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96 Cards in this Set

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Cefazolin
1st generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Cephalexin
1st generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Cefoxitin
2nd generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Cefaclor
2nd generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Cefuroxime
2nd generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Ceftriaxone
3rd generation cephalosporin. DOC for gonorrhea. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Cefotaxime
3rd generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Ceftazidime
3rd generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Cefepime
4th generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
Cefpiramide
4th generation cephalosporin. b-lactam drug that inhibits cell wall synthesis but are less susceptible to penicillinases.

SE - disulfarim effect with alcohol.

increases NEPHROtoxicity when given with amingoglycosides.
antianxiety agent that has least nauseau
buspirone
Great realease of histamine with a nueromuscular blocking agent?
Tubocurarine , decreased BP and bronchospasm occcurs.
Overdose of beta blocker give?
Glucagon b/c it has positive inotropic and chronotropic effects via glucagon receptors that are G protein linked and increase adeny cyclase.
Aztreonam
Inhibits cell wall synthesis by binding to PBP3. gram negitave rods just not anaerobes. FOR RENAL INSUFFICIENCY PATIENTS WHO CANT TAKE AMINOS OR HAS ALLERGY TO PENICILLIN.

SE - GI upset
Imipenem
beta lactamase resistant carpapenem. Always administer with CILASTATIN to inhibit renal dihydropeptidase. This will decrease inactivation of the drug in the renal tubules.
DOC for enterobacter!

SE - GI distress, skin rash, CNS toxicity specifically seizures at high plasma levels.
Vancomycin
inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors. MOA of resistance is a change from D-ala D-ala to D-ala D-lac.

SE - nephro, oto, thrombophlebitis.. RED MAN SYNDROME... remember infuse slolwy and give antihistamines to stop this from occuring.
Gentamicin
inhibit formation of initiation complex and cause misreading of mRNA. REQUIRES 02 so cannot work on anaerobes.

SE - Nephrotoxic when combined with cephalosporins. Ototoxic with loop diuretics.
Teratogen.
Neomycin
Used to eliminate urea from the body!! For bowel surgery.

inhibit formation of initiation complex and cause misreading of mRNA. REQUIRES 02 so cannot work on anaerobes.

SE - Nephrotoxic when combined with cephalosporins. Ototoxic with loop diuretics.
Teratogen.
Amikacin
inhibit formation of initiation complex and cause misreading of mRNA. REQUIRES 02 so cannot work on anaerobes.

SE - Nephrotoxic when combined with cephalosporins. Ototoxic with loop diuretics.
Teratogen.
Tobramycin
inhibit formation of initiation complex and cause misreading of mRNA. REQUIRES 02 so cannot work on anaerobes.

SE - Nephrotoxic when combined with cephalosporins. Ototoxic with loop diuretics.
Teratogen.
Streptomycin
TB drug also. Deafness and nephrotoxic.

inhibit formation of initiation complex and cause misreading of mRNA. REQUIRES 02 so cannot work on anaerobes.

SE - Nephrotoxic when combined with cephalosporins. Ototoxic with loop diuretics.
Teratogen.
Demeclocycline
ACTS AS A DIURETIC IN SIADH. ADH antagonist.

Binds to 30s and prevents attachment of aminoacyl-tRNA. Don't take with milk, antacids or iron containg preparations because divalent cations inhibit its absorption in the gut.

Remember tetracycline and doxycline are in this category too. doxycyline is the only one that is fecally excreted so can be given to renal failure patients.
Minocycline
Binds to 30s and prevents attachment of aminoacyl-tRNA. Don't take with milk, antacids or iron containg preparations because divalent cations inhibit its absorption in the gut.


Remember tetracycline and doxycline are in this category too. doxycyline is the only one that is fecally excreted so can be given to renal failure patients.
Macrolides
Azithro, erythro, clarithro

inhibits protein synthesis by blocking translocation. binds to the 23s rRNA of the 50S ribosomal subunit.

DOC for chlymadia (azithromycin, 1 pill kills it all) good shit ;)

INCREASES SERUM CONCENTRATIONS OF STUFF. p450 INHIBITORS.

ALSO INCREASE THEOPHYLLINE

SE - skin rashes, acute cholestatic hepatitis, eosinophilia
Drugs causing gynecomastia
digoxin, cimetidine, ketoconazole
Chlormphenicol
inhibits 50s peptidyl transferase.

SE - anemia, aplastic anemia, gray baby sydrynome due to child not having UDP-glucuronyl transferase.. primarily seen in premature infants.
Clindamycin
blocks peptide bond formation at 50s ribosomal subunit.
Sulfonamides
PABA antimetabolites inhibit dihydropteroate synthase.

DOC for UTI.

SE - hypersensitivity, G6PD, nephrotoxocity (tubulointerstitial nephritis), kernicterus in infants.

DISPLACES DRUGS FROM ALBUMIN LIKE WARFARIN!!!
Trimethoprin
Inhibits bacterial diydrofolate reductase. synthergy with sulfonamides. KNOW CHART FA p. 173.

TMP SMX DOC For pneumocystis carnii.

SE - megaloblastic anemia, leukopenia, granulocytopenia. cann alleviate with supplmental folic acid.
-oxacin (AKA fluoroquinolones)
inhibit DNA gyrase AKA topioisomerase 2. (inserts negative supercoils by nicking the DNA strand).

SE - tendonitis, tendone rupture in adults, leg cramps and myalgias in kids.

contraindicated in pregnancy.
Metronidazole
forms toxic metabolites in the bacterial cell. protozoal infections.

This with bismuth and amoxy is used for H. pylori.

SE - disulfarim like reactions with alcohol. metallic taste, headache.
Polymxins
B and E.
Binds to cell membranes of bacteria and disrupts there osmotic properties.

SE - neurotoxic, acute renal tubular necrosis.
Which TB drug works good at acid pH in phagolysosomes?
pyrazinamide
INH
decreases syntehsis of mycolic acid.

SE - G6PD, neurotoxic, hepatoxic, SLE like syndrome, pridoxine (b6) can prevent neurotoxic.
Rifampin
inhibits DNA -dependant RNA polymerase.

SE - minor hepatoxic.

P450 inducer, lowers serum concentrations of other drugs.
Resistance to penicillin occurs how?
b-lactamse cleavage of b-lactam ring.
Resistance to amingoglycosides is how?
modification via acetylation, adenylation, or phosphorylation.
Resistance to chloramphenicol is how?
modification via acetylation.
Resistance to macrolides is how?
methylation of rRNA near erythromycin's ribosome binding site.
Resistance to tetracyclines is?
decrease uptake or increase transport out of cell
Resistance to sulfonamides is how?
altered enzyme, dihydropteroate synthetase.
Amphotericin B
binds ergosterol. forms membrane pores that allow leakage of electolytes and disrupt homeostasis.

SE - fever, chills, hypotension, nephrotoxic, arrythmias, anemia, IV phlebitis. hydration reduces nephrotoxicity.

shake and bake
Nystatin
binds to ergosterol and disrupts membranes. SWISH AND SWALLOW ONLY!!! oral thrush. topical for diaper rash or vaginal candidiasis.
-azoles
inhibit fungal synthesis (aka ergosterol synthesis).

SE - hormone synthesis inhibition (gynecomastia), fever, chills.

INHIBITS P450 so increased serum levels.
flucytosine
inhibits DNA synthesis by conversion to fluorouracil, which competes with uracil.

systemic fungus infections

SE - nause, vomitting and bone marrow suppresion.
Caspofungin
inhibits cell wall synthesis.
invasive aspergillosis!

SE - gi upset and flushing.
Terbinafine
inhibits the fungal enzyme squalene epoxidase.

dermatophyte treatment
Griseofulvin
interferes with microtubule functions, disruptis mitosis (M). deposits in keratin containing tissue.

used for tinea, ringworm, dermatophytes, etc.

SE - teratogen, confusion, headaches.

INCREASE P450 system and WARFARIN METABOLISM.
Amantadine
blocks viral penetration and uncoating (M2 protein). releases dopamine from intact nerve terminals.

SE - ataxia, dizziness, slurred speech.
Zanamivir
Inhibits influenza neuraminidase. can't release virus then.
Oseltamivir
Inhibits influenza neuraminidase. can't release virus then.
Ribavirin
inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase.

RSV and Hep C.

SE - Severe teratogen and hemolytic anemia.
Acyclovir
viral thymidine kinase activates. nephrotoxic
Ganciglovir
CMV. viral kinase activates.
Foscarnet
Viral DNA polynermase inhibitor that binds to the pyrophosphate binding site of an enzyme. does not require activiation by viral kinase.

nephrotoxic
how are antivirals get resisted too?
mutation of the DNA polymerase for foscarnet and mutations of thymidine kinase in others.
-avirs (protease inhibitors)
inhibits assembly of new viruse by blocking protease in progeny virions.

SE - hyperglycemia, lipodystrophy, thrombocytopenia
interferon alpha
chronic hep b and c, kaposis sarcoma

glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis. induce ribonuclease that degrades viral mRNA.
intereron beta
MS


glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis. induce ribonuclease that degrades viral mRNA.
interferon gamma
nadph oxidase deficiency.


glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis. induce ribonuclease that degrades viral mRNA.
Filgrastim
g-csf.... recoveres bone marrow
Sargramostsim
g-mcsf... recovery of bone marrow.. the m is for monocyte.
Oprelvekin
IL-11.. thromobctyopenia treatment... can also use thrombopoietin.
FK506
tacrolimus... inhibits FK-binding potein which inhibits secretion of IL-2 and other cytokines.
Cyclosporine
binds to cyclophilins... blocks the differentiation and activation of T cells by inhibiting calcineuria thus preventing the production of IL-2 and its receptors.
fentanyl
opoid

toxicity - pinpoint pupils..
give naxolone or naltrexone.. which is an opoid receptro antagonist.

02 IS CONTRINDICATED IN MORPHINE OVERDOSE!!!
codeine
opoid

toxicity - pinpoint pupils..
give naxolone or naltrexone.. which is an opoid receptro antagonist.

02 IS CONTRINDICATED IN MORPHINE OVERDOSE!!!
heroin
opoid

toxicity - pinpoint pupils..
give naxolone or naltrexone.. which is an opoid receptro antagonist.

02 IS CONTRINDICATED IN MORPHINE OVERDOSE!!!
meperidine
opoid

toxicity - pinpoint pupils..
give naxolone or naltrexone.. which is an opoid receptro antagonist.

02 IS CONTRINDICATED IN MORPHINE OVERDOSE!!!
dextromethorphan
opoid

toxicity - pinpoint pupils..
give naxolone or naltrexone.. which is an opoid receptro antagonist.

02 IS CONTRINDICATED IN MORPHINE OVERDOSE!!!
coumadin overdose
IV vitamin K and fresh frozen plasma
warfarin overdose
IV vitamin K and fresh frozen plasma
heparin overdose
protamine sulfate
methotraxate
S phase antimetabolite. leucovorin recovery.
macrovascular fatty change in liver.

SE - myelosuppression
5-FU
S phase antimetabolite. Pyrimidine analog bioactivated to 5F-dUMP which covalently complexes folic acid. This inhibits thymidylate synthase resulting in decrease dTMP.

Synergy with MTX which blocks DHF reductase.

CAN ONLY RESCUE WITH THYMIDINE

myelosuppression and phototoxicity.
6-MP (6-mercaptopurine)
blocks de novo purine synthesis. activated by HGPRTase.

INCREASED TOXICITY WITH ALLOPURINOL.

BONE MARROW, GI, LIVER.
Cytarabine (ara-c)
inhibitds DNA polymerase... AML... luekopenia, megaloblastic anemia, thrombocytopenia.
Vinblastine, vincristine
mylesuppresion - vinblastine
neurotoxicity - vincristine

M phase specific alkoid that binds to tubulin and blocks polymerization of microtubules so that mitotic spindle cannot form.
Paclitaxel and other taxols
M phase specific agent that binds to tubulin and hyperstabilizes polymerized microtubules so that mitotic spindle cannot break down. (anaphase cannot occur)

myelosuppresion
Imatinib (gleevec)
philadelphia chromomsome brc-able tyrosine kinase inhibitor. CML and GI stromal tumors.

SE - Fluid retention
Trastuzumab (herceptin)
monoclonal antibody against HER-2 (erb-b2). helps kill breast cancer cells that overexpress HER-2, possibly through antibody dependant cytotoxicity.

SE - cardiotoxicity
Tamoxifen does?
increases risk of endometrial carcinoma
Prednisone
Triggers apoptosis.

SE - cushings like symptoms, immunosuprresion, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis
Etoposide (VP-16)
G2 phase sepcific agent that inhibits topoisomerase 2 and increases DNA degradations.

SE - Myelosuppresion, GI irritation, alopecia
Bleomycin MOA
induces formation of free radicals which cause sbreaks in DNA strands. G2!!!
Dactinomycin (actinomycin D)
intercalates DNA.

SE - myelosuppresion
Busulfan
alkyates DNA.

SE - pulmonary fibrosis and hyperpigmentation (bleomycin also gives pulmonary fibrosis)
Cisplastin
alkyates DNA.. crosslinks DNA

SE - nephrotoxic and acoustic nerve damage
-ustines

streptozocin
alkyates DNA. requires bioactivation and can cross BBB!!!!!!

SE - CNS toxicity.
Cyclophosphamide
alykating agents.
covalently x-link (interstrand) DNA at guinine N-7. require bioactivation by liver.

MESNA RESCUE
Iron OD
Deferoxamine
Lead OD
Succimer for kids... dimercaprol for adults or penicillamine.
Cyanide
Nitritie, hydroxocobalamin, thiosulfate
Methemoglobin
Methylene blue
Methanol or ethylene glycol
Ethanol
tPA OD and MOA
aminocaproic acid... inhibits plasminogen to go to plasmin..