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174 Cards in this Set
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REVIEW:
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What is the c/u for drugs that block transpeptidase crosslinking?
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Drug = Penicillins (3 MOA's):
G+ cocci & rods G- cocci Spirochetes |
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What is/are the SE(s) for drugs that block transpeptidase crosslinking?
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Drug = Penicillins
Hypersensitivity Hemolytic Anemia |
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What does Methicillin toxicity cause?
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Interstitial nephritis
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What is the c/u for Methicillin?
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S. Aureus
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What are the anti-Staph Penicillins?
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*CONDM
Cloxacillin Oxacillin Nafcillin Dicloxacillin Methicillin (Anti-Staph Pen's = 2nd Gen Pen's) |
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What are the anti-Pseudomonas Penicillins?
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*PTC of Pseudomonas in the AM
Piperacillin Ticarcillin Carbenicillin Azlocillin Mezlocillin (Anti-Pseudomonas = 4th Gen Pen's) |
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What is the c/u of Ampicillin/Amoxicillin?
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*HELPS Enterococci
H. Influenza E. Coli Listeria Proteus Salmonella Enterococci (Ampicillin/Amoxicillin = 3rd Gen Pen's) |
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What does Ampicillin/Amoxicillin toxicity cause?
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Hypersensitivity
Ampicillin rash Pseudomembranous colitis |
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What other antibiotic causes Pseudomembranous Colitis?
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Clindamycin
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What is the MOA of Clindamycin?
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Inhibits peptide bond formation
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What is the c/u of Clindamycin?
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Anaerobes above the diaphram
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What is the tx for Pseudomembranous Colitis?
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Metronidazole
Vancomycin |
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What is the MOA of Metronidazole?
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Form toxic metabolites in the bacterial cell wall that damage DNA
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What is the toxicity of Metronidazole?
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Disulfram-like reaction with alcohol
Dysguzia Drug-induced pancreatitis Teratogenic |
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What is the c/u for Metronidazole?
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*GET GAP
Giardia Entomeba Trichamonas Gardnerella Anaerobes H. Pylori |
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What is the tx for bacterial vaginosis for pregnant pt's?
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Metro cream
Clindamycin cream |
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What is the MOA of Vancomycin?
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Inhibits D-ala D-ala (t/f can't make peptidoglycan)
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What are the peptidoglycan synthesis inhib's?
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Bacitracin
Vancomycin Cycloserine |
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What is the c/u for Vancomycin?
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MRSA
C. Difficile Nosocomial infections (presumeably drug-resistent infections) |
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What is the tx for VRSA?
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Linezolid
Streptogramins |
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What is the MOA of Linezolid?
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Inhibition of 50s
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What are the 50s Inhib's?
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*CCELLS (Buys AT 30 CCELLS at 50)
Chloramphenicol Clindamycin Erythromycin (macrolides) Lincomycin Linezolid Streptogramins |
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What are the Streptogramins?
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Dalfopristin
Quinopristin |
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What blocks mRNA Synthesis
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Rifampin
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How does Rifampin's MOA work?
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Inhibition of DNA-dependent RNA polymerase, thereby blocking mRNA synthesis
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What is the c/u of Rifampin?
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TB
Meningiococcal Prophylaxis Close contacts of Pt's with Hib Delays Dapsone resistence in the tx of Leprosy |
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What are the Penicillinase/B-Lactamase inhibitors?
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*AIM
Aztreonam Imipenem/Cilastatin Meropenem |
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What is the MOA of Aztreonam?
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*AzTHREEonam
Binds to PBP #3 |
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What is the c/u of Aztreonam?
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G- Rods
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What pt's is Aztreonam used to tx?
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Pt's who cannot tolerate AMG's
OR Pt's who are allergic to Penicillin OR Pt's in Renal Failure |
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With what is Imipenem co-administered? Why?
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Cilistatin
Prevents breakdown of Imipenem by inhibiting renal dihydropeptidase-1 |
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What is the c/u of Imipenem/cilistatin?
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Enterobacter
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What is the c/u for 2nd Gen Ceph's?
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*HEN PEcKS (c = cocci)
H. Influenza Enterobacter Neisseria Proteus E. Coli Klebsiella Serratia G+ cocci |
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What is a 3rd Gen Ceph used for the tx of Pseudomona?
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Ceftazidime
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What is a 3rd Gen Ceph used for the tx of Gonorrhea?
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Ceftriaxone
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What are the Ceph's used for the tx of Gonorrhea?
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*TRI to FIX a FOX
Ceftriaxone Cefixitine Cefoxitime |
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What is the one-dose tx for Gonorrhea?
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Azithromycin
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What is the MOA of Azithromycin?
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*Inhibits ""Macroslide"" (macro = 50s; slide = translocation)
Blocks translocation from the A --> P site by binding the 23s subunit of the 50s ribosome |
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What is the c/u of Macrolides?
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*UPS Lost My Brand New Car
URI's (caused by G+ cocci) Pneumonia (caused by G+ cocci) STD's (caused by G+ cocci) Legionella Mycoplasma Bordatella Neisseria Chlamydia |
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What is an alternative MOA of Erythromycin?
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Binds to motilin receptors, causing hypermotility motility --> GI upset
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What is the toxicity of Macrolides?
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Acute cholestatic hepetatis
Eosinophilia |
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MOA of Tetracyclines?
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Protein synthesis inhibition by preventing amino acyl tRNA attachment
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What is the c/u for Tetracyclines?
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*VACUuM The BR
Vibrio Cholerea Acne (Propionibacterium Acnes) Chlamydia Ureaplasma Urealyticum Mycoplasm Tularemia H. Pylori Bordetella Rickettsia |
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What is the toxicity of Tetracyclines?
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Discoloration of teeth (children)
Abnormal bone growth (children) Photosensitivity Drug-induced Hepatitis Fanconi Syndrome (old Tetracyclines) |
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What is an alternative MOA of Dimiclocycline?
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Blocks ADH receptors
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What drugs block ADH receptors?
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Dimiclocycline
Lithium |
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What is the MOA of Lithium?
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Inhibition of Phosphoinositol Cascade
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What is the c/u for Lithium?
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Mood Stabilizer
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What is the toxicity of Lithium?
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*LMNOP
L = Lithium M = Muscle rigidity = tremors N = Nephrogenic Diabetes Insipidus O = HyOthyroidism P = Pregnancy = Ebstein's Anomaly or Total Anomalous Pulmonary Venous Return (TAPVR) P = Psoriasis Exacerbation |
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"
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What is the MOA of Chloramphenicol?
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"Inhibits Peptidyltransferase, the enzyme responsible for transferring nucleotides from A --> P site
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"
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What is the c/u for Chloramphenicol?
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Bacterial meningitis
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What is the toxicity of Chloramphenicol?
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"Dose-dependent Anemia
Dose-independent Aplastic anemia Grey Baby Syndrome (premature infants who lack UDP-glucuronyl transferase) |
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"
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What drugs inhibit Fungal DNA Synthesis?
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Griseofulvin
Flucytosine |
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"
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What drugs INHIBIT Fungal Membrane Synthesis?
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*CAT
Caspofungin ""Azoles"" Terbinafine |
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"
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What drugs DESTROY fungal Membranes?
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Amphotericin B
Nystatin |
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What is the MOA of Caspofungin?
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Inhibits Theta-13 Delta-Glucan
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What is the c/u for Caspofungin?
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*CASPofungin
ASPergillosis (invasive) Systemic Candidiasis |
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What is the MOA of Terbinafine?
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Inhibits cell wall synthesis by blocking squaline epoxidase
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What is the c/u of Terbinafine?
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Dermatophytes
Superficial fungal infections |
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What drugs can be used for Dermatophytes?
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Terbinafine
Griseofulvin |
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What is the MOA of Griseofulvin?
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Binds microtubules, arresting the cell in mitosis
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What is the MOA of Amantidine?
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Prevents viral ""uncoating""
Prevents viral penetration Increases DA |
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What is the c/u for Amantidine?
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*Influenza A, RubellA & the CerebellA
Influenza A RubellA Parkinson's (the CerebellA) |
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What is the MOA of Oseltamivir and Zanamivir?
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Inhibits viral influenza neuraminidase, decreasing the release of viral progeny
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What is the c/u of Oseltamivir and Zanamivir?
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Influenza A and B
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What is the tx for Influenza C?
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Acetaminophen
Full Name: N-Acetyl-Para-Aminophenol (APAP) Other Names: Tylenol (U.S.) Paracetamol (outside North America) |
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What is the MOA of Acetaminophen?
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Tylenol = Acetaminophen
MOA: REVERSIBLY blocks Cox I & Cox II Full Name: N-Acetyl-Para-Aminophenol (APAP) Other Names: Tylenol (U.S.) Paracetamol (outside North America) |
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What is the tx for acetaminophen toxicity?
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N-Acetylcysteine
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What is the MOA of N-Acetylcysteine?
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Regenerates glutithione & binds toxic metabolite NAPQI
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What is the MOA of Ribavirin?
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Inhibits Guanine nucleotide synthesis by competitively inhibiting IMP Dehydrogenase
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What is the c/u of Ribavirin?
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Chronic Hepatitis C
RSV |
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What is the tx for chronic Hepatitis C?
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Ribavirin
INF-alpha |
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What is the tx for Hepatitis B?
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INF-alpha
Lamuvidine |
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What are the SE's of the Lamuvidine?
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Lactic acidosis
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What is the c/u of INF-beta?
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MS
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What drugs are used to tx MS?
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INF-beta
Glatiramer Acetate |
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What is the c/u of INF-gamma?
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CGD (NADPH oxidase deficiency)
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What is the MOA of Acyclovir?
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Inhibition of viral DNA polymerase when phosporylated by the VIRAL thymidine kinase
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What is the c/u of Acyclovir?
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Any HSV except HSV III and HSV V
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What are the SE's of the NRTI's?
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All NRTI's: Lactic acidosis
Ziduvidine (AZT/ZDV) --Aplastic anemia --Megaloblastic anemia Didanosine (DDI) --Drug-induced pancreatitis Zalcytobine (DDC): --SJS --Peripheral neuropathy Lamuvidine (3TC) --only lactic acidosis Stavudine (D4T) --Peripheral neuropathy Abacavir (ABC) --Hypersensitivity syndrome |
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What is the tx for Chagas?
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Nifurtimox
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What is the 2nd line tx for PCP?
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2nd: Aerosolized Pentamidine
1st: TMP/SMX 3rd: Dapsone NOTE: PCP = PneumoCystis Pneumonia BUG: Pneumocystis Jiroveci (formerly Pneumocystis Carinii) |
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"
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What is the SE of Aerosolized Pentamidine?
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Drug-induced pancreatitis
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What is the tx for Entamoeba Histolytica?
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Metronidazole
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What is the tx for P. vivax or P. ovale?
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Primaquine for "latent" hypnozytes (otherwise tx = Chloroquine)
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How do you tx a patient with Chloroquine-resistent Malaria?
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Methloquine
Malaria from the indian subcontinent/subsahara is assumed to be resistent to Chloraquine |
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"
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What is the tx for Diphyllobothrium Latum?
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Niclosamide
Note: WIKI says Praziquental (1st) or Niclosamide (2nd) |
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"
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What is the tx for Leishmaniasis ?
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Pentavir Antimony
Na+ Stipigluconate |
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"
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What is the tx for Necator Americanis?
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Pyrantal Pamoate followed by Mebendazole
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What is the tx for Schistosoma Mansoni?
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Praziquental
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What is the tx for Onchocerca (River Blindness)?
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Ivermectin
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DAY 9:
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What are 4 drugs that inhibit the conversion of plasminogen to plasmin?
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There is only one:
Amino Caproic Acid |
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What are 4 drugs that stimulate the conversion of plasminogen to plasmin?
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tPA (aka Altaplase)
Urokinase Streptokinase |
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What is the tx of uremic coagulopathy seen in chronic renal failure?
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Desmopressin
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Why is Desmopressin used in the tx of uremic coagulopathy seen in chronic renal failure?
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Increases the release of vWF & CF VIII from the endothelium
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What is the MOA of Clopidogrel/Ticlopidine?
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"Inhibits plt aggregation by IRREVERSIBLY blocking ADP receptors on plt's which inhibits fibrinogen conversion in the formation of GP IIb/IIIa (i.e. GP IIb/IIIa isn't even formed)
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"
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What is the MOA of Infliximab?
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Monoclonal antibody to TNF-a
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What is the MOA of Abciximab?
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*Spell it this way: ABcixAmAB --> that way it has 2 b's and 3 a's (IIb/IIIa)
Monoclonal antibody to glycoprotein IIb/IIIa which REVERSIBLY inhibits the GP IIb/IIIa receptor |
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"
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What is the SE(s) of Ticlopidine?
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Agranulocytosis
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What are the drugs that cause Agranulocytosis? What is the MOA of each?
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Clozapine -- Block 5-HT-2 & D2 receptors
Colchicine -- Depolarizes microtubules Carbamazepine -- Blocks Na+ channels PTU -- Inhibits thyroid peroxidase (central) and conversion of T4 to T3(peripheral) Dapsone -- Inhibition of bacterial DHF synthesis by binding Dihydropteroate Synthetase Ticlopidine -- IRREVERSIBLY blocks ADP receptors on plt's therefore inhibiting fibrinogen conversion in the formation of GP IIb/IIIa (i.e. GP IIb/IIIa isn't even formed) Methimazole -- Inhibits thyroid peroxidase (central only) |
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"
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What effect does insulin have on the liver?
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Increases storage of glucose as glycogen
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What effect does insulin have on muscle?
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Increases glycogen
Increases protein synthesis Increases intake of K+ |
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Why is there an increase of K+ intake into the muscles in the presence of insulin?
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Any time glucose is taken into a cell, K+ & insulin is required
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What effect does insulin have on adipose tissue?
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Increases TG storage
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What are the two types of insulin?
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Normal
NPH |
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What is the T 1/2 of normal insulin?
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2 - 4 hrs
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What is the T 1/2 of NPH?
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6 - 8 hrs
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Which insulin do diabetic pt's get at 8:00 AM?
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Both
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Which insulin do diabetic pt's get at 8:00 PM?
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Both
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After administration of insulin & NPH, when does these drugs "kick in"?
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Normal insulin: between 10:00 AM - 12:00 PM (i.e. T 1/2 = 2 - 4 hrs)
NPH: between 2 PM - 4 PM (i.e. T 1/2 = 6 - 8 hrs) |
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What do you do if a diabetic pt's chart shows hypoglycemia consistently at 10:00 AM?
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Decrease the 8:00 AM dosage of normal insulin
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What do you do if a diabetic pt's chart shows hyperglycemia consistently at 1:00 PM?
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Realize he probably just ate
Increase the dosage of NPH (possibly) |
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What do you do if a diabetic pt's chart shows hypoglycemia consistently at 10:00 PM?
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Decrease the 8:00 PM dosage of normal insulin
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What do you do if a diabetic pt's chart shows hyperglycemia consistently at 7:30 AM?
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Take NPH at bedtime (10:00 PM) instead of at mealtime (8:00 PM) so that it will ""kick in"" later in the evening and preventing the Dawn Effect
Dawn Effect: No food from 8:00 PM to 7:30 AM should put the pt in a ""fasting state"" & glucagon takes over --> releases GH, IGF --> stimulates lipolysis, glycogenolysis, gluconeogenesis --> resulting in a morning hyperglycemia NOTE: Incr'd NPH will worsen the situation and could turn the Dawn Effect into Chronic Somogyi Rebound |
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What is the difference between the Dawn Effect and Somogyi Rebound?
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Dawn Effect: morning rise in blood sugar in response to waning insulin and a growth hormone surge (that further antagonizes insulin).
Somogyi Rebound: is the morning hyperglycemia that results from insulin-induced early morning (2 - 3 AM) hypoglycemia (i.e. a rebounding high blood sugar that is in response to low blood sugar) |
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What are the 1st Gen Sulfonylureas?
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Tolbutamide
Chlorpropamide |
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What are the 2nd Gen Sulfonylureas?
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Glyburide
Glipizide |
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What are the SE(s) of 1st Gen Sulfonylureas?
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Disulfiram-like reaction
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What are the SE(s) of 2nd Gen Sulfonylureas?
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Hypoglycemia
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What is the MOA of Sulfonylureas?
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"Blocks K+ Channels leading to depolarization, therefore insulin release is increased due to increase in Ca2+
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What is the MOA of Sulfonylureas in IDDM pt's?
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It doesn't work in type I diabetics, b/c they don't have B-cells to make insulin
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What is the MOA of Metformin?
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Inhibits gluconeogenesis
Stimulates glycogenolysis |
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What is the SE(s) of Metformin?
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Lactic Acidosis
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What are the Glitazone drugs?
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Glitazones aka Thiazolidinediones:
Rosiglitazone Pioglitazone |
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What is the MOA of Pioglitazone?
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Increases target cell receptor response to insulin via binding PPAR-gamma receptors
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What are the Alpha-glucosidase inhibitors ?
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Acarbose
Miglitol |
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A female pt comes to your office; she is "hairy" and has irregular cycles; how do you tx her? What else must she be tx'd for?
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Dx = Hirsutism secondary to PCOS
Tx = OCP's Tx = Metformin (prophylactic tx of DM) |
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What is the MOA of Leuprolide?
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GnRH Agonist (pulsatile fashion)
GnRH Antagonist (continuous fashion) |
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What is the c/u of Leuprolide (pulsatile fashion)?
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Infertility
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What is the c/u of Leuprolide (continous fashion)?
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Prostate cancer
Uterine fibroids Idopathic precocious puberty |
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What drugs tx precocious puberty?
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Leuprolide (continous fashion)
Danazol |
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What is the MOA of Methimazole?
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Inhibits thyroid peroxidase (central only) therefore it inhibits organification & coupling
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What is the MOA of PTU?
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Central: Inhibits thyroid peroxidase therefore it inhibits organification & coupling
Peripheral: Blocks conversion of T4 to T3 |
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What is the MOA of Finasteride?
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5a-Reductase inhibitor
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What is the MOA of Flutamide?
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Non-steroidal androgen antagonist at the testosterone receptor (i.e. testosterone antagonist)
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What is the c/u of Flutamide?
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Prostate cancer
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What is the c/u of Finasteride?
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Epithelial-predominant BPH
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What is the tx of smooth muscle-predominant BPH?
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a1-Blockers:
Prazosin Terazosin Doxazosin |
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What is the MOA of Sildenafil?
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Inhibits cGMP phosphodiesterase (PDE) leading to incr'd cGMP
Physiology: cGMP normally functions to relax smoothe muscle (VD); excess results in erection cGMP Normal balance: Nitric Oxide (NO) binds guanylate cyclase, stimulating synthesis of cGMP PDE's degrade cGMP |
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What is the c/u of Sildenafil?
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Erectile Dysfunction
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What is the SE(s) of Sildenafil?
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Blue-Green color vison
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What are the contraindications of Sildenafil?
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Currently taking Nitroglycerides
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What is the MOA of Clomifene Citrate?
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Partial estrogen receptor agonist in the pituitary, increasing LH & FSH
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What is the c/u of Clomifene Citrate?
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Infertility
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What is the SE(s) of Clomifene Citrate?
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Ovarian hyperstimulation syndrome (OHSS) --> Ovarian torsion --> ovarian infarction --> OVARIAN FAILURE!!!
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What is the tx for Lichen Sclerosis?
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High-Dose Steroids:
Clobetasol (sounded like secholabestol?) Halobetasol (sounded like halobestol?) |
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What is the tx for Hypertrophic Dystrophy of the Vulva?
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1% Corticosteroid cream
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What is the tx for Atrophic Vaginitis in a woman without a uterus?
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Estrogen cream
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What is the tx for Atrophic Vaginitis in a woman with a uterus?
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Estrogen-Progesterone (estrogen cream alone can lead to cervical cancer)
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What is the tx for dysfunctional uterine bleeding (DUB)?
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High-Dose IV Estrogen
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What is the tx for Luteal Phase Defects?
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1st Line: Progesterone
2nd Line: Clomiphene Citrate or Human Menopausal Gonadotropin (hMG) |
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What is the MOA of Misoprostol?
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PGE-1 analog:
Decr'd acid production Incr'd mucous production/secretion |
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What is the MOA of Mifepristone?
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Mifepristone = RU-486 aka the morning after pill
Progesterone antagonist used as an abortifacient |
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What is the tx for Acute Gout?
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Colchicine
Indomethacin |
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What is the MOA of Indomethacin?
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REVERSIBLY inhibits the Cox I & Cox II
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What is the MOA of Colchicine?
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Depolarizes microtubules:
Impairs leukocyte chemotaxis Impairs mast cell degranulation |
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What is the tx for Chronic Gout?
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Probenecid
Allopurinol |
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What is the MOA of Probenecid?
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Inhibits reabsorption of uric acid
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What is the MOA of Allopurinol?
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Inhibits Xanthine Oxidase
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What is the c/u of Allopurinol?
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Chronic Gout
Tumor Lysis Syndrome (secondary to chemotherapy tx for Lymphomas/Leukemias) |
