Exam 8 Pharm Flashcards

Question

Cephtriaxone

Answer 1

Third gen cephalosporin Treats meningitis

Answer 2

Cefepime Parenternal Goood against pseudomonas, enterobacteria, MSSA, Strep pneumoniae, Haemophilus, Neisseria Crosses into CSF Cleared renally

Answer 3

Ceftaroline Parenternal Increases binding to PBP2a so greater affinity for MRSA. Used in skin and soft tissue infections and pneumonia. Renally excreted

Answer 4

Cross sensitivity in those allergic to penicillin in early generations. Irritation after IM injection Thrombophlebitis after IV injection Cefotetan can cause hypoprothrombinemia and bleeding disorders so avoid alcohol.

Answer 5

Aztreonam Monocyclic beta-lactam ring G- aerobic Penetrates CNS IM or IV accumulation possible in renal failure Mostly nontoxic Caution with pts allergic to ceftazidime

Answer 6

Ertapenem, imipenem, meropenem Hard hitters (not used every day) Penetrate tissues and fluids well Used for organisms resistant to other drugs

Answer 7

Carbapenem Wides spectrum against G+, G- rods, anaerobes REsistant to some beta-lactamases

Answer 8

AE more common with impenem NVD rashes seizures cross sensitivity in less than 1% of pts allergic to penicillin

Answer 9

Glycopeptide Inhibits bacterial cell wall synthesis Binds side chain to prevent elongation of peptidoglycan and cross linking G+

Answer 10

Renally cleared Poorly absorbed in intestinal tract Orally - C. diff colitis Parenteral - MRSA

Answer 11

Infections and endocarditis caused by MRSA Used with gentamicin for endocarditis if pt has penicillin allergy Used with cefotaxime, ceftriaxone, or rifampin for meningitis caused by penicillin resistant pneumococcus

Answer 12

Phlebitis Flushing syndrome (red man syndrome) from release of histamine

Answer 13

Telavancin, oritavancin, dalbavancin Bactericidal Conc dependent G+

Answer 14

Lipoglycopeptide G+ Inhibits wall synthesis OR disrupts bacterial cell membrane. Can cause nephrotoxicity Potentially tetratogenic

Answer 15

Lipoglycopeptide Long half life Interfere with phosphollipid reagents used in asssessing coagulation. Alternative therapy with heparin use

Answer 16

Lipopeptide G+ Inserts tail into cell membrain via Ca insertion. Tails agreagater forming hole and Potassium efflux then death Treats vancomycin resistant stuff

Answer 17

Lipopeptide Inhibits enolpyruvate transferase blocking first step in making peptidoglycan Cross resistance unlikely because of unique structure Single 3g dose for simple UTI in female

Answer 18

Cyclic peptide mixture G+ TOPICAL Inhibits recycling of carrier that transports cell wall precursors across plasma membrane

Answer 19

Chloramphenicol Macrolides Lincosamides Oxazolidinones

Answer 20

Aminoglycosides

Answer 21

Tetracycline

Answer 22

Impaired influx or increased efflux Ribosome protection intefering tetracycline binding Enzymatic inactivation Most use efflux pump

Answer 23

Amikacin, gentamicin, neomycin, streptomycin, tobramycin. Aerobic G- bacilli Used in combo with other agents for drug-resistant organisms. Used with beta-lactams for Enterococcus faecalis Very toxic Mean girl

Answer 24

Bind to 30S subunit to distort structure so 50S can't bind. Can also misread/miscode mRNA making non-functional proteins Irreversible effects

Answer 25

Long post antibiotic effect. Poor gut absorption so given parenternally. Neomycin is topical bc of nephrotoxicity

Answer 26

Ototoxicity Nephrotoxicity NEOMYCIN with loop diuretics (fluerosemide/Lasix) causes nephrotoxicity. Neuromuscular paralysis

Answer 27

Doxycycline, minocycline, demeclocycline Four rings Variable R segments Broad spectrum G+, G-, protozoa, spirochetes, mycobacteria bacteriostatic Chelate devalent metal ions (calcium) Goes into CSF

Answer 28

Enter bacteria through passive diffusion or energy dependent transport. Reversibly bind to 30S subunit Stops addition of amino acid to peptides

Answer 29

Tetra and demeclocycline given on empty stomach Dairy inhibits absorption

Answer 30

Tetracycline with very long half life (36hrs)

Answer 31

Used for rickettsia, Borrelia, H. pylory Chlamydia Acne Doxycycline used for secondary syphylis in pts allergic to penicillin

Answer 32

Stains teeth and stunts growth from calcium effects(don't give to kids) Phototoxicity (burn fast) Hepatotoxicity Don't use in pregnant or breastfeeding women

Answer 33

Erythromycin, Clarithromycin, Azithromyxin Macrocyclc lactone ring to one or more doxy sugars G+ bacilli, G- rods

Answer 34

Irreversibly bins to 50S subunit inhibiting translocation of protein synthesis.

Answer 35

Mycoplasma Chlamydia (with azithromycin or doxycycline)

Answer 36

Macrolide Need enteric coating to protect from stomach acid Food effects absorption Alternative for penicillin

Answer 37

Macrolide Improved acid stability Great against intracellular

Answer 38

Macrolide Less active against strep and staph. Moree active against respiratory pathogens Great for chlamydia Very long 1/2 life (3 days) Does not inactivate CYP450

Answer 39

GI disturbances Jaundice Ototoxicity QT prolongation bc of effect on K channels Erythromycin and azithromycin bad for liver. Erythromycin and clarithromycin inhibit metabolism of other drugs

Answer 40

Lincosamide Interferes with translocation reactions binding to 50S subunit

Answer 41

G+ and anaerobic including MRSA Skin and soft tissue infection. Used with pen G for treating toxic shock or necrotizing fasciitis from group A strep Dental procedures if allergic to penicillin

Answer 42

Distributes well into body fluids but not CSF Penetrates well into abscesses

Answer 43

Linezolid, Tedizolid Binds to 50S subunit to block formation of 70S ribosome.

Answer 44

G+ Bacteriostatic Bacteriocidal against strep Good against TB Treat infections caused by dreg resistanc G+

Answer 45

Gi effects. Thrombocytopenia Anemia Neutropenia

Answer 46

Oxazolidinone Increased potency against staff Highly active against G+

Answer 47

Only used in life threatening situations. Reversibly binds to bacterial 50S. Inhibits peptidyl transferase Prevents formation of peptide bonds

Answer 48

Bacteriostatic Sometimes bactericidal Broad spectrum G+, G- Only life threatening

Answer 49

Anemia Gray baby syndrome (babies can't break it down so drug accumulates)

Answer 50

Reduced to free radical metabolites in anaerobic bacteria Forms concentration gradient Increased uptake of metronidazole Free radicals destroy DNA

Answer 51

ANAEROBIC bacteria and some protozoa Vaginitis Intraabdodminal infections (C. diff) Brain abscess

Answer 52

Clidamycin Metronidazole

Answer 53

GI Metallic taste Stomatitis Peripheral neuropathy Disulfiram-like effect with alcohol (No alcohol when taking drug) Seizures

Answer 54

Act on type II topoisomerase enzymes. Effecting way DNA is twisted DNA gyrase in G- relax supercoiled DNA Topoisomerase IV in G+ Separating daughter chromosomes

Answer 55

Bind DNA gyrase and topoisomerase IV Interfere with DNA ligation Generate lots of double stranded breaks. Cell lysis Death

Answer 56

Fluoroquinolone used for traveler's diarrhea G-

Answer 57

Respiratory Fluorquinolone Used for S pneumonia and CAP

Answer 58

Respiratory fluoroquinolone G+ and G- Mycobacterium CAP

Answer 59

Respiratory Fluoroquinolone Oral

Answer 60

Levofloxacin Moxifloxacin Gemifloxacin

Answer 61

Fluoroquinonlone G+ Skin infections IV or PO

Answer 62

Good absorption in GI Calcium containing foods are bad for absorption High concentrations in bone, urine kidney, prostate, lungs

Answer 63

Tendonitis Tendon rupture Worsening of myasthnia gravis Irreversible peripheral neuropathy CNS effects Phototoxicity Blood glucose imbalance QT prolongation C. diff risk Saved for emergencies

Answer 64

Coenzyme needed in RNA and DNA synthesis. Bacteria make their own.

Answer 65

Folate inhibitor Competes with PABA inhibiting dihydropteroate synthsis. Inhibits dihydrofolic acid formation

Answer 66

Rarely single agent Can be topical

Answer 67

Crystalluria Hypersensitivity Hemolytic anemia in pts with G6PD deficiency Granulocytopenia and thrombocytopenia Kernicterus

Answer 68

Don't give to infant under 2 months Pregnant women Methenamine

Answer 69

Folate inhiitor Inhibits dihydrofolate reductase Used with sulfamethoxazole for UTI.

Answer 70

Hyperkalemia Folic acid deficiency megoblastic anemia, leukopenia, granulocytopenia

Answer 71

Combonation of sulfamethoxazole and trimethoprim Stronger than the drugs on their own. Inhibits tetrahydrofolate synthesis Used in UTI Used in skin and soft tissue. Works on MRSA

Answer 72

Nucleotide without phosphate group

Answer 73

Different stages of viral life cycle. Attachment, entry, transcription, translation, replication, release

Answer 74

Only active against replicating virus. Don't effect latent virus. Monotherapy for acute Combo therapy for chronic Might harm host cell Start treatment immediately after symptoms

Answer 75

Herpes labilais Cold sores Fevers Blisters

Answer 76

Genital herpes

Answer 77

Blister like rash Spreads via direct contact with blister fluid. Itching Fever

Answer 78

Herpes zoster aka Shingles Follows nerve (dermatome) PAIN, tingling, fever, sensitivity to light Post herpetic neuralgia most common

Answer 79

Herpes simplex virus (HSV-1+2) Varicella zoster virus (varicella and herpes zoster)

Answer 80

Guanosine analogs. (Acyclovir and Valacyclovir)

Answer 81

Triphosphorylated Competes with dGTP for viral DNA polymerase. No viral replication

Answer 82

More effective against anogenital than labialis

Answer 83

High doses of antiherpes against IV acyclovir for serious infections

Answer 84

Herpes/VZV Guanosine analog Prodrug Better bioavailability than acyclovir

Answer 85

Herpes/VZV Guanosine anolog Given IV or oral Oral NVD IV renal toxicity, neuro effects, neutropenia

Answer 86

Herpes/VZV Nucleoside analog Poor bioavailability Topical

Answer 87

Herpes/VZV Nucleoside analog Oral prodrug of penciclovir Better bioavailability

Answer 88

Over the counter cream Herpes labialis No benefit for genital herpes Stabilizeds host cell membrane to prevent viral fusion with host cell

Answer 89

Common in immunocompromised Spread via body fluid. CAUSE INFECTIOUS BIRTH DEFECTS

Answer 90

CMV Guanosine analogs Require triple phosphorilation. Inhibit DNA polymerase so no DNA elongation Ganciclovir IV for systemic Valgancyclovir ophthalmic gel for acute herpetic keratitis

Answer 91

NVD HA Insomnia Neutropenia Myelosuppression Carcinogenic Teratogenic

Answer 92

CMV Oral prodrug with better bioavailability

Answer 93

CMV Cytosine nucleotide Phosphorylation via host enzymes. Active against kinase-deficient or altered CMV or HSV. Diphosphate is active form Inhibits and distracts DNA polymerase. INcorperates into viral DNA

Answer 94

Cross resistance with ganciclovir. Need aggressive hydration to prevent nephrotoxicity. Gonadotoxic Embryotoxic

Answer 95

CMV Direct viral enzyme inhibitor DOES NOT REQ PHOSPHORYLATION Blocks pyrophosphate binding site on herpevirus DNA/RNA polymerase Used when things are very bad (organ failure)

Answer 96

Nephrotoxicity Serum creatinine increase Metabolic abnormalities

Answer 97

Amantadine and rimantadine Anti-flu A Inhiit uncoating step of RNA to prevent replication Tetratogenic Dose reduction for renal impairment in elderly

Answer 98

Oseltamivir (tamiflu), Zanamivir, Peramivir Cover influenza A and B

Answer 99

Inhibit viral neuraminidase Stops cleavage of new virion from host cell membrane Clumping of virions to each other and infected host cell membrane. Block virion release

Answer 100

within 48 hours of symptoms

Answer 101

NVD HA Take with food to avoid GI upset Skin allergic rxns Don't give to person who had LAIV two weeks before. Don't give to person with ESRD without dialysis

Answer 102

Anti-flu A and B (neruaminidase inhibitor) Tablet or suspension 13 yo+ give 75mg BID for 5 days or QD for 10 days Peds based on weight

Answer 103

Anti-flu A and B (neruaminidase inhibitor) Dry powder inhaler or parenteral infusion. 2 puffs Q12 hrs for 5 days or Q24 for 7 days

Answer 104

Bronchospasm, reversible. decrease in pulmonary function, transient nasal and throat discomfort

Answer 105

Anti-flu A and B (neuraminidase inhibitor) Single IV dose for adults with uncomplicated flu. Up to five days of IV

Answer 106

Flu Endonuclease inhibitor Inhibits viral replication Used for uncomplicated flu in 5yo+ or 12 yo+ at high risk of complications Single dose good for the whole sickness (long half life)

Answer 107

<20 kg = 2mg/kg/dose suspension 20-79kg = 40mg single tablet >80kg = 80 mg single tablet

Answer 108

Protease inhibitor N blocks MPRO cleaving two viral proteins in budding process. R is a CYP3A4 inhibitor to delay metabolism (prolong half-life)

Answer 109

Q12hrs x 5 days Within five days of symptom onset

Answer 110

Metallic taste Diarrhea Elevated serum aminotransferases Covid rebound between 2-8 days after recovery

Answer 111

EUA for adults with mild-moderate Covid. Prodrug of NHC (nucleoside) Triphosphorylated and incorporated into RNA causing mutations and inhibition of viral replication

Answer 112

Q12 hrs x 5 days Treatment within 5 days of symptom onset. Not for <18 yo

Answer 113

Adenoside analog Broad spectrum antiviral All ages hospitalized pts with moderate-severe covid. IV infusion for at least five days. Loading dose needed Competes for incorporation into RNA chains by viral RNA polymerase causing chain termination

Answer 114

Nausea, bradycardia, hypotension. Dont give to children, pregnant, lactating, hepatic or renal imparement

Answer 115

Guanaside analog Used for RSV and HCV Inhibits synthesis of GTP decreasing GTP available to cap mRNA. INcorporates into viral RNA Inhibits RNA polymerase

Answer 116

Anemia, Pruritis, Upper respiratory symptoms. Tetratogenic. Women taking or men must use two forms of contraceptive

Answer 117

Trichophyton Microsporum Epidermophyton Cause Tinea infections

Answer 118

Athletes foot

Answer 119

Scalp ringworm

Answer 120

Onchomycoses. Discoloratoin, thickening, separation of nail from nailbed

Answer 121

Very toxic Only give for life threatening mycoses. IV for systemic Rarely used topically Broadest spectrum of antifungals

Answer 122

Candida albicans Histoplasma capsulatum Cryptococcus neoformans Coccidioides immitis Blastomyces dermatidis Aspergillus strains

Answer 123

Bind to ergosterol in fungal membrane. Form pores in membrane. Cell death

Answer 124

IV for systemic PO for GI fungi only

Answer 125

Fever, chills 1-3 hrs after starting IV Renal damage Hypotension with hypokalemia

Answer 126

Oral Pyrimidine analog Used with Amphotericin B INcreases permiability of fungal cell

Answer 127

Inhibit CYP450 3A4 enzymes Reduces ergosterol synthesis. Disrupts fungal membrane structure and funciton Blocking fungal cell growth and causing death

Answer 128

Very broad. Candida, C neoformans, endemic mycoses, dermatophytes. Some azoles effective against aspergillus

Answer 129

First oral azole Less selectivve for fungal P450 Topical form (shampoo) against dermatotyphosis

Answer 130

First triazole antifungal. PO and IV SIngle dose therapy for vulvovaginal cadidiasis Excreted unchanged in urine

Answer 131

Works against most candida Used in recurrent vulvovaginal candidiasis Lower affinity for CYP enzymes

Answer 132

-fungin Available for slow IV once daily Work against aspergillus and candida

Answer 133

Inhibit glucan synthesis necessary to make fungal cell wall

Answer 134

Allylamine inhibits fungal enzyme squalene epoxidase Increases membrane permeability

Answer 135

Cidal Vulvovaginal candidiasis adn recurrent vulvovaginal candidiasis. NOT for preg women

Answer 136

Oral. Absorption increased with fatty foods. Disrupts mitotic spindle inhibiting fungal mitosis 2-6 wks for skin and hair infections. 6-12 months for onychomycosis

Answer 137

Orally used against thrush Polyene macrolide Candida infections

Answer 138

Solution painted onto nails' Onychomycosis fo toenails Highest cure rate for topical onychomycosis (15-18%)

Answer 139

Topical cream for dermatophytosis, candidias. Shampoo or foam for seborrheic dermatitis

Answer 140

Allylamines usd against dermatophytes. Effecteive for tinea cruris and tinea corporis

Answer 141

Benzylamine related to allylamines Inhibits epoxidatoin of squalene blocking ergosterol synthesis stopping cell wall synthesis. Good for superficial dermatophytosis

Answer 142

Effective dermatophyte infections Not active against candida

Answer 143

Inhibits DNA and RNA synthesis. Painted on nail

Answer 144

Topical antifungal for toenail onchomycosis

Exam 8 Pharm Flashcards

(171 cards)