midterm Flashcards

(117 cards)

1
Q

vWD

A

autosomal dominant, stabilizes factor VIII

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2
Q

desmopressin

A

procoagulent, like vasopressin, releases endogenous fVIII, vWF, plasminogen

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3
Q

aminocaproic acid, tranexamic acid

A

inhibits plasminogen from binding to fibrin, for surgeries on hemophiliac pt or large blood loss pt

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4
Q

vitamin K

A

procoagulant, warfarin antidote

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5
Q

protamine

A

procoagulant, heparin antidote

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6
Q

unfractionated heparin

A

anticoagulant, extracted from cow lung, pig intestines (so no animal allergies), tx of DVT, PE, and MI

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7
Q

enoxaparin, dalteparin

A

anticoagulant, LMWH

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8
Q

fondaparinux

A

like a LMWH, NO ANTIDOTE!

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9
Q

dabigatran

A

anticoag., no monitoring of INR/aPTT monitoring, idarucizimab is antidote

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10
Q

rivaroxaban and apixaban

A

anticoag., NO ANTIDOTE, no monitoring of INR/aPTT

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11
Q

warfarin

A

less consistent anticoag., LOTS of INXNS!, inhibits vit. K reductase, impactive by vit. K levels in liver, metabolized by CYP450 enzymes in liver, inxt with ABs, anti-fungals, NSAIDS, herbs, vit. K rich foods, must MONITOR INR/aPTT! antidote = vit. K

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12
Q

aspirin

A

platelet inhibitor, COX inhibitor

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13
Q

clopidogrel

A

platelet inhibitor, irreversible inhibition of P2Y12 receptor

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14
Q

use anticoagulants in dentistry?

A

NO!

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15
Q

safe INR for warfarin pts:

A

4.0 for simple OS, 3 for OS resulting in lots of blood loss

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16
Q

stop aspirin for OS?

A

Nope

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17
Q

who to consult before modifying anticoagulation therapy>

A

Prescribing physician or anticoag. clinic!

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18
Q

who has LPS

A

gram negative bacteria

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19
Q

who has thick cell wall

A

gram postitive bacteria

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20
Q

prevents cell growth or replication and limits spread of infection…

A

bacteriostatic

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21
Q

induces bacterial cell death

A

bactericidal

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22
Q

act on single or ltd group of bacteria, 1st choice

A

narrow spectrum, eg. isoniazid

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23
Q

effective against gram + and - bacteria

A

extended spectrum, ampicillin

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24
Q

active against wide variety of microbial species

A

broad spectrum, eg. tetracycline

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25
what kills MRSA
NOT beta-lactam ABs, vancomyscin or ceftaroline preferred
26
acquired mechanism for beta-lactam resistance
bacteria produces beta-lactamases which hydrolyze beta-lactam ring!
27
clavulanic acid
beta lactamase inhibitor, given with amoxicillen --> AUGMENTIN
28
tazobactam
beta lactamase inhibitor, PIPERACILLIN
29
sulbactam
beta lactamase inhibitor, AMPICILLIN
30
narrow spectrum penicillins
Penicillin V and beta-lactamase resistant Dicloxacillin
31
extended spectrum penicillins
amoxicillin/clavaulanic acid, ampicillin/sulbactam, pipercillin/tazobactam
32
penicillin V
1st choice for tx of odontogenic infections, for moderate to severe gingivitis
33
Dicloxacillin
antistaphylococcal penicillin, rarely by dentists
34
Ampicillin with...
sulbactam
35
Amoxicillin with...
clavulanate
36
principle adverse effect of penicillins...
allergic rxn
37
1st gen. cephalosporins
cefazolin, cephalexin
38
2nd gen. cephalosporins
cefuroxime, cefprozil
39
3rd gen. cephalosporins
cefdinir, ceftriaxone --> penetrates CNS, both associate with c. dif. diarrhea
40
which cephalosporin penetrates CNS
ceftriaxone
41
4th gen. cephalosporin
cefepime --> beta lactamse resistant
42
5th gen. cephalosporin
ceftaroline --> MRSA
43
cephalosporins adverse rxns
allergic, not for pt with penicillin allergy bc cross hypersensitivity
44
drug ixn with cephalosporins
antacids, antihistamines, proton pump inhibitors, Fe supplements
45
monobactam
aztreonam --> IV for serious infectiosn
46
vancomycin
AB, inhibits cell wall synthesis, MRSA, S. pneumoniae, enterocolitis by C. dif., RED MAN SYNDROME!
47
Erythromycin, clarithromycin, azithromycin...
binds reversibly to 50s ribosomal subunit, bacteriostatic
48
Adverse effects of erythromycin, clarithromycin, an azithromycin
GI tract Ototoxic (erythromycin) --> reversible tinnitus arrhythmia
49
tx of H. pylori infections
clarithromycin
50
Clindamycin...
good for penicillin-resistant bacteria acute orofacial infections used as bacterial endocarditis prophylaxis in pts with penicillin allergy can CAUSE C. diff infections!
51
tetracycline/doxycycline
can cause permanent staining of teeth
52
adverse effects of tetracyclines
``` black furry tongue nephrotoxic hepatotoxic not for kids under 8 yoa not during pregancy tooth discoloration enamel hypoplasia photosensitivity superinfections (eg. C. albicans) drug/food ixns ```
53
drug/food ixns of tetracyclines
``` dairy Ca++ Mg++ Fe++ Al+++ antacids ```
54
gentamicin
bactericidal aminoglycoside, serious Gram Negative infection
55
adverse effects of aminoglycosides
``` nephrotoxic Ototoxic poor oral absorption poor CNS penetration narrow therapeutic index ```
56
Linezolid
oxazolidinone, tx of vancomycin-resistant E. faecium!
57
Sulfamethoxazole, trimethoprim
bactericidal sulfonamides, prevent folic acid synthesis
58
uses for sulfonamides
``` respiratory GI UTI not dentistry (can cause anemias) ```
59
Metronidazole
``` bactericidal anaerobes: C. diff. H. pylori parasitic infections NOT effective against aerobes !! used for JUVENILE / REFRACTORY PERIODONTITIS !! disulfiram rxn when taken with ethanol ```
60
Fluoroquinolones
ciprofloxacin, levofloxacin, moxiflocaxin target DNA GYRASE in gnb target TOPOISOMERASE IV in gpb inhibits growth and DNA replication
61
adverse rxns of fluroquinolones
photoxicity tendon rupture arrhythmia NSAID ixn --> convulsive seizures!
62
Isoniazid
tx of M. tuberculosis and M. kansasii
63
Rifampin
inhibits bacterial DNA-dependent RNA polymerase | tx of ACTIVE TB
64
common pathogens causing IE
viridans group streptococci (VGS) | Staph
65
Cardiac conditions for which prophylaxis is recommended
unrepaired cyanotic CHD completely repaired congineital heart defeft with prosthetic in FIRST 6 MONTHS AFTER PROCEDURE repaired CHD with residual defects cardiac transplant pt with valvulopathy
66
how to administer AB prophylaxis for IE
single dose BEFORE procedure, or up to 2 hours after procedure if they forgot to take it before
67
RNA viruses rely on...
...enzymes in the virion to synthesize mRNA for synthesis of viral proteins
68
Amantadine
tx of influenza inhibits fxn of M2 protein prevents uncoating and release of viral RNA
69
Osteltamivir, zanamivir
inhibits viral neuraminidase blocking release of progeny virus from infectd host cells TAMIFLU
70
antiherpetic agents
``` acyclovir valacyclovir ganciclovir penciclovir foscarnet ```
71
antiherpetic agents not effective for treating CMV may be used for ...
CMV prophylaxis in immune compromised pts
72
chronic hepatitis infections throughout world
HBV and HCV
73
NRTIs
treat HIV require activation !! TERATOGEN (efavirenz) NNRTI !! zidovudine, lamivudine, emtricitabine, tenofovir
74
Protease inhibitors
ritonavir ritonavir + lopinavir (fixed dose combination) use of PI + 2 NRTIs is synergistic
75
Integrase Strand Inhibitors
Raltegravir, prevents HIV from multiplying in host
76
to prevent HIV from becoming drug resistant usually they are ...
combined into a single product
77
typical anti-HIV regimen:
2 NNRTIs + PI or NRTI
78
how to monitor HIV
viral load and CD4+ cell count every 2-8 weeks
79
majority of HSV viral lesions treated by...
acyclovir
80
penciclovir
tx of herpes labialis
81
AIDS pt oral lesions
HPV CMV oral hairy leukoplakia
82
characteristics of fungi
eukaryotic cell membrane has ergosterol cell wall has chitin
83
fungal infection locations
superficial subQ systemic
84
most common site of fungal infection
superficial | skin, nails, mucous membranes
85
subcutaneous fungal infections
hair, nailbeds, skin | from puncture wounds with soil fungi
86
systemic fungal infectiosn
various internal organs immunocompromised pts at high risk high mortality
87
most common fungal infection orally
C. albicans
88
class of antifungals used topically for superficial infectiosn
polyene
89
amphotericin B
antifungal detected for up to 4 wks in blood and 4-8 wks in urine after discontinuation of IV therapy most toxic in use REVERSIBLE ANEMIA
90
Nystatin
antifungal | DRUG OF CHOICE FOR TX OF ORAL CANDIDA INFECTIONS
91
Echinocandin antifungal
caspofungin discrupts fungal cell wall MC rxn --> phlebitis Teratogenic
92
Ketoconazole
ORAL AND TOPICAL FORMULATIONS teratogenic gynecomastia in men mentrual irregularities in women
93
Fluconazole
ORAL AND IV FORMULATIONS | EXCELLENT CNS PENETRATION (treat fungal meningitis)
94
Clotrimazole troche
tx oropharyngeal candidasis in pts with AIDS
95
Flucytosine
cytosine deaminase | ltd antifungal spectrum (candida and cryptococcus)
96
Terbinafine
highly lipophilic and keratophilic antifungal | remains in skin and nails for up to 3 mos
97
Griseofulvin
dermatophyte infections CYP3A4 INDUCER !! can reduce plasma cxn of warfarin, barbiturates, oral contraceptives
98
MC type of oral fungal infection and txs
``` Candidiasis topical txs: clotrimazole oral troches nystatin oral pastilles nystatin RINSE FOR PTS AT RISK FOR LIVER TOXICITY Miconazole tablets ```
99
systemic tx of oral candidiasis
oral therapy for AIDS Ketoconazole (with topical nystatin) Fluconazole
100
IV tx of oral candidiasis
amphotericin B | w or wo flucytosine bc high drug toxicity
101
tx of oral candidiasis with lichen planus
topical nystatin or clotrimazole with topical corticosteroid
102
Histamine derived from
diet or bacteria in GIT, synthesized by mast cells
103
histamine content of organs
highest in lung skin intestinal mucosa
104
highest cxn of histamine in
mast cells leukocytes ENTEROCHROMAFFIN CELLS OF GIT
105
tissue injury causes...
immediate release of histamine from mast cells | increase in vascular permeability
106
allergic rxns cause...
histamine release | causing mild symptoms to severe symptoms
107
H1 activation of histamines
increase in bronchiolar smooth muscle contraction | TARGET FOR ANTIHISTAMINES
108
H2 activation of histamines
increase gastric acid secretion | TARGET FOR H2 BLOCKERS
109
Histamine toxicity/shock treated by...
Epinephrine
110
1st gen H1 antagonists
diphenhydramine, promethazine, meclizine sedative, anti-nausea, xerostomia
111
2nd gen H1 antagonists
loratadine, fexofenadine, cetirizine do not cross BBB less sedative
112
H1 receptor antagonists ixt with H1 receptors on target cell and ...
competively inhibit can beovercome by increasing cxn of histamine
113
are antihistamines used for anaphylactic shock or asthma?
no, EPI is
114
do 1st gen H1 antihistamines reduce gastric acid secretion?
no, 2nd gen H1 do
115
uses for antihistamines in dentistry
CNS actions, sedation
116
H2 receptor antagonists include...
cimetidine, ranitidine, famotidine
117
H2 receptor antagonists used for ...
reduce gastric acid secretion tx peptic ulcers tx GERD