Exam Two Flashcards by J Michael Bausch

How do drugs cross the blood brain barrier

passage across the blood brain barrier is limited to lipid-soluble drugs

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What PD drugs are used for restless leg syndrome

Pramipexole
Ropinirole

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Who should NOT get donepezil (Aricept) and why?

Individuals who have COPD or asthma should not receive donepezil because of elevation of acetylcholine at synapses in lungs can cause bronchoconstriction

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Side effects of Aricept (cholinesterase inhibitor).

bradycardia

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Adverse effects of phenytoin (Dilantin).

Gingival hyperplasia - risk can be minimized by good oral hygiene, including dental flossing and gum massage

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Interactions of phenytoin (Dilantin)

decreases the effects of oral contraceptives

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Black Box warning of carbamazepine

may cause serious skin reactions such as SJS (Stevens-Johnson Syndrome) and TEN.
Asian ancestry - this risk is higher with those carrying the HLA-B81502 gene variant.

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Which medication is approved for cerebral palsy spasticity? Route?

Dantrolene and cyclobenzaprine (most efficacious muscle spasm/pain)

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Cluster headache description

unilateral pain near eye/temporal area

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Abortive therapy for cluster headache

100% oxygen

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Side effects of triptans

“heavy arms” or “chest pressure” experienced by 50% of users

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Common organisms that cause community-acquired pneumonia (CAP)

S. pneumoniae
Mycoplasma spp.
H. influenzae
Staph aureus (pcn resistant)

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What are drugs of choice for gardnerella vaginalis (gram negative bacilli)

metronidazole

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Drug of choice for H. pylori (gram neg bacilli)

Clarithromycin + amoxicillin + omeprazole

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Drug of choice for pasteurella multocida (animal bites) (gram neg bacilli)

Pen G

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What drugs are beta-lactamase inhibitors

clavulanic acid :
amoxicillin/clavulanate
(Augmentin & Clavulin)

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What generation of cephalosporins cover for MRSA?

5th generation only -
ceftaroline

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What treats c diff?

vancomycin

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Which cephalosporins can induce a reaction if taken with alcohol?

cefazolin (Ancef) & cefotetan

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What is the black box warning for clindamycin

can potentially cause fatal c. diff

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What antibiotic is classified as an aminoglycoside?

gentamycin

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Black box warning for aminoglycosides

ototoxic

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What are the therapeutic uses for neomycin?

ocular bacterial infections

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Drug interaction for sulfanomides/trimethoprim?

folate deficiency

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Drug of choice for uncomplicated acute cystitis?

nitrofurantoin trimethoprim/sulfamethoxazole

S/S of prostatitis

high fever, chills, malaise, myalgia, & localized pain UTI symptoms- dysuria, nocturia, urinary urgency, frequency, and retention

Drug names/combinations for TB

rifapentine, rifabutin, pyrazinamide, and ethambutol

Side effects of rifampin

red/orange urine & sweat

Black box warnings of fluoroquinolones

Achilles tendon rupture exacerbation of myasthenia gravis (cipro)

Treatments for systemic mycoses

Azoles - PO, less toxic superficial mycoses

How long to treat tinea infections with antifungals after they appear gone?

tinea corporis and tinea cruris - 1 week after s/s cleared

Can antifungals affect renal function?

Yes, amphotericin mixed with other nephrotoxic drugs can cause damage. Diflucan & fluconazole

Common treatments for onychomycosis (oral vs topical)

oral antifungal drugs (terbinafine/Lamisil OR itraconazole/Sporanox)

What is the treatment for genital HSV in pregnancy

acyclovir 700mg TID

What are common adverse effects of protease inhibitors used to treat HIV

hyperglycemia/diabetes

First line treatment for gonorrhea/dysuria

ceftriaxone azithromycin

First line of treatment for chlamydia (asymptomatic)

azithromycin doxycycline

First line of treatment for genital herpes

famciclovir

For which STDs do you treat the partner too?

Trichomoniasis

ancylostomiasis and necatoriasis (hookworm)

walking barefoot adult hookworms attach to wall of small intestine and suck blood leading to chronic blood loss & progressive anemia

which drugs can treat both scabies and lice

permethrin, lindane ivermectin - topical for lice, oral for scabies

Dopamine agonists used in PD & what also are they indicated for

pramipexole & ropinirole also indicated for restless leg syndrome

Non-selective MAOI examples and what can happen when mixed with levodopa

phenelzine isocarboxazid trancyclopromine these can cause hypertensive crisis! when given with levodopa

Alzheimers drugs

donepezil galantamine rivastigmine

cholinesterase inhibitor adverse effects

bronchoconstriction CV effects - symptomatic bradycardia, fainting, falls, and need for pacemaker

Alzheimer's drug for severe

memantine (Namenda) NMDA - n-methyl-D-aspartate receptor antagonist

phenytoin (Dilantin) mechanism of action & drug of choice for what types of seizures

inhibits sodium channels & drug of choice for tonic-clonic seizures

Black box warning for phenytoin (Dilantin) for IV use

can cause severe hypotension and cardiac dysrhythmias

Black box warning for carbamazepine (Tegretol)

SJS TEN HLA-B*1502 variant

Black box warning for valproic acid

fatal hepatic failure pancreatitis teratogenic (do NOT use in pregnancy!!!)

Baclofen is indicated for

MS & spinal cord injury NO CP or stroke spasticity

3 things about cerebral palsy

1. dantrolene is the ONLY med officially indicated for CP 2. black box warning for dantrolene is hepatotoxicity. get baseline LFT 3. baclofen is not indicated for CP (but can be used off label)

Narrow spectrum antibiotics

Gram + cocci & gram + bacilli & gram - aerobes

Broad spectrum antibiotics

gram + cocci & gram - bacilli

Side effects of tetracyclines

do not give to kids because may cause permanent discoloration of teeth avoid in pregnant women

black box warning for aminoglycosides (TAG amigos-mycin)

irreversible ototoxicity nephrotoxicity with high doses and prolonged use flaccid paralysis & fatal respiratory depression

Sulfonamides and trimethoprim

bactrim, septra, TMP-SMZ no pregnant women !! (because folic acid helps neural tube development) works by blocking folic-acid synthesis of bacteria bacteriostatic - inhibits growth

cautions for sulfonamides/trimethoprim

caution in pts w/ renal impairment caution in pts with folic acid deficiency Pregnancy Category C contraindicated in babies less than 2 months (kernicterus)

adverse effects of sulfonamides/trimethoprim

rashes prescribe different med for alcoholics/drinkers (folate deficiency)

drug of choice for uncomplicated cystitis (UTI)

trimethoprim/sulfamethoxazole nitrofurantoin cipro fosfomycin (1 dose)

prostatitis treatment & causative organism

E coli IV fluroquinolone then oral agent for 2-4 weeks

4 drugs that are 1st line treatment of TB

isoniazid rifampin pyrazinamide ethambutol

what antibiotic should not be given to pts with myasthenia gravis

ciprofloxacin b/c it can exacerbate muscle weakness

fluoroquinolones warnings

pregnancy category C no children younger than 18

drug of choice for candidiasis

amphotericin B fluconazole, either one, +flucytosine

warning for amphotericin B

can cause kidney toxicity and damage

Treatment of topical tinea infections

topical azole or allylamine treatment should continue for at least 1 week after symptoms have cleared

onychomycoses

treat with oral antifungal topical ciclopirox get LFT at baseline when treating orally

Exam Two Flashcards

(68 cards)