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Last Minute Review Flashcards

(49 cards)

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1
Q

What drug class would you use for treatment of Zollinger-Ellison syndrome?

A

PPI - PEORL (“-prazole”)

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2
Q

Treating gastric ulcers, what should not be give with Sucralfate?

A

Antacids

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3
Q

What is Pirenzepine?

A

M1 selective antagonist used in the treatment of peptic ulcers, as it reduces gastric acid secretion and reduces muscle spasm.

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4
Q

What are the two mu opioid agonist used as antidiarrheals?

A

Loperamide and diphenoxylate

**note that diphenoxylate has a little bit of atropine added to it to inhibit potential for abuse

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5
Q

What is Pentazocine?

A

Mixed k Agonist and mu partial agonist/Antagonist

Potent analgesic in opioid naive patients but precipitate withdrawal in pts that are physically dependent on opioids. It has a ceiling effect and illicit psychomimetic effects.

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6
Q

What mixed agonist/antagonists used as opioids have psychotomimetic effects?

A

Pentazocine
Butorphanol
Nalbuphine

**note that the last one is buprenorphine and this does not have a pyschotomimetic effect as it is a kappa antagonist whereas the others are kappa agonists

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7
Q

Adverse effects of TCA?

A

constipation, dry mouth, blurred vision,

tachycardia, urinary retention

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8
Q

What channels do gabapentin and carbamazepine block?

A

Gabapentin - VG Ca2+ channels

Carbamazepine - VG Na+ channels

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9
Q

What are the first line drugs used to PREVENT migraines?

A
  1. B-blockers
  2. Valproate
  3. Topiramate

Valproate – indicated for bipolar disorder, epilepsy and migraine prophylaxis. It functions by inhibiting VG Na+ channels and T-type Ca2+ channels. AE - GI side effects, thrombocytopenia, hepatotoxicity (rare), teratogenic

Topiramate – indicated for epilepsy and migraine prophylaxis. It inhibits VG-Na+ channels, acts as a GABAa receptor agonist and glutamate receptor antagonist. AE - somnolence, fatigue, cognitive slowing, nervousness, confusion, acute myopia, glaucoma, hyperthermia, renal stones, teratogenic [CNS AE are the most common]

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10
Q

Which NSAID can precipitate acute gout attacks?

A

NSAIDs

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11
Q

DOC for postherpetic neuralgia and trigeminal neuralgia?

A

Trigeminal neuralgia - carbamazepine

Postherpetic neuralgia - lidocaine

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12
Q

Adverse effects of glucocorticoids?

A

[short term] – HTN, HYPERGLYCEMIA, immunosupression, psychotic reactions, cognitive impairment

[long term] – myopathy, Cushing’s syndrome, osteoporosis

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13
Q

What is Leflunomide?

A

Prodrug that is converted to teriflunomide leading to an inhibition of pyrimidine synthesis. [inhibits dihydroorotate dehydrogenase]

Uses…

  1. RA
  2. SLE
  3. Myasthenia gravis

**do not use in pregnancy

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14
Q

DOC chlamydia?

A

Doxycycline

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15
Q

Organisms that Vancomycin treats?

A

Gram positive - multi drug resistance!

**s. epidermidis, enterococcus species, oral dose for c. diffe

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16
Q

When should Nitrofurantoin not be used in pregnancy?

A

After 38 weeks, or within the 1st month of life

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17
Q

Empiric therapy for life threatening sepsis?

A

Cefepime + vancomycin – empiric therapy for
life‐threatening infections – IV, broad spectrum
& effective against MDR bacteria

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18
Q

Empiric therapy for Severe Febrile Neutropenia?

A

USE BROAD SPECTRUM (ex. Cefipime)

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19
Q

Tx severe acne?

A

Docycycline

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20
Q

When should you not give tetracyclines?

Study These Flashcards
A

Pregnant women and growing children! - inhibits bone growth and causes discoloration of teeth

21
Q

1 yo with Otitis media with minor PCN allergy?

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A

mild PCN - you can use carbapenems so Cetriaxone

Severe PCN -

22
Q

What categories of drugs should you not give to pts with SEVERE PCN allergies?

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A

PCN, amoxicillin, ampicillin, pseudomonas and staph -cillins, carbapenems, monobactams (Aztreonam), cephalosporins

23
Q

DOC syphillis?

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A

Benzathine PCN G

24
Q

What is mupirocin?

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A

Antibiotic belonging to monoxycarbolic acid glass that has activity against most gram positive cocci, including MRSA and streptococci (but not enterococci). It is the only topical/intranasal agent with activity against MRSA.
Mucpirocin binds bacterial isoleucyl transfer-RNA synthetase resulting in the inhibition of protein synthesis.

Intranasal - eradicats nasal colonization of MRSA in healthcare workers

Topically - treats impetigo or secondary infected traumatic skin lesion due to S. aureus or S. pyogenes

AE - resistance develops if used for long periods, local and dermatologic effects (burning, edema, tenderness, dry skin, pruritus)

25
What are Quinupristin and Dalfopristin?
These medications are given in combination as they act synergistically to have bactericidal action. They bind to separate sites on the 50S bacterial ribosome and leave a long post-antibiotic effect. Resistance with these drugs are uncommon as at least 2 mutations needs to occur for drug resistance to be achieved. * Administration - IV only * Penetrates macrophages and polymorphonucleocytes * inhibits CYP3A4 These medications are effective against gram-positive cocci and target multi-drug resistant bacteria (streptococci, PRSP, MRSA, E. faecium). -- because they are effective towards these bacteria, treatment with Streptogramins is restricted to treatment of infections caused by drug-resistant staphylococci or VRE. AE - usually infusion related (venous irritation, arthralgia and myalgia), GI effects, CNS effects (headache, pain)
26
What are the common causes of resistance to cipro and other fluoroquinolones?
1. chromosome-encoded mutation in DNA GYRASE 2. plasmid-mediated resistance 3. efflux pump
27
How is resistance with macrolides achieved?
methylation of 23S rRNA-binding site therefore drug can no longer bind
28
What is linezolid?
Binds 50S subunit preventing proteins synthesis by inhibiting formation of initiation complex. used for gram positive species with MDR AE - BM suppression, peripheral neuropathy, SEROTONIN SYNDROMES
29
Which cephalosporins may cause a disulfiram reaction?
Cefamandole Cefotetan Cefaperazone
30
AE of ganciclovir?
Myelosuppression
31
What is foscarnet?
Organic analog of inorganic pyrophosphate thereby selectively inhibiting pyrophosphate binding site of viral DNA polymerase. Does not require phosphorylation and is used in resistant herpes. Resistance - pt mutations in polymerase Administered via IV - last resort drug AE - nephrotoxicity is extremely significant and problematic, electrolyte disturbance, anemia, genital ulceration (in men), CNS (hallucinations seizures, headache)
32
When treating CMV colitis, what should be administered with Cidofovir?
Probenecid - this prevents nephrotoxicity
33
Most common adverse effect of cyclosporine?
Nephrotoxicity
34
Which medication increased HDL the most? Decreases TAGs the most?
Increases HDL - niacin | Decreases TAGs - fibrates
35
D2 receptor antagonists used as anti-emetics?
Phenothiazines, promethazine, droperidol Phenothiazines (prochlorperazine) - antagonist at D2 receptors and muscarinic receptors [AE - extrapyramidal symptoms, hypotension, sedation] Promethazine - anti-dopaminergic and anticholinergic used as antiemetic, antipsychotic effects and sedative Droperidol - anti-dopinergic, antiemetic, antipsychotic and neuroleptic analgesic agent
36
DOC toxo? What if Toxo encephalitis?
Toxo - TMP-SMX Toxo encephalitis - pyrimethamine+clindamycin or SMX or folinic acid
37
AE of quinine?
prolonged QT interval, hypotension, hypoglycemia, cinchonism, uterine contractions
38
Action of terbinafine?
Inhibition of squalene epoxide
39
DOC echinococcus granulosus?
Albendazole
40
DOC taenia solium?
Albendazole
41
DOC leishmaniasis?
Sodium stibogluconate OR Amphotericin B
42
DOC hemolymphatic stage of trypanosomiasis?
Pentaminide
43
DOC trypanosomiasis?
Melarsoprol or suramin
44
AE chloroquine?
retinopathy and hemolysis due to G6PD deficiency
45
AE mefloquine?
neuropsychiatric toxicity
46
NSAIDs and GI risks?
celecoxib has lowest GI risk (aspirin, ibuprofen and diclofenac have low risk, prioxicam has high risk!)
47
Alternative treatments to PCP?
clinamycin+primaquine dapsone+trimethoprim atovaquone pentamidine
48
H. pylori tx regimes
Treatment regimens... PPI+Clarithromycin+amoxicillin = 10-14 days PPI+Clarithromycin+metronidazole = 10-14 days Bismuth subsalicylate+metronidazole+tetracycline+Ranitidine or PPI = 10-14 days
49
Tx of infective endocarditis in pts with native valve vs prosthetic valve.
Native valve - PCN G + gentamicin Prosthetic valve - Vancomycin + gentamicin

Pharm 2 (18 decks)

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