Pharm 3
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| show | Phenobarbital
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| - Generalized Tonic-clonic and partial seizures. -efficacy is due both to drug and active metabolites (Phenobarbital). -two active metabolites, phenobarbital and phenylethylmalonamide (PEMA) | show 🗑
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| show | Carbamazepine (Tegretol)
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| show | Oxcarbazepine (Trileptal)
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| -central agent in treating absence seizures. - More effective in managing absence seizures than trimethadione SE : euphoria, anemia Bone marrow depression, Stevens-Johnson syndrome -Tegretol decreases levels. - Isoniazid increases levels. | show 🗑
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| show | Lamotrigine (Lamictal)
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| -used to treat partial sz in adults and neuropathic pain -mono- or adjunctive therapy -bind to synaptic vesicles decreasing release of NT -SE h/a, anxiety, CNS depression ,initial sedation, depression , hallucinations -no liver met or protein binding | show 🗑
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| show | Benzodiazepines
Diazepam (Valium)
Lorazepam (Ativan)
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| show | Clonazepam (Klonopin)
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| show | Phenytoin (Dilantin)
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| show | Fosphenytoin
(Generic)
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| - Partial, generalized seizures and absence seizures -extensively protein bound and conjugated - MOA d/t ^^ recovery time of voltage activated Na+ channels. -Can cause serum phenobarbital to increase by 40%. | show 🗑
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| -adjunct for partial and generalized seizures, obesity, migraines and Parkinson’s disease -acts at GABAA receptor to enhance GABA binding - blocks voltage-gated T-type calcium channels -metabolism can be inhibited by ketoconazole, carbamazepine(Tegreto | show 🗑
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| -adjunct for partial sz, anxiety disorders (panic attacks), and neuropathic pain - inhibits GABA neuronal reuptake -^^ duration of GABA interaction at receptor zone - ^^ neuronal inhibition -use may actually trigger sz in non-epileptics | show 🗑
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| show | Topamax
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| -no longer the clinical agent of choice for absence seizure due to toxicity. MOA: Similar to ethosuximide (Zarontin) -inhibits T-type Ca++ currents. -metabolite Dimethadione. | show 🗑
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| show | Gabapentin (Neurontin)
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| • Cross links DNA (cant divide). • DLT is bone marrow dep • Uses: Hodgkin’s lymphomas, leukemias, lung breas, ovarian ca, burkitt’s lymphoma • agent for kids w/ neuroplastomas/ Retinoblastomas • used in combo w/ methorexate + 5-fluorouracil for breast | show 🗑
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| show | Alkylating agent:
Busulfan (myleran)
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| • Inhibit topisomerase II • Bind to DNA to inhibit DNA/RNA synthesis • O2 radical production • DLT for doxorubin and saunorubicin is CM (d/t O2 radicals) • Bone marrow dep in 2 weeks, recovery in 4 weeks. More severe w/ dexrazoxane | show 🗑
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| • Uses: soft tissue osteogenic an other sarcomas; lungs, bladder, ovarian, thyroid cancers; Hodgkin, lymphoma, acute leukemia • If given to rapidly IV, erythematous streaking along proximal veins • Chelates iron and other metals | show 🗑
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| • uses: acute leukemias, some solid tumors in children. • Daunoxome approven 1st line therapy for advance Karposi sarcoma | show 🗑
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| show | *Bleomycin
Antibiotic anti cancer agent
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| show | Anti metabolic anti cancer agent: *Methotrexate;
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| show | *5-Fluorouracil
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| • Isolated from the periwinkle plant. • MOA; spindle poisons, causes mitotic arrest at metaphase. • May need allopurinol to prevent hyperuricemia • Fatal if given intrathecally | show 🗑
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| from the Pacific and European Yew Tree (Bark fungus) • MOA mitotic spindle poison. • Uses; breast head, lung ca, Kaposi sarcoma & restinosis (taxus). • Docetaxel & Carbazitaxel for prostate ca • SE: N/V alopecia, neutropenia, anemia, thrombocytopenia | show 🗑
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| show | Natural product anticancer Agents:
Cisplatin (Platinol)
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| • Less nephrotoxic than cisplatin • 2nd generation compound • Uses: ovarian, head, neck and lung ca • DLT: bone marrow depression • Longer half life than cisplatin | show 🗑
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| show | . Alcohol
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| • Benzalkonium and Cetylpyridinium • Effective against most bacteria, fungal and viruses. NOT mycobacterium tuberculosis • Mixed with alcohol to increase efficacy • Alters cell permeability • Also used as preservatives and to sterilize surgical equip. | show 🗑
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| show | . Iodine
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| show | Iodophors
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| show | Hexachlorophene (pHisoHex)
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| • Used as a caustic astringent and antiseptic • Bactericidal, and often used in eyes of newborns of mothers with gonococcal infections • Used on burns and other wounds | show 🗑
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| • Mercurochrome & Merthiolate (Thiomersal) • Not used much now. Thiomersal used as preservative in a few vaccines • Poor efficacy • Allergic reactions and poisoning (oral) | show 🗑
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| show | Antiseptic
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| show | Aldehydes
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| show | Cresol
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| show | Ethylene Oxide
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| show | Disinfectants
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| show | Tetracyclines
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| show | Aminoglycosides
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| show | Spectinomycin (Trobicin)
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| show | Macrolides
- erythromycin (E-mycin), clarithromycin (Biaxin), azithromycin Zithromax)
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| binds reversibly to 50S subunit of bacterial ribosomes & inhibits PRO synthesis (like macrolides) -lincomycin (Lincocin),clindamycin (Cleocin) | show 🗑
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| PRO synthesis inhibitor by reversibly binding to 50S subunit of bacterial ribosomes & inhibits transpeptidation by inhibiting peptidyl transferase. It prevents binding of AA end of aminoacyl tRNA to the acceptor site on 50S subunit. | show 🗑
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| Inhibits PRO synthesis by binding to bacterial 23S ribosomal RNA of the 50S subunit thus px formation of a functional 70S initiation complex, an essential step (unique MOA & doesn’t show cross resistance to other antibx) | show 🗑
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| Bind to 23S RNA of the 50S subunit (like macrolides); do not induce the methylase enzyme (so not subject to MLS resistance?) | show 🗑
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| Same as other B-lactam antibx: Disrupts synthesis of peptidoglycan layer of bacterial cell wall. Inhibits final stage of cell wall synthesis that involves peptide crosslinking by transpeptidases; structural analog of d-ala d-ala | show 🗑
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| Parenterals: methicillin and Nafcillin, Oral: Isoxazolyls | show 🗑
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| Carboxypenicillins (ticarcillin disodium(Timentin – with clavulanic acid) , Ureidopenicillins (piperacillin) | show 🗑
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| Same as other B-lactam antibx: Disrupts synthesis of peptidoglycan layer of bacterial cell wall. Includes 1st, 2nd, 3rd, and 4th generations | show 🗑
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| Oral:Cephalexin (Keflex),Cefadroxil Parenteral: Cefazolin (Ancef, Kefzol) | show 🗑
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| show | 2nd gen. Cephalosporins
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| Oral: Cefixime (Suprax) Cefpodoxime proxetil Ceftibuten (Cedax) Parenteral: Cefotaxime (Claforan) Ceftriaxone (Rocephin) Ceftazidime (Fortaz) | show 🗑
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| Cefepime (Maxipime) | show 🗑
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| show | Carbapenems
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| Same as other B-lactam antibx: Disrupts synthesis of peptidoglycan layer of bacterial cell wall. Begins with Mono. | show 🗑
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| show | Vancomycin
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| Inhbits cell wall synthesis by binding to a precursor of cell wall& forming unusable complex; acts 1 step before the one inhibited by vancomycin | show 🗑
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| show | Fosfomycin Tromethamine
(Monurol)
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| PABA analog that competitively inhibits DHPS which is required for folic acid synthesis; it only affects bacteria that synthesize own folic acid | show 🗑
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| Nitro group activated by intracellular electron transport PRO in anaerobic organism to chemically reactivate intermediates that react with DNA & can> ↑ degradation of existing DNA, altered DNA helical structure, ↑ strand breaks, & inhibition of DNA syn. | show 🗑
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| anoxic or hypoxic condition is required for formation of cytotoxic metabolites) | show 🗑
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| Surface active agents that disrupt osmotic properties and transport mechanisms of cell membranes in gram – bacteria only; also binds & inactivates endotoxins | show 🗑
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| Reversibly binds to bacterial isoleucyl-tRNA synthase & blocks PRO synthesis | show 🗑
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| Inhibits DNA gyrase which is a topoisomerase responsible for breaking & rejoining DNA strands necessary for DNA replication -ciprofloxacin ophthalmic (CILOXAN), ofloxacin , etc | show 🗑
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| show | Ketolides
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| show | Urinary tract Antiseptics:
Methenamine (Hiprex), Nitrofurantoin (Furadantin), Hemolytic anemia (if G6PD-deficient)
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| show | Sulfa
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| DOC for prevention of burn infections | show 🗑
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| show | Trimethoprim + sulfamethoxazole (Bactrim, Septra)
5:1 SMZ:TMPà [blood] ratio of 20:1
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| Listeria monocytogenes | show 🗑
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| show | AminoPCN (ampicillin, amoxicillin)
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| 1 of DOC for pseudomonas aeruginosa | show 🗑
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| show | PCN
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Use Pen V or benzathine Pen G
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| DOC Endocarditis prevention if valvular disease undergoing dental/surgical procedures | show 🗑
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| Typhoid fever DOC | show 🗑
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| show |
Ceftriaxone or cefixime
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| DOC for enterobacteriaceae (E. coli, Klebsiella, Proteus, Providencia stuartii, Serratia | show 🗑
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| Drug used for H. flu meningitis | show 🗑
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| Drugs used for Surgical Prophylaxis | show 🗑
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| show | Imipenem
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| Reserved for very serious gram- infections resistant to less expensive drugs | show 🗑
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| show | Macrolides
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| show | tetracyclines
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| DOC for UTI due to pseudomonas aeruginosa | show 🗑
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| show | Fluoroquinolones
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| show | Chloramphenicol
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| show | Streptomycin
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| show | Zyvox
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| show | Vancomycin
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| show | Flagyl
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| show | PCN, cephalosporins, carbapenems, fluoroquinolones, flagyl, monobactam, aminoglycosides, fosfomycin
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| show | sulfamides, macrolides, lincosamides, tetracyclines, chloramphenicol, Zyvox, Vancomycin, spectinomycin
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| show | Flagyl
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| show | Vancomycin
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| -it’s a weak MAOI (avoid tyramine rich foodsà HTN crisis) | show 🗑
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| show | aminoglycosides
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| SE: -nephrotoxicity: ↑BUN & Crt; its reversible since proximal tubular cells can regenerate Drug: dose or duration (streptomycin least nephrotoxic, gentamicin most nephrotoxic) Patient: age extremes, & critically ill pts | show 🗑
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| show | Aminoglycosides
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| show | Chloramphenicol
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| show | Chloramphenicol
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| -rare & infrequent s/e -cartilage deterioration (arthropathy) in young animals so c/I in kids < 18y/o or during pregnancy or nursing -Ofloxacin (Floxin) may potentiate anticoagulant activity of warfarin | show 🗑
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| show | tetracyclines
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| -binds to Ca2+ deposits in new forming bone & teeth à permanent brown discoloration of teeth in kids <8y/o & depression of bone growth (so c/i in pregnancy and peds) -Vestibular toxicity with minocycline (abates after d/c’d) | show 🗑
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| -Benign intracranial HTN in adults (pseudotumore cerebri) manifested as H/A, blurred vision, bulging fontanels -Can ↓ prothrombin activity (so may need to decrease dose of anticoagulants) -↓ effectiveness of oral contraceptives | show 🗑
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| -High incidence of diarrhea & pseudomembranous colitis not r/t dose or route (caused by necrotizing endotoxin) | show 🗑
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| show | macrolides
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| show | macrolides
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| show | True
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| show | True
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| -Cefotetan & Cefoperazone: contain N-methylthiotetrazole group that can be cleaved & inhibit Vit K metabolism & aldehyde dehydrogenase > hypoprothrombinemia, bleeding disorders, & disulfiram-like rxn | show 🗑
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| show | Cephalosporins
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| -CarboxyPCN: high Na+ content > CHF -Carbenicillin: abnormal platelet aggregation & bleeding -Intrathecal PCN: epileptogenic (never give IT) | show 🗑
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| -Toxic concentrations of all PCN possible if patient renally impaired > seizures -Ampicillin rash: not a hypersensitivity rxn -Jarisch-Herxheimer rxn: if used in patients with secondary syphilis | show 🗑
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| -may be antagonized by LA with are esters of PABA (procaine) -toxic epidermal necrolysis & Stevens-Johnson syndrome if hypersensitivity rxn occurs | show 🗑
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| SE: -hepatic necrosis -blood dyscrasias (agranulocytosis, aplastic anemia, hemolytic anemia) -Mafenide: metabolic acidosis d/t inhibition of carbonic anhydrase -Bactrim or Septra: CNS toxicity in AIDS patients | show 🗑
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