

Elimination of Cephalosporins

A

Hepatic => Ceftriaxone, Cefoperazone

Renal => Everything else`

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43
Q

Adverse effects of Cephalosporins

A

*Presence of NMTT side chain on certain drugs can interfere w/ Vitamin K dependent clotting factors => bleeding

   (Cefamandole, Cefoperazone)
  • Presence of NMTT along w/ alcohol consumption => severe sickness
  • 10% cross reactivity w/ penicillin => Possible allergies
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44
Q

1st Generation Cephalosporins

A

Cefazolin

Good for treating Gram + and Piddly Gram -

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45
Q

2nd Generation Cephalosporins

A

Cefuroxime

Good for treating Gram + and Gram - H. flu and PEK (fence)

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46
Q

2nd Generation Cephalosporins (Cephamycins)

A

Cefoxitine and Cefotetan

Good against Gram +, H. flu and PEK, AND ANAEROBES

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47
Q

Third Generation Cephalosporins

A

Ceftriaxone and Cefotaxime

Covers Strep and up to SACE gram negs

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48
Q

Third Generation Cephalosporins (antipseudonomal)

A

Ceftazidime and Cefoperazone

Covers SPACE

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49
Q

Fourth Generation Cephalosporins

A

Cefapime

Gram + and SPACE

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50
Q

5th Generation Cephalosporin

A

Ceftarazine

Staph, Strep, and Enterococcus and SCE

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51
Q

Drugs used for surgical prophylaxis

A

Cefazolin

-Will cover Staph aureus infxns that can occur when penetrating the skin

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52
Q

Imipenem

A

Treats all bacteria except for the atypicals

Undergoes extensive renal metabolism; add cilastatin to prevent

*Toxicity => Seizures, possible hematologic disorders

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53
Q

Ertapenem

A

Weaker version of imipenem/meropenem that doesn’t cover enterococcus or psedomonas

*Requires less doses

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54
Q

Aztreonam

A

Good against all gram neg organisms but saved for severe, life-threatening conditions

Monobactam antibiotic: structured much like penicillin

*Can also be used if penicillin allergy present

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55
Q

Problems with Aminoglycoside Distribution

A

Poor concentrations to the lungs and CSF w/ inflammation

*Also has poor absorption in the gut

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56
Q

Adverse Effects of Aminoglycosides (Neomycin)

A

Nephrotoxicity- occurs when the trough levels are too high

Ototoxicity- occurs when the peak levels are too high

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57
Q

Treatment of TB

A

Streptomycin

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58
Q

Indications for use of neomycin

A
  1. Surgical prophylactic for colorectal surgery- suppresses growth of intestinal flora
  2. Hepatic coma- decreases number of NH4 forming flora
  3. Hyperlipidemia- decreased flora => decreased cholesterol absorption
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59
Q

Vancomycin Absorption and Distribution

A

Must use IV for systemic infxn
-Oral route only used for C. dificile infxn (might want to just drink IV $$$$$$$$$$$$)

Distributed freely but only to the CSF w/ inflammation

60
Q

Adverse Effects of Vancomycin

A

Red-Man Syndrome: Histamine-like allergic rxn; must slow the infusion

Hypersensitivity w/ Maculopapular rash

Nephrotoxicity and Ototoxicity

61
Q

Vancomycin Indications

A

Serious infxn by B-lactam resistant gram pos organisms

Pseudomembranous colitis that is non-responsive to metronidazole

Surgical prophylactic for major surgeries involving implantation of prosthetics

Surgical prophylactic for pts. w/ beta-lactam allergies

Surgical prophylactic for pts. w/ serious endocarditis

62
Q

Vancomycin Dosing

A

Nomogram for initial dose; then adjust by 3rd administration given peak and trough values

Typically 1-15 g/12 hr

63
Q

Synercid

A

Dalfopristin/Quinupristin

Good for MRSA, PCN-resistant S. pneumo, and VRE

*Requires central line placement

Could use if Vancomycin doesn’t work

BUT…

*NOT GOOD AGAINST E. FAECALIS

64
Q

Linezolid

A

Good for MRSA, VRE, PCN-resistant S. pneumo

  • Common side effect = Thrombocytopenia
  • Co-administration w/ SSRI => SEROTONIN STORM
65
Q

Mupirocin

A

Topical treatment used to eradicate MRSA from the nares

66
Q

Colistin

A

Used as a LAST RESORT to pan-resistant gram negative orgs

Will also cover the SPACE orgs

67
Q

Fosfomycin

A

Used on UTIs only and in patients w/ multiple antibiotic allergies

Covers Gram pos, neg, MRSA, and ESBL

68
Q

Daptomycin

A

Coverage: Gram + (MRSA and VRE), Right-sided endocarditis from IV drug users

Adverse Effects: Rhabdomylosis

*Rapidly inactivated by pulmonary surfactant

=»No good for pneumonia

69
Q

Telavancin

A

Coverage: Skin and soft tissue infxns; Gram +

Adverse: Red Man Syndrome, QT prolongation, Nephrotoxicity

*Similar to vancomycin

70
Q

Sulfonamides

A

Mechanism: Competes w/ PABA for dihyrdopteroate synthetase and decreases bacterial folic acid synthesis

Spectrum: Gram +, PEK

Adverse: Nephrotoxicity
Steven-Johnson Syndrome (separation of epidermis from dermis)
*Kernicterus if given to pregnant women in 3rd trimester
=>increased unconjugated bilirubin

Resistance: Bacteria can structurally alter dihydropteroate synthetase or overproduce PABA

*Treats uncomplicated UTI, nocardosis, toxoplasmosis, malaria if chloroquine (R)

71
Q

Trimethoprim

A

Mechanism: Inhibits dihydrofolate reductase => decreased THF

Spectrum: Gram +, Gram -, and Pneumocystis carinii in combo w/ dapsone

Adverse: Caution in pts. w/ folate deficiency
(Pregnant women, alcoholics, malnourished)

*Treats uncomplicaed UTI or recurrent UTI prophylaxis AND TRAVELER’s DIARRHEA (caused by ETEC)

72
Q

Trimethoprim/Sulfamethoxazole (Bactrim)

A

Spectrum: UTIs, respiratory infxns, STD, Traveler’s Diarrhea

*Potentiates the effects of Warfarin and Methotrexate

73
Q

Nitrofurantoin

A

Spectrum: Gram + (including MRSA and Enterobacter), Gram - excluding Pseud. and up to CE

Adverse Effects: Pulmonary Reactions; peripheral neuropathy

*Used exclusively for UTI due to high urine concentration; can’t use in males due to PROSTATE TISSUE

74
Q

Methenamine

A

Mechanism: Denatures bacterial proteins when activated

Adverse: Avoid in hepatic insufficiency (NH4+ byproduct) and Renal Failure (Acidosis)

  • Used for UTI prophylaxis, NOT NORMAL UTI; works for virtually all bacteria
  • Frequent voiding of the bladder via catheterization will decrease the formaldehyde allowing the bacteria to survive
75
Q

Erythromycin

A

Spectrum: Covers Gram +, atypicals, and Peddlys (except M. cat and H. flu)

Absorption: Better when fasting; dissolved by gastric acid if not made with stearate
-Estolate form is unaffected by food, however, is extra bad for pregnant women

Adverse: Severe GI symptoms (cramps, nausea)
Ototoxicity
Cholestatic Hepatitis
Hypersensitivity to Estolate compound causing fever

*Stimulates motilin receptor => gastric emptying
Interferes w/ p-450 enzymes =>decreased metabolism of Theophylline, Warfarin, Cyclosporin

76
Q

Clarithromycin

A

Spectrum: Gram +, atypicals, M. cat, H. flu, H. pylori

Adverse: Not as severe as erythromycin

*Interferes w/ p-450 enzymes

77
Q

Azithromycin

A

Spectrum: Gram +, atypicals, M. cat, H. flu

Excretion: Excreted in feces via biliary; slow release from tissues

Adverse: Less severe than erythromycin

*DOES NOT inactivate p-450 enzymes

78
Q

Clindamycin

A

Spectrum: Gram +, anaerobes

Adverse: Diarrhea and C.diff infxns (wipes away anaerobes in gut)

79
Q

What bacteria do cephalosporins typcially NOT cover?

A

Atypicals

Enterococcus (ex. Ceftaroline)

MRSA (ex. Ceftaroline)

80
Q

Tigecycline

A

Used for complicated abdominal infxns

Good against: Broad-spectrum resistant gram negs, Acinetobacter, and anaerobes

  • Doesn’t reach adequate blood levels
  • Go to if you have a CARBAPENEM- RESISTANT ENTEROBACTERIA
81
Q

Major drug that can cause interstitial nephritis

A

Methicillin

82
Q

Prevpak

A

Treatment for H. Pylori

Combination of Clarithromycin and Amoxicillin

83
Q

Chloramphenicols

A

MOA: Reversibly binds to the 50s ribosomal subunit

Absorption: Must be hydrolyzed in the intestines to be activated; IV form not as effective

*Excellent CSF distribution

SOA: Gram pos, Gram neg, Anaerobes, Rickettsia, Chlamydia

ADR: *Bone marrow hypoplasia (Anemia)

     *Gray-baby syndrome

Indications: Bacterial Meningitis, Rickettsia

84
Q

Gray-Baby Syndrome

A

Toxicity in newborns due to the excessive inhibition of mitochondrial protein synthesis

  • GRAY COLOR, hypothermia, respiratory collapse, vomiting
  • Occurs due to excess chloramphenicols in the system because newborns lack the proper hepatic fnxn to conjugate and clear the drug
85
Q

What is the one time oral vancomycin is used?

A

Treating pseudomembranous colitis from C diff after metronidazole has been ineffective

86
Q

Quinolones

A

MOA: Inhibits DNA gyrase and blocks the negative supercoiling of DNA
*Inhibits a post-antibiotic effect

ADR: QT prolongation
CNS symptoms in elderly (confusion, dizziness)
Arthopathy (in young athletes) and tendon rupture (in elderly on steroids)

Interactions: Theophylline (Ciprofloxacin doubles conc.)
Warfarin (Ciprofloxacin increases effect)
Avoid antacids

SOA: Gram + (levofloxacin better), ^SPACE, atypicals
*Moxicillin covers anaerobes

Indications: PID, LRIs, bone and joint infxns, intrabdominal infxns (must add metronidazole to cipro or levo, can use moxi alone)

87
Q

Best drug for Pseudomonas

A

Ciprofloxacin

88
Q

Hepatobiliary excreted tetracyclines

A

Doxycycline and Minocycline

89
Q

Tetracylines

A

MOA: Binds to the 30s ribosomal subunit

Absorption: Better on fasting state

ADR: Photosensitivity, yellow teeth, *Diabetes Insipidus
*Concept sometimes used to treat SIADH
Fanconi-like syndrome (N/V, proteinurea, lethargy, acidosis)

Interactions: Decreased absorption w/ dairy products or metallic ion consumption

-Increased INR

Indications: Broad spectrum coverage, good for inxns from atypicals, Rocky Mountain Spotted Fever, H.pylori (used w/ clarithromycin)

90
Q

Brucellosis

A

Consumption of unpasteurized dairy products leads to infxns of the heart or CNS

-Recurrent fever, joint pain, headache

TREATMENT: Tetracycline + Gentamicin

91
Q

Cholera

A

Infxn by V. cholerae resulting in prod. of watery diarrhea; can lead to lethal dehydration

TREATMENT: Tetracyclines

92
Q

Lyme Disease

A

Infxn by Borrelia burgdorferi resulting in a “target” shaped rash along w/ joint pain and headaches

TREATMENT: Tetracyclines

93
Q

What is the only drug that is harmful after the expiration date?

A

Tetracyclines

94
Q

Penicillin G

A

Used for Gram + orgs (minus Staph)

95
Q

Piperacillin Spectrum

A

Bacteroides fragilis

Streptococcus, Enterococcus

PEK, SPACE

*Used in place of ticarcillin in hypertensive pts.

96
Q

Timentin

A

Ticarcillin/Clavulonic Acid

97
Q

Unasyn

A

Ampicillin/Sulbactam

98
Q

Enterococcus treatment

A

Ampicillin + Gentamycin

99
Q

Indications for neomycin (oral AGC)

A
  1. Suppression of IF for colorectal surgery
  2. Hepatic coma (decreases amount of NH4+ forming bacteria)
  3. Hyperlipidemia (decreases intestinal cholesterol absorption)
100
Q

Macrolides are found in high concentration in what type of cell?

A

Phagocytic (PMNs and Macros)

=»treat Intracellular organisms that survive in these cells

Ex.- Mycoplasma, Chlamydia, Legionella

101
Q

Go-to drug for ESBL organisms

A

Carbapenems

102
Q

Common culprits of HAP

A

SPACE bugs

=>Empiric treatment should cover these

103
Q

Treatment for CAP

A

Beta-lactam + Macrolide

104
Q

Which FQN is used for complicated intra-abdominal infxns?

A

Moxifloxacin

*Is also the only one you can’t use for UTIs due to reasons

105
Q

Which FQNs cover Staph and Strep best?

A

Levofloxacin and Moxifloxacin

106
Q

Most potent FQN against Pseudomonas

A

Ciprofloxacin; also covered by levofloxacin

107
Q

Amphotericin B

A

MOA: Binds to ergosterol on the fungal cell membrane increasing the permeability and resulting in lysis

Distribution: Must give intrathecally if CSF desired

ADR: Nephrotoxicity (direct effect on afferent renal arterioles)
Anemia
Fever - *Should premedicate w/ NASAIDs or meperidine to prevent

Spectrum: Broad (Candida, Aspergillus, Histoplasmosis, Coccidiomyces)

*Lipid formulations (ABLC) => Useful for patients who are intolerant for the normal drug and are less nephrotoxic while equally efficacious (may require higher doses though)

108
Q

Flucytosine

A

MOA: Penetrates the fungal cell wall where is transformed to 5-fluorouracil and inhibits pyrimidine synthesis

ADR: Bone marrow hypoplasia; esp. w/ Amphotericin-B

Indications: Serious cryptococcal infxns (must use in synergy)

109
Q

Azoles

A

MOA: Interferes w/ C-P450 fnxn inhibiting lanosterol conversion to ergosterol

ADR: Depression of ACTH and Testosterone
=>gynecomastia, hypogonadism, decreased libido

(Mostly by ketoconazole)
110
Q

Fluconazole

A

Rapidly absorbed and not affected by acid or food; readily distributed to the CSF

  • Drug of choice for Cryptococcus and Coccidiomycoses meningitis
  • Candida prophylactic
111
Q

Itraconazole

A

Mostly used for treatment of aspergillosis but has a wide spectrumis not well distributed to the CSF

*Use Amphotericin-B first, then switch to this

112
Q

Voriconazole

A

Used to treat invasive aspergilosis

Contraindicated if pt. is on: Rifamipin (Decreased Voriconazole AUC), Quinidine, or Sirolimus (Increased)

113
Q

Posaconazole

A

Can be used if itraconazole not available

114
Q

Caspofungin Acetate

A

Blocks fungal wall cell synthesis (glucan)

  • Used in invasive aspergillosis if pt. has not responded to other drugs
  • Can cause left-shift, phlebitis, fever
115
Q

Griseofulvin

A

MOA: Disrupts mitotic spindle of fungal cells arresting division

Absorption: Microsize- Increased w/ fats
Ultrasize- Completely absorbed

  • Used for dermatophytosis if topical agents fail
  • Is a CYP-450 inducer => Increase Warfarin dose if pt. is currently taking this medication
116
Q

Terbinafine

A

MOA: Inhibits squalene oxidase inhibiting ergosterol formation

Indications: Onychomosis

  • Clearance of terbinafine is increased 100%w/ co-administration of rifampin
  • Should not be used for pregnant women or liver/renal dysfunction patients
  • Assoc. w/ headache and rash
117
Q

Drug of choice for CAP

A

Ceftriaxone

118
Q

Drug of choice for ESBL

A

Meropenem

119
Q

Penicillin-Binding Protein

A

Transpeptidase

120
Q

Red-Man Syndrome

A

Slow down the infusion rate or give antihistamines

121
Q

Ideal treatment of walking pneumonia

A

Macrolides

122
Q

Only Tetracycline that causes Diabetes insipidus

A

Dimiclocycline (Tigecycline)

123
Q

Inactivated Vaccines

A

Use large amounts of antigen to elicit an immune response w/o risk of infxn

*Safe to use in pts. who may have allergies to other vaccines

  • Administered w/ adjuvants to enhance uptake into DCs and macros
    • Most are precipitated w/ alum
124
Q

Toxoid Vaccine

A

Inactivated toxin that is completely safe because it HAS NO CHANCE of causing disease

-Because there is no bacteria present!

125
Q

Conjugate Vaccines

A

Polysaccharides linked to protein carriers

*Polysaccharides alone CANNOT elicit a T-dependent immune response in children

126
Q

Inactivated Vaccine Disadvantages

A

Immunity is not life-long (requires boosters)

Immunity is only humoral

Does not elicit an IgA response

127
Q

Live Vaccine

A

Immunity is long-lived and elicits a response similar to that of the infection

  • Vaccine is attenuated by growth in improper conditions causing it to lose its virulence factors
  • Dangerous to give these to IC patients
128
Q

Acyclovir

A

MOA: Drug is phosphorylated to monophosphate form and then triphosphate form via HSV or VZV ultimately resulting in chain termination
=»Ultimately a polymerase inhibitor

ADR: Nephrotoxicity (like AGCs) and some CNS abnormalities

Indications: Herpes/Varicella infxns
-Excellent CSF penetration so used for meningitis also

129
Q

Valacyclovir

A

MOA: Rapidly converted to acyclovir via intestinal and hepatic metabolism

  • Is the pro-form (oral) of acyclovir
  • Reaches nearly the same levels w/ less toxicity but it does take longer
130
Q

DOC for viral encephalitis

A

Acyclovir

131
Q

Ganciclovir

A

Similar to acyclovir

*Much more potent to CMV; is FIRST LINE of treatment for
CMV retinitis

ADRs include neutropenia and thrombocytopenia

132
Q

Valaganciclovir

A

Pro-drug of galanciclovir

*Is surgically implanted in CMV retinitis in AIDS pts.

133
Q

Penciclovir/Famicyclovir (Pro)

A
  • Similar to acyclovir

* Topical treatment for herpes cold sores

134
Q

Cidovir

A

MOA: Interacts w/ DNA polymerase as alternative substrate or inhibitor

ADR: Severe nephrotoxicity
*Must administer w/ saline to limit

Indication: Treatment of CMV retinitis after ganciclovir has failed
(5mg/kg for 2 weeks, then continue until ADR is too severe)

-Administer w/ Probenecid

135
Q

Foscarnet

A

MOA: Competes for pyrophosphate in viral DNA polymerases

ADR: Nephrotoxicity, seizures, anemia (increased with Zidovudine) , EKG changes

  • Used as last ditch effort in CMV-retinitis AIDS pts.
    • Avoid if possible due to ADRs

-Also used in HSV-AIDS pts. If acyclovir doesn’t work

136
Q

Interferons

A

Type I (a and b) => Hep B, Hep C, Kaposi’s Sarcoma

Type II => MS

ADR: Flu-like symptoms, personality changes (in kids), neurotoxicity, alopecia

137
Q

Lamivudine

A

MOA: Inhibits reverse trancscriptase

ADR: SEVERE Lactic Acidosis, Hepatosplenomegaly, Rash, Peripheral neuropathy

Indications: Treat HBV w/ interferon
AIDS

138
Q

DOC for RSV pneumonia

A

Ribavirin; touted as wide-spectrum antiviral

139
Q

Amantadine/Rimantidine

A

MOA: Prevents viral entry into host

*Amantadine needs renal adjustment for dosage

ADR: Confusion, neurological symptoms (worse w/ Amantadine)
=»Use rimantadine in elderly patients

Indications: Influenza A

140
Q

Osteltamivir/Zanamivir

A

MOA: Inhibits viral release from cell by inhibiting neuroaminidase

Osteltamivir => PO can cause GI symptoms

Zanamivir =»Drug is delivered by inhalation and can cause bronchospasm (avoid in COPD pts.)

Indications: Influenza A AND B

141
Q

Allyamines

A

Inhibits squalene conversion and ultimately ergosterol synthesis

142
Q

Azoles not affected by antacids

A

Fluconazole and Voriconazole

143
Q

Drug of choice for Coccidiomycoses meningitis

A

Fluconazole

144
Q

Which penicillin covers anaerobes?

A

Piperacillin (Bacteroides)

145
Q

Which FQN does not cover UTIs?

A

Moxifloxacin

146
Q

Concentration dependent antibiotics

A

FQNs and AGCs

147
Q

Paracoccidiomycosis follow-up therapy

A

Sulfonamides

POD Exam 2 (3 decks)

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