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OcPharm > OcPharm_Test1 > Flashcards

OcPharm_Test1 Flashcards

1
Q

Name three things that can occur when you overtreat a patient?

A
  1. Cause hypersensitivity or toxicity reactions.
  2. Increase risk of superinfection
  3. Facilitate resistance
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2
Q

Which two categories do we notice that if the benefit of a drug outweighs the risk, then u can take?

A

C

D

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3
Q

Which category do we notice that a prego chick should not take a drug if the risk outweighs the benefit?

A

X

There are reported fetal abnormalities

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4
Q

Define category B

A

Animal studies show toxicity.

Human studies are inadequate.

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5
Q

Which groups of antibiotics work against cell wall synthesis?

A 
PCN
Cephalosporins
Bacitracin
Gramicidin
Vancomycin
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6
Q

Category B drugs

A

PCN
Cephalosporin
Bacitracin (combo = C)
Gramicidin (combo = C)

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7
Q

Category C drugs

A 
Vancomycin
Clarithromycin
Sulfonamides
Pyrimethamine
Trimethoprim
Phenylephrine
Hydroxyamphetamine
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8
Q

Is polysporin a cat B or C drug?

A

Cat C.

It is polymixin B and Bacitracin mixed in together.

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9
Q

Which aminoglycosides are Cat B or C

A 
B:
Tobramycin
Neomycin (C in combo)
C:
Gentamicin
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10
Q

Name the one category D drug?

A

Tetracyclines

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11
Q

What category does macrolide fall under?

A

B/C

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12
Q

What category does Fluoroquinolones fall under?

A

Cat C

Both oral and topical

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13
Q

Name the three drugs that are Folic Acid inhibitors?

A

Sulfonamides
Pyrimethamine
Trimethoprim

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14
Q

What does Bactrim compose of?

Category?

A

Trimethoprim
Sulfamethoxazole
Category C

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15
Q

What category is PolyTrim

A

Cat C.

Polymixin B/ Trimethoprim

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16
Q

Which group of drugs work on DNA gyrase aka topoisomerase II and topoisomerase IV?

A

Fluoroquinolones

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17
Q

How must you take Penicillin G?

A

Intramuscularly.

If take orally, stomach acid will destroy

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18
Q

What is type I hypersensitivity rxn to PCN?

A

Itching
Swelling
Anaphylaxis

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19
Q

What is type II hypersensitivity rxn to PCN?

A

Hemolytic anemia

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20
Q

What is type III hypersensitivity rxn to PCN?

A

Intestinal nephritis
vasculitis
serum sickness

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21
Q

What is type IV hypersensitivity rxn to PCN?

A

Steven Johnson’s

Contact dermatitis

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22
Q

What are some bad things that PCN is guilty of?

A

Alters normal flora causing nausea, vomiting, diarrhea.

Renders birth control ineffective.

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23
Q

What makes Cephalosporin diff from PCN?

A

Their beta lactam ring

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24
Q

What is the primary topical agent for Cephalosporin in the 1st gen?

A

Cefazolin

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25
Q

Keflex is a brand of?

A

Cephalexin

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26
Q

What drug belongs under second generation Cephalosporin?

A

Ceclor/Cefaclor

Has increased activity against gram - organisms (H. flu)

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27
Q

Name a third gen cephalosporin?

A

Ceftriaxone

IM, effective against gonorrhea and pseudomonas causing Endophthalmitis

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28
Q

What Abs do you use when other antibiotics just don’t work?

A

Keflex

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29
Q

Name a 4th gen cephalosporin?

A

Cefepime

No ophthalmic application

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30
Q

Which is the only gram negative that is susceptible to Bacitracin?

A

Neisseria gonorrhea

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31
Q

Is bacitracin available in solution form?

A

Nope.

It gets replaced by gramicidin

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32
Q

What’s so special about vancomycin?

A

It is effective against MRSA.
Also good for C. difficile and endophthalmitis
We can only make into soln from IV.

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33
Q

Why isn’t there widespread eyedrops for Vancomycin?

A

Because it is really toxic to the eyes.

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34
Q

Why isn’t Polymixin B used systemically?

A

Due to neuro and nephrotoxicity

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35
Q

List the Aminoglycosides

A

Gentamicin
Tobramycin
Neomycin

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36
Q

Are aminoglycosides able to cover both gram + and -?

A

Yes. Good against Staph.
Horrible against anaerobes.
Bad against Strep, Enterococci, and MRSA

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37
Q

All aminoglycosides are effective against pseudomonas except what?

A

Neomycin .35%

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38
Q

What can’t you combine in a syringe with aminoglycosides?

A

PCNs

Cephalosporins

39
Q

Are aminoglycosides well absorbed in the GI?

A

Nope.

Do it IV or IM

40
Q

What percentage of incidence does Neomycin have for contact dermatitis?

A

4%

41
Q

Name the drugs that have neomycin in them?

A

Neosporin
Polysporin
Maxitrol
Cortisporin

42
Q

Tell me side effects of Aminoglycosides

A

Ototoxicity, Nephrotoxicity
Don’t use on open globes
Local toxicity (PEK, irritation)

43
Q

MOA of tetracycline?

A

Binding of 30s subunit of ribosome

44
Q

What are the primary ophthalmic uses for Tetracyclines?

A

Chlamydia

MGD

45
Q

What can doxycycline reduce?

A

MMP’s

Pro-inflammatory interleukins

46
Q

What is the brand name for doxycycline?

A

Vibramycin

47
Q

What are the uses for doxycycline?

A

Antibiotic
Anti-seborrheic
Anti-collagenase

48
Q

T/F?

Doxycycline is affected by food and dairy?

A

False

49
Q

Side effects of Doxy?

A

Photosensitivity
Hypersensitivity
Diarrrhea
Intracranial HTN risk

50
Q

Who don’t you use Vibramycin on?

A 
Prego chicks - cat D
Children under 8 = tooth development
Those who are on coumadin
Liver problems
IIH
51
Q

What is the drug of choice for chlamydia in kids and prego chicks?

A

Erythromycin

QID oral dosing

52
Q

What dosing is Clarithromycin?

A

BID

53
Q

What are the two ways that Macrolides are resisted by bacteria?

A
  1. Altering binding site on the ribosome

2. Pumping out the antibiotic

54
Q

What is the dosing for Zithromax for kids?

A

20 mg/kg

Azithromycin

55
Q

When do you use chloramphenicol?

A

Severe recalcitrant cases

56
Q

Name the three drugs that affects folate metabolism?

A

Sulfonamides
Pyrimatamine
Trimethoprim

57
Q

Which drug inhibits the first step in synthesis of folic acid?

A

Sulfa drugs
Inhibits the conversion of PABA
The other two inhibits the 2nd step

58
Q

How do bacteria resist sulfa drugs?

A

Overproduce PABA

Resistance to one sulfa drug means resistance to all sulfa drugs

59
Q

What are the components of Bactrim?

A

Sulfamethoxazole

Trimethoprim

60
Q

What two things is bactrim used to treat?

A

Sulfamethoxazole

Trimethoprim

61
Q

Name the side effects of sulfa drugs?

A 
GI upset
Allergic skin rxns
Stevens Johnson
Myopic shift
Photosensitivity
62
Q

What three organisms did the Ocular Trust study look at?

A

Staph aureus
Strep pneumoniae
H. Flu

63
Q

Caleb, would you give a patient a fluoroquinolone to treat MRSA?

A

Nope.

I would give them Trimethoprim

64
Q

Which drug is good against Strep pneumoniae?

A

Newer FLQs

Don’t give a patient polymixin B

65
Q

Which drugs worked against H.Flu?

A

Pretty much all antibiotics except for Trimethoprim and AzaSite (PCN deriv)
PCN sucks against H.Flu

66
Q

Who headed up the ARMOR study?

A

B&L

67
Q

What does MIC stand for

A

Minimum Inhibitory Concentration.

The lower the number, the better the antibiotic is at killing the organism

68
Q

Top 3 that is good against MRSA under ARMOR study

A

Vancomycin
Besivance
Trimethoprim

69
Q

Worst three against MRSA?

A

Azithromycin
Tobramcin
Ciprofloxacin

70
Q

Top two against Staphy Epi?

A

Vancomycin

Bsivance

71
Q

Worst two against Staph Epi?

A

Azithromycin

Trimethoprim

72
Q

Top three against S. Pneumoniae?

A

Besivance
Vigamox
Zymar/Zymaxid

73
Q

Worst two against S. Pneumoniae?

A

Azithromycin

Trimethoprim

74
Q

Good against H. Flu under armor?

A

Pretty much all FLQs

75
Q

Worst against H. Flu under armor?

A

Trimethoprim
Azithromycin
Tobrmycin

76
Q

THe best against P. Aeruginosa under Armor study?

A

Cipro
Levo
ALl other FLQs

77
Q

The worst against P. aeruginosa undr armor?

A

Azithromycin

Trimethoprim

78
Q

Examples of polyenes?

A

Amphotericin B

Natamycin

79
Q

Low doses for antifungals = ?

A

Fungistatic

Fungicidal = higher doses

80
Q

MOA of polyenes

A

Bind to ergosterol on cell membrane.
Increases permeability
Can be either fungistatic or fungicidal

81
Q

MOA of azoles?

A

Impair ergosterol synthesis

Increases cell permeability

82
Q

Are azoles funistatic or cidal in nature?

A

Static

83
Q

What is topical and oral Voriconazole effective against?

A

Fusarium

Aspergillis

84
Q

Name examples of azoles?

A 
Itraconazole
Ketoconazole
Voriconazole
Miconazole
Fluconazole
85
Q

MOA of pyrimidines?

A

Block thymidine synthesis.

Also known as antimetabolites

86
Q

Are pyrimidines fungistatic or -cidal?

A

Static

87
Q

Ex of pyrimidine?

A

Flucytosine.

Don’t use alone.

88
Q

What drugs do we use against Acanthamoeba?

A

PHMB

Chlorhexidine

89
Q

Which drugs are known as Biguanide Antimicrobial compounds

A

Acanthamoeba

90
Q

MOA of trifluridine?

A

Incorporated into viral DNA.

Leads to defective proteins

91
Q

MOA of zirgan?

A

Inhibition of nucleic acid synthesis

92
Q

MOA of oral antivirals?

A

Inhibit DNA synthesis/replication

93
Q

Vitrasert is used for?

A

CMV end stage.

An intravitreal implant

94
Q

How does Valacyclovir work?

A

Converted to acyclovir by intestinal and hepatic metabolism.

OcPharm (2 decks)

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