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Adv Pharmacodynamics > Test #2 > Flashcards

Test #2 Flashcards

1
Q

Most common bacteria in the GI GU track

A

E-Coli

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2
Q

What led to drug resistant drugs?

A

The overuse and many times abuse of antibiotics have led to drug resistance bacteria and are leading us to return to a possible day where we are powerless to fight infections

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3
Q

When to choose anti microbial treatment

A

Age
Allergies
Bacteria

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4
Q

What is the recommended dose of folic acid

A

3mg Dose

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5
Q

Ace-inhibitors common side effect

A

Dry cough

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6
Q

Are Most respiratory infections viral?

A

True

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7
Q

Women with UTI - 1st Step

A

C&S

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8
Q

Fluoroquinolones 6 & Black Box

A
  1. Permanent peripheral neuropathy
  2. Tendon ruptures
  3. Tinnitus
  4. Tachycardia, shortness of breath
  5. Rashes, hair loss
  6. Nausea, vomiting, diarrhea

FDA Black Box Warnings: Disabling CNS effects, tendinitis, tendon ruptures, peripheral neuropathy. Exacerbation of myasthenia gravis and severe muscle weakness. **Newest warning and concern that oral fluoroquinolone use is associated with an increased risk of aortic aneurysm or dissection.

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9
Q

Fluoroquinolones

A 
Ciprofloxacin (Cipro)	
Levofloxacin (Levaquin)
Gemifloxacin (Factive)	
Moxifloxacin (Avelox)
Norfloxacin (Noroxin)
Ofloxacin (Floxin)
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10
Q

Abx Best practice

A

Best practice is to confirm the diagnosis of bacterial infections before placing a patient on an antibiotic. Viral infections should NOT be treated with an antibiotic.

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11
Q

Selecting an antibiotic

A
  • Narrowest spectrum
  • Most effective
  • Lowest toxicity
  • Lowest potential for allergy
  • Most cost-effective
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12
Q

Penicillin

A 
Ampicillin, 
Amoxicillin,
Augmentin (Amoxicillin and Clavulanate), 
Dicloxacillin, 
Penicillin V, 
Penicillin G (IM).
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13
Q

Cephalosporins

A 
Cefadroxil, 
Cephalexin (1st generations),
Cefdinir (Omnicef) 
Ceftriaxone 
(Rocephin) (IM) (3rd generation)
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14
Q

Macrolides

A

Azithromycin,
Erythromycin
Clarithromycin.

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15
Q

Abx Inhibitor to 3A4

A

Macrolides
Clindamycin and erythromycin
Heavily metabolized by the liver.

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16
Q

Type I hypersensitivity

A

Immediate or anaphylactic hypersensitivity.
Skin (urticaria and eczema),
Eyes (conjunctivitis)
Nasopharynx (rhinorrhea,rhinitis),
Bronchopulmonary tissues (asthma)
Gastrointestinal tract (gastroenteritis).

Usually takes 15 - 30 minutes from dose 
Delayed onset (10 - 12 hours).

Type 1 reaction to PCN, but in reality it is rare <2%.
**Only ~2% cross reactivity with cephalosporins)

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17
Q

Type II hypersensitivity

A

Cytotoxic hypersensitivity affect a variety of organs.

Drug-induced hemolytic anemia,
Granulocytopenia
Thrombocytopenia

The reaction time is minutes to hours.

18
Q

Type III hypersensitivity

A

Immune complex hypersensitivity

General (e.g. serum sickness, fever, rash, arthralgia)
Skin (e.g., systemic lupus erythematosus, Arthus reaction)
Kidneys (e.g., lupus nephritis)
Lungs (e.g., aspergillosis)
Blood vessels (e.g., polyarteritis)
Joints (e.g., rheumatoid arthritis)

3 - 10 hours after dose
Rule this out in a patient who presents with fever of unknown origin! Look at the drugs the patient is on currently or any newly added drugs to their regimen

19
Q

Type IV hypersensitivity

A

Mediated or delayed type hypersensitivity.

The classical example of this hypersensitivity is tuberculin (Mantoux) reaction (figure 5), which peaks 48 hours after the injection of antigen.

PPD

20
Q

B-lactamase Inhibitors (e.g., Augmentin)

A

(e.g., Augmentin)
An enzyme called beta-lactamase is present in many different types of bacteria, which serves to ‘break’ the beta lactam ring, which effectively nullifies the antibiotic’s effectiveness.

21
Q

PCN allergies with children

A

Use Cephlasporins

```
Cefadroxil
Cephalexin (1st generations
Cefdinir (Omnicef)
Ceftriaxone
Rocephin) (IM) (3rd generation)
~~~

22
Q

Med Cause Prolonged QT

A

Fluoroquinolones?

23
Q

Abx and pregnancy

A

Clindamycin?

Macrolides, Azalides, Ketolides?

24
Q

Common Antihypertensive Drugs in Pregnancy

A

Labetalol.

2nd Choice of HTN (moderate to high) is Methyldopa (Aldomet)and Procardia.

25
Q

COQ10 & Statins

A

Statins drop COQ10 levels .

COQ10 supplement might reduce the risk of muscle-related side effects.

26
Q

Red Yeast Rice

A

Mevinolin, the active ingredient of the drug lovastatin

DO NOT USE IN PREGNANCY ! Same pregnancy risk factor as a statin- X!!!

27
Q

ACE inhibitors

Angiotensin-converting enzyme

A 
Accupril (quinapril)
Aceon (perindopril)
Altace (ramipril)
Capoten (captopril)
Lotensin (benazepril)
Mavik (trandolapril)
Monopril (fosinopril)
Prinivil, Zestril (lisinopril)
28
Q

ARBs

Angiotensin II Receptor Blockers (ARBs)

A 
azilsartan (Edarbi)
candesartan (Atacand)
eprosartan (Teveten)
irbesartan (Avapro)
telmisartan (Micardis)
valsartan (Diovan, Prexxartan)
losartan (Cozaar)
olmesartan (Benicar)
29
Q

Mixing ACEs & ARBs

A

Never Mix Due to risk of Hypercalcemia

30
Q

ACE inhibitors common side effect

A

Dry Cough

31
Q

MOA- PCSK9 Inhibitors

A

Humanmonoclonal antibodies drastically lower LDL cholesterol
alirocumab (Praluent)
evolocumab (Repatha).

SubQ either every 2 weeks or once monthly. $1400.monthy

32
Q

Lipid Lowering Drugs In Pregnancy

A

Statins have a Pregnancy Risk Category of X. This means you should not prescribe statins to a woman of childbearing age

33
Q

Dog Bites

A

Amoxicillin and clavulanate (Augmentin)
P.Multocida

Allergies
Cephalosporins
Cefadroxil, Cephalexin, Cefdinif, Ceftriaxone, & Rocephin (IM)

34
Q

Bile Acid Resins

A

These drugs work extensively in the GUT and do not affect the liver, so they may be a good/better choice for pts with elevated liver disease

35
Q

Sequestrants
Cholestyramine Resin (Questran)
Colesevelam (Welchol)
Colestipol (Colestid).

A

Bile Acid Resins

36
Q

Potent CYP450 inhibitors with Macrolides

A

Diazepam & Calcium channel blockers verampril

37
Q

Off Label Calcium Channel Blockers
Amlodipine (Norvasc)
Nifedipine (Procardia)

A

Raynaud’s disease
Premature labor (nifedipine)
Pediatric Hypertension
Migraine prevention

38
Q 
Off Label Thiazide Diuretics
Chlorothiazide (Diuril)
Chlorthalidone (Hygroton) 
Indapamide (Lozol) 
Hydrochlorothiazide (HCTZ &amp; Hydrodiuril)
A

Osteoporosis in post menopausal women
Lithium Induced Diabetes Insipidus
Calcium nephrolithiasis
Hypertension in children and adolescents (chlorothiazide) comes in an oral suspension)

39
Q

Male Fertility

A

ED with HTN meds

40
Q

Lipid soluble antibiotics

A

Rifampin, a highly fat-soluble drug, rapidly enters the brain

41
Q

Bacterial folic acid synthesis

A

Antimicrobial
Sulfonamides and Trimethoprim (e.g., Bactrim DS)

Bad in early pregnancy

Adv Pharmacodynamics (3 decks)

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