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Intro to Pharm > Drugs to Know NOW Exam 1 > Flashcards

Drugs to Know NOW Exam 1 Flashcards

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1
Q

Fosfomycin

A
  • MOA: inhibits murein monomer synthesis by inhibiting synthesis of UDP-NAM by inhibiting MurA. Enters cells via transporters for glycerophosphate or G6P
  • Spectrum: G- bacteria in urinary tract - E. coli and Klebsiella and serratia
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2
Q

Vancomycin

A
  • MOA: inhibits murein polymerization by binding to D-Ala-D-Ala terminus of the monomer
  • Spectrum: G+ rods and cocci including MRSA
  • Route: not absorbed orally so give orally for intestinal illness and IV for systemic
  • ADE: nephrotoxic, ototoxic, red man syndrome (flushing, itching, non-IgE mediated)
  • Cleared renally and requires monitoring
  • Time dependent killing
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3
Q

Clavulanic Acid

A

Beta-lactamase inhibitor

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4
Q

Tazobactam

A

Beta-lactamase inhibitor

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5
Q

Penicillin

A
  • used in streptococcal and drug of choice for syphilis
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6
Q

Amoxicillin

A
  • Aminopenicillin - penicillinase-sensitive
  • spectrum: non-beta-lactamase producing Neisseria, Escherichia, Haemophilus, enterococci, Listeria, H pylori, Klebsiella
  • most active of all PO beta-lactams against S. pneumo
  • adding a beta-lactamase inhibitor covers H. influenzae and enterobacteriaceae
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7
Q

Amoxicillin/Clavulanate

A
  • acute otitis media, URI, UTI where beta-lactamase + strains are likely
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8
Q

Nafcillin

A
  • Penicillinase-Resistant

- used for confirmed staphylococcal infections

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9
Q

Piperacillin

A
  • antipseudomonal penicillin
  • Spectrum: staph aureus, coag neg staph, strep pneumo, strep spp, H. influenzae, Moraxella, Niesseria, E. coli, Klebsiella, pseudomonas, enterobacteriaceae, bacteroides
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10
Q

Piperacillin/Tazobactam

A
  • broadest spectrum of penicillins

- antipseudomonal

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11
Q

Cefazolin

A
  • 1st gen cephalosporin

- Spectrum: gram + and PEcK

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12
Q

Cefoxitin

A
  • 2nd gen cephalosporin
  • Spectrum: gram + and HENPEcK
  • may cover bacteroides fragilis after abdominal or gyne surgery
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13
Q

Cefriaxone

A
  • 3rd gen cephalosporin
  • NOT cleared renally
  • Spectrum: highly effective against enterobacteriaceae, Neisseria and H. influenza, pneumococci
  • community acquired pneumonia
  • can displace bilirubin in neonates and is contraindicated
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14
Q

Ceftazidime

A
  • 3rd gen cephalosporin
  • Spectrum: highly effective against enterobacteriaceae, Neisseria and H. influenza, pneumococci
  • community acquired pneumonia
    pseudomonas
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15
Q

Cefepime

A
  • 4th gen cephalosporin

- broad spectrum including pseudomonas

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16
Q

Ceftaroline

A
  • 5th gen cephalosporin

- 3rd gen plus MRSA

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17
Q

Meropenem

A
  • Carbapenem
  • Spectrum: EBSL gram negatives, pseudomonas, acinetobacter, anaerobes
  • NOT effective against atypical pneumonia, legionella and MRSA
  • ADE: seizures
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18
Q

Ertapenem

A
  • Carbapenem
  • Spectrum: EBSL gram negatives, anaerobes
  • NOT pseudomonas
  • ADE: seizures
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19
Q

Imipenem/Cilastatin

A
  • Carbapenen
  • Spectrum: EBSL gram negatives, pseudomonas, acinetobacter, anaerobes
  • Cilastatin added to prevent deactivation in the renal brush border thus increasing urinary concentrations
  • ADE: seizures (highest)
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20
Q

Aztreonam

A
  • safe even in severe beta-lactam allergy

- Spectrum: aerobic gram - including pseudomonas

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21
Q

Gentamycin

A
  • aminoglycoside
  • MOA: active transport across cell membrane via an oxygen dependent process, passive diffusion via porin channels, bactericidal d/t irreversible binding to the 30S
  • Spectrum: aerobic gram negatives including pseudomonas
  • Toxicity: nephrotoxic, ototoxic associated with high trough levels
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22
Q

Tobramycin

A
  • aminoglycoside
  • MOA: active transport across cell membrane via an oxygen dependent process, passive diffusion via porin channels, bactericidal d/t irreversible binding to the 30S
  • Spectrum: aerobic gram negatives including pseudomonas
  • Toxicity: nephrotoxic, ototoxic associated with high trough levels
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23
Q

Tetracycline

A
  • MOA: bacteriostatic, reversibly bond 30S subunit
  • Spectrum: many G+ including MRSA, G- but many resistant, toxin secretors (cholera), rickettsia, mycoplasma and chlamydia
  • incompletely absorbed orally, worse if taken with dairy, antacids
  • concentrates in tissues with high Ca content
  • ADE:photosensitivity, chelation, GI upset, renal tubular acidosis if expired meds
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24
Q

Doxycycline

A
  • MOA: bacteriostatic, reversibly bond 30S subunit
  • Spectrum: many G+ including MRSA, G- but many resistant, toxin secretors (cholera), rickettsia, mycoplasma and chlamydia
  • incompletely absorbed orally, worse if taken with dairy, antacids
  • concentrates in tissues with high Ca content
  • ADE:photosensitivity, chelation, GI upset, renal tubular acidosis if expired meds
  • also used in chemoprophylaxis of malaria - good for last minute travelers or when traveling to an area of high resistance
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25
Tigecycline
- MOA: reversibly binds to the 30S, bacteriostatic - Spectrum: broad including MRSA and acinetobacter, gram negs but NOT pseudomonas, protues, providencia - ADE: chelation, n/v/d, hepatotoxicity, phototoxicity - rapid distribution - not for bacteremia
26
Azithromycin
- Macrolide - MOA: bacteriostatic, binds irreversibly to 50S, taken up by leukocytes and delivered to site of infection - Spectrum: G+, G-, intracellulars, H pylori - community acquired pneumonia (+3rd gen cephalosporin) - ADE: motilin receptor agonists (diarrhea), ototoxicity, hepatotoxic
27
Erythromycin
- Macrolide - MOA: bacteriostatic, binds irreversibly to 50S, taken up by leukocytes and delivered to site of infection - Spectrum: G+, G-, intracellulars, H pylori - community acquired pneumonia (+3rd gen cephalosporin) - inhibits cytochrome P450 - ADE: motilin receptor agonists (diarrhea), ototoxicity, hepatotoxic, prolonged QT interval
28
Fidaxomicin
- Macrolide - MOA: bacteriostatic, binds irreversibly to 50S, taken up by leukocytes and delivered to site of infection - Spectrum: G+, G-, intracellulars, H pylori - community acquired pneumonia (+3rd gen cephalosporin) - inhibits cytochrome P450 - ADE: motilin receptor agonists (diarrhea), ototoxicity, hepatotoxic, prolonged QT interval
29
Chloramphenicol
- MOA: binds reversibly to 50S - Broad spectrum - Toxic --> gray baby syndrome bc babies lack glucuronidine transferase
30
Clindamycin
- MOA: binds 50S - Spectrum: G+, some G-, anaerobes - above the belt anaerobic drug - hepatically cleared (safe for kidney impairment) - high risk of C diff
31
Linezolid
- MOA: binds 50S - G+ including MRSA, VRE and Listeria - ADE: generally mild, HA, thrombocytopenia, irreversible peripheral neuropathy and optic neuritis with prolonged use - MAO inhibitor so can precipitate serotonin syndrome in pts on SSRIs
32
Mupirocin
- inhibits Ile tRNA - Spectrum: G+ - Use: topical only, impetigo, MRSA in nose
33
SMX/TMP
- folate antagonist - Spectrum: PJP, enterobacteriacae, CA-MRSA, protozoa - N-acetylation - ADE: hypersensitivity (Steven-johnson), rash, crytalluria, photosensitivity, hemolytic anemia in G6PD, leukopenia, macrocytic anemia
34
Pyrimethamine
- Dihydrofolate reductase inhibitor | - spectrum: malaria
35
Metronidazole
- generates ROS - Spectrum: protozoa, anaerobes, H pylori - use: extraluminal ameobiasis, giardiasis, trich - ADE: metallic taste, neurotoxic effects, disulfram like reaction
36
Rifampin
- MOA: inhibits RNA polymerase - Spectrum: very broad including mycobacteria - resistance: mutation of rpoB gene which is rapid and predictable - use in combination for TB tx (RIPE/RISE) ADE: stains fluids orange, enzyme inducer, hepatitis
37
Nitazoxanide
- MOA: generates ROS - few side effects or drug reactions - used for giardia in kids
38
Nitrofurantoin
- MOA: generates ROS - Spectrum: E coli, enterococci - Use: urinary tract only - acidic urine better and prophylaxis of uncomplicated UTI ADE: G6PD anemia, hepatotoxicity, neurologic disturbance
39
Ethambutol
- MOA: inhibits arabinosyl transferase interfering with cell wall synthesis - Spectrum: for TB and MAC - ADE: optic neuritis (test for colorblindness), hepatitis, thrombocytopenia
40
Isoniazid
- MOA: activated by mycobacterial catalase-peroxidase (inactivation = resistance) and interferes with synthesis of mycolic acid - Spectrum: used only for TB, choose for latent TB - metabolized by N-acetylation - ADE: hepatitis, peripheral neuropathy (give B6 to prevent), lupus like syndrome in slow acetylators
41
Chloroquine
- highly effective against blood schizonticide - resistance very common in P. falciparum - choose bc: taken weekly - avoid bc: resistance is high, may exacerbate psoriasis
42
Mefloquine
- effective against multi-drug resistant P. falciparum - half life is 20 days - ADE: neurologic and psychiatric toxicities in 50% of pts - choose bc: good for long trips - avoid bc: last minute travel or short trips
43
Quinine
- effective blood schizonticide against all 4 species, gametocidal against vivax and ovale - used for uncomplicated falciparum malaria - ADE: tinnitus, HA, nausea, dizziness, flushing, visual disturbances (cinchonsim) - not used in chemoprophylaxis
44
Thalidomide
- used for erythema nodosum leprosum, multiple myeloma, mycobacterial infection - toxic if used during pregnancy --> flipper babies
45
Amphotericin B
- MOA: bind to ergosterol and increase cell permeability - Spectrum: BROAD including yeasts, endemic mycosis organisms, pathogenic molds including aspergillus - cleared renally - Very toxic bc it pokes hole in our cells too - liposomal forms are less toxic but expensive
46
Nystatin
- MOA: bind to ergosterol and increase cell permeability | - only used topically for Candida spp
47
Flucytosine
- MOA: pyrimidine analog that interferes with RNA and protein synthesis - synergy with Ampho B - poorly protein bound --> penetrates all body cavities - Spectrum: some candida spp, C neoformans - ADE: toxic compound flouorouracil --> chemo like side effects including bone marrow toxicity, leukopenia, thrombocytopenia
48
Ketoconazole
- MOA: decreased ergosterol synthesis by inhibition of fungal cyp450 - Used topically for tineas, cutaneous candidiasis, dandruff - systemic use for prostate cancer and hyper adrenal states - can cause gynecomastia
49
Itraconazole
- MOA: decreased ergosterol synthesis by inhibition of fungal cyp450 - doesn't effect mammalian steroid synthesis - spectrum: dimorphic fungi including aspergillus - ADE: negative ionotropic effects - exacerbates CHF
50
Fluconazole
- MOA: decreased ergosterol synthesis by inhibition of fungal cyp450 - least effect on hepatic microsomal enzymes, high water solubility, good CSF penetration and bioavailability - spectrum: candida (except C krusei), C galbrata, Coccidoides, Histoplasmosa, Cryptococcul - Use: orally for tx and prevention of vaginal yeast infections
51
Voriconazole
- MOA: decreased ergosterol synthesis by inhibition of fungal cyp450 - good absorption and bioavailabilty - spectrum: candida spp, dimorphic fungi, aspergillus - ADE: rash, high liver enzymes, visual disturbances
52
Clotrimazole
- topical azole
53
Miconazole
- topical azole that also inhibits FA synthesis, fungal oxidases and peroxidases
54
Caspofungin
- MOA: interfere with cell wall synthesis by noncompetitive inhibition of beta-(1,3)-D- glycan synthase - Spectrum: Candida (including azole resistant), aspergillosis - IV only - ADE: histamine rxns, hemolysis, hepatic effects (rare)
55
Micafungin
- MOA: interfere with cell wall synthesis by noncompetitive inhibition of beta-(1,3)-D- glycan synthase - Spectrum: Candida (including azole resistant), aspergillosis - IV only - ADE: histamine rxns, hemolysis, hepatic effects (rare
56
Griseofulvin
- MOA: binds to tubulin and inhibits mitotic spindle - deposits in newly fowmed skin - Use: systemic tx of dermatophytosis - ADE: disulfram like rxn
57
Terbinafine
- MOA: squalene epoxidase inhibitor - Spectrum: dermatophytes and onychomycosis - oral or cream - accumulated in nails - ADE: hepatotoxicity
58
Albendazole
- MOA: inhibits MT synthesis - Spectrum: larvicidal in hydatid disease, cysticercosis, ascariasis, and hookworm. Ovicidal in ascariasis, ancyclostomiasis, and trichusiasis - oral absorption increased with a fatty meal - ADE: few, increased liver enzymes, pancytopenia
59
Mebendazole
- MOA: inhibits MT synthesis - Spectrum: larvicidal in hydatid disease, cysticercosis, ascariasis, and hookworm. Ovicidal in ascariasis, ancyclostomiasis, and trichusiasis - < 10% absorbed orally - ADE: few, increased liver enzymes, pancytopenia
60
Diethylcarbamazine
- MOA: immobilizes microfilaria - Use: filariases - Side effects: limited and depend on number of microfilaria - kills rapidly and can cause big immune response so give initial dose slowly - can only be obtained from the CDC - can worsen eye disease in onchocerciasis
61
Ivermectin
- MOA: tonic paralysis of musculature - Spectrum: broad vs roundworms, also used for ectoparasites - well tolerated but Mazzotti-like reaction in filarial infection
62
Permethrin
- MOA: interferes with sodium transport | - bed bugs, lice, scabies
63
Pyrantel Pamoate
- MOA: spastic paralysis - Spectrum: pinworms, ascariasis, hookworms - available OTC

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