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Pharm test 2
ISU PA
80
Pharmacology
Graduate
10/17/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
natural penicillins drawbacks
Definition
penicillinase sensitive
short half-lives (4x daily dosing)
Term
antistaphylococcals side effects
Definition
allergies (type 1) and GI upset
Term
Penicillins MOA
Definition
cell wall synthesis inhibitors
Term
aminopenicillins spectrum
Definition
broad spectrum
effective against various gram+, some gram-
Term
antipseudomonals spectrum
Definition
IV broad specturm
good for pseudomonas
more gram- coverage
both come available with b-lactamase inhibitor
Term
b-lactamase inhibitor combination spectrum
Definition
good anaerobic coverage
broad spectrum
use if suspect resistant infection
(if not resistant, will not help extra)
Term
cephalosporins (definition & classification)
Definition
semi-synthetic antibiotics that are chemically similar to natural penicillins
classified in generations according to bacterial spectrum
Term
1st gen cephalosporins spectrum
Definition
skin and soft tissue infections
better for Gram+, MSSA
"non prodrugs" - don't need to be activated
oral formulations
Term
2nd gen cephalosporins spectrum
Definition
Gram-, Gram+, some anaerobes
oral formulations
Term
3rd gen cephalosporins spectrum
Definition
better Gram- and good Gram+ (except Staph) & anaerobic coverage
oral formulations
better Gram-, good Gram+ (except staph) and good anaerobes
Term
Quinolones spectrum
Definition
good for pneumonia, soft tissue, bone infections, UTIs
almost 100% bioavailability
broad spectrum: favorable Gram+, excellent Gram-, intercellular and good anaerobes (broad spectrum)
*often reserved for severe infections
Term
moxifloxacin & gatifloxacin spectrum
Definition
good for respiratory and kidney infections
Term
sulfonamides spectrum
Definition
good for UTIs, ear infections, E. coli, pneumocystis prevention in HIV pts
broad spectrum
Term
tetracyclines spectrum & MOA
Definition
treat acne, STDs
binds to 30s ribosome; are bacteriocidal
broad spectrum
Term
Macrolides (MOA & side effects)
Definition
bind to 50s ribosome, preventing translocation
side effects: GI and hypersensitivity
Term
clarithromycin spectrum
Definition
chlamydia, gonnorhea
Term
azithromycin dosage (& frequency of use)
Definition
macrolide used 90% of time
z-Pac = 5 day treatment, Tri-pac = 3day treatment
Term
erithromycin (spectrum/side effect)
Definition
used more for eye infections because of diarrhea when taken orally
delayed release
Term
antivirals side effects
Definition
side effects: headache, nausea, diarrhea
Term
acyclovir dosing & forms
Definition
capsules, tabs, ointment, cream, suspenstion
dosed 4-5 x day for treatment
2 x day for prophylaxis
(poor outcomes because of this)
Term
valacyclovir dosing
Definition
2 x daily dosing for treatment
1 x daily dosing for prophylaxis
Term
famcyclovir dosing
Definition
dosing 2-3 x day
Term
penciclovir dosing & spectrum
Definition
cream 1%
every 2 hrs while awake at 1st signs of cold sore tingling
Term
antifungals MOA
Definition
inhibit cytochrome p450 in the liver, which is enzyme responsible for development of cell membranes
for Fungi - need cholesterol to maintain cellular integrity
lots of drug interactions
Term
antidepressants MOA
Definition
increase transmission of one or more neurotransmitters
*all increase suicidal tendencies in 23 yo and younger*
Term
SSRIs MOA
Definition
block amine reuptake pumps by presynaptic neuron
well absorbed
highly metabolized in liver
Term
fluoxetine
Definition
1/2 life of 7 days
Term
paroxetime
Definition
controlled release further in the GI tract (less absorption)
Term
citalopram
Definition
S & R isomers
Term
escitalopram
Definition
S isomers only
Term
Tricyclic antidepressants (TCAs)
Definition
mixed effects on seratonin and norepinephrine (block reuptake)
side effects: antihistamine, anticholinergic, alpha-blocking
*dirty drugs, less commonly used*
Term
amitriptyline
Definition
TCA for neuropathic pain and sleep
Term
SNRIs spectrum & side effect
Definition
for depression; can increase BP
Term
NDRIs spectrum & side effects
Definition
antidepressants,act against dopamine
side effects: GI disturbances, sexual dysfunction
Term
other antidepressants side effect
Definition
trazodone and mirtazapine
sedative side effects
Term
benzodiazepines MOA
Definition
BZDs: for sedation and anti-anziety
bind to GABA receptors, promote Cl channel openings (synaptic inhibition)
metabolized by CYP450
Term
short-acting BZDs
Definition
last 4-6 hours (also includes zolpidem (Ambien)
Term
intermediate-acting BZDs
Definition
last 8hrs
Term
long acting BZDs
Definition
last 12 hrs
Term
BZD antagonist
Definition
blocks BZD action (for overdose)
Term
BZD like drugs
Definition
appropriate for insomnia, not anxiety
eszopiclone approved for long-term use
Term
antipsychotics spectrum, MOA
Definition
AKA "neuroleptics"
for psychosis, schizophrenia (off-label for bipolar, dementia, autism, migraines)

-excess dosage=Parkinson symptoms
*Expensive*
affects nigrostriatal, mesolimbic, & mesocortical pathways
Term
risperidone forms
Definition
oral disintegrating and long-acting injections
Term
Antiepileptic drugs MOA
Definition
AEDs - stabilize membranes
also known as "mood stabilizers"
Term
phenytoin
Definition
prevents cortical seizures
acts on Na, K, Ca conductance; promotes efflux of Na from neurons
slow and well-absorbed, has a plasma range of 10-20 mcg/mL
available injectable
Term
divalproex spectrum & MOA
Definition
MS, bipolar, dementia, migrain
increases brain levels of GABA
Term
stimulants spectrum & MOA
Definition
for ADHD
mimic norepinephrine
highly addictive
metabolized in the liver
Term
atomoxetine
Definition
non-scheduled stimulant
Term
Adderall XR
Definition
Schedule II
special dosage form
Term
methylphenidate XR
Definition
Schedule II
Term
Beta-lactams
Definition
include penicillins and cephalosporins
inhibit critical step in bacterial cell wall synthesis
Term
penicillin v potassium
Definition
tabs, suspension
Term
penicillin g forms
Definition
IM or IV
dosed in units
Term
cloxacillin and dicloxacillin
Definition
oral formulations
Term
nafcillin and oxacillin
Definition
IV
S. aureus that are resistant to either of these is considered MRSA
Term
amoxicilin
Definition
tabs, caps, suspension, chew tabs
Term
voriconazole
Definition
available IV
Term
4 mechanisms of Beta-lactam resistance
Definition
1. inactivation of beta-lactam ring
(S. aureus, M cat, N Gonorrhoeae, H flu
2. alteration of penicillin binding proteins
(S pneumonia, Enterococcus, and MRSA)
3. reduction of antibiotic access to penicillin binding proteins
4. elaboration of antibiotic efflux mechanisms
Term
sulfa drug resistance
Definition
decreased bacterial permeability to drug; increased production of the enzyme that the drug inhibits
Term
tetracycline resistance
Definition
decreased cell permeability; increased cell efflux of the drug
Term
antiviral resistance
Definition
mutations in enzyme activity which prevent drug from becoming active
Term
type I allergy
Definition
from penicillins; anaphylaxis within 30 minutes
can be single organ or multiple
usually from IV antibiotics
Term
type II allergy
Definition
cytotoxic reaction; erythema 5-12 hours after ingestion; penicillin and sulfa drugs
Term
type III allergy
Definition
caused by penicillin or sulfa drugs; immune complex reaction 3-8 hours later; less common
Term
type IV allergy
Definition
delayed hypersensitivity reaction mediated by T-cells, 48-72 hours later
more common reaction
Term
natural penicillins spectrum
Definition
good gram+, some gram-
good for strep pneumonia
Term
antistaphylococcals spectrum
Definition
staph. aureus and epidermis
narrower-spectrum
penicillinase and b-lactamase resistant
penicillinase and b-lactamase resistant
Term
Quinolones MOA
Definition
inhibit bacterial DNA synthesis by acting on DNA gyrases
Term
Quinolones side effects
Definition
GI side effects, all interact with Warfarin, contraindicated for pregnant, BF, and kids whose epi plates have not closed; also increase blood sugar
Term
sulfonamides MOA
Definition
bacteriostatic
inhibit synthesis of folic acid with PABA
Term
sulfonamides side effects
Definition
side effects: hypersensitivity, prone to sunburn, interacts with Warfarin & Dilantin
tabs, DS tabs, and suspenstion
Term
tetracyclines side effects
Definition
side effects: GI, fetal teeth, sun-sensitive
contraindicated in pregnant, kids <8
Term
antivirals spectrum
Definition
treatment & prevention of HSV-1 & -2, secondary VZV, influenza, and hepatitis
Term
antivirals MOA
Definition
target various stages of viral replication: binding, uncoating, synthesis of viral compounds, assembly of viral particles, release of the virus
Term
antifungals spectrum
Definition
for Candida, coccidiomycosis, histoplasmosis, aspergillosis
oral, vaginal, genital, feet, etc
Term
SSRIs side effects
Definition
GI disturbance 1st week, sexual dysfunction
best for drinkers
Term
BZDs side effects
Definition
not as effective in hepato-compromised pts
tolerance and dependence develop when used over time
Schedule IV
Term
antipsychotics MOA
Definition
block dopamine (D2 receptors) at postsynaptic level
newer drugs block 5-HT2 (seratonin) receptors
incompletely absorbed- highly lipid soluble (=longer duration), significant 1st pass metabolism, can be detected in urine after pt stops taking the drug
Term
antipsychotics side effects
Definition
sleepiness/restlessness, amenorrhea, decreased libido, gynecomastia in men & orthostatic hypotension
Term
Macrolides spectrum
Definition
gram+, strep pneumo, poor gram- (exccept M cat, H flu & legionella), good intracellular against mycoplasma (& other URIs)and chlamydia; not good anaerobic
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