Pharmacology Quiz: Antibiotics and Prophylaxis

Pharmacology Study Notes

• Pharmacology is a heavily tested topic on the INBDE. A strong foundation is crucial.
• Local anesthetics are categorized into amides and esters.
• Amides are metabolized by the liver, and their names typically end with "-caine." Key examples include lidocaine, mepivacaine, articaine, and prilocaine.
• Lidocaine is considered safe for use in children.
• Mepivacaine causes the least vasodilation.
• Articaine has the shortest duration of action.
• Prilocaine carries a risk of methemoglobinemia, which can lead to insufficient oxygen delivery.
• Esters are metabolized in plasma by pseudocholinesterase enzymes. Their names also end in "-caine." Key examples include benzocaine, cocaine, and procaine.
• Benzocaine is a common topical anesthetic.
• Cocaine is a vasoconstrictor.
• Procaine has a prolonged duration of action, making it unsafe for children.
• Local anesthetics block sodium channels in neurons, preventing the influx of sodium ions and thus pain signals.
• Non-ionized (free-base) form is crucial for crossing the hydrophobic neuron membrane.
• Inflammation reduces local anesthetic effectiveness.
• Key concepts of pharmacokinetics are important for the INBDE. Pharmacokinetics describes how the body responds to a drug.
• Protein binding increases duration of action.
• Local anesthetics are categorized by their effect on blood vessels, either causing vasoconstriction (like cocaine) or vasodilation.
• Maximum epinephrine dosages are important to remember, especially for healthy and cardiac patients.
• Specific methods of local anesthetic injection (e.g., IAN block, buccal block, mental nerve block) and their steps are crucial.
• There are different types of needles and techniques used in injections.
• Side effects of antibiotics, including pseudomonas colitis, superinfection, and aplastic anemia are important, especially in the context of interactions and dosages.
• Antibiotic prescriptions will depend on patient factors like age, medical history, and other medications.
• Understanding the classes of antibiotics (e.g., penicillins, cephalosporins, macrolides, tetracyclines, sulfonamides) and their mechanisms of action is critical.
• Key concepts of how antibiotics work, like inhibiting cell wall synthesis or protein synthesis, are critical.
• Certain drug combinations are contraindicated due to potential interactions and drug effects.
• Analgesics, such as acetaminophen and NSAIDs (aspirin, ibuprofen, naproxen), have specific mechanisms and side effects.
• Acetaminophen (or Tylenol) is a common drug for fever and pain relief, but has a maximum daily dose.
• NSAIDs (like ibuprofen and aspirin) work by inhibiting COX-1 and COX-2.
• Side effects of aspirin can include GI bleeding and metabolic acidosis.
• Specific steroids, given for periods of inflammation or similar conditions, have important side effects to note. Examples include prednisone, hydrocortisone, and dexamethasone.
• The risk of adrenal insufficiency is a concern with corticosteroid therapy.
• Morphine, codeine, oxycodone, and hydrocodone are examples of narcotics with various side effects, including an elevated risk of overdose, which requires medical intervention.
• Drug schedules classify drugs based on their potential for abuse (Schedule I being the highest).
• Nitrous oxide (laughing gas) is another topic of note, with its special properties and side effects being important to remember.
• Detailed knowledge of pharmacokinetics (stages of absorption, distribution, metabolism, and elimination, including the first-pass effect, volume of distribution) is critical.
• Important principles of drug-drug interactions (competitive vs non-competitive antagonism, induction vs inhibition, drug interactions affecting metabolism, and affecting other drugs' toxicities) is very important.
• There are details about the sympathetic and parasympathetic nervous system.
• Specific receptors (like muscarinic and adrenergic receptors) for drugs in the autonomic nervous system are relevant.
• Knowledge of agonists, antagonists, and inverse agonists is necessary.
• Specific drugs are categorized as direct-acting or indirect-acting agonists and antagonists, or as competitive or non-competitive inhibitors.
• Information on various drugs and their effects on various body systems is necessary.