Pharmacology Flashcards

1
Q

Chloramphenicol MOA

A
  • blocks peptidyltransferase at 50S bacterial ribosomal subunit
  • bacteriostatic
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2
Q

3 adverse effects of Chloramphenicol

A
  1. anemia ( dose dependent)
  2. aplastic anemia ( dose independent)
  3. gray baby syndrome ( in premature infants, because they lack liver UDP- glucuronyl transferase)
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3
Q

What are 2 clinical uses for Chloramphenicol? causing agents?

A
  1. Meningitis
    - Haemophilus influenzae
    - Niesseria meningitidis
    - Streptococcus pneumoniae
  2. Mountain spotted fever
    - Rickettsia rickettsii
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4
Q

what is a mechanism of resistance for Chloramphenicol

A

Plasmid-encoded acetyltransferase inactivates the drug

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5
Q

What class of drug is Azithromycin

A

Macrolide

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6
Q

MOA for Azithromycin

A
  • Inhibit protein synthesis by blocking translocation (macroSLIDES)
  • bind to 23S rRNA of 50S ribosomal subunit
  • bacteriostatic
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7
Q

Clinical use for Azithromycin (4)

A
  1. atypical pneumonias
    - mycoplasma
    - chlamydia
    - legionella
  2. STI - chlamydia
  3. gram + cocci
    - streptococcal infection in patients allergic to penicillin
  4. B. pertussis
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8
Q

Adverse effects of Azithromyocin

A

MACRO

  1. gastrointestinal Motility issues
  2. Arrhythmia caused by prolonged QT interval
  3. acute Cholestatic hepatitis
  4. Rash
  5. eOsinophilia
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9
Q

drug interaction of Azithromyocin

A

increase serum concentration of theophylline and oral anticoagulants

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10
Q

what is a MOA of Clarithromycin and Erythromycin

A

inhibit cytochrome P450

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11
Q

what is a mechanism of resistance for Macrolides

A

methylation of 23S rRNA-binding site, prevents binding of drug

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12
Q

What is the class of drug for Ciprofloxacin

A

Fluoroquinolones

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13
Q

MOA of Ciprofloxacin

A
  • Inhibit prokaryotic enzymes topoisomerase II ( DNA gyrase) and topoisomerase IV
  • bactericidal
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14
Q

Fluoroquinolones can not be mixed with what

A

antacids

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15
Q

clinical use for Ciprofloxacin

A

gram - rods of urinary and GI tracts
- Pseudomonas
- Neisseria
some gram +

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16
Q

adverse effects of fluoroquinolones

A
GI upset
superinfections
skin rashes 
headache 
dizziness
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17
Q

are are less common side effects of fluoroquinolones

A

leg cramps and myalgias

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18
Q

Fluoroquinolones are contraindicated in who

A

pregnant women
nursing mothers

less than 18 years due to cartilage damage
older than 60 also taking Prednisone : tendontitis or tendon rupture irks

19
Q

impact on other organs of Flurorquinolones

A

prolong QT interval

20
Q

MOA of tetracyclines

A
  • bind 30S and prevent attachment of aminoacyl-tRNA
  • bacteriostatic
  • limited CNS penetration
21
Q

what can you not take tetracyclines with

A
  • milk (Ca2+) and antacids (Ca2+ or Mg2+)

- iron-containing preparations b/c divalent cations inhibit drugs’ absorption in the gut

22
Q

Renal failure patients can take what tetracycline and why

A

Doxycycline b/c fecally eliminated

23
Q

clinical use for tetracycline

A

Borrelia burgdorferi
M. penumoniae
Rickettsia
Chlamydia

24
Q

Adverse effects of tetracycline

A

GI distress
discoloration of teeth
inhibition of bone growth in children
photosensitivity

25
Q

tetracycline is contraindicated in who

A

pregnant women

26
Q

what is a mechanism of resistance for tetracyclines

A
  • increase uptake

- decrease efflux out of bacterial cells by plasmid-encoded transport pumps

27
Q

MOA of cephalosporins

A
  • Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases
  • bactericidal
28
Q

Name organisms not covered by 1st-4th generation cephalosporins ? any exceptions

A
LAME
Listeria
Atypicals ( chlamydia, mycoplasma) 
MRSA ( Ceftraline, 5th)
Enterococci
29
Q

Name 1st generation cephalosporins

A

Cefazolin

cephalexin

30
Q

what cephalosporin is sued prior to surgery to prevent S. aureus wound infections

A

Cefazolin

31
Q

1st generation cephalosporins treat against what

A

Proteus Mirablils
E.Coli
Klebsiella

32
Q

name 2nd generation cephalosporins

A

Cefaclor
Cefoxtin
Cefuroxime

FAke FOX FUR

33
Q

what organisms do 2nd generation cephalosporins cover

A
HENS PEcK
H influenzae 
Enterobacter aerogenes
Neisseria spp
Serratia 
Proteus 
E coli 
Klebsiella pneumoniae
34
Q

Name 3rd generation cephalosporins

A

ceftriaxone
cefotaxime
ceftazidime

35
Q

what organisms do 3rd generation cephalosporins cover

A

serious gram (-) infections resistant to other beta lactams

36
Q

what does Ceftriaxone used to treat

A

meningitis
gonorrhea
disseminated Lyme disease

37
Q

what does Ceftazidime treat

A

pseudomonas

38
Q

name 4th generation cephalosporins

A

cefepime

39
Q

what organisms do cefepime cover

A

gram (-) organisms with increased activity against pseudomonas and gram (+) organisms

40
Q

name 5th generation cephalosporin

A

Ceftaroline

41
Q

what does Ceftaroline cover

A
broad gram (+) and gram (-) organism coverage including MRSA 
- not pseudomonas
42
Q

adverse effects of cephalosporins

A

hypersensitivity reactions
autoimmune hemolytic anemia
disulfiram-like reaction
vitamin K deficiency

43
Q

what are drug interaction with cephalosporins?

A
  • cross-reactivity with penicillins

- increases nephrotoxicity in aminoglycosides

44
Q

what is mechanism of resistance for cephalosporins

A

Structural change in penicillin-binding proteins ( transpeptidase)