Exam 2 - Cushman/Erdman (Drug Classes) CONTINUED Flashcards Preview

Therapeutics V Spring 2019 (P3 Spring) > Exam 2 - Cushman/Erdman (Drug Classes) CONTINUED > Flashcards

Flashcards in Exam 2 - Cushman/Erdman (Drug Classes) CONTINUED Deck (70):
1

Clindamycin is made from _________ (a naturally occuring abx)

from Lincomycin

2

Lincomycin --> clindamycin by adding

CHLORINE!! and Ph3P
(Clindamycin has chlorine in its structure)

3

Resistance in clindamycin is also seen in resistance of what drug class due to similar MOAs

macrolides
(both bind to 50s ribosome)

4

Clindamycin or Tetracyclines have the issues with Chelation?

Tetratcyclines

5

how to prevent chelation with tetracyclines?

take abx 1 - 2 hours before the multivalent metals

Dosage wise: package with EDTA - EDTA will chelate Ca2+!

6

Tetracyclines should be avoided in who because of the "teeth side effect"

kids! or pregnant women

7

how do tetracyclines affect teeth and what is the remaining effect

they chelate to Ca2+ during teeth formation leads to permanent gray/brown teeth

8

Tetracyclines used to have painful injections --- this has been minimized how?

injectable formulations now have EDTA in it to chelate with the Ca2+ this way no insoluble Ca2+/tetracycline combos are administered

9

what two orgo reactions can occur to make tetracycline in active

epimerization and dehydration

10

which orgo reaction to tetracycline will create a toxic substance to the kidneys and what is that substance

dehydration will create "4-EpiANHYDROtetracycline" = v toxic to da kidneys

11

if a tetracycline lacks a _______ group there is no chance of forming the kidney toxic molecule of 4-epianhydrotetracycline

lack a 6-OH group
(this beneficial adaption is seen in minocycline, doxycycline, tigecycline)

12

which tetracycline has vestibular toxicities (vertigo, ataxia, nausea)
*these ADEs are not seen in other tetracyclines

minocycline

13

which tetracycline has a bunch of drug interactions (per cushman lecture)

Sarecycline

14

what are the Saracycline drug interactions

do not give with oral retinoids, antacids, iron preperations
can affect PCNs (make PCNs less effective)
dose reduce anticoags and PgP substrates

15

what is the really serious ADE with chloramphenicol

aplastic anemia

16

what are the 1st gen quinolones

Oxolinic acid
Nalidixic acid

17

what are the 2nd gen quinolones

Ciprofloxacin

18

what are the 3rd/4th gen quinolones

Levofloxacin, Moxifloxacin, Delafloxacin

19

what structure things differentiate 1st vs 2nd/3rd/4th gen quinolones

2/3/4 all have a -F group at pos. 6 and a ring with some nitrogen at pos. 7

20

what quinolone is a weirdo and has a side effect of hyperglycemia and hypoglycemia in diabetic pts

Gatifloxaxin

21

what drugs are tetracyclines

tetracycline
doxycycline
minocycline

22

what drugs are glycylcyclines

tigecycline

23

what drugs are sulfonamides

SMX-TMP

24

what drugs are polymycins

Colistin
Polymixin B

25

what drugs are lincosamides

Clindamyacin

26

what drugs are Nitromidazoles

metronidazole

27

different b/w minocycline and teglecycline

tegecycline = glycylamindo moiety added to position 9

28

what are the two main major mechanisms of resistance for tetracyclines

tetracycline specific efflux pumps
decrease access to ribosome via ribosomal protection proteins

29

which -cycline is usually resistant to the 2 major resistance mechanisms

tigecycline (resistance seen when multi drug efflux pu,p)

30

what two things does Tigecycline NOT cover

Pseduomonas!!
Proteus

31

what drugs cause QT prolongation

FQs
Macrolides
Telavancin

32

what drugs notably cause thrombophlebitis

vanco
Macrolides
synercid

33

what drugs causes myopathy

synercid
daptomyocin

34

what drug cause acute eosinophilic pneumnoa

daptomyocin (aka why dont use in pneumonia)

35

what drugs cause peripheral neuropathy

Linezolid
FQs
Metronidazole

36

what drugs have an alcohol reaction

metronidazole
cefotetan (NMTT side chain)

37

what drugs should not be used in pregnancy

SMZ-TMP
Lipoglycopeptides (black box: Telavancin)
Metronidazole
FQs
Tetracyclines

38

what drugs have CYP interactions

Synercid
Macrolides (not azithromycin)

39

what drugs go into the CSF

ALL PCNs
Cephs: parenteral cefuroxine/3rd/4th gen
Meropenem
Aztreonam
Vancy
SMZ-TMP
Linezolid
Metronidazole

40

what drugs are chelators

FQs
Tetracyclines

41

ADEs of tetracyclines

Nausea/Vomiting
Photosensitivity
Pregnancy risk (teeth color weirdness)

42

explain the MOA of SMZ-TMP

PABA --> Dihydrofolic acid --> Tetrahydrofolic acid --> Purines (U) --> Thymine -- > DNA

SMZ inhibits 1st step and TMP inhibits 2nd step

43

SMZ-TMP does not cover ______ or _____

not pseudomonas
NO anaerobes

44

SMZ-TMP is DOC for what

pneumocystis carinii/jirovecci

45

ADEs of SMZ-TMP

hypersensitivity
Pregnancy - billirubin issue
Renal insufficiency/hyperkalemia/crystalluria

46

Polymyxins:
Cover only one of the following - which one?
Gram +
Gram -
or
Anaerobes

ONLY gram -
(only target organism is Pseudomonas)

47

what Gram - bugs do POLYMYXINS not cover

proteus
providencia
serratia
(bruella, burkholderia)

48

dosing for Polymyxins -- use what weight for parenteral dosing

IBW (aka LBW)

49

Clindamycin: Distribution
Gets into ______ but not ____

bone - yes
CSF - no

50

Clindamycin: Renal or Liver?

liver!!

51

ADEs of clindamycin

C.Diff inducer!!
Hepatoxicity

52

Metronidazole:
Cover only one of the following - which one?
Gram +
Gram -
or
Anaerobes

only anaerobes
(target wise: BDA and C.diff only!)

53

Metronidazole:
into CSF?

yes!

54

ADEs of metronidazole?

metallic taste
peripheral neuropathy
Pregnancy caution - teratogenic
(disulfiram and warfarin)

55

Disinfectant, Sterilant, or Antiseptic?
Chlorhexidine

antiseptic

56

Disinfectant, Sterilant, or Antiseptic?
Povidone-Iodine

antiseptic

57

Disinfectant, Sterilant, or Antiseptic?
iodine

antiseptic

58

Disinfectant, Sterilant, or Antiseptic?
Bleach

disinfectant

59

Disinfectant, Sterilant, or Antiseptic?
halazone

disinfect (for water)

60

Disinfectant, Sterilant, or Antiseptic?
NaDCC

disinfectant (for water and better than halazone)

61

Disinfectant, Sterilant, or Antiseptic?
Phenols

disinfect

62

Disinfectant, Sterilant, or Antiseptic?
Quaternary Ammonium Compounds

used ONLY for Gram + bugs
(THUS do not use as antiseptic bc could cause infections if used as antiseptic...)

63

Disinfectant, Sterilant, or Antiseptic?
Aldehydes

Sterilant
(carcinogenic)

64

Disinfectant, Sterilant, or Antiseptic?
Peroxygen compounds

disinfectants/sterilants

65

Disinfectant, Sterilant, or Antiseptic?
Ethylene oxide

EXPLOSIVE!
Sterilant
so tiny it get through packaging

66

Disinfectant, Sterilant, or Antiseptic?
heavy metals

disinfectant

67

Methylparaben /Propyl paraben cover what

yeasts and molds

68

Definition - Disinfectant?

kills every but spores (on inanimate objects)

69

Definition - Sterilant?

kills everything even spores (inanimate objects)

70

Definition - Antiseptic

use on living tissues