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67 Cards in this Set
- Front
- Back
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-afil
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erectile dysfunction
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-ane
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inhalation anesthetic
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-azepam
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Benzodiazepine
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-azine
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Phenothiazine (neuroleptic, antiemetic)
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-azole
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Anti-fungal (-conazole)
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-barbital
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Bartbiturate
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-caine
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Local anesthetic
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-cillin
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Penicillin
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-cycline
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Antibiotic, protein synthesis inhibitor
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-etine
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SSRI
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-ipramine
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TCA
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-navir
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Protease inhibitor
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-olol
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Beta blocker
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-opedridol
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Butyrophenone (neuroleptic)
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-oxin
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Cardiac glycoside (inotropic)
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-phylline
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Methylxanthine
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-pril
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ACE inhibitor
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-terol
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B2 agonist
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-tidine
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H2 antagonist
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-triptan
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5-HT1A agonists (migraine)
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-triptyline
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TCA
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-tropin
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Pituitary hormone
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-zosin
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alpha1 antagonist
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-dranate
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bisphosphonate (osteoporosis)
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-sartan
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ARB
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-chol
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Cholinergic/muscarinic agonists
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-stigmine
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anti-cholinesterase
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-mustine
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Nitrose urea
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-curonium
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Non-depolarizing NMJ blockers
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-statins
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HMG CoA reductase inhibitors
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-bendazole
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anti-parasitics
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-dipine
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dihydropyridine Ca channel blockers
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-prost
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Prostaglandin analogs
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Block cell wall synthesis by inhibition of peptidoglycan cross-linking
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Penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
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Block peptidoglycan synthesis
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Bacitracin, vanocmycin
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Disrupt bacterial cell membranes
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Polymyxins
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Block nucleotide synthesis
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sulfonamides, trimethoprim
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Block DNA topoisomerases
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Quinolones
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Block mRNA synthesis
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Rifampin
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Block protein synthesis at 50S ribosomal subunit
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Chloramphenicol, macrolides, clindamycin, streptogramins, (quinupristin, dalfopristin), linezolid
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Block protein synthesis at 30S ribosomal subunit
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Aminoglycosides, tetracyclines
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Bacteriostatic
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Erythromycin, Clindamycin, Sulfamethoxzole, Trimethoprim, tetracylines, Chloramphenicol.
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Batericidal
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Vancomycin, Fluoroquinolones,Penicilin, Aminoglycosides, Cephalosproins, Metronidazole
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Penicillin
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Mechanism:
Penicillin G (IV form), Penicillin V (oral), Prototype B-lactam antibiotics 1, Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes Clinical Use: Bactericidal for gram-positive cocci, gram-positive rods, gram-negative cocci and spirochetes. Not penicillinase resistant Toxicity: Hypersensitivity reactions, hemolytic anemia |
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Methicillin, nafcillin, dicloxacillin (penicillinase-resistant penicillins)
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Mechanism:
Sames as peniciilin, Narrow spectrum; penicillinase resistant because of bulkier R group. Clinical Use: S aureus (except MRSA: resistant because of alterned penicillin-binding protein target site) Toxicity: Hypersensitivity reactions; methicillin - interstitial nephritis |
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Ampicillin, amoxicillin(aminopenicillins)
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Mechanism:
Same as penicillin, Wider spectrum; penicillinase sensitive. Also combine with clavulanic acide (penicillinase inhibitor) to enhance spectrum. AmOxicillin has greater Oral bioavailability than ampicillin. Clicinical Use: Extended-spectrum penicillin - certain gram-positive bacteria and gram-negative rods (haemophilus influenzae, E.coli, Listeria monocytogenes, Proteus mirabilis, salmonella, enterococci) Toxicity: Hypersensitivity reactions; ampicillin rash; pseudomembranous colitis |
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Ticarcillin, carbenicillin, piperacillin (antipseudomonals)
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Mechanism:
Same as penicillin, Extended spectrum. Clinical Use: Pseudomonas spp, and gram-negative rods; susceptible to penicillinase; use with clavulanic acid (B-lactamase inhibitor) Toxicity: Hypersensitivity reactions |
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Cephalosporins
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Mechanism:
B-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactercidal. Toxicity: Hypersensitivity reactions. Cross-hypersensitivity with penicillins occurs in 5-10% of patients. Incr nephrotoxicity of aminoglycosides; disulfiram-like reaction with ethanol (in cephalosporins with a methylthiotetrazole group, e.g., cefamandole) |
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Cephalosporins
First generation |
(cefazolin, cephalexin) - gram positive cocci, Proteus mirabilis, E.Coli, Klebsiella pneumoniae.
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Cephalosporins
Second Generation |
(cefoxitin, cefaclor, cefuroxime) - gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E.Coli, Klebsiella pneumoniae
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Cephalosprins
Third Generation |
(Ceftriaxone, Cefotaxime, ceftazidine) - serious gram-negative infections resistant to other B-lactams; meningitis (most penetrate the blood-brain barrier). Examples: ceftazidime for Pseudomonas; ceftriaxone for gonorrhea.
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Cephalosporins
Fourth Generation |
(cefepime) - incr. activity against Pseudomonas and gram-positive organisms.
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Aztreonam
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Mechanism:
A monobactam resistant to B-lactamases. Inhibits cell wall synthesis (binds to PBP3), synergistic with aminoglycosides. No cross-allergenicity with penicillins Clinical Use: Gram-negative rods - Klebsiella spp., Pseudomonas spp., Serratia spp. No activity against gram-positives or anaerobes. For penicillin-allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides. Toxicity: Usually nontoxic; occasional GI upset. No cross-sensitivity with penicillins or cephalosporins |
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Imipenem/cilastatin, meropenem
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Mechanism
Imipenem is a broad-spectrum, B-lactamase-resistant carbapenem. Always administered with cilastatin (inhibitor of renal dihydropeptidase I) to decr. inactivation in renal tubules Clinical Use: Gram-positive cocci, gram-negative-rods, and anaerobes. Drugs of choice for enterobacter. The significant side effects limit use to life-threatening infections, or after other drugs have failed. Meropenem, however, has a reduced risk of seizures and is stable to dihydropeptidase I Toxicity: GI distress, skin rash and CNS toxicity (seizures) at high plasma levels |
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Vancomycin
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Inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors. Bactericidal. Resistance occurs with amino acide change of D-ala D-ala to D-ala D-lac
Clinical Use: Used for serious, gram-positive mutidrug-resistant organisms, incoluding S Aureus adn Clostridium difficile(pseudomembranous colitis) Toxicity: Nephrotoxicity, ototoxicity, Thrombophlebitis, diffuse flushing - "red man syndrome" (can largely prevent by pretreatment with antihistamines and slow infusion rate). Well tolerated in general |
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Protein Synthesis inhibitors
30S inhibitors |
A = Aminoglycosides (streptomycin, gentamicin, tobramycin, amikacin( [bactericidal]
T= Tetracyclines [bateriostatic] |
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Protein synthesis inhibitors
50S inhibitors |
C= Chloramphenicol, Clindamycin [bacteriostatic]
E= Erythromycin [bateriostatic] L = Linocomycin [bacteriostatic] L = Linezolid [variable] |
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Aminoglycosides
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Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
Mechanism: Batericidal: inhibit formation of initiation complex and cause misreading of mRNA. Require O2 for uptake; therefore ineffective against anaerobes Clinical use: Severe gram-negative rod infections. Synergistic with B-lactam antibiotics. Neomycin for bowel surgery Toxicity: Nephrotoxicity (especially when used with cephalosporins) Ototoxicity )especially when used with loop diuretics) Teratogen. |
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Tetracyclines
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Tetracycline, Doxycycline, demeclocycline, minocycline
Mechanism: Bateriostatic: bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration. Doxycycline is focally elimiated adn can be used in patients with renal failure. Must NOT take with milk, antacids or iron-containing preparations because divalent cations inhibit its absorption in the gut Clinical Use: Vibrio cholerae, Acne, Chlamdydia, Ureaplasma urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Boprrelia burgdoferi (lyme disease), Rickettsia. Toxicity: GI distress, discolortion of teeth and inhibition of bone growth in children, photosensitivity. Contraindicated in pregnancy |
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Macrolides
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Erythromycin, azithromycin, clarithromycin
Mechanism:Inhibit protein synthesis by blocking trnslocation; bind to the 23S rRNA oif the 50S ribosonal subunit. Bacteriostatic. Clinical Use: URIs, penumonias, STDs--gram-positive cocci, (streptococcal infections in pateints allergic to penicillin) Mycoplasma, Legionella, Chlamydia, Neisseria Toxicity: GI discomfort (most common cause of noncompliance), acute cholestatic hepatitis, eosinophilia, skin rashes. Increases serum concentration of theophyllines, oral anticoagulants. |
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Chrloramphenicol
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Mechanism - Inhibits 50S peptidyltransferase activity. Bacteriostatic.
Clinical Use - Meningitis (haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae). Conservative use owing to toxicities. Toxicity: Anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome (in premature infants because they lak liver UDP - glucuronyl transferase). |
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Clindamycin
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Mechanism - blocks peptide bond formation at 50S ribosomal subunit. Bacteriostatic.
Clinical use - Treat anaerobic infections (e.g., Bateriodes fragilis, clostridium perfringens) Toxicity - Pseudomembranous colitis (C difficle overgrowth), fever, diarrhea. |
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Sulfonamides
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Sulfanethoxazole (SMX), sulfisoxazole, sulfadiazine.
Mechanism - PABA antimetabolites inhibit dihydropteroate synthetase. Bacteriostatic. Clinical Use - Gram-positve, gram-negative, Nocardia, Chlamydia. Triple sulfas or SMX for simple UTI. Toxicity - Hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity (tubulointerstitial nephritis), photosensitivity, kernicterus in infants, displace other drugs from albumin (e.g., warfarin). |
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Trimethoprim
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Mechanism - Inhibitws bcterial dihydrofolate reductase. Bacteriostatic.
Clinical Use - Used in combination with sulfonamides (trimethoprim-sulfamethoxazole (TMP-SMX), causing sequential block of folate synthesis. Combination used for recurrent UTIs, Shigella, Salmonella, Pneumocystis jiroveci pneumonia. Toxicity - Megaloblastic anemia, leukopenia, granulocytopenia. (May alleviate with supplemental folinic acid) |
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Sulfa Drug allergies
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Patients who do not tolerate sulfa drugs should not be given sulfonamides or other sulfa drugs, such as sulfasalazine, sulfonylureas, thiazide diuretics, acetazolamide, or furosemide.
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Fluoroquinolones
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Ciprofloxacin, norfloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin, (fluoroquinolones), nalidixic acid (a quinolone).
Mechanism - Inhibit DNA gyrase (topoisomerase II) Bactericidal. Must not be taken with antacids. Clinical Use - Gram-negative rods of urinary and GI tracts (including pseudomonas), neisseria, some gram-positive organisms. Toxicity - GI upset, superinfections, skin rashes, headache, dizziness. Contraindicated in pregnant women and in children beause animal studies show damage to cartilage. Tendonitis and tendon rupture in adults; leg cramps and myalgias in kids. |
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Metronidazole
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Mechanism - Forms toxic metabolites in the bacterial cell that damage DNA, Bactericidal, antiprotozoal.
Clinical Use - Treats Giardia, Entamoeba, Trichomonas, Gardnerella Vaginalis, Anaerobes (Bacteroides, Clostridium). Used with bismuth and amoxicillin (or tetracycline) for "triple therapy" against H. Pylori Toxicity - Disulfiram-like reaction with alcohol; headache, metallic taste |
