PHARM EXAM 1 part 1 (antibiotics)

say whether its gram posiitve or gram negative

• thick peptidoglycan

• thin peptidoglycan

• pink

• purple

• 3 layers

• 2 layers

• positive

• negative

• negative

• positive

• negative

• positive

• pruritis =

• utricaria =

• itching

• hives

SX of pseudomembranous colitis and or cdiff?

consistent bloody diarrhea, fever, abdominal pain

• ____: treating a likely cause of infection before the specific bacteria is known

• ____: administration of antibiotics based on known result of culture/testing

• ____: antibiotics taken before anticipated exposure to infectious organism to prevent infection (ex: vaccines, antibiotics before surgery)

• empiric therapy

• definitive therapy

• prophylactic therapy

• ____: how safe a drug is based on ratio of drug’s lethal dose to its therapeutic dose

• is a low/narrow therapeutic dose RISKY or pretty SAFE?

• is a high therapeutic dose RISKY or pretty SAFE?

• therapeutic index

• risky

• safe

addiction (aka psychologic dependence)

CHRONIC neurological disease

• analgesic=

• adjuvant analgesic drugs=

• pain relieving meds without losing conciousness

• drugs added for combined therapy with primary drug; may have additional or indepedent analgesic traits

• agonist =

• antagonist =

• agonist-antagonist (aka partial agonist) =

• substance that binds to receptor and causes response

• drug that binds to receptor and blocks a repsonse

• substance that binds to receptor but causes partial weaker response compared to agonist’s response

• analgesic ceiling effect

• breakthrough pain

• given analgesic no longer effective even tho the safest highest dose was given

• pain experienced inbxn doses of pain meds

• central pain

• referred pain

• visceral pain

• somatic pain

• superficial pain

• vascular pain

• any pain that damages CNS

• occuring in area away from organ of origin

• pain originating from organs or smooth muscles

• pain originating in skeletal muscles/joints/ligaments

• pain originating in skin or mucous membranes

• pain resulting from conditions of the vascular or perivascular tissue

chronic pain

hard to treat

• lasts longer than 3-6 months

• or pain longer than 1 month after healing of acute injury

• or pain accompanying nonhealing injury

• neuropathic pain =

• nociception =

• nocieptors =

• results from disturbance of a nerve’s function

• the brain’s processing of pain signals = leading to feeling pain

• sensory nerves that sense pain signals from body toward CNS

nonsteroidal antiinflammitory drugs (NSAIDS) =

• drugs that are analgesics + also are antiinflamatory and antipyretic (aka reduces fever)

• opioids

• opioid analgesics

• treats pain (analgesic) but is a very potent type of analgesic

• synthetic drugs that bind to opioid receptors to relieve pain

• opioid naive =

• opioid tolerance =

• patient who is a first time opioid analgesic recipient and arent accustomed to its effects

• results from long term opioid use (1 week or more); large doses of opioid required to maintain the numbing effect of analgesic; withdrawal issues can occur (bc body is physically dependent now)

syngergistic effect

effect of combo of 2 or more drugs is GREATER than sum of individual their effects

what are signs that kidneys in distress?

• increased BUN

• increased creatinine (anything above 1.2 is BAD)

• urine output less than 30ml

VANCOMYCIN

• MOA?

• treats what?

• adverse side effects?

• inhibit cell wall synthesis

• prophylaxis for cdiff (oral route) + prophylaxis for MRSA (IV route)

• red man syndrome, nephrotoxicity, ototoxicity

signs of red man syndrome?

• which drug is involved?

• what reason does this happen?

• how do you approach red man syndrome?

• ***all SX manifest at head and chest area*** flushing, itching, shortness breath, chest pain

• vancomycin

• IV infusion too fast

• hold the infusion > let SX relieve (u can order antihistamines if needed) > restart IV infusion slowly over 1 hr

METRONIDAZOLE

• generic name?

• MOA?

• treats what?

• regular side effects?

• adverse side effects?

• notes?

• flagyl

• inhibit DNA synthesis

• cdiff, STI (importantly trichomoniasis), abdominal infxns (ex: any -itis inflammtion of abdomen) , gynecologic infxns (**BV)

• dark urine, GI distress, metallic bitter taste

• none (only if u drink alcohol then youll feel like death; throwing up etc.)

• take with food (to reduce GI distress)

Peaks and troughs for infusions

• when should you measure peak of a drug in patient’s blood?

• when should you measure trough of a drug in patient’s blood?

• IMMEDTIATELY right after infusion

• IMMEDIATLEY before next dose (or within 30 mins before next dose)

CLINDAMYCIN

• MOA?

• treats what?

• adverse side effects?

• inhibit protein synthesis

• genitourinary infxns (ex: BV), abdominal infxns, bone infxns

• pseudomembranous colitis, cdiff

NITROFURANTOIN

• generic name?

• MOA?

• treats what?

• normal side effects?

• adverse side effects?

• macrobid

• inhibit cell wall synthesis

• UTI

• dark urine, GI distress

• pulmonary toxicity, liver toxicity

LINEZOLID

• generic name?

• MOA?

• treats what?

• adverse side effects?

• notes?

• zyvox

• inhibit protein synthesis

• MRSA, VRE

• serotonin syndrome, hypertension

• avoid dairy, cured meats

MACROLIDE

• what prefix or suffix does these drugs have?

• MOA?

• treats what?

• adverse side effects?

• notes?

• -thromycin (for ex: azithromycin)

• inhibit protein synthesis

• resp tract infection, STI (gonnorhea, chlamydia)

• hepatotoxicity, prolonged QT complex, disrupt oral contraceptived

• ALTERNATIVE drug for ppl allergic to penicillin

TETRACYCLINE

• MOA

• what prefix or suffix does these drugs have?

• treats what?

• adverse side effects?

• notes?

• inhibit protein synthesis

• -cycline

• acne, rocky mountain fever, lyme disease, STI, chalmydia

• superinfection (ex: cdiff), mottling, disrupts oral contraceptives, photosensitivity

• hydrate + avoid anti-acids + avoid dairy, Ca, Mg, Fe, Al + avoid taking with food + AVOID IF PREGNANT

AMINOGLYCOSIDES

• what prefix or suffix does these drugs have?

• MOA?

• what 5 specific drugs are included in aminoglycosides (bc some other drugs have same suffix, but arent counted as aminoglycosides)

• treats what?

• adverse side effects?

• notes?

• -mycin or -micin

• inhibit protein synthesis

• (hint: GNATS): gentramycin, neomycin, amikamycin, tobramycin, streptomycin

• pseudomonas

• ototoxicity, nephrotoxicity

• dont take with food

SULFANOMIDES

• what prefix or suffix does these drugs have?

• MOA?

• treats what?

• adverse side effects?

• cross sensitivities?

• notes?

• sulfa- (2 main examples are sulfisoxazole + sulfamethozaole-trimethoprim)

• inhibit folic acid synthesis

• UTI

• steven jonson syndrome, agranulocytosis, disrupts oral contraceptives, hepatotoxicity, photosensitivity

• celecoxib

• avoid bloodthinners (ex: warfarin) + hydrate

FLUOROQUINOLONES

• what prefix or suffix does these drugs have?

• MOA?

• treats what?

• adverse side effects?

• notes?

• -floxacin

• inhibit DNA synthesis

• resp.infections, skin infxns, UTI, bone/joint infxn

• tendon rupture/tendonitis, photosensitivity, CNS (confusion, depression, etc), psueomembrane colitis/cdiff, hepatoxicity, prolonged QT

• hydrate + avoid dairy, Ca, Mg, Al, Fe, Zn + avoid anti-acids + 2-2 food drug rule (2 hrs before meal, 2 hrs after meal)

which antibiotics TREAT cdiff?

which antibiotics have ADVERSE EFFECT of cdiff?

• vancomycin, metronidazole

• clindamycin, fluoroquinolones, tetracyclines

which antibiotics treat UTI?

• sulfanomide

• nitro

• penicillin

• cephalosporins

• fluoroquinolones

which antibiotics treat STI?

• tetracycline

• metronizadole

• macrolide

• penicillin

which antibiotics cause prolonged QT complex?

• macrolide

• fluoroquinolones

which antibiotics treat resp infections?

• nitrofurantoin

• cephalosporins

• penicillin

• macrolide

• fluoroquinolones

PENICILLIN

• MOA?

• treats what?

• adverse side effects?

• cross-sensitivities?

• notes?

• inhibit cell wall synthesis

• UTI, resp tract infections, STI (important mentions: gonorrhea, syphilis)

• allergic reaction, anaphylaxis, reduce oral contraceptives

• cephalosporins

• avoid grapefruit/acidic fruit/juice + contains beta lactam ring in structure

CEPHALOSPORINS

• what prefix or suffix does these drugs have?

• MOA?

• treats what?

• adverse side effects?

• cross sensitivities?

• notes?

• how many generations of cephalosporins are there?

• which generation treats MRSA? which specific cephalosporin drug treats MRSA?

• which generation treats meningitis

• which generation treats otitis media?

• Cef- or ceph-

• inhibit cell wall synthesis

• otitis media + MRSA, lower resp infections (ex: strep throat) + pharyngitis, tonsillitis + UTI + used for prophylaxis reasons

• allergic reaction + anaphylaxis + disrupts oral contraceptives

• penicillin

• avoid antiacids, alcohol, iron + contains beta lactam ring in structure

• 5 generations total

• 5th gen (specifically the drug ceftaroline)

• 3rd and 4th gen

• 1st gen

which antibiotics disrupt oral contraceptives?

• tetracyclines

• sulfanomides

• macrolides

• Penicillin

• cephalosporins

which antibiotics are dangerous for preggo women?

• tetracyclines

what is the ONLY FULLY EFFECTIVE antibiotic against MRSA?

ceftaroline (a 5th generation cephalosporin)

what are the normal values for these things:

• creatinine?

• BUN

• potassium?

• urine output?

• ALT

• AST

• 0.6-1.2

• 7-20

• 3.5-5 = good

• above 30 urine = good

• 4-46

• 8-33

which antibiotics should u avoid antiacid?

hint: all the meds that contain beta-lactam ring require acidic enviornment to dissolve and be effective = hence we cant use anti-acid

• penicillin

• cephalosporin

• carabpenem

• tetracyclines

• fluoroquinolones

which antibotics disrupt oral contraceptives?

• tetracycline

• sulfanomides

• penicillin

• cephalosporins

• macrolides

which antibiotics used for prophylaxis?

cephalosporins

penicillin

which antibiotics need to avoid juice/grapefruit/acidic fruit

penicillin

CARABPENEMS

• suffix associated with these drugs?
  MOA?

• used for?

• normal side effects?

• adverse side effects?

• notes?

• -penem

• inhibit cell wall synthesis

• complicated infxns for hospitalized patients

• rash

• seizure

• contains beta lactam ring in structure + cross sentitivity with penicillin, must be infused slow over 1 hr

• how long MUST vancomycin be infused to avoid red man syndrome?

• what r the optimal trough levels for vancomycin?

• how long MUST carabpenem be infused?

• infuse slow over 1 hour

• 10-20 mcg/mL

• infuse slow over 1 hr

3 penicillin derivatives (u want to know these bc they dont end in -cillin)?

 clavulanate, sulbactam, and tazobactam

***hint: sulli kpop idol on tazo skinny tea and her clavicles are poppin out bc so skinny***