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Patho/Pharm > Pharm Exam 1 > Flashcards

Pharm Exam 1 Flashcards

1
Q

What is CYP/Cytochrome P450?

A

Enzymes in the liver and gut wall that work together to process drugs

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2
Q

affinity

A

degree of attraction between drug and receptor

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3
Q

Antagonists

A

Prevent receptor activation by endogenous regulatory molecules and drugs

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4
Q

When patients are allergic to PCN what drug is used instead?

A

macrolides

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5
Q

Common receptors (9)

A

Cholinergic receptors
-nicotinic and muscarinic
Adrenergic
-Alpha 1&2 and Beta 1&2
Opiod
-Mu, kappa, delta

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6
Q

Cephalosporin interactions with other drugs

A

interferes with vitamin K so adjust blood thinners
use with aspirin and NSAIDs increased effect of platelet inhibition and leads to risk of bleeding
IM injections not recommended

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7
Q

Code of ethics

A

promote health
prevent illness
restore health
alleviate suffering

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8
Q

Mechanisms of actions of penicillins, cephalosporins, vancomycin, and imipenem?

A

inhibators of cell wall synthesis

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9
Q

General treatment for protozoa and helminths (and c diff)

A

metronidazole-flagyl

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10
Q

protein drug targets

A

membrane receptors
intracellular receptors
enzymes
ion channels
carriers or transporters

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11
Q

drugs that are synthetic/semisynthetic

A

most drugs

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12
Q

Impact of food on drug absorption

A

decreased absorption or rate of absorption (milk and tetracycline or fiber and digoxin)
increased absorption (high calorie meal and saquinavir)

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13
Q

extended-spectrum penicillins

A

carbenicillin and ticarcillin (interferes with platelet fx)
pseudomonas a. and klebsiella

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14
Q

examples of drugs that come from animals

A

hormones and heparin

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15
Q

How is cephalosporin eliminated?

A

kidneys

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16
Q

consequences of drug-drug interactions (3)

A

intensification of effects
reduction of effects
creation of a unique response

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17
Q

Properties of an ideal drug (3) plus 7

A

effective
safe
selective
reversible
predictable
easy to give
no interactions
low cost
stable chemically
simple generic name

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18
Q

drug interactions with fluoroquinolones

A

inhibit theophylline and warfarin
bind with antacids, calcium, iron, foods, and decrease bioavalability

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19
Q

What stage does penicillin work best in?

A

inflammatory phase of infection

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20
Q

non opportunistic fungi

A

coccidiodes, histoplasma, blastomyces

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21
Q

How does hepatic transformation affect drugs?

A

inactivation
change to active metabolite
activation of a pro drug to an active substance
activation to a toxic metabolite

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22
Q

what does miconazole treat

A

common OTC
tinea pedis, cutaneous candida, and other ringworms
given IV if allergic to amphotericin B

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23
Q

Agonists

A

molecules that activate receptors
affinity and high intrinsic activity
Dobutamine mimics NE at cardiac receptors
can make processes go faster or slower

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24
Q

What is the mechanism of action for fluoroquinolones

A

inhibition of DNA synthesis

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25
Q

Beta lactamase inhibitors and their combos

A

clavulanic acid + amoxicillin or ticarcillin
sulbactam + ampicillin
tazobactam + piperacillin

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26
Q

Nystatin

A

treatment for oral thrush via lozenges

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27
Q

mechanism of action of macrolides and aminoglcosides

A

inhibitors of protein synthesis

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28
Q

antagonist

A

a drug which has affinity but no intrinsic activist. Binds to receptor and does not activate it and blocks other molecules. Beta-blockers and metoprolol

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29
Q

What happens in the pharmacodynamic phase?

A

drug receptor interaction

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30
Q

What are the two absorption routes?

A

Parenteral (outside intestines) or enteral (intestines)

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31
Q

CDiff/Pseudomembranous colitis process and treatment

A

destruction of normal flora allows c. diff to flourish
C. Diff causes toxin that erodes cell lining of GI tract
treated with metronidazole

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32
Q

mechanism of action for sulfonamides and trimethoprim

A

inhibits folic acid synthesis

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33
Q

Are macrolides bacteriocidal or bacteriorstatic

A

bacteriostatic

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34
Q

narrow spectrum w/ penicillinase resistance and what it works on

A

nafcillin and dicloxicillin
staph aureus

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35
Q

drug

A

any chemical substance other than those required for normal sustenance which produces a biological effect

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36
Q

What is the main site of drug metabolism?

A

liver

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37
Q

3 basic mechanisms of drug-drug interactions (pharmacodynamic interactions)

A

at the same receptor: inhibitory
at separate sites: potentative (stronger) (diazepam and morphine) or inhibitory (hydrochlorothiazide and spironlactone)
combined toxicity should not be used together

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38
Q

What are 5 variables relating to drug distribution in the body?

A
  1. blood flow to tissues
  2. ability of drug to exit vascular system
  3. body fat
  4. protein binding
  5. blood-brain barrier
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39
Q

what is the most common fluoroquinolones

A

ciprofloxin

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40
Q

Drugs that cause steven johnson syndrome

A

penicillins, sulfas, quinolones, phenytoin, carbamazepine, barbiturates, and lamictal

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41
Q

Mechanism of action of amphotericin

A

binds to ergosterol membrane of the fungus and pokes holes in it

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42
Q

VRSA

A

vancomycin resistant staph aureus

43
Q

examples of drugs that come from microorganisms

A

some antibiotics

44
Q

What happens in the pharmacokinetic phase?

A

absorption
distribution
metabolism
excretion

45
Q

pharmacology

A

study of drug or medicine

46
Q

What is the spectrum and types of bacteria fluoroquinolones are good for?

A

broad spectrum bactericidal
gram neg and some gram pos

47
Q

drugs from genetic engineering

A

epogen and interferon

48
Q

tolerance

A

a change in the responsiveness to drugs

49
Q

What are the three steps of kidney excretion of drugs?

A

glomerular filtration
passive re-absorption
active secretion/transport

50
Q

Induction at P450

A

Enhances metabolism of the drugs taken concurrently which prevents effectiveness of drug therapy
Metabolized too fast to be effect

51
Q

opportunistic fungi

A

cryptococcus, aspergillus, and candida

52
Q

VISA

A

vancomycin insensitive staph aureus

53
Q

erythromycin is the first line treatments for (3)

A

legionella pneumophila, whooping cough, and diphtheria

54
Q

implication of sulfonamides and trimethoprim

A

crystalluria- H2o and cranberry juice
toxic nephrosis from sulfur crystals
anemia
SJS
allergy

55
Q

toxicology

A

the study of adverse effects of drugs and other chemicals

56
Q

therapeutic index

A

ratio between lethal dose (LD50) and effective dose (ED50), wider TI is better

57
Q

relative potency

A

the amount of a drug that must be given to illicit a response

58
Q

What happens in the pharmaceutical phase?

A

disintegration and dissolution of drug form
drug becomes available for absorption

59
Q

What are the three isoforms of CYP450 dedicated to metabolizing drugs?

A

CYP 1,2,3
CYP3A4- 50% of drug transformation
CYP2D6- 30%
CYP 1A2, 2C19, 2C9, and 2E1- 20%

60
Q

What are 4 variables related to drug absorption?

A

route of administration
blood flow to the site
solubility of the drug (acid/base)
concentration of the drug

61
Q

MRSA

A

methicillin resistance staph aureus

62
Q

side effects vs. adverse reactions

A

side effects are predictable; adverse reactions are unpredictable (anaphylaxis)

63
Q

VRE

A

vancomycin resistant enterococcus faecaelis

64
Q

Besides the kidneys, where can drugs be excreted?

A

lungs, sweat, saliva, mammary glands, and dialysis.

65
Q

What are the three aminoglycosides and how are they administered

A

IV only
amikacin
gentamycin
tobramycin

66
Q

biologic half-life

A

rate of metabolism and excretion determines half life (time it takes to excrete 50% of the drug and for it to decrease by 50% in the body). Does not change with dose of drug.

67
Q

mechanism of actions of the -azole antifungals

A

block the synthesis of sterol by inhibiting P450

68
Q

Are macrolides broad or narrow spectrum?

A

broad

69
Q

types of allergic reactions to PCN

A

immediate 2-30 mins, anaphylaxis
accelerated 1-72 hours, weals and hives, rashes
days to weeks, rashes

70
Q

agonist

A

a drug which has affinity and intrinsic affinity
A drug or substance that binds to a receptor inside a cell or on its surface and causes the same action as the substance that normally binds to the receptor. B-agonists and albuterol

71
Q

Which bacteria are fluoroquinolones good for?

A

e.coli, klebsiella, salmonella, campylobacter jejuni, p. aeruginosa, h. flu, and anthrax spores

72
Q

What are the major implications of aminoglycosides

A

ototoxic and nephrotoxic

73
Q

pharmacotherapeutics

A

use of drugs to treat disease

74
Q

pharmacokinetics

A

how the body interacts with the drug

75
Q

5 “rights” plus an additional 5

A
  1. right drug
  2. right patient
  3. right dose
  4. right route
  5. right time
  6. right assessment
  7. right documentation
  8. right evaluation
  9. right of patient to education
  10. right of patient to reduce care
76
Q

pharmacodynamics

A

how drug interacts with cells, tissues, and organs

77
Q

maximal efficacy

A

the largest effect that a drug can produce

78
Q

Adverse reactions for fluoroquinolones

A

insomnia, c diff, achilles tendon rupture in the elderly, steven johnson syndrome, QT prolongation.

79
Q

three phases of drug interaction

A
  1. pharmaceutical
  2. pharmacokinetic
    -drug become available for action-
  3. pharmacodynamic
    -effect of drug is seen-
80
Q

What are the three ways the liver affects drugs in order to remove them from the body?

A

Increase H2O solubility for urine elimination
Inactivates the chemical
Coverts the chemical for elimination through the gut

81
Q

broad spectrum penicillin and what it works on

A

ampicillin and amoxicillin
H Flu, E coli, P mirabilis, neisseria, salmonella, shigella

82
Q

signs and symptoms of a suprainfection related to penicillin use

A

darkened tongue, creamy vaginal discharge, watery diarrhea with cramping

83
Q

How is amphotericin B administered

A

IV or intrathecally (spinal fluid)

84
Q

What type of bacteria is vancomycin active against?

A

gram pos

85
Q

efficacy

A

ability of a drug to initiate biologic activity as a result of binding to a given receptor

86
Q

Shared adverse reactions of antimicrobial agents

A

antibiotic associated colitis
allergic or hypersensitive reaction
suprainfection

87
Q

4 primary mechanisms of antibiotic resistance

A

descrease concentration of the drug at it’s site of action
alter the drug target molecule
antagonist production
drug inactivation

88
Q

What are the two ways drugs exert their action?

A

Activate a series of cellular events creating a biological effect
bind to receptors without stimulating them and block other chemicals from binding with the receptor

89
Q

Uses for sulfonamides and trimethoprim

A

UTI pathogens such as e.coli, klebsiella, p. mirabilis.
pneumocystis carinii pneumonia
acute exacerbations of chronic bronchitis
prostatitis and sinusitis

90
Q

How are vancomycin and imipenem administered

A

IV only

91
Q

Symptoms of SJS and type of hypersensitivity

A

type IV hypersensitivity
flu like symptoms within two weeks of starting drug
rash follows, followed by skin sloughing

92
Q

MDR-TB

A

multi drug resistant TB

93
Q

implications of amphotericin B

A

-fever and chills, give tylenol and antihistamine before giving
-nephrotoxicity in 80% of patients
-alveolar hemorrhage

94
Q

drugs that come from minerals

A

calcium and iron

95
Q

narrow spectrum penicillins and what they work on

A

penicillin G, V, or VK
streptococcus and neisseria

96
Q

what do penicillins interact with?

A

oral contraceptives, anti-coagulants, and aminoglycides

97
Q

What is the main site for drug excretion?

A

kidneys

98
Q

examples of drugs that come from plants

A

digitalis and atropine

99
Q

Inhibition at P450

A

One drug blocks the enzymes that metabolize the other drugs leading to increased blood concentrations of unmetabolized drug (toxic)

100
Q

which drug is the choice for all candida species

A

fluconazole

101
Q

What parts of the body are fluoroquinolones good for and which aren’t they?

A

good for lungs, prostate, and GU, bad for CSF

102
Q

Spectrum and type of bacteria for aminoglycosides

A

narrow spectrum and gram negative

103
Q

What generation of cephalosporins have CSF penetration?

A

3rd and 4th

Patho/Pharm (11 decks)

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