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Pharmacology II

Exam 1

B-lactam antibiotics, cycloserine, vancomycin, and bacitracin all function to...? Inhibit bacterial cell-wall synthesis
Polymyxin, nystatin, amphotericin B-antifungals, and daptomycin all function to..? Act directly on cell membrane of the microorganism and increase permeability
Chloramphenicol, clindamycin, tetracyclines, erythromycin, and linezolid all function to..? Reversible inhibition of protein synthesis
Aminoglycosides function to..? Alter protein synthesis
Rifampin and fluoroquinolones function to..? Affect bacterial nucleic acid metabolism
Trimethoprim and sulfonamides are both in this antibiotic classification? Antimetabolites
Acyclovir, efavirenz, nevirapine, protease inhibitors and enfuviritide are all classified as what type of antimicrobials? Antiviral agents
These antibiotics inhibit peptidoglycan synthesis or "transpeptidation" of bacterial cell wall. B-lactam antibiotics
Which Penicillins do not require dose adjustments in renal impairment? Nafcillin, Oxacillin
Which penicillins are both IV drugs for Pseudomonas? Ticarcillin, Piperacillin
What has no antimicrobial activity but helps a medication to live longer and "out-do" the organism? B-Lactamase Inhibitors
Which cephalosporin does not require dose adjustments in renal impairment? Ceftriaxone
Which cephalosporins have mostly gram positive coverage? First generation
Which cephalosporins have pseudomonas coverage? Ceftazidime, cefepime
Doripenem, Imipenem, Meropenem, Ertapenem all fall into which antibiotic class? Carbapenems
Which Carbapenem is the only one that does not cover for Pseudomonas? Ertapenem
What is the bleeding disorder that can be an adverse effect of B-lactams and may be prevented with vitamin K therapy? Hypoprothrombinemia
What is the only drug of the monobactam class that has activity against gram negative bacteria including pseudomonas? Aztreonam
Cephalosporins are not active against which 2 groups of microorganisms? Enterococci and L. monocytogenes
This drug has gram positive coverage only, is good for VRE and has adverse effects of myopathy and increased CPK Daptomycin
Which of the following is not an adverse effect of vancomycin? ototoxicity, red man's syndrome, ALT elevations, nephrotoxicity ALT elevations
Which of the macrolides is the worst for causing the adverse effect of GI symptoms? Erythromycin
Which antimicrobial is broad spectrum that can cause Gray baby syndrome? Chloramphenicol
Which of the fluoroquinolones are respiratory, used for CAP? Levofloxacin, Moxifloxacin
Which NNRTI is Pregnancy Category D and can worsen psychiatric illness? Efavirenz
Which of the following fluoroquinolones are not PO? Levoflaxacin, Norfloxacin, Ciprofloxacin, Moxifloxacin Norfloxacin
Which TB agent can cause retrobulbar neuritis? Ethambutol
Which of the following non-retroviral agents are not used for CMV? Docosonal, Acyclovir, Foscarnet, Ganciclovir Docosanol
Which antifungal is known to cause anemia, nephrotoxicity, and infusion-related toxicity? Amphotericin B
Which of the following drugs is not used for Hepatitis B? Adefovir, Telbivudine, Sofosbuvir, Entecavir Sofosbuvir
Which of the following ART drugs is a CCR5 receptor antagonist and has a BBW of hepatotoxicity? Indinavir, Maraviroc, Abacavir, Stavudine Maraviroc
Which penicillin would be prescribed to treat a Pseudomonas infection? Oxacillin, Amoxicillin, Ticarcillin, Penicillin G Ticarcillin
What is the BBW for fluoroquinolones? Tendon rupture
Which of the following is not a side effect of Isoniazid (INH)? Hepatotoxicity, ototoxicity, peripheral neuropathy, drug-induced SLE? Ototoxicity
What can you give along with elemental iron to improve its absorption? Vitamin C/acidic environment
What adverse effects would you warn your patient about when started on oral iron therapy? Dark stools, constipation
How do you treat iron toxicity? Deferoxamine, Deferasirox
Which iron therapy would you perform a test dose first with the patient in order to avoid a hypersensitivity reaction? Iron dextran
Which of the following is not an etiology of iron deficiency anemia? Menstruating women, blood donations, strict vegetarians, corticosteroids Strict vegetarians
Which of the following is a parenteral preparation for Vitamin B12 deficiency? Hydroxocobalamin, pyridoxine, nicotinic acid, iron dextran Hydroxocobalamin
What deficiency is caused by inadequate dietary intake, pregnancy, or medications such as methotrexate? Folic acid deficiency
What is the difference between folic acid deficiency and vitamin B12 deficiency? No neurologic symptoms in folic acid deficiency
What is the recommended dose and formulation for someone with folic acid deficiency and what could the dose be if they have a malabsorption syndrome? 1 mg PO daily and up to 5 mg daily
What is the dose given to pregnant women at low risk for folic acid deficiency and women who have some sort of history of neural tube defect issues? 0.4 mg daily low risk and 4 mg daily high risk
A patient is on Epoetin alfa because he is an HIV infected patient being treated with what drug most likely? Zidovudine
What are the black box warnings for patients on erythropoeitin stimulating agents? Chronic kidney disease, cancer, perisurgery
Which of the following is not an adverse effect of erythropoeitin stimulating agents? Bone pain, bone marrow suppression, pure red cell aplasia, thrombotic events Bone marrow suppression
Meg presents with ataxia, weakness, and other neurological symptoms. What would the best treatment option be for her? IV cyanocobalamin, oral folic acid, ferrous fumarate, epoetin alfa IV cyanocobalamin
Which of the following is not an indirect thrombin inhibitor? Enoxaparin (Lovenox), Warfarin (Coumadin), Fondaparinux (Arixtra), Dalteparin (Fragmin) Warfarin (Coumadin)
What is the sister drug to Rivaroxaban (Xarelto)? Apixaban (Eliquis)
Which of the following is not an indication of Dabigatran (Pradaxa)? DVT/PE treatment, DVT prophylaxis in patients undergoing hip/knee athroplasty, prevention of stroke and systemic embolism in nonvalvular afib DVT prophylaxis in patients undergoing knee/hip surgery
How are the emerging oral anticoagulants dosed and excreted (Pradaxa, Xarelto, Eliquis)? Renally
What would you counsel your patient to do if they miss a dose of their warfarin? Skip that dose entirely and then continue on their normal time schedule
Which of the following is an acceptable intervention for someone on too much warfarin? Protamine sulfate, phytonadione, factor IIa, pyridoxine Phytonadione
What is aspirin available in combination with as Aggrenox? dipyridamole
Which of the following drugs is a glycoprotein IIB/IIIA receptor antagonist? Enoxaparin (Lovenox), Abciximab (Reopro), Clopidogrel (Plavix), Ticagrelor (Brilinta) Abiciximab (Reopro)
What is the recommended therapy for a CHA2DS2 VASc score of 2 or more? Anticoagulant or Aspirin + clopidogrel
What is a non-immune mediated response to heparin and what is the management? HIT Type I; no intervention required
What is an immune-mediated response to heparin and is intervention required? HIT Type II; intervention required
Which of the following medications cannot be used as an alternate medication for a patient with HIT? Fondaparinux, Lepirudin, Protamine sulfate, Argatroban Protamine sulfate
What is the blackbox warning for Dabigatran (Pradaxa) and Rivaroxaban (Xarelto)? Spinal/epidural hematoma
What are the adverse effects of warfarin? Bleeding, bruising, purple toe syndrome
What is the initial dose and administration of warfarin? 5-10 mg PO
What is the therapeutic INR range you would want for someone at risk for a VTE? 2-3
Medications that increase INR, increase _______, while medications that decrease INR increase ________. bleed risk, clot risk
What are the goals of therapy for a diabetic patient? A1c<7; pre-prandial plasma glucose 70-130, post-prandial plasma glucose <180
What are the goals for hypertension of a diabetic patient? SBP <130-140 and DBP <80
The medications tolbutamide, chlorpropramide, and glimepiride all fall into what drug class. Which of them is preferred? Sulfonylureas; Glimepiride
What are some adverse effects of sulfonylureas? Weight gain, hypoglycemia, not tolerated well in the elderly
What are the CIs of sulfonylureas? Hypersensitivity to sulfonamides; poor renal function
What is not an adverse effect of metformin? Lactic acidosis, metallic taste, weight gain, vitamin B12 deficiency Weight gain
What are the renal levels that are needed to be maintained while the patient is on metformin? Males SCr >1.5, Females SCr > 1.4; CrCl<60
What are the CIs of metformin? Iodinated contrast studies, renal impairment, increased lactic acidosis risk
Which drugs are indicated for postprandial glucose elevations? Meglitinides
CIs of this drug class include heart failure, hepatic impairment, increased MI risk, increased bladder cancer risk, PCOS ovulation resumption Thiazolidinediones
Which drug class causes GI symptoms but has a minimal risk of hypoglycemia? alpha-glucosidase inhibitors
What is the SQ injection drug that is contraindicated with gastroparesis? Amylin analog: Pramlintide (Symlin)
Which drug class increases insulin secretion, decreases glucagon secretion, and increases satiety as well as slows gastric emptying? Give examples and its formulations. GLP-1 analog; Exenatide, Liraglutide; SQ injection
Personal or family history of thyroid C-cell hyperplasia carcinoma, MEN2, and CrCl <30 are all contraindications of which drug class? GLP-1 analog
What is the adverse effect of exenatide? Acute pancreatitis
Which two DPP-4 inhibitors are renally dose adjusted? Sitagliptin, Saxagliptin
Which of the following drugs have a CI of decreased GFR and a precaution of drug interactions with UGT inducers/inhibitors? Sitagliptin (Januvia), Dapagliflozin (Forxiga), Pramlintide (Symlin), Acarbose (Precose) Dapagliflozin (Forxiga)
What is the definition of hypoglycemia? <70 mg/dl
What is the management for hypoglycemia? Conscious and able to tolerate PO: 15-20 g glucose (fruit juice, sugar packets)
What is Telavancin used to treat? Hospital acquired pneumonia
Which drug has renal dose adjustment and has adverse reactions of red man's syndrome and ALT elevations? Dalbavancin
Which drug has adverse effects of myopathy and increased CPK? Daptomycin
What is the CI of daptomycin? Pneumonia
Which two NRTIs have the adverse effects of peripheral neuropathy? Didanosine and Stavudine
What is the adverse effect of zidovudine? Bone marrow suppression
What of the following is not an adverse effect of NRTIs? GI symptoms, Kernicterus, Lactic acidosis, severe hepatomegaly Kernicterus
What is an adverse effect of Indinavir? Nephrolithiasis
What are adverse effects of Protease Inhibitors as a class? Metabolic issues: hyperglycemia, lipodystrophy syndrome, hyperlipidemia, increased LFTs
T/F: 3 NRTIs is an acceptable ART regimen. False
Which ART drug is administered SQ BID and can cause injection site reactions? Enfuvirtide (Fuzeon)
A patient on Raltegravir needs to be instructed to report any myalgias because of this adverse effect. Increased CPK
What are the adverse effects of acyclovir/valacyclovir? Nephrotoxicity, neurologic toxicity
This drug has adverse effects of myelosuppression and CNS toxicity and is available IV, PO, intravitreal injection, and intraocular implants. Ganciclovir/Valganciclovir
Which of the following is not an adverse effect of Foscarnet: CNS toxicity, ototoxicity, electrolyte disturbances, renal impairment ototoxicity
Which of the following drugs has these adverse effects: nephrotoxicity, ocular toxicity, neutropenia. Abacavir, Cidofovir, Famciclovir, Interferon alfa Cidofovir
What are the contraindications of interferon alfa? Autoimmune disease, arrhythmias, hepatic deompensation
Which of the following drugs can be used to treat both hepatitis C and influenza? Ribaviran
Which of the following drugs is used to treat Hepatitis B only? Telbivudine, Ribaviran, Ganciclovir, Abacavir Telbivudine
Which protease inhibitor has adverse effects of photosensitivity and can also be used to treat Hepatitis C? Simepravir
Which of the following drugs inhibits the viral replication of influenza? Oseltamivir, Amantadine, Zanamivir, Ribaviran Amantadine
Which drug has an infusion-related toxicity similar to vancomycin as well as anemia and nephrotoxicity? Amphotericin B
Which of the following is not an antifungal: Nystatin, Metronidazole, Terbinafine, Griseofulvin Metronidazole
Created by: LexFuturePAC