Question Answer
What is gram positive bacteria? It’s walls are composed of a uniform monolayer of peptidoglycans.
What color does gram + bacteria stain? Purple
Is gram + bacteria easier to kill? Yes
What is gram negative bacteria? It’s wall are composed of multiple layers, including an outer membrane and an inner peptidoglycan layer.
What color does gram negative bacteria stain? Pink
Is gram negative bacteria harder to kill? Yes
What are two types of gram positive bacteria? Staphylococci streptococci
What are some gram-negative bacteria types pseudomonas bacteroids campylobacter Haemophilus Klebsiella Legionella Mycoplasma
What is MIC? Minimal Inhibitory Concentration. The lowest concentration of antimicrobial agent that inhibits the growth of the orgaqnism.
What is MBC The minimum bacterial concentration determines killing activity associated with an antimicrobial.
What is the treatment for RSV? Anti-Viral called Ribavirin Administered via small particle generator (SPRAG) 12-18 hours daily, for 3-7 days
What is the treatment for MRSA? Vancomycin
What is the treatment for a tick bite? Tetracyclines (doxycycline)
What is the treatment for candida albicans? Anti funals such as Nystatin Monistat Diflucan Amphotericin B
What are Beta Lactans? Includes penicillins, cephalosporins, monobactams and penems
What is the action of beta lactams class? Act by inhibition of cell wall synthesis. Bacteria have the ability to develop resistance.
What is the mechanism of action for cephalosporins? inhibit cell wall synthesis. Derivative of Beta Lactams
How long do cephalosporins last? They have a longer half life than penecillin (outpatient parenteral dosing)
How many generations of cephalosporins are there? Four
What is the fourth generation of cephalosporins used for? Pneumonia UTI Skin Infections
Are cephalosporins very toxic? No
Penecillins Are A part of the Beta Lactams group Came about in the 1940’s and was the beginning of the antibiotic era.
How have researchers developed many penicillin derivatives? by changing the basic structure. Penicillin is a derivitave of the Beta Lactams class
What are the side effects of penecillin? Diarrhea
How do penecillins act? By inhibition of cell wall synthesis
Are penecillins toxic? No
What percentage of the population is allergic to penecillin? 15-20%
What are some examples of penecillin? Penicillin G, ampicillin, amoxicillin
Facts about the Quinolones class Bacteriacidal Block enzyme responsible for DNA growth.
Do humans have the enzyme for DNA growth that Quinolones block? No
What are Quinolones used for? Treatment of UTI’s
What bacteria does Quinolones cover? gram-
What is an example of a quinolone? NeGram
What are the interactions of quinolone? can’t be mixed with antacids phototoxic may cause super infections
What are some examples of respiratory quinolones? Cipro Levaquin
What are aminoglycosides class used for? Serious infection
What type of coverage do aminoglycosides cover? Gram negative
What can aminoglycosides be used with to fight gram + bacteria other antibiotics
Are aminoglycosides bacteriostatic or bacteriocidal? bacteriocidal
What is the dose of aminoglycosides? Weight and renal function
How are aminoglycosides toxic? ototoxic, nephrotoxic
Why do aminoglycosides increase muscle weakness? They can block signals from the neuromuscular junction
Aminoglycosides fact Because of systemic toxicity they may have applications for aerosol use
What are examples of aminoglycosides? gentamicin tobramycin
Vancomycin Class The strongest antibiotic available today. Bactericidal
How does the Vancomycin class function They bind to the cell wall and prevent mucopeptide formation. The bacteria cell then becomes susceptible to lysis.
What do you use Vancomycin for? Serious life-threatening infections
Is vancomycin used for gram + or gram – bacteria? gram + cocci
What is one thing that vancomycin treats? MRSA
What are the side effects of vancomycin? Hypotension nephrotoxicity rapid infusions can cause histamine release. flushed skin (redneck syndrome)
What must be monitored with vancomycin? Serum drug levels
Protein synthesis inhibitors class includes marcolides & tetracyclines
What do the macrolides in the protein synthesis inhibitors class treat? pulmonary infections
What are some examples of drugs in the protein synthesis inhibitors class? erythromycin Biaxin Zithromax
Antifungals Class have a rigid cell wall
Fungus produced by spores
Fungi include yeasts, mushrooms and molds
How do antifungals act? prevent the making of ergosterol, which is the building block for cell membranes
What are examples of fungal infections? ringworm jock itch athletes foot
histoplasmosis fungal infection of the lungs
Candita albicans thrush -rinse mouth post steroid use
What are some examples of antifungals Nystatin Monistat Diflucan ampotericin B
Amphotericin B is highly toxic and can cause renal or liver damage
the two agents used to treat TB are Isoniazid (INH) No alcohol rifampin RIMACTANE
What are the agents used to treat PCP pneumonia? (pneumocystis carinii pneumonia) Pentamidine (antiviral)
What are some common antibiotics used for inhalation? gentamicin tobramycin
What are the respiratory infection pathogens for epiglottitis? Haemophilus Influenzae
What are the respiratory infection pathogens for croup Parainfluenza virs/staphylococus aureus
What are ectopic foci? Excitable areas of the heart that fire outside of the normal conduction pathway and impair cardiac output
What is the refractory period? The time when cells cannot be excited after electrical stimulation.
What is the normal pacemaker of the heart? The SA node.
What is preload? the amount of blood in the ventricles before contraction?
What is afterload? The force against which the heart must pump.
What are common atrial arrythmias? Atrial fibrilation Arterial flutter PSVT (Supraventricular tachycardia)
What are common ventricular arrythmias? PVC’s, V-tach, tordsade de pointes, ventricular fibrulation
What is an arrhythmia? Deviation in ekg tracing includes disorders of the automatcity and or conduction.
What causes arrhythmias? oxygen deficit electrolyte imbalance proarrhytmias
What are proarrhythmias? Arrythmias due to medication
Chronotropic drugs affect heart rate positive chronotropic drugs increase heart rate. Negative chronotropic drugs decrease heart rate.
What are inotropic drugs? Drugs that affect the force of contraction. Positive- increase force negative-decrease force
What are dromotropic drugs? Drugs that alter the rythem or electrical conduction. Positive dromotropic speed up conduction. Negative dromotropic slow down conduction.
What is an action potential? a change in membrane voltage that occurs with cardiac conduction. -Na, Ca, K
What is depolarization? Contraction
What happens during repolarization? It recharges so it can contract again.
During depolarization… K moves out of the cell and Na moves into the cell.
During repolarization K moves in the cell and sodium moves out.
What is the P wave on the rhythm strip? Atrial depolarization (contraction)
What is the QRS complex? Ventriclular depolarization/atrial repolarization.
What is the T wave Ventricular repolarization.
What is the generic name for lasix? furosemide
What are the signs of CHF? Pedal Edema JVD Clubbing of the digits Slow capillary refill time
Types of ACE inhibitors captopril (Capoten) benazepril (Lotensin) enapril (Vasotec)
Types of Beta blockers Metoprolol bisoprolol
What is adenosine used for? AKA Adeno Card Used to convert supraventricular tachycardia into a sinus rhythm IV route Short half life (seconds)
digoxin inhibits Na and K+ exchange pump in the heart. Causes increased contraction half life 36 hours or longer A-Fib
Angina treatment #1 Beta Antagonists Decrease myocardial oxygen consumption by decreasing HR, contractility,blood pressure and afterload.
Angina Treatment #2 Calcium-Channel Blockers Inhibit Calcium Influx Decrease oxygen demands, contractility, AV conduction, automaticity
Angina Treatment #3 Nitroglycerine Relaxes smooth muscle reduction of preload reduced afterload
CHF Treatment #1 Digoxin inhibits the sodium/potassium exchange pump in the heart and increases intracellular sodium and calcium. This causes an increase in the contractility of the heart.
CHF Treatment #2 Beta Antagonists Slows the heart rate to allow more time for complete ventricular filling, reduces myocardial oxygen demand and controls blood presssure.
CHF treatment #3 ACE inhibitors decrease blood levels of angiotension II, there fore inducing vasodilation.
CHF treatmen #4 ARBS Block angiotenson II regardless of its origin. Causes vasodilation
What are some agents used to treat high blood pressure? • Ace inhibitors • Angiotensin II – receptor blockers • Vasodilators • Diuretics • B-Antagonist


Question Answer
What are the aerosolized antiinfectives we have learned about? Pentamidine-Nebupent, Ribavirin-Virazole, Tobramycin-TOBI, Zanamivir-Relenza
What is the recommended dosage for Pentamidine/NebuPent? 300mg/6ml sterile water; once/4wks
What is the recommended dosage for Ribavirin/Virazole? 20mg/ml; 12-18hrs/day for 3-7days by SPAG
What is the recommended dosage for Tobramycin?TOBI? 300mg bid; 28 days on/28 days off; >6yrs
What is the recommended dosage for Zanamivir/Relenza? 10mg bid with DPI diskhaler; bid 5 days
What are the indications for Pentamidine/NebuPent? PCP prophylaxis in HIV pt
What are the indications for Ribavirin/Virazole? RSV
What are the indications for Tobramycin/TOBI? P. aeruginosa in CF
What are the indications for Zanamivir/Relenza? Influenza
What is the mode of action for Ribavirin/Virazole? Inhibits DNA replication/reproduction
What special precautions should be taken when delivering Ribavirin/Virazole? PPE’s should always be worn; Women who are pregnant or planning pregnancy should not administer
What special precautions should be taken when administering Pentamidine/NebuPent? Use Respigard II neb system, administer in negative pressure room or under exhaust, always wear PPEs
What is the mode of action for Pentamidine/Virazole? Inhibits DNA, RNA, phospholipids and protein synthesis
What is the mode of action for Ribavirin/Virazole? Stops viral DNA replication
What is the mode of action for Tobramycin/TOBI? Bacterialcidal – blocks protein synthesis
What is the mode of action for Zanamivir/Relenza? Binds to viral enzyme and block action
What are the side effects of Tobramycin/TOBI and Gentamicin? Dizziness, nausea, neuromuscular blockade;
What can worsen the side effects of TOBI and Gentamicin? Myasthenia and use of neuromuscular blockades
Question Answer
Singulair (Montelukast) Leukotriene Modifier Class for Alternative to Corticosteroids
Methacillin Oxacilline Nafacillin Class: Penicillin RESISTANT – Type Anibiotic used to treat Gram Positive Bacterial Infections that are RESISTANT to Normal Penicillin
Carbenicillin Amoxicillin Ampicilline Class: Penicillin-Type Antibiotic Used to treat Gram Positive Bacterial Infections (staphyloccus, streptococcus, etc.)
Gentamycin Class: Antibiotic Used to treat Gram Negative Infections (Pseudomonas, E. Coli)
Erythromycin Class: Non-Penicillin-Type Antibiotic Used for Patients ALLERGIC to Penicillin or Mycoplasma Pneumonia
Ribravirin (Virazole) Class: Antiviral (Deliver with a SPAG Unit or Particle Scavenger Device) Used to treat RSV (Respiratory Syncytial Virus)
Nicorette Class: Stop-smoking Assistance Used to Curb Addiction to Nicotine
NicoDerm Class: Stop-smoking Assistance Used to Curb Addiction to Nicotine (Dermal Patch)
Nocotrol NS Class: Stop-smoking Assistance Used to Curb Addiction to Nicotine
Nipride (Sodium Nitroprusside) Class: Vasodilator for Lower Blood Pressure Decrease Ventricular Preload
Pronestyl (Procainamide) Class: Anti-Arrhythmic Agent for Atrial Arrhythmias & Ventricular Tachycardia
Lidocaine Class: Anti-Arrhythmic Agent for PVCs, Pulseless V-Tach and V-Fib
Amioderone Class: Anti-Arrhythmic Agent for Pulseless V-Tach and V-Fib (non responsive to defibrillation)
Verapamil Class:Class: Anti-Arrhythmic Agent for Control Ventricular Rate (supraventricular tachycardia)
Nitroglycerine Class: Anti-Angina for Angina Pectoris (chest pain)
Quindine or Propranolol (Inderal) Class: Cardiac Glycoside for Atrial Arrhythmias
Digoxin (Lanoxin) Class: Cardiac Glycoside for Increase Cardiac Contractility (CHF, Left Heart Failure)
Digitalis (Crystogdigin) Class: Cardiac Glycoside for Increase Cardiac Contractility (CHF, Left Heart Failure)
Pentamadine (Nebupent) Class: Antipneumocystis Agent Used to treat Pneumocystis Carinii (mostly seen in AIDS)
Nedocromil (Tilade) Class: Asthma Prophylaxis DO NOT Give When Wheezing Present Dose: MDI2 puffs QID for Prevent Bronchoconstriction
Intal (Cromolyn Sodium) Class: Asthma Prophylaxis DO NOT Give When Wheezing Present Not a Rescue Medication for Inhibit Histamine Release (prevent Bronchoconstriction)
Racemic Epinephrine (S2 or Vaponephrine) Class: Decongestant Mucosal Vasoconstrictor for Acute Epiglottitis, Stridor Following Extubation
Codeine Class: Narcotic Analgesic Used to Provide Sedation and Pain Relief (DO NOT Use On COPD)
Demoral (Meperidine) Class: Narcotic Analgesic Used to Provide Sedation and Pain Relief (DO NOT Use on COPD)
Morphine Class: Narcotic Analgesic Used to Provide Sedation and Pain Relief (DO NOT Use on COPD)
Narcan (Naaloxone) Class: Narcotic Agonist Used to Reverse Narcotic Influence
Rifampin Class: Antituberculin Used to treat Tuberculosis **Used with Isoniazid
Ethambutol Class: Antituberculin Used to treat Tuberculosis
Isoniazid (INH) Class: Antituberculin ONE YEAR USE Used to treat Tuberculosis **Used with Rifampin
Sodium Bicarbonate Class: Surface Active Agent used to treat Thich Secretions LOWERS pH
Aspirin, Ibuprofen (Motirin, Advil), Naproxen (Naprosyn, Aleve) Class: Non-Steroid Anti-Inflammatory Used to treat General Inflammation
Tetracycline Class: Broad-Spectrum Antibiotic Used to Treat Rocky Mountain Spotted Fever, Mycoplasma Pneumonia, Chronic Bronchitis
Caphalotihin (Keflin), Cephaloridine (Loridine), Caphalexin (Keflex) Class: NON-Penicillin-Type Antibiotic Used to Treat Gram positive Bacterial Infections for Patients ALLERGIC to Penicillin
Streptomycin Class: Antibiotic Used to treat Gram Negative Infections Also used with Tuberculosis
Tobramycin Class: Antibiotic Used to treat Gram Negative Infections (Pseudomonas, E. Coli)
Exosurf Class: Artificial Surfactant Used for Immature Neonatal Lungs
Curosurf Class: Artificial Surfactant Used for Immature Neonatal Lungs
Survanta Class: Artificial Surfactant Used for Immature Neonatal Lungs
Infasurf Class: Artificial Surfactant Used for Immature Neonatal Lungs
Versed (Midazolam) Class: Sedative Minor Tranquilizers Used to Provide Sedation
Seconal (Secobarbital) Class: Sedative Barbiturate Used to Provide Sedation
Valium (Diazepam) Class: Sedative Minor Tranquilizers Used to Provide Sedation
Dalmane (Flurazepam) Class: Sedative NON-Barbiturate Used to Provide Sedation
Pentabarbital (Nembutal) Class: Sedative Barbiturate Used to Provide Sedation
Phenobarbital (Luminal) Class: Sedative Barbiturate Used to Provide Sedation
Quaalude (Methaqualone) Class: Sedative NON-Barbiturate Used to Provide Sedation
Noctec (Chloral Hydrate) Class: Sedative NON-Barbiturate Used to Provide Sedation
Question Answer
Alupent Metaproterenol
Proventil, ventolin Albuterol
Serevent Salmeterol Xinafoate
Xopenx Levalbuterol
Vaponephrine Racemic Epinephrine
Spiriva Tiotropium Bromide
Atrovent Ipratropium Bromide
QVAR Beclomethasone Diproprionate
Azmacort Trimcinolone
Aerobid Flunisolide
Flovent Fluticasone Propionate
Pulmicort Budesonide
Asmanex Twisthaler Mometasone Furate
Alvesco Ciclesonide
Intal Cromolyn Sodium
Tilade Nedocromil Sodium
Mucomyst N-Acetylcystein
Pumozyme Dornase Alpha
Sodium Bicarb Neut
DuoNeb Combivent Atrovent and Albuterol
Xolair Omalizumab
Singulair Montelukast
Symbicort Budesonide and Fromoterol
Advair Salmeterol Xinafoate and Fluticasone