Anti-Bacterial Drugs: Ch. 38-39 Flashcards
Explain:
Prophylactic Therapy
Definitive Therapy
Empiric Therapy
prevention of infection
-surgery
A culture revealed bacteria and the best method of treatment is identified
Often done while waiting for the culture results
Explain:
Superinfections
Secondary Infections
Normal flora are reduced/eliminated
-Vaginal yeast infections
-C. Diff
Developing a second infection after the first
-Person w/ viral URI also develops sinus infection
Explain 3 reasons for antibiotic resistance
Over-prescription of antibiotics
Nonadherence to regimen
Food-drug interactions (tetracyclines w/ dairy)
Explain 2 genetic abnormalities concerning hosts and antibiotics
Slow acetylation: drugs metabolize slower
G6PD Deficiency: hemolysis
Explain Stevens-Johnson Syndrome
severe allergic reaction involving skin vesicles and sloughing off
Explain the 4 mechanisms of action for antibiotics
Inference with cell wall synthesis
Interference w/ protein synthesis
Interference w/ DNA/RNA replication
Anti-metabolites: disrupt critical metabolic reactions inside cell
Are G-negative or G-positive bacteria harder to kill?
G-negative
Explain ESBL
Extended-Spectrum Beta-Lactamases
-Enzymes that allow a bacteria to be resistant to beta-lactam antibiotics
What types of drugs can treat bacteria that produce ESBL?
Carbapenems or Quinolones
What is the most common AE of ABX?
What is a common drug interaction for all ABX?
What do most ABX decrease the effectiveness of?
N/V/D
Warfarin
Oral contraceptives
What are the renal function labs?
What are the liver function labs?
Creatinine, BUN
ALT, AST, Bilirubin
Explain Beta Lactam Meds:
structure
MOA
4 types
Ring structure
Disrupt cell wall synthesis- cell lysis
(bactericidal)
Penicillins
Cephalosporins
Carbapenems
Monobactams
Explain the beta-lactamase enzyme
How is it disrupted?
Enzyme that bacteria use to break up the beta-latam ring
Combo medications can bind to enzyme and prevent it from breaking down penicillin
PENICILLINS:
-how is it tolerated?
-what is the most common AE?
-Cross reactivity?
-drug interactions?
Well-tolerated, usually safe
Allergic reaction
Cross-reactivity w/ cephalosporins- ONLY if there is a severe allergic reaction
NSAIDs, warfarin, methotrexate
CEPHALOSPORINS
-how many Gens?
-Which Gen strongest against G-negative?
-Notable drug?
5 gens
3rd Gen: strongest against G-neg, some G-postitive
Rocephin (ceftriaxone)
-give IV/IM
-long half-life
-Crosses BBB (CNS)
CARBAPENEMS
-spectrum?
-used for?
-route?
-infusion time
-Risk of?
-Example?
-How does the example work?
Broadest spectrum of any antibiotic to date
Complicated infections in acutely ill, hospitalized patients
Crosses BBB
IV only- infused over 60 mins
Risk of seizures, thronbocytopenia
Impinem/cilastatin= Primaxin
-cilistatin inhibits the metabolism of imipenem
What are the two types of Macrolides that are best tolerated?
-duration of action?
What is the MOA?
AE?
Cardiac effects?
Azithromycin
Clarithromycin
-long duration of action
-better tolerated
-better tissue penetration/efficacy
Inhibits protein synthesis
GI adverse effects
Prolongated QT Segment- potentially lethal dysthymias
TETRACYCLINES
-MOA?
-food interactions?
-Contraindications?
MOA: inhibits protein synthesis
Reduced oral absorption w/ dairy, antacids, iron salts
Children <8, pregnant/lactating women
-can cause permanent tooth discoloration, binds to calcium in teeth
-may retard fetal skeletal development
Explain some AEs of tetracyclines
Superinfection risks
-C. Diff.
-Enterocolitis
-Vaginal candidiasis
Maculopapular rash
Photosensitivity- sunburn
SULFONAMIDES
-often given with?
-example?
-MOA?
Often given w/ another antibiotic
Sulfamethoxazole + trimethoprim= Bactrim/Septra
Prevents folic acid synthesis needed by bacteria
What are some AEs of sulfonamides?
How are they handled/prevented?
Hemolytic/aplastic anemia, agranulocytosis, thrombocytopenia
-Assess CBC prior to treatment
Photosensitivity
-sun protection
Stevens-Johnson Syndrome
-Report rashes immediately
Hepaotoxicity, seizures, toxic nephrosis
What drug do sulfonamides interact with, affecting blood glucose?
Sulfonylureas
-both lower BG, interaction risks hypoglycemia
AMINOGLYCOSIDES
-spectrum?
-MOA?
-Example
-Risk of?
Broad-spectrum
inhibits protein synthesis
Gentamicin
serious toxicities
AEs of aminoglycosides?
Ototoxicity
Nephrotoxicity: monitor renal function
Superinfections
Headaches/dizziness/paresthesia
Skin rash
