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CPR 2 Exam 2 > Pharmacology For Cardiopulmonary Infections - Dr. Wolff > Flashcards

Pharmacology For Cardiopulmonary Infections - Dr. Wolff Flashcards

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1
Q

how to prevent S. Pneumoniae

A
  1. CHILDREN : Prevnar
  2. ADULTS : Pnumvax
    = vaccine taken
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2
Q

4 viral pneumonias

A
  1. influenza MOST COMMON
  2. adenovirus
  3. Parainfluenza
  4. Respiratory Syncytial virus (RSV)
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3
Q

2 drugs for treating influenza virus

A
  1. Oseltamivir (zanamivir, Peramivir)

2. Baloxavir

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4
Q

viral pneumonias usually cause what

A

superinfections with bacterial infection ( S. pneumonia, S. Aureus, H. Influenzae)

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5
Q

Oseltamivir MOA and effects

A
  1. inhibits viral neuraminidase

2. X viral budding from host cell (quickens flu recovery)

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6
Q

Oseltamivir clinical use and Side effects

A
  1. acute uncomplicated influenza A and B, also prophylaxix of influenza A and B
  2. N, V, dont use if organ problems
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7
Q

Baloxavir MOA and effects

A
  1. inhibits endonuclease activity = X viral gene transcription
  2. quickens recovery by 1 - 2 days
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8
Q

Baloxavir clinical use and side effects

A
  1. acute uncomplicated influenza A and B, prophylaxis influenza A and B
  2. D
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9
Q

Baloxavir pharmokinetics to know

A
  1. NOT FOR PREGNANT

2. UGT1A3 + CYP3A4 using

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10
Q

Amantadine MOA and effects

A
  1. antiviral unknown moa

2. quickens recovery from influenza A

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11
Q

Amantadine clinical use

A

TX PARKINSONS

= not used against influenza A anymore

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12
Q

Multidrug resistant bacteria (resistant to 1 in 3)

A
  1. MRSA (S. Aureus)

2. Vancomycin- resistant enterococci (VRE)

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13
Q

Extensively drug resistant bacteria ( resistant to 1 of 2)

A
  1. Mycobacterium TB

2. pseudomonas aeruginosa, Klebsiella pneumonia

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14
Q

Pandrug resistant (all in all resistant)

A

pseudomonas aeruginosa, Klebsiella pneumonia , Acinetobacter Baumannii

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15
Q

penicillin drugs used for staph aureus

A

pencillinase - resistant penicillins (Nafcillin)

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16
Q

penicillin drug for gram - bacteria

A

broad spectrum penicillins (Ampicillin, amoxicillin)

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17
Q

penicillin drug used for P. aeruginosa

A

extended spectrum penicillins (Piperacillin, Ticarcillin) + B-lactams (clavulanate, tazobactam, sulbactam)

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18
Q

fluoroquinolones treat what 2 things and how

A
  1. gram - (Ciprofloxacin)** : X DNA Gyrase

2. gram + (respiratory fluroquinolones) : X Topo4

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19
Q

Amoxicillin + clavulanate MOA and clinical use

A
  1. X cell wall + B-lactam inhibitor
  2. Community acquired pneumonia (Gram + and Gram -)
  • not psudomonas
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20
Q

Piperacillin + Tazobactam MOA and effects

A
  1. X cell wall + B-lactam inhibitor

2. Gram +, Gram -, Anaerobic + aerobic , Psuedomonas)

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21
Q

Piperacillin + Tazobactam clinical use

A
  1. community acquired pneumonia
  2. hospital and ventilator acquired pneumonia
    = gram +, gram -, pseudomonas
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22
Q

parenteral cephalosporins 3

A
  1. ceftazidime (3rd)
  2. cefepime (4th)
  3. ceftriaxone (3rd)
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23
Q

oral cephalosporins 2

A
  1. cefditoren (3rd)

2. cefpodoxime - proxetil (3rd)

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24
Q

psudomonas drugs

A
  1. piperacillin/ ticarcillin + B-lactam - extended spec penicillin + BL
  2. Ceftriaxone/ cefpodoxime/ cefditoren, ceftazidime - cephalosporins
  3. Ciprofloxacin (BEST - resp fluoroquinolone)
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25
cephalosporins for MRSA + gram +
cefepime
26
ceftriaxone + ceftazidime MOA and clinical use
1. X cell wall | 2. CAP + many other infections in body + P. Aeruginosa
27
ceftriaxone + ceftazidime administration and side effects
1. IV | 2. B- lactam allergy + superinfection
28
Cefpodoxime + Cefditoren MOA and clinical use
1. X cell wall | 2. CAP, UTI, COPD + many other infections
29
Cefpodoxime + Cefditoren administration and side effects
orally | B- lactam allergy + superinfection
30
tetracyclines attack what (clinical use)
CAP (H. influenza, Klebsiella spp., Mycoplasma pneumoniae) + S. pneumonia + S. spp.
31
tetracyclines contraindication and name of drug
DOXYCYCLINE | = in children to prevent permanent teeth staining
32
Doxycycline clinical use
tetracycline = CAP (H. influenza, Klebsiella spp., Mycoplasma pneumoniae) + S. pneumonia + S. spp.
33
Doxycycline Side effects
high BUN, intracranial htn, superinfection, lower bone growth, esophageal ulcer, photosensitive, skin hyperpigmentation
34
Macrolides 3
1. erythromycin 2. clarithromycin 3. azithromycin
35
Macrolides effective against what
gram + | only haemophilus + Neisseria, pasteurella gram -
36
macrolides are good for who
pts with penicillin allergies
37
erythromycin side effects and pharm
1. GI problems | 2. CYP3A4 inhibitor MAJOR
38
erythromycin clinical use
1. S. pyogens 2. S. pneumonia 3. S. Aureus 4. Mycoplasma pneumonia 5. Legionella pneumonia 6. diphtheria, pertussis 7. acne, gastroparesis, copd, endoscopy
39
Clarithrocycin clinical use
same as erythromycin only low GI probs | + same pharm
40
azithromycin clinical use
1. CAP (chlamydophilia, H. influenzae, Legionella, M. catarrhalis, Mycoplasma pneumoniae)
41
azithromycin pharm
NO inhibition of CYP450
42
Respiratory fluoroquinolones 4 and effectiveness
1. Levofloxacin (3rd) 2. Gemifloxacin (4th) 3. Moxifloxacin (4th) 4. Ciprofloxacin (2nd = only gram - P. Aeurgonas) more effective then tetracyclines and mscrolides only high tolarance rates
43
Respiratory fluoroquinolones risk in elderly
achille tendon rupture
44
Levofloxacin clinical use
1. CAP (Multidrug resist. S. pneumonia, nosocomial pneumonia, copd, acute exacerbation or acute bacteria)
45
Respiratory fluoroquinolones SIDE EFFECTS *
1. tendinitits, tendon rupture 2. peripheral neuropathy 3. myasthenia gravis worse 4. rare CNS probs * * cant reverse adverse effects and reactions**
46
Vancomycin given clinically when
1. MRSA + MRSE + pts allergic to penicillin 2. C. Difficile colitis if NOT responsive to metronidazole 3. Endocarditis 4. S. aureus 5. B-lactam resistant staph
47
Vancomycin risk
Red Man Syndrome = if infused too fast
48
C. Diff TX
1. Metronidazole | 2. Vancomycin if needed
49
Linezolid MOA and effects
1. X protein translation | 2. GRAM +, vancomycin resistant enterococci, MRSA
50
Linezolid clinical use
1. VRE 2. CAP from S. pneumonia, S. aureus 3. MRSA (gram +) (oral + IV)
51
Aztreonam MOA and effects
1. X peptidoglycan making | 2. GRAM - (including Pseudomonas)
52
Aztreonam clinical use
GRAM - and pseudomonas | IM or IV
53
Aztreonam side effects
anaphylactic + hypersensitivity reaction + superinfection
54
Imipenem MOA and effects
1. X wall 2. GRAM - GRAM + wide for multiresistant
55
Imipenem clinical use
LRI, bacterial sepsis (multiresistant gram - , gram +)
56
Gentamicin clinical use
1. Resp infection (GRAM - including Pseudomoas, klebsiella AND GRAM+ Staph aureus) 2. sepsis
57
Gentamicin side effects
nephrotoxicity *(reversible) Neurotoxic + ototoxicity * superinfection / hypersensititvity
58
clindamycin clinical use and risk
``` aspirational pneumonia (not anymore) = C. Diff ```
59
what tx for aspirational pneumonia
1. Ampicillin - sulbactam | 2. amoxicillin - clavulanate
60
most ABs resistant bacteria
``` ESKAPE E : Enterobacter S : Staph aureus K : Klebsiella A : Acinetobacter Baumannii P : Pseudomonas E : E. Coli ```
61
Left valve endocarditis : S. Aureus TX
1. Nafcillin or oxacillin or Cefazolin | 2. methicillin resistant : Vanco
62
Left valve endocarditis : S. Viridans, S. Bovis TX
1. Penicillin G (ampicillin, ceftriaxone, or vanco if needed)
63
Left valve endocarditis : enterococcal strain TX
1. Penecillin G, ampicillin, | 2. Gentamicin (or vanco, ceftriaxone)
64
Left valve endocarditis : enteroccoci with B-lactam strains TX
1. Ampicillin - Sulbactam | or Vanco + gantamicin
65
Left valve endocarditis : enterococcal resistant to penicillin, vanco, aminoglycosides TX
1. Linezolid OR 2. Daptomycin
66
Left valve endocarditis : HACEK bacteria TX
1. Ceftriaxone or ampicillin, or ciprofloxacin
67
Right valve endocarditis : TX
nafcillin oxacillin (if uncomplicated)
68
Amphotericin B clinical use and side effects
1. invasive severe fungal infections | 2. GI probs, kidney, cns, electrolyte probs
69
Fluconazole MOA and clinical use + side effect
1. X lanosterol --> ergosterol 2. anti-fungal great when YEAST (candida*) 3. hepatic toxic
70
Voriconazole MOA and effects what organism
1. X lanosterol --> ergosterol | 2. Aspergillus
71
Voriconazole clinical use
1. invasive aspergillus | 2. fluconazole resistant candida
72
Voriconazole side effects
hepatotoxic | visual changes and hallucinations
73
Itraconazole effects what organisms
1. aspergillus | 2. sporothrix schenckii
74
Itraconazole clinical use
aspergillus blastomycosis histoplasmosis Sporothrix CANT take Amphotericin B
75
Itraconazole side effects
worsening HF | hepatotoxic
76
caspofungin, micafungin, anidulafungin MOA and clinical use
1. inhibit beta-D -glucan | 2. invasive candida or resistant to fluconazole
77
flucytosine clinical use and side effects
1. meningitis, crypto, candida, endocarditits, pylo | 2. extreme monitoring needed in renal impairment * + hepatic status
78
endocarditis native valve : candida Tx primary
1. amphotericin B + flucytosine 2. high does -fungins (IV) (later go to fluconazole)
79
endocarditis prosthetic valve : candida Tx primary
1. amphotericin B + flucytosine 2. high does -fungins (IV) (later go to fluconazole)
80
thrombophlebitits : candida Tx primary
1. amphotericin B + flucytosine 2. high does -fungins (IV) (later go to fluconazole)
81
Isoniazid clinical use and side effects
1. active or latent TB | 2. hepatits (can happen months later), peripheral neuropathy --> give pyroxidine daily
82
Rifampin (Rifampicin) Clinical use
latent or active TB
83
pyrazinamide clinical use
TB during pregnancy | or TB + other TB drugs
84
Ethambutol clinical use
TB with other TB drugs (Pulmonary TB)

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