PharmII_Exam 1 Flashcards by Caleb Saint

What are the four drug classes of beta lactam?

PCN
Cephalosporins
Carbapenems
Monobactams

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What is the name of the beta lactamase that is equivalent for cephalosporins?

Cephalosporinase

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Name the three drugs under the category of Macrolides?

Erythromycin
Azithromycin
Clarithromycin

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T/F?

Aminoglycosides are protein synthesis inhibitors?

True

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T/F?

Fluoroquinolones are bacteriostatic in action?

False.

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What’s the diff b/w first line Tb drugs and second line Tb drugs?

Second line agents:
Less effective
Several Adverse Effects

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Is INH bacteriostatic or bacteriocidal?

Bacteriostatic

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T/F?

Ethambutol is able to penetrate many cell layers in the human body?

True

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In what kinds of cells do Tb hide in?

Macrophage cells.

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Can you use mebendazole in prego chicks?

NOPE, it is a contraindication.

Mebendazole is detoxified in the liver.

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What enzyme is PCN G susceptible to?

Beta lactamases.

They are unstable at acidic pH and gastric invronment inactivates PCN G and only 30% absorbed from the duodenum

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For which organism is Vancomycin used for?

Clostridium dificile.
Red man or redneck syndrome
Rescue drug

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What is the name of a tetracycline that enters brain in absence of inflammation?

Minocycline.

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What is the name of a tetracycline that can be used with renal infections?

Doxycycline

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What is the name of a tetracycline that inhibits ADH and is used for SIADH?

Demeclocycline

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Sulfonamides and trimethoprim act as what?

Antimetabolites

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How does bacteria synthesize folic acid?

Through the utilization of PABA!

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Name the three folate reduction inhibitors?

Pyrimethamine
Trimethoprim
Proguanil

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Is the combo of sulfonamide and trimethoprim bactericidal or bacteriostatic?

Bactericidal

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Resistance to sulfonamides?

1)Cause overproduction of PABA (substrate)
2) Cause production of a folic acid-synthesizing enzyme that has low affinity for
sulfonamides
3) Impair permeability to the sulfonamide

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Pharmacokinetics of sulfonamides?

1) Oral absorbable –> further classified as short, intermediate or long acting
2) Oral nonabsorable
3) Topical
4) Parenteral

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What are some adverse effects of Sulfonamides?

Nausea, vomitting, diarrhea.
G6PDH deficient patients may develop acute hemolytic anemia
Crystalluria and Hematuria

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What is Mafenide good for?

Prevention of colonization of burns.

It is a sulfonamide

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What is an adverse effect of Oral Trimethoprim?

hematological disorders that can be ameliorated with

supplementary folinic acid (leucovorin)

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What is proguanil good for?

Malaria. -Used in combination with atovaquone (Malarone) in prevention and treating malaria (#1 for tx malaria)

Use of IV Trimethoprim-Sulfamethoxazole

Used in mgt of severe pneumocystitis carinii pneumonia, in AIDS pts -Also useful in gram neg bacterial sepsis— enterobacter and serratia -Shinellosis, typhoid fever, or UTI when pt is unable to take the drug by mouth

Use of oral Oral Trimethoprim-Sulfamethoxazol (TMP-SMZ)

second line drug for typhoid fever and mgt of carriers of these strains

MOA of Fluoroquinolones?

-Block bacterial DNA synthesis by inhibiting bacterial topoisomerase II (DNA gyrase) and topoisomerase IV

Is fluoroquinolones bactericidal or static?

bactericidal

T/F? | Fluoroquinolones have good oral bioavailability?

True

Which generation of fluoroquinolones are anaerobic bacteria not immune to?

3rd & 4th gen

Which type of organisms are fluoroquinolones effective against?

Effective against gram neg organisms (pseudomonas, h. flu, moraxella catarrhalis, legionella, brucella, myoplasma, Chlamydia and mycobacteria

Can you use fluoroquinolones in prego chicks?

NO. This is a major contraindication. Can't use in children either

What would ciprofloxacin do in children?https://www.brainscape.com/decks/1813639/cards/quick_new_card

Cause cartilage erosin (inhibits growth)—rarely used below 18 yo

What does 2nd and 3rd gen Fluoroquinolones do to the heart?

cause QT prolongation

Which two fluoroquinolones is best used for UTI

Cipro | Levo

List some horrible toxic symptoms associated with Fluoroquinolones?

arthralgia, joint swelling, tenonditis and tendon | rupture have been reported with use

What does methenamine produce?

Formaldehyde. | This will kill anything. Can go blind.

What contributes to mycobacterium acid-fastness?

Mycolic acid. | Long chain fatty acid

What does MDR tuberculosis stand for?

Multi-drug resistant tuberculosis

What does XDR tuberculosis stand for?

Extensive drug resistance.

How does MDR tuberculosis result?

From misuse of first line agents

How does XDR tuberculosis result?

From misuse of second line agents. Resistant to INH, rifampin plus resistant to any fluoroquinolone and at least one of three injectable second line durgs (amikacin, kanamycin, or capreomycin)

What is XXDR Tb?

resistant to all 1st and 2nd line drugs (basically | everything), making it nearly impossible to tx

Why is Therapy for infxns by m. tub, m. leprae and m. avium intracellulare

due to the limited information about mechanisms, drug resistance, the intracellular location of infxn and the advancement of disease

What is direct observation therapy?

drugs given directly to pts and watching them swallow the medications; preferred core mgt strategy for all pts w/ TB

MOA of INH?

-Inhibits synthesis of mycolic acids, which are essential components of mycobacterial cell walls mediated via oxygen dependent pathways

Is INH bacteriostatic or -cidal

Static. | It is used in prophylaxis of skin test converters

AE of INH?

- Hepatotoxicity | - Nephrotoxicity

Is rifampin bacteriostatic or bacteriocidal?

-Cidal

MOA of rifampin?

Blocks bacterial RNA synthesis by binding to DNA | dependent RNA polymerase in myobacteria (inhibiting RNA synthesis)

Contra-indication for Rifampin?

HIV pts taking protease inhibitors

Which drug turns urine, sputum, saliva, poop, and | body fluids to a red-orange color

Rifampin

Uses for Rifampin?

-TB ! used as prophylactic drug in isoniazid intolerant pts -Leprosy

Uses of Rifapentine?

Considered 1st line therapy in pt taking retroviral drugs but technically 2nd line for tx of TB

CI in ptx's taking Rifapentine?

pts taking protease inhibitors

What does Ethambutol block?

blocks arabino-galactin, a | component of mycobacterial cell wall

what is AE of Ethambutol?

-Visual disturbances (green blindness), retinal damage (retrobulbar optic neuritis), headache, confusion, peripheral neuritis

How long to use pyrazinamide?

6 months in combo therapy for Tb. | Highly toxic

What is Rifamate?

Rifampin + Isoniazid

What is Rifater?

Rifampin INH PZA

Which is the most effective drug used in Hensen's disease?

Dapsone

MOA of dapsone?

Inhibit folate synthesis (like sulfonamides)

Uses of dapsones?

-Mycobacterium leprae -Used to prevent and tx pneumocytisis jiroveci pneumonia in AIDS pts

Name the two sulfone drugs?

Acedapsone | Dapsone

Name the three drugs used for M. Leprae?

Dapsone Acedapsone Clofazimine

What does M. Avium cause?

causes disseminated infections in AIDS pts— | antimycobacterial agents along with another antibiotics are used

Name the two anti-fungals that contain polyene structures?

Amphotericin B | Nystatin