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Antibiotics

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oeshnoeugo123's version from 2018-01-09 02:07

Smoking Cessation and Migraine

Question Answer
Bupropion (Zyban)MOA is DA and NE reuptake inhibition
Bupropioncaution with seizure prone patients and increases suicidal thinking
Varenicline (Chantix)Nicotine receptor antagonist
Vareniclineincreases suicidal thinking, increases incidence of stroke and heart attack
MidrinAbortive therapy for headaches. Combination analgesic containing acetaminophen, with a vasoconstrictor and a sedative.
TriptansAbortive therapy for headaches. 5-HT1B/1D receptor agonists which block effects of serotonin, cause vasoconstriction
Prevention of Migrainesbeta-blockers like propranolol, calcium channel blockers like verapamil, anticonvulsants like valproate, and TCAs
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Parkinson's medications

Question Answer
Sinemetcombination of levodopa and carbidopa.
CarbidopaBlocks destruction of levodopa by dopa-B-carboxylase in peripheral tissues allowing increased penetration of levodopa into brain where it gets converted to DA.
Mirapexsynthetic DA receptor agonist,– has caused compulsive gambling in some patients
Selegiline (Eldepryl)MAO-B blocker, also can be used as an antidepressant
MAO-B blockerprevents breakdown of DA by MAO-B
EntacaponeCOMT blocker
COMT blockerprevents breakdown of DA by COMT
Cogentinanticholinergic agent used to reduce tremoring caused by excessive acetylcholine activity
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Anticonvulsants

Question Answer
GABAa major inhibitory neurotransmitter involved in the mechanism of action of benzodiazepines and barbiturates
Ethosuximide (Zarontin)anticonvulsant drug of choice for treating absence or petit mal seizures
Carbamazepine (Tegretol)anticonvulsant drug useful in treating trigeminal neuralgias (trigeminal neuralgia also tx by mixed acting Lamotrigine [Lamictal])
Valproic Acid (Valproate, Depakote)anticonvulsant that can alter blood coagulation ability thus shouldn’t be combined with aspirin
Lorazepam (Ativan)
Midazolam
Diazepam
Phenytoin (Dilantin)
benzodiazepine useful for treating status epileptics
Phenobarbitaldrug of choice for febrile seizures in children
Levitiracetam (Keppra)Ideal pharmacokinetics = rapid uptake & onset, no effects on liver enzymes, not plasma protein bound
Levitiracetam (Keppra)Novel mechanism of action, unlike other AEDS, basically unknown
Zonisamide (Zonegran)Combined effect of blocking Na channels & reducing T calcium currents
Phenytoin (Dilantin)anticonvulsant most associated with causing gingival hyperplasia
Pregabalin (Lyrica)marketed for relief of burning foot syndrome and fibromyalgia
Phenobarbital and Benzos (Diazepam, Ativan, Midazolam, Clonazepam)anticonvulsant that acts by enhancing the inhibitory action of GABA
Phenytoin (Dilantin)anticonvulsant that causes hypertrichosis (xcess hair growth)
Carbamazepine (Tegretol)anticonvulsant that can cause hepatotoxicity when combined with erythromycin
Phenytoin (Dilantin)anticonvulsant that is associated with fetal hydantoin syndrome (cleft palate)
Tiagabine (Gabatril)inhibits GABA reuptake
Ethosuximide (Zarontin)acts by blocking T calcium currents
Vagabatrin (Gabril) & Valproic acidinhibits GABA breakdown
Phenobarbitalmay cause paradoxical excitement in children
Topiramate (Topamax)anti seizure drug that combines the action of sodium channel inactivation, enhancement of GABA reuptake, and glutamate receptor block
Phenytoin (Dilantin) and Carbamazepine (Tegretol)sodium channel inactivator
Topiramatecommonly used drug for the management of mania in bipolar disorder
Lamotrigine (Lamictal)side effect of drug = Steven Johnson's syndrome - life threatening rash
Topiramate (Topamax)commonly used for migraine prophylaxis
Topiramate, Valproate, Lamotrigine, Zonisamideanticonvulsants that inhibit both voltage gated Na and Ca channels
Phenytoin (Dilantin), Carbamazepine (Tegretol), Oxcarbazepine, Felbamateanticonvulsants that inhibit ONLY Na channels
Ethosuximide (Zarontin)anticonvulsants that inhibit ONLY Ca channels
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CVD

Question Answer
Prazosin and TerazosinAlpha-1 selective blockers, inhibits nerve induced release of NE resulting in vasodilation
ClonidineCentrally acting Alpha-2 agonist, selective agonist stimulates alpha-2 receptors in the CNS to reduce sympathetic outflow to peripheral vessels resulting in vasodilation
PropranololNonselective beta blocker reduces cardiac output and decreases renin secretion
Atenolol and Metoprololselective beta-1 blocker, reduced cardiac output and decreases renin secretion
Labetalolalpha-1 block and non-specific beta block
MethyldopaCentrally acting alpha 2 agonist, decrease sympathetic outflow from CNS
Captopril and LisinoprilACE inhibitors
ACE Inhibitorblock the enzyme which converts angiotensin I to angiotensin II (a potent vasoconstrictor), decreases aldosterone release (decreases fluid retention)
ACE Inhibitor side effectsdry cough, angioedema, hyperkalemia
Losartan and ValsartanAngiotensin II receptor blockers
Angiotensin II receptor blockersprevents angiotensin II from binding to its receptor, same beneficial action as ACE Inhibitors without the side effects of dry cough and angioedema
Verapamil and DiltiazemCalcium Channel blocker, Type I
Type I Calcium Channel Blockerprimarily works directly on myocardium to reduce contractility as well as to some extent vasodilator
Type II Calcium Channel Blockervasodilates to reduce afterload
Nifedipine and AmlodipineCalcium Channel blocker, Type II
Diureticsdecrease the renal absorption of sodium, thus resulting in fluid loss and a reduction in blood volume.
HCTZThiazide diuretic
Lasixhigh ceiling, loop diuretic
Spironolactone and AmiloridePotassium sparing
Ace Inhibitor and diureticZestoretic
HyzaarAngiotensin II receptor blocker and diuretic
LotrelACE inhibitor and Calcium channel blocker
Nitroglycerinanti-anginal medication, increases oxygen supply to the heart by a direct vasodilatory action on the coronary arteries and reduced preload
Prophylaxis against angina attacksBeta-Blockers, reduce oxygen demand by preventing chronotropic responses to endogenous epinephrine, emotions, and exercise
Calcium Channel Blockersprophylaxis against angina attacks
Digitalisused in heart failure to as a positive inotropic agent, increasing the force of contraction of the myocardium. Reduces compensatory changes such as increased heart size, rate, and edema.
ACE Inhibitorused as 1st line therapy for congestive heart failure. Can prolong life expectancy by preventing enlargement of heart.
Loop Diureticsreduce fluid backup/ edema in heart failure.
Simvastatin (Zocor) and Atorvastatin (Lipitor)Statins
Pravacholstatin, pravastatin
StatinHMG_COA reductase, increases the number of LDL receptors in liver and enhances the removal of LDL from blood
Type 1A anti-arrythmicQuinidine, acts by increasing the refractory period of cardiac muscle
Type 2B anti-arrythmicLidocain, decreases cardiac excitability
Digitalis (Digoxin)used in atrial fibrillation by decreasing the rate of A-V conduction
Verapamil and DigoxinTreat supra ventricular arryhthmias
Warfarin (Coumadin)Inhibtis Vitamin K depepndent coagulation factors, measured by using INR
Heparin, Low Molecular Weight Heparin (lovenox)blocks conversion of prothrombin to thrombin. Effect measured by PTT.
HeparinIV, in the hospital setting
LovenoxSubcutaneous injection, used in the hospital for DVT Prophylaxsis and on an outpatient basis
AspirinProphylaxis against stroke and MI
Aspirininhibits thromboxane synthetase
Alpha-blocker side effectspostural hypotension, can potentially reverse epi
Beta-blocker side effectsincreases lipids, masks signs of hypoglycemic signs in diabetics, impotence.
Non-selective beta-blocker side effectspotentiation of insulin induced hypoglycemia, worsening of bronchoconstriction in asthmatics
Beta-Blocker and epinephrine interactionrisk of hypertension and bradycardia
Beta-Blocker and Lidocaine interactionslows the metabolism of lidocaine
Beta-Blocker and NSAIDs interactiondecreased antihypertensive effect of BB
Side effects of Captoprilcan alter taste sensation (dysguesia)
Side effects of Calcium-channel blockersankle edema, GI upset, headache, and postural hypotension
Nifedipine side effectsgingival hyperplasia
Side effects of Nitratesheadache
Side effects of Digoxinnausea, extrasystoles, yellow-green vision
Digoxin and Macrolide interactiondecrease GI bacteria that metabolize digoxin, therefore increasing plasma levels of digoxin
Diuretics side-effectshypokalemia
Statin side-effectsrhabdomyolosis
Statin and macrolide interactionincreased risk of rhabdo when the two are combined
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Antibiotics

Question Answer
Amoxicillin and Ampicillinan extended spectrum penicillin
Erythromycinhistorical alternative for PCN-allergic patients – unfortunately, resistance limits effectiveness
Fluoroquinolonesbroad spectrum, cidal, has side effects of weakening tendons and cartilage, especially in patients over 60 – FDA warning 2008
Doxycyclineactive ingredient in Atridox, an antibiotic gel placed into perio pockets
Bactrimcombines sulfonamide with trimethoprim; combination is cidal
Amoxicillincombined with clavulanic acid to form "AUGMENTIN"
Erythromycincan interact adversely with digoxin
Tetracyclinewill not be absorbed from GI tract if taken with antacids
Metronidazolebactericidal inhibits DNA synthesis
Tetracyclinebacteriostatic agent that sees use in periodontics for treating deep pocket infections; general dentistry use is limited due to problem of wide but unpredictable spectrum of activity
Penicillin Vkacid-stable form of penicillin used for oral administration
Ciprofloxacinbroad spectrum cidal – inhibits P4501A2, caution in patient taking theophylline, coumadin
Vancomycinbactericidal agent primarily used IV, active against Gm+ organisms; very little known resistance
Pen VKbactericidal drug; cell wall synthesis inhibitor
Tetracyclinebacteriostatic antimicrobial that inhibits growth and multiplication of bacteria by interfering with protein synthesis; can permanently discolor growing teeth
Clavulanic Acidirreversible inhibitor of beta-lactamase of penicillin resistant microorganisms; used in combination with amoxicillin in "AUGMENTIN"
Cephalexin (Keflex)structure and function similar to penicillin, but with 5-10% cross allergenicity
Clindamycinbacteriostatic alternative for patients allergic to penicillins
Metronidazolebactericidal agent useful primarily against anaerobic infections
Metronidazolecan cause Antabuse effect in alcoholics
Metronidazoleantibiotic used to treat C. dificile superinfection
Vancomycinhas adverse side effects of thrombophlebitis, deafness, renal toxicity and “Red Man Syndrome”
Metronidazoleused with penicillin as “poor man’s Augmentin”
Metronidazoleavoid use in patients with Crohn’s disease – can increase risk of GI cancer
Fluoroquinolonesinhibits DNA gyrase needed for the replication of DNA
Clarithromycinnewer macrolide antibiotic with reduced GI irritation
Amoxicillinprophylaxis standard for patients with prosthetic limbs
FluoroquinolonesFDA warning that this drug can cause tendon rupture and cartilage damage
Tetracyclinecan cause hepatotoxicity in patients with renal insufficiency
Ciprofloxacinantibiotic that inhibits P450-1A2
Azithromycintaken once a day for five days
Azithromycinmacrolide type antibiotic that is not an inhibitor of P450 3A4
Tetracyclineonly antibiotic drug class that is clearly pregnancy category D
Clindamycin and Erythromycinselective toxicity comes from this agent targeting the 50S ribosome
Minocycline"medication used for acne that can cause a grayish brown discoloration of the incisal 1⁄2-3/4 of the crowns of the teeth."
Cephalosporinsbactericidal agent (hint: it doesn’t start with the letter M) that may interfere with vitamin K synthesis and thus might increase risk of bleeding in the anticoagulated patient
Clarithromycinonly macrolide antibiotic that is not safe in pregnancy or renal compromised patients
Doxycycline"subantimicrobial dosing modulates host inflammatory response, suppressing collagenase, helping to treat periodontal problems"
Sulfonamidesselective toxicity is due to inhibition of folic acid synthesis
Penicillinbroad spectrum bactericidal – can be used in combo with metronidazole to treat AA (actinobacillus actinomycetemcomitans) periodontal infection
Metronidazolespectrum of activity extends only to gm+ and gm- anaerobes
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Amoxicillin : pediatric dose for this antibiotic would be 20-40 mg/kg in three divided doses per day

Antifungals

Question Answer
Nystatina polyene antifungal agent which acts by binding to a component in bacterial membrane called ergosterol and is useful in the treatment of Candida
Amphotericin Bsystemic antifungal agent ; can cause impaired renal function
Echinocanidansnew class of antifungal agents
Clotrimazoleimidazole antifungal
Fluconazole (Diflucan)antifungal that can inhibit the metabolism of certain drugs
Fluconazole (Diflucan)selective toxicity relates to its ability to inhibit the synthesis of ergosterol
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Antivirals

Question Answer
Docosanol (Abreva)non-prescription antiviral agent for the treatment of oral facial herpes simplex - prevents virus entering the cell by preventing fusion of human cell membrane with lipid envelope containing virus
Acyclovirprescription antiviral with good activity against Herpes
Acyclovirgets converted to triphosphate active form that inhibits viral DNA polymerase, terminating chain
Valcyclovir (Valtrex)not best choice for immunocompromised patients
NorvirHIV drug that inhibits cytochrome P-450 3A4
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