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91 Cards in this Set

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Name a Tricylic Glycopeptide
Vancomycin
What type of infection does Tricylic Glycopeptide treat?
Only Gram positive, drug choice for MRSA, or oral C. diff
What is Redman Syndrome?
A massive histamine reaction when Vancomycin is administered to fast.
What side effects can occur with Tricylic Glycopeptide?
Nephrotoxic, ototoxic, redman syndrome, thrombophlebitis
What test should be done when taking Tricylic Glycopeptide?
Need to obtain peaks and troughs (narrow therapeutic range), BUN and Creatinine
Describe a Tetracyclines?
Suppress bacterial growth by inhibiting protein synthesis
Common uses for Tetracyclines?
Acne, chlamydia, cholera, H-pylori, PNA, lyme disease, antrax
Teaching for patients taking Tetracylines?
Patients need to drink a whole glass of water to prevent esophageal irritation.
When is Tetracyclines contraindictated? Why?
Children between the ages of 4 months and 8 years due to the permanent discoloration of teeth. Also Patient with Renal disease.
What labs should be checked prior to administration of Tetracyclines?
Check renal and hepatic labs
What are the adverse side effects of tetracyclines?
Renal toxicity
Describe the class of Macrolides?
Broad Spectrum antibiotics, inhibit protein synthesis. Great for patient compliance.
Name a Macrolides?
erythromycin, Azithromycin (Zithromax), (Biaxin), (Dynabec), (Tao)
What are the side effects of a Macrolides?
GI irritability, diarrhea
What is a good use of Macrolides?
Good alternative to PCN allergies, considered safest antibiotic
When is a Macrolide contra indicated?
With patients that have hepatic disease
What is the use of a Macrolide?
Respiratory Tract infections, otitis media, uncomplicated skin infections
Name a Aminoglycosides?
Amikacin, Gentamicin, Tobramycin (Nebin)
Describe a Aminoglycoside?
Narrow spectrum- Gram Negative, Disrupts bacterial protein synthesis
What is the biggest side effect with Aminoglycosides?
Very NEPHROTOXIC, check BUN and Creatinine before admin. Ototoxic as well. Need to check Peak and Trough
How are Aminoglycosides given?
IV only, not absorbed from the GI and will not enter the CSF
Describe Fluroquinlones?
Broad spectrum antibiotics, gram positive, but mostly gram negative. Inhibits bacterial DNA gyrase rapidly bacterial
Name a Fluroquinolones?
There are four generations
levoFLOXacin (levaquin), moxiFLOXacin (Avelox),- effective against anaerobes, and cipro
Fluroquinolones Drug of Choice for what?
Prophylaxis of anthrax, UTI's, STD's, infections
What are the side effects of Fluroquinolones?
Nausea, Vomiting, diarrhea, Deep tendon rupture
Describe sulfonamides?
Wide spectrum of coverage- gram positive and negative, pervents conversion of PABA to folic acid which is essential for bacterial growth
Name a sulfonamides?
Sulfonamide and Trimethoprim (Bactrium, Septra), given in a Fixed Dose- TMP/SMZ
What is Steven Johnson Syndrome?
Side effects of sulfonamides are characterized by widespread lesions of the skin, mucous membranes, fever, mailaise, and toxemia. Syndrome has a mortality rate of 25%
What are the side effects of Sulfonamides?
Itchy rash, Steven Johnson Syndrome
What is Sulfonamides usually used for?
Great against E. coli, UTI's, Otitis media, bronchitis, PNA
Name a Urinary Tract Analgesic? What is unique about this drug?
Pyridium, turns the urine orange, it exerts a direct topical analgesic effort. There is a potential for renal/hepatic toxicity.
Describe a Anti-protozoal?
Flagyl, primarily used for anaerobic bacteria
What are the top two drug choices of Anti-protozoal?
C. diff, prophylaxis in surgical procedures with high risk of anaerobes: abd, vaginal, and colorectal
Name a Anti-protozoal?
Metronidazole (Flagyl)
Name an Anti-Fungal?
Fluconazole (Diflucan)- well absorbed in the gut
What is the use of a Anti-Fungal?
Used to treat candidiosis- yeast infection
Name a Oxazolinones?
Linezolid (Zyvox)
What is an Oxazolinones?
Newest class of antibiotics, MDR gram positve pathogens reserved for VRE and MRSA
What are the side effects of Oxazolinones?
MAO Inhibitor
Rapid Acting Insulins? Onset, peak, and duration
Must be used along with intermediate or long actung agents.
Aspart: 5-10 min, 1-3 hrs, 3-5 hrs
Lispro:< 15 min, .5- 1.5 hr, 2-4 hr
Short acting insulin? Onset, peak, and duration
Humulin R, Novolin R
.5-1 hr, 2-3 hr, 3-6 hr
Intermediate Acting insulin? Onset, peak, and duration
NPH 2-4 hrs, 4-10 hrs, 10-16 hrs
Ditemir (Levemir) 1-2 hr, no peak, 12-20 hrs
Long Acting Insulin? Onset, peak, and duration
Glargine (Lantus) 1.1, no peak, 24 hrs
What is Lipodystrophies?
Altered depoistion of subcutaneous fat
What is Lipotrophy?
Loss of subcutaneous fat
What is Lipohypertrophy?
Accumulation of subcutaneous fat
Name the 5 families of Oral Hypoglycemics?
Sulfonylureas, Meglitnides, Biguanides, Thiazolidnediones (Glitazones), Alpha-glucosidase inhibitors
Describe Sulfonylureas?
They work by promoting insulin resistance. Gotta have working beta cells. Can cause hypoglycemia
Name a Sulfonylurea?
Orinase (Glucotrol), Micronase, DiaBeta (Amaryl)
Name a Biguanides?
Metformin (Glucophage)
Name a Meglitinides?
Repaglinide (Prandin)
Nateglinide (Starlix)
Describe Biguanides?
They suppress gluconeogensis and enhance glucose uptake in the muscles. Doesn't cause hypoglycemia and rarely Lactic acidosis
Describe Meglitinides?
Promote insulin releas. Can cause hypoglycemia.
What is Metformin contraindicated?
Renal impairment or Heart Failure
What are the side effects of Biguanides?
Decrease appatite, nausea, and diarrhea, toxicity- lactic acidosis
Describe Thiazolidinediones (Glilazones)
Reduces glucose levels by decreasing insulin resistance
Name a Glitazones?
Rosigitazone (Avandia), proglitazone (Actos)
What patient profiling should be done?
Drugs are not favored and should be avoided in patients with cardiac problems.Moniter liver and can cause fluid retention.
Describe Alpha-Glucosidase Inhibitors?
They slow the absorption of dietary carbohydrates and reduce the rise in blood glucose after a meal.
Name a Alpha Glucosidase?
Acarbose (Precose)
What are the side effects of Alpha Glucosidase?
GI problems: superbad flatulence, abd distention, and diarrhea
Name a Amylin Mimetics?
Pramlintide (Symlin)
Describe a Amylin Mimetics?
Reduce postproandial levels of glucose. Delays gastric emptying and suppresses glucagon. The brain thinks the stomach is full.
Describe Incretin Mimetics?
Synthetic version of a peptide found in Gila monster saliva. Slows gastric emptying, inhibits glucagon and suppresses the appetite.
Name a Incretin Mimetics?
Exanatide (Byetta)
Describe DPP-4 Inhibitor?
Enhances the body's own ability to release insulin. Breaks down the proteins that increase the release of insulin.
Name a DPP-4 Inhibitor?
Sitagliptin (Januvia)
What three factors determine stroke volume?
Myocardial contractility, afterload, and preload.
What is Preload? What affects preload?
End Diastolic volume, what is left in the ventricle after contraction.
Fluid/volume and stretch
What is Afterload? What affects afterload?
End systolic wall stress or resistance.
Resistance or Constriction
What regulates blood pressure?
At first the Autonomic system within seconds and then the RAAS!
Explain Angiotension II?
Powerful Vasoconstriction
What is a Natruretic peptide?
They are released to Decrease volume by inhibiting ADH and aldosterine. Also there is dilaion of arterioles and veins. (Decrease preload)
What is the mechanism of an ACE inhibitor?
Reduce levels of angiotension II and decrease aldosterone, therefore they decrease preload and afterload.
What does aldosterone effect?
Preload, by the release it increases sodium and water retention. This increases Volume.
What are the uses of ACE inhibitors? What should before administering?
HTN, HF, Diabetes nephropathy, post MI
K+, BP (hold for a BP <100)
What are the side effects of ACE Inhibitors?
First dose hypotension, and dry persistant cough, hyperkalemia.
Name a ACE Inhibitor? What does it end in?
Captopril (Capoten), enalapril (Vasotec)
End in -Pril
What is the mechanism of action of an Angiotension II Receptor Blocker (ARB's)?
Block the action of angiotension II.
Why is an ARB better than the ACE inhibitor?
No accumulation of bradykinin's... no cough! Less problems with K+.
What are the uses of ARB's? What are the side effects of ARB's?
HTN, HF, Diabetic Nephropathy, post MI, Stroke prevention.
Angioedema, renal failure
Name a Angiotension II Receptor Blocker (ARB's)?
Valsartan (Diovan), they end in -Tan.
What is the mechanism of action of Aldosterone Antagonist?
Decrease in aldosterone. Blockade produces retention of K+ and the loss of Na+ and water.
Name a Aldosterone Antagonist?
Spironolactone (Aldactone), Eplerenone (Inspra)
What are the uses of a Aldosterone Antagonist? and side effects?
HTN and HF
SE: increase in K+
What is the mechanism of action of a Calcium Channel Blocker?
Regulate the function of SA and AV node. Decreases the force of contraction. Vasodilation.
Name a Calcium Channel Blocker?
verapamil (Calan), nefedipine (Procardia), nimodipine (Nimotop) ends in -Pine
What are the uses of a Calcium Channel Blocker? What are the side effects?
Angina, HTN, vasospasm
SE: Bradycardia, hypotension, dizziness, gingival hyperplasia, constipation
Why control Blood Pressure?
Leading cause of MI, HF, Angina pectoris, Kidney disease, and Stroke
Receptor sites:
-Beta I
-Beta II
-Increase heart rate and contractility
-Cause bronchodilation
Receptor sites:
-Alpha I
-Alpha II
-Causes vasoconstriction

-Causes vasodilation