Antibacterial/Anti-Infective Agents Flashcards
1
Q
actions of antibiotics (5)
A
- inhibition of cell wall synthesis
- alteration in membrane permeability
- inhibition of protein synthesis
- inhibition of RNA & DNA synthesis
- interference with cellular metabolism
2
Q
examples of superinfection (2)
A
leukoplakia, candidiasis
3
Q
what do you need to calculate before administering antibiotics?
A
GFR - normal should be 85-135 mL/min
4
Q
what is the formula used to estimate GFR?
A
Cockcroft and Gault Formula: (140 – age) x weight in kg / 72 x serum creatinine
- multiply product by 0.85 for females
5
Q
antibiotics that inhibit cell wall synthesis (3)
A
- penicillins
- cephalosporins
- glycopeptides
6
Q
antibiotics that inhibit protein synthesis (4)
A
- macrolides
- tetracyclines
- aminoglycosides
- lipopeptides
7
Q
antibiotics that inhibit DNA synthesis (2)
A
- fluoroquinolones
- lipopeptides
8
Q
antibiotics that inhibit cell metabolism (1)
A
sulfonamides
9
Q
examples of uricosuric drugs (2)
A
- Probenecid
- Sulfinpyrazone
10
Q
uricosuric drugs action
A
decreases excretion of penicillin → increases serum penicillin levels → increases effectiveness
11
Q
basic penicillin use
A
- narrow spectrum
- introduced to kill staphylococcus
12
Q
broad-spectrum penicillins use
A
may treat both gram-positive and gram-negative bacteria - E. coli, Salmonella spp., Haemophilus influenzae
13
Q
penicillinase-resistant penicillins use
A
treats penicillinase-producing S. aureus (enzyme that prevents antibiotic from going into cell)
14
Q
extended-spectrum penicillins use
A
- against gram-negative organisms - Pseudomonas aeruginosa, Proteus spp., Klebsiella pneumoniae
- treat bone, joint, skin, soft tissue, respiratory tract, urinary tract infections
15
Q
extended-spectrum penicillin example
A
Piperacillin (Pipracil)
16
Q
beta-lactamase inhibitors use
A
given in combination with penicillinase-sensitive/broad-spectrum penicillin
17
Q
beta-lactamase inhibitors action
A
inhibits bacterial beta-lactamase enzyme
18
Q
beta-lactamase inhibitor example
A
clavulanic acid in Amoxicillin-Clavulanate (Augmentin)
19
Q
broad-spectrum penicillin example
A
Amoxicillin-Clavulanate (Augmentin)
20
Q
penicillin side effects (2)
A
- allergic reactions/hypersensitivity in 5-10% of people - rash, reaction leading to anaphylaxis
- N/V, diarrhea
21
Q
treatment for penicillin allergic reaction/hypersensitivity
A
- stop medication
- for mild reaction: Diphenhydramine (Benadryl)
- for anaphylaxis: manage airway, administer epinephrine/corticosteroids, give saline/plasma expanders
22
Q
penicillin contraindications
A
- history of hypersensitivity to penicillins
- avoid with severe renal insufficiency
23
Q
food may _____ absorption of many oral penicillins
A
decrease
24
Q
penicillins action
A
- interferes with cell wall synthesis
- bactericidal
25
cephalosporins action
- inhibit bacterial cell-wall synthesis
| - bactericidal
26
penicillins and cephalosporins have a _______ structure
beta-lactam ring structure
27
first generation cephalosporins use
effective against gram-positive bacteria
28
first generation cephalosporin example
Cefazolin (Ancef)
29
fourth generation cephalosporins use
- more extended gram-negative activity including Pseudomonas
- broader gram-positive activity
30
fourth generation cephalosporins example
Cefepime (Maxipime)
31
cephalosporins general use
treats respiratory, urinary tract, skin, bone, joint, and genital infections
32
cephalosporins side effects (4)
- hypersensitivity
- N/V, diarrhea
- alterations in blood clotting, neutropenia, hemolytic anemia
- nephrotoxicity
33
cephalosporins + alcohol interaction
causes flushing, dizziness, headache, nausea/vomiting
34
macrolides action
- inhibits protein synthesis
| - bacteriostatic, bactericidal in large doses
35
macrolides examples (3)
- Azithromycin (Zithromax)
- Clarithromycin (Biaxin)
- Erythromycin (E-Mycin)
36
macrolides uses (4)
- active against most gram-positive bacteria and some gram-negative bacteria
- treat moderate to severe infections of respiratory, GI tract, skin and soft tissue
- Mycoplasma pneumoniae
- Legionnaires’ disease
37
macrolides side effects
- GI distress
- tinnitus, ototoxicity
- superinfection
- hepatotoxicity
38
macrolides ______ serum levels of Carbamezapine (Tegretol), Theophyline, Warfarin (Coumadin)
increase
39
erythromycin + Fluconazole (Diflucan), Ketoconazole (Nizoral) interaction
increases erythromycin levels
40
azithromycin + antacids interaction
azithromycin levels may be reduced
41
glycopeptides action
inhibits bacterial cell wall synthesis
42
glycopeptide example
Vancomycin (Vancocin)
43
glycopeptides general use
primarily active against gram positive bacteria
44
IV glycopeptides use
treat drug resistant staph. infections
45
oral glycopeptides use
treat staph. enterocolitis and antibiotic-associated pseudomembranous colitis due to C. difficile
46
IV vancomycin adverse reactions (5)
- red neck/red man syndrome
- nephrotoxicity
- ototoxicity
- blood dysrasias
- Stevens-Johnson syndrome
47
red neck/red man syndrome prevention
dilute vancomycin (500 mg in 100 mL, 1000 mg in 250 mL) and infuse slowly (over 60-120 minutes)
48
tetracyclines action
- inhibits bacterial protein synthesis
| - bacteriostatic
49
tetracyclines uses (4)
- first broad-spectrum antibiotic effective against gram positive and negative bacteria + many other organisms
- Mycoplasma pneumoniae
- treat H. Pylori in combination with metronidazole and bismuth subsalicylate
- oral and topical used for severe acne vulgaris
50
tetracyclines side effects (6)
- very irritating to gastric mucosa: nausea/vomiting, diarrhea, flatulence, epigastric distress, abdominal discomfort, heartburn
- rash, pruritus
- photosensitivity
- headache
- teratogenic
- teeth discoloration (esp. if younger than 8 y/o)
51
do not give tetracycline with _____ or _____
dairy products or antacids
52
aminoglycosides action
- inhibits bacterial protein synthesis
| - bactericidal
53
aminoglycoside example
Gentamicin (Garamycin)
54
aminoglycosides use
- narrow spectrum
| - for "serious" infections
55
aminoglycosides side effects (8)
- rash
- numbness
- tremors
- muscle cramps or weakness
- visual disturbances
- photosensitivity
- skin sensitivity
- tinnitus
56
aminoglycosides adverse reactions (9)
- oliguria
- urticaria
- palpitations
- superinfection
- ototoxicity
- nephrotoxicity
- thrombocytopenia, agranulocytosis
- neuromuscular blockade
- liver damage
57
aminoglycosides + loop diuretics interaction
increases risk for ototoxicity
58
aminoglycosides + amphotericin B, polymyxin, cisplatin, furosemide, vancomycin interaction
increased risk for nephrotoxicity
59
fluoroquinolones action
- interrupts DNA synthesis
| - bactericidal
60
fluoroquinolone example
Levofloxacin (Levaquin)
61
fluoroquinolones use
- broad-spectrum
| - UTI, bone and joint infections, bronchitis, pneumonia, gonorrhea
62
fluoroquinolones side effects (7)
- nausea/vomiting, diarrhea, abdominal pain/cramps, flatulence
- headache, dizziness
- fatigue, restlessness, insomnia
- rash
- flushing
- photosensitivity
- tinnitus
63
fluoroquinolones adverse reactions (5)
- Stevens-Johnson syndrome
- encephalopathy
- seizures
- Pseudomemrabous colitis - C. Diff, inflammation of bowel wall
- dysrhythmia
64
fluoroquinolones + oral hypoglycemics and theophylline interaction
increased effects of fluoroquinolones
65
fluoroquinolones + antacids and iron interaction
decreased absorption of fluoroquinolones
66
lipopeptides action
- inhibits protein, DNA, and RNA synthesis
| - bactericidal
67
lipopeptide example
Daptomycin (Cubicin)
68
lipopeptides uses
- complicated skin infections
- septicemia due to staph. A infections
- infective endocarditis due to MRSA
69
daptomycin side effects (7)
- hypo/hypertension
- anemia
- numbness
- tingling
- dizziness
- insomnia
- pain/burning in urination
70
daptomycin adverse reactions (4)
- elevated creatine kinase (rhabdomyolysis) especially when given with statins
- unexplained mypopathy, neuropathy
- hypo/hyperkalemia, hyperglycemia
- pleural effusion
71
daptomycin + tobramycin interaction
risk for toxicity
72
daptomycin + Coumadin interaction
increased bleeding
73
sulfonamides action
- inhibits cell metabolism - interferes with formation of folic acid in bacterial cells which is essential for bacterial growth
- bacteriostatic
74
sulfonamides uses
gram-negative infections, UTI, prostatitis, respiratory infections, burn wounds (topical), meningococcal meningitis, newborn eye prophylaxis, chlamydia, toxoplasmosis
75
antiviral drugs action
interfere with viral nucleic acid synthesis in cell
76
antiviral drugs uses (4)
herpes simplex virus, influenza, viral hepatitis, CMV
77
antiviral example
Acyclovir Sodium (Zovirax)
78
acyclovir side effects (5)
- nausea/vomiting, diarrhea
- headache, lethargy, tremors
- rash, pruritus
- increased bleeding time
- phlebitis at IV site
79
acyclovir adverse reactions (6)
- urticaria
- anemia
- nephrotoxicity
- bone marrow depression
- thrombocytopenia, leukopenia, granulocytopenia
- acute renal failure
80
acyclovir contraindications (2)
- hypersensitivity
| - caution with several renal or hepatic disease
81
metronidazole action
interferes with DNA function of bacteria
82
metronidazole use
treats anaerobic infections
83
metronidazole side effects (7)
dizziness, headache, confusion, depression, irritability, weakness, insomnia
