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Pharmacology > Antibiotic > Flashcards

Antibiotic Flashcards

1
Q

Mechanism
First choice
penicillin and cephalosporins

A

Cell wall synthesis inhibitors

P revent C ell wall

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2
Q

Mechanism
Rifampin and Fluoroquinolones

A

RNA and DNA synthesis inhibitors

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3
Q

Mechanism
Tetracycline and Macrolides

A

Protein synthesis inhibitors

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4
Q

Mechanism
Sulfonamides

A

Antimetabolites

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5
Q

Prophylactic therapy

A

Prevention!!
ex) Before after surgery

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6
Q

Empiric therapy

A

suspected infection where the organism not known

We don’t know what exactly, so cover everything

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7
Q

Definitive/ directed therapy

A

Antibiotics used after culture and sensitivity known
Narrowing therapy

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8
Q

Guidelines
Use the most a_________ agent appropriate for the patient’s infection

A

narrow spectrum

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9
Q

Host defenses
Bactericidal vs Bacteriostatic

A

Bactericidal
-abx kills bacteria
Bacteriostatic
-prevent bacteria from growing/replicated

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10
Q

If pt is immunocompromised, which one we need to use?
Bactericidal or Bacteriostatic?

A

Bactericidal
Because their immune system cannot kill the bacteria

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11
Q

Gram positive pathogen 3

A

Staphylococcus
Streptococcus
Enterococcus

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12
Q

Gram Negative Pathogens
Enterobacteriaceae

A

E. coli
Klebsiella
Proteus
Shigella
Salmonella

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13
Q

SPACE bugs

A

Serratia
Pseudomonas
Acinetobacter
Citrobacter
Enterobacter

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14
Q

Gram Negative Pathogens
Respiratory

A

Haemophilus influenza(H flu)
-causes most of upper respiratory tract infection
Moraxella catarrhalis

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15
Q

Gram Negative Pathogens
Neisseria

A

N. meningiditis
N. gonorrhoeae

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16
Q

“Atypical” Pathogens?
what is that?

A

Have unique things that makes it hard to treat.
And all are involved in respiratory tract infection

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17
Q

Atypical Pathogens
Name of pathogen
a) Must infect another cell to reproduce
b) No cell wall

A

a) Chlamydophila pneumoniae
b) Mycoplasma pneumoniae

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18
Q

Anaerobic Pathogens

A

Bacteroides
Clostridium (c-diff)

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19
Q

Bacteria possess many mechanisms for a_________________

A

a) antibiotic resistance

Bacteria always mutating　突然変異
Always make resistance

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20
Q

Beta- Lactams

a) All beta-lactams cause?
b) All beta-lactams are?
c) They most lack activity against?

A

a) hypersensitivity reactions
rush, fever
b) bactericidal
c) MRSA

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21
Q

Beta- Lactams is a______ dependent killing

A

Time
Give small, frequent doses, multiple times per day
Goal is to get drug levels above MIC
(Minimal inhibition concentration)

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22
Q

a_______ can result from very high doses of any beta-lactam

A

Seizures
-Most often occurs in patient with renal
dysfunction

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23
Q

PCN allergy
symptoms are drug fever or rash, what to do?

A

Cross-reactivity with ß-lactams
- 3 to 5% (likelihood)
May safely give other ß-lactams

Only 3 to 5% get worsen rash, but so what?? better than dyeing

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24
Q

PCN allergy
symptoms are hives or anaphylaxis
what to do?

A

Do NOT give ß-lactams with potential cross reactivity
Give aztreonam instead

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25
Q

Penicillin
Characteristic

A

Very short half-lives and therefore are dosed multiple times per day
Many are poorly absorbed
–Can lead to diarrhea
–Will likely have different oral vs IV doses

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26
Q

Natural Penicillin
Spectrum

A

Streptococcus
Enterococcus
Gram +

NOT Staphylococcus

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27
Q

Natural Penicillin
a) Commonly found in?
b) All Penicillin is?

A

a) bread mold
b) bactericidal

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28
Q

Parenteral Natural PCNs
Aqueous PCN G

A

Most common
Penetrates CSF
Neuro Syphilis
Short duration every 4hr

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29
Q

Parenteral Natural PCNs
Procaine PCN G

A

IM only
detectable levels 12-24 hrs
used to treat gonorrhea
dosed q12-24h

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30
Q

Parenteral Natural PCNs
Benzathine PCN G

A

IM only
detectable levels 15-30 days
used to treat syphilis, pharyngitis

Very think solution and pain

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31
Q

Penicillinase-Resistant
Spectrum

A

Gram +
Staph aureus

32
Q

Penicillinase-Resistant
Parenteral agents

A

nafcillin
-Most active
-Best CNS penetration
methicillin
-nephrotoxic
oxacillin

33
Q

Penicillinase-Resistant
Oral

A

dicloxacillin
-Good oral absorption
cloxacillin
-Best oral absorption

34
Q

Aminopenicillin
Spectrum

A

Gram + and Gram -
NSHEPS

35
Q

Aminopenicillin
Spectrum name for NSHEPS

A

N. meningitidis
Salmonella
H. influenzae
E. coli
P. mirabilis
Shigella

But they develop beta-lactamase

36
Q

Aminopenicillin
ampicillin combo

A

ampicillin
ampicillin/sulbactam
Unasyn®

37
Q

ampicillin ADRs
amoxicillin ADRs

A

ampicillin
-Diarrhea and rash
amoxicillin
-Better absorption
-Less GI problems

38
Q

Aminopenicillin
amoxicillin combo

A

amoxicillin/clavulanic acid
Augmentin®
Clavulanic acid is a beta-lactamase inhibitor
More GI side effects

39
Q

Antipseudomonal Penicillin
Parenteral
Spectrum

A

Pseudomonas
-Kill Pseudomonas

40
Q

Antipseudomonal Penicillin
This combo for kill pseudomonas and unknown organisum

A

Piperacillin/tazobactam
Zosyn®

41
Q

First Generation
Cephalosporins
Spectrum

A

Gm+

42
Q

First Generation
Cephalosporins
agents

A

Anspor®
Ancef®
Keflex®
Duracef®

43
Q

Second Generation
Cephalosporins
Spectrum

A

Similar work as aminopenisillin
Kill good Gram + and Gram -
-H.influenzae
-M,catarrhalis
-N.meningitidis
-N.gonorrhoeae

44
Q

Second Generation
Cephalosporins
agents

A

cefoxitin
cefotetan
cefuroxime
cefprozil
cefaclor
loracarbef

45
Q

Third Generation
Cephalosporins
Spectrum

A

Kill good Gram -

46
Q

Third Generation
Cephalosporins
agents

A

Cefditoren pivoxil
Cefdinir
Cefdibuten
Cefotaxime (Claforan®)
Ceftriaxone (Rocephin®)
Ceftazidime (Fortaz®)

47
Q

Third Generation
Cephalosporins
Clinical use

A

Pneumonia
Bacteremia
UTI

48
Q

Fourth Generation
Cephalosporins
Spectrum

A

Very BROAD spectrum antibiotic
Gram+ and Gram -
Good for empiric therapy

49
Q

Fourth Generation
Cephalosporins
Agents

A

Maxipime®
Ancef®(1st) + Fortaz® (3rd) (VERY BROAD)

50
Q

Fifth Generation
Cephalosporins
Spectrum

A

Kill RESISTANCE gram +
MSSA, MRSA

51
Q

Fifth Generation
Cephalosporins
agent

A

Teflaro®

52
Q

Monobactams
agent

A

Aztreonam
Gram - only

53
Q

Aztreonam
Spectrum

A

Type I PCN allergies
For pt who had hives/anaphylaxis to other B-lactams!

54
Q

Carbapenems
agent

A

Imipenem
Meropenem
Ertapenem
Doripenem

penem

55
Q

Carbapenems
Clinical uses

A

Wide range of bacterial infections
*Empiric therapy
systemic infections
mixed infections

56
Q

Glycopeptides
agents

A

Vancomycin
Telavancin

57
Q

Glycopeptides
Spectrum

A

Gram + only
c-diff
MASA!!!

58
Q

Vancomycin
ADRs

A

Red man syndrome
-histamine release
-dilation, redness, itching very bad

Serious nephrotoxicity
Ototoxicity
Neutropenia
Phlebitis

59
Q

Cyclic Lipopeptides
agent

A

Daptomycin
Vancomycin

60
Q

Daptomycin
BBW

A

SHOULD NOT be used in the treatment of pneumonia!!
Death rate and serious cardiorespiratory adverse events were significantly higher

61
Q

Fluoroquinolones
agents

A

ciprofloxacin
ofloxacin
levofloxacin
moxifloxacin
gemifloaxcin

“floxacin”

62
Q

Fluoroquinolones
Spectrum

A

Good staph, moderate strep
Excellent for some Gram-
(H.flu, P.aeruginosa)
Bactericidal

63
Q

Fluoroquinolones
Waring

A

Tendons rupture
Acute sinusitis
acute bronchitis
UTI

64
Q

Macrolides
agents

A

erythromycin
clarithromycin
azithromycin

Bacteristatic, bactericidal at high doses

65
Q

Macrolides
Spectrum

A

Gm+
Gm- (H. flu)

66
Q

Which macrolides work best?
a) Mycoplasma pneumonia
b) Helicobacter pylori

A

a) azithromycin
b) clarithromycin

67
Q

Macrolides
indication

A

Mycoplasma infections
Chlamydia infections during pregnancy
URI/LRI
STD
Acne

68
Q

Tetracyclines
Spectrum

A

Gm+
Gm-
bacteriostatic

69
Q

Tetracyclines
agents
a) short-acting
b) long-acting

A

a) tetracycline
b) doxycycline, minocycline

70
Q

Metronidazole
Spectrum

A

Bactericidal
Gm+ and Gm-

71
Q

Clindamycin
a) Spectrum
b) indication

A

a)
Bacteriostatic
Gm+ and Gm-

b)
B. fragilis
acne vulgaris
Toxoplasmosis

72
Q

SMX-TMP
a) Spectrum
b) indication

A

a)Bactericidal
Gm+ and Gm-
b)UTI
URI
–Salmonella, Shigella
Travelers Diarrhea
PCP Infections

73
Q

Aminoglycosides
a) Spectrum
b) ADRs

A

a) Powerful Gm- activity
b) Nephrotoxicity, ototoxicity

74
Q

Aminoglycosides
agengts

A

gentamicin
tobramycin
neomycin

75
Q

Fidaxomicin/Dificid®
used for?

A

Clostridium difficile infection
C. Diff!!!

–Can cause severe diarrhea and serious bowel inflammation
–Typically seen after treatment with antibiotics
–Normally treated with oral vancomycin (cheaper)

Pharmacology (34 decks)

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