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TOP 300 > Antibacterials and Antifungals > Flashcards

Antibacterials and Antifungals Flashcards

1
Q

generic name and class

amoxil

A

generic: amoxicillin
class: aminopenicillins

beta lactam

gram positive coverage; Streptococcus spp., Enterococcus spp, Staphylococcus spp, and some Enterobacterales

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2
Q

generic name and class

augmentin

A

generic: amoxicillin/clavulanic acid
class: aminopenicillins

beta lactam

gram-positive and gram-negative coverage; co-formulation of amoxicillin with a beta-lactamase inhibitor allows for extended coverage of Gram
negatives that produce beta-lactamases

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3
Q

generic name and class

omnicef

A

generic: cefdinir
class: 3rd gen cephalosporins

beta lactam

gram-positive and gram-negative coverage

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4
Q

generic name and class

ceftin

A

generic: cefuroxime
class: 2nd gen cephalosporins

beta lactam

mostly gram-positive coverage

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5
Q

generic name and class

kaflex

A

generic: cephalexin
class: 1st gen cephalosporins

beta lactam

mostly gram-positive coverage

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6
Q

generic name and class

penicillin vk

A

generic: penicillin
class: natural penicillins

beta lactam

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7
Q

MOA

beta-lactams

A

mechanism-based inhibition of penicillin binding proteins to prevent bacterial cell wall growth, maintenance and homeostasis

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8
Q

ADRs and contraindications

beta-lactams

A
  • allergy
  • anaphylaxis
  • serum sickness
  • rash
  • glomerulonephritis
  • DRESS
  • altered microbiome: GI upset/diarrhea
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9
Q

key counseling points

beta lactams

A
  • take to completion
  • will not affect contraceptives
  • can use probiotics for diarrhea not yeast infections
  • take with food
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10
Q

generic name and class

cipro, cipro xr

A

generic: ciprofloxacin oral
class: fluoroquinolones

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11
Q

generic name and class

ciprodex otic, cetraxal, cipro hc

A

generic: ciprofloxacin otic
class: fluoroquinolones

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12
Q

generic name and class

levaquin

A

generic: levofloxacin
class: fluoroquinolones

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13
Q

generic name and class

zymar, zymaxid

A

generic: gatifloxacin ophthalmic
class: fluoroquinolones

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14
Q

indication

fluoroquinolones

A
  • Gram positive activity—active against MSSA, typically resistant in MRSA but susceptibility testing will decide utility
  • Gram negative activity—generally considered “gram negative” agent; provides broad gram-negative coverage, including to Pseudomonas
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15
Q

MOA

fluoroquinolones

A

block bacterial DNA synthesis through inhibition of topoisomerase II and topoisomerase IV

  • Topoisomerase II inhibition—results in supercoiled DNA
  • Topoisomerase IV inhibition—prevents DNA from being separated into daughter cells during
    cell division
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16
Q

ADRs

fluoroquinolones

A
  • QT prolongation (low)
  • C. diff associated diarrhea
  • ciprofloxacin - no renal adjustments needed
  • levofloxacin - renal adjustments needed
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17
Q

contraindications

fluoroquinolones

A

hypersensitivity

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18
Q

BBW

fluoroquinolones

A
  • tendon rupture
  • peripheral neuropathy
  • exacerbations of myasthenia gravis
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19
Q

key counseling points

fluoroquinolones

A
  • will not affect oral contraceptives
  • take to completion
  • probiotics help for diarrhea not for yeast infections
  • avoid taking with food or drinks high in calcium (dairy, vitamins, other medicines, etc.)
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20
Q

generic name and class

blaxin

A

generic: clarithromycin
class: macrolide

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21
Q

generic name and class

erythrocin

A

generic: erythromycin
class: macrolide

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22
Q

generic name and class

zithromax

A

generic: azithromycin
class: macrolide

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23
Q

indication

macrolides

A
  • Gram positive activity—Pneumococci, Streptococci, Staphylococci, Listeria monocytogenese
  • Gram negative activity—H. pylori, Chlamydia, Mycoplasm, Neisseria
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24
Q

MOA

macrolides

A
  • binds to rRNA of 50S subunit of bacterial ribosome
  • protein synthesis inhibition
25
Q

ADRs

macrolides

A
  • GI side effects
  • QT prolongation (moderate)
  • change in taste
  • SJS
26
Q

contraindications

macrolides

A
  • hypersensitivity
  • DDI-inhibits CYP3A4 metabolism
27
Q

key counseling points

macrolides

A
  • will not affect contraceptives
  • take to completion
  • probiotics help for diarrhea not for yeast infections
28
Q

generic name and class

vibramycin

A

generic: doxycycline
class: tetracyclines

29
Q

generic name and class

minocin

A

generic: minocycline
class: tetracycline

30
Q

indication

tetracyclines

A
  • Gram positive activity—Pneumococci, Streptococci, Staphyloccci, Listeria monocytogenese
  • Gram negative activity—H. pylori, Chlamydia, Mycoplasm, Neisseria
31
Q

MOA

tetracyclines

A
  • protein synthesis inhibition
  • binds to rRNA to 30S subunit of bacterial ribosome
  • prevent binding of tRNA to ribosome complex stopping addition of new amino acids to peptide chain
32
Q

ADRs

tetracyclines

A
  • GI side effects
  • increased skin sensitivity to light
33
Q

contraindications

tetracyclines

A
  • allergy
  • children under 8 years old
  • pregnancy
  • concurrent retinoic acid derivatives (accutane)
34
Q

key counseling points

tetracyclines

A
  • will not affect contraceptives
  • take to completion
  • probiotics help diarrhea but not yeast infections
  • avoid taking with foods or drinks high in calcium and magnesium
  • don’t use leftover antibiotics
35
Q

generic - brand

miscellaneous

A
  1. metronidazole - flagyl
  2. trimethoprim/sulfamethoxazole - bactrim and septra
  3. nitrofurantoin - macrodantin and macrobid
  4. mupirocin - bactroban
  5. chlorhexidine - paroex and peridex and hibiclens
  6. fidaxomicin - dificid
  7. clindamycin - cleocin
36
Q

indications

miscellaneous

A
  1. metronidazole - C. diff, H. pylori, anaerobic bacteria
  2. trimethoprim/sulfamethoxazole - gram positive, P. jirovecii (PCP pneumonia), some gram negative activity
  3. nitrofurantoin - gram + or gram -, UTIs only
  4. mupirocin - topical only, used for impetigo (staphylococci, streptococci)
  5. chlorhexidine - topical only, antiseptic rather than antibiotic
  6. fidaxomicin - C. diff
  7. clindamycin - gram positive: streptococci, staphylococci, pneumococci
37
Q

MOA

miscellaneous

A
  1. metronidazole - accumulation of toxic byproduct in bacteria
  2. trimethoprim/sulfamethoxazole - disrupts synthesis of nucleotide precursors by acting as folate antagonist
  3. nitrofurantoin - accumulation of toxic byproduct in bacteria
  4. mupirocin - protein synthesis inhibitor
  5. chlorhexidine - membrane destabilization of gram + and gram - and mycobacteria
  6. fidaxomicin - protein synthesis inhibitor
  7. clindamycin - protein synthesis inhibition by binding to 50S subunit of ribosome (like macrolides)
38
Q

ADRs

miscellaneous

A
  1. metronidazole - DDI: warfarin, CYP3A4/5 substrates
  2. trimethoprim/sulfamethoxazole - upset stomach, renal failure, hyperkalemia, SJS
  3. nitrofurantoin - discolored urine, upset stomach, pulmonary fibrosis/interstitial lung disease
  4. mupirocin - well tolerated/topical, pruritis, local burning/stinging
  5. chlorhexidine - well tolerated/topical, pruritis, local burning/stinging
  6. fidaxomicin - nausea and fever
  7. clindamycin - C. diff, diarrhea, maculopapular rash, DRESS
39
Q

contraindications

miscellaneous

A
  1. metronidazole - allergy, 1st trimester pregnancy, alcohol
  2. trimethoprim/sulfamethoxazole - sulfonamide allergy, history of drug induced thrombocytopenia w/ sulfonamides
  3. nitrofurantoin - allergy, hemolytic anemia risk in pregnant women at term, CrCl < 60
  4. mupirocin - allergy
  5. chlorhexidine - allergy
  6. fidaxomicin - allergy
  7. clindamycin - allergy
40
Q

key counseling points

miscellaneous

A
  1. metronidazole - no alcohol
  2. trimethoprim/sulfamethoxazole - diarrhea, weak inhibition of human folate
  3. nitrofurantoin - discolored urine
  4. clindamycin - diarrhea for >3 days or after finishing antibiotic should discuss w/ physician , take with food
41
Q

generic name and class

diflucan

A

generic: fluconazole
class: azoles

42
Q

generic name and class

nizoral

A

generic: ketoconazole topical
class: azoles

43
Q

indications

azoles

A

Spectrum: Anti-fungal with activity against
* Cryptococcus
* Candida

44
Q

MOA

azoles

A

inhibition of fungal CYP51 to block synthesis of ergosterol, a critical component of membrane

45
Q

ADRs

azoles

A
  • headache
  • DDIs with other agents metabolized by CYP3A4
46
Q

contraindications

azoles

A
  • allergy
  • moderate QT prolongation
  • pregnancy
47
Q

key counseling points

azoles

A

take with food

48
Q

generic name and class

biostatin

A

generic: nystatin oral
class: nystatin

49
Q

generic name and class

mycostatin, nyamyc, nystop

A

generic: nystatin topical
class: nystatin

50
Q

indications

nystatin

A

Spectrum: Anti-fungal with activity against
* Candida

51
Q

MOA

nystatin

A

polyene macrolide that binds and destabilizes fungal cell membrane

52
Q

contraindications

nystatin

53
Q

key counseling points

nystatin

A

take with food

54
Q

generic name and class

lamisil

A

generic: terbinafine
class: terbinafines

55
Q

indications

terbinafine

A

Spectrum: activity against dermatophytes, yeasts (e.g., candida), and dimorphic fungi
* Typically used to treat nail infections

56
Q

MOA

terbinafine

A

allylamine that inhibits ergosterol synthesis through inhibition of squalene epoxidase to destabilize the fungal cell membrane

57
Q

ADRs

terbinafine

A
  • hepatoxicity with systemic
  • SJS/TEN - emergency
58
Q

contraindications

terbinafine

A
  • allergy
  • existing liver disease
59
Q

key counseling points

terbinafine

A

possible temp alterations to taste and smell

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