Pharm Fall Test 1

Question 1

What is the primary organism of BV?

Answer 1

Gardnerella vaginalis. A facultative anaerobic gram-variable rod.

Question 2

What are the tx for BV?

Answer 2

Clindamycin 300mg PO, 1 suppository qHS x3 days, or cream 1 applicator qHS x3 days is DOC.
Metronidazole 500mg PO x7days or 2g PO single dose. No alcohol for at least 3 days after use. This is Okere’s preferred

Question 3

What is the most common organism of UTI and pyelonephritis?

Answer 3

E. Coli (75-95%). In the elderly it’s staph saprophyticus.

Question 4

What is the tx for UTI that is uncomplicated?

Answer 4

Nitrofurantoin, Bactrim, Fosfomycin

Question 5

What is the tx for UTI that is complicated?

Answer 5

Bactrim DS BIDx14 days, Cipro 500mg BIDx7days, Cipro ER 1000mg qDx7 days, Levo 750mg qDx5days.

Question 6

What do you do before giving oral tx if there is a complicated UTI with a fever of 38 degrees or higher?

Answer 6

give 1g of ceftriaxone IM then start oral tx.

Question 7

What are the side effects of quinolones?

Answer 7

tendonitis & nerve damage.

Question 8

If a patient is pregnant, what is the tx for UTI?

Answer 8

Use augmentin. If resistant, and not in third trimester then Bactrim can be used.

Question 9

What are the therapies for n/v?

Answer 9

5-HT agonists, corticosteroids, neurokinin-1 receptor agonists, benzodiazepines, DA receptor agonists, phenothiazines, cannabinoids

Question 10

What are the side effects of 5-HT agonists?

Answer 10

QT prolongtion - always correct hypolakemia and hypomagnesemia before initiating to avoid this.

Question 11

What are the 5-HT agonists?

Answer 11

Ondansetron (Zofran), Dolasetron (Anzemet), Granisetron (Granisol), Palonosetron (Aloxi).

Question 12

What is a neurokinin-1 receptor agonist? Example?

Answer 12

pass the BBB to bind substance P and NK receptors. Aprepitant.

Question 13

What is a DA receptor agonist used for n/v?

Answer 13

Metoclopramide (Reglan)

Question 14

What are phenothiazines used for n/v?

Answer 14

Promethazine (Phenergan) and Prochlorperazine (Compazine)

Question 15

What are cannabinoids used for n/v?

Answer 15

Dronabinol (Marinol) and Nabilone (Cesamet)

Question 16

How long after chemo does n/v begin if:
acute
delayed
anticipatory

Answer 16

initial 24 h post tx
more than 24 h post tx
days to hours prior to tx

Question 17

What are the fluoropyrimidines?

Answer 17

Antimetabolites. 5-fluorouracil and Capecitabine.

Common SE: neutropenia, thrombocytopenia and anemia.

Question 18

5-fluorouracil

Answer 18

IV admin
inhibits thymidine synthesis by blocking the enzyme responsible. Is a prodrug.
SE: neutropenia, thrombocytopenia and anemia. Hand foot syndrome and diarrhea if given continuous IV.

Question 19

Capecitabine

Answer 19

PO admin
pyrimidine analogue of Uracil and is a prodrug of 5-FU.
SE: neutropenia, thrombocytopenia, anemia, increased risk of bleeding death so monitor INR if patient is on coumadin.

Question 20

What are the Cytidine Analogs?

Answer 20

Antimetabolites. Cytarabine (ara-C), Bencitabine, Azacytidine and Decitabine.

Question 21

Cytarabine

Answer 21

Arabinose analogue of Cytosine. Requires phosphorylation in tumor cells and then inhibits DNA polymerase.
SE: bone marrow suppression, hepatic dysfunction, nausea, vomiting, abdominal pain, and oral ulcerations.

Question 22

Gemcitabine

Answer 22

Inhibits DNA polymerase activity and ribonucleotide reductase. Related structurally to cytarabine.

Question 23

Azacytidine and Decitabine

Answer 23

Nucleotide analogue. Indicated to slow progression of Myelodysplastic syndrome to AML.
SE: myelosuppression, but reduces transfusion requirements.

Question 24

What are Purine Antimetabolites?

Answer 24

Antimetabolites. Mercaptopurine, Thioguanine, Fludarabine, Cladribine and Pentostatin.

Question 25

Mercaptopurine (6-MP) and Thioguanine (6-TG)

Answer 25

inhibits purine biosynthesis by multiple metabolites following metabilization by TPMT.
SE: myelosuppression, hepatic toxicity.
Interacts with allopurinol (reduced metabolism - therefore increased concentrations - of the drug b/c of allopurinol)

Question 26

Fludarabine

Answer 26

interferes with DNA polymerase. Analogue of the purine adenine.
SE: myelosuppression, increased risk of opportunistic infection.

Question 27

Cladribine

Answer 27

antitumor activity on both actively dividing and resting cancer cells. Purine analog that resists deactivation by deaminase.
SE: myelosuppression, increased risk of infection. Don’t combine with Fludarabine (pulm tox).

Question 28

Pentostatin

Answer 28

Potent inhibitor of adenosine deaminase. Purine analog.
SE: myelosuppression, increased risk of infection. Don’t combine with Fludarabine (pulm tox).
Renal, liver, pulmonary and CNS toxicity but this is dose limited.

Question 29

What are the antifolates?

Answer 29

Methotrexate and pemetrexed - high dose. Folates are cofactors in DNA synthesis, without it then the cells can’t replicate DNA and divide.

Question 30

What are the side effects of antifolates?

Answer 30

megaloblastic (pernicious) anemia, neutropenia, thrombocytopenia, hepatotoxicity, mucositis, n/v. Can help with the neutropenia if B12 supplement and folic acid supplements are given. When combined NSAIDs and Methotrexate - renal toxicity.