Loads and loads and loads of drugs (GI sold separately) Flashcards
(205 cards)
1
Q
2 main classes of gram positive cocci
A
Staphyloccocus and streptococcus
2
Q
How are streptococci differentiated
A
Haemolysis
3
Q
How are staphylococcus differentiated
A
Coagulase test
4
Q
Commonest cause of pneumonia
A
Streptococcus pneumoniae
5
Q
Treatment for strep pneumoniae
A
Penicillin
6
Q
2 main groups of alpha haemolytic streptococcus
A
Strep pneumoniae and Strep viridans
7
Q
Common cause of endocarditis
A
Strep viridans
8
Q
2 main groups of beta haemolytic streptococcus
A
Group A Strep and Group B strep
9
Q
Most pathogenic strep
A
Group A strep (strep pyogenes)
10
Q
Treatment for beta-haemolytic strep
A
Penicillin/amoxicillin
11
Q
Examples of non-haemolytic strep
A
Enterococcus (faecalis and faecium)
12
Q
Common cause of UTI’s
A
Enterococcus faecalis
13
Q
Catalase positive cocci
A
Staphylococcus
14
Q
Catalase negative cocci
A
Streptococcus
15
Q
Coagulase positive organisms
A
Staph aureus
16
Q
Coagulase negative organisms
A
All staph apart from staph aureus
17
Q
Common cause of infected prosthetic heart valves and joints
A
Staph epidermidis (coagulase negative staph)
18
Q
Treatment for coagulase negative staph
A
Vancomycin
19
Q
Common cause of skin infections, abscesses, resp infections and food poisoning
A
Staph aureus
20
Q
The most common cause of bacteraemia
A
Staph aureus
21
Q
Treatment for staph aureus
A
Flucloxacillin
22
Q
Treatment for MRSA
A
Co-trimoxazole and clindamycin
23
Q
Gram negative cocci that causes bacterial meningitis
A
Neisseria meningitis
24
Q
Gram negative cocci that causes gonorrhoea
A
Neisseria gonorrhoea
25
Gram negative cocci that look like E.coli when cultured
Coliforms
26
Common gut commensals
E.coli, klebsiella and enterococcus
27
Common gut pathogens
Verotoxin producing E.coli (E.coli 1057), shigella and salmonella
28
Treatment for coliform infection
Gentamycin
29
Examples of gram negative bacilli that are strict aerobes
Legionella (gram- bacilli)
| pseudomonas (gram- bacilli)
30
Spiral/curved aerobic gram negative bacilli
Vibro cholera, campylobacter and H. pylori
31
Gram negative organism that commonly causes chest infections (esp in COPD)
Haemophilus influenza
32
Gram positive organism that commonly causes C. diff
Clostridium
33
Treatment for strict aerobes
Metronidazole
34
Treatment for TB
Rifampicin, isonazide, pyrazinamide and ethambutol
35
Causative organism of syphilis
Treponema pallidum
36
Cause of Lyme disease
Borrelia burgdorferi
37
Class of organisms that do not stain
Spirochaetes
38
Enzyme that is resistant to the early penicillins (like amoxicillin)
Beta-lactamase
39
Enzyme that is resistant to all penicillin, cephalosporins and carbapenems
Carbapenemase
40
Staph aureus that is resistant to flucloxacillin
MRSA
41
Antibiotics that work on the cell wall
Penicillin, cephalosporins and glycopeptides
42
Penicillin that is used for gram positive organisms
Flucloxacillin
43
Penicillin that is used for gram positive and gram negative organisms
Amoxicillin, co-amoxiclav, tazocin
44
Used first line for staph aureus
Flucloxacillin
45
Basically treats everything apart from pseudomonas and MRSA
Co-amoxiclav
46
Reserved for intensive care but can basically treat everything apart from MRSA
Tazocin
47
Only active against coliforms (gram negative organisms)
Temocillin
48
Broad spectrum antibiotics that are avoided in hospitals as they can cause C. diff
Cephalosporins
49
Examples of glycopeptides
Vancomycin and teicoplanin
50
Antibiotics that inhibit protein synthesis
Macrolides, tetracyclines and aminoglycosides
51
The only group of protein synthesis inhibiting antibiotics which are bacteriocidal
Aminoglycosides
52
Examples of macrolides
Erythromycin, clarithromycin and azithromycin
53
How are macrolides excreted
By the liver NOT the urine
54
Example of an aminoglycoside
Gentamicin
55
How must gentamicin be given
IV
56
Side effects of gentamycin
Kidney/renal damage, damage to CN VII causing deafness and dizziness
57
Antibiotics that work on bacterial DNA
Metronidazole, trimethoprim and fluoroquinolones
58
Used for pneumocystis jirovecii
Co-trimoxazole
59
Examples of fluoroquinolones. Note these are severely restricted in Tayside due to risk of C. diff
Ciprofloxacin and levofloxacin
60
Can cause tendonitis
Ciprofloxacin
61
Interacts with alcohol
Metronidazole
62
Antibiotics to avoid (the 4 C's)
Ciprofloxacin, co-amoxiclav, cephalosporins and clindamycin
63
Treatment for mild/moderate CAP
IV/PO Amoxicillin (PO doxycycline if allergic)
64
Treatment for severe CAP
IV Co-amoxiclav + clarithromycin OR doxycycline PO
| IV levofloxacin if allergic
65
Treatment for non-severe HAP
PO Amoxycillin and metronidazole
| If penicillin allergic PO Co-trimoxazole + Metronidazole
66
Treatment for severe HAP
IV Amoxicillin + Metronidazole + Gentamicin
| If penicillin allergic: IV Co-trimoxazole + Metronidazole +/- Gentamicin
67
Specific treatment for Staphylococcal Pneumonia
Flucloxicillin
| If MRSA suspected add vancomycin
68
Specific treatment for Klebsiella Pneumonia
Cefotaxime or Imipenem
69
Specific treatment for Pseudomonas Pneumonia
Anti-pseudomonal penicillin, cerftazidime, meropenum, or ciprofloxacin + aminoglycoside
70
Specific treatment for Mycoplasma Pneumonia
Clarithromycin or Tetracycline or Fluroquinolone (e.g. ciprofloxacin or norfloxacin)
71
Specific treatment for Legionella Pneumonia
Clarithromycin + rifampicin OR
| Fluoroquinolone (e.g. cirporfloxin) for 2-3 weeks
72
Specific treatment for Chlamydophilia Psittaci Pneumonia
Tetracycline or Clarithromycin
73
Specific treatment for Viral Pneumonia
Ciprofloxacin and Co-Amoxiclav.
| Prophylactically oseltamivir is given
74
Specific treatment for Pneumocystis Pneumonia (PCP)
High dose co-trimoxazole or pentamidine.
| Steroids are beneficial if severe hypoxaemia. Prophylaxis often used.
75
Treatment for Native valve (Subacute) Endocarditis (enterococcus)
IV Amoxicillin + Gentamicin, b.d.
76
Treatment for Native valve severe sepsis (Acute) Endocarditis (staph aureus)
IV Flucloxacillin
77
Native valve severe sepsis + risk factors for resistant pathogens Endocarditis
Vancomycin IV + Meropenem IV
78
Explain CURB 65 Score
```
Confusion
Urea >7 mmol/L
Resp. Rate ≥ 30/min
Bp <90mmHg (systolic) or ≤60mmHg (diastolic)
65 Age ≥65
1 point for each criteria
0-2 = Mild/Moderate CAP
3-5 = Severe CAP
```
79
Mechanism of Penicillins, Glycopeptides and Cephalosporins
Inhibit cell wall formation
80
Mechanism of Macrolides (e.g. erythromycin), Aminoglycosides and Tetracyclines
Inhibit protein synthesis
81
Mechanism of Rifampicin
Inhibit RNA synthesis
82
Gram+ organisms stain...
Purple
| Stain well due to thick peptidoglycan layer
83
Gram- organisms stain...
Pink
| Thinner peptidoglycan layer doesn't retain stain well
84
Endotoxin is produced by...
Gram-
| Part of cell wall
85
Exotoxin is produced by...
Gram+
| Exported from cell
86
Gram+ cocci in chains are?
Strep
87
The 5 methods of spread of infection are...
Inhalation, Ingestion, Inoculation, mother to Infant, Intercourse
88
Viruses contain RNA or DNA, never both. True/False?
True
| Size of their capsid (protein coat) limits space
89
Bactericidal antibiotics inhibit cell growth. True/False?
False
| Kill bacteria directly - bacteriostatic inhibits cell growth
90
Vancomycin is part of which family of antibiotics?
Glycopeptides
91
Penicillins are bactericidal/bacteriostatic, safe/not safe in pregnancy, excreted via kidneys/urine/liver
Bactericidal, safe in pregnancy, kidneys
92
Cephalosporins are bactericidal/bacteriostatic, safe/not safe in pregnancy, excreted via kidneys/urine/liver
Bactericidal, safe in pregnancy, kidneys + urine
93
Gentamicin [aminoglycoside] is bactericidal/bacteriostatic, safe/not safe in pregnancy, excreted via kidneys/urine/liver
Both bacteriostatic + bactericidal, not safe in pregnancy, urine
94
Metronidazole is bactericidal/bacteriostatic, safe/not safe in pregnancy, treats aerobes/anaerobes
Bactericidal, safe in pregnancy, anaerobes (Clostridium and Bacteroides)
95
Treatment of non-severe C.Difficile
Metronidazole PO 10days
96
Treatment of severe C.Difficile
Vancomycin PO/NG (10 days)
| +/- IV Metronidazole
97
What is the main treatment for CF?
if Staph. aureus - flucloxacillin (PO) and septrin (PO)
if pseudomonas - azithromycin (PO), nebuliser colomycin and nebuliser tobramycin
Creon for pancreas
laxido/ gastrogaffin if constipation
98
What is the side effect of Ivacaftor?
Can't eat grapefruit
99
What is the treatment for the flu?
oseltamivir/zanamivir
100
What vaccine for the flu is given to which group of people (live/killed)?
Killed - adults that need it (e.g. health care workers and elderly/ asthmatics
Live - for children aged 2-5 and NOW all primary school children are offered
101
What treatment is given to those with CAP caused by an atypical bacteria?
Tetracycline and Macrolides
102
What drugs do you NOT give to people with bronchiolitis?
salbutamol, adrenaline, antibiotics, ipratropium, corticosteroids, montelukast or saline
103
What treatment do you give to those with bronchiolitis?
O2 (if below 92%), consider CPAP
104
What treatment should be given to those having an exacerbation of COPD?
amoxicillin 500mg (5 days), doxycycline if allergic to penicillin 200mg
105
What is the treatment for whooping cough?
less than a month - clarythromycin
more than a month - clarythromycin and azithromycin
if pregnant - erythromycin
106
What treatment should be given to those with Legionnaires disease?
clarythromycin, erythromycin and quinolones (levofloxacin)
107
What is the treatment for aspergilloma?
Amphoteric B, Voriconazole and surgery
108
What is the treatment for TB?
Two months of Rifampicin, isoniazid, pyrazinamide and ethambutol
A further 4 months of rifampicin and isoniazid
" 2RIPE 4RI"
109
What are the side effects of the treatments for TB?
rifampicin - orange tears n urine
isoniazid - peripheral neuropathy
pyrazinamide - joint pain, gout
ethambutol - optic neuritis
110
What is the initial treatment for those diagnosed with asthma?
SABA (IH) PRN
111
If the initial treatment for asthma isn't working, what the treatment can be given?
ICS - beclometasone
LABA - only used in combination with ICS - salmeterol
CystLT receptor antagonist - montelukast
cromone - sodium cromoglicate
xanthine - used in combination with SABA/LABA and ICS - theophylline
112
What is ivabradine?
A selective HCN channel blocker that slows HR in angina
113
When is dobutamine used as a treatment?
During acute but possibly reversible heart failure
114
What do B-blockers do?
Propanolol, atenolol, bisoprolol - reduce HR and force - can cause bradycardia or bronchospasms( yeh even cardio selective ones according to passtest)
115
When are B-blockers used?
to decrease tachycardia, AF, treat angina, heart failure and hypertension
116
What are the side effects of B-blockers?
```
bronchospasm
bradycardia (heart block in those with coronary disease)
masks a hypo
fatigue
cold extremities
```
117
What is atropine?
Muscarinic receptor antagonist - increases HR
118
Why is atropine used clinically?
For patients with SEVERE bradycardia
119
What should you be careful of when using atropine?
Always give in 600mg or more doses because if given in lower doses, can cause more bradycardia (lol how unlucky could you get)
120
What is digoxin used for?
Heart failure
121
What are the side effects of digoxin?
Can cause tachycardia, an ectopic beat, hypokalemia, heart block, nausea, vomiting, diarrhoea, disturbances of colour vision, tender breasts
Basically, it's a riot
122
What is levosimendan?
A calcium- sensitiser - causes vasodilation
123
When are diuretics used?
```
Hypertension (mild - thiazide)
Heart failure (strong - Loop)
```
124
Loop diuretics side effects include
HYPO - everything basically
125
What is an example of a non selective b blocker and what is it used for?
propanolol
| thyrotoxicosis
126
When are anti platelets used?
angina
acute MI
CVA/TIA
127
What is an example of an antiplatelet?
aspirin
| clopidogrel
128
What are the side effects of anti platelets?
haemorrhage
peptic ulcer
aspirin sensitivity
129
What are examples of anticoagulants?
```
Heparin IV
Warfarin IV (blocks clotting factors 2,7,9,10)
```
130
What is the treatment for an acute MI?
```
MONAC
moprhine = anti emetic
oxygen
nitrates (GTN)
aspirin
clopidogrel
```
131
What is used for an acute phase SVT?
vagal manoeuvres
IV adenosine
IV verapamil
132
What drug can control rhythm in AF?
K+ channel blockers
| amiodarone, soltalol
133
What is the treatment for post MI?
```
SABA
statin (simvastatin)
ACEI/ARB (lisinopril/losasartan)
B blocker (atenolol)
Aspirin
```
134
What drug can control AF rate?
b blocker - NOT sotalol
Rate limiting channel blockers - verapamil, diltiazem
digoxin for those that don't got off their arse (that was flannigan not me, i'm not a dick to ppl with AF)
135
What is the treatment for chronic SVT?
B blockers
Calcium channel antagonist
Ablation
136
What is the treatment of sinus bradycardia?
Atropine
| Pacing if haemodynamic compromise
137
What is the treatment pathway for angina?
1. B blocker/ calcium channel blocker
2. Can add long acting nitrate, ivabradine, nicorandil
then ACEI
statins
138
What is the treatment for Ventricular fibrillation?
CRP
Defib
after 3rd shock - IV adrenaline
-IV amiodarone
139
What is the treatment of Ventricular tachycardia?
```
DCCV
catheterisation
electrolyte correction
amiodarone
lidocaine
```
B blockers are initial therapy
140
What are the side effects of heparin?
osteoporosis
haemorrhage
hypoaldosteronism
141
What do aldosterone antagonists do and give an example?
gets rid of excess water and Na retention (RAAS inhibitor), increases potassium levels, lowers high BP, treats heart failure
- spironolactone
142
What are side effects of spironolactone?
gynecomastia (lol)
| hyperkalaemia
143
What does ezetimibe do?
reduces the absorption of cholesterol to decrease LDL
144
Who can ezetimibe not be given to?
breast feeding females (females who are breast feeding their kids not ones who are feeding off breasts)
145
Name the 4 classes of Anti-Hypertensive drugs
Diuretics, Beta-blockers, Ca2+ Channel Antagonists and Vasodilators
146
Name the two types of Diuretics and their relative strength
Thiazide mild
| Loop strong
147
Name the two types of Beta Blockers and the difference between them
Cardioselective - Only block B1 receptors
| Non -selective - Block B1 and B2 receptors
148
Name the 3 types of Vasodilators
Alpha-Blockers a1 adrenoreceptor antagonists
ACE inhibitors
Angiotensin receptor blockers
149
Give an example of a Loop diuretic
Furosemide
150
Give an example of a Cardioselective beta blocker
Atenolol
151
Give an example of a Non-selective beta blocker
propanolol
152
Give an example of a Dihydropyridine Ca2+ Channel antagonist
Amlodipine
153
Give examples of Rate limiting calcium antagonists (Ca2+ channel antagonists)
Verapamil
| Diltiazem
154
Give examples of Alpha Blocker vasodilators
Prazosin
| Doxazosin
155
Give an example of an ACE inhibitor vasodilator
Ramipril
156
Give an example of an Angiotensin receptor blocker vasodilator
Losartan
157
Name the monoclonal antibody against IgE?
olamizumab (yeh that weird one that you can't pronounce)
158
What is the monoclonal antibody against IL-5?
mepolizumab
159
What treatment is used for those who present with an acute asthma attack?
```
O2 (high flow)
Salbutamol nebulised
Hydrocortisol (or prednisolone)
Ipratropium
Magnesium sulphate
Theophylline
Anaesthetist
```
160
What is the treatment for those suffering an acute exacerbation of COPD?
What is the treatment for those suffering an acute exacerbation of COPD?
161
What is the recommended treatment for COPD?
A LABA/LAMA combination inhaler
| and stop smoking so you dont die as soon
162
What is an example of an Ultra - LABA?
Indacaterol (cos it's shorter acting than salmeterol)
163
What other drugs can be used in the treatment for COPD?
Rofumilast - PDE4 inhibitor
164
What is the main drug given to those diagnosed with rhinitis?
Glucocorticoids - beclometasone, prednisolone
165
What other treatments can be given to those with rhinitis?
Anti-histamines - Loratadine, Fexofenadine, Cetirizine
SAMA - Ipratropium
Cromones - sodium cromoglicate
CystLT - montelukast
Vasoconstrictors - oxymetazoline
(if ur keen, take a look at rebecca's Resp cards she loves rhinitis)
166
Mechanism of diuretics
Promote Na+ and water excretion from the kidneys by inhibiting reabsorption in the loop of Henle or distal tubule
167
What is the mechanism of cardioselective beta blockers
Only block β1 receptors – β1 adrenoceptors stimulate Gs - ↑ cAMP, ↑PKa - ↑CICR VIA RyR2, ↑Contractility
168
What is the mechanism of non-selective beta blockers
Block β1 & β2 receptors – β2 adrenoceptors cause vasodilation of the coronary arteries and ↑ HR
169
What is the mechanism of Alpha Blocker vasodilators
Block vascular α1-adrenoceptors - ↓ TPR and MABP
170
What is the mechanism of Ace inhibitors
Block the conversion of angiotensin I – angiotensin II
171
What is the mechanism of Angiotensin Receptor Blockers
AT1 receptor antagonist – competitively blocks the agonist action of angiotensin II at AT1 receptors – Venous dilatation (↓ preload) and arteriolar dilatation (↓ afterload and ↓TPR), ↓ MABP
172
Name the 4 types of Anti- Anginal drugs
Beta Blockers Ca2+ Channel Antagonists Nitrates Potassium channel openers
173
Give 2 examples of Nitrates
Glyceryl trinitrate Spray (GTN Spray) Isosorbide mononitrate
174
Give 2 examples of Potassium channel openers
Nicorandil Ivabradine
175
What is the mechanism of Nitrates
Relax all types of smooth muscle, via their metabolism to nitric oxide. Small doses – vasorelaxation - ↓ CVP (preload) reduces SV Higher doses - ↓ MAP - ↓ afterload ↑ Coronary blood flow. In angina, there is no overall increase, but blood is directed towards the ischaemic zone – collateral arterioles dilated >> ↓myocardial O₂ req., ↓ afterload, ↑Ischaemic perfusion
176
How you doing?
Good shift for making it this far, just checking up on you, click the wee blue comment symbol and lemme know how ur feeling
177
What conditions can Potassium channel blockers be used for
Nicorandil - Stable Angina Ivabradine - Chronic Heart Failure, Angina Pectoralis
178
What are the side effects of nitrates
Repeated Administration may be associated with diminished tolerance. Build in ‘nitrate low’ periods. Postural hypotension Headaches leave 8hrs of the day nitrate free
179
What are the side effects of Potassium channel openers
Hypovolaemia – low systolic BP Palpitations, Weakness
180
Name 2 statins
Simvastatin
| Atorvastatin
181
Name 2 fibrates
Bezafibrate
| Gemfibrozil
182
Name 3 Bile acid Binding Resins
Colestyramine
Colestipol
Colesevelam
183
Name an Ezetimibe
Ezetimibe (just making sure ur paying attention and not just boosting ur flashcard number)
184
What is the mechanism of statins
Block HMG-CoA reductase (competitive inhibitors) – Reduction of LDL production in Liver
Surface expression of the LDL receptors increases → increased clearance of LDL in the liver.
↓ inflammation, reversal of endothelial dysfunction, ↓ thrombosis, stabilisation of atherosclerotic plaques
185
What conditions are statins used for
```
Hypercholesterolaemia
Diabetes
Angina/MI
CVA/TIA
High risk of MA & CVA
```
186
What conditions are fibrates used for
Low HDL cholesterol
| Hypertriglyceridaemia – first line treatment
187
What are the side effects of statins
Myopathy
Rhabdomyolysis
sreenal failure lol
Should not be prescribed to pregnant → cholesterol needed for foetus development
188
What are the side effects of fibrates
May cause myositis – advised combining with statins.
189
When can statins not be used
Ineffective in Homozygous familial hypercholesterolaemia, where LDL receptors are lacking
190
What is the mechanism of bile acid binding resins
Cause the excretion of bile salts resulting in more cholesterol to be converted to bile salts by interrupting enterohepatic recycling
↓ absorption pf triglycerides, ↑ LDL receptor expression
191
What are the side effects of bile acid binding resins
G.I. tract irritation
192
Name the 4 types of Anti-Arrhythmic drugs
Class I Class II Class III Class IV
| you've nailed it, ur basically a doctor now
193
Name the 3 types of Class I Anti-Arrhythmic drugs
IA IB IC
| congrats ur now a consultant
194
Give an example of a Class IA drug
Disopyramide
195
Give an example of a Class IB drug
Lignocaine
196
Give an example of a Class IC drug
Flecainide
197
Give an example of a Class II drug
Metoprolol
198
Give an example of a Class III drug
Amiodarone
199
Give an example of a Class IV drug
Verapamil
200
How to remember mechanisms of the 4 classes of anti arrhythmic drugs
Seumy Barker Pulls Cammy
Sodium, Beta, Potassium, Calcium
1, 2, 3, 4
201
Name 3 types of inotropic drugs
Digoxin
Calcium sensitizers
Beta-Adrenoceptor agonists
202
Name the 2 types of Digoxin
Digoxin I
Digoxin II
mate, ur basically a surgeon now
203
Name 2 Beta-Adrenoceptors
Adrenaline
| Dobutamine - IV
204
What is the mechanism of Digoxin I
Blocks atrial-ventricular conduction – produces an AV conduction delay. Blocks the Sarcolemma ATPase - Na+/K+ATPase blocked, ↑[Na]I and ↓Vm, ↓Na+/Ca2+ exchange and ↑[Ca2+]I, ↑ storage of Ca2+ in SR, ↑CICR; ↑contractility (Increases contractility of the heart)
205
What is the mechanism of Digoxin II
Increases ventricular irritability which produces ventricular arrhythmias – always bad, narrow therapeutic index BAD BAD BAD BAD
