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Pharmacology PaxFlan > ABX overview > Flashcards

ABX overview Flashcards

1
Q

bacteriocidal ABX MOA + examples

A

disrupt cell wall production (B-lactams, monobactams, glycopeptides)
inhibit DNA synthesis (FQ, metronidazole)
destabilize cell membranes (cyclic lipopeptides)
destabilize cell wall + membranes (lipoglycopeptides)

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2
Q

bacteriostatic ABX MOA + examples

A

inhibit protein synthesis
- 50S - macrolides, lincosamines, oxazolidinones, pleuromutilins
- 30S - AG, TTC, glycylcyclines
inhibit folic acid synthesis - TMP-SMX

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3
Q

B-lactamases mechanism of ABX resistance

A

drug inactivation by enzymes

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4
Q

3 mechanisms of ABX resistance

A

decrease intracellular [drug], drug inactivation by enzymes (B-lactamases, aminoglycosides), ABX target modification

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5
Q

list bacteriocidal ABX

A 
*B-lactams
monobactams
glycopeptides
lipoglycopeptides 
cyclic lipopeptides
aminoglycosides
*fluoroquinolones 
nitroimidizoles
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6
Q

list bacteriostatic ABX

A 
*tetracyclines 
glycylcyclines
*macrolides
lincosamides 
oxazolidinones
pleuromutilins
sulfonamides
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7
Q

concentration-dependent killing drugs

A

Aminoglycosides
Fluoroquinolones
glycopeptides/lipoglycopeptides

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8
Q

time-dependent killing drugs

A

B-lactams

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9
Q

ABX against intracellular organisms

A

FQ, macrolides

TTC, TMP-SMX, clindamycin, rifampin

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10
Q

anti-anaerobic ABX

A

clindamycin, metronidazole, Augmentin (PO), Unasyn (IV), Zosyn (IV), carbapenems

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11
Q

bioequivalent ABX

A

*FQ
*TTCs
*Metronidazole
Rifampin
TMP-SMX
linezolid

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12
Q

renal excretion

A

(most)
B-lactams, monobactams, glycopeptides, cyclic lipopeptides/lipoglycopeptides, AGs, FQs, TTC/Glycylcyclines, oxazolidinones

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13
Q

hepatic excretion

A

ceftriaxone, all macrolides, metronidazole

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14
Q

oral contraceptives and ABX

A

recommend back-up birth control while on ALL ABX

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15
Q

ABX that increase INR

A

metronidazole, TMP-SMX

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16
Q

ABX that decrease INR

A

rifampin

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17
Q

ABX that cause dysrhythmia

A

macrolides

fluoroquinolones

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18
Q

ABX associated with ototoxicity

A

aminoglycosides, vancomycin, minocycline

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19
Q

what ABX can induce seizures

A

PCNs, CPHs, carbapenems

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20
Q

what ABX is linked to psychosis + cognitive impairment in pts being treated for H. pylori

A

clarithromycin

21
Q

what ABX may induce insomnia, confusion, hallucinations, other CNS effects

A

FQ (levofloxacin&raquo_space;)

22
Q

what ABX may induce encephalopathy

A

metronidazole

23
Q

ABX associated with nephrotoxicity

A

aminoglycosides (gentamycin)
vancomycin
PCNs (nafcillin > piperacillin) + FQs (ciprofloxacin)

24
Q

ABX associated with hepatotoxicity

A

amoxicillin/clavulanate (Augmentin)
TMP-SMX (Bactrim
INH > RIF = PZA

25
Q

ABX that cause chemical phlebitis

A

*nafcillin
cefepime
vancomycin
clindamycin

26
Q

what ABX should you recommend that pt does not drink alcohol while on AND WHY

A

(usually) Metronidazole - no ETOH while on ABX and for 2-3 days after last dose
causes disulfram-like reactions

27
Q

red man/neck syndrome

A

rapid vancomycin infusion

*not an allergy!

28
Q

red lobster syndrome

A

rifampin - red/orange discoloration of urine, tears, sweat

29
Q

discolored teeth

A

TTCs

30
Q

loss of red/green color perception

A

ethambutol

31
Q

yellow baby syndrome

A

sulfonamides

32
Q

ABX that can cause hyperkalemia

A

Trimethoprim

increased risk with ACEi/ARB/spironolactone

33
Q

ABX that can cause hypokalemia

A

PCNs (nafcillin >)

34
Q

ABX that cause C. diff

A 
Clindamycin (highest incidence)
oral aminopenicillins (amoxicillin & amox/clav)
oral cephalosporins (cephalexin)
35
Q

what ABX, when given with an EBV infection, can cause a maculopapular rash

A

aminopenicillin

36
Q

ABX to avoid in pregnancy

A

Fluoroquinolones
Aminoglycosides
Sulfonamides
Tetracyclines

37
Q

what two ABX have the highest percent of cross-reactivity

A

aminopenicillins (amoxicillin, ampicillin) and CPHs

38
Q

combos of penicillins and cephalosproins with identical R1 side chain

A

ampicillin – cephalexin

amoxicillin – cefprozil

39
Q

pts with h/o IgE-mediated rxn to PCN management

A

treated with non-B-lactam ABX or referred to an allergist for skin testing

40
Q

pts with h/o severe non-IgE mediated rxn to PCN management

A

should NOT receive PCNs or CPHs in any form

skin testing/desensitization are CONTRAINDICATED

41
Q

someone has a MP rash to a penicillin… what can they try

A

CPH, carbapenems, aztreonam

42
Q

someone anaphylaxes to PCN, what can they try

A

aztreonam or “non-B-lactam ABX”

cant use PCN, CPH, carbapenems

43
Q

sulfa reaction characteristics

A

7-14 days after

fever +/- MP rash

44
Q

3 classes of sulfa drugs

A
  1. sulfonylarylamines (sulfamethoxazole), HIV PIs (darunavir)
  2. nonsulfonylarylamines - carbonic anhydrase anhibitors, cox-2 inhibitors, loops/thiazides, sulfonylureas, Tamsulosin, -triptans
  3. sulfonamide-moiety containing drugs - AEDS (topiramate), HCV PIs
45
Q

anti-MSSA ABX (oral and IV) gold + silver standard

A

oral - dicloxacillin, cephalexin

IV - nafcillin, cefazolin

46
Q

anti-MRSA ABX (oral and IV)

A

oral - linezolid/tedizolid, minocycline/doxycycline, TMP-SMX, clindamycin
IV - vancomycin

47
Q

anti-pseudomonal ABX (oral and IV) gold + silver

A

oral - ciprofloxacin & levofloxacin

IV - pip/tazo, aztreonam, ceftazidime/ceftolazone/cefepime, cipro or levo, tobramycin, doripenem

48
Q

anti-VRE ABX

A

oral - linezolid/tedizolid

IV - linezolid/tedizolid, daptomycin, tigecycline, telavancin/oritavancin

49
Q

anti-anaerobic ABX (oral and IV) gold + silver

A

oral - metronidazole or amox/clav, (silver) clindamycin

IV - b-lactam/b-lactamase inhibitor combo (pip/tazo), carbapenems, metronidazole, (silver) clindamycin

Pharmacology PaxFlan (12 decks)

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