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Chemo 2
slides 119-199
62
Pharmacology
Graduate
04/17/2010

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Cards

Term
Does bacterial protein synthesis involve a a 70s or 80s ribosome?
Definition
70s ribosome
Term
True or False: 70s ribosomes are found in mitochondria of mammalian cells
Definition
True.
Term
Are aminoglycosides 30s or 50s inhibitors?
Definition
30s inhibitors
Term
Are tetracyclines 30s or 50s inhibitors?
Definition
30s inhibitors
Term
Are glycylcycline 30s or 50s inhibitors?
Definition
30s inhibitors
Term
Is Chloramphenicol a 30s or 50s inhibitor?
Definition
50s inhibitor
Term
Are macrolides 30s or 50s inhibitors?
Definition
50s inhibitors
Term
Is clindamycin a 30s or 50s inhibitor?
Definition
50s inhibitor
Term
Are streptogramins 30s or 50s inhibitors?
Definition
30s inhibitor
Term
Is linezolid a 30s or 50s inhibitor?
Definition
50s inhibitor
Term
What is the name of the aminoglycoside used to treat the plague?
Definition
Streptomycin
Term
What is the phase 1 mechanism of action for Aminoglycosides?
Definition
Positively charged aminoglycoside enter bacteria through negatively charged pore. If aerobic, changes permeability of membrane causing subsequent aminoglycoside entry
Term
What is the phase 2 mechanism of action for aminoglycosides?
Definition
Inhibition of protein synthesis-binds various sites of bacterial 30s ribosomal subunits
Term
True or False: There is not a minimum-required concentration for activity of aminoglycosides to occur
Definition
False, aminoglycosides are concentration-dependent.
Term
Do aminoglycosides have short or long durations of actions?
Definition
Long. Aminoglycosides have a post-antiobiotic effect, lasting the duration of the frozen monozome.
Term
What is the spectrum of action for aminoglycosides?
Definition
Aerobic gram negative
Term
Where do aminoglycosides concentrate in the body?
Definition
Bone, renal cortical, and endo- and peri-lymph of the ear
Term
Do aminoglycosides have a high or low margin of safety?
Definition
Low, they are very harsh
Term
Would you administer verapamil or calcium with aminoglycosides to reduce nephrotoxicity?
Definition
Verapamil. Calcium will prevent aminoglycosides from entering bacteria.
Term
Streptomycin and gentamicin are associated with what adverse effect?
Definition
Cochlear toxicity
Term
Neomycin, amikacin, and tobramycin are associated with what kind of ototoxicity?
Definition
Vestibular toxicity
Term
What are the 3 black box warnings for aminoglycosides?
Definition
Nephrotoxicity, Ototoxicity, and neuromuscular blockade
Term
Do penicillins enhance or harm the activity of aminoglycosides?
Definition
Penicillins enhance the activity of the aminoglycosides by enhancing permeability of the bacterial wall
Term
What can impair the oral absorption of tetracyclines?
Definition
Food and metal ions. Tetracyclines with chelate with metal ions.
Term
What two tetracylines have an improved oral absorption with food?
Definition
Doxcycline and minocycline
Term
Are the short acting or long acting tetracylines better distributed in lipid solubility and protein binding?
Definition
Longer acting tetracyclines
Term
Where in the body do tetracyclines accumulate?
Definition
Teeth and bone (places with high levels of calcium)
Term
What class of drugs causes photosensitivity?
Definition
Tetracyclines
Term
Minocycline and doxycycline are associated with what adverse effect?
Definition
Vestibular toxicity
Term
What happens to Chloramphenical before excretion?
Definition
Chloramphenical is inactivated by conjugation before excretion.
Term
Dose related anemia due to bone marrow depression is an adverse effect of what medication?
Definition
Chloramphenicol
Term
"Gray baby syndrome" associated with Chloramphenicol is due to what process?
Definition
Neonates have poorly develop conjugation processes, allowing blood levels of chloramphenical to increase
Term
Neurological problems associated with Chloramphenicol are most common in what type of patient?
Definition
Neurological problems occur more often in patients with cystic fibrosis.
Term
What is the mechanism of action for macrolides?
Definition
Macrolides inhibit translocation and block acceptor site
Term
What is an adverse effect of macrolides when therapy >10 days or there are repeated courses?
Definition
Cholestatic hepatitis
Term
Because macrolides use the cytrochrome P450 enzyme, what other medications can be affected when combined?
Definition
Anti-epileptics, HIV meds, anticoagulants-if used together, effectiveness of these medications will be decreased.
Term
True or False. Macrolides can be safely co-administered with cisapride.
Definition
False. Co-administration will cause prolongation of QT interval.
Term
Sudden cardiac death can result from concurrent use of erythromycins and what other drugs?
Definition
Drugs that inhibit CYP3A4:Ca channel blockers, antifungals, and typical antidepressants
Term
Macrolides are commonly used to treat what STI?
Definition
Chlamydia
Term
What is the black box warning for Clindamycin?
Definition
Pseudomembranous colitis
Term
What medication causes a "constipation" of the ribosome?
Definition
Quinupristin-Dalfopristin
Term
What is an adverse effect of Quinupristin-Dalfopristin?
Definition
Hepatotoxicity in 1% of patients
Term
What is the main indication for using Quinupristin-Dalfopristin?
Definition
Vancomycin-resistant streptococcus faecium
Term
What can Linezolid cause with prolonged use?
Definition
Reversible thrombocytopenia
Term
What medication contains phenylalanine and should not be given to phenylketonurics?
Definition
Linezolid
Term
What medication inhibits monamine oxidase and should not be combined with alpha agonists because of an increased risk of HTN?
Definition
Linezolid
Term
Insoniazid is inactiviated by what?
Definition
Genetically determined acetylation
Term
Do high acetylators have an increased or decreased risk of hepatotoxicity with Isoniazid?
Definition
Higher risk
Term
What drug causes retrobulbar neuritis?
Definition
Ethambutol
Term
What is it important to educate patients NOT to skip Rifampin doses?
Definition
Intermittent therapy has immunosuppressive effects
Term
What medication causes red/orange to red/brown coloration of urine and secretions?
Definition
Rifampin
Term
What Tb medication can cause sodium overload?
Definition
Para-Aminosalicylic Acid
Term
What is the mechanism of action for Rifampin?
Definition
Inhibits RNA synthesis
Term
If patients need higher doses of IZD, will they be at an increased or decreased risk of hepatotoxicity with Rifampin?
Definition
Increased
Term
Why do 3rd world countries still use pyrazinamide to treat Tb?
Definition
It allows for a flexible treatment schedule
Term
Nongouty polyarthralgia and asymptomatic hyperuricemia are adverse effects of what medication?
Definition
Pyrazinamide
Term
What 2nd line Tb drug has a similar mechanism of action to the sulfonamide class?
Definition
Para-aminosalicylic acid
Term
Patients on what type of diet need to be careful when taking para-aminosalicylic acid?
Definition
Patients on sodium-restricted diets for HTN
Term
What can be given with IZD treatment to minimize CNS effect?
Definition
Vit B6
Term
What 2nd line Tb medication is similar to IZD?
Definition
Ethionamide
Term
What 2nd line Tb medication has a similar mechanism of action to Vanco?
Definition
Cycloserine-competitive inhibitor of D-alanine
Term
What 2nd line Tb medication is similar to Rifampin in mechanism of action?
Definition
Rifabutin
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