MT 3 Materials

Question 1

DMARDs (Disease Modifying AntiRheumatic Drugs)

Answer 1

• Methotrexate, hydroxycholoroquine, sulfasalizine, leflunomide, azathioprine
• Organic gold compounds ( Aurothioglucose, Auranofin)
• Penicillamine ( Cuprimine)
• Chlorambucil ( Leukeran)
• Cyclophosphamide (also anticancer)
• Cyclosporine
• Etanercept (mechanism - antagonism of tumor necrosis factor)

Question 2

Chronic Gout Drugs

Answer 2

• Colchicine
• Allopurinol, Oxypurinol, Febuxostate (Xanthine oxidase inhibitors)
• Probenecid, Sulfinpyrazone (Uricosuric Agents)

Question 3

Short Acting Glucocortioids

Answer 3

• hydrocortisone, cortisone
• Prednisone, Prednisolone
• Methylprednisolone
• Meprednisone

Question 4

Long Acting Glucocorticoids

Answer 4

Betamethasone

Dexamethasone

Question 5

Intermediate Acting Glucocorticoids

Answer 5

• Triamcinolone
• Paramethasone
• Fluprednisolone

Question 6

Topical Corticosteroid

Answer 6

Bechlomethasone

Question 7

Inhaled Corticosteroids

Answer 7

Beclomethasone, Budesonide, Fluticasone, Mometasone, Triamcinolone

Question 8

Glucocorticoids used for anti-inflammatory effects and that have both glucocorticoid and mineralcorticoid

Answer 8

Hydrocortisone, cortisone, prednisone, prednisolone

Question 9

Glucocorticoid activity & no mineralocorticoid activity

Answer 9

• Triamcinolone
• Methylprednisolone
• Fluticasone
• Beclomethasone
• Budesonide
• Mometasone

Question 10

Opioid Agonists

Answer 10

Pure Phenanthrenes ( 3 six carbon rings)

• Codeine, Hydrocodone ( Weak)
• Hydromorphone, Morphine, Oxycodone, Levorphanol (Strong)

Pure Phenylpiperidines

• Alfentanil, Fentanyl, meperidine, Sulfentanil, Tapentadole

Pure Diphenylheptanes

• Metadone (strong)
• Propoxyphene (Weak)
• Hepatic Metabolism
• Toxicities: respiratory depression, constipation, addiction

Question 11

Mixed Opiate Agonist/Antagonists

Answer 11

• Buprenorphine
• Nalbuphine
• Pentazocine
• Butorphanol

Question 12

Opioid Antagonists

Answer 12

• Naloxone
• Naltrexone
• Nalmefene
• Methylnaltrexone
• Alvimopan

Question 13

Antitussives

Answer 13

• Codeine
• Dextromethorphan
• Tramadol ( seizures if overdose)

Question 14

Opioid Partial Agonists

Answer 14

• Codeine
• Hydrocodone
• Genetic Variation in metabolism ( due to being metabolized by CYP2D6)

Question 15

`Glucocorticoids ( Agonist)

Answer 15

• Cortisol
• Hydrocortisone
• Dexamethasone
• Betamethasone
• Prednisone
• Triamcinolone
• Budesonide

Question 16

Mineralocorticoids (Agonist)

Answer 16

• Aldosterone
• Deoxycortisone
• Fludrocortisone

Question 17

GLucocorticoids Antagonists

Answer 17

Mifepristone

Question 18

Mineralocorticoid Antagonist

Answer 18

• Eplerenone
• Spironolactone

Question 19

Synthesis inhibitors (antagonist)

Answer 19

• Ketoconazole
• Aminoglutethimide
• Metyrapone

Question 20

Most ototoxic (auditory damage) agents

Answer 20

Neomycin, kanamycin, and amikacin

Vancomycin

Question 21

Most Nephrotoxic agents

Answer 21

Neomycin, tobramycin, and gentamicin

Vancomycin

Question 22

induce ethanol intolerance, disulfiram-like reaction

Answer 22

• Tinidazole, Metronidazole
• Cefoperazone, Cefotelan, Cefamandole (Cephalosporins)

Question 23

Quinupritin/Dalfopristin (Synercid)

Answer 23

• Spectogramins class of antibacterials
• CYP3A4 inhibitos
• Can cause myopathy (muscle pain)
• Activity against aerobic gram + microorganisms

Question 24

Linezolid

Answer 24

• Weak MAO inhibitor
• DDI with SSRI’s
• The first oxazolidinone created

Question 25

Beta LActamase Inhibitors

Answer 25

* Sulbactam * Tazobactam * Clavulanic

Question 26

Which antibacterial would be the drug of choice for a patient with an upper respiratory infection and who has experienced an episode of bronchospasm following carbapenem therapy?

Answer 26

Telithromycin (Ketolide)

Question 27

Respiratory Fluoroquinolones

Answer 27

Levofloxacin, Moxifloxacin, Gemifloxacin

Question 28

Caution is warranted for which antibacterial/s in patients with renal dysfunction?

Answer 28

* Penicillins (except Methicillin, nafcillin) and Cephalosporins (except ceftriaxone) * Aminoglycosides * Tetracyclines (except doxy & mino) * Chloramphenicol * Fluroquinolones (80% excreted through kidney) * Sulfonamides & Trimethoprim * Clindamycin (is excreted by both kidney and via bile tract) * Nitrofurantoin * Vancomycin * Metronidazole

Question 29

Which drugs work on anaerobes?

Answer 29

 Clindamycin (drug of choice against B. fragilis)  Metronidazole (drug of choice against B. fragilis & Clostridium species)  Penicillin G (Clostridium perfringens)  Ticarcillin (effective against Bacteroides fragilis)  Piperacillin & Mezlocillin (more effective against B. fragilis)  Imipenem (effective against anaerobes)

Question 30

Alternative drugs in patients with a history of severe (anaphylactic) penicillin allergy

Answer 30

* Macrolides * Vancomycin * Clindamycin * Aztreonam (a monobactam; primarily indicated for Gram negative organisms and is not a drug of first choice)

Question 31

Exhibits excellent MRSA activity

Answer 31

* Vancomycin * 3rd gen Quinolones * **Tigecycline** (IV only) * Clindamycin * Quinupristin-Dalfopristin * ceftaroline (5th gen cephalosporins) * Linezolid

Question 32

Bacterial cell wall synthesis inhibitor

Answer 32

* Beta lactams; * cephalosporins; * carbapenems; * monobactams; * glycopeptide antibiotics (Vancomycin )

Question 33

Patients allergic to sulfonamides antibiotics can have a risk of allergic reactions to

Answer 33

Celecoxib

Question 34

Gram-Negative Antibacterial

Answer 34

* Aztreonam; * Meropenem; * Aminopenicillins; * Cephoslosporins ( 2nd and 3rd ); * Ceftaroline * Fluoroquinolones (both - and +) * Aminoglyosides

Question 35

The mechanism/property attributed to the gastric ulcer by NSAIDs includes

Answer 35

Acidic functional groups and the ability to decrease gastric secretion by inhibition of COX-1

Question 36

eliminated mainly by the liver

Answer 36

* Macrolides, * Ketolides (Telithromycin), * Lincosamide (Clindamycin), * Chloramphencol, * streptogramins (Synercid) , * oxazolidinones (Linezolid)

Question 37

Which of the following drugs are effective in the treatment of penicillin-resistant Streptococcus pneumoniae?

Answer 37

Vancomycin in combination with 3rd generation cephalosporin such as ceftriaxone.