Pharmocology Flashcards

1
Q

Well absorb drugs (oral)

A

Anti-folate
FQ
Nitrofurantoin
Metronidazole

Tetracycline
Lincosamide
Linezolid

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2
Q

Poor absorption oral

A

Carbapenams
Monobactam
Glycopeptide

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3
Q

Not absorb orally

A

Daptomycin
Polymyxin
Aminoglycoside

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4
Q

Penicillin oral absorption

A

Penicillin V 60%
Amoxicillin 75%
Cloxacillin 50%

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5
Q

Cephalosporin oral absorption

A

Cephalexin 90%

Cefuroxime 52%

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6
Q

Tetracycline and doxycycline oral absorption

A

Tetra 60-80%

Doxy 90-100%

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7
Q

Macrolide oral absorption

A

Azithromycin 40%
Clarithromyxin 50%
Erythromycin 15-45%

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8
Q

Good CSF penetration

A

Gen 3&4 cephalosporins and cefuroxime

Meropenem
Imipenem

Anti-folate
Metronidazole

FQ(m>I>c)

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9
Q

Abscess distribution

A

Glycopeptide

Lincosamide

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10
Q

Bile distribution

A

Tetracycline

Lincosamide

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11
Q

Metabolism liver

A
Tetracycline 
Tigecycline (minimal)
Macrolide 
Lincosamide 
Linezolid (not cyp 450) 
Anti folate 
Macrolide (partly; inhibit liver also) 
Metronidazole
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12
Q

Not metabolize in liver

A
Penicillin 
Cephalosporin 
Carbapenams 
Monobactam 
Glycopeptide
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13
Q

Excrete in kidney

A
Penicillin
anti staphy (bile and renal)
Cephalosporin (except ceftriaxone) 

Carbapenans
Monobactam
Glycopeptide
Daptomycin

Polymyxin(?)
Aminoglycoside 
Tetracycline (and bile) 
Tigercycline (mainly bile) 
Macrolide (4-30%) 
Lincosamide (and bile)
Linezolid (and non renal) 

Anti folate
Nitrofurantoin
Metronidazole

FQ (except mo and nalidixic )

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14
Q

Excreted in bile

A

Nafcillin
Antistaph

Ceftriaxone
Tetracycline
Tigecycline
Lincosamide

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15
Q

Time dependent killings

A
Penicillin (40-50%)
Cephalosporin (40-50%)
Carbapenams (40-50%) 
Monobactam (50-60%) 
Glycopeptide
Tetracycline 
Lincosamide 
Linezolid
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16
Q

Concentration killing

A
Daptomycin 
Polymyxin 
Aminoglycoside 
FQ
Metronidazole
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17
Q

Daptomycin should not be use to treat

A

Pneumonia

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18
Q

Vancomycin is not as effective as _______________ for treatment of serious infections such as endocarditis caused by MSS strain.

A

Anti staphylococcus penicillin

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19
Q

MSSA choices of drugs

A

1st
Nafcillin

2nd
Cefazolin (1gen)
Vancomycin (if allergic to pcn)

Oral
Dicloxacillin
Cephalexin (1gen)
FQ

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20
Q

CONS DOC

A

Nafcillin
Vancomycin

Daptomycin
Carbapenams

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21
Q

Strep grp a / b DOC

A

Pcn g + clindamycin

Any BL
Vancomycin (pcn allergy)

Clindamycin
Amoxicillin
Tmp/smx

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22
Q

Viridans strep doc

A

Pcn g

Ceftriaxone
Vancomycin
Amoxicillin

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23
Q

Faecalis doc

A

Ampicillin

Pcn g
vancomycin

Amoxicillin

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24
Q

Pseudomonal aeruginosa is resistant to

A

Tetracycline inc tigecycline
And
Sulfonamide

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25
Q

Static or cidal

Beta lactam 
AG
Tetracycline 
Macrolide 
Linezolid
A

Cidal
Cidal
Cidal at high conc
Static but cidal against streptococci

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26
Q

Macrolide activity is enhanced at

A

Alkaline ph

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27
Q

Sulphonamide may ppt in Urine esp at _______ producing crystalluria, hematuria or even obstruction

A

Neutral or acid pH

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28
Q

Sulphonamide
Trimethoprim

Co trimoxazole

Cidal or static

A

Static
Static

Cidal

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29
Q

Co-trimoxazole ratio

A

Trimethoprim :

Sulfamethoxazole 1:5

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30
Q

FQ cidal or static

A

Cidal (broad spectrum)

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31
Q

FQ block DNA synthesis by _______

A

Inhibiting bacterial. Topoisomerase II (DNA gyrase)

And topoisomerase IV.

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32
Q

Nitrofurantoin is cidal or static

A

Cidal at right dose

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33
Q

Nitrofurantoin antagonizes action of ____

A

Nalidixic acid

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34
Q

It is desirable to keep urine ph __________ when using nitrofurantoin to treat Chronic UTI

A

Below 5.5

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35
Q

Metronidazole Moa

A

Non enzymatically reduced by reacting with reduced ferrodoxin.

This result in production of toxic product.

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36
Q

Fosfomyxin MOA

A

An analogue of phosphoenolopyruvate.
It inhibits the cytoplasmic enzyme enolpyruvate transferase by covalently binding to the cysteine residue of the active site and blocking the addition of phosphoenolpyruvate to UDP-N-acetylglucosamine.

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37
Q

Uptake of fosfomycin require

___

A

Glycerophosphate or glucose 6 phosphate transport system.

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38
Q

Protein binding penicillin

A

Penicillin 80%
Amoxicillin 25%
Cloxacillin 95%

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39
Q

Protein binding cephalosporins

A

Cefepime 20%

Ceftriaxone 90%

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40
Q

Protein binding carbapenams

A

Meropenem 2%

Ertapenam 95%

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41
Q

Monobactam protein binding

A

56%

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42
Q

Vancomycin
Teicoplanin
Protein binding

A

Vanco 30-55%

Teicoplanin 90%

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43
Q

Daptomycin protein binding

A

90%

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44
Q

Polymyxin protein binding

A

80-90%

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45
Q

Aminoglycoside protein binding

A

10%

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46
Q

Tetracycline BP

A

T: 20-67%
D: 82-93%

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47
Q

Tigecycline BP

A

79-81%

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48
Q

Macrolide BP

A

A 7-50%
C 65%
E 70%

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49
Q

Lincosamide BP

A

85-94%

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50
Q

Linezolid BP

A

13%

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51
Q

SMZ binding protein

A

70%

52
Q

TMP BP

A

44-62%

53
Q

FQ BP

A

Low 30-50%

54
Q

Metronidazole BP

A

<20%

55
Q

Penicillin half life

A

30-90min short

56
Q

Cephalosporin half life

A

1-2hr

Ceftriaxone 8hr

57
Q

Carbapenams half life

A

1hr

Ertapenem 4hr

58
Q

Monobactam half life

A

2hr

59
Q

Vancomycin half life

A

4-12hr

60
Q

Teicoplanin half life

A

83-168hr

61
Q

Daptomycin half life

A

7-9hr

62
Q

Polymyxin Bhalf life

A

4-6hr

63
Q

AG halflife

A

1.5 -3.5hr

64
Q

Tetracycline half life

A

6-12hr

65
Q

Doxycycline halflife

A

15-48hr

66
Q

Tigecycline halflife

A

24-42hr

67
Q

Macrolide half life

A

A: 68hr
C: 5-7hr
E: 2-4hr

68
Q

Lincosamide halflife

A

2.5hr

69
Q

Linezolid half life

A

4-5hr

70
Q

Tmp half life

A

11hr

71
Q

SMZ halflife

A

9hr

72
Q

FQ half life

A

M: 9.5hr
L: 6-8hr
C: 4hr

73
Q

Nitrofurantoin halflife

A

0.3-1hr

74
Q

Metronidazole half life

A

6-14hr

75
Q

MRSQ doc

A
Vancomycin 
Teicoplanin 
Linezolid 
TMP/SMZ
Clindamycin 
Doxycycline 
Rifampin
76
Q

Cefazoline

A

1st gen cephalosporins

77
Q

Cefadroxil

A

1st

78
Q

Cephalexin

A

1st

79
Q

Cephalothin

A

1st

80
Q

Cephapirin

A

1st

81
Q

Cephradine

A

1st

82
Q

Cefazoline ROA

A

Parenteral

83
Q

Cefaclor

A

2nd

84
Q

Cefamandole

A

2nd

85
Q

Cefonicid

A

2nd

86
Q

Cefuroxime

A

2nd

87
Q

Cefprozil

A

2nd

88
Q

Loracarbef

A

2nd gen cephalosporins

89
Q

Ceforanide

A

2nd

90
Q

Cefoxitin

A

2nd

91
Q

Cephamyxin

A

2nd

92
Q

Cefmetazole

A

2nd

93
Q

Cefotetan

A

2nd

94
Q

Cefoperazone

A

3rd

95
Q

Cefotaxime

A

3rd

96
Q

Ceftazidime

A

3rd

97
Q

Ceftizoxime

A

3rd

98
Q

Ceftriaxone

A

3rd

99
Q

Cefixime

A

3rd

100
Q

Cefpodoxime

A

3rd

101
Q

Cefdinir

A

3rd

102
Q

Cefditoren

A

3rd

103
Q

Ceftibuten

A

3rd

104
Q

Cefepime

A

4th

105
Q

Ceftaroline

A

5

106
Q

Ceftobiprole

A

5th

107
Q

Moxifloxacin

A

4th FQ

108
Q

Levofloxacin

A

3rd FQ

109
Q

Ciprofloxacin

A

2nd FQ

110
Q

Norfloxacin

A

2nd FQ

111
Q

Ofloxacin

A

2nd FQ

112
Q

Nalidixic acid

A

1st FQ

113
Q

Clinical use of daptomycin

A

Complicated skin and soft tissue infections and bacteremia.
Right sided endocarditis.
Less in cap

114
Q

Polymyxin Clincial uses.

A

Infection of skins, mucous membrane, eye, ear.

Salvage therapy for treatment of infection caused by multi drug resistance organism.

115
Q

MOA AG

A

Changes the shape of 30S portion causes code on mRNA to be read incorrectly.

116
Q

MOA tetracycline

A

Interfere with attachment of tRNA to mRNA ribosome complex.

117
Q

50s inhibitors MOA

A

Block peptide bond formation

118
Q

Azithromycin covers

A

Mycobacterial avium

119
Q

Compare macrolide with erythromycin

A

Azithromycin is 2-4fold less active against streptococcus and staphylococcus than erythromycin

Clarithromycin is 2-4 fold more active against streptococcus and staphylococcus than erythromycin

120
Q

Oxazolidione MOA

A

Inhibits protein synthesis by binding to 50S ribosomal subunit near to surface interface of 23S ribosomal RNA

121
Q

Sfx and TMP MOA

A

Sulfonamide susceptible organism unlike mammals cannot use exogenous folate but must synthesize it from PABA.

This pathway is essential for production of purines and NA synthesis.

As structural analog of PABA, sulphonamide inhibits
Dihydropteroate synthase and folate production.

Trimethoprim inhibit dihydrofolate reductasd.

122
Q

PABA

A

P aminobenzoic acid.

123
Q

Antifolate cidal or static

A

Static

Unless together then is cidal

124
Q

Nitrofurantoin cidal or static

A

Static

125
Q

FQ static or cidal

A

Cidal

126
Q

Fosfomycin MOA

A

Inhibits enolpyruvate transferases by covalently binding to the cysteine residue of the active site.

Blocking the addition of phosphoenoloyruvate to UDP-N-acetylglucosamine

127
Q

Metronidazole MOA

A

Enzyme nitroreductase
Reduces the nitro group in metronidazole to cytotoxic metabolite which bind to DNA to cause strand breakage and loss of helical structure
This interfering with nucleic synthesis

Aerobic microbes do not have the enzyme to activate this drug