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Pharm Exam 2 > Antibacterial/Anti-Infective Agents > Flashcards

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
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2
Q

examples of superinfection (2)

A

leukoplakia, candidiasis

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3
Q

what do you need to calculate before administering antibiotics?

A

GFR - normal should be 85-135 mL/min

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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

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5
Q

antibiotics that inhibit cell wall synthesis (3)

A
  • penicillins
  • cephalosporins
  • glycopeptides
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6
Q

antibiotics that inhibit protein synthesis (4)

A
  • macrolides
  • tetracyclines
  • aminoglycosides
  • lipopeptides
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7
Q

antibiotics that inhibit DNA synthesis (2)

A
  • fluoroquinolones

- lipopeptides

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8
Q

antibiotics that inhibit cell metabolism (1)

A

sulfonamides

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9
Q

examples of uricosuric drugs (2)

A
  • Probenecid

- Sulfinpyrazone

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10
Q

uricosuric drugs action

A

decreases excretion of penicillin → increases serum penicillin levels → increases effectiveness

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11
Q

basic penicillin use

A
  • narrow spectrum

- introduced to kill staphylococcus

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12
Q

broad-spectrum penicillins use

A

may treat both gram-positive and gram-negative bacteria - E. coli, Salmonella spp., Haemophilus influenzae

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13
Q

penicillinase-resistant penicillins use

A

treats penicillinase-producing S. aureus (enzyme that prevents antibiotic from going into cell)

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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
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15
Q

extended-spectrum penicillin example

A

Piperacillin (Pipracil)

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16
Q

beta-lactamase inhibitors use

A

given in combination with penicillinase-sensitive/broad-spectrum penicillin

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17
Q

beta-lactamase inhibitors action

A

inhibits bacterial beta-lactamase enzyme

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18
Q

beta-lactamase inhibitor example

A

clavulanic acid in Amoxicillin-Clavulanate (Augmentin)

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19
Q

broad-spectrum penicillin example

A

Amoxicillin-Clavulanate (Augmentin)

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20
Q

penicillin side effects (2)

A
  • allergic reactions/hypersensitivity in 5-10% of people - rash, reaction leading to anaphylaxis
  • N/V, diarrhea
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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
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22
Q

penicillin contraindications

A
  • history of hypersensitivity to penicillins

- avoid with severe renal insufficiency

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23
Q

food may _____ absorption of many oral penicillins

A

decrease

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24
Q

penicillins action

A
  • interferes with cell wall synthesis

- bactericidal

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25
Q

cephalosporins action

A
  • inhibit bacterial cell-wall synthesis

- bactericidal

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26
Q

penicillins and cephalosporins have a _______ structure

A

beta-lactam ring structure

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27
Q

first generation cephalosporins use

A

effective against gram-positive bacteria

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28
Q

first generation cephalosporin example

A

Cefazolin (Ancef)

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29
Q

fourth generation cephalosporins use

A
  • more extended gram-negative activity including Pseudomonas
  • broader gram-positive activity
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30
Q

fourth generation cephalosporins example

A

Cefepime (Maxipime)

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31
Q

cephalosporins general use

A

treats respiratory, urinary tract, skin, bone, joint, and genital infections

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32
Q

cephalosporins side effects (4)

A
  • hypersensitivity
  • N/V, diarrhea
  • alterations in blood clotting, neutropenia, hemolytic anemia
  • nephrotoxicity
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33
Q

cephalosporins + alcohol interaction

A

causes flushing, dizziness, headache, nausea/vomiting

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34
Q

macrolides action

A
  • inhibits protein synthesis

- bacteriostatic, bactericidal in large doses

35
Q

macrolides examples (3)

A
  • Azithromycin (Zithromax)
  • Clarithromycin (Biaxin)
  • Erythromycin (E-Mycin)
36
Q

macrolides uses (4)

A
  • 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
Q

macrolides side effects

A
  • GI distress
  • tinnitus, ototoxicity
  • superinfection
  • hepatotoxicity
38
Q

macrolides ______ serum levels of Carbamezapine (Tegretol), Theophyline, Warfarin (Coumadin)

A

increase

39
Q

erythromycin + Fluconazole (Diflucan), Ketoconazole (Nizoral) interaction

A

increases erythromycin levels

40
Q

azithromycin + antacids interaction

A

azithromycin levels may be reduced

41
Q

glycopeptides action

A

inhibits bacterial cell wall synthesis

42
Q

glycopeptide example

A

Vancomycin (Vancocin)

43
Q

glycopeptides general use

A

primarily active against gram positive bacteria

44
Q

IV glycopeptides use

A

treat drug resistant staph. infections

45
Q

oral glycopeptides use

A

treat staph. enterocolitis and antibiotic-associated pseudomembranous colitis due to C. difficile

46
Q

IV vancomycin adverse reactions (5)

A
  • red neck/red man syndrome
  • nephrotoxicity
  • ototoxicity
  • blood dysrasias
  • Stevens-Johnson syndrome
47
Q

red neck/red man syndrome prevention

A

dilute vancomycin (500 mg in 100 mL, 1000 mg in 250 mL) and infuse slowly (over 60-120 minutes)

48
Q

tetracyclines action

A
  • inhibits bacterial protein synthesis

- bacteriostatic

49
Q

tetracyclines uses (4)

A
  • 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
Q

tetracyclines side effects (6)

A
  • 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
Q

do not give tetracycline with _____ or _____

A

dairy products or antacids

52
Q

aminoglycosides action

A
  • inhibits bacterial protein synthesis

- bactericidal

53
Q

aminoglycoside example

A

Gentamicin (Garamycin)

54
Q

aminoglycosides use

A
  • narrow spectrum

- for “serious” infections

55
Q

aminoglycosides side effects (8)

A
  • rash
  • numbness
  • tremors
  • muscle cramps or weakness
  • visual disturbances
  • photosensitivity
  • skin sensitivity
  • tinnitus
56
Q

aminoglycosides adverse reactions (9)

A
  • oliguria
  • urticaria
  • palpitations
  • superinfection
  • ototoxicity
  • nephrotoxicity
  • thrombocytopenia, agranulocytosis
  • neuromuscular blockade
  • liver damage
57
Q

aminoglycosides + loop diuretics interaction

A

increases risk for ototoxicity

58
Q

aminoglycosides + amphotericin B, polymyxin, cisplatin, furosemide, vancomycin interaction

A

increased risk for nephrotoxicity

59
Q

fluoroquinolones action

A
  • interrupts DNA synthesis

- bactericidal

60
Q

fluoroquinolone example

A

Levofloxacin (Levaquin)

61
Q

fluoroquinolones use

A
  • broad-spectrum

- UTI, bone and joint infections, bronchitis, pneumonia, gonorrhea

62
Q

fluoroquinolones side effects (7)

A
  • nausea/vomiting, diarrhea, abdominal pain/cramps, flatulence
  • headache, dizziness
  • fatigue, restlessness, insomnia
  • rash
  • flushing
  • photosensitivity
  • tinnitus
63
Q

fluoroquinolones adverse reactions (5)

A
  • Stevens-Johnson syndrome
  • encephalopathy
  • seizures
  • Pseudomemrabous colitis - C. Diff, inflammation of bowel wall
  • dysrhythmia
64
Q

fluoroquinolones + oral hypoglycemics and theophylline interaction

A

increased effects of fluoroquinolones

65
Q

fluoroquinolones + antacids and iron interaction

A

decreased absorption of fluoroquinolones

66
Q

lipopeptides action

A
  • inhibits protein, DNA, and RNA synthesis

- bactericidal

67
Q

lipopeptide example

A

Daptomycin (Cubicin)

68
Q

lipopeptides uses

A
  • complicated skin infections
  • septicemia due to staph. A infections
  • infective endocarditis due to MRSA
69
Q

daptomycin side effects (7)

A
  • hypo/hypertension
  • anemia
  • numbness
  • tingling
  • dizziness
  • insomnia
  • pain/burning in urination
70
Q

daptomycin adverse reactions (4)

A
  • elevated creatine kinase (rhabdomyolysis) especially when given with statins
  • unexplained mypopathy, neuropathy
  • hypo/hyperkalemia, hyperglycemia
  • pleural effusion
71
Q

daptomycin + tobramycin interaction

A

risk for toxicity

72
Q

daptomycin + Coumadin interaction

A

increased bleeding

73
Q

sulfonamides action

A
  • inhibits cell metabolism - interferes with formation of folic acid in bacterial cells which is essential for bacterial growth
  • bacteriostatic
74
Q

sulfonamides uses

A

gram-negative infections, UTI, prostatitis, respiratory infections, burn wounds (topical), meningococcal meningitis, newborn eye prophylaxis, chlamydia, toxoplasmosis

75
Q

antiviral drugs action

A

interfere with viral nucleic acid synthesis in cell

76
Q

antiviral drugs uses (4)

A

herpes simplex virus, influenza, viral hepatitis, CMV

77
Q

antiviral example

A

Acyclovir Sodium (Zovirax)

78
Q

acyclovir side effects (5)

A
  • nausea/vomiting, diarrhea
  • headache, lethargy, tremors
  • rash, pruritus
  • increased bleeding time
  • phlebitis at IV site
79
Q

acyclovir adverse reactions (6)

A
  • urticaria
  • anemia
  • nephrotoxicity
  • bone marrow depression
  • thrombocytopenia, leukopenia, granulocytopenia
  • acute renal failure
80
Q

acyclovir contraindications (2)

A
  • hypersensitivity

- caution with several renal or hepatic disease

81
Q

metronidazole action

A

interferes with DNA function of bacteria

82
Q

metronidazole use

A

treats anaerobic infections

83
Q

metronidazole side effects (7)

A

dizziness, headache, confusion, depression, irritability, weakness, insomnia

Pharm Exam 2 (3 decks)

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