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103 Cards in this Set

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  • Back
What is the primary mechanism of acquired resistance to penicillin?
production of β-lactamase
Which has better acid stability and absorption?

-penicillin G
-penicillin V
penicillin V
Which of the following is not stable in an acidic medium?

- cloxacillin
- dicloxacillin
- nafcillin
- oxacillin
nafcillin
Which has better acid stability, absorption, and half-life?

- amoxicillin
- ampicillin
amoxicillin
What kind of penicillins are amoxicillin and ampicllin?
aminopenicillins
What kind of penicillins are carbenicillin, piperacillin, and ticarcillin?
β-lactamase sensitive penicillins
What kind of penicillins are cloxacillin, dicloxacillin, flucloxacillin, methicillin, nafcillin, and oxacillin?
β-lactamase resistant penicillins
What is the most common side effect of penicillin?
hypersensitivity
What is the mechanism of action for penicillins?
inhibition of PBPs --> structural irregularities --> cell lysis
What is the mechanism of action for cephalosporins?
inhibition of PBPs --> inhibits cross-linking of peptidoglycan --> cell lysis
What kind of bacteria are first generation cephalosporins effective against?
Gram positives
(only modest against Gram negatives)
What kind of bacteria are second generation cephalosporins effective against?
better for Gram negatives but worse for Gram positives compared to first generation
What kind of bacteria are third generation cephalosporins effective against?
better for Gram negatives (like Enterobactericeae) but worse for Gram positives compared to second generation
What kind of bacteria are fourth generation cephalosporins effective against?
greater spectrum of activity than third generation, and increased stability against β-lactamase
Which bacteria are β-lactamase resistant penicillins especially effective against?
Staphylococcus aureus
What is the mechanism of action for β-lactam antibiotics?
bind to PBPs --> disrupt cell wall synthesis --> cell lysis
What kind of antibiotics are clavulanic acid and sulbactam?
β-lactamase inhibitors
What is the mechanism of action of vancomycin?
inhibition of cell wall polymerization
Which is vancomycin effective against?

- Gram negatives
- Gram positives
Gram positives
Why are aminoglycosides effective against bacteria, while not affecting mammalial proteins?
difference in ribosomal subunits
What kind of drugs are gentamicin, neomycin, and streptomycin?
aminoglycosides
What is the mechnism of resistance for aminoglycosides?
modification of ribosomal binding site
metabolites competing with aminoglycosides
Compared to other drugs, aminoglycosides have relatively low cytotoxicity.

- True
- False
False
Which of the following have the side effect of ototoxicity?

- aminoglycosides
- cephalosporins
- penicillins
aminoglycosides
What is the mechnism of action for macrolides?
bind reversibly with 50s ribosomal subunit to inhibit translocation of peptide chain to P site
What are the mechanisms of resistance for macrolides?
efflux pumps
esterases that decrease drug binding
mutation in 50s subunit
Which of the following macrolides has the poorest absorption and acid stability?

- azithromycin
- clarithromycin
- erythromycin
erythromycin
Which macrolide mainly accumulates in phagocytes?
clarithromycin
Which of the following macrolide is eliminated in urine?

- clarithromycin
- erythromycin
clarithromycin
Which macrolide has the best activity, especially against S. pyogenes and S. pneumonia?
clarithromycin
What is the first choice aminoglycoside drug?
gentamicin
What is the mechanism of action for tetracyclines?
compete with tRNA for A site on 50s ribosomal subunit
What is the mechanism of resistance for tetracyclines?
increased efflux of tetracycline
R protection proteins dislodge the drug from ribosomes
The absorption of which type of drugs is impaired by dairy products?
tetracyclines
Which is better absorbed?

- doxycycline
- tetracycline
doxycycline
What are some important side effects of tetracyclines?
GI irritation
photosensitivity
tooth discoloration
Gray baby syndrome (neonatal toxicity) is a side effect of which drug?
chloramphenicol
Which metal(s) is 2, 3-dimercaptosuccinic acid (Succimer) a chelating agent for, and what is its route of administration?
lead
mercury

oral administration
Which metal(s) is 2, 3-dimercaptoproponol (BAL, Dimercaprol) a chelating agent for, and what is its route of administration?
lead
mercury

IM administration
Which metal(s) is EDTA a chelating agent for, and what is its route of administration?
lead

IV administration
Which metal(s) is penicillamine a chelating agent for, and what is its route of administration?
lead
mercury
arsenic

oral administration
Which metal(s) is deferoxamine a chelating agent for, and what is its route of administration?
iron

IM, slow IV, or oral (under rare circumstance) administration
Toxicity from which metal inhibits heme biosynthesis?
lead
Toxicity from which metal inhibits a1-antitrypsin, leading to emphysema and nephrotoxicity?
cadmium
Toxicity from which metal precipitates proteins, causing necrosis and inhibition of enzymes?
mercury
Toxicity from which metal increases vascular permeability and inhibits anaerobic & oxidative phosphorylation?
arsenic
Why can't EDTA be given via IV?
it can't cross the cell membrane
Why is EDTA given as calcium disodium salt?
to balance the calcium level
What is the difference between diabetes mellitus Type 1 and Type 2?
Type 1: severe or absolute insulin deficiency

Type 2: resistance to insulin action combined with relative deficiency in insulin secretion
Which of the following describes insulin lispro, insulin glulisine, and insulin aspart?

- Intermediate acting
- Long acting
- Rapid acting, short duration
- Short acting, rapid onset
rapid acting, short duration
Which of the following describes regular insulin with zinc?

- Intermediate acting
- Long acting
- Rapid acting, short duration
- Short acting, rapid onset
short acting, rapid onset
Which of the following describes isophane insulin suspension (NPH) and lente insulin?

- Intermediate acting
- Long acting
- Rapid acting, short duration
- Short acting, rapid onset
intermediate acting
Which of the following describes insulin detemir and insulin glargine?

- Intermediate acting
- Long acting
- Rapid acting, short duration
- Short acting, rapid onset
long acting
What is the rationale for using mixed insulin therapy?
provides tighter glycemic control and combines rapid & intermediate acting insulins
Sulfonylureas and medlitinides are which type of drugs?

- antihyperglycemic
- hypoglycemic
hypoglycemic
Biguanides, thiazolidinediones, and α-glucosidase inhibitors are which type of drugs?

- antihyperglycemic
- hypoglycemic
antihyperglycemic
What kind of drugs are tolazamide, glipizide, and glyburide?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
sulfonylureas (hypoglycemic drugs)
What kind of drugs are nateglinide and repaglinide?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
meglitinides (hypoglycemic drugs)
What kind of drug is metformin?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
biguanide (antihyperglycemic drug)
What kind of drugs are pioglitazone and rosiglitazone?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
thiazolidinediones (antihyperglycemic drugs)
What kind of drug is acarbose?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
α-glucosidase inhibitor (antihyperglycemic drug)
Which of the following increase insulin secretion to treat Type 2 diabetes mellitus?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
meglitinides
sulfonylureas
Which of the following increase insulin sensitivity to treat Type 2 diabetes mellitus?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
thiazolidinediones
Which of the following decrease glucose absorption to treat Type 2 diabetes mellitus?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
biguanides
Which of the following block enzymes which process complex sugar digestion, in order to treat Type 2 diabetes mellitus?

- α-glucosidase inhibitors
- biguanides
- meglitinides
- sulfonylureas
- thiazolidinediones
α-glucosidase inhibitors
What kind of drugs are apomorphine and ipecac?

- antidiarrheal
- antiemetic
- laxatives & cathartics
- proemetic
- prokinetic
proemetic
What kind of drugs are bethanachol, metoclopramide, and erythromycin?

- antidiarrheal
- antiemetic
- laxatives & cathartics
- proemetic
- prokinetic
prokinetic
What are proemetic drugs primarily used to treat?
oral poisoning
What are prokinetic drugs primarily used to treat?
gastroparesis or lack of motility in upper GI tract
Which of the following is both a prokinetic and antiemetic drug?

- bethanachol
- erythromycin
- metoclopramide
- ondansetron
- scopalamine
metoclopramide
What kind of drugs are diphenhydramine, meclzine, scopalamine, metclopramide, promethazine, ondansetron, dronabinol, and marijuana?

- antidiarrheal
- antiemetic
- laxatives & cathartics
- proemetic
- prokinetic
antiemetic
What kind of drugs are kaopectate, metamucil, bismith salycilate, loperamide, diphenoxylate, difenoxin, and octreotide?

- antidiarrheal
- antiemetic
- laxatives & cathartics
- proemetic
- prokinetic
antidiarrheal
What kind of drugs are dietary fiber, methylcellulose, psyllium seed husk, magnesium salts, phosphates, glycerin, bisacodyl, castor oil, senna, and cascara?

- antidiarrheal
- antiemetic
- laxatives & cathartics
- proemetic
- prokinetic
laxatives & cathartics
Antacids are only useful for episodic treatment of indigestion, but not chronic disease.

- True
- False
True
The most effective treatment strategies for GERD and PUD involve multiple therapeutic approaches.

- True
- False
True
Which of the following H2 histamine antagonists is a potent inhibitor of CYP?

- cimetidine
- famotidine
- nizatidine
- ranitidine
cimetidine
What kind of drugs are the current drugs of choice in combination regimens for GERD and PUD?
proton pump inhibitors
What class of immunosuppressants are prednisone and prednisolone?

- corticosteroids
- cytotoxic agents
- T-cell suppressants
corticosteroids
What class of immunosuppressants are cyclophosphamide and azathioprine?

- corticosteroids
- cytotoxic agents
- T-cell suppressants
cytotoxic agents
What class of immunosuppressants are cyclosporin and tacrolimus?

- corticosteroids
- cytotoxic agents
- T-cell suppressants
T-cell suppressants
What is the mechanism of action for nucleoside analogs?
compete with native nucleosides for incorporation into viral DNA, then inhibit viral DNA polymerase and cause DNA chain termination
What kind of drugs are acyclovir, ganciclovir, idoxuridine, and vidarabine?
nucleoside analogs
What are nucleoside analogs used to treat?
herpes
What are amantidine and rimantadine used to treat?
influenza
Amantidine and rimantadine are nucleoside analogs.

- True
- False
False
Nucleoside reverse transcriptase inhibitors (NRTIs) are active against chronically infected cells.
False
What kind of drugs are zidovudine, didanosine, zalcitabine, stavudine, and ribavirin?
nucleoside reverse transcriptase inhibitors (NRTIs)
NRTIs competitively inhibit HIV-1 & HIV-2 reverse transcriptase.

- True
- False
True
NNRTIs competitively inhibit HIV-1 and HIV-2 reverse transcriptase.

- True
- False
False
What kind of drugs are nevirapine, delavirdine, and efavirenz?
non-nucleoside reverse transcriptase inhibitors (NNRTIs)
What kind of drugs are saquinavir and ritonavir?
protease inhibitors
What are protease inhibitors used to treat?
HIV infeciton
What are NRTIs and NNRTIs used to treat?
HIV infection
What is the mechanism of action of local anesthetics?
they reversibly bind to voltage-gated sodium channels, blocking sodium influx, which blocks action potential and nerve conduction
Where are ester-linked anesthetics metabolized?
in the blood by plasma pseudocholinesterase
Where are amide-linked anesthetic metabolized?
in the liver
What are four ester-linked anesthetics?
cocaine
procaine
tetracaine
benzocaine
What are three amide-linked anesthetics?
lidocaine
mepivacaine
bupivacaine
Why are vasoconstrictors often added to local anesthetic preparations?
reduce their absorption, thus prolonging anesthetic effect and reducing systemic toxicity
What is the mechanism of action of alkylating drugs?
form bonds with reactive amines and phosphates on DNA, which makes the strands unable to uncoil and separate, thus preventing duplication
What is the mechanism of action of antimetabolites?
interfere with DNA synthesis by producing false nucleotides
What are the toxic side effects of alkylating agents used against cancer?
bone marrow suppression and ulcers
What kind of drugs are mechlorethamine, cyclophosphamide, chlorambucil, melphalan, and bis-chloroethyl nitrosourea (BCNU)?

- alkylating agents
- antimetabolites
alkylating agents