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Pharmtest4...
pharm4
| Question | Answer |
|---|---|
| penicillin V | [oral; BACTERIOCIDAL] bind PBPs (block transpeptidase --> inhibit cell wall synthesis); USE = Gram+, Gram- cocci, spirochetes; AE = allergy, drug-induced hemolytic anemia |
| penicillin G | [IV; BACTERIOCIDAL] bind PBPs (block transpeptidase --> inhibit cell wall synthesis); USE = Gram+, Gram- cocci, spirochetes; AE = allergy, drug-induced hemolytic anemia |
| methicillin | binds PBPs --> blocking peptidoglycan cross-link; USE = S. aureus; AE = interstitial nephritis; OTHER = b-lactamase resistant; SIMILAR DRUGS = nafcillin, oxacillin, dicloxacillin |
| ampicillin | binds PBPs --> blocking peptidoglycan cross-link; USE = (HELPS = H. influenza, E. coli, Listeria, Proteus, Salmonella) & enterococci; AE = skin rash, colitis; SIMILAR DRUGS = amoxicillin (great ORAL bioavailability) |
| ticarcillin | binds PBPs --> blocking peptidoglycan cross-link; USE = Pseudomonas; AE = allergy; SIMILAR DRUGS = piperacillin, carbenicillin (Take Care of Pseudo) |
| 1st-gen cephs | [-CIDAL] binds PBPs --> blocking peptidoglycan cross-link; USE = Gram+ cocci, PEcK (Proteus, E.coli, Klebsiella); AE = disulfiram-like, nephrotoxic, allergy, bleeding (block vit K epoxidase); OTHER = b-lactamase resistant; DRUGS = cephalexin, cefazolin |
| 2nd-gen cephs | [-CIDAL] binds PBPs --> block peptidoglycan crosslink; USE = Gram+ cocci, HENPEcKS (H.influenza, Klebsiella, Enterobacter, Neiserria, Proteus, E.coli, Serratia); AE = disulfiram-like, nephrotoxic, allergy, bleed; DRUGS = cefotetan, cefoxitin, cefuroxime |
| 3rd-gen cephs | [-CIDAL] binds PBPs --> blocking peptidoglycan cross-link; USE = meningitis, Neiserria (ceftriaxone), Pseudomonas (ceftazidime); AE = disulfiram-like, nephrotoxic, allergy, bleeding (block vit K epoxidase); DRUGS = ceftriaxone, cefotaxime, ceftazidime |
| 4th-gen cephs | [-CIDAL] binds PBPs --> blocking peptidoglycan cross-link; USE = Haemophilus, Enterobacter, Neiserria, Pseudomonas, Serratia, S. aureus, S. pneumo; AE = disulfiram-like, nephrotoxic, allergy, bleeding (block vit K epoxidase); DRUGS = cefipime |
| imipenem | binds PBPs --> blocking peptidoglycan cross-link; USE = Enterobacter, gram+ cocci, gram- rods, anaerobes; AE = GI upset, seizures; OTHER = always given with cilastatin! |
| aztreonam | monocyclic b-lactam: binds PBPs --> blocking peptidoglycan cross-link; USE = Gram- rods (Pseudomonas, Serratia, Klebsiella); AE = GI upset; OTHER = used in penicillin allergy & renal insufficiency |
| vancomycin | binds D-ala D-ala terminus --> inhibit transglycosylase (weakened cell wall); USE = Gram+ rods (-static)/cocci (-cidal), MRSA, C. difficile; AE = nephrotoxic, ototoxic, thrombocytopenia, rash; OTHER = resistance via D-ala D-lactate; |
| cilastin | inhibits renal dihydropeptidase I (which inactivates imipenem in renal tubules) |
| clavulanate | inactivate B-lactamases (added to amoxicillin or ampicillin to increase spectrum) |
| Bacteriostatic | ECSTaTiC (erythromycin, chloramphenical, SMX, TMP, tetracycline, clindamycin |
| Bacteriocidal | Very Fucking Proficient At Cell Murder (Vanc, Fluroquinolones, Penicillin, Aminoglycosides, Cephalosporins, Metronidazole) |
| tetracycline | [-STATIC] 30S(aa-tRNA binding); USE = VACUuM THe BedRoom (Vibrio, Acne, Chlamydia, Ureaplasma, Mycoplasma, Tularemia, H. pylori, Borrelia, Rickettsia); AE = teratogen, tooth discoloration, dec bone grow, photosensitive; OTHER = iron/milk/antacids inhibit |
| Is tetracycline useful in patients with renal failure? | No but doxycycline is! |
| aminoglycosides | [-CIDAL] 30S (interfere w/ initiation complex & misreading of mRNA > premature termination in polysome); USE = Gram- rods; AE = nephrotoxic, ototoxic, teratogen (NOT); OTHER = needs O2 for uptake & synergistic w/ b-lactams |
| chloramphenicol | [-STATIC] bind 50S (prevent aa-tRNA binding); USE = bacterial meningitis (SHiN), Rickettsia; AE = gray-baby syndrome (absence of UDP-glucuronyl transferase), dose-dep anemia, dose-indep aplastic anemia; OTHER = inhibit CYP3A4, reaches CNS |
| macrolides | [-STATIC] bind 23S of 50S (inhibit translocation); USE = Gram+ cocci, URT (mycoplasma/legionella), STDs (neisseria/chlamydia - prophylactic neonate eye drops); AE = GI upset, cholestatic hepatitis, long QT w/ VT |
| clindamycin | [-STATIC] binds 50S (inhibit translocation); USE = anaerobic infection above diaphragm aka aspiration or lung abscess, babesiosis; AE = pseudomembranous colitis |
| 30s inhibitors | buy AT 30 (aminoglycosides, tetracycline) |
| 50S inhibitors | CCELLS at 50 (clindamycin, chloramphenicol, erythromcyin, linezolide, lincomycin, streptogramins) |
| How would you treat a patient w/ gonorrhea & chlamydia? | tetracycline (chlamydia) & ceftriaxone (gonorrhea) |
| Sulfonamides | [-STATIC] PABA analog (competitive inhibitor of dihydropteroate synthase); USE = Gram+/-, Nocardia, Chlamydia; AE = hemolytic anemia (G6PD-D), agranulocytosis, photosensitive, Stevens Johnson, rash, kernicterus |
| trimethoprim | [-STATIC] inhibits dihydrofolate reductase; USE = recurrent UTI, Shigella, Salmonella, PCP; AE = Megaloblastic anemia, leukopenia, granulocytosis |
| TMP-SMX | [-CIDAL] inhibits folic acid synthesis; USE = enteric bacteria, Nocardia, PCP, UTIs, cyclosporiasis/isosporiasis, toxo (prophylaxis); AE = hemolytic anemia, kernicterus, Steven-Johnsons |
| fluoroquinolones | [-CIDAL] inhibits DNA gyrase (topo II); USE = Gram- (urinary/GI/URT/) & Legionella, Mycoplasma, Neisseria; AE = tendonitis & rupture, muscle cramps, teratogen (damage growing cartilage), colitis; OTHER = don't take with dairy/antacids; DRUGS = -oxacin |
| metronidazole | [-CIDAL] forms toxic metabolites in cell & prevent reoxidation of NADH/NADPH; USE = GET GAP (giardia, Entamoeba, Trichomonas, Gardnerella, anaerobes, H. Pylori) & VRE; AE = leukopenia, disulfuram-like, seizures, metallic taste |
| TB drugs | RIPES (rifampgin, INH, Pyrazinamide, Ethambutol, Streptomycin) |
| M. avium prophylaxis | Azithromycin |
| TB prophylaxis | INH |
| PCP prophylaxis | TMP-SMX |
| Recurrent UTI prophylaxis | TMP-SMX |
| Prophylaxis for dental procedures w/ endocarditis | Penicillin |
| Treatment of VRE | streptogramin & linezolid |
| enfuvirtide | binds viral gp41 --> blocks fusion of HIV virion to lymphocytes; USE = HIV; AE = pneumonia, hypersensitivity |
| amantadine | binds M2 (prevent uncoating) & causes dopamine release from nigra striatum; USE = influenza A (90% resistance) & Parksinson's; AE = ataxia, dizziness, slurred speech |
| rimantadine | binds M2 (prevent uncoating); USE = influenza A; AE = ataxia, dizziness, slurred speech; OTHER = does NOT cross BBB |
| oseltamivir | inhibit neuraminidase (no sialic acid cleavage --> needed for viral replication); USE = influenza A & B |
| zanamivir | inhibit neuraminidase (no sialic acid cleavage --> needed for viral replication); USE = influenza A & B |
| acyclovir | guanosine analog - phosphorylated by thymidine kinase (inhibit viral DNA polymerase); USE = HSV 1/2, VZV, EBV |
| gancyclovir | guanosine analog - phosphorylated by viral kinase (inhibit CMV DNA pol); USE = CMV retinitis; AE = pancytopenia |
| ribavirin | guanosine analog - competitively inhibits IMP DH (no guanine nucleotides); USE = RSV, HCV (w/ IFN-a); AE = teratogen, hemolytic anemia |
| entecavir | guanosine analog - inhibits HBV DNA polymerase & reverse transcriptase; USE = HBV |
| telbivudine | thymidine analog - inhibits HBV DNA polymerase & reverse transcriptase; USE = HBV |
| foscarnet | inhibits viral DNA pol (no viral kinase activation); USE = CMV retinitis (2nd line), acyclovir-resistant HSV/VZV; AE = nephrotoxic |
| zidovudine | [NUCLEOSIDE-NRTI] thymidine analog (competes w/ dTTP for binding on HIV-RT); USE = HIV; AE = megaloblastic anemia, neutropenia, lactic acidosis, nausea, insomnia |
| lamivudine | [NUCLEOSIDE-NRTI] inhibit HIV-RT (no DNA synthesis by competing w/ dNTPs); USE = HIV, HBV; AE = GI upset, neutropenia, insomnia, fatigue |
| abacavir | [NUCLEOSIDE-NRTI] inhibit HIV-RT (no DNA synthesis by competing w/ dNTPs); USE = HIV; AE = hepatomegaly, hypersensitivity, lactic acidosis |
| nevirapine | [NNRTI] binds/blocks HIV-RT; USE = HIV; AE = Steven-Johnson, fulminant hepatitis |
| efavirenz | [NNRTI] binds/blocks HIV-RT; USE = HIV; AE = nightmares & CNS disturbances |
| Protease inhibitors | [-NAVIR] inhibit HIV protease (responsible for cleaving precursor into mature -> no replication); USE = HIV; AE = lipodystophies (w/ buffalo hump or central obesity), hyperglycemia, GI disturbances, elevated bili & ARF (both indinavir) |
| raltegravir | HIV integrase strand transfer inhibitor; USE = multi-drug therapy for HIV |
| Nucleoside-RTIs | zidovudine, didanosine, stavudine, abacavir, lamivudine |
| NNRTIs | nevirapine, efavirenz, delavirdine (Never Ever Deliver) |
| amphotericin B | binds ergosterol (forms membrane pores for leakage); USE = Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor, Sporothrix; AE = fevers, chills, nephrotoxic, phlebitis, anemia |
| nystatin [NOT ON LIST] | binds ergosterol (forms membrane pores); USE = oral & cutaneous candidiasis; AE = far more toxic than amphotericin B |
| itraconazole | inhibit 14-a-demethylase (no ergosterol made); USE = dermatophytoses (skin) & onychomycosis (nails); AE = CHF, fever, chills, gynecomastia, hepatotoxic |
| fluconazole | inhibit 14-a-demethylase (no ergosterol made); USE = cryptococcal meningitis, Candida esophagitis; AE = fever, chills, gynecomastia, hepatotoxic |
| terbinafine | inhibits squalene epoxidase; USE = topical (tinea cruris/pedis/corporis), oral (tinea capitis & cutaneous candida); AE = local burning, pruritis, contact dermatitis, alopecia, fatigue |
| caspofungin | inhibit B(1,3)-D-glucan synthase (disrupt fungal cell wall); USE = candidiasis & invasive aspergillosis; AE = GI upset |
| flucytosine | cytosine analog --> inhibit thymidylate synthetase (no fungal DNA/RNA); USE = cryptococcus & candida (w/ amphotericin B); AE = bone marrow suppression, hepatotoxic |
| griseofulvin | interfere with microtubule formation; USE = nail/skin/hair infections by Epidermophyton, Micosporum, Trichophyton; AE = teratogenic, carcinogenic, headache, confusion |
| IFN-B | USE = MS |
| IFN-gamma | USE = CGD, osteopetrosis |
| IFN-a | USE = HCV, HBV, Kaposi sarcoma, CML, hairy cell leukemia |
| INH | [BACTERIOSTATIC/-CIDAL] inhibits mycolic acid synthesis; USE = TB; AE = neurotoxic, hepatotoxic, allergies; OTHER = activated via CATALASE PEROXIDASE |
| Rifampin | [BACTERICIDAL] inhibits DNA-dep RNA-pol; USE = TB, meningococcal (H. influenza), leprosy (w/ dapsone); AE = orange body fluids, hepatotoxic, nephritis, thrombocytopenia |
| Ethambutol | [BACTERIOSTATIC] inhibits arabinogalactan synthesis; USE = TB; AE = optic neuritis (red-green blindness) |
| cyclosporine | binds to cyclophilin --> inhibit calcineurin --> block IL-2 expression; USE = organ transplants (GvHD), autoimmune; AE = nephrotoxic, neurotoxic, HTN, hirsuitism, gingival hyperplasia |
| tacrolimus | binds to FKBP --> inhibit calcineurin --> block IL-2 expression; USE = kidney/liver transplant; AE = nephrotoxic, neurotoxic, HTN, inhibit pancreatic B-cell |
| sirolimus | binds to FKBP --> inhibit PI-kinase relates protein kinase mTOR --> lack of IL-2 Tcell response; USE = acute rejection after kidney transplant, restenosis; AE = anemia, thrombocytopenia, hyperlipidemia |
| mycophenolate mofetil | inhibit IMP-DH (no purine synthesis --> no lymphs); USE = renal/heart transplant; AE = diarrhea, leukopenia |
| leflunomide | inhibits dihydroorotate DH (pyrimidine synthesis); USE = active RA; AE =diarrhea, nausea, hepatotoxic; |
| daclizumab | chimeric Ab against IL-2R a-chain (CD25) --> inhibits IL-2 T-cell activation; USE = kidney/cardiac transplants; AE = hypersensitivity |
| infliximab | chimeric Ab against TNF-a; USE = Crohns, UC, RA, psoriasis, ankylosing spondylitis; AE = increased infection |
| etanercept | chimeric Ab (p75-TNF & IgG Fc region) --> takes up free TNF; USE = RA, ankylosing spondylitis, psoriasis; AE = URI, malignancy |
| Adalimumab | binds TNF-a receptor; USE = RA, psoriasis, ankylosing spondylitis |
| muromonab | mouse monoclonal Ab against T-cell CD3 e-chain --> blocks TCR engagement; USE = reversal of organ rejection |
| azathioprine | purine analog metabolized to 6-MP --> inhibits purine synthesis; USE = RA, kidney transplant; AE = GI upset, leukopenia; OTHER = xanthine oxidase metabolizes |
| anakinra | IL-1R antagonist analog; USE = RA; AE = bacterial infections |
| cyclophosphamide | alkylating agent(N-7 of guanine) --> nitrogen mustard; USE = NHL, breast & ovary cancer; AE = pulm fibrosis, cystitic, water retention, alopecia, immunosuppression |
| lomustine | alkylating agent --> nitrosourea; USE = malignant glioma; AE = hematopoietic depression, pulm fibrosis, renal insufficiency, alopecia |
| carmustine | alkylating agent --> nitrosourea; USE = malignant glioma; AE = hematopoietic depression, pulm fibrosis, renal insufficiency, alopecia |
| busulfan | alkylating agent; USE = CML; AE = hyperpigmentation, pulm fibrosis |
| cisplatin | platinum complex --> alkylating agent (form cross-links); USE = genital & head/neck cancer; AE = myelosuppresion, nephrotoxic, ototoxic |
| procarbazine | alkylating agent; USE = Hodgkin dz [MOPP]; AE = MAO inhibitor, carcinogen, myelosuppression |
| vincristine | vinca alkaloids --> binds tubulin (depolymerization of mitotic spindle); USE = ALL, Wilms, Ewings, HL [MOPP]; AE = neuropathy, myelosuppression, stimulate ADH; OTHER = M-phase |
| vinblastine | vinca alkaloids --> binds tubulin (depolymerization of mitotic spindle); USE = testicular/breast cancer, lymphomas; AE = BM suppression; OTHER = M-phase |
| paclitaxel | taxane --> binds tubulin (promote polymerization of mitotic spindle = halts mitosis); USE = breast/ovarian cancer, restenosis; AE = BM suppression, arrhythmias, neutropenia |
| etoposide | inhibit topoisomerase II; USE = small-cell lung cancer, Hodgkins dz; AE = BM suppression, pancytopenia, alopecia |
| teniposide | inhibit topoisomerase II; USE = small-cell lung cancer, Hodgkins dz; AE = BM suppression, pancytopenia, alopecia |
| doxorubicin | DNA intercalation & introduction of ssDNA breaks, also produce oxygen radicals; USE = solid malignancies, HL [ABVD]; AE = cardiac toxicity, BM suppression |
| daunorubicin | DNA intercalation & introduction of ssDNA breaks, also produce oxygen radicals; USE = acute leukemia, neuroblastoma, HL [ABVD]; AE = cardiac toxicity, BM suppression |
| dactinomycin | DNA intercalation; USE = Wilms, Ewings, rhabdomyosarcoma; AE = myelosuppresion |
| bleomycin | binds DNA --> triggers oxygen radical formation; USE = testicular tumors, Hodgkins dz [ABVD], squamous cell carcinomas (non-lung); AE = pulm fibrosis, skin lesions |
| methotrexate | inhibits dihydrofolate reductase; USE = abortifacient, RA, Crohns, ALL, breast cancer, head/neck cancer, osteosarcoma, choriocarcinoma; AE = BM suppression, teratogen, pulm toxicity, hepatotoxic, nephrotoxic |
| leucovorin | supplies reduced folate to bypass inhibited reductase in MTX; USE = reduces BM suppression in MTX administration |
| 5-FU | metabolized to 5-FdUMP --> inhibit thymidylate synthase; USE = adenocarcinoma, basal cell carcinoma; AE = BM suppression; OTHER = S-phase specific |
| cytosine arabinoside | metabolized to araCTP --> inhibitor of DNA pol; USE = ALL, AML; AE = BM suppression; OTHER = S-phase specific |
| 6-MP | converted to thio-IMP via HGPRT --> inhibit purine synthesis; USE = ALL, AML; AE = BM suppression, hepatotoxic; OTHER = metabolized via S-methylation (TPMT) & oxidation (xanthine oxidase) |
| 6-TG | converted to nucleoside monophosphate via HGPRT --> inhibit purine synthesis; USE = ALL; AE = myelosuppression, hepatotoxic; OTHER = metabolized via S-methylation |
| asparaginase | inhibits protein synthesis; AE = lack of secreted proteins |
| imatinib mesylate | inhibit tyrosine kinase enzymes; USE = CML & Ph+ ALL (bcr-abl), GIST (c-kit, PDGF); AE = CHF, myelosuppression |
| trastuzumab | monoclonal Ab against erb-B2 receptor; USE = HER-2+ breast cancer; AE = cardiotoxic |
| ATRA | USE = APML |
| hydroxyurea | inhibits ribonucleotide reductase (no DNA synthesis); USE = myeloproliferative (CML, polycythemia); AE = BM suppression; OTHER = S-phase specific |
| tamoxifen | ER agonist (endometrial), antagonist (breast); USE = postmenopausal ER+ breast cancer; AE = hot flashes, vaginal bleeding, dermatitis, endometrial cancer, thromboemboli |
| raloxifene | ER agonist (bone), antagonist (breast); USE = postmenopausal ER+ breast cance, osteoporosis; AE = hot flashes, vaginal bleeding, dermatitis, thromboemboli |
| anastrozole | aromatase inhibitor; USE = postmenopausal breast cancer |
| letrozole | aromatase inhibitor; USE = postmenopausal breast cancer |
| exemestane | aromatase inhibitor; USE = postmenopausal breast cancer |
| leuprolide | GnRH analog (agonist = pulsatile, antagonist = continuous); USE = infertility (pulsatile), metastatic breast & prostate cancer (continuous) |
| goserelin | GnRH analog (agonist = pulsatile, antagonist = continuous); USE = infertility (pulsatile), metastatic breast & prostate cancer (continuous) |
| abarelix | GnRH antagonist (no LH/FSH); USE = prostate cancer |
| flutamide | androgen antagonist; USE = prostate cancer |
| bicalutamide | androgen receptor antagonist; USE = prostate cancer |
| Pyrazinamide | inhibits mycobacterial FA synthase I gene; USE = TB (short-term); AE = hepatotoxic; OTHER = activated by PYRAZINAMIDASE |
| Dapsone | inhibits folate synthesis; USE = leprosy; AE = hemolysis, GI upset, erythema nodosum leprae |
| abatacept | chimeric Ab (CTLA-4 & IgG Fc region) --> block CD80/86 bindind to CD28 for T-cell; USE = RA |
| streptogramins | [-CIDAL] A (binds & induces 50S conformation change) & B (binds 50S --> inhibit translocation); USE = gram+ cocci; AE = phlebitis, arthralgias, myalgias |
Created by:
lamsonma