Antibiotics, antifungal, antivirals, and cancer Flashcards

Question

betamethasone

Answer 1

corticosteroids

Answer 2

Non Biological Gold Standard for RA Also treats SLE MOA: unknown in RA Route: PO x1 week Give with folic acid to reduce GI, hepatic, and hematological toxicity Common AE: N/V/D, alopecia, malaise Less Common: hepatoxicity, nephrotoxicity, thrombocytopenia, bone marrow suppression

Answer 3

Non-biologic DMARD anti-malarial MOA: impacts mediator of inflammatory response AE: GI, renal toxicity

Answer 4

Biologic TNF inhibitors DMARDs MOA: bind to TNF alfa AE: headache, infection

Answer 5

Biologic TNF inhibitors DMARDs MOA: bind to TNF alfa AE: headache, infection

Answer 6

Biologic Non-TNF DMARDs MOA: impacts inflammation

Answer 7

anesthetics

Answer 8

TNF inhibitor | DMARD

Answer 9

TNF inhibitor DMARD

Answer 10

Non TNF inhibitor | DMARD

Answer 11

antibiotic

Answer 12

macrolides CYP450 inhibitor

Answer 13

Regional anesthetics

Answer 14

antibiotic glycopeptide hypotension

Answer 15

penicillin antibiotic

Answer 16

penicillin antibiotic

Answer 17

penicillin antibiotic

Answer 18

Cephalosporins Antibiotic

Answer 19

cephalosporin antibiotic

Answer 20

Cephalosporins | Keflex

Answer 21

Aminoglycosides antibiotic ototoxicity Nephrotoxicity Usage p. aeeruginosa

Answer 22

macrolide antibiotic

Answer 23

tetracycline antibiotic Photosensitivity

Answer 24

lincosamide antibiotic that can cause cdiff

Answer 25

Fluoroquinolone Antibiotic tendon rupture phototoxicity hypoglycemia

Answer 26

Fluoroquinolone Antibiotic tendon rupture phototoxicity hypoglycemia

Answer 27

Mild: NSAIDS, Acetaminophen, short acting opioid Moderate: short acting opioid Severe: strong opioid or long acting

Answer 28

``` Increased fall risk fatigue pain emotional distress Chemo induced peripheral neuropathy decrease cognition decreased muscle strength (sarcopenia) cardiac and pulmonary damage ```

Answer 29

antifungal Treats FI Route: PO, Topical AE: PO- N/V/D, cramps, topical-rash, urticaria (hives/itching)

Answer 30

hormones and drugs that use the immune system to treat cancer

Answer 31

DAmage cancer cells by blocking specific genes or proteins

Answer 32

Drugs that inhibit growth and replication of cancer cells

Answer 33

FATIGUE!!! | Radiation fibrosis

Answer 34

``` myelosuppression NVD stomatitis reproductive dysfunction hair loss ``` **try Nadir after chemotherapy

Answer 35

treatment used before primary treatment

Answer 36

used after primary treatment in conjunction with other therapy

Answer 37

Cure, control, or palliation

Answer 38

chemotherapy, biotherapy, radiation, and/or surgery

Answer 39

G0: rest stage- cells considered resistant to exposure from many chemotherapeutic agents G1: pre DNA: protein synthesis G2: premitosis: all cellular and structural compnents needed..checkpoint for cell sructures M: mitosis- cell division PMAT= 2 daughter cells

Answer 40

uncontrolled cell growth

Answer 41

Inactivated (killed pathogen) Subunit or conjugated (piece of pathogen) Live attenuated (weakened pathogen)- avoid if immunocompromised Toxoid (pathogen toxin) **AE: injection site reaction, fever, headaches

Answer 42

damage to liver and kidneys (fluid retention)

Answer 43

Azoles that treat FI AE: N/V, photophobia, cardiac arrhythmia, menstrual irregularities

Answer 44

Broad Spectrum | PO: fluconazole and ketoconazole

Answer 45

Nystatin and Amphotericin B

Answer 46

Polyenes and Azoles Common CYP interactions

Answer 47

Cell membrane

Answer 48

Superficial (ring worm or vaginal yeast infection) and systemic (meningitis)

Answer 49

aka mycoses Risk for FI increased after antibacterial use, immunisuppression, pregnancy, diabetes, elderly

Answer 50

Exercise tolerance may be affected (malaise, fatigue, INFs may cause flu like symptoms, anemia) Track vital signs and Rate of PE

Answer 51

Opportunistic infections: look out for long term antibiotics and wash hands Neuromuscular: pain, dysfunction, myopathy, peripheral neuropathy

Answer 52

Antiretroviral agents in combo Treatment for naive patients bictegravir/emtricitabine/tenofovir alafenamide

Answer 53

dolutegravir/abacavir/lamivudine Antiretroviral agents in combo Treatment for naive patients

Answer 54

``` NRTI NNRTI Protease Inhibitor Entry Inhibitors Integrase inhibitor ```

Answer 55

treatment for HIV

Answer 56

HAART= highly active antiretroviral treatment Synergistic drug-drug interation

Answer 57

AE: fatigue, weakness, and headache Also when combined with amiodarone will see bradycardia

Answer 58

In the past treatments hardly tolerated, now there are 11 DAA products to cure

Answer 59

Interferon- (injection) but causes flu like symptoms Nucleoside/nucleotide analogs- (PO) better tolerated

Answer 60

Pre and post exposure prophylaxis Vaccine, immune globulin, rest and hydration, antiemetics (nausea), antipyretics (fever) 2-6 months of recovery

Answer 61

inflammation of the liver caused by a virus

Answer 62

Oseltamavir (Tamiflu) | Baloxavir (Xofluza)

Answer 63

- ovir - ivir - alfa - ine

Answer 64

``` Attachment to host cell Entry Replication Assembly Release (budding or host cell lysis) ```

Answer 65

A very small invader that can only replicate in a host cell and enters the body via skin, mucous membranes, GI or respiratory tract. 3 components: envelope, capsid, nucleic acid core

Answer 66

antibiotic that fights Atypical pathogens causing pneumonia- this is a CYP450 inhibitor (look out for DDIs)

Answer 67

Used to treat community acquired pneumonia- look out for tendon rupture

Answer 68

Leading cause of death Causes: bacteria, virus, or mycoplasmas Inflammation affecting parenchyma of the lungs Transmission: airborne pathogens, circulation, sinus or contiguous infection, aspiration May be nosocomial (hospital acquired) which is more deadly

Answer 69

On skin Spread via contact Treatments: linezoid and quinupristin/dalfopristin

Answer 70

Gram + Transmission: contact or fecal to oral Symptoms: diarrhea, cramping, fever Occurs when normal GI flora interrupted **can survive up to 5 months DOC: metronidazole (IV) vancomycin

Answer 71

Liver and kidney issues visual disturbances CN VIII damage neurological symptoms Beware of resistance due to resistant strain of TB infection or noncompliance with medications

Answer 72

Contain and cure infection This process can last months to a year

Answer 73

Latent TB: carries bacteria without symptoms Active: individuals are infectious and can spread disease

Answer 74

fever, night sweats, malaise, weight loss

Answer 75

Myobacterium tuberculosis is inhaled into lungs, aveoli and surrounded by macrophages to set off an immune response

Answer 76

airborne particles

Answer 77

overuse/misuse international OTC antibiotics Antibiotics in livestock

Answer 78

Innate: organism isnt susceptible Acquired: Inactivated drug, modify drug target, export drug from bacteria, or bypass antibiotic inhibition

Answer 79

when bacteria or other microbes become resistant to the effects of a drug after being exposed to it

Answer 80

Sulfonamides Steven-Johnsons syndrome

Answer 81

Sulfamethoxazole/trimethoprim (Bactrim, SMX/TMP) Broad coverage of Gram - and + AE: can cause allergy or steven johnson syndrome

Answer 82

Nitroimidazole antibiotic Metallic taste neuropathy

Answer 83

Metronidazole (Flagyl) Use: Anaerobes AE: GI, metallic taste, Uncommon: peripheral neuropathy

Answer 84

Ciprofloxacin Levofloxacin (levaquin) Gram - AE: GI, Photosensitivity Rare: tendon rupture, significant hypoglycemia

Answer 85

Clindamycin Gram + GI and can Cause cdiff

Answer 86

Doxycycline Broad coverage gram + and - and atypicals AE: GI or photosensitivity

Answer 87

Azithromycin (Z-pak) Some gram + and - AE: GI issues, QT prolongation, CYP450 inhibitor (DDI)

Answer 88

Gentamicin Usage: Gram +, P. aeruginosa AE: ototoxicity and nephrotoxicity

Answer 89

Vancomycin ``` MRSA, Cdiff Increasing resistance (VRE) ``` AE: Hypotension

Answer 90

Cephalexin (Keflex), ceftriaxone (Rocephin) Nosocomial infections, surgical prophylaxis GI and Hypersensitivity

Answer 91

Amoxicillin, Amoxicillin/clavulanate (Augmentin) and Piperacillin/tazobactam(Zosyn) Broad coverage of Gram+ and Gram- AE: GI and hypersensitivity

Answer 92

``` Cell wall cell membrane protein synth dna synth dna strand ```

Answer 93

effective against many or few types of infection

Answer 94

``` Bacterial factors (identify and susceptibility) Host specific factors (allergies, renal function, ect) Drug specific factors (DDI, route, ect) ```

Answer 95

kill bacteria

Answer 96

inhibit bacterial growth, requires an immune host

Answer 97

Positively charged but favors negatively charged compounds Thinner cell wall (5-7 strands)

Answer 98

Is negatively charges but favors positvely charged compounds Thick cell wall (20-30 strands)

Answer 99

Drug that is only actively against bacteria

Answer 100

Drug that is active against bacteria, virus, fungi, or parasite

Answer 101

general anesthetic | causes loss of consciousness

Answer 102

Neuromuscular Weakness Impaired airway clearance Immune function suppressed In older adults pulmonary complications or reduced cough reflex

Answer 103

AE: rare but possible: CNS stimulation progressing to depression, CV issues, respiratory depression Duration: 20 min up to 6 hours

Answer 104

MOA: reversibly bind a receptor site within the pore of the Na+ channels in nerves ->block ion movement through the pore ->blocks action potential for nerve conduction, especially at small myelinated axons that carry nociceptive input Advantages: quick recovery, low systemic toxicity, confined to nerve tissue Disadvantages: incomplete analgesia, longer time to anesthesia

Answer 105

Route: topical, infiltration anesthesia, peripheral nerve block, IV regional block, epidural or spinal administration Categories: central neuraxial block: epidural or intrathecal space peripheral nerve block: near a nerve or the plexus innervating the are undergoing surgery field block: adjoining tissues so the drug will diffuse to the surgical area for minor hand or foot procedures Can be used in combo w/ decrease general anesthesia dose

Answer 106

Adipose tissue

Answer 107

``` Barbiturates (thiopental) Dissociative (ketamine) Misc (etomidate, propofol) Opioids (fentanyl) Benzodiazepines (midazolam) ``` Quick onset and quick recovery May be used with inhaled too

Answer 108

``` Gas (nitrous oxide) Volatile Liquids (halothane) ```

Answer 109

Balanced anesthesia: combo of IV and inhaled anesthetics, analgesics and neuromuscular blocking agents

Answer 110

loss of consciousness, analgesia, amnesia, skeletal muscle relaxation, inhibition of sensory and autonomic reflexes

Answer 111

Can have respiratory or cardiovascular collapse

Answer 112

Completely unconscious and respiration is more regular

Answer 113

Will lose consciousness and respirations may change

Answer 114

May or may not remember but generally still conscious

Answer 115

General: Iv and inhaled Regional: Intrathecal and epidural Local: Injection and topical

Answer 116

General: Iv and inhaled Regional: Intrathecal and epidural Local: Injection and topical

Answer 117

Pharmacological side effects (AE to meds) Problems with delivery

Answer 118

Opioids (Morphine, fetanyl, hydromorphine) Local anesthetics (epidural)

Answer 119

Load Dosing, Demand Dosing, Lockout interbal, 1 and 4 hour limits, background infusion rate Measures successful vs. total demand

Answer 120

Enables continuous pain control and lowers incidence side effects

Answer 121

Patient self administers analgesic via small pumps worn, implanted devices, or pumps on a pole Route: Catheters, IV, Intrathecal, epidural space

Answer 122

Viral infections Fungal infections Photosensitivity

Answer 123

80 % of infections | soft tissue infection can lead to sepsis

Answer 124

Pts w/ SLE already risk for infection | Increased risk with DMARDS and steroids

Answer 125

Methotrexate and azathioprine are most common MOA: Decrease the immune response so body does not attack itself AE: N/V Boxed warning: serious infection, secondary malignancy

Answer 126

High Dose steroids | Immunosuppressants

Answer 127

NSAIDS Steroids Antimalarials Immunosupressants

Answer 128

chronic inflammatory autoimmune disease affecting variety of organs Direct infiltration of immune complexes into organs and joints -> destruction of tissue -> clinical symptoms

Answer 129

Short term RA treatment NSAIDS can help Opioids for pain

Answer 130

``` Biological DMARD RA Route:PO Common AE: infection, nasopharyngitis Boxed warning: infections Tofacitinib (Xeljanz) Baricitinib (Olumiant) ```

Answer 131

``` Biological DMARD RA Route: IV or subcut Common AE: injection reactions, increased LFTs, antibody devlopment Boxed Warning: serious infections Rituximab (Rituxan) Abatacept (Orencia) Tocilizumab (Actemra) Sarilumab (Kevzara) Anakinra (Kineret) ```

Answer 132

Biological DMARD RA Route: IV or subcut Common AE: headache, infection, antibody development, infusion reactions ``` Boxed warnings: serious infections ◦Adalimumab (Humira) ◦Golimumab (Simponi) ◦Infliximab (Remicaide) ◦Certolizumab pegol (Cimzia) ◦Etanercept (Enbrel) ```

Answer 133

Non-biologic DMARD RA Treats Lupus too (reduces disease progression and prolongs survival) ◦MOA: impacts mediators of inflammatory response ◦Route: PO ◦Common AE: GI and skin reactions ◦Rare AE: retinal toxicity (regular ophthalmologic exams) ◦Addresses symptoms but not progression ◦Used for other disease states too (lupus, malaria, etc)

Answer 134

Nonbiological DMARD Biological DMARD (TNF inhibitors, NonTNF inhibitors and Janus Kinase inhibitors) MOA: inflammation usually

Answer 135

A chronic, progressive, systemic, inflammatory autoimmune disease Often swollen and inflamed

Answer 136

Not recommended But possibly help with OA Antithrombotic effect

Answer 137

OA treatment Injections Trimacincolone (Kenalog) Methylprednisolone (Depo-Medrol)

Answer 138

For hip or knee OA MOA: visoelastic solution to provide joint lubrication AE: injection site pain, swelling, rash

Answer 139

Tylenol, if not topical NSAID, corticosteroids, tramadol, or oral NSAID Second line: opioids, surgery, intraarticular hyaluronate If over 75 Topical NSAID or Capsaicin or tramadol (avoid oral NSAIDs)

Answer 140

Slow, progressive degeneration of joint surfaces (cartilage all the way to bone) Inc thickness of subchondral bone reduces ability to absorb energy= more strain on articular cartilage-> cartilage erodes and bones directly contact each other

Answer 141

Neuropathic Treatment | AE: burning sensation and erythema

Answer 142

Neuropathic GABA analog and anticonvulsant AE: dizziness and drowsiness INEXPENSIVE

Answer 143

shooting or shock like

Answer 144

numbness or tingling

Answer 145

normal stimulus that shouldnt cause pain but does

Answer 146

experiencing more pain than we would expect

Answer 147

results from mechanical, thermal, or chemical stimuli

Answer 148

Shooting, shock-like, aching, crushing, burning

Answer 149

associated with disease or injury to PNS or CNS Causes: Diabetes, immune deficiencies, shingles, trauma, MS, ischemic issues, cancer, drugs, ect. Due to damage nocioreceptors are highly sensitive to stimuli or produce pain signals w/o a stimulus

Answer 150

NSAID (topical)

Answer 151

Indications: analgesia, antipyretic, anti-inflammatory MOA: reversibly inhibits COX1 and 2 (decrease prostiglandins precursors) AE: GI, inc BP, nephrotoxicity, CV risk (variable) Look out for GI Bleed, elderly, and renal issues May impact muscle repair

Answer 152

Stimulus signals arachidonic acid Which inc. inflammation, cytokines, and activates COX1 and COX2 COX2 does vasodilation, vascular perm, cytokine release, leukocyte migration, and pain COX1 does fever and neurotransmission- always present When NSAID blocks these enzymes anti-inflammatory, analgesia and antipyretic happen

Answer 153

not an NSAID Tylenol Indications: analgesia and antipyretic MOA: inhibits prostaglandin synthesis in CNS Route: PO,IV, Rectal AE: Hepatoxicity *SIP enzymes break it into metabolites that are toxic to the liver

Answer 154

Codeine, Hydrocodone, Vicodin, Morphine, Oxycodone, Percocet, Fetanyl, Hydromorphone, Meperdine - Binds to receptors in CNS to inhibit asc pain pathway - Dont develop tolerance to constipation and miosos * anaglesia, antitissive - PO, rectal, IM, IV, topical, subcut, epidural, intrathecal, transmucosal

Answer 155

naltrexone (vivitrol)- PO- 4 maintenance of abstinence- not acute overdose naloxone (evizio/narcan)- IV,IM,Subcut, Intranasal- acute overdose or respiratory depression *reverses respiratory depression and euphoria

Answer 156

Strong: all but codeine and tramadol

Answer 157

gate keeper | rich in opioid receptors

Answer 158

Nocioceptive: injury, stabbing, aching Neuropathic: burining, tingling sensation Psychogenic: origin to psych

Answer 159

Pain signal to brain via ascending pathway to brain stem to spinal cord Injury: produce cytokines which release prostaglandins Sensory nerve fibers (afferent) respond to prostaglandins (1st order) 2nd order goes up spinothalamic tract to brain to thalmus 3rd order relays yo somatosensory cortec on opposite sides of the brain Dorsal horn of SC- substance P activates next cell, so no sub P= inhibit

Answer 160

myelinated and are localized pain

Answer 161

unmyelinated and diffuse pain

Answer 162

Descending Pathway: Neurons in gray matter signals to silence 2nd order and travels down dorsal horn to inhibit Substantia gelatinosa: gate keeper 2 regulate transmission of nocioceptive fibers This blocks release of substance p and inhibits pain

Answer 163

Drug passes BBB Lipid soluble passes quicker Opioids bind to opioid receptors (G-coupled) Cause presynaptic and postsynaptic inhibition Blocks pain by stopping desc and thus stopping the pain loop with ascending pathway

Answer 164

Response> sum of response to both positive: HIV cocktail viral load suppression negative: CNS depression with opioid and benzo

Answer 165

The effect will be altered or modified when more than one drug is given because one drug changes another drug's action.

Answer 166

Lower blood cholesterol Block HMG-CoA to prevent liver from making chol Can be used for leukemia, dementia, lung cancer, OP Can induce myopathy (muscular weakness)

Answer 167

Desensitization due to long term exposure to agonist

Answer 168

One drug induces or inhibits the metabolism of another

Answer 169

2 drugs with opposite effects

Answer 170

2 substances that diminish the effect

Answer 171

Smallest curve is most potent Shortest curve is also probably the partial agonist b/c there was not a high response Most effective curve is the quickest one to reach 100 percent response

Answer 172

Only bind to Beta 1 or Beta 2

Answer 173

only bind to alpha or beta

Answer 174

Occupy receptors but do not activate

Answer 175

Drugs occupy receptors= activate

Answer 176

Does not fit receptor exactly Lower dose= agonist effect Higher does= less response b/c it blocks receptors where agonists would usually bind

Answer 177

Greatly diminishes effect, increasing agonist will not overcome antagonist

Answer 178

Antagonist and agonist compete for receptor, higher concentration wins

Answer 179

Effective dose to get 50 % of expected response | Lower ED50= more potent drug b/c less drug is needed for greater effect

Answer 180

maximal response, receptors filled

Answer 181

Enzymes and Non-human cells (penicillin-bacteria cell wall and oseltamauir-infected cells)

Answer 182

Calls attention to serious risks associated with medicine

Answer 183

Ligand- quick, ligand binds, voltage gated channels open to transmembrane protein to allow ion flow G- Protein- quick- transmembrane receptors cross 7 times- intracellular effects Kinase- hours- ligand binds and makes receptors pair up (ex:insulin, GLU4, uptake glucose) DNA- hours- intracellular with lipophilic ligand, receptor binds ligand and DNA to activate or depress gene expression (ex levothyroxine)

Answer 184

Ratio of TD50 to ED50 | Lower the TI= more likely AE/toxicity

Answer 185

Cross BBB quicker

Answer 186

- removal of a drug from the body - Kidneys and liver - First order (most common- proportional to concentration- 1/2 life) and second order (not proportional to conc- steady downward slope) - 1/2 life= how long it takes to eliminate half the drug - A drug is cleared after 5 (1/2) lives

Answer 187

CYP enzymes: break down molecule into active or inactive products **Some drugs inhibit CYP which inc. drug concentration and may inc. likelihood of AE

Answer 188

Vd=total conc of drug in body/plasma higher Vd= more drug in tissue highly protein bound= less active drug in tissue

Answer 189

Enteral (GI) vs. Parentheral (not GI) Passive Diffusion via lipid memebrane or aqueous channel or carrier mediated Bio-availability: % of drug in systemic circulation (varies with pH, gut motility, and food) First Pass: In liver, liver takes out most of the drug (PO)

Answer 190

What the body does to the drug (ADME)

Answer 191

How the drug affects the body (MOA, Potency, Efficacy)

Answer 192

One: small, healthy, for safety Two: Small, diseased, for efficacy Three: Large, long, and randomized Four: After approval and post marketing

Answer 193

Medical use and little to no abuse (ex: antidiarrheal, antitussive, analgesia)

Answer 194

Medical use and low abuse (ex: tramadol, xanax, ambien)

Answer 195

Medical use and mid abuse (ex:codeine & anabolic steroids)

Answer 196

Medical Use and High abuse (ex: cocaine, meth, fetanyl, addy, oxy, hydros)

Answer 197

No medical use and high abuse ex:heroin, LSD, MaryJ

Answer 198

owned by manufacturer & uppercase

Answer 199

official name & lowercase

Answer 200

Using drugs for something not approved by the FDA (ex:different ages, diseases, or doses)

Answer 201

~20 years later other companies can make the drug without permission from the original manufacturers

Antibiotics, antifungal, antivirals, and cancer Flashcards

(226 cards)