Test 4 Flashcards

Question

canagliflozin

Answer 1

- inhibitor of glucose reabsorption - Inhibit SGLT2 in kidney - UTI's, up urination - DM Type 2

Answer 2

- thyroid hormones - T4 - thyrotoxicosis, cardiovascular stress - hypothyroid

Answer 3

- thyroid hormones - T3 - thyrotoxicosis, cardiovascular stress - hypothyroid

Answer 4

- thyroid hormones - T4, T3 - thyrotoxicosis, cardiovascular stress - hypothyroid

Answer 5

- thioamides/thioureylenes - stops thyroid peroxidase. ALSO inhibits peripheral conversion of T4->T3 - agranulocytosis, LIVER TOX - hyperthyroid (safer during pregnancy)

Answer 6

- thioamides/thioureylenes - stops thyroid peroxidase - agranulocytosis - hyperthyroid

Answer 7

-Other -inhibits synth of T3 & T4. Oral, fast. - -Hyperthyroid (not sole therapy!), prevents uptake of radioactive Iodine

Answer 8

-Other -destroys thyroid - -Hypothyroid (delayed). VERY slow acting (months)

Answer 9

- other - B blocker (nonselective) - heart failure/heart block - Treat cardiovascular symptoms of hyperthyroid

Answer 10

- GH-related - stim IGF-1, antagonizes insulin - carpal tunnel, diabetes, hypothyroid - GH deficiency, chronic renal failure

Answer 11

- GH-related - GHRH analog - headache - GH deficiency, chronic renal failure

Answer 12

-GH-related -IGF receptor agonist - -ONLY syndrome of GH resistance

Answer 13

-GH-related -GH antag doesn't allow dimerization - -For hyper-GH syndromes

Answer 14

- somatostatin agonist - 2 & 5 receptor agonist - gallstones - For hyper-GH syndromes

Answer 15

- D2 agonist - suppresses prolactin - orthostatic hypotension - amenorrhea, infertility, galactorrhea

Answer 16

- D2 agonist - suppresses prolactin - orthostatic hypotension - amenorrhea, infertility, galactorrhea

Answer 17

-Posterior pituitary -stim V2 R's: reabsorb water - -pituitary diabetes insipidus

Answer 18

-Posterior pituitary -stim V1 R's: vasoconstrict. and V2 R's: reabsorb water - -pituitary diabetes insipidus

Answer 19

-Posterior pituitary -modulates transmembrane ion currents in sm muscle - -induce labor

Answer 20

-Vitamin D -Increases Ca absorption and decreases excretion - -Ca deficiency, prostate and breast health

Answer 21

- ergocalciferol | - Same as vit D

Answer 22

- calcitriol | - Same as vit D

Answer 23

-Misc -Low dose daily stimulates blasts - -Osteoporosis

Answer 24

-misc -prevents bone resorption - -hypercalcemia or osteoporosis (nasal spray)

Answer 25

- bisphosphonates - Inhibit geranylgeranyl diphosphate synthase->down bone resorption - esophagitis, osteonecrosis of jaw - hypercalcemia or osteoporosis

Answer 26

- bisphosphonates - Slows dissolution of hydroxyapatite AND Inhibits geranylgeranyl diphosphate synthase->down bone resorption - esophagitis, osteonecrosis of jaw - hypercalcemia or osteoporosis

Answer 27

- bisphosphonates - Inhibit geranylgeranyl diphosphate synthase->down bone resorption - esophagitis, osteonecrosis of jaw - hypercalcemia or osteoporosis

Answer 28

- bisphosphonates - Inhibit geranylgeranyl diphosphate synthase->down bone resorption - esophagitis, osteonecrosis of jaw - hypercalcemia or osteoporosis

Answer 29

- bisphosphonates - Inhibit geranylgeranyl diphosphate synthase->down bone resorption - esophagitis, osteonecrosis of jaw - hypercalcemia or osteoporosis

Answer 30

-RANKL antibody -Adsorbs to RANKL so it can't activate the RANK receptor in osteoclasts->down bone resorption - -osteoporosis

Answer 31

- estrogens - agonist at bone, breast, CV system, endometrium, vaginal epithelium - block resorption of bone, increase HDL/lower LDL, increase risk of stroke/embolism, breast cancer, increase progesterone receptors - too rapidly inactivated, synthetic analogues used instead

Answer 32

- estrogens - agonist at bone, breast, CV system, endometrium, vaginal epithelium - block resorption of bone, increase HDL/lower LDL, increase risk of stroke/embolism, breast cancer, increase progesterone receptors - contraception (w/ progestin), suppression of HPG axis, replacement therapy. This is the most common in progestin + estrogen therapy.

Answer 33

- estrogens - agonist at bone, breast, CV system, endometrium, vaginal epithelium - block resorption of bone, increase HDL/lower LDL, increase risk of stroke/embolism, breast cancer, increase progesterone receptors - contraception (w/ progestin), suppression of HPG axis, replacement therapy

Answer 34

- estrogens - first non steroidal estrogen, no longer in use - block resorption of bone, increase HDL/lower LDL, increase risk of stroke/embolism, breast cancer, increase progesterone receptors - contraception (w/ progestin), suppression of HPG axis, replacement therapy

Answer 35

- SERM - antagonist at breast, agonist everywhere else - not mentioned in lecture - estrogen dependent breast cancer, osteoporosis, postmenopausal symptoms

Answer 36

- SERM - antagonist at breast, agonist at bone and cardio, neutral on endometrium and vaginal epithelium. - not mentioned in lecture - estrogen dependent breast cancer, osteoporosis, postmenopausal symptoms

Answer 37

- SERM - agonist at vaginal epithelium bone, and cardio, antagonist at breast, neutral at endometrium - not mentioned in lecture - VAGINAL ATROPHY (agonistic effect on vaginal epithelium)

Answer 38

- estrogen antagonist - antagonize inhibitory effects of estrogen on the pituitary and hypothalamus - bone resporption due to lack of estrogen, increase lipids - ovulation induction

Answer 39

- estrogen antagonist - antagonize inhibitory effects of estrogen on the pituitary and hypothalamus - bone resporption, increased lipids - ovulation induction

Answer 40

- aromatase inhibitor - non-steroidal, inhibits conversion of androgen to estrogen - hot flashes - ovulation induction

Answer 41

- aromatase inhibitor - steroidal, inhibits conversion of androgen to estrogen - hot flashes - ovulation induction

Answer 42

- progestin - enhanced activity as mineralocorticoid antagonist and andgrogen antagonist. decrease amount and increase viscosity of cervial mucus to prevent fertilization (main). - headache, abnormal menstrual bleeding (when used with estrogen) - contraceptive

Answer 43

- progestins - -decrease amount and increase viscosity of cervial mucus to prevent fertilization (main). also prevent ovulation by inhibiting hypothalamus and pituitary - headache, abnormal menstrual bleeding (when used with estrogen) - too rapidly inactivated, synthetic analogues used instead

Answer 44

- Progestins - decrease amount and increase viscosity of cervial mucus to prevent fertilization (main). also prevent ovulation by inhibiting hypothalamus and pituitary - headache, abnormal menstrual bleeding (when used with estrogen) - IM (3 months) contraception

Answer 45

- progestins - decrease amount and increase viscosity of cervial mucus to prevent fertilization (main). also prevent ovulation by inhibiting hypothalamus and pituitary - headache, abnormal menstrual bleeding (when used with estrogen) - oral/IUD contraception

Answer 46

- progestins - decrease amount and increase viscosity of cervial mucus to prevent fertilization (main). also prevent ovulation by inhibiting hypothalamus and pituitary - headache, abnormal menstrual bleeding (when used with estrogen), NAUSEA and VOMITING, breast tenderness, dizziness, cramps - oral/IUD/SubQ contraception, post-coital contraception (plan B)

Answer 47

- selective progesterone receptor modulator - antagonizes actions of progesterone on granulosa cell receptors. This action of progesterone is needed for follicular rupture. - headache, nausea, vomiting, dizziness - post-coital contraception (within 5 days)

Answer 48

- progestin receptor antagonist - blocks progesterone effect on endometrium - none listed (also glucocorticoid antagonist) - oral for abortion/post-coital contraception, cushing's syndrome, type II DM

Answer 49

-gonadotropins - - - Induce follicular growth. IM!!

Answer 50

-gonadotropins - - - Diagnostics for pregnancy, induce ovulations IM!!!!

Answer 51

- GnRH and analogs - stimulate gonadotropin secretion - Google-Difficulty breathing, flushing, up HR, Itching - delayed puberty, anovulatory disorders

Answer 52

-GnRH and analogs -GnRH agonist, initial stim then suppresion - -Tx: Prostate Cancer! precocious puberty& androgen excess male, dysmenorrhea, ovulation induction

Answer 53

-GnRH and analogs -GnRh antagonist - -Tx:precocious puberty& androgen excess male, dysmenorrhea, ovulation induction

Answer 54

-Androgens- - -virilization, feminization, suppress HPG, (hepatic toxicity) - hypogonadism replacement, catbolic states/muscle wastingTransdermal or buccal tablets

Answer 55

-Androgens - -virilization, feminization, suppress HPG, (hepatic toxicity) - hypogonadism replacement, catbolic states/muscle wasting. intramuscular

Answer 56

-17a-alkylated androgens - - hepatic toxicity, virilization, feminization, suppress HPG -hypogonadism replacement, catbolic states/muscle wasting

Answer 57

-17a-alkylated androgens - -hepatic toxicity, virilization, feminization, suppress HPG -hypogonadism replacement, catbolic states/muscle wasting

Answer 58

- anti-androgen - 5a-reductase inhibitors,inhibits conversion to dihydrotestosterone - erection/ejac. problems, down desire, testicular pain, depression - Tx. Androgen excess, or androgen dependent disorders

Answer 59

- antiandrogen - 5a-reductase inhibitors, inhibits conversion to dihydrotestosterone - erection/ejac. problems, down desire, testicular pain, depression - Tx. Androgen excess, or androgen dependent disorders

Answer 60

- anti-androgen - androgen receptor antagonist - not specified (google-nause, vomit, diarrhea, down sex desire,) - Tx. Androgen excess, or androgen dependent disorders

Answer 61

- anti-androgen - androgen receptor antagonist - not specified (google-nause, vomit, diarrhea, down sex desire,) - Tx. Androgen excess, or androgen dependent disorders

Answer 62

- antiandrogen - androgen receptor antagonist - not specified (google-nause, vomit, diarrhea, down sex desire,) - Tx. Androgen excess, or androgen dependent disorders

Answer 63

- polyene - bind ergosterol, compromise fungal cell membrane. fungicidal - anaphylaxis, nephrotoxicity - most life-threatening sytemic fungal infections

Answer 64

- polyene - bind ergosterol, compromise fungal cell membrane - bitter and unpleasant taste, too toxic to be used parenterally - topically to treat candida infections of the muscosa, skin, instestnal tract, and vagina

Answer 65

- imidazoles - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase - restricted to oral/topical use (minimal GI upset if swallowed) - drug of choice for oropharyngeal candidiasis in AIDS patients

Answer 66

- imidazole - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase - inhibit adrenal and gonadal steroid hormone synthesis, hepatitis - "use is limited due to availability of safer drugs"

Answer 67

- imidazole - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase - topical only (systemic use causes thrombophlebitis) - jock itch, ringworm, athlete's foot, vaginal infections, oral thrush

Answer 68

- azole - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase- - none mentioned in lecture - oral or IV for cryptococcal meningitis (good CNS penetration). not active against molds, C. krusei, or C. glabrata

Answer 69

- azole - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase - none emphasized in lecture - aspergillus + some fluconazole-resistant candida species (especially esophageal candidiasis)

Answer 70

- azole - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase - rash, elevated hepatic enzymes, numerous drug interactions - only azole with activity against zygomycoses (Rhizopus, Mucor). Prophylaxis against invasive fungal infections in BMT and neutropenia.

Answer 71

- azole - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase - none emphasized in lecture - invasive mold infections in immunocompromised patients (invasive aspergillosis!)

Answer 72

- azole - block ergosterol synthesis by binding and inhibiting fungal cytochrome P450 enzyme lanosterol 14-alpha-demethylase - SAFE (minor irritation) - topical treatment of onychomycosis

Answer 73

- allylamine - inhibits ergosterol synthesis by blockign squalene epoxidase. Fungicidal. - co-admin w/ rifampicin doubles clearance of terbinafine. cimetidine decreases clearance. - topical or oral for dermatophytes

Answer 74

- echinocandin - inhibit glucan synthesis, weakens fungal cell wall and causes lysis - well tolerated - IV primarily for Aspergillus and azole resistant candida

Answer 75

- echinocandin - inhibit glucan synthesis, weakens fungal cell wall and causes lysis - well tolerated - IV primarily for Aspergillus and azole resistant candida

Answer 76

- echinocandin - inhibit glucan synthesis, weakens fungal cell wall and causes lysis - well tolerated - IV primarily for Aspergillus and azole resistant candida

Answer 77

- antimetabolite - pyrimidine analog, inhibits fungal DNA/RNA synthesis. Fungal cell enzyme cytosine deaminase converts to active form (5-FU) then becomes 5-FdUMP which competitively inhibits thymidilate synthetase to block fungal DNA synthesis. 5-UTP incoportated into defective RNA to reduce protein synthesis as well. - GI intolerance, bone marrow depression, anemia, leukopenia, thrombocytopenia - oral for systemic candida and cryptococcus infections

Answer 78

- mitotic spindle poison - blocks fungal mitosis by interacting with polymerized microtubules - INDUCES various CYP isoforms in liver and alters pharmacokinetics with warfarin and oral contraceptives - oral for systemic treatment of dermatophytosis (now limited use)

Answer 79

- 1st line anti-MTB - interferes with biosynthesis of cell wall arabinogalactan - optic neuritis, color blindness - effective against multiplying bacilli

Answer 80

- 1st line anti-MTB - inhibits cell wall synthesis (INH-NAD adduct inhibits FASII system), must be converted to active form by bacterial enzyme (pro-drug) - peripheral neuropathy, elevation of liver enzymes, hepatitis - kills actively growing bacteria. also used as single drug for treatment of latent TB

Answer 81

- 1st line anti-MTB - metabolized via pyrazinamidase (pncA) to pyrazinoic acid (pro-drug). Mechanism unknown (disrupts energy metabolism and membrane) - hepatotoxicity, GI intolerance - kills dormant TB and more active against phagocytized TB (lower pH)

Answer 82

- 1st line anti-MTB and leprosy - binds to beta subunit to prevent transcription of mRNA (inhibits RNA polymerase). Bactericidal. - orange color to urine sweat tears, rash, thrombocytopenia, nephritis, hepatitis, CYP 450 inducer - kills rapidly growing and slowly metabolizing bacilli, also effective for leprosy and M. ulcerans (Buruli ulcer)

Answer 83

- former first line drug for MTB, now less useful due to increased resistance - not mentioned - not mentioned - Buruli Ulcer treatment

Answer 84

- 2nd line anti-MTB - blocks protein synthesis by targeting 16S rRNA, 70S ribosome, and rRNA methyltransferase - not given - tuberculosis

Answer 85

- not given - not given - not given - atypical mycobacterial infections

Answer 86

- 2nd line anti-MTB - inhibits cell wall synthesis and peptidoglycan synthesis by acting as a D-alanine analogue - not mentioned - tuberculosis

Answer 87

- 2nd line anti-MTB - blocks mycolic acid synthesis/cell wall by targeting acyl carrier and protein reductase (inhA) - not mentioned - tuberculosis

Answer 88

- 2nd line anti-MTB - blocks protein synthesis by targeting 16s rRNA - not mentioned - tuberculosis

Answer 89

- anti-m. avium complex - not given - not given - not given

Answer 90

- anti-leprosy - inhibits bacterial synthesis of dihydrofolic acid leading to inhibition of DNA and RNA synthesis - hemolysis, hepatitis, nausea, rash - leprosy

Answer 91

- anihelminth (intestinal and cysts) - binds tubulin and inhibits glucose uptake - well absorbed - do not use in pregnancy

Answer 92

- anihelminth (intestinal only) - binds tubulin and inhibits glucose uptake - poorly absorbed - do not use in pregnancy

Answer 93

- anihelminth - uses Cl- currents to kill microfilariae only not adults - Drug of choice for onchovera volvius but can be used for all

Answer 94

-antihelminth -Ca+ release, worm paralysis and damage. -Effective against cestode adult and larval cysts, active against all trematodes excepts one.

Answer 95

- antimalarial - drug of choice for "self treatment" drug for most malaria - based of chineese herbs

Answer 96

-antimalarial -Active against hypnozoite stage (liver) -prophylaxis only against all types of malaria, and treatment for CQ resistant P. falciparum

Answer 97

- antimalarial - digests vessicles of intra-erythrocyte parasite - used for prevention and treatment for all but CQ resistant P. falciparum

Answer 98

- antimalarial - digests vessicles of intra-erythrocyte parasite - prophylaxis ONLY against ALL types of malaria. - Can cause neuropsychiatric problems (dreams/hallucinations)

Answer 99

- antiprotozoal - disrupts DNA - Entamoeba and Giardia

Answer 100

- antiprotozoal - ferredoxin oxidoreductase - Cryptosporidium and resistant Giardia

Answer 101

- glucocorticoid - -mixed glucocorticoid/mineralcorticoid activation (50/50) - cushing syndrome/immunosuppression/hyperglycemia

Answer 102

- glucocorticoid (No mineralcorticoid activity) | - cushing syndrome/immunosuppression/hyperglycemia

Answer 103

- glucocorticoid - mixed glucocorticoid/mineralcorticoid (more gluco) - oral or injectable

Answer 104

- mineralcorticoid - mixed glucocorticoid/mineralcorticoid (more mineral) - oral only - hypokalemia/hypernatremia/hypertension - DRUG OF CHOICE for mineralcorticoids

Answer 105

- Aldosterone antagonists - Block aldosterone receptor - spironolactone also inhibits androgen synthesis pathway

Answer 106

- adrenal cortex pathway inhibitor - prevents conversion of cholesterol to pregnenolone - treatment for cushings syndrome

Answer 107

- adrenal cortex pathway inhibitor - prevents conversion of 11 desoxycortisol to cortisol & 11 deoxycorticosterone to corticosterone. - Allows for a lot of deoxycorticosterone to persist which is a good mineralcorticoid. - Treat cushing syndrome

Answer 108

- adrenal cortex pathway inhibitor | - antifungal that inhibits many steps in MC, GC, & androgen synthesis

Answer 109

- iron - ferrous better absorbed-325 tablet, 106mg iron - nausea, epigastric pain, constipation, diarrhea, black stool - iron deficiency- 2-3/day

Answer 110

- iron - ferrous better absorbed/ 320 tablet, 37mg iron - -nausea, epigastric pain, constipation, diarrhea, black stool - iron deficiency- 3-4/day

Answer 111

- iron - ferrous better absorbed-325mg/65mgiron - -nausea, epigastric pain, constipation, diarrhea, black stool - iron deficiency- 3-4/day

Answer 112

- vitamin B12 - - anaphylaxis with IV, hypokalemia, secondary iron deficiency - parenteral for pernicious/resections-oral supplement deficient diet of B12

Answer 113

-folate - -mask B12 deficiency, reduce phenobarbital, phenytoin primidone, raltritrexed -all folate def. except for inhibiotrs of DHFR(leucovorin)

Answer 114

- chelator - binds iron - IV can lead to hypotension, neurotoxicity, susceptible to infection - SubQ or IM for iron toxicity

Answer 115

- Hematopoietic growth factor - stim prolif,maturation and Hgb by CFU-E, synergy with IL3, and GMCSF expand BFU-E compartment, stim release of reticulocytes - inc. clot during dialysis, hypert., seizures (allergic reaction mild infreq) - anemia of renal failure, Aids tx w/AZT, cancer chemo, preop autologous trans.

Answer 116

-Myeloid growth factor- G-CSF -stim granulocyte colonies and neutrophils, promotes granulo release - -

Answer 117

-myeloid growth factor- GM-CSF -w/IL3, stim prolif of gran, monoc, macro, megakaryocytes - -

Answer 118

- penicillin (beta-lactam) - structural analogs of D-Ala-D-Ala blocking PDG X-linking - allergies, dose-dep neurotoxicity & seizures, Stevens-Johnson syndrome - Non-penicillinase producing microbes: S. pneumonia, staph spp, N. meningitides, Clostridum spp, Treponema pallidum

Answer 119

- penicillin (beta-lactam) - structural analogs of D-Ala-D-Ala blocking PDG X-linking - allergies, Stevens-Johnson syndrome - Non-penicillinase producing microbes: S. pneumonia, staph spp, N. meningitides, Clostridum spp, Treponema pallidum

Answer 120

- beta-lactamase R penicillins - structural analogs of D-Ala-D-Ala blocking PDG X-linking - hepatitis (high doses), allergies, Stevens-Johnson syndrome - penicillinase-producing staph & strep

Answer 121

- beta-lactamase R penicillins - structural analogs of D-Ala-D-Ala blocking PDG X-linking; hydrolyzed & destroyed by kidneys - allergies, Stevens-Johnson syndrome - penicillinase-producing staph & strep

Answer 122

- Extended spectrum penicillins - structural analogs of D-Ala-D-Ala blocking PDG X-linking; better absorption than ampicillin, not affected by food - NA - non-lactamase G- bacilli (E. coli, H. influenza, Salmonella, Shigella)

Answer 123

- Extended spectrum penicillins - structural analogs of D-Ala-D-Ala blocking PDG X-linking - NA - non-lactamase G- bacilli (E. coli, H. influenza, Salmonella, Shigella)

Answer 124

- Extended spectrum penicillins - structural analogs of D-Ala-D-Ala blocking PDG X-linking-NA - NA - anti-pseudomonal; Klebsiella or Pseudomonas, often in combo with aminoglycoside to prevent resistance; non-lactamase G- bacilli (E. coli, H. influenza, Salmonella, Shigella)

Answer 125

- Extended spectrum penicillins - structural analogs of D-Ala-D-Ala blocking PDG X-linking - NA - anti-pseudomonal; non-lactamase G- bacilli (E. coli, H. influenza, Salmonella, Shigella)

Answer 126

- beta-lactamase suicide inhibitor - structurally related to penicillins but poor antibiotic acitivity alone - NA - fixed concentrations with extended spectrum penicillins

Answer 127

- beta-lactamase suicide inhibitor - structurally related to penicillins but poor antibiotic acitivity alone - NA - fixed concentrations with extended spectrum penicillins

Answer 128

- beta-lactamase suicide inhibitor - structurally related to penicillins but poor antibiotic acitivity alone - NA - fixed concentrations with extended spectrum penicillins

Answer 129

- cephalosporins (beta-lactam) - structural analogs of D-Ala-D-Ala blocking PDG X-linking - Disulfiram-like rxn, hypersensitivity (X-allergenic with pens) similar to pens (allergies etc) - broadest spec against G+ cocci, effective against G- bacilli; used for surgical prophylaxis

Answer 130

- cephalosporins (beta-lactam) - structural analogs of D-Ala-D-Ala blocking PDG X-linking - Disulfiram-like rxn, hypersensitivity (X-allergenic with pens) similar to pens (allergies etc) - anaerobes

Answer 131

- cephalosporins (beta-lactam) - structural analogs of D-Ala-D-Ala blocking PDG X-linking - Disulfiram-like rxn, hypersensitivity (X-allergenic with pens) similar to pens (allergies etc) - anti-pseudomonal & -pneumoncoccal; serious G- infections (meningitis, pneumonia, gonorrhea)

Answer 132

- cephalosporins (beta-lactam) - structural analogs of D-Ala-D-Ala blocking PDG X-linking - Disulfiram-like rxn, hypersensitivity (X-allergenic with pens) similar to pens (allergies etc) - anti-pseudomonal, Enterobacter, pens-R strep

Answer 133

- carbapenems (beta-lactam) - structural analogs of D-Ala-D-Ala blocking PDG X-linking, bind PBPs more efficiently & R to most beta-lactamases - GI effects, superinfections, neurotoxicity, X-allergenicity to pens - broadest activity of all beta-lactams; 2nd line therapy for serious nosocominal infections

Answer 134

- petidase inhibitor - inhibits dehydropeptidases - NA - imipenem always admin with cilastatin

Answer 135

- monobactams - structural analogs of D-Ala-D-Ala blocking PDG X-linking - NA No X-reactivity with pens - narrow (G- aerobes including Pseudomonas, penetrates CNS); G- UTIs, lower RTIs, systemic infections

Answer 136

- Non-beta-lactam - deletes lipid carrier for PDG synthesis - severe nephrotoxicity - topical app ONLY for skin/eye infections, good combo with polymyxin B; narrow spectrum (G+, Neisseria, T. pallidum)

Answer 137

- Non-beta-lactam - structural analog of D-alanine, blocks PDG synthesis - serious CNS effects, reversible - broad spec; restricted 2nd line for M. tuberculosis

Answer 138

- Non-beta-lactam - structural analog of PEP, blocks PDG synthesis - few adverse effects - single dose oral tx of uncomplicated UTIs (rapid resistance)

Answer 139

- Non-beta-lactam - binds D-Ala-D-Ala growing end of pentapeptide, interferes with X-linking in PDGG synthesis - red man syndrome, ototoxicity, nephrotoxicity - narrow spec for serious G+ infecitons, MRSA, combo with aminoglycosides (cidal except static in enterococci)

Answer 140

- Other-membrane depolarizer - Novel cyclic lipopeptide, cidal by membrane depolarization - myopathy - narrow spec G+ similar to vancomycin, treats VREF & MRSA

Answer 141

- aminoglycosides - irreversible binding to 30s bacterial ribosomal subunit & inhibiting protein synthesis at several levels; bactericidal & PAE - ototoxicity (irreversible hearing loss), vestibular toxicity - severe G-aerobe infections, combo therapy with vanc/pens for staph

Answer 142

- aminoglycosides - irreversible binding to 30s bacterial ribosomal subunit & inhibiting protein synthesis at several levels; bactericidal & PAE - ototoxicity (irreversible hearing loss), vestibular toxicity, renal toxicity (reversible) - widespread use for bowel surgeries (resistance), enterocolitis outbreaks

Answer 143

- aminocyclitol - binds 30s ribosomal subunit, bacteriostatic - NA - MRSA, enterococci, antibiotic-R gonorrhea

Answer 144

- glycylglycines - tetracycline analogue: reversible binding to 30s ribosomal subunit blocking A site - NA - tetracycline-R strains, Hershey isolate of MRSA

Answer 145

- tetracyclines - reversible binding to 30s ribosomal subunit blocking A site; oral admin decr by divalent and trivalent cations & when gastric pH elevated - GI irritation, superinfections (pseudomembranous colitis), discoloration of teeth (not admin to pregnant women or children - fetal & childhood risks), renal/liver toxicity, photosensitivity, vestibular disturbances - acne, Rickettsial diseases

Answer 146

- tetracyclines - reversible binding to 30s ribosomal subunit blocking A site; oral admin decr by divalent and trivalent cations & when gastric pH elevated - GI irritation, superinfections (pseudomembranous colitis), discoloration of teeth (not admin to pregnant women or children - fetal & childhood risks), renal/liver toxicity, photosensitivity, vestibular disturbances - acne, Rickettsial diseases

Answer 147

- tetracyclines - reversible binding to 30s ribosomal subunit blocking A site; oral admin decr by divalent and trivalent cations & when gastric pH elevated - GI irritation, superinfections (pseudomembranous colitis), discoloration of teeth (not admin to pregnant women or children - fetal & childhood risks), renal/liver toxicity, photosensitivity, vestibular disturbances - acne, Rickettsial diseases

Answer 148

- macrolides - reversibly bind to 50s subunit & competitively inhibit streptogramins, clindamycin, & chloramphenicol - no CYP interactions - alternative to pens with allergy, RTI from Legionella, mycoplasma; common bacterial infections

Answer 149

- macrolides - reversibly bind to 50s subunit & competitively inhibit streptogramins, clindamycin, & chloramphenicol - inhibits CYP3A4 - alternative to pens with allergy, RTI from Legionella, mycoplasma; common bacterial infections

Answer 150

-macrolides -reversibly bind to 50s subunit & competitively inhibit streptogramins, clindamycin, & chloramphenicol; oral admin with salts, esters, or enteric coated tablets (acid labile) -inhibits CYP3A4; GI disturbances, allergic cholestatic hepatitis (from erythromycin estolate) -less effective against anaerobes than others in class; pentrates abscesses, alternative to pens with allergy, RTI from Legionella, mycoplasma; common bacterial infections

Answer 151

- Macrolide (ketolide) - reversibly bind to 50s subunit & competitively inhibit streptogramins, clindamycin, & chloramphenicol; semi-synthetic der of erythromycin with incr acid stability, addinity for 50s ribosome, & reduced resistance; conc-dep bactericidal - GI, blurred vision; rare: liver damage/failure; contraindic in myasthenia gravis - CA-RTIs, effective against S. pneumonia, H. influenza, M. catarrhalis, some S. aureus

Answer 152

- lincomycins - binds 50s ribosomal subunit - diarrhea, pseudomembranous colitis, skin rash, Stevens-Johnson syndrome, anaphylaxis; contraindic in liver failure - RTIS caused by anaerobes, abscesses, MRSA, Group A strep, osteomyelitis

Answer 153

- streptogramins - bind 50s ribosomal subunit, same site as macrolides; Quinupristin/dalfopristin (30:70 prep); combined cidal - pain, phlebitis, dereg of drug levels that are metabolized by CYPs - MRSA, vancomycin-R G+ infections, VREF, VRSA, Strep pneumoniae

Answer 154

- streptogramins - bind 50s ribosomal subunit, binds nearby macrolide spot > synergistically enhances quinupristin binding; Quinupristin/dalfopristin (30:70 prep); combined cidal - pain, phlebitis, dereg of drug levels that are metabolized by CYPs - MRSA, vancomycin-R G+ infections, VREF, VRSA, Strep pneumoniae

Answer 155

-protein synth inhibit other -bind reversibly to 50s ribosome subunit at the peptidyltransferase site (site near that of clindamycin & macrolides) -hematological toxicities, aplastic anemia, gray baby syndrome -restricted to infections not treatable by less toxic drugs; Rickettsial infections in patients who cannot take tetracycline

Answer 156

- protein synth inhibit other - binds novel site in 23s ribosomal RNA of 50s ribosomal unit; no X-reaction with other protein synthesis inhibs - NA - treat serious infections: MRSA, multi-drug R S. pneumoniae, VREF

Answer 157

- protein synth inhibit other - inhibits isoleucyl tRNA synthetase; topical use ONLY - NA - impetigo caused by MRSA or Group A strep

Answer 158

-sulfonamides -DHPS inhibitor in folic acid synth pathway, false substrate preventing binding of PABA to DHPS; bacteriostatic, well-distributed (in CNS) -hemolytic anemia (G6PD def), kernicterus, Stevens-Johnson syndrome; GI effects, rash, bone marrow/liver toxicity -not used alone (combo with trimethoprim)! common bacterial infections (UTIs but R & toxicity), malaria, CNS toxoplasmosis

Answer 159

-DHFR inhibitor -DHFR inhibitor in folic acid synth pathyway (100,000x more selective for bacterial over human); alone static -NA -combo with sulfamethoxazole;

Answer 160

- Combo sulfonamide/DHFR inhib - synergism bactericidal - same toxicities as sulfamethoxazole (hemolytic anemia, kernicterus, Steves-Johnson syndrome); anti-folate effects (don't use in pregnant womenor alcoholics) - CA-MRSA, UTIs, Pneumocystis pneumonia in immunocompromised, sinusitis, otitis media

Answer 161

- fluoroquinolones - inhibit bacterial DNA gyrase & topoisomerase > irrevers DNA damage; (older, better against G-) ciprofloxacin, levofloxacin, moxifloxacin (newer, better against G+); conc-dep killing: higher AUC/MIC better efficacy - target AUC/MIC: immunocompromised 100, immunocompetent 25 - GI issues, hepatotoxicity, MRSA & C. dif colonization, do NOT give to children (arthropathy) or athletes (achilles tendon rupture) - nosocomial infections, complicated UTIs, bacterial prostatitis, pneumonias, STIs, osteomyelitis (majority of use inappropriate)

Answer 162

- fluoroquinolones - inhibit bacterial DNA gyrase & topoisomerase > irrevers DNA damage; (older, better against G-) ciprofloxacin, levofloxacin, moxifloxacin (newer, better against G+); conc-dep killing: higher AUC/MIC better efficacy - target AUC/MIC: immunocompromised 100, immunocompetent 25 - GI issues, hepatotoxicity, MRSA & C. dif colonization, do NOT give to children (arthropathy) or athletes (achilles tendon rupture) - nosocomial infections, complicated UTIs, bacterial prostatitis, pneumonias, STIs, osteomyelitis (majority of use inappropriate)

Answer 163

- fluoroquinolones - inhibit bacterial DNA gyrase & topoisomerase > irrevers DNA damage; (older, better against G-) ciprofloxacin, levofloxacin, moxifloxacin (newer, better against G+); conc-dep killing: higher AUC/MIC better efficacy - target AUC/MIC: immunocompromised 100, immunocompetent 25 - GI issues, hepatotoxicity, MRSA & C. dif colonization, do NOT give to children (arthropathy) or athletes (achilles tendon rupture) - nosocomial infections, complicated UTIs, bacterial prostatitis, pneumonias, STIs, osteomyelitis (majority of use inappropriate)

Answer 164

- somatostatin analog - Acts on 2 & 5 receptors (not in pancreas) - gallstones - Hyper-GH syndromes