ULTIMATE Pharmacology Study guide (YOU GOT THIS!!)

Antibiotics Anti-Inflammatories Glucocorticoids RA Gout Anticoagulants Parkinson's Disease AEDs Antispasmodics Depression Anxiety Insomnia Psychiatric Disorders Laxatives Men and Women's Health Hemodynamics

Name four penicillins

1. Piperacillin

2. Ticarcillin

3. Amoxicillin

4. Ampicillin

Penicillin is used mostly for Gram ____ bacteria, unless there is an extended spectrum.

positive

When should penicillin be given?

On an empty stomach. Either:

1. 1 hour before eating

2. 2 hours after eating

Penicillin is the safest known antibiotic, but it can combat the effects of _____ _____

birth control

What are the five most common allergic reactions to penicillin?

1. Rash

2. Hives

3. Wheezing

4. SOB

5. Increased HR

Penicillin is used for ______, ______ and these four types of infections:

Pneumonia; Meningitis

1. Joint

2. Blood

3. Valve

4. Stomach

Name five Macrolides (CADET)

1. Erythromycin

2. Azithromycin (Zithromax)

3. Clarithromycin (Biaxin)

4. Dirithromycin (Dynabec)

5. Troleandomycin (Tao)

A macrolide is an alternative to _____ for patients who are allergic to _____.

penicillin; penicillins

Macrolides are contraindicated in patients with what kind of disease?

hepatic disease

What is the most common adverse reaction to macrolides?

Increased GI motility (DIARRHEA)

A macrolide is a ____ spectrum antibiotic that inhibits bacterial ______ _______

broad; protein synthesis

Are macrolides big or small molecules?

BIG BOYS

Which antibiotics interact with P450 in the liver?

Macrolides

Macrolides have good compliance 1 or 2x a day. They are used for ______ infections, _____ ______, and uncomplicated ____ infections.

respiratory; otitis media; skin

Name five Aminoglycosides

1. Amikacin (Amikin)

2. Gentamicin (Gentak, Garamycin)

3. Neomycin (Neomycin Sulfate)

4. Kanamycin

5. Tobramycin (Tobrex)

Aminoglycosides are _____ spectrum drugs that target aerobic Gram ___ Bacilli bacteria by disrupting ____ _____.

Narrow; Negative; protein synthesis

Concentration dependent aminoglycosides lead to ____ and _____

peaks; troughs

How are Aminoglycosides administered?

IV (not absorbed from GI tract)

Aminoglycosides are not used for meningitis or Spinal cord related infections because they can’t enter the ____. They are also rapidly excreted by the ____

CSF; kidneys

What are two adverse reactions of Aminoglycosides?

1. Ototoxicity (impairs both hearing and balance)

2. Nephrotoxicity (Fries renal tubules) (related to cumulative dose)

When aminoglycosides are at risk for causing nephrotoxicity, what should be measured?

Peaks and troughs (to measure highest and lowest therapeutic effects when drug is in blood)

Aminoglycosides are rarely prescribed as monotherapy. Renal labs should be checked _____ (before/ after) administration because they bind tightly to renal tissue.

BEFORE

Nalidixic acid (NegGram), Cinoxacin (Cinobac), Ciprofloxin (Cipro), Moxifloxin (Avelox), and Tovafloxacin (Trovan) are all

Fluroquinolones

Fluroquinolones are ____ spectrum drugs but are used for mostly gram ______ bacteria

broad; negative

What do fluroquinolones inhibit?

DNA Gyrase

Fluroquinolones are used for ______, ____, ______, and these five types of infections:

Anthrax; STD’s; Diarrhea

1. UTI’s

2. Respiratory Tract Infections

3. Skin infections

4. bone infections

5. joint infections

What are the three most common adverse reactions to fluroquinolones?

Nausea

Vomiting

Diarrhea

What are the two rare adverse reactions of fluroquinolones?

Deep tendon rupture

Prolonged QT intervals

Fluroquinolones have good compliance in the body 1 or 2x a day, but caution must be taken in patients with problems in three different areas:

1. CNS

2. Liver

3. Renal

Which fluroquinolone is most commonly used for anthrax?

Ciprofloxacin

Fluroquinolones have potential drug interactions with ______ and _______

Theophylline and Warfarin

How can fluroquinolones be administered?

IV or PO

Fluroquinolones are absorbed easily, but absorption can be reduced by Aluminum and Magnesium containing ______

antacids

What are three carbapenems?

1. Imipenem/ Cilastin (Primaxin) (Seizurecillin)

2. Meropenem (Merrem)

3. Ertapenem (Invanz)

Carbapenems are ____ spectrum drugs reserved for the BIG infections like:

Broad

1. UTI’s

2. Lower Respiratory tract infections

3. Bone infections

4. Joint infections

5. Skin infections

6. Intra-Abdominal infections

7. Bacterial Septicemia (Blood Poisoning)

8. Endocarditis

What is the only way to administer carbapenems?

IV ONLY

50% of patients allergic to ______ will also have an allergy to _______

Penicillin; Carbapenems

_______ is a normal body enzyme, but it’s tubular secretion is blocked by renal dehydropeptidase, so ______ is combined with the enzyme to prevent inactivation.

Imipenem; cilastin

Carbapenems are at risk for cross sensitivity. An adverse reaction of using carbapenems can also create this GI infection.

C. DIff

The imipenem/ cilastin (primaxin) carbapenem should be taken with caution for patients with epilepsy, so it is also known as ______

seizurecillin

Carbapenems are known to be the AK47 (big guns) because they are only used if __________

absolutely necessary!!!!!

Name four b-lactamase inhibitors:

1. Ampicillin/Sulbactam (Unasyn)

2. Amoxicillin/ Clavulanic Acid (Augmentin)

3. Ticarcillin/Clavulanic Acid (Timentin)

4. Piperacillin/Tazobactam (Zosyn)

What is the mode of action for b-lactamase inhibitors?

To combine with extended spectrum penicillin to extend the antimicrobial spectrum.

Vancomycin is a tricyclic ________. It is usually given through __ except in the cases of pseudomembranous colitis. Vanco releases ______ which decreases BP. It is dangerous because it can cause ________ and ________. Labs to check include ___, ___, ___ and ___

glycopeptide; IV; histamines; nephrotoxicity; cytotoxicity; BUN, Cr, peaks, troughs

Erythromycin is a ______. It is a ____ spectrum drug used both for ____ and ____ bacteria. It is a great alternative to _____ for those who are allergic. It can cause _____ due to ______ gastric mobility

macrolide; broad; gram + and gram -; penicillin; diarrhea; increased

Fluroquinolones include drugs that end in ______, like _______. There is a high risk for ________. They are used for _____ and can cause ___ interval problems and cardiac arrhythmias

-floxacin; ciprofloxacin; deep tendon rupture; anthrax; Q-T

Tetracyclines are ____ spectrum drugs. They are good for ___, Chlamydia and Gonorrhea. They can rot ___ and cause sensitivity to _____. You don't want to take these with ___ and you want to drink water to avoid ________ erosion. You also don't want to give to _____ people or children under __

Broad; STD's; teeth; sunlight; calcium; esophageal; pregnant; 8

Penicillin is a cheap drug and the safest ______. It is mostly for gram __ unless there is an extended spectrum. Side effects can range from ____ to _____ and occurs in patients with ____

antibiotic; +; rash; anaphylaxis; allergies

Penicillin's have a cross-sensitivity to what drug?

Carbapenems

Penicillin is problematic when used with

birth control

Cephalosporins have __ generations. Generations 1 to 4 get better are reaching the ___, better at inhibiting ______, and better at fighting gram __ bacteria

5; CSF; beta-lactamase; -

Cephalosporins 5th generation like ____ is used for ____. Side effects occur in the ____ and the ____. Side effects include _____, ___, ____, and ____

Ceftarolene; MRSA; thymus; kidneys; diarrhea; vomiting; rash; headache

E coli is gram - or gram + ?

gram -

Staphylococcus is gram - or gram + ?

gram +

Streptococcus is gram - or gram + ?

gram +

After colectomy, the patient needs abdominal anaerobic antibiotics. Which ones?

- Clindamycin (can cause pseudomembranous colitis by altering the normal bacteria in the colon and encouraging overgrowth Clostridium difficile)

- Metronidazole

What drug is used for Epilepsy?

- Imipenem

Should you give Imipenem to seizure patients?

NO

What drug is used for C. Diff?

Metronidazole

Why shouldn't you take Metronidazole with alcohol?

It can cause severe abdominal pain

What are 2 superinfections

- Yeast infections

-C. diff

Gentamycin is an ______. It must be used on a ___. It is used for gram __ and is dangerous because it can fry _______. Labs include ____, ___, ___ and ____

Aminoglycoside; pump; renal tubules; BUN, Cr, peaks and troughs

Vancomycin, Daptomycin, and Ceftarolene are all used for

MRSA

Daptomycin is a

- cyclic glycopeptide

Daptomycin is great for ___ but bad for ___ because it decreases ____

skin; lungs; surfactant

Ceftarolene is the __ gen _______. It can be toxic to the ____ and is better at all 3 cephalosporin traits

5th; carbapenem; kidneys

Penicillin, Vancomycin, and __ and __ cephalosporin generations are used for gram __ bacteria

1st; 2nd; +

antibiotics for Gram - coverage include ______ and __ and ___ cephalosporin generations

Aminoglycosides; 3rd; 4th

Sulfa drugs are used to treat ___ and ___ infections with a major side effect being a ________

UTI's; ear; burning rash

Fluconazole is an anti-fungal used for ____ infections

yeast

What does half-life mean?

- 50% of the drug degrades

Half life drugs

- Naprosyn (lasts longer than Ibuprofen)

-Morphine

-Sulfate

- Adenosine (used for ventricular tachycardia) (helps in restoring rhythmic heartbeat) (can stop the heart for seconds)

- Succi Coline (paralyzes patient before admitting tube)

- Lorazepam (For anxious patients who pull out tubes)

Ideal qualities for a drug

- Effectiveness (does it work?)

- Safety (will it cause harm?)

- Selectiveness (does it elicit a response for the intended purpose?) (don't want to kill other cells)

- Profiled to the individual

Antagonist ______ receptor activation and must have an ____ around to work

prevents/ blocks; agonist

Agonist ________ receptors and _______ intrinsic activity

activates; promotes

Cytochrome P450 is the main enzymatic system to _______ drugs. It also determines how long the drug stays in the body

metabolize

ED50

Effective dose for 50% of national population

LD50

- Lethal dose for 50% of national population

The wider the dose,

the safer the drug

What are the most important organs for excretion and metabolism that changes with age?

Kidneys and liver

Factors affecting reabsorption

- routine

-pH

-Surface area

-blood flow to area

- ability to dissolve/ dissolution of a product (people would rather use liquids than solid, oral medications)

First pass effect occurs in all ____ drugs. It is absorbed in the GI tract and then carried directly to the ____ via the hepatic portal vein. It causes rapid hepatic inactivation of certain oral drugs before they reach their target sites or systemic circulation

oral; liver

Drug distribution is the process by which the drug is delivered to the ___ and ___ of the body

tissues and fluids

In drug absorption, drugs have to be absorbed across the _________

cell membranes. (phospholipids)

drug administration is the movement of a substance from the site of ______ across the body _____ to circulating fluids

administration; membranes

What are the 2 types of anti-inflammatory drugs?

NSAIDS and glucocorticoids

Is Tylenol an anti-inflam drug?

NO

NSAIDS are used for four things

1. inflammation

2. pain control

3. fever (pyretic)

4. Menstrual cramps (dysmenorrhea)

NSAIDS are used for the treatment of

gout

Aspirin is used only for the prophylaxis of _____ disease (including _____ and ____) and the prophylaxis of possible ___ cancer

heart; myocardial infarction; stroke; colon

NSAID's work to inhibit cyclooxygenase, AKA _____

COX

COX is the enzyme that converts arachidonic acid into ______ in all tissues

prostaglandins

Prostaglandins are made at sites of tissue damage or infection to cause 3 things (FIP)

1. Fever

2. Inflammation

3. Pain

COX 1 protects the mucosa of the __, supports ____ function, and promotes aggregation of ______

GI; renal; platelets

COX 2 is ____ COX because it sensitizes receptors to _____ stimuli in tissue and the ____

bad; painful; brain

Aspirin, Ibuprofen, Ketorolac, and Indomethacin are all ___ gen NSAIDS that inhibit _______

1st; COX 1 and COX2

Celecoxib (Celebrex) is the __ gen NSAID to only inhibit ___. It is not proven to be better or safer that __ gen and it can increase the risk of _____

2nd; COX-2; 1st; MI/ Stroke

are NSAIDs addicting?

NO

Do NSAID's cause sedation?

NO

What is the antidote for NSAID's

nothing