TEST 1: midterm Flashcards
What is one function of COX 1?
Protect stomach mucosa from stomach acid
What is the main function of COX 2?
Inflammation
Are NSAIDs selective or non-selective? (To what?)
non-selective
inhibiting both COX 1+2
What is the function of prostaglandins?
Regulation of inflammation
What happens if you decrease the synthesis of prostaglandins?
an anti-inflammatory effect occurs
What is the source of pain for uterine contractions?
Prostaglandins
What does ADME stand for?
Absorption
Distribution
Metabolism
Excretion
What organ is associated with excretion? Metabolism?
Excretion - Kidney
Metabolism - liver
What is the role of an agonist?
To mimic the antibody and activate the receptor
- sometime permanent
What is a competitive antagonist?
Blocks the receptor site
What is a non-competitive antagonist?
Binds to its own receptor site and deactivates R
- even with agonist binding, will not work
What is a chemical antagonist?
Binds to the agonist to not allow it to be able to bind to binding site
What is anaphylactic shock?
Extreme allergic rxns
Evidence of alterations within the body as perceived by the patient are called:
Symptoms
Clear evidence of alteration to the body that can be perceived by others, doctors, etc:
Signs
What is the term for diseases caused by medical treatment?
Iatrogenic
Which type of bacteria have THICK cell walls?
Gram POSITIVE bacteria
Why are gram negative bacteria harder to treat with antibiotics?
They have a second cell membrane
What is bioavailability? Which route of administration have 100% bioavailability?
- the fraction of drug that reaches circulation unchanged
- Intravenous (IV)
What are the 3 semisynthetic PCNs?
Methicillin
Oxacillin
Nafcillin
Which type of penicillin cannot be taken orally?
Penicillin G
Why doesn’t penicillin attack our human cells?
Because they do not have cell walls, and penicillin attacks selectively cell walls which are located only on the bacteria
What are the 4 antibiotics that inhibit the synthesis of the cell wall?
- penicillins
- vancomycins
- cepholasporins
- bactrams
Can B-lactamase inhibitors be used alone? What must you combine them with?
- no
- antimicrobials
What are the narrow spectrum penicillins?
Penicillin G and Penicillin V
Name the 2 aminopenicillins.
- ampicillin
- amoxicillin
Name the 2 first generation cephalosporins.
Cefazolin
Cephlexin
What cephalosporin has a severe effect with alcohol?
Second generation CEFOTETAN
Which generation cephalosporins are NOT effective against anaerobic bacteria?
1st, 3rd, 4th
Which generation of cephalosporin is effective against pneumococcus?
3rd
Which generations of cephalosporins are effective against pseudomonas?
3rd, 4th, 5th
What kind of infections are 1st, 2nd, and 3rd generation cephalosporins treat?
1st: skin
2nd: abdominal
3rd: lung
What would you give to someone who has acquired HCAP and why?
vancomycin + pip/tazo
- treating for MRSA and pseudomonas because they are in the hospital setting
What is the suffix used for cephalosporins class MACROLIDES?
-omycin
Macrolides cannot be administered with what, why?
Fruit juices
- acidity decreases the activity of these drugs
What cephalosporin has an adverse effect of hearing loss?
Macrolides
What is the suffix for tetracyclines?
-cycline
What is the 1/2 life of tertracyclines, macrolides?
T: short
M: long
What are the 6 classes of cephalosporins?
- macrolides
- tetracyclines
- clindamycin
- aminoglycosides
- nitrofurantoin
- fluoroquinolones
State the characteristics of macrolides.
BACTERIOSTATIC
- inhibits protein synthesis
Which one of the macrolides has Gram- activity?
Clarithromycin
What kind of macrolide would you use for strep or staph?
Erythromycin
State the characteristics of tetracyclines.
BACTERIOSTATIC
- inhibits protein synthesis
- works on most gram+ and common gram-
- POOR activity with pseudomonas and c. diff.
- binds to calcium
What is the purpose of inflammation?
to protect and minimize injury
What are the 3 goals of inflammation?
- increase blood flow to site
- increase healing cells at site
- prepare for tissue repair
Tissue damage causes release of _____ factors that trigger a local increase in ____ and _____.
chemotaxis
blood flow
permeability
The term for crossing the intact vessel wall.
Diapedesis
What enzyme is responsible for the conversion of the phospholipid membrane into arachidonic acid?
- phospholipase A
What are 3 harmful effects of inhibiting COX 1?
- stomach problems, ulcers
- GI bleeding, bleeding out
- renal impairment
Which COX can help protect against colon cancer?
COX 2
Which spoken about drug is NOT an NSAID?
acetaminophen
Name an NSAID with selective COX 2 inhibitors. What would this do to the body?
Celecoxib
- reduce inflammation, pain, fever
- promote blood clotting
- protect against colon cancer
Name 2 NSAIDs that are non selective and inhibit both COX 1 and COX 2. What effect do they have on the body?
Aspirin, ibuprofen, naproxen, ketorolac
- inhibit production of gastric mucus (ulcers)
- reduce inflammation, pain and fever
- risk of GI bleeding
- renal impairment
What does antipyretic and salicylate mean?
antipyretic: To reduce fever
salicyclate: inhibit platelet aggregation (thinning blood)
Why must a child never be given aspirin?
Linked with Reye’s syndrome
What is Reye’s syndrome?
Swelling of the liver and brain
- diarrhea
- vomiting
- seizures
- irritable behaviour
- lethargic (sluggish)
- rapid breathing
Does acetaminophen suppress platelet aggregation?
no
Does acetaminophen decrease renal blood flow or cause impairment?
No
Overdose of acetaminophen can cause severe ____ injury
Liver
What is Steven Johnson’s syndrome?
Blotchy red rashes
What are 2 levels that, if they are high, there is always inflammation?
ESR and CRP
What has a greater anti-inflammatory effect than NSAIDs?
Glucocorticoids
What are long term adverse effects of Glucocorticoids? (8)
- glucose intolerance
- osteoporosis
- myopathy
- adrenal insufficiency
- electrolyte imbalance
- cataracts/glaucoma
- risk of ulceration with use of NSAIDs
- cushing’s syndrome
During long term therapy, the ant. pit. gland loses ability to manufacture _____, then the adrenal glands atrophy then lose ability to synthesize ____ and other glucocorticoids.
- ACTH
- Cortisol
What are characteristics of clindamycin class cephalopsporins?
BACTERIOSTATIC
- does not cover C. Diff
- hepatic and renal elimination (caution in those with impairment in both)
Clindamycin class cephalosporins are good for treating: (3)
- necrotizing pneumonia
- diabetic feet
- necrotizing fascitis
What is the most common adverse effect of clindamycin?
Diarrhea
What are characteristics of aminoglycoside class cephalosporin?
BACTERICIDAL
- inhibits protein synthesis
- only available as IV, cannot be absorbed though GI tract
- pseudomonas
- INACTIVE against most gram +
- poor tissue penetration
- excellent urine penetration
What are characteristics of fluoroquinolone class cephalosporin?
BACTERICIDAL
- drug interactions with caffeine, warfarin, etc.
Is vancomycin a beta lactam?
No
Broad spectrum antibiotics act against a _____ group of bacteria.
Large
Narrow spectrum antibiotics act against a _____ group of bacteria.
Limited/smaller
What is a disease that is type 4 hypersensitivity?
Multiple sclerosis
What is a disease that is type 3 hypersensitivity?
Rheumatoid arthritis
What is the first response immunoglobulin?
IgM
The most common immunoglobulin that can cross the placenta?
IgG
What are all of the immunoglobulins?
IgM IgG IgA IgD IgE
Which immunoglobulin can be be secreted in the mucus and breast milk?
IgG
Which immunoglobulin is involved in B cell activation?
IgD
Which immunoglobulin is involved in allergies and histamine reactions?
IgE
What is the first exposure to an allergen called?
Sensitization
What do H1 receptors do when activated?
bronchi and smooth muscle contraction
