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Pharm > ABX > Flashcards

ABX Flashcards

1
Q

What to know about vancomycin

A

cell wall synth interupter - gram + only

used for Cdiff and MRSA
nephrotoxicity - avoid NSAIDs
check serum levels
ototoxicity
IV admin - rapid infusion - red man syndrome

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2
Q

PCNs

A

cell wall weakeners
resistance is common -beta lactamase
pcn G - 1st pcn - narrow spectrum - stomach acid - IV or IM
#1 allergy inducer
gram + only

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3
Q

broad spectrum penecillin

A

Ampicillin, amoxicillin

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4
Q

extended spectrum PCN

A

pipercillin

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5
Q

tetracycline

A

broad spectrum protein synthesis inhibitor
2nd line for infectious dx
1st line for a range of infx - ricketts, chlamydia, cholera, lyme, anthrax, mycoplasma pna
treats acne - PO and topical
used for PUD - H.pylori - in combo w/ metronidazole

contraindicated for children developing teeth/pregnant women - binds to Ca+ (also chelates with other metals -zinc,mg, fe, aluminum)

empty stomach

hepatotoxic, nephrotoxic

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6
Q

Clindamycin

A

broad spectrum, anaerobic gram + outside of CNS (think moist and dark)

Strongly associated with the development of Cdiff superinfection

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7
Q

Azithromycin and other macrolides

A

broad spectrum - used instead of PCN in case of allergy

look out for prolonged QT interval

newer generation (azithromycin, clarithromycin) - Zpack - daily dosing - easier adherence than earlier generation

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8
Q

Aminoglycosides

A

tobramycin, gentamycin etc
narrow spectrum - aerobic gram - bacilli

ototoxic, nephrotoxic (usually reversible) - elevated trough levels can indicate toxicity
monitor serum levels (check peak -therapeutic and trough-toxicity)

only IM or IV (highly polar) - cannot cross GI or BBB

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9
Q

Sulfonamides

A

important use - UTI trmt
- Trimethoprim/Sulfa-methoxazole (Bactrim)

closely following PCNs for allergy inducing

rash mild –> severe - Steven Johnson Syndrome - flu-like plus severe rash/blisters
x in pregnancy or infants <2mo - kernicterus (displacement of bilirubin to brain)

Topical: Silver Sulfadiazine (Silvadene)

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10
Q

metronidazole

A

protein synthesis disruptor

anaerobic (broad spectrum) and anti-protozoal
DOC for Cdiff

monitor for phlebitis
ADRS: CNS, rash –> SJ’s

*avoid alcohol - causes disulfiram-like rxn

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11
Q

Cephalosporin

A

Cell wall weakener
5 generations - increased effectiveness to gram - and ability to reach CSFwith each generation
- used to treat difficult to reach infections like **meningitis **(5th gen)
- use in lower doses for renal impairment

many require IV or IM (poor abs. in GI)

avoid alcohol - strong disulfiram-like effect

cross allergy w/ PCNs

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12
Q

Carbapenem

A

cell wall weakener
broad-spectrum gram+ and gram -

IV admin- not absorbed
judicious use to avoid resistance
not effective x MRSA

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13
Q

fluoroquinalone

A

disrupt DNA replication
eg ciprofloxacin
-preferred s/p anthrax

choice for pyelonephritis

may worsen myesthenia gravis
tendonitis - especially achilles - under 18 and elderly
avoid in pts on glucocorticoids
QT prolongation
CNS
photosensitivity

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14
Q

Acyclovir

A

topical/PO antiviral

can be used in pregnancy (esp near term to prevent transmission)

do not spread between sites

IV - phlebitis
prolonged/IV use - nephrotoxicity, neurotoxicities

decrease dose for renal impairment

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15
Q

gancyclovir

A

rarely used because of significant ADRs/*black box warning**

only approved to prevent cytomegalovirus in immunocompromised pts

  • bone marrow suppression, immunosuppression and thrombocytopenia, teratogenic, hepatotoxic, neurotoxic, nephrotoxic
    careful handling - absorbs into skin
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16
Q

interferon alpha

A

part of HCV cocktail
SQ or IM
flu-like sx, depression
black box warning - SI

17
Q

Ribavirin

A

part of HCV cocktail

ADRs - hemolytic anemia/cardiac effects, flu like sx, depression
fetal injury

18
Q

Protease Inhibitors for hcv

A

simeprevir etc (previr)

hepatotoxic, significant photosensitivity

19
Q

PEP vs PrEP

A

PEP - occupational - post-exposure
When do we check labs when exposed - baseline, 6 wks, 12 wks, months later
28 days treatment - good
effective trmt starts early (w/in 1-2 hrs)

PrEP - high risk exposure - pre-exposure

PEP - NRTIs and PI
PrEP - 2 NRTIs

20
Q

linezolid

A

used for multidrug resistant organisms, reserved for MRSA and VRE

ADR- myelosuppression - monitor CBC

21
Q

amphotericin B

A

anti-fungal - polyene macrolide

not used much anymore - azoles preferred as broad spectrum anti-fungal

ADR - infusion reaction - fever, chills, rigors, HA, n/v, hypotension, dyspnea, resp failure (1-3 hrs post start)

pretreat with tylenol + diphenhydramine

22
Q

azoles

A

systemic mycoses
PO or IV

less toxic

Itraconazole - avoid in HF - negative inotrope

23
Q

echinocandins

A

IV only
disrupt cell wall
use: intolerant/unresponsive to other meds
for candidiasis

24
Q

Vulvovaginal candidiasis

A

1-3 days clotrimazole (or other azole)

PO - single dose fluconazole

25
Q

Nystatin

A

polyene macrolide
topical/mouth rinse

rare/minor ADR- GI, topical irritation

ok for infant thrush/diaper rash

26
Q

HIV drug: NRTIs
(Specifically Zidovudine AZT)

A

black box warning:
severe anemia, neutropenia
potentially fatal lactic acidosois with hepatic steatosis

no longer recommended, except for short-term to reduce perinatal transmission

27
Q

Protease Inhibitors “avir”

A

reduces HIV viral count to undetectable

providers must check d-d interactions

hyperglycemia
fat redistribution - lipodystrophy
hyperlipidemia

28
Q

Phenazopyridine

A

non opioid urinary analgesic “AZO”
bright orange urine

29
Q

treatment of UTI

A

nitrofurantoin (macrobid) - “urinary tract antiseptic”
rust colored urine
contraindicated in pregnancy
hepatotoxicity
check renal fxn - can accumulate to toxicity
CNS
peripheral neuropathy
pulmonary rxns (acute hypersensitivity –> subacute dyspnea, cough, pna)

sulfanamide/trimethoprim
fosfomycin

phenazopyridine (not ABX - pain relief - “AZO”) - orange urine

Pharm (11 decks)

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