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Pharm 2300 > Anti-infectives > Flashcards

Anti-infectives Flashcards

1
Q

Antiseptics

A

Chemicals applied only to living tissue, not meant to kill them

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2
Q

Disinfectants

A

Chemicals used on non-living objects

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3
Q

Anti-invectives

A

To kill or inhibit the pathogen

-bacteria, fungus, parasite, virus

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4
Q

Bactericidal

A

Drugs that kill the organism

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5
Q

Bacteriostatic

A

Drugs that limit the growth of organism

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6
Q

Superinfection

A

Overgrowth of another bacteria or organism that will not be treated by the medication administered.

*opportunistic infection

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8
Q

Antibiotics are not effective against?

A

Viruses, parasites and fungal infections

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9
Q

Antibiotics side effects

A

Nausea, vomiting, diarrhea, photo sensitivity, opportunistic yeast infections

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10
Q

Antibiotics SERIOUS adverse effects

A

Ototxicity, nephrotoxicity, hepatotoxicity

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11
Q

General patient teaching of antibiotics

A

Take all pills
Take on an empty stomach to aid with absorption (take w/ food if upset stomach occurs)
Drink plenty of water
Stop and call if rash develops

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12
Q

4 target areas of antibiotics

A
  1. Cell wall synthesis
  2. Protein synthesis disruption
  3. Folate syntheses inhibition
  4. Nucleic acid (DNA) synthesis
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13
Q

Cell wall synthesis inhibitors

A

Beta lactams - beta lactation rings
Penicillins
Cephalosporins

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14
Q

Penicillin MOA

A

Inhibits the cell wall synthesis in bacteria > causes loss of osmotic pressure, cell lysis, loss of nutrients and cell death

**bactericidal

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15
Q

Penicillin Uses

A

Strep, staph, upper/lower respiratory infections, UTI, otitis media, extended spectrum in urinary tract

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16
Q

Generation 1 “Natural Penicillins”

A
  • Narrow spectrum
  • Effective against gram positive bacteria
  • often treat common infections of ear, throat, STIs
  • not as easy to absorb PO
  • not effective against beta lactamase
  • *penicillin V (Veetids)
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17
Q

Generation 2 - Aminopenicillins

A
  • broader spectrum - covering more of the gram negative bacteria
  • all drugs can be given orally - better absorption
  • not effective against lactamase
  • amoxicillin (Amoxil)
  • ampicillin (Principin)
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18
Q

Combo Drug: Augmentin

A

Amoxicillin+clavulanate

**clavulanate limits beta lactamase enzyme produced by bacteria so antibiotic can function

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19
Q

Penicillins

A

Penicillin (1st gen) - Veetids®
Amoxicillin (2nd) - Amoxil®
Ampicillin (2nd) - Principen®
Dicloxacillin (1st-resist) - Dynapen ®

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20
Q

Other penicillins

A
  • resistant to beta lactamase
  • narrower spectrum (gram+ only)

*dicloxicillin (Dynapen)

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22
Q

Cephalosporin MOA

A

Inhibits the cell wall synthesis of the bacteria > causes loss of the osmotic pressure, cell lysis, loss of nutrients, cell death

**bactericidal

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23
Q

Cephalosporin Uses

A

Strep, staph, upper/lower respiratory infections,UTI, otitis media

**broad spectrum, sub for penicillin, some gram-‘s

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24
Q

Cephalosporins 1st Gen

A
  • active agains gram+ bacteria and a few gram-
  • cephalexin (Keflex)
  • cefazolin (Kefzol)
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25
Q

Cephalosporins 4th Gen

A
  • greater resistance to b-lactamase inactivation enzymes
  • broad spectrum & longer 1/2 life
  • parenteral dose only

*Cefapime (Maxipime)

26
Q

Cephalosporins (cefs)

A 
1st gen
Cefazolin - Kefzol®
*Cephalexin - Keflex®
2nd Gen
Cefotetan - Cefotan®
Cefaclor - Ceclor®
3rd Gen
Ceftriaxone - Rocephin®
Ceftazidime - Fortaz®
4th Gen Cefipime - Maxipime®
27
Protein Synthesis Inhibitors
* Aminoglycosides - Bactericidal * Tetracycline - Bacteristatic * Macrolides - Bacteristatic
28
Aminoglycosides MOA
Drug binds to bacteria, attaches to the ribosomes (irreversible) 30s & 50s inhibits protein synthesis *bactericidal Primarily given IV/IM
29
Aminoglycosides Uses
Senior gram- infections | May give po to ‘cleanse’ gut before surgery
30
Aminoglycoside Side Effects
* When admin parenterally: ototoxicity (ears) and nephrotoxicity (kidneys) * pregnancy category D * may enhance muscle blockade during surgery
31
Aminoglycoside “mycin”
* Streptomycin (TB) * Gentamycin - Garamycin ® * Tobramycin - Tobrex® * Neomycin (skin, eye drops) - Poly-pred ®
32
TETRACYCLINES MOA
* Thought to Interfere with protein synthesis of bacteria by preventing the binding of transfer RNA to messenger RNA in the Ribosome—30S site * Gram +/- infections, broad spectrum *bacteriostatic
33
TETRACYCLINES Uses
• Acne, lower respiratory tract infection, chlamydia--Rocky Mt. Spotted fever, Cholera, Lyme disease
34
TetraCYCLINES
* Tetracycline - Achromycin® * Doxycycline - Vibramycin® * Minocycline - Minocin®
35
Tetracyclines Side Effects
* GI upset * Photosensitivy * Binds to Ca so yellowing of the teeth, suppress bone growth (not recommended for children of pregnant women) * Do not take with dairy, antacids, & Fe+ * nephrotoxicity (kidneys) * Superinfection - candida
36
Macrolide MOA
Inhibits protein synthesis at the Ribosomal site. (50s subunit site) *bacteriostatic
37
Microlide Uses
1. Gram Positive infections (strep and staph) (allergy to PCN/ceph) 2. upper/lower respiratory infections 3. Gram- infection (Moraxella and Neisseria) 4. Chlamydia infection
38
Macrolides - “thromycin”
``` •Erythromycin -E-mycin ®, Erythrocin •Clarithromycin - Biaxin ® •Azithromycin (ear/resp infections) Zithromax ®-Z-Pak ® (Long half life - 65-70 hrs) •Dirithromycin - Dynabac ® ```
39
Macrolide Side Effects
* GI disturbances—especially erythromycin. Take with Food * Z-Pak ® has shown an elevation in Liver function tests * Biaxin ® has been shown to leave a metallic taste in the mouth * Drug/drug interactions—be sure to check Statins, theophylline, dilantin, steroids, etc.
40
Ketolide --telithromycin(Ketek) (related to macrolides)
* blocks protein synthesis-greater affinity (more effective in lower doses) * Use: Resp. infections; Acute bacterial sinusitis * Community acquired pneumonia * Resistant strains from other antitbx * Side effects: NVD, possible C/V effects * CYP450 strong inhibitor--watch interactions--especially “statins” Norvasc, etc * Once/ day dosing-enteral only
41
Sulfonamides MOA
Inhibits the synthesis of folic acid (folate is naturally occuring form) and thereby inhibiting growth *Bacteriostatis
42
Sulfonamides Uses
* Some used topically (burns) or urinary/GI infections (concentrated in urine) * there are more resistant strains--limits use
43
Sulfonamides
* Sulfamethoxazole/ Trimethoprim - Bactrim®/ Septra® * Sulfasalazin - Azulfidine ® * Sulfisoxazole - Gantrisin ® * Sulfadiazine - Silvadene ® * Sulfacetamide - Sulamyd ® * Sulfasalazine - Azulfidine ® * Sulfonamide Comb (vaginal) - Sultrin ®
44
Sulfonamide Side Effects
* Photosensitivity/allergic rx (Stevens-Johnson syndrome; fatal skin rx) * Crystalluria - crystal formation in urine (drink lots!) * Blood disorders: Anemia, Leukopenia, Thrombocytopenia * Watch for drug/drug interactions like warfarin, diabetic agents
45
Fluroquinolones MOA
* Inhibits DNA Gyrase, which is essential for bacterial replication (Nucleic Acid Synthesis inhibitor) * Synthetic, broad spectrum, one advantage=well absorbed via GI route G+ and G- *bactericidal
46
Fluroquinolones Uses
UTI, GI, Respiratory, and bone and joint, (including serious versions) inhalation anthrax
47
Fluroquinolones “floxacin”
* Ciprofloxacin - Cipro ® (anthrax) * Levafloxacin - Levaquin ® * Moxifloxacin - Avelox ®
48
Fluroquinolone Side Effects
* HA * Dizziness * Photosensitivity/rash/Stevens-Johnson * GI disturbances/ avoid dairy * Black box warning—can damage connective tissue so not given to children; achilles tendon rupture 3-4x more likely * Relatively few reactions
49
Lincomycin
* Clindamycin (Cleocin ®) * Inhibits protein synthesis/bacteriostatic * Good against anaerobic organisms * Uses: deep tissue infections (sometimes malaria/MRSA) * Side effects: diarrhea * Can cause overgrowth of clostridium difficile_ Pseudomembranous colitis caused by the the toxin. * Patient teaching—report diarrhea—pay attn!
50
Vancomycin
* *Vancomycin (Vancocin ®)-Bactericidal * MOA: Inhibits Cell Wall Synthesis * Last Resort. Only G+ (very potent) * Used to treat MRSA/resistant staph infections * Must be given IV, nephrotoxic, peak/troughs, etc
51
Metronidazole
* *Metronidazole (Flagyl® ) * Inhibits DNA replication * Treats: bacterial and protozoa infections (Think GI infections) * Drug interaction:With Alcohol!!!! Experiences: N/V and HA
52
Nitrofuratoin
* Nitrofuratoin (Macrodantin® ) * Treats: urinary tract infections due to it’s antiseptic properties. (no systemic effect) * Short 1⁄2 life * Patient Teaching: Drink with lots of water. * Phenazopyridine (Pyridium ®) - Urinary Tract Analgesic—not antibiotic * Patient Teaching: Changes color of urine to orange - Only use for first couple of days—is antibiotic working?
53
Cephalosporins 2nd Gen
- Active against gram- and some gram+ - Broader spectrum - More potent * Cefaclor (Ceclor) * Cefotetan (Cefotan)
54
Cephalosporins 3rd Gen
- most active against gram- bacteria and less effective against gram+ bacteria - more lipid soluble > cross blood brain barrier * ceftazidime (Fortaz) * ceftriaxone (Recephin)
55
Tuberculosis
* Mycobacterium tuberculosis: Slow growing, Acid fast bacteria * Transmitted: By droplets from infected person in the air by coughing or sneezing * Can spread to other organs: bones, joints, CNS GU, skin
56
Active TB symptoms
* Cough—eventually blood * Weight loss * Malaise * Fever * Night Sweats
57
TB treatment
•Multi-drug regimen: months to yrs •MOA: inhibit cell wall synthesis or protein synthesis Drugs: Isoniazid (INH), Rifadin (Rifampin)--stains urine/tears orange, Pyrazinamide (Tebrazid), Ethambutal *latent or active disease
58
TB treatment regimens
• Latent disease –one drug approx 9 months • Active disease (non HIV): 2 months: Isoniazid, Rifampin, pyrazinamide Combo brand name: Rifater - Then 4-7months: Isoniazid & Rifampin • Ethambutal may also be used if unsure resistant strai

Pharm 2300 (6 decks)

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