PharmII_Exam 1 Flashcards
What are the four drug classes of beta lactam?
PCN
Cephalosporins
Carbapenems
Monobactams
What is the name of the beta lactamase that is equivalent for cephalosporins?
Cephalosporinase
Name the three drugs under the category of Macrolides?
Erythromycin
Azithromycin
Clarithromycin
T/F?
Aminoglycosides are protein synthesis inhibitors?
True
T/F?
Fluoroquinolones are bacteriostatic in action?
False.
What’s the diff b/w first line Tb drugs and second line Tb drugs?
Second line agents:
Less effective
Several Adverse Effects
Is INH bacteriostatic or bacteriocidal?
Bacteriostatic
T/F?
Ethambutol is able to penetrate many cell layers in the human body?
True
In what kinds of cells do Tb hide in?
Macrophage cells.
Can you use mebendazole in prego chicks?
NOPE, it is a contraindication.
Mebendazole is detoxified in the liver.
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
For which organism is Vancomycin used for?
Clostridium dificile.
Red man or redneck syndrome
Rescue drug
What is the name of a tetracycline that enters brain in absence of inflammation?
Minocycline.
What is the name of a tetracycline that can be used with renal infections?
Doxycycline
What is the name of a tetracycline that inhibits ADH and is used for SIADH?
Demeclocycline
Sulfonamides and trimethoprim act as what?
Antimetabolites
How does bacteria synthesize folic acid?
Through the utilization of PABA!
Name the three folate reduction inhibitors?
Pyrimethamine
Trimethoprim
Proguanil
Is the combo of sulfonamide and trimethoprim bactericidal or bacteriostatic?
Bactericidal
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
Pharmacokinetics of sulfonamides?
1) Oral absorbable –> further classified as short, intermediate or long acting
2) Oral nonabsorable
3) Topical
4) Parenteral
What are some adverse effects of Sulfonamides?
Nausea, vomitting, diarrhea.
G6PDH deficient patients may develop acute hemolytic anemia
Crystalluria and Hematuria
What is Mafenide good for?
Prevention of colonization of burns.
It is a sulfonamide
What is an adverse effect of Oral Trimethoprim?
hematological disorders that can be ameliorated with
supplementary folinic acid (leucovorin)
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
