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PHARM > Aminoglycosides, Sulfonamides, Fluoroquiolones > Flashcards

Aminoglycosides, Sulfonamides, Fluoroquiolones Flashcards

1
Q

What is the prototype for aminoglycosides?

A

Gentamicin

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2
Q

Therapeutic use for Gentamicin?

A

serious aerobic gram negative infections (E coli, Klebsiella pneumoniae, proteus mirabilis, and pseudomonas aeruginosa).

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3
Q

MOA of Gentamicin?

A

Bactericidal: inhibits protein synthesis in bacteria at level 30S ribosome

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4
Q

Adverse effects of Gentamicin?

A

ataxia, vertigo, ototoxicity, nephrotoxicity, and inhibition of neuromuscular transmission (weakness or worsen myasthenia gravis)

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5
Q

Contraindications for Gentamicin?

A

hypersensitivity to gentamicin or other aminoglycosides

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6
Q

Gentamicin precautions?

A

renal impairment, hearing impairment, myasthenia gravis

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7
Q

Gentamicin interactions?

A

PCN: ↓ effects

Loop diuretics: ↑ risk for nephrotoxicity and ototoxicity

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8
Q

Route, metabolism, and excretion of Gentamicin?

A

Route: IM and IV; rapid onset
Metabolism: NOT by liver
Excretion: > 90% kidneys

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9
Q

Gentamicin should be combined with what other medication to treat serious infections?

A

Vancomycin or beta-lactam

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10
Q

Dosing considerations with Gentamicin?

A
  • Reduce dose in patients with renal impairment.

- Adjust dose to achieve effective trough serum level.

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11
Q

How is IV Gentamicin administered?

A

IV piggyback slowly (30 min or longer)

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12
Q

What sx might indicate ototoxicity?

A

HA, tinnitus, hearing loss, nausea, dizziness, and vertigo

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13
Q

What labs might indicate nephrotoxicity?

A

proteinuria, casts in the urine, dilute urine, elevated BUN, and elevated creatinine

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14
Q

What sx can indicate nephrotoxicity?

A

hematuria, cloudy urine, oliguria/anuria

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15
Q

Prototype for Sulfonamide combination?

A

Trimethoprim-sulfamethoxazole (Bactrim)

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16
Q

Therapeutic use of Trimethoprim-sulfamethoxazole (Bactrim)?

A

bronchitis, shigella enteritis, OM, pneumocystis jirovecii pneumonia (PCP), UTI, Traveler’s diarrhea, prevention of PCP in HIV + patients

17
Q

MOA of Bactrim?

A

Bacteriostatic: combination inhibits the metabolism of folic acid in bacteria at two different points

18
Q

Adverse effects of Bactrim?

A

N/V, rash, phlebitis, ↑ K ↓Na, Steven-johnson syndrome, pseudomembranous colitis, several hematological effects

19
Q

Route, metabolism, and excretion of Bactrim?

A

Route: PO and IV; rapid onset
Metabolism: 20% liver
Excretion: active form via renal

20
Q

Contraindications for Bactrim?

A

hypersensitivity (sulfa allergy), History of sulfonamide- or trimethoprim-induced immune thrombocytopenia, megaloblastic anemia, infants <2 mos, severe hepatic or renal impairment, pregnancy

21
Q

Precautions with Bactrim?

A

mild to moderate hepatic or renal impairment and G6PD deficiency

22
Q

Interactions with Bactrim?

A

multiple drug interactions d/t inhibition of cytochrome P450

23
Q

Prototype for Fluoroquinolones?

A

Ciprofloxacin

24
Q

Therapeutic use of Cipro?

A

gram negative infections and some gram positive organisms

25
Q

MOA of Cipro?

A

bactericidal: inhibits bacterial DNA synthesis by inhibiting DNA enzyme

26
Q

Adverse effects of Cipro?

A

N/D, phlebitis at IV site, tendinitis, tendon rupture, photosensitivity, elevated ICP, seizures, hepatotoxicity, anaphylaxis, pseudomembranous colitis

27
Q

Cipro contraindications?

A

hypersensitivity, concurrent use of tizanidine

28
Q

Cipro precautions?

A

Known CNS disorders, renal impairment, hx of prolonged QT interval

29
Q

Cipro interactions?

A

can ↑ theophylline concentration, iron, multivitamins, calcium, magnesium, drugs that prolong the QT interval

30
Q

Route, metabolism, and excretion of Cipro?

A

Route: PO, PO-ER, and IV; rapid onset
Metabolism: small amts in liver
Excretion: 40-50% unchanged by kidney

PHARM (35 decks)

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