Micro Pharm Flashcards Preview

Rapid Review STEP 1 > Micro Pharm > Flashcards

Flashcards in Micro Pharm Deck (73):
1

Difference between peniciliin G and V.

G = IV and IM. V = oral. pharmacology micro

1

Penicillin(mechanism,use,toxicity)

Bind penicillin-binding proteins(transpeptidases), block cross linking of peptidoglycans;most effective on G+, also N. Meningitidis, Treponema;hypersensitivy reaction, hemolytic anema. pharmacology micro

2

Oxacillin,Naficillin,Dicloxacillin(mechanism,use,toxicity)

bind transpeptidases, penicillanse resistant due to bukly r-group blocking B-Lactamse; S. Aureus, except MRSA; hypersensitivity and interstitial nephritis. pharmacology micro

3

Ampicillin, amoxicillin(mecanism,use,toxicity)

bind transpeptidases, wide spectrum and more penicillinase sensitive. combo with claculanic acid to protect from B-lactams;kills enterococci(HELPSS)H.iB, E.coli,Listera,Proteus,Salmonella,Shigella,enterococci;hypersensitivity reaction,rash,pseudomemrane colitis. pharmacology micro

4

Which has better bioavailibility; amoxicllin or ampicillin?

amOxicllin has better Oral bioavilability. pharmacology micro

5

What does clavulanic acid do?

B-lactamse inhibitor pharmacology micro

6

Ticarcillin,piperacillin(mechanism,use,toxicity)

transpeptidase inhibitor but extended spectrum;pseduomonas and g- rods, use with claculanic acid due to B-lactamse suspectibilty; hypersensitivity reaction. pharmacology micro

7

List the B-lactamse inhibitors

(CAST) Clavulanic Acid, Sulbactam,Tazobactem. pharmacology micro

8

Cephalosporin(mechanism,use,toxiciity)

inhibit cell wall synthesis but are less susceptible to B-lactamases, are bactericidal;use depends on generation, there are four;hypersensitivty reactions, vitamin K defiency, increased nephrotoxicity of aminoglycosides. pharmacology micro

9

give use of cefazolin, cephalexin.

1st generation cephalosporins. PEcK. Proteus, E.coli,Klebsiella. Cefazolin used preop to prevent A.aureus infections. pharmacology micro

10

give use of cefoxitin, cefaclor,cefuroxime`

2nd generation cephalosporins. HEN PEcKs. H.ib, Enterbacter, Neisseria, Proteus, E.coli,Klebsiella, Serratia. pharmacology micro

11

give use of ceftriaxone, cefotaxime,ceftazidime

3rd gen. cephalosporins. Serious gram - infections. Ceftriaxone = meningitis and gonorrhea. Ceftazidime = pseudomonas. pharmacology micro

12

give use of cefepime.

increased activity against pseudomonas and G+ bugs. pharmacology micro

13

Aztreonam(mechanism,use,toxicty)

a monobactem resistant to B-lactamases, prevents binding to PBP3 and is synergistic with aminoglycosides;gram - rods only;very nontoxic, some GI upset. pharmacology micro

14

what transpeptidase inhibitor can be used in penicillin allergy?

aztreonam. pharmacology micro

15

imipenem/cilastatin,meropenem,etrapenem,doripenem(mechanism,use,toxicity)

broad spectrum, B-lactamase resistent but imipenem needs cilastatin to inhibit renal dehydropeptidase. later carbepenems do not;G+ cocci,G- rods, anerobes. used only in life threating events;skin rash, CNS toxicity, seizures. pharmacology micro

16

Vancomycin(mechanism,use,toxicty)

inhibits cell wall binding peptidoglycan formation by binding D-ala percursors, is bacterialcidal; G+ only, especially for multidrug resistant onces;NOT - nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome. pharmacology micro

17

How is redman syndrome prevented in vancomycin use?

slow infusion and rate and antihistamines. pharmacology micro

18

How does vancomycin resistant occur?

amino acid change of D-ala D-ala to D-ala D-lac. pharmacology micro

19

List antibiotic protein synthesis inhibitors

AT 30, CCEL at 50. 30S = Aminoglycosides, Tetracyclines. 50S = Chloramphenicol, Clindamycin, Erythromycin, Linezolid. pharmacology micro

20

Gentamicin, neomycin, amikacin,tobramycin,streptomycin(mechanism,use,toxicity)

aminoglycosides, bacterialcidal, block translocation but require oxygen for uptake;ineffective in anaerobes,use in gram - rod infections and before bowel surgery; nephrotoxicty, NMJ block, ototoxicity, teratogen. pharmacology micro

21

how does resistenace to aminoglycosides occur?

transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. pharmacology micro

22

tetracycline, doxycycline, demecycline,minocycline(mechanism, use, toxicity)

bacteriostatic, prevents aminoacyl-tRNA binds;Borrela, M. Pneuomo, Rickettsia, Chlamysia; can't take with milk, antacids, iron because ions bind it, GI distress, discoloration of teeth, inhibition of bone growth, contraindication in pregnancy. pharmacology micro

23

how does resistance to tetracyclines occur?

decrease uptake into cells or increased efflux by pumps. pharmacology micro

24

Azithromycin, clarithromycin, erythromycin(mechanism,use,toxicity)

bacteriostatic, blocks translocation; atypical pneumonias, chlamydia, gram + cocci; MACRO: increased Motility, arrhythmia, Cholestatic hepatitis, Rash, eOsinophilia. pharmacology micro

25

how does resitance to macrolides occur?

methylation of 23s rRNA binding site. pharmacology micro

26

Chloramphenicol(mechanism,use,toxicity)

Bacterialstatic, blocks peptidlytransferase; Meningitis in adults, used in power countries due to being cheap; dose dependent anemia, dose independent aplastic anemia, gray baby syndrome. pharmacology micro

27

what causes grey baby syndrome?

use of chloramphenicol in premature infants, they lack UDO-glucuronyl-transferase. pharmacology micro

28

How does resistance to chloramphenicol occur?

plasmid-encoded acetyltransferase. pharmacology micro

29

clindamycin(mechanism,use,toxicity)

Bacteriostatic. Blocks peptide transfer; anaerobic infections in lung infections and oral anerobes; C. Diff infection, fever, diarrhea. pharmacology micro

30

Sulfamethoxazole(SMX), sulfisoxazole, sulfadiazine(mechanism, use, toxicity)

Bacteriostatic, PABA metabolites inhibit dihydropteroate synthase; Gram +, G-, Nocardia, Chlamydia, UTI; hypersensitivty, hemolysis in G6PD, nephrotoxic, kernicterus, displaces other drugs from albumin. pharmacology micro

31

how does resistance to sulfonamides occur?

altered bacterial dihydropteroate or increased PABA synthesis. pharmacology micro

32

Trimethoprim(mechanism,use,toxicity)

Bacteriostatic, inhibits bacterial dihydrofolate reductase, blocks folate synthesis; used in UTI, PCP (prophylacis and treatment), shigella, salmonella; megaloblastic anemia, leukopenia, granulocytopenia. pharmacology micro

33

ciprofloxacin, norfloxacin, levofloxacin, etc...(mechanism, use, toxicity)

bactericidal, inhibits DNA gyrase(topo II and IV);G- rods of urinary and GI tracts, Neisseria, some G+;( lones hurt the bones) tenonitis and tendon rupture, superinfections, don't give to kids or pregnant women due to cartilage damage. pharmacology micro

34

how does resistance to fluroquinolones occur?

mutation in DNA gyrase or efflux pumps. pharmacology micro

35

What groups are susceptible to fluorquinolone tendon rupture?

older than 60 or taking prednisone pharmacology micro

36

Metronidazole(mechanism, use, toxicity)

bacterialcidal, forms free radical toxic metabolites that damge bacterial DNA damage; (GET GAP) Giardia, Entamoeba, trichomonas, Gardnerella, Anaerobes, Pylori; causes disulfiram like reaction, headache, metallic taste. pharmacology micro

37

Isoniazid(mechanism,use,toxicity)

decrease synthesis of mycolic acids, bacterial catalase peroxidase(KatG) must activate INH; TB drug, only one used as prophylaxis and in latent TB; peripheral neuropathy, hepatoxic, lupis like drug interaction, pyridoxine antagonist. pharmacology micro

38

Rifampin(mechanism,use,toxicity)

inhibits DNA-dependent RNA polymerase; TB, Leprosy, prophylaxis in meningococcus and Hib type B; hepatotox, p450 inducer, orange body fluids. pharmacology micro

39

Pyrazinamide(mechanism, use, toxicity)

unknown; TB; hyperuricemia, hepatotoxic. pharmacology micro

40

Ethambutol(mechanism,use,toxicity)

decreased carbohydrate polymerization of TB cell wall, blocks arabinosyltransferase; TB; optic neuropathy(red-green color blindness_ pharmacology micro

41

Amphotericin B(mechanism, use, toxicity)

binds fungal ergosterol, causes holes in membranes; use in systemtic and CNS mycoses infections; fever/chills, hypotension, arrythmias, nephrotoxic, IV phlebitis, must supplement K and MG. pharmacology micro

42

nystatin(mechanism,use,toxicty)

binds fungal ergosterol;topical only due to high toxicity, used for oral thrush and topical diaper rash or vaginal candidiasis. pharmacology micro

43

Fluconazole, ketoconazole, clotrimazole, itraconazole, voriconazole(mechanism, use,toxicity)

inhibits fungal ergosterol synthesis by binding p450;Fluconazole for suppression of cryptococcus in AIDs patients, itraconazle for blasto, coccio, histo. pharmacology micro

44

Flucytosine(mechanism, use, toxicity)

inhibits fungal DNA and RNA synthesis by conversion to 5FU; used in systemic fungal infections, especially cryptococcus; bone marrow suppression. pharmacology micro

45

Caspofungin, micafungin(mechanism, use, toxicity)

inhibits fungal cell wall synthesis by inhibiting B-glucan synthesis; invasive aspergillosis, candida; flushing via histamine releae. pharmacology micro

46

terbinafine(mechanism,use,toxicity)

inhibits fungal squalene epoxidase; treat dermatophytes - toe nail infection especially;abnormal LFT, visual disturbances. pharmacology micro

47

Griseofulvin(mechanism,use,toxicity)

interferes with microtubules, stops mitosis in fungi;deposits in keratin so used in superficial infections, stops dermatophytes; teratogenic, carcinogenic, confusion, p450 inducer. pharmacology micro

48

Pyrimethamine use

toxoplasmosis pharmacology micro

49

suramin and melarsoprol use

trypanosoma brucei pharmacology micro

50

nifurtimox use

trypanosoma cruzi pharmacology micro

51

sodium stibogluconate use

leshmaniasis pharmacology micro

52

Chloroquine(mechanism,use,toxicity)

blocks formation of heme into hemozoin. Heme accumulates and is toxic to plasmodia;used on all species but falciparum(too much resitance); retinopathy pharmacology micro

53

quinidine use

lifethreatening malaria pharmacology micro

54

artemether/lumifantrine use

p. falciparum killing pharmacology micro

55

Zanamivir,oseltamivir(mechanism,use)

inihibits influenza neuraminidase, stops progeny release; treamt of influenze a and b pharmacology micro

56

Ribavarin(mechanism,use,toxicity)

inhibits sythesis of guanine nucleotides by competitvely inhibiting IMP dehydrogenase; RSV, chronic hep C; hemolytic anemia, severe teratogen pharmacology micro

57

Acyclovir,valacyclovir(mechanism, use, toxicity)

Guanosine analog, inhibits viral DNA polymerase; monophosphorylated by thymidine kinase in HSV/VZV so active in lesions and encephalitis, good for prophylaxis, pharmacology micro

58

Famciclovir use

used in herpes zoster active infections pharmacology micro

59

mechanism for resistance to acyclovir

mutated viral thymidine kinase pharmacology micro

60

Ganciclovir,valgangciclovir(mechanism,use,toxicity)

guanosine analog, 5'-monophosphate formed by CMV viral kinase, inhibits viral DNA polymerase;CMV infections;leukopenia,neutopenia,thrombocytopenia,renal toxicity pharmacology micro

61

mechanism for resistance to acyclovir

mutated CMV DNA polymerase or lack of viral kinase pharmacology micro

62

Foscarnet(mechanism,use,toxicity)

viral DNA polymerase inhibitor, binds to pyrofosphate binding site, doesn't need viral kinase activation;CMV retinitis when ganciclovir fails and acyclovir restitant HSV; nephrotoxic pharmacology micro

63

mechanism for resistance to foscarnet

mutated DNA polymerase pharmacology micro

64

cidofovir(mechanism,use,toxicity)

inhibits DNA polymerase, doesn't require activiation by viral kinase; CMV retenitis, acyclovir resistant HSV; nephrotoxic pharmacology micro

65

HAART consist of what?

[2 NRTI] +[1 NNRTI OR 1 protease inhibitor OR 1 integrase inhibitor] pharmacology micro

66

give mechanism and toxicity of protease inhibitors

all end in -NAVIR! stops HIV mRNA cleavage into functional parts; hyperglycemia, GI upset, lipodystrophy. pharmacology micro

67

Ritonavir does what to be a "booster"

inhibits cytochrome p-450, boosting concentration of other drugs. pharmacology micro

68

Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didansoine, stavudine(mechanism,use,toxicity

(NRTI)competitively blocks binding of nucleotide to reverse transcriptase, only tenofovir doesn't need to be activated;all NRTIs, zidovidine used in pregnancy to reduce fetal transmision; bone marrow suppression, lactic acidosis, peripheral neuropathy. pharmacology micro

69

Nevirapine, Efavirenz, Delavirdine(mechanism,use,toxicity)

(NNRTI) bind at a site different from NRTIs, no don't require activation don't compete with nucleotides; bonow marrow suppression, peripheral neuropathy, lactic acidosis, pharmacology micro

70

Raltegravir(mechanism,use,toxicity)

inhibits integrase, which stops HIV integration into host cells;HIV;hypercholesterolemia pharmacology micro

71

Interferons(mechanism,use,toxicity)

glycoproteins synthesized my virus infected cells, block RNA and DNA virus replication; INFa- chronic hep b and c, Kaposi sarcoma, IFN-b -MS, INF-gamma -NADPH oxidase defiency; neutropenia, myopathy. pharmacology micro

72

What antibiotics must be avoided in pregnancy?

SAFe Children Take Really Good Care. sulfonamides(kericterus), aminoglycosides(ototox), fluoroquinolones(cartilage damage), Clarithromycin(embryotoxic), Tetracycline(teeth,bone damage),Ribavarin(teratogenic),Griseofulvin(teratogenic),Chloramphenicol(grey baby) pharmacology micro