PE/P HTN/PNA Flashcards by Natalie Tupper

AE associated w/ inhaling prostanoids?

cough

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What color are arterial clots? What drugs used to tx?

WHITE (abundance of platelets)

platelet targeting drugs

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What is PAH?

mean PAP >25 at rest & PCWP <15

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What is pneumovax 23?

vax against broader range of Strep pneumo

NOT effective in kids<2yo

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What is aztreonam?

monobactam active v G- bacterial

targets cell wall synthesis & can be used in pts w/ B lactam allergy

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What occurs in pulmonary vasculature that increases resistance to flow?

remodeling

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What is caused by drugs used to tx PAH?

vasodilatation

results in HA, flushing

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Major AE w/ fluoroquinolone tx in young & old pts

tendon rupture

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What is pathognomonic of PAH?

plexiform lesions

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What are plexiform lesions?

bypass regions outside of plugged pulmonary arterioles that provide blood to multiple pulmonary capillaries

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What are macrolides?

bacteriostatic drugs that bind to bacterial 50S to block peptide chain elongation

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When are clot busters used?

used to tx PE in setting of hemodynamic instability

admin via peripheral vein

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What is amoxicillin?

typical oral penicillin for combo tx of CAP

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When is vancomycin used?

admin IV for MRSA

admin orally for resistant C diff infxns

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Who does PAH classically affect?

young mom

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What is gentamicin?

IV agent used to tx PNA in pts who cannot tolerate B lactams

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What is indicative of R HF?

peripheral edema

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What is super-infection?

occurs due to overgrowth of bacteria not susceptible to broad spectrum antibiotic

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What is the CDC responsible for?

maintains database of bacterial resistance & issues guidelines on antibiotic stewardship

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What metabolizes S-warfarin to 7-OH warfarin?

CYP2C9

increases warfarin potency 3-5x

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What is endothelin?

exceptionally potent vasoconstrictor produced by endothelial cells

levels are + correlated w/ PAH

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What is cefpodoxime?

orally active cephalosporin

pts w/ CAP allergic to penicillin

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What is plasminogen?

enzyme that breaks down clots

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What drug class is effective v Mycoplasma?

tetracyclines

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Where must dabigatran be stored?

in a desiccator to avoid excess heat or cold b/c is unstable drug

What is prostacyclin?

made by endothelial cells from AA promotes vascular relaxation, suppresses growth of vascular smooth m cells, inhibits platelet aggregation

What enzyme is inhibited by clavulanate, tazobactam, and sulbactam?

block bacterial enzyme Beta-lactamase

What is major AE w/ penicillins?

allergic rxns

What lab test monitors anticoagulant activity of heparin?

aPTT

What is cor pulmonale?

enlargement of R heart due to high blood pressure in pulmonary circulation

What is the tx of fat PE?

only SUPPORTIVE tx

What antibiotics should NOT be admin @ same time as bactericidal drugs?

bacteriostatic

What is sildenafil?

orally active PDE5 inhibitor used to tx PAH

What syndrome is caused by infusing vancomycin too fast?

red man syndrome

What are sxs in PE?

chest pain, dyspnea, cough

What enzyme is inhibited by Linezolid?

inhibits MAO

When is dabigatran inferior to warfarin in inhibiting thromboembolism?

pts w/ mechanical heart valves

How is sensitivity of bacteria to an antibiotic measured?

disk diffusion test

Levels of what are high in PAH?

BNP

What is an IVC filter used for?

limit PE in pts who cannot use anticoagulant tx

What is MOA & use of aspirin?

irreversibly blocks synthesis of TXA2 by platelets admin daily after discontinue of anticoagulation tx for VTE to prevent recurrence

What is an AE of tetracyclines & fluoroquinolones?

photosensitivity

What is AE assoc w/ prostanoids?

jaw pain

What is formed by tetracycline w/ Ca2+, Mg?

precipitate

What is concern of endothelin receptor antagonists in PAH tx?

teratogenesis in Fs

What is predictable for both fondaparinux & LMWH?

pharmacokinetics can be admin @ home

What are aminoglycosides?

IV antibiotics w/ G- & G+ activity

What are major AEs w/ aminoglycosides?

nephrotoxicity | ototoxicity

What is rivaroxaban?

direct inhibitor of Factor X inhibits generation of thrombin

What is riociguat?

used to tx PAH by directly activating GC & stabilizes its interaction w/ NO enhances cGMP production in vascular smooth m cells

What type of PNA can follow viral PNA?

bacterial

What is bosentan?

orally active non-selective blocker of endothelin receptors alters conc of OCPs

What is a chronic PE?

has eccentric location w/ recanalization & arterial webbing to bypass it

What is selexipag?

orally active prostacyclin analog to tx PAH (esp in kids)

What is an AE of PAH?

syncope

What makes ampicillin & amoxicillin broad spectrum?

have activity v G- bacteria

What is epoprostenol?

IV drug to tx PAH continuous pump & t1/2 of 6 min

What is ambrosentan?

orally active endothelin antagonist that selectively blocks ETa receptors to tx PAH

What type of shock is caused by PE, cardiac tamponade or pneumothorax?

obstructive shock

What is a fatal AE of bosentan?

hepatotoxicity

What topoisomerase is targeted by respiratory fluoroquinolones?

topoi IV

What is nifedipine?

CCB used in tx of pts w/ PAH & respond to vasopressor test

What is heparin?

binds to antithrombin to inhibit Facto Xa & thrombin

What does use of heparin increase risk of?

hematoma in brain or spinal cord

What is dabigatran?

orally active & reversible direct inhibitor of thrombin

What is linezolid?

anti-MRSA/VRE agent that can be used ORALLY to tx MRSA PNA

What are signs of progressive pulm artery HTN?

blue lips near syncope swollen legs/ankles

What is doxycycline?

tetracycline used for tx of CAP in combo w/ B-lactam in pts who cannot tolerate macrolides

What is MDR?

bacteria w/ nonsusceptibility to at least 1 agent in 3 different anti-microbial classes

What are fluroquinolones?

broad-spectrum orally active drugs w/ activity v G- bacteria & some G+ bacteria

What should you not mix penicillins with?

aminoglycosides

What is cefepime?

IV 4th gen cephalosporin greater ability to penetrate into G- bacteria

What is clarithromycin?

add-on drug to B-lactams when tx PNA less epigastric pain, blocks CYP450

What is clindamycin?

past drug of choice for aspiration PNA frequent cause of C diff colitis

What does use of ventilator increase risk of?

increased risk of HAP (often due to MDR pathogen)

What receptor contributes to PAH?

5HT receptor

What are cephalosporins?

B-lactam containing antibiotics

What is a mild AE of tadalafil, sildenafil or riociguat (esp when admin w/ a1 blocker)?

hypotension

What is an early sign of PAH when assoc w/ physical activity?

dyspnea

What is the antidote for heparin?

protamine

What is cefditoren?

orally active cephalosporin used in pts w/ CAP w/ penicillin allergy

What is an indication for alteplase?

acute & massive pulmonary embolism

What is levofloxacin?

3rd gen respiratory fluoroquinolone more G+ activity

What is preferred tx of PE?

anti coagulation also used in PAH to minimize in situ thrombosis

What is ceftriaxone?

widely used 3rd gen IV cephalosporin eliminated by LIVER

What keeps platelets in inactivated state?

PGE2 (released by endothelial cells)

What can be inserted in arteries or veins to improve blood flow?

stents

What is iloprost?

prostacyclin analog inhaled 6-9 times/day

What is the status of fluoroquinolones in tx of CAP?

reserve status to reduce appearance of tolerance

What is azithromycin?

macrolide that does not block CYP450 slowly released @ bacteriostatic levels over several days

What is andexanet alfa?

antidote for Factor Xa inhibitors (rivaroxaban, apixaban)

What is treprostinil?

prostacyclin analog w/ longer 1/2 life admin IV, subQ, inhalation, orally for tx PAH

What is ending for drugs that fxn as tPA?

plase

What is piperacillin?

extended spectrum w/ activity v Pseudo aeruginosa

What is lefamulin?

pleuromutilin used to tx CAP when other agents do not work

What is risk of cephalosporins?

bleeding

What is argatraban?

admin IV for prophylaxis & tx of thrombosis in pts @ risk of HIT

What is prevnar 13?

S pneumo vax admin to newborns & pts>65

What are prostanoids?

drug class to tx PAH w/ more sxs

What is tadalafil?

orally active PDE5 inhibitor to tx PAH

What is an AE of tetracyclines?

turn developing teeth gray/brown

What is erythromycin?

macrolide used instead of penicillin

What is antidote for dabigatran?

idarucizumab

What is macitentan?

non-selective endothelin receptor blocker

What is life threat concern w/ IV prostanoid admin?

sepsis

What is ipipenem?

carbapenem drug that targets bacterial cell wall synthesis activity v many MDR bacteria

What is blocked by B-lactam antibiotics?

cell wall synthesis

What does heparin permanently inactivate?

thrombin very rapidly limits extension of a clot

What is the color of clots in venous side of circ?

RED (fibrin mesh)

What enzyme is blocked by fluoroquinolones?

DNA gyrase

What must be administered in tx of PAH?

OXYGEN (to maintain saturation >90%)

What is route of admin for PDE5 inhibitors?

ORAL

What is enoxaparin?

LMWH inhibits factor Xa

What is mnemonic for MDR bacteria of greatest concern?

ESKAPE cause 80% of VAP

What is alteplase?

glycoprotein that acts like human tPA

PE/P HTN/PNA Flashcards

(115 cards)