Omed Flashcards

Front 1

immunophilin ligands: 3 types, mechanism, use, !

Back 1

cyclosporine, tacrolimus, sirolimus; interfere w/ t-cell immunity; high doses to tx GVH in transplants; !: nephro and neurotoxicity

Front 2

cytotoxic drugs: mechanism; !, 3 types; uses

Back 2

iterfere w/ rapidly dividing cells; !: BM suppression, malignancies; Azathioprine, mycophenolate (tx pemphigus), methotrexate (tx pemphigoid)

Front 3

thalidomide: type of drug; tx

Back 3

immune modulator (immunosuppression); tx leprocy, behcets, HIV wasting, GVHD; temp taken off market bc teratogen

Front 4

DMARDs: 3 types w/ fxn/mech

Back 4

sulfasalazine (anti PG for UC, RA, psoriasis); gold (interferes w/ macrophages); dapsone (Abx for leprosy, malaria, toxoplasmosis)

Front 5

RAS: biopsy? Related factors

Back 5

no biopsy; iron/folic acid/vit B def, tobacco decr freq, S. sanguis, HSV, cinnamic aldehyde, Na lauryl sulfate

Front 6

lichen planus: biopsy? Findings?

Back 6

biopsy almost always indicated; DIF: + for fibrinogen along BMB and - for IG's

Front 7

LP: topical tx? Order of strength?

Back 7

clobetasol > fluocinonide > betamethasone > triamcinolone > HC; if pt cannot tolerate CS's, tacrolimus, cyclosporine (IL's)

Front 8

LP: systemic tx for widespread case? Severe/refractory case?

Back 8

SCS's; if severe case, azathioprine, levamisole, dapsone

Front 9

pemphigoid: biopsy? Best test? Tx?

Back 9

always; DIF distinguishes from other +nikolsky tests; oral corticosteroid (prednisone) w/ topical agents (azathioprine, methotrexate)

Front 10

pemphigus: biopsy? Best test? Tx?

Back 10

always; ELISA (desmoglein present); oral CS (prednisone) w/ combo (azathioprine, mycophenolate, IVIG for severe cases)

Front 11

angular cheilitis tx

Back 11

nystatin + triamcinolone (TCS)

Front 12

fluconazole uses

Back 12

systemic candidiasis, cyrptococcal infections

Front 13

itraconazole uses, !

Back 13

deep fungal infection, strong inhibitor of cytochrome P450

Front 14

Tx of fungal infections if azole resistance? Adverse?

Back 14

amphotericin B (systemic polyene) tx systemic candidiasis and aspergillosis; neprhotoxicity and GI isues

Front 15

rank of antifungal classes?

Back 15

echinocandins > new triazoles > polyenes > old triazoles > imidazoles

Front 16

acyclovir: use

Back 16

genital herpes and VZV (rarely used for oral)

Front 17

valacyclovir: use

Back 17

mostly for oral herpes; HSV 1,2 > VZV

Front 18

famciclovir: use

Back 18

mostly for oral herpes; VZV and HSV 1,2; note penciclovir is like topical fam

Front 19

ganciclovir: use

Back 19

for serious conditions; CMV retinitis in HIV, CMV prophylx in trasnplant, acyclovir-R HSV

Front 20

foscovir: use

Back 20

CMV retinitis and acyclovir-R HSV in HIV

Front 21

cidofovir: use

Back 21

IV prep for CMV retinitis in HIV

Front 22

NRTI (-)s

Back 22

neuropathy, lactic acidosis, hepatic steatosis, BM suppression, oral ulcers

Front 23

NNRTI (-)s

Back 23

drug resistance is easy, CYP450 interactions, hepatotoxicity

Front 24

Protease inhibitors (+), (-),

Back 24

(+) low risk of resistance; (-) complex food req, insulin R, osteonecrosis, hyperlipidemia, lipodystrophy (fascial wasting), hepatotoxicity

Front 25

HCV: tx? Adverse?

Back 25

pegylated interferon + ribavirin; PI's can also be used; interferon !'s: neuropsychiatric effects, blood disorders

Front 26

development of oral flora

Back 26

sterile -> S. salivarius -> S. mutans + sanguis + actino + fuso -> spirochetes

Front 27

Penicillins: spect? Use?

Back 27

narrow; facultative g+/- (strep, staph) w/ some anaerobes (spiro, fuso)

Front 28

extended spect penicllins: use?

Back 28

broad; pen spect + pneumonia, salmon, e.coli, H.influ; good for post op infections

Front 29

cephalosporins: spect? Use?

Back 29

broad; extended penicillin + pseudomonas; good for hospital acquired pneumonia

Front 30

macrolide: spect?

Back 30

narrow: strep, staph, pneumonia, some anaerobes

Front 31

types of prot synthesis Abx

Back 31

tetracyclines, macrolides, clindamycin

Front 32

metronidazole: spect? !'s

Back 32

narrow: anaerobes; !: mutagenic, alchohol and anti coag interactions

Front 33

types of nucleic acid synth inhibitors

Back 33

metronidazole, quinolones

Front 34

odontogenic infection: cause, tx

Back 34

facultative w/ some anaerobes; narrow (pen V, clarithro); if in face space, clinda, metronidazole, klebsiella

Front 35

periodontal infection: cause, tx: normal, aggressive, refractory

Back 35

g+/- (porphyromonas, bacteriodes); doxy/metronidazole; tetra for aggressive cases; clinda for refractory cases

Front 36

ANUG: cause, tx

Back 36

F. nucleatum + B. vincentii; 3% H2O2; metronidazole if severe

Front 37

salivary gland infection: cause? Tx?

Back 37

staph aureus; lacrimal probe -> tetracycline or cephalexin

Front 38

osteomyelitis cause?

Back 38

s. aureus

Front 39

oral malodor cause?

Back 39

superficial anaerobes

Front 40

gingko biloba: use, !s

Back 40

dementia and leg claudication; !: spontaneous bleeding, GI, interacts w/ MAOI, ASA, anti platelets

Front 41

garlic: use, !s

Back 41

reduce cholesterol; !: bleeding, GI, use caution w/ anti PLTs

Front 42

St. John's Wort: use, !s

Back 42

mild-moderate depression; !: interaction w/ PI’s (HIV), cyclosporine, coumadin, oral contraceptives, SSRI’s

Front 43

Soy: use, !s

Back 43

menopausal symptoms; !: long term estrogen effects

Front 44

Kava Kava: use, !s

Back 44

sedative, tx of anxiety: !: cases of severe hepatotoxicity; combo w/ BZDs may cause semicomatose state

Front 45

ginseng: use, !s

Back 45

incr physical/cognitive performance; !: interacts w/ anticoags (warfarin), MAOI’s; not to be used w/ stimulants or antipsychotics (causes excessive hyperactivity)

Front 46

ginger: use, !s

Back 46

motionsickness; !: caution w/ anti-PLTs

Front 47

antacid/H2 antagonist interactions

Back 47

increases absorption of enteric coated meds; prevents absorption of pH sensitive meds (PCN, ketoconazole, digoxin

Front 48

tetracycline interaction

Back 48

antacids/Ca enriched products prevent absorption of tetracycline; tetracycline decr metab of digoxin (toxicity)

Front 49

oral anticoagulant interactions

Back 49

anticoags displaced from prot binding site by sulfonomides (Abx) and asprin

Front 50

phenobarbital interaction

Back 50

phenobarbital increases breakdown of coumadin -> coumadin ineffective

Front 51

St. John's Wort interactions (x5)

Back 51

incr metabolism of protease inhibitors (HIV progression), cyclosporine (immunosuppression), coumadin (bleeding), contraceptives (unwanted pregnancy); also incr effect of SSRI's (serotonin toxicity)

Front 52

Metronidazole interactions

Back 52

blocks clearance of coumadin (bleeding) and lithium (renal toxicity)

Front 53

erythromycin (abx), azole (antifungal), grapefruit juice interactions (x7)

Back 53

blocks clearance of digoxin (bradycardia), theophyline and terfenadine (tachycardia), carbamazepine (CNS effects), prednisone (steroid toxicity), coumadin (bleeding), cyclosporin (immunosuppression and nephrotoxicity)

Front 54

rifampin interaction

Back 54

rifampin (Abx) incr clearance of contraceptives (estrogen/progesterone)

Front 55

non-selective B-blockers interaction

Back 55

NS B-blockers incr effect of epi in LA -> incr HR and BP

Front 56

heparin, coumadin interactions (x7)

Back 56

incr effect by ASAs and NSAIDs (GI bleeding); also interactions w/ phenobarbital, st. johns wort, metronidazole, erythro/azole/grapefruit juice