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

Pharmacology For Cardiopulmonary Infections - Dr. Wolff Flashcards

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
Q

cephalosporins for MRSA + gram +

A

cefepime

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26
Q

ceftriaxone + ceftazidime MOA and clinical use

A
  1. X cell wall

2. CAP + many other infections in body + P. Aeruginosa

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27
Q

ceftriaxone + ceftazidime administration and side effects

A
  1. IV

2. B- lactam allergy + superinfection

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28
Q

Cefpodoxime + Cefditoren MOA and clinical use

A
  1. X cell wall

2. CAP, UTI, COPD + many other infections

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29
Q

Cefpodoxime + Cefditoren administration and side effects

A

orally

B- lactam allergy + superinfection

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30
Q

tetracyclines attack what (clinical use)

A

CAP (H. influenza, Klebsiella spp., Mycoplasma pneumoniae)
+ S. pneumonia
+ S. spp.

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31
Q

tetracyclines contraindication and name of drug

A

DOXYCYCLINE

= in children to prevent permanent teeth staining

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32
Q

Doxycycline clinical use

A

tetracycline
= CAP (H. influenza, Klebsiella spp., Mycoplasma pneumoniae)
+ S. pneumonia
+ S. spp.

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33
Q

Doxycycline Side effects

A

high BUN, intracranial htn, superinfection, lower bone growth, esophageal ulcer, photosensitive, skin hyperpigmentation

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34
Q

Macrolides 3

A
  1. erythromycin
  2. clarithromycin
  3. azithromycin
35
Q

Macrolides effective against what

A

gram +

only haemophilus + Neisseria, pasteurella gram -

36
Q

macrolides are good for who

A

pts with penicillin allergies

37
Q

erythromycin side effects and pharm

A
  1. GI problems

2. CYP3A4 inhibitor MAJOR

38
Q

erythromycin clinical use

A
  1. S. pyogens
  2. S. pneumonia
  3. S. Aureus
  4. Mycoplasma pneumonia
  5. Legionella pneumonia
  6. diphtheria, pertussis
  7. acne, gastroparesis, copd, endoscopy
39
Q

Clarithrocycin clinical use

A

same as erythromycin only low GI probs

+ same pharm

40
Q

azithromycin clinical use

A
  1. CAP (chlamydophilia, H. influenzae, Legionella, M. catarrhalis, Mycoplasma pneumoniae)
41
Q

azithromycin pharm

A

NO inhibition of CYP450

42
Q

Respiratory fluoroquinolones 4 and effectiveness

A
  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
Q

Respiratory fluoroquinolones risk in elderly

A

achille tendon rupture

44
Q

Levofloxacin clinical use

A
  1. CAP (Multidrug resist. S. pneumonia, nosocomial pneumonia, copd, acute exacerbation or acute bacteria)
45
Q

Respiratory fluoroquinolones SIDE EFFECTS *

A
  1. tendinitits, tendon rupture
  2. peripheral neuropathy
  3. myasthenia gravis worse
  4. rare CNS probs
    * * cant reverse adverse effects and reactions**
46
Q

Vancomycin given clinically when

A
  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
Q

Vancomycin risk

A

Red Man Syndrome = if infused too fast

48
Q

C. Diff TX

A
  1. Metronidazole

2. Vancomycin if needed

49
Q

Linezolid MOA and effects

A
  1. X protein translation

2. GRAM +, vancomycin resistant enterococci, MRSA

50
Q

Linezolid clinical use

A
  1. VRE
  2. CAP from S. pneumonia, S. aureus
  3. MRSA
    (gram +)
    (oral + IV)
51
Q

Aztreonam MOA and effects

A
  1. X peptidoglycan making

2. GRAM - (including Pseudomonas)

52
Q

Aztreonam clinical use

A

GRAM - and pseudomonas

IM or IV

53
Q

Aztreonam side effects

A

anaphylactic + hypersensitivity reaction + superinfection

54
Q

Imipenem MOA and effects

A
  1. X wall
  2. GRAM - GRAM + wide
    for multiresistant
55
Q

Imipenem clinical use

A

LRI, bacterial sepsis (multiresistant gram - , gram +)

56
Q

Gentamicin clinical use

A
  1. Resp infection
    (GRAM - including Pseudomoas, klebsiella AND GRAM+ Staph aureus)
  2. sepsis
57
Q

Gentamicin side effects

A

nephrotoxicity *(reversible)
Neurotoxic + ototoxicity *
superinfection / hypersensititvity

58
Q

clindamycin clinical use and risk

A 
aspirational pneumonia (not anymore)
= C. Diff
59
Q

what tx for aspirational pneumonia

A
  1. Ampicillin - sulbactam

2. amoxicillin - clavulanate

60
Q

most ABs resistant bacteria

A 
ESKAPE 
E : Enterobacter 
S : Staph aureus
K : Klebsiella
A : Acinetobacter Baumannii
P : Pseudomonas
E : E. Coli
61
Q

Left valve endocarditis : S. Aureus TX

A
  1. Nafcillin or oxacillin or Cefazolin

2. methicillin resistant : Vanco

62
Q

Left valve endocarditis : S. Viridans, S. Bovis TX

A
  1. Penicillin G (ampicillin, ceftriaxone, or vanco if needed)
63
Q

Left valve endocarditis : enterococcal strain TX

A
  1. Penecillin G, ampicillin,

2. Gentamicin (or vanco, ceftriaxone)

64
Q

Left valve endocarditis : enteroccoci with B-lactam strains TX

A
  1. Ampicillin - Sulbactam

or Vanco + gantamicin

65
Q

Left valve endocarditis : enterococcal resistant to penicillin, vanco, aminoglycosides TX

A
  1. Linezolid
    OR
  2. Daptomycin
66
Q

Left valve endocarditis : HACEK bacteria TX

A
  1. Ceftriaxone or ampicillin, or ciprofloxacin
67
Q

Right valve endocarditis : TX

A

nafcillin
oxacillin
(if uncomplicated)

68
Q

Amphotericin B clinical use and side effects

A
  1. invasive severe fungal infections

2. GI probs, kidney, cns, electrolyte probs

69
Q

Fluconazole MOA and clinical use + side effect

A
  1. X lanosterol –> ergosterol
  2. anti-fungal great when YEAST (candida*)
  3. hepatic toxic
70
Q

Voriconazole MOA and effects what organism

A
  1. X lanosterol –> ergosterol

2. Aspergillus

71
Q

Voriconazole clinical use

A
  1. invasive aspergillus

2. fluconazole resistant candida

72
Q

Voriconazole side effects

A

hepatotoxic

visual changes and hallucinations

73
Q

Itraconazole effects what organisms

A
  1. aspergillus

2. sporothrix schenckii

74
Q

Itraconazole clinical use

A

aspergillus
blastomycosis
histoplasmosis
Sporothrix

CANT take Amphotericin B

75
Q

Itraconazole side effects

A

worsening HF

hepatotoxic

76
Q

caspofungin, micafungin, anidulafungin MOA and clinical use

A
  1. inhibit beta-D -glucan

2. invasive candida or resistant to fluconazole

77
Q

flucytosine clinical use and side effects

A
  1. meningitis, crypto, candida, endocarditits, pylo

2. extreme monitoring needed in renal impairment * + hepatic status

78
Q

endocarditis native valve : candida Tx primary

A
  1. amphotericin B + flucytosine
  2. high does -fungins (IV)
    (later go to fluconazole)
79
Q

endocarditis prosthetic valve : candida Tx primary

A
  1. amphotericin B + flucytosine
  2. high does -fungins (IV)
    (later go to fluconazole)
80
Q

thrombophlebitits : candida Tx primary

A
  1. amphotericin B + flucytosine
  2. high does -fungins (IV)
    (later go to fluconazole)
81
Q

Isoniazid clinical use and side effects

A
  1. active or latent TB

2. hepatits (can happen months later), peripheral neuropathy –> give pyroxidine daily

82
Q

Rifampin (Rifampicin) Clinical use

A

latent or active TB

83
Q

pyrazinamide clinical use

A

TB during pregnancy

or TB + other TB drugs

84
Q

Ethambutol clinical use

A

TB with other TB drugs (Pulmonary TB)

CPR 2 Exam 2 (12 decks)

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