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pharm midterm
midterm
70
Pharmacology
Graduate
10/11/2009

Additional Pharmacology Flashcards

 


 

Cards

Term
ex of penicillins
Definition
penicillin, ampicillin, unasyn, amoxicillin, augmentin, oxacillin, dicloxacillin, zosyn
Term
penicillins
Definition
bind to penicillin binding protein (PBP) & inhibit cell wall syn, most pens are destroyed by beta-lactamase
- Covers Strep, and varying activity against other bact
- Adverse effects: rash- 10%, diarrhea- augmentin
Term
Penicillin
Definition
IV, IM, PO- pharyngitis, syphilis
Term
Ampicillin
Definition
IV, PO- drug of choice (DOC) for ENTEROCOCCUS (in combo w/ gentamicin if a systemic infection)
Term
Unasyn
Definition
( IV)- community- acquired pneumonia (CAP), intra abd infections, cellulites, diabetic foot infections, cat/human/dog bites
*sulbactam is a beta-lactamase inhibitor, making this beta-lactamase stable
Term
amoxicillin
Definition
PO- DOC for otitis, acute sinusitis, very good for enterococcus (works for strep & entero, but not staph)
Term
Augmentin
Definition
(PO)- 2nd line for otitis, oral follow-up for unasyn same applications as unasyn (clavulanate = beta-lactamase inhibitor)
Term
Oxacillin
Definition
(IV, PO) beta-lactamase stable penicillin, anti-staph pen (has a narrow spectrum, only really used for staph)
Term
Dicloxacillin
Definition
(PO)- preferred oral follow-up to beta-lactamase stable pen (oxacillin) only used for staph
Term
zosyn
Definition
(IV)- extended spectrum pen, beta-lactamase stable d/t tazobactam anti-Pseudomonal activity nosocomial infections (used for hospital & serious infections), serious intra abd infections.
Term
Cephalosporins
Definition
see penicillin’s (also same adverse effecs)
divided into gen that roughly desc relative activity against GPC vs. GNR , most have some activity against both stable in the presence of beta-lactamase but other nz & resistance mech exist to reduce effectiveness
Term
ex of Cephalosporins
Definition
keflex, ancef, cefzil, rocephin, claforan, fortaz
Term
keflex
Definition
PO, treatment of S/SI, CAP, DFI *oral equivalent to ancef
Term
ancef
Definition
surgical prophylaxis, S/SI *IV equivalent to Keflex
Term
Cefzil
Definition
PO- 2nd line for otitis, CAP, S/SI, more effective against H. flu than keflex and ancef
Term
rocephin
Definition
IV/IM- CAP, S/SI, MENINGITIS
Term
claforin
Definition
IV- CAP S/SI, MENINGITIS
Term
fortaz
Definition
IV- nosocomal, and ANTI-PSEUDOMONAL ACTIVITY
Term
Carbapenems
Definition
same as pens (adverse effects same as pens also)
Beta-lactamase stable
Term
ex of carbapenems
Definition
ertapenem and imipenem
Term
ertapenem
Definition
IV- CAP, S/SI, DFI, intra-abd infections (no anti-pseudomonal activity) binds to PBP in diff place than pen
Term
imipenem
Definition
IV- ANTI-PSEUDOMONAS ACTIVITY, nosocomial infections, severe intra-abd infections (reserve for pseudomonas or resistant infections) *may cause seizures in ptnts w/ meningitis or reduced renal funct
Term
monobactams
Definition
same as pens, adverse effects same too
Term
ex of monobactam
Definition
azactam
Term
azactam
Definition
ANTI-PSEUDOMONAL ACTIVITY, nosocomal infections, ONLY GRAM - ACTIVITY must be paired w/ a gram + for complete therapy *resistence d/t enzymatic degradation
Term
Aminoglycosides
Definition
(IV only, PO for GI decontamination) binds irreversibly to 30S sub-unit of bact ribosome’s (inhibiting protein synthesis) primarily for inptnt use, treatment for gram (-) anaerobic organisms, synergistic w/ beta-lactamase antib & vanco for selected gram (+) organisms, resistance dev d/t changes in ribosome’s or drug-modifying nz’s
*adverse effects inc renal toxicity, & odotoxicity (irreversible deafness, balance prob & ringing)
*these & vanco are the only 2 that you can do serum levels on (narrow therapeutic index)
*doses based on ptnts wt and renal funct
Term
ex of aminoglycosides
Definition
gentamycin, tobramycin and amkin
Term
gentimycin
Definition
sepsis, pneumonia, wounds intra-abd, GI S/SI
Term
tobramycin
Definition
same as gent, infections resistant to gent, 1ST LINE FOR PSEUDOMONAS, paired w/ another agent
Term
amkin
Definition
same as for gent and tobra, last line of aminoglycosides RESERVED FOR RESISTANT ORGANISMS
Term
peak and troughs for aminoglycosides
Definition
peak: gent/tobra = 7-10 mcg/ml
amkin = 25-30 mcg/ml
trough: gent/tobra = <1 mcg/ml
amkin = <5 mcg/ml
Term
Macrolides
Definition
binds to 50S ribosome- staph, strep, atypical, H. flu resistance dev d/t antib pumps or changes to ribosome
*adverse effects- nausea, vomiting , diarrhea
Term
ex of microlades
Definition
zithromax, biaxin and erythromycin
Term
zithromax
Definition
(IV,PO) outptnt for CAP, otitis, STDs, inptnt w/ cephalosporin for CAP or alone (IV)
Term
biaxin
Definition
(PO) outptnt for CAP, S/SI, peptic ulcer disease and SINUSITIS (tastes offal)
Term
erythromycin
Definition
IV,PO CAP and strep
Term
Clindamycin
Definition
(IV/PO) binds to 50S ribosome, in or out ptnt for S/SI, toxic shock synd, early DFI, aspiration pneumonia (w/ drug for GNR) resistance dev d/t changes in ribosome’s
*only covers gram (+) cocci and anaerobes
*adverse effects = GI complications (nausea) esp w/ PO, PO causes antib assoc colitis
Term
Glycopeptide
Definition
bind to PBP, gram (+) organisms, surgery prophylaxis in cephalosporin- allergic ptnts, serious or resistant gram (+) infections, MRSA/MRSE alternate for antib assoc colitis
*resistance mounting d/t changes in PBP or inc cell wall thickness
*adverse effects: red man’s synd, same as Aminoglycosides (odotoxicity, renal toxicity)
Term
Ex of glycopeptide
Definition
vancomycin
Term
vancomycin
Definition
IV-synthetic, PO-GI only (doesn't get absorbed) IV and PO are not interchangable
Term
dosing considerations for vancomycin
Definition
10-15mg/kg/dose
interval based or CrCL
target trough = 10-20 mcg/ml
Term
Sulfa drugs
Definition
block folic acid syn, 3 day therapy for UTI, alternative treatment for S/SI, works for MRSA (esp CA-MRSA) *resistance dev d/t changes in folic acid metabolism
*adverse effects: cause rashes; can cause Steven Johnson synd, photosensitivity
Term
ex of sulfa drugs
Definition
bactirm (IV/PO)
Term
Fluoroquinolones
Definition
bind to DNA gyrase (the nz responsible for uncoiling DNA) DO NOT USE UNLESS ABSOLUTELY NECESSARY
*resistance dev d/t changes in DNA gyrase
*adverse effects: all cause jt pain, contraindicated for children, DO NOT USE IN PREGNANT WOMEN UNLESS YOU HAVE TO!
Term
ex of fluroquinolones
Definition
Cipro, levaquin, mocifloxacin
Term
cipro
Definition
(IV,PO)- primarily for Gram (-) infections, nosocomial infections, pseudomonas (usually in combo) 3-day for uncomplicated UTI, intra-abd infections, prophylaxis or treatment in allergic ptnts
*best against pseudomonas, only use if allergies, suspect resistance, or failed previous
Term
levaquin
Definition
alternate for in or out ptnt treatment of CAP, other resp infections, S/SI, UTI, infections unresponsive to other antibs
Term
mocifloxacin
Definition
(IV, PO)- same as Levaquin except not UTI, and no pseudomonas coverage
Term
Tetracyclines
Definition
bind to 30S ribosome, in or out ptnt of CAP, cat bite, STD, acne, alternate for MRSA,
*resistance dev d/t changes in ribosome
*adverse effects: not for ages 7 and younger, b/c it binds to Ca, causes discoloration in teeth
Term
ex of tetracyclines
Definition
doxycycline and tigecycline
Term
doxycycline
Definition
(IV, PO)- PID (pelvic inflammatory disease), MRSA, CAP
Term
tigecycline
Definition
(IV only)- severe CA or nosocomial infections (not bacteremia/sepsis) b/c goes into tissues, doesn’t stay in bld. Esp polymicrobial infections
Term
Oxazolidinone
Definition
inhibits protein syn at the ribosome, covers GP organisms inc many that are resistant to other antib like vanco
*resistance dev d/t changes in ribosome
*adverse effects: causes photosensitivity, check CBC weekly b/c can cause any type of anemia, neuropathy (pins and needles)
* must be taken w/ B6
Term
ex of oxazolidinone
Definition
Linezolid
Term
linazolid
Definition
(IV/PO)- limited role, but very imp drug treatment of GP infections that are resistant (MRS, enterococcus)
Term
Flagyl
Definition
(IV,PO)- reduced in bact mitochondria, binds to DNA and inhibits nucleic acid syn, inptnt treatment for intra-abd infections, some STDs, PO or IV for antib assoc colitis,
*only for anaerobes
*adverse effects: unbearable taste, interacts with ethanol
Term
human bite
Definition
staph/strep/anaerobes
mild = augmentin (po)
severe = unasyn (IV)
alt = clinda + bactrim or clinda = FQ
Term
cat bite
Definition
pasteuella/staph
augmentin, doxycycline
Term
dog bite
Definition
pasteuella, staph or anaerobes
augmentin, clinda + bactrim, clinda + FQ
Term
cellulitis
Definition
staph/strep
augmentin, cephalexin, Dicloxacillin, clindamycin; IV equivalent if severe
Term
DFI
Definition
staph/strep (shallow)- see cellulites
staph/strep/GNR/anaerobes (deep)- Unasyn, clinda + Bactrim, clinda + FQ, ertapenem
Term
UTI- outptnt
Definition
3 days and 7-10 days (same)
E. coli, other GNR, staph
Bactrim, Cipro or levaqui, Macrodantin
Term
UTI inptnt/pyelonephritis
Definition
E. coli, other GNR, staph
IV FQ, amp + gent, rocephin
Term
lungs- outptnt
Definition
viruses, pneumococcus, H. flu (smokers), mycolasma
zithromax, biaxin, augmentin, cefzil, Levo or moxi
Term
lungs- admitted to hospital
Definition
pneumococcus, H. flu, mycoplasma

rocephin +zithromax/biaxin, levo/moxi,
ertapenem + zithromax/biaxin
Term
lungs- aspiration
Definition
mouth flora

unasyn, zosyn, rocephin + flagyl
Term
lungs- nosocomial
Definition
pneumococcus, H. flu, pseudomonas

zosyn + cipro,
zosyn + tobra,
imipenem + cipro,
imipenem + tobra other double-coverage regimens
Term
osteomyelitis
Definition
staph/strep

IV oxacillin
rosephin
vanco or linezolid (if MRSA)
Term
meningitis
Definition
pneumococcus, meningococcus, H. flu

rocephin or claforin plus rifampin and vancomycin
Dexamethasone as anti-inflam
Term
Otitis media
Definition
AMOX, augmentin, cefzil,zithromax/biaxin
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