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Advanced Pharmacology > pharm exam 2 > Flashcards

pharm exam 2 Flashcards

1
Q

Quinolones/Fluroquinolone examples

A 
ciprofloxacin
besifloxacin
gatifloxacin
levoflaxacin
moxifloxacin
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2
Q

Quinolones/Fluroquinolone black box warning

A

increased risk of tendon rupture; tendonitis

may exacerbate MG

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3
Q

Lincosamide BB warning

A

(clindamycin)

BB warn for severe colitis

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4
Q

Long acting beta 2 agonists BB warnings

A

do not use salmeterol or formeterol singly in asthma for all ages; two-fold increase in catastrophic events

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5
Q

step 1 asthma therapy

A
  • SABA prn
  • s/s when exposed to triggers
  • exercise can be mild intermittent
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6
Q

step 2 asthma therapy

A
  • one long term control med daily
  • low dose ICS (mainstay for all ages)
  • cromolyn or leukotriene modifier are alternatives
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7
Q

step 3 asthma therapy

A

-medium dose ICS or low dose ICS plus LABA
OR
-medium dose ICS plus leukotriene receptor modifier

  • exacerbations may require oral steroids
  • consider allergy therapy/allergist referral
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8
Q

step 4 asthma therapy

A 
-medium dose ICS plus:
LABA
or
medium dose corticosteroid
or
leukotriene modifier
or
theophylline
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9
Q

step 5 asthma therapy

A
  • consult pulmonology or immunology

- high dose ICS plus LABA

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10
Q

step 6 asthma therapy

A

-high dose ICS plus LABA and oral corticosteroids

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11
Q

asthma exacerbation

A
  • treat with oral steroids to regain control, if not effective step up therapy
  • increase inhaled beta agonist (2-6 puffs q20min)
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12
Q

ICS reduction recommendation

A

dose of ICS should be reduced 25-50% every 2-3 months to lowest possible dose to maintain control

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13
Q

pregnant patients with asthma

A
  • inhaled beta agonists are drug of choice during pregnancy

- ICS are long term drug of choice

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14
Q

transient wheezing

A

caused by prematurity or smoking during pregnancy, children usually outgrow by age 3

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15
Q

persistent early onset wheezing

A

carries on with kids through school age and early adolescence

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16
Q

late onset wheezing

A

often associated with eczema

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17
Q

LABA should not be prescribed without what?

A

ICS

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18
Q

Theophylline

A

a methalyxanthine derivative that causes;

  • bronchial smooth muscle relaxation
  • SNS stimulants
  • CV effects
  • increased gastric acid production
  • stimulates skeletal muscle
  • increase renal blood flow and GFR
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19
Q

theophylline dosage

A
  • 2nd or 3rd line drug for asthma or COPD
  • adult start at 6mg/kg/day
  • dose is increased by 25% q3days until serum levels are 10-20mcg/ml
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20
Q

theophylline ADRs

A

irritability, restlessness, seizures, insomnia, dyspepsia, palpitations, tachycardia, hypotension, arrhythmias

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21
Q

theophylline toxicity greater than 20mcg/ml

A

NVD, HA, vomiting, diarrhea, insomnia, irritability

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22
Q

theophylline toxicity greater than 35mcg/ml

A

hyperglycemia, hypotension, cardiac arrythmias, tachycardia, seizures, brain damage, death

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23
Q

what increases clearance of theophylline

A
  • smoking tobacco
  • low carb/high protein diet
  • charcoal broiled foods accelerate hepatic metabolism of theo
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24
Q

when to draw theophylline levels

A
  • Q 6-12 months when steady state reached

- when a new drug is added or deleted from regimen

25
Q

1st line for AOM and sinusitis

A

amoxicillin

26
Q

1st line for infection following bites, including human

A

amoxicillin/clavulanate

27
Q

1st line for MRSA, and in special populations (children, pregnancy)

A

Lincosamides (clindamycin)

28
Q

1st line for C. trachomatis and ureaplasma urealyticum

A

doxycycline

29
Q

COPD exacerbation

A
  • Augmentin
  • double strength sulfamethoxazole/trimethoprim
  • macrolide abx
30
Q

macrolide antibiotics

A

erythromycin
azithromycin
clarithromycin

31
Q

healthy adult with CAP

A

macrolide (or doxy if allergic) and treat for 5 days

32
Q

adult CAP with comorbidities, or risk of DRSP

A

fluroquinolone
beta lactam
macrolide

33
Q

CAP in pregnancy

A

macrolide; azithromycin 1st choice pregnancy category B

34
Q

abx for AOM is PCN allergy

A

Lincosamide (clindamycin) plus 3rd generation cephalosporin

35
Q

what bugs cause otitis media?

A

S. pneumoniae, nontypeable H. influenza (HIB), M. catarrhalis

36
Q

ADR’s of sulfonamides, nitrofurantoin, and trimethoprim

A

anorexia, NVD, stomatitis, rashes, increased hypersensitivity reactions, photosensitivity, HA, dizziness, drug interactions

37
Q

long term nitrofurantoin complication

A

fibrosis- check CXR

38
Q

sulfonamides, nitrofurantoin, and trimethoprim used to treat what?

A

Most commonly used with UTI infections

MRSA is susceptible in some areas

39
Q

pharmacodynamics of tetracyclines

A

tetracycline and doxycycline

Bind reversibly to the 30S subunit of the bacterial ribosome

40
Q

pharmacokinetics of tetracyclines

A

food, milk, and calcium decrease absorption

41
Q

beta lactam contraindications

A

pregnancy category B

not for hypersensitive reactions to pcn

42
Q

macrolide contraindications

A

most are safe in pregnancy and children

43
Q

tetracycline contraindications

A

do not give in pregnancy, lactating women, or children less than 8

44
Q

1st and 2nd line for group A strep

A
  • 1st line PCN/amoxicillin/augmentin
  • macrolides if pcn allergy
  • cephalosporins if PCN doesn’t work
45
Q

meds to avoid in COPD patients

A 
beta blockers (produce bronchial spasms)
antitussives
46
Q

first line for asthma

A

SABA

  • albuterol
  • metaproterenol
  • terbutaline
  • bitolterol
  • pirbuterol
  • levalbuterol
47
Q

LABA

A
  • salmeterol
  • formeterol
  • indacaterol
  • arformoterol
48
Q

safe SABA for kids less than 4?

A

albuterol and metaproterenol

49
Q

Buproprion contraindicated in patients with?

A
  • sz disorder
  • bulimia
  • anorexia
  • use of MAOI within 14 days
  • hx of stroke, brain tumor, brain surgery, or closed head injury
  • use cautiously in hepatic cirrhosis
50
Q

PCN increases what drugs?

A

methotrexate (dont give)

warfarin (monitor INR)

51
Q

what beta blocker is contraindicated with ampicillin

A

atenalol

52
Q

1st generation cephalosporin used for?

A
  • Used for skin and soft tissue infections

- Primarily active against gram-positive bacteria, S. aureus and S. epidermidis

53
Q

2nd generation cephalosporin used for?

A
  • Active against same as first generation(gram positive, S. aureua, and S. epidermidis)
  • plus Klebsiella, Proteus, E. coli
54
Q

3rd generation cephalosporin used for?

A
  • Used for broader indications

* More active against gram-negative bacteria

55
Q

4th generation cephalosporin used for?

A
  • Resistant to beta-lactamase

* Primarily active against gram-positive bacteria

56
Q

valcyclovir ADRs

A

thrombocytopenia purpura

hemolytic uremic syndrome

57
Q

FDA warning about Levaquin

A

psych reactions
hypoglycemia –> coma
tendon rupture

58
Q

vancomycin SE

A

ototoxicity
nephrotoxicity
red man syndrome
neutropenia

59
Q

abx for perforated TM?

contraindicated for perforated TM?

A

ciprofloxacin is contraindicated

Ofloxacin can be given

Advanced Pharmacology (3 decks)

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