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PHARMACOLOGY > ANTIBACTERIAL AND ANTI-INFECTIVE AGENTS (PART 1) > Flashcards

ANTIBACTERIAL AND ANTI-INFECTIVE AGENTS (PART 1) Flashcards

1
Q

kills bacteria, without host defense mechanisms

A

bactericidal

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2
Q

inhibits microbial growth, requires hosts defense mech, does not kill bacteria

A

bacteriostatic

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3
Q

minimum inhibitory concentration

A

lowest concentration needed for inhibiting growth

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4
Q
  • targets the cell wall of the organism
  • selectively interfere with the synthesis of the cell wall
A

beta-lactam antibiotics

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5
Q
  • binds to PBPs
  • inhibition of transpeptidases
  • production of autolysin
A

penicillin

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6
Q

classification of penicillin:

pen g - IV
pen v - ORAL

A

narrow spectrum

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7
Q

classification of penicillin:

nafcillin
oxacillin
cloxacillin
dicloxacillin

A

very narrow spectrum

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8
Q

classification of penicillin:

ampicillin
amoxicillin

A

extended spectrum

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9
Q

classification of penicillin:

sulbenicillin
carbenicillin
ticarcillin
piperacillin

A

antipseudomonal

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10
Q

classification of penicillin:

targets gram-positive except:
- penicillinase prod. bacteria
- meningo
- spirochetes
- anaerobic

A

narrow spectrum

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11
Q

dose for syphilis

A

PEN G
2.4 million units IM - single dose

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12
Q

prophylaxis for rheumatoid fever

A

PEN V
2500 mg - PO BID

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13
Q

classification of penicillin:

targets most penicillinase prod. staphylo

A

vary narrow

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14
Q

dosage for cellulitis (very narrow)

A

CLOXACILLIN
500 mg - QID

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15
Q

classification of penicillin:

targets gram-positive
- cocci
- enterococci
- l. monocytogenes

A

extended spectrum

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16
Q

dosage for cellulitis (extended)

A

AMOXICILLIN
500 mg - TID

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17
Q

most important adverse reaction of penicillin

A

hypersensitivity

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18
Q

all adverse reactions of penicillin

A

HDN-NHC

hypersensitivity
diarrhea
nephritis
neurotoxicity
hematologic toxicities
cation toxicity

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19
Q

nursing implication for penicillin:

carefully monitor for at least ___ minutes after administration

A

30

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20
Q

nursing implication for penicillin:

oral penicillin effectiveness is decreased when taken with?

A
  • caffeine
  • citrus fruit
  • cola beverages
  • fruit juices
  • tomato juice
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21
Q
  • similar to penicillin in structure
  • 7 aminocephalo-sporanic acid
  • more stable to may bacterial betalactamases
  • broader spectrum
  • 5 generations
  • less susceptible to penicillinases
A

cephalosporins

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22
Q

what generation of cephalosporins:

  • cefazolin
  • cephalexin
A

1st gen

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23
Q

what generation of cephalosporins:

  • cefoxitin
  • cefaclor
  • cefuroxime
A

2nd gen

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24
Q

what generation of cephalosporins:

  • ceftriaxone
  • ceftazidime
  • cefixime
A

3rd gen

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25
Q

what generation of cephalosporins:

cefepime
cefpirome

A

4th gen

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26
Q

what generation of cephalosporins:

ceftobiprole
ceftaroline fosamil

A

5th gen

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27
Q

what generation of cephalosporins:

targets gram positive cocci, inclu penicillin resistant s. aureus, except:
- MRSA
- MRSE

also targets SOME gram negative bacili
- e coli
- k. pneumonia
- p. mirabilis

A

1st gen

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28
Q

prophylaxis for cardio and general surgeries

A

CEFAZOLIN
1-2g IV - single dose pre-op

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29
Q

dosage for respiratory infections

A

CEPHALEXIN
250 mg - PO q6

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30
Q

what generation of cephalosporins:

improves activity against:
- h. influenza
- m. catarrhalis
- n. meningitids
- n. gonorrhea

enahnced against staphy, non entero, and some entobacteriaceae

A

2nd gen

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31
Q

prophylaxis for non perforated appendicits

A

CEFOXITIN
1-2g IV - pre-op

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32
Q

dosage for pharyngitis or tonsillitis

A

CEFUROXIME
250 mg - PO Q12 for 10 days

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33
Q

common adverse reaction of cephalosporin

A

allergic manifestations

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34
Q

adverse reaction of cephalotin (cephalosporin)

A

nephrotoxicity (high doses = acute tubular necrosis)

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35
Q

adverse reaction of cefamandole, cefotetan, cefoperazone (cephalosporin)

A

disulfram-like reactions (similar to when alcohol is taken)

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36
Q

nursing implications for cephalosporin

orally administered should be given (before / after) meals to decrease GI upset

A

after

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37
Q
  • 5 member ring system
  • different from penicillin by being saturated and containing a CARBON atom, instead of sulfur
  • broad spectrum
  • drug of choice for enterobacter infections (resistant to beta lactamase)
A

carbapenems

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38
Q
  • interact with PBPs, induces formation of long, filamentous bacterial structure
  • extremely resistant to beta lactamases
A

monobactam

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39
Q

carbapenem / monobactam?

  • meropenem
  • imipenem
  • ertapenem
A

carbapenem

40
Q

carbapenem / monobactam?

used for nosocomial infections caused by resistant polymicrobial infections caused by gram + and - organisms, anaerobic bacteria and ESBL + organisms

A

carbapenem

41
Q

carbapenem / monobactam?

aztreonam

A

monobactam

42
Q

carbapenem / monobactam?

activity limited to gram (-) bacili:
- enterobacteriaceae
- aeromonas sp
- n. gonorrhea
- h. influenza
- p. aeruginosa

A

monobactam

43
Q

dosage for intraabdominal infections

A
  • MEROPENEM - 1g - IV q8
  • IMIPINEM - 500 mg - IV q6 OR 1g IV q8 for 4-7 days
44
Q

dosage for pseudomonal infections

A

AZTREONAM
2g IV/IM q6-8

45
Q

carbapenem / monobactam?

side effects:
- nausea and vomiting*
- seizures
- cross-sensitivity allergic reactions

A

carbapenems

46
Q

carbapenems is contraindicated to people with?

A

epilepsy

47
Q

carbapenem / monobactam?

side effects:
- streptococcus and enterococci superinfections
- elevation of transaminases
- cause abnormal liver function test

A

monobactam

48
Q
  • resemble beta-lactam molecules, weak antibacterial
  • may inhibit beta lactamases thus protecting penicillin from inactivation
  • fixed combinations with specific penicillins
A

beta lactamase inhibitors

49
Q

clavulanic acid is usually paired with?

A

AMOXICILLIN or TICARCILLIN

50
Q

sulbactam is usually paired with?

A

AMPICILLIN

51
Q

tazobactam is usually paired with?

A

PIPERACILLIN

52
Q

dosage for exacerbation of chronic bronchitis

A

CO-AMOXICLAV
1g BID

53
Q

dosage for severe infections; nosocomial pneumomia

A

PIPERACILLIN / TAZOBACTAM
4.5g IV q6

54
Q

other cell wall inhibitors:

inhibit cell wall mucopeptide formation by binding D-ala-D-ala portion of cell wall percursors

A

vancomycin

55
Q

other cell wall inhibitors:

active against MRSA, MSSA, coagulase-negative staphy, enterococci, streptococci, c. diptheria, c. difficile, and listeria

A

vancomycin

56
Q

dosage for vancomycin for MRSA

A

VANCOMYCIN
15-20 mg/kg IV q12

57
Q

side effects of vancomycin

A
  • phlebitis at injection site
  • red man / red neck syndrome
58
Q

block 30s subunits to block binding of aminoacyl-tRNA to acceptor site ribosome-mRNA complex

A

tetracycline

59
Q

classification of tetracycline:

  • tetracycline
  • oxytetracycline
A

short acting

60
Q

classification of tetracycline:

  • demeclocyline
  • mathacycline
A

intermediate acting

61
Q

classification of tetracycline:

  • doxycycline
  • minocycline
  • tigecycline
A

long acting

62
Q

tetracycline is usually given to ___ allergic patients with leptospyrosis, syphilis, actinomycosis, tularemia, meliodosis, and skin and soft tissue infection

A

penicillin

63
Q

DOXYCYCLINE 100 mg PO BID is given to patients with:

A
  • cervicitis
  • nongonococcal infections
  • donovanosis
  • lymphogranuloma venereum
64
Q

most important adverse effect of tetracycline

A

phototoxicity

65
Q

nursing implication for tetracycline:

milk products, iron, anatcids, and other dairy should be avoided because of the ___ and brug-binding that occurs

A

chelation

66
Q

nursing implication for tetracycline:

all medications should be taken with ___ onuces of fluid

A

6-8

67
Q
  • mainstay for the treatment for aerobic gram negative bacili
  • irreversible inhibition of protein synthesis
  • once outside the cell, they bind to polysomes (causes misreading)
A

aminoglycosides

68
Q
  • amikacin
  • streptomycin
  • tobramycin
A

aminoglycosides

69
Q

dosage in addition to antipseudomonal beta-lactam or carbapenem in HAP

A

AMIKACIN
20 mg/kg day IV

70
Q

dosage for tuberculosis

A

STREPTOMYCIN 15
12-18 mg/kg IM per day

71
Q

adverse effects:

  • ototoxicity
  • nephrotoxicity
  • neuromuscular paralysis
  • allergic reaction
A

aminoglycosides

72
Q

nursing implications for aminoglycosides:

monitor ___ and ___ blood levels of these agents to prevent nephrotoxicity and ototoxicity

A

peak and trough

73
Q
  • macrocyclic lactone ring
  • prevents translocation at the 50s subunit
  • at higher doses, can be bactericidal
A

macrolides / ketolides

74
Q

streptomyces erytheus
- drug of first choice
- alternative to penicillin in pts allergic to beta lactam antibiotics

A

eythromycin

75
Q

active against aerobic gram positive cocci and bacilli:
- legionella
- mycoplasma
- chlamydia

A

macrolides / ketolides

76
Q

dosage for acute bronchitis

A

AZITHROMYCIN
500 mg PO BID

77
Q

dosage for cervicitis; chancroid

A

AZITHROMYCIN
500 mg PO single dose

78
Q

dosage for chancroid

A

ERYTHROMYCIN
500 mg PO QID for 7 days

79
Q

adverse effects:

  • GI distress
  • cholestatic jaundice
  • ototoxicity
A

macrolides / ketolides

80
Q

macrolides / ketolides is contraindicated to people with?

A

hepatic dysfunction

81
Q

nursing implication for macrolides / ketolides:

absorption if oral ERY is enhanced when taken on an ___

A

empty stomach

82
Q
  • inhibition of peptide bond formation at the 50s subunit
  • blocks binding of the aminoacyl moiety of the charges tRNA molecule to the acceptor site of ribosmal mRNA complex
A

chlorampenicol

83
Q

targets aerobic and anaerobic bacteria

A

chloramphenicol

84
Q

chlorampenicol is usually given to patients with

A

fully susceptible typhoid

SEVERE - 100 mg/kg (14-21 days)
UNCOMPLICATED - 50-75 mg/kg (14-21 days)

85
Q

adverse effects:

  • anemia
  • gray baby syndrome
  • blocks metabolism of warfarin, phenytoin, tolbutamide, and chlorpropamide
A

chlorampenicol

86
Q
  • chlorine-substituted derivative of lincomycin from s. lincolnensis
  • better tolerated than ERY
  • distributed well in the body fluids except CSF
  • blocks peptide bond formation at 50s ribosomal subunit
A

clindamycin / lincomycin

87
Q

dosage for CA MRSA

A

CLINDAMYCIN
600 mg IV q6-8

88
Q

dosage for bacterial vaginosis

A

CLINDAMYCIN cream 2%
1 full applicator (5g) intravaginally HS for 7 days

89
Q

adverse effects:

  • diarrhea
  • skin rashes
  • impaired liver function
  • neutropenia
  • antibiotic related colitis
A

clindamycin / lincomycin

90
Q
  • a mix of 2 streptogramins in a ration of 30:70
  • reserved for treatment of vancomycin resistant enterococcus faecium
  • interupts protein synthesis by binding on 50s bacterial ribosome
A

quinupristin / dalfopristin

91
Q

adverse effects:

  • venous irritation
  • arthralgia and myalgia
  • hyperbilirubinemia
  • inhibition of cytochrome p450
A

quinupristin / dalfopristin

92
Q

introduced to combat resistant gram positive organisms such as:
- vancomycin resistant s. aureus
- vancomycin resistant e. faecium and e. faecalis
- penicillin resistant strep

synthetic of oxazolidinone

A

linezolid

93
Q
  • inhibits bacterial protein sythesis by binding at the 70s initiation complex
  • it binds to a site on the 50s subunit near the interface with the 30s subunit
A

linezolid

94
Q

adverse effects:

  • usually well tolerated
  • GI upset
  • headache
  • rash
  • thrombocytopenia (if taken > 2 weeks)
A

linezolid

95
Q

interfere with bacterial DNA synthesis by inhibiting
- toposomerase II (DNA gyrase) in gram negative organism
- topoisomerase IV in gram positive organism

usually bactericidal against susceptible organisms

exhibit post antibiotic effect

A

quinolones

96
Q

adverse effects:

  • GI upset
  • headache, dizziness
  • photoxicity
  • connective tissue problems
  • QT interval prolongation
A

quinolones

97
Q

nursing consideration for quinolones:

should be taken with atleast ___ of fluid per day

A

3 liters

PHARMACOLOGY (9 decks)

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