pharm - ID1.txt

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tallone4830
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pharm - ID1.txt
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2012-06-12 21:15:38
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pharm ID1
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pharm - ID1.txt
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  1. natural penicillins
    Pen V oral, Pen G IV (Pen G Benzathine/Procaine = long-acting IM)
  2. aminopenicillins
    amoxicillin (Amoxil) oral, ampicillin oral/IV
  3. aminopenicillin + b-lactamase inhibitors
    amoxicillin-clavulanate (Augmentin) oral, ampicillin-sulbactam (Unasyn) IV
  4. narrow spectrum penicillins
    dicloxacillin oral, nafcillin IV(only), oxacillin IV
  5. extended spectrum penicillin
    piperacillin IV
  6. extended spectrum penicillin + b lactamase inhibitors
    piperacillin-tazobactam (Zosyn) IV(only), ticarcillin-clavulanate (Timentin) IV(only)
  7. probenecid
    benificial interaction c penicillins -- compete for same transporter in kidney
  8. amoxicillin dosing
    Amoxil 500-875 BID, max 4g/d
  9. amoxicillin-clavulanate dosing
    Augmentin 500-875/125 BID
  10. pen VK dosing
    500 BID-TID x 10d
  11. strep throat
    penicillin
  12. otitis media
    amoxicillin
  13. hospital acquired pneumonia (likely MDR)
    piperacillin-tazobactam (Zosyn)
  14. 1st generation cephalosporins
    cePHALexin (Keflex), ceFADroxil (Duricef), ceFAZolin
  15. 2nd generation cephalosporins
    cefAClor (Ceclor), cefPROzil (Cefzil), ceFURoxime, ceFOXitin, ceFOtetan
  16. 3rd generation cephalosporins
    cefDINir (Omnicef), cefTRIazone (Rocephin), all the other cefs
  17. 4th generation cephalosporins
    cefepime
  18. 5th generation cephalosporins
    ceftaroline
  19. cephalosporin MOA
    b-lactams, mess with cell wall PBPs. moltiple modifiable sites, so more resistant to cleavage by b-lactamases.
  20. penicillin MOA
    b-lactams, mess with cell wall PBPs.
  21. MRSA
    ceftaroline
  22. cephalosporin c CNS penetration
    3rd generation
  23. cephalosporin c long half life (ODD)
    ceftriaxone (Rocephin)
  24. cephalosporin interaction
    cefotetan+ethanol (disulfiram-like rxn)
  25. cephalexin dosing
    Keflex 1G 1000-4000/d div BID-QID
  26. cefdinir dosing
    Omnicef 3G
  27. wound
    cephalexin 1G
  28. carbapenems
    meropenem (Merrem), ertapenem (Invanz), doripenem (Doribax), imipenem-cilastatin (Primaxin - cilastin inhibits breakdown if imipenem in kidney)
  29. carbapenems MOA
    b-lactams, mess with cell wall PBPs. parenteral only.
  30. drug-resistant UTI
    doripenem
  31. glycopeptide
    vancomycin (Vancocin)
  32. vancomycin MOA
    inhibits peptidoglycan synthesis by attatching to end of peptidoglycan and being bulky
  33. vancomycin kinetics
    poorly absorbed orally, so route based on where the infection is (GI vs outside)
  34. vancomycin SE
    neutropenia, hearing loss (especially c aminoglycosides), nephrotoxicity, red man syndrome (c rapid infusion)
  35. fluoroquinolones
    ciprofloxacin (Cipro), levofloxacin (Levaquin), moxiflixacin (Avelox), gemifloxacin (Factive), norfloxacin (Noroxin), ofloxacin (Floxin)
  36. fluoroquinolones MOA
    target DNA and replication by inhibiting DNA gyrase (topoisomerase)
  37. parenteral/oral fluoroquinolones
    Cipro, Levaquin, Avelox. all others oral only. Avelox only one not excreeted renally.
  38. fluoroquinolones interactions
    fluoroquinolone+cations (chelation)
  39. fluoroquinolones SE
    achilles tendon rupture, QT prolongation
  40. ciprofloxacin dosing
    Cipro 250-750 BID
  41. levofloxacin
    Levaquin 500-750 PO/IV qd x 5-7d
  42. complicated UTI
    ciprofloxacin
  43. respiratory fluoroquinolones
    Levaquin, Avelox, Factive
  44. aminoglycosides
    oral = neomycin, paromomycin, tobramycin inhaled (Tobi). parenteral = streptomycin, gentamicin, tobramycin, amikacin ,kanamycin
  45. aminoglycosides MOA
    protein synthesis inhibitors, also attack/put holes in outer bacterial membrane (they are polar molecules).
  46. aminoglycosides SE
    ototoxicity, nephrotoxicity (accumulation in tubules)
  47. lincosamides
    clindamycin (Cleocin)
  48. clindamycin MOA
    inhibit protein synthesis (bacteriostatic). also because toxins are often proteins, lincosamides are helpful in toxin-producing infections (necrotizing fasciitis, toxic shock syndrome)
  49. tetracyclines and glycylcyclines
    tetracycline, doxycycline (Vibramycin), minocycline (Minocin), demeclocycline
  50. tetracyclines MOA
    inhibit protein synthesis (bacteriostatic).
  51. tetracyclines contraindications
    PREGNANCY
  52. tetracyclines interactions
    TCA+cations (chelation)
  53. tetracycline SE
    photosensitivity, teeth mottling (core ring is a chelator of calcium, causing discoloration and Ca deposition in growing bones, so avoid in kids). minocycline also hyperpigmentation.
  54. doxycycline dosing
    Vibramycin 100 BID day 1, qd day 2+
  55. TCA uses
    acne/rosacea, malaria/Lyme prophylaxis, atypipcal infections, magic mouthwash
  56. SIADH
    demeclocycline (inhibits binding of ADH to its receptor)
  57. macrolides
    erythromycin, azithromycin (Zithromax), clarithromycin (Biaxin)
  58. macrolides MOA
    inhibit protein synthesis, bacteriostatic. they are delivered to the site of infection by macrophages.
  59. macrolides kinetics
    erythromycin is unsable in gastric acid (enteric coating or parenteral). azithromycin given for 5 days, stays in system for 10 (no CNS).
  60. erythromycin indication
    also for gastroparesis
  61. macrolides interactions
    erythromycin/clarithromycin are CYP3A4 inhibitors
  62. macrolides SE
    GI (particularly erythromycin), QT prolongation, liver impairment
  63. azithromycin dosing
    Zithromax 500 x1 day 1, 250 qd day 2-5
  64. oxazolidinones
    linezolid (Zyvox)
  65. linezolid MOA
    inhibits protein synthesis (bacteriostatic)
  66. linezolid interactions
    linezolid is a weak MAOI...
  67. linezolid SE
    thrombocytopenia, anemia, leukopenia. serotonin syndrome, neuropathies. hyperlactatemia, metabolic acidosis.
  68. sulfonamides and folate synthesis inhibitors
    trimethoprim-sulfamethoxazole (Bactrim, Septra), sulfisoxazole-erythromycin, sulfadiazine
  69. sulfonamides MOA
    bacteria are unable to absorb folate like humans. sulfonamides competitively inhibit PABA, the first reaction in the folate synthesis pathway. trimethoprim blocks the last step in the pathway.
  70. sulfonamides SE
    stevens-johnson syndrome, kernicterus (bilirubin-induced brain dysfunction -- contraindicated in pts <2 months)
  71. imidazoles
    metronidazole (Flagyl)
  72. metronidazole MOA
    anaerobic bacteria naturally reduce the prodrug metronidazole to its active form via an enzyme called ferredoxin. once reduced, it is postulated to lead to toxic products that result in DNA breakage and subsequent cell death.
  73. imidazole interactions
    metronidazole+ethanol (inhibits aldehyde dehydrogenase, resulting in buildup of toxic metabolites)
  74. metronidazole SE
    metallic taste, furring of the tongue
  75. MDR TB
    resistant to isoniazid and rifampin
  76. XDR TB
    resistant to isoniazid, rifampin, fluoroquinolones, 1+ second line drugs
  77. primary vs secondary resistance
    primary = initial infection, secondary = acquired during TB therapy
  78. first-line TB
    isoniazid + rifampin + pyrazinamide + ethambutol for 4 months, followed by isoniazid + rifampin (or alternate) for 2 months
  79. latent TB
    isoniazid for 6-9 months
  80. ethambutol MOA
    blocks formation of cell wall in organisms c mycolic acid, bacteriostatic.
  81. ethambutol SE
    optic neuroitis (decr vision, red/green issues)
  82. isoniazid MOA
    prodrug activated by mycobacterial bacterial katG, inhibits mycolic acid synthesis by blocking InhA.
  83. isoniazid interactions
    hepatic enzyme inducer. isoniazid+warfarin (increases INR)
  84. isoniazid SE
    hepatitis, peripheral neuropathy (can be combated by vitamin B6 (pyridoxine))
  85. pyrazinamide MOA
    prodrug activated by mycobacterial pyrazinamidase, also inhibits mycolic acid synthesis
  86. pyrazinamide SE
    hepatic injury
  87. rifamycins
    rifampin, rifabutin, rifapentine
  88. rifampin MOA
    very lipophilic, so easily penetrates bacteria/biofilms (and CNS too!). Inhibits RNA synthesis by binding bacterial RNA polymerase
  89. rifampin indications
    can also be used outside TB for other infections, usually in combinations (good gr +, moderate gram -, good for N. meningitidis)
  90. rifampin interactions
    induces both CYP enzymes and P-glycoproein transporters. rifampin+warfarin (decreases INR)
  91. rifampin SE
    red-orange secretions, hepatitis

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