Pharmacology Flashcards by Brock rose

what metabolizes esters

esterases in the blood

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what is the mechanism of action of local anesthetics

prevent generation of nerve impulses by preventing sodium transport into the neuron

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what form of LA is absorbed into the neuron

non-ionized form (free base form)

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how does inflammed tissue affect LA absorption

is decreases the pH of the tissue which decreases the amount of non-iodized form of the LA meaning less gets into the nerve

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Effect of beta blockers on LA concentrations

taking beta blockers slows down heart conduction and blood flow and thus causes LA to be in circulation longer

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What is the initial effect of LA in toxic concentration, then second effect at higher levels

first they inhibit inhibitory neurons = convulsions

higher doses inhibit inhibitory and excitatory = CNS depression, coma, death

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What does epinephrine initially cause

elevated pulse rate

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Graves disease

hyperthyroidism = high metabolic state

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Which is the only LA that causes vasocontriction

Cocaine

also causes stimulation of the cerebral cortex

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what happens to the ratio of ionized and free base form of a LA if the pH and pKa are the same

there will be 50/50 ionized and free base form

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penicillin V vs. G

G is more sensitive to acid degredation and thus usually injected

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which penicillin has the best gram negative spectrum

ampicillin

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which antibiotics are cross-allergenic with penicillin

cephalosporin

not erythromycin

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dicloxacillin

penicillinase resisitant

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what antibiotic for pseudomonas infection

extended spectrum carbenicillin

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Bacterial types 
Healthy gongiva
Chronic perio
Aggressive perio
ANUG

Actinomyces Viscosis
Porphyromonas gingivalis
Bacterioides forsythus
AA 
Treponema denticola

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Macrolides

Bind 50s subunit of ribosomes, inhibit translation
protein synthesis inhibitor
bacteriostatic
Azithromycin, erythromycin, clarithromycin
Use: patients with penicillin allergies
SE: GI upset, inhibition of drug metabolism, QT prolongation

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Nystatin

Antifungal
topically administered
used for oral candidosis

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Beta lactams

Bacteriocidal

penicillins
carbapenems
monobactams
cephalosporins

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Penicillin G

narrow spectrum

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Penicillin V

narrow spectrum

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Penicillins

beta lactams (cell wall inhibitors)
bacteriocidal
effective against gram negative cocci

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Naficillin

administration: IV
used to treat methicillin sensitive staph aureus
Penicillinase resistant

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Oxacillin

administration: IV
used to treat methicillin sensitive staph aureus
Penicillinase resistant

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Clavulanic Acid Sulbactam Tazobactam

beta lactamase inhibitors

Carbenicillin

pseudomonas aeruginosa infections "Antipseudomonal penicillin" administration: enteral or parenteral used with aminoglycoside to prevent resistance formation

Sulfonamides

folic acid sytnthesis inhibitor Bacteriostatic Use: UTI, RA, Ulcerative colitis, ance, conjuctivitis used less frequently due to increasing bacterial resistance SE: Crystalluria, Rashes, Psychosis

Piperacillin

antipseudomonal

Trimethoprim

Folate inhibitor | Used to treat UTI

Trimethoprim

Folate inhibitor Use: UTI SE: Rash, Megaloblastic anemia, Leukopenia used with sulfamethoxazole

Amphenicols

protein synthesis inhibitor (bacteriostatic) used for serious, resistant infections SE = severe bone marrow depression (gray baby syndrome)

Tetracycline

protein synthesis inhibitor Bacteriostatic Broad Spectrum use: for periodontitis, severe acne, chlamydia EX: tetracycline, doxycycline, minocycline

Aminoglycosides

protein synthesis inhibitor EX: gentamycin, amikacin, Neomycin, Streptomycin SE: Ototoxicity, Nephrotoxicity

Clindamycin

narrow spectrum 50 S subunit inhibitor Use: Oral infections, prophylaxis BT: S. Pneumonia, S. Pyogenes, S. Aureus, Viridans, Bacteroids

Streptomycin

Used for Tuberculosis

Penicillin G

administration = IV or IM (unstable in gastric acid)

Penicillin V

administration = Enteral

Floroquinolones

Levofloxacin, Ciprofloxacin, Moxifloxacin, norfloxacin, sparfoloxacin

Most common antibiotics for oral infections

penicillin

Amphotercin B

SE: Lipophilic can lead to toxicity

Acyclovir

Prodrug

Amantadine

Use: influenza (resistance is common)

Rimantadine

Use: influenza (resistance is common)

patients who need prophylaxis

1. Heart Valve surgery 2. Endocarditis 3. Heart transplant with abnormal valve function 4. uncured cyanogenic congenital heart disease 5. congenital heart defects repaired in last 6 months 6. residual heart defects

What to use as prophilactic with penicillin allergy

clindamycin clarithromycin azithromycin

What to use as prophilactic, no allergy, no oral medication

ampicillin cefazolin Ceftriaxone

What to use as prophilactic, allergy, no oral medication

Clindamycin Cefazolin Ceftriaxone

Inipenem

atypical beta lactam | Use: P. Aeruginosa, Gram - rods, Streptococci

Vancomycin

last resort antibiotic Use: MRSA, C dificile administration: IV

Aminopenicillins

Amoxicillin, Ampicillin, Bacampicillin

Amoxicillin

SE: Rash in people with mono or taking allopurinol

Ampicillin

Administration: Parenteral Use: intraabdominal infections, severe UTI taken with sulbactam

Ticarcillin

antipseudomonal | taken with clavulanic acid

Penicillinase resistant penicillins

``` methicillin oxacillin dicloxacillin cloxacillin nafcillin ```

Cloxacillin

penicillinase resistant

Metronidazole

narrow spectrum | use: parasitic infection

Oseltamivir (tamiflu)

neuraminidase blocker (required for viral budding)

What occurs when diazepam or triazolam is taken with the following drugs: itraconazole clarithromycin cytochrome P-450 inhibitors

increased sedation

What occurs when tetracyclines are taken with the oral antacids

reduced absorption of tetracylines

What occurs when aspirin is taken with anticoagulants

increased bleeding tendancy

what occurs when aspirin is taken with probenicid

decreased effect of prebenicid

what occurs when aspirin is taken with methotrexate

increased methotrexate toxicity

what occurs when acetominophen is taken with alcohol

increased risk of liver toxicity

what occurs when local anesthetics are given with cholinesterase inhibitors

reduced effect of the cholinesterase inhibitors

What drugs are contraindicated in a patient with methaglobin reductase deficiency

benzocaine, prilocaine | causes methemogloinemia

What drugs are contraindicated in a patient with Glucose -6-phosphate dehydrogenase deficiency

aspirin, primaquine, sulfonamides | hemolytic anemia

What drugs are contraindicated in a patient with abnormal heme synthesis

barbiturates, sulfonamides | porphyria

What drugs are contraindicated in a patient with Low plasma cholinesterase activity

procaine and other ester anesthetics | Local anesthetic toxicity