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Clinical Pharm > AB Basics explain it to me like im 4 > Flashcards

AB Basics explain it to me like im 4 Flashcards

1
Q

Pen V K class

A

B-lactam (penicillins)

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2
Q

Pen V K MOA

A

primary - bactericidal (only when they are actively growing and synthesizing a cell wall)
secondary - bacteriostatic

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3
Q

Pen V K SOA

A
  • G + cocci
  • G + rods
  • most oral anaerobes
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4
Q

Pen V K metab and excretion

A

excreted by kidneys

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5
Q

Pen V K indications in dent

A
  • choice for orofacial infections
    —-> soft tissue, cellulitis, pupal origins
  • txs NUG
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6
Q

Pen V K how does bacteria become resistant

A
  • enzy. inactivation (B-lactamases) **
  • altered AB target
  • tolerance by loss of cell wall autolysis
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7
Q

Amox class

A

B - lactam (penicillin)

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8
Q

Amox MOA

A

primary - bactericidal
secondary - bacteriostatic

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9
Q

Amox SOA

A

better against G - bacteria than Pen V K

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10
Q

Amox metab and excretion

A
  • metab. in liver
  • excreted 60% unchanged by liver
  • better oral absorption than Pen V K
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11
Q

Amox indication in dentistry

A
  • choice for orofacial infections
    —-> soft tissue, cellulitis, pupal origins
  • txs NUG
  • juvenile perio, early onset perio, refractory perio
  • AB prophy for bacterial endocarditis
  • when Pen & Amox ineffective: add metronidazole
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12
Q

Amox adverse rxns:

A
  • amp/amox rash
  • potential superinfection of vagina and GI tract
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13
Q

Augmentin is what combined

A

amox. + clavulanic acid

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14
Q

augmentin class

A

B-lactam (penicillins)

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15
Q

Augmentin MOA

A
  • clavulanic acid binds irreversibly to active site of B-lactamases to stop hydrolysis of ABs
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16
Q

Augmentin SOA

A

same as amox. but a few others too:
better against G - bacteria than Pen V K

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17
Q

augmentin metab and excretion

A

metab in liver
excreted by kidneys

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18
Q

augmentin uses in dentistry

A
  • B- lactamase prod. bacteria &/or unresponsive to PenVK or amox.
  • adjunctive tx of rapidly progressive perio
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19
Q

T/F clavulanic acid has antibacterial activity by itself

A

F. it does not

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20
Q

dicloxacillin class

A

B - lactamase (penicillins)

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21
Q

dicloxacillin MOA

A

(B-lactam AB so bactericidal)
reistant to inactivation by staph penicillinase***

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22
Q

dicloxacillin SOA

A
  • same as Pen V K
  • most notably effective against: coagulase positive B - lactamase producing staph. **
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23
Q

dicloxacillin metab and excretion

A

metab in liver
excreted by kidneys

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24
Q

cephalosporins class

A

B - lactam (functionally identical to penicillins)

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25
Q

cephalosporins MOA

A
  • inhibit bacterial cell wall peptidoglycan synthesis by inhibition of penicillin sensitive enzymes
  • more stable to bacterial beta-lactamses = broader spectrum of activity
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26
Q

cephalosporins SOA first gen

A

G + aerobic cocci

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27
Q

cephalosporins SOA second gen

A

G - anaerobic

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28
Q

cephalosporins SOA third gen

A

G - (with expanded efficacy)

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29
Q

cephalosporins excretion

30
Q

erythromycin, azithromycin, clarithromycin class

A

macrolides

31
Q

erythromycin, azithromycin, clarithromycin MOA

A

bacteriostatic via inhibition of RNA-dependent protein sythesis

32
Q

erythromycin SOA

A

G + anaerobic & aerobic cocci

33
Q

clarithromycin SOA

A

G + anaerobes

34
Q

azithromycin SOA

A

G - anerobes

35
Q

erythromycin, azithromycin, clarithromycin metab and excretion

A
  • metab in liver
  • excreted in bile, feces (***), and urine
36
Q

what is a notable property of macrolides (& tetracyclines & clindamycin)

A

selective uptake by phagocytic cells and fibroblasts, which function as repository drug depots and as a drug delivery system to areas of infection

37
Q

erythromycin most common adverse reaction

A

severe epigastric pain

38
Q

macrolides indication in dentistry

A

acute orofacial infections in patients that are allergic to penicillins

39
Q

which macrolides are preferred for the tx or prevention of acute orofacial infections

A

azithromycin or clarithromycin

40
Q

which ABs are recommended for the AB prophy for the prevention of bacterial endocarditis in pts allergic to Pen or Amp

A

azithromycin or clarithromycin

41
Q

which macrolides have the greatest number of significant drug interactions (& what do they do)

A

erythromycin and clarithromycin
- affect liver drug metabolism (cytochrome p-450)

42
Q

which 4 drugs are erythromycin and clarithromycin NOT to be used with:

A
  • amiodarone (antiarrhythmic)
  • fluconazole (antifungal)
  • lovastatin
  • simvastatin
43
Q

clindamycin class

44
Q

clindamycin MOA

A

functionally equivalent to erythromycin

45
Q

clindamycin SOA

46
Q

clindamycin metab and excretion

A
  • oral absorption
  • metabolized in liver
  • excreted in bile, feces, liver
47
Q

clindamycin adverse rxns

A
  • has the highest rate of serious and non-serious adverse drug reactions among ABs that dentists prescribe
  • highest fatal ADR rate mostly related to C. difficile infection
48
Q

clindamycin drug interactions

A
  • avoid clindamycin and erythromycin concurrent use
  • acts synergistically with neuromuscular blocking drugs
49
Q

metronidazole class

A

nitroimadazole

50
Q

metronidazole MOA

A

bactericidal
- diffusing into organisms and causes loss of DNA structure

51
Q

metronidazole SOA

A
  • antiprotozoal
  • obligate anaerobic bacteria
52
Q

metronidazole metab and excretion

A

metab in liver
excreted in urine and liver

53
Q

which ABs are considered tetracyclines

A
  • tetracyclines HCl
  • minocycline
  • doxycycline
54
Q

tetracyclines MOA

A

bacteriostatic
- inhibit protein synthesis

55
Q

which ABs are fluoroquinolones

A
  • ciprofloxacin
  • levofloxacin
  • ofloxacin
56
Q

metronidazole most frequent adverse reaction is what

57
Q

most important mechanism for resistance to tetracyclines

A

drug efflux

58
Q

T/F complete cross-resistance usually occurs between demeclocycline, doxycycline and minocycline

A

F.
occurs between demeclocycline, doxycycline, and tetracycline

59
Q

T/F tetracyclines are not usually indicated for the tx of acute orofacial infections

60
Q

tetracyclines advers rxns & minocyclines specifically

A
  • superinfections (C. dif-associated diarrhea, vaginal & oral candidiasis, and staph enterocolitis)
  • photosensitivity (exaggerated sunburn)
  • minocycline:
    —> vestibular toxicity
    —> blue-gray-black discoloration of the skin, thyroid, nails, sclera, teeth, conjunctiva, tongue and bone
61
Q

which ABs are considered nephrotoxic

A

tetracyclines

62
Q

T/F tetracyclines are not CI during pregnancy

A

F. They are relatively CI during pregnancy

63
Q

which ABs are considered fluroquinolones

A

ciprofloxacin
levofloxacin
ofloxacin

64
Q

fluoroquinolones MOA

A

bacteriostatic/cidal via inhibition of DNA gyrase and topoisomerase IV

65
Q

which AB is/are in fluoroquinolones group I and what do they target

A

norfloxacin
- least active against G - and G + organisms

66
Q

which AB is/are in fluoroquinolones group II and what do they target

A
  • ciprofloxacin
  • ofloxacin
  • levofloxacin
    —> excellent G - activity and moderate to good G + activity
    —> **best for orofacial infections
67
Q

which AB is/are in fluoroquinolones group III and what do they target

A
  • moxifloxacin
  • gemifloxacin
    —> improved G + activity
68
Q

group I fluoroquinolones are generally used to tx what

69
Q

which group II fluoroquinolones is the most active against G -

A

ciprofloxacin

70
Q

T/F ofloxacin, followed by levofloxacin have superior activity against G + organisms

A

F. levofloxacin, followed by ofloxacin

71
Q

fluoroquinolones adverse rxns

A
  • tendon inflammation/rupture (chondrotoxicity)

Clinical Pharm (5 decks)

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