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  1. ARVS
    NRTIs names?
    NNRTIs names?
    PIs names?
    • Nukes- AZT, 3tC, DDI, D4T
    • Non Nukes- EFV, NVP (Nevirapine)
    • Protease Inhibitors-Lopinavair, Ritonavir
  2. How do nukes work?
    grab DNA reverse transcriptase is trying to build
  3. How do non nukes work?
    hook reverse transcriptase itself to keep it from working
  4. How do PIs work?
    prevent final assembly of virus
  5. Who needs ARVs?
    • Depends on CD4 count (WHO stage II w CD4 count below 350mm3
    • clinical sx (opportunistic infections)
    • do they want to
    • WHO stage 3 of HIV disease regardless of CD4 count
  6. ARV tx success?
    by 24 weeks less than 400 copies/mL
  7. HIV SEs
    drug adverse effects
    anorexia, sore dry mouth, swallowing difficulties, constipation/diarrhea, n/v/altered taste, depression tiredness lethargy

    Lactic acidosis, hepatox, pancreatitis, peripheral neuropathy, fat accumulation, hyperlipidemia, premature CAD, hyperglycymie, insulin resistance/DM, bone disorders, osteoperosis, bone marrow suppression, hypersensitivity reactions, skin rashes
  8. What ABs can cause renal toxicity?
    aminoglycosides and sulfanamides, flouroquinalones
  9. What abs can cause thrombocytopenia
    penicillins and cephalosporins
  10. ABs and weird side effects in kids
    weight bearing joint effects?
    ototoxicity and nephrotoxicity?
    blacken teeth
    liver and kidney monitoring in babies?
    • flouroquinalones
    • aminoglycosides
    • tetracyclines
    • clindamycin
  11. which ABs alter membrane perm?
    PCNs, cephalo, vanco
  12. which ABs inhib protein sybnth
    EES, tetracyclines, clindamycin, aminoglycosids
  13. Which ABs inhibit nucleic acid syth?
    flouroquinalones, HIV anti retrovirals
  14. Which AB inhibits cell metab and growth?
  15. Which ABs effect bacterial cell walls?
    • Penicillins
    • Cephalosporins-cefotaxime
    • Vancomycins-vancomycin
    • Carbapenems-meropenem
    • Monobactam
  16. Which ABs have beta lactam?
    penicillins, cephalosporins, carbapenems
  17. broad spectrum ABs
    • cephalosporins
    • Carbapenems
    • Tetracyclines
  18. ABs w AEs other than nvd and allergies
  19. cephalosporins
    don't give if
    • pt is allergic to penicillins
    • Oral—Keflex (cephalexin); Ceclor (cefaclor), Lorabid (lorcarbef); Omnicef (cefdinir)
    • Parenteral—Ancef (kefzol); Mefoxin (cefoxitin); Claforan (cefotaxime), Fortaz (ceftazidime), Rocephin (ceftriaxone); Maxipime (cefepime)
  20. Carbapenems (meropenem, primaxin)
    how given?
    all parenteral
  21. Monobactam (azactam, aztreonam)
    • has beta lactams, but stable in presc of beta lactamase
    • active against g- bacteria, lots of resistant strains
    • preserves normal g pos and anaerobic flora
  22. ABs affecting protein synthesis
    • aminoglycosides- gentamycin
    • tetracyclines-tetracycline
    • macrolide antibiotics-erythromycin
  23. Narrow spectrum ABs
  24. Bacteriocidal ABs
    Aminoglycosides/gentamycin (G- orgs), flouroquinalones (cipro)
  25. Aminoglycosides
    what do they do? How? spectrum?
    How do you check therapeutic levels?
  26. cidal G-, G+, narrow spect
    • protein synth inhibitors
    • pneumonia, MRSA, some URIs, endocarditis, bacteremia, sepsia, skin infections, UTIs
    • accumulate in kidneys and ears
    • ototox, nephrotox
    • Peak and trough
  27. Bacteriostatic ABs
    Sulfas, Tetracyclines
  28. What AB do they give for chlamydia, mycoplasma, protozoa?
  29. What AB causes renal and phototoxicity and kid's teeth blue?
  30. What do macrolides (erythromycin, Zithromax (azithromycin), Biaxin (clarithromycin), and Dynabac (dirithromycin) work against?
    what kind of tox is risk?
    DDIs with
    • G+ cocci like Neisseria, terponema, mycoplasma, bacteroides, clostridia, corynebacterium
    • liver/hepatic
    • coumadin, theophylline, prednisone, norpace, lanoxin, tegretol, alfenta, parlodel (dopamine agonist)
  31. What ABs are contraindicated in liver disease?
    flouroquinalones, macrolides
  32. photosensitivity
    Fucking terrible sunburn
    flouroquinalones, macrolides, sulfanamides
  33. Vancomycin
    often treats
    • MRSA
    • G + only, hypotension, flushing, rash
  34. Cleocin (clindamycin)
    • G+ cocci
    • good for acne and BV
    • can cause colitis
  35. Flagyl
    • good against clostridium and protozoa like giardis, amebiasis, trich
    • topically for rosacea, BV
    • avoid ETOH
  36. Aminoglycoside DDIs
    amphocerin, vancomycin, cephalosporins, loop ds, neuro blocking agents can inc effects
  37. What are sulfas used for
    UTIs, pneumocystis carinii
  38. Which ABs can cause bone marrow depression, folic acid def, and cholestatic jaundice?
    may cause crystalluria, tx ulcerative colitis and RA
  39. silver sulfadiazine is useful in_____
  40. Antifungals
    • fluconazole (Diflucan)
    • Nystatin (P), (Mycostatin)
    • may be used orally, topically or vaginally
    • generally well tolerated
  41. Acyclovir is a_________
    • antiviral
    • HSV, Herpes zoster
    • lightheadedness, anorexia, n/v, HA
    • confusion, tremors, sz
    • IV may be nephrotoxic
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