Pharm Test 1.

It is the beginning of the semester, less than 2 weeks in and here comes a big exam, Pharmacology exam 1.

Folate

  • Sulfonamides [sulfamethoxazole + Trimethoprim SMX – TMP] Bactrim, Septra

Bacteriostatic: inhibits the growth of bacteria:

    • prevents synthesis of folic acid = Antimetabolites
    • Sulfonamides primary treatment for UTI
    • Treats Upper Respiratory Tract infections
    • Also, Treats HIV-associated Pneumonia

 

Adverse Effects

  • Blood: Agranulocytosis, Aplastic Anemia, Thrombocytopenia.
  • GI: Hepatotoxicity, Pancreatitis
  • Skin: Photosensitivity, Dermatitis, Steven-Johnson Syndrome

DNA

Quinolones (-floxacin) Levofloxacin, Ciprofloxacin, Gemifloxacin

These are Bactericidal: they alter DNA of the bacteria cells, causing the death of the bacteria.

Indications (Uses)

  • Complicated UTI’s
  • Respiratory
  • Bone, Joint, Skin
  • STD’s
  • Anthrax (ciprofloxacin)

Interactions

  • Antacids
  • Calcium
  • Oral Anticoagulants
  • Nitrofurantoin
  • Enteral Tube Feedings

Adverse Effects

  • CNS: Depression, restlessness
  • GI: p-450 inhibitor
  • Skin: Rash, pruritus
  • Other: Ruptured tendon, Tendonitis, Blurred Vision

Metronidazole (Flagyl)

  • It is a Bactericidal: It interferes with Bateria DNA: causing Cell Death
  • Anaerobic organism [GI]
  • When taking Flagyl be sure to avoid all forms of ALCOHOL 24 prior to and 36 hours post medication
  • Non-Bronchodilating Respiratory Drugs

    Leukotriene Receptor Antagonist (LTRA’s): Leukotriene causes inflammation, bronchoconstriction and mucus production.

    • Montelukast (Singulair): LTRA’s prevent/block leukotrienes from attaching to the receptors.
    • Zafirlukast (accolate): LTRA’s prevent/block leukotrienes from attaching to the receptors.

    Corticosteroids

    • Budesonide (Pulmicort)
    • Fluticasone (flovent>
    • Flunisolide (AeroBid)
    • Prednisone
    • Methylprednisone

    They prevent/stabilizes cells from releasing inflammatory agents. They increase bronchial smooth muscle response to Beta-Adrenergic Stimulation.

    Contraindications

      • Those with systemic fungal infections.

    Adverse Effects

        • coughingDry mouth
        • Oral Fungal Infection: Be sure to rinse mouth after use

    Monoclonal Antibody: Antiasthmatic
    Omalizumab (Xolair) – Binds to Immunoglobulin E = Limits the Release of Mediators of the allergic response.

 

Alpha 1: Vasoconstrict- sphincter, muscle

Beta 1 increases heart rate (increases Cardio)

Beta 2: VasoContrict,Bronchodilator

 

Beta-Adrenergic Agonist: [Short Acting Beta Agonnist + Long Acting Beta Agonis] :adrenergic receptor of sympathetic system, also vasocontrictor.

Non-selective: epinephrine/Epi – Pen: alph 1, Beta 1, Beta 2.
Non- Selective Beta – Metaprolol: Beta 1, Beta 2.
Selective Beta: Albuterol/Ventolin: Beta 2

Indications:

  • prevention
  • releif
  • Acute attacks
  • Hypotension
  • Shock

Contraindications

  • allergy
  • hypertension
  • Dysrhythmias
  • stroke

Anti-Cholinergics : Blocks ACH (Bronchial contrictor) from binding to airway.

Tiotropium (Spiriva)

Ipratropium (Atrovent): Oldest and most common: use BID (Twice Daily).

Indication: Action is slow/ Prolonged. Used for prevention.

Contraindications: Known allergy.

Xanthine Derivatives: Increases cAMP production causing smooth muscle relaxation and Bronchodilation.

Theophylline: Bronchodilator: therapeutic range 10-20 mcg/ml
Caffeine.

Indication:

  • prevention
  • Not management
  • Potential for drug interaction.

Contraindications:

  • dysrhythmias
  • seizures
  • hyperthyrodism
  • cardiac disease.

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