Antibiotic Meds Flashcards
List some signs of infection
Fever, chills, sweats, redness, pain & swelling at the site, fatigue, weight loss, elevated WBC
Classify bacteria into 3 categories according to their shape
Coccus, Bacillus, and Spirochete
Describe culture reports and sensitivity reports
Culture: gram + or - , shape, and name of bacteria
Sensitivity: R (resistant) or S (sensitive)
List the 4 most common mechanisms of action of antibiotics
- Inhibit bacterial cell wall synthesis
- Lethal/non-lethal inhibition of bacterial protein
- inhibition of DNA synthesis
- anti-metabolites
Compare prophylactic therapy with empiric therapy
prophylactic: prevention of infection (before procedure)
empiric: infection present
List the 4 major subclasses of beta-lactam antibiotics
- Penicillin
- Cephalosporins
- Carbapenems
- Monobactams
These subclasses may give cross-allergy!
Classify penicillin into 4 groups with examples of each
- narrow-spectrum + penicillinase sensitive (penicillin G and V)
- narrow-spectrum + penicillinase resistant (Nafcillin, Oxacillin, etc.)
- broad-spectrum (ampicillin, amoxicillin)
- extended -spectrum (piperacillin)
Describe the mechanism of action of penicillin
P: penetrate cell wall & bind to protein
C: cell wall becomes weak and leaky
L: lysis
Define the role of the beta-lactamases
enzymes produced by bacteria that inactivate penicillin
List 3 drugs that inhibit the beta-lactamases
- clavulanic acid
- sulbactam
- tazobactam
Name 4 examples of drugs that are combinations of penicillins and beta-lactamase inhibitors
Amoxicillin + CA
Ticarcillin + CA
Ampicillin + sulbactam = Unasyn
Piperacillin + tazobactam
Specify the therapeutic indication of penicillin
treat gram-positive bacteria
Identify 5 symptoms of allergic reaction with penicillin
hives, rash, itching, angioedema, and sometimes anaphylaxis
List 3 alternative antibiotics for patients with penicillin allergy
Vancomycin, erythromycin, and clindamycin
Compare 5 generations of cephalosporins
1-2: not effective in CSF
3-5: effective!
- gram positive only
- gram negative too!
- first choice for meningitis
- hospital-associated pneumonias
- MRSA
List an example of 5 generations of cephalosporins
- cephalexin
- cefoxitin
- cefotaxime
- cefepime
- ceftaroline
Specify 4 adverse effects of cephalosporin
- allergic reactions
- bleeding (cefotetan& ceftriaxon can interfere with VK metabolism)
- thrombophlebitis
- hemolytic anemia
Describe the interaction of cephalosporin & alcohol
Disulfiram-like effect (severe flushing, tachycardia, hypotension)
Do not mix with alcohol!
List 4 example of carbapenems
end in “-penem”
Imipenem, meropenem, ertapenem, doripenem
very broad spectrum!
Describe monobactams and identify the adverse effects
narrow-spectrum (only gram negative)
must be given IV –> risk of thrombophlebitis
Describe the indications of vancomycin
- used for treating C. diff and MRSA
- alternative for penicillin allergy
List 3 adverse effects of vancomycin
allergic reaction, red man syndrome, renal toxicity
Identify 5 signs of red man syndrome
flushing, rash, severe itching, tachycardia, hypotension
Specify the measure to prevent red man syndrome
infuse slowly, pre-medicate with Tylenol and diphenhydramine
Describe tetracyclines and specify 3 uses
Bacteriostatic inhibitor of protein synthesis
Used to treat acne, peptic ulcer disease, periodontal disease
List some adverse effects of tetracycline
- esophageal erosion
- superinfection
- calcium deposit on teeth
- suppress long bone growth in premature infants
- hepato, nephrotoxicity
- photosensitivity!!!
List 3 examples of macrolides
Azithromycin (Z-pack)
Clarithromycin
Erythromycin
Specify the indications of erythromycin
It mostly hits gram-positive bacteria (whooping cough, chlamydia)
Alternative to penicillin
2 adverse effects of erythromycin
- GI distress
- risk of cardiac QT prolongation
Specify the indications of clindamycin
Active against gram + and -
- serious anaerobic infections outside CNS
- severe group A streptococcus
- alternative to penicillin
2 adverse effects of clindamycin
- C. diff (4-6 weeks after you stopped)
- erosive esophagitis
Specify 4 therapeutic indications of linezolid
Keep it for severe infection!
- VRE, MRSA
- strep community-acquired pneumonia (CAP)
- strep aureus infection
List 3 adverse effects of linezolid
- GI distress
- myelosuppression –> pancytopenia!
- rare peripheral neuropathy
Describe therapeutic use and adverse effect of Dalfopristin/quinupristin
- used for VRE
- hepatotoxicity –> watch for ALT (more specific for liver enzymes!)
List 3 examples of aminoglycosides
Gentamicin, Tobramycin, Amikacin
Describe aminoglycosides
- bactericidal inhibitor of bacterial protein
- must be given IV or IM
- serum levels should be monitored (peak & trough)
Specify 2 adverse effects of aminoglycosides
Ototoxicity
Nephrotoxicity
Describe sulfonamides
- bacteriostatic
- widespread resistance to sulfonamides
- primarily used for UTI
Explain the reason sulfonamides are not given to infants less than 2 months age
Due to risk of kernicterus (elevated bilirubin causing brain damage)
Explain the importance for patients on sulfonamides to drink enough fluids
Sulfonamides may cause crystalline aggregates in renal system
3 adverse reactions of sulfonamides
- hypersensitivity reactions
- Stevens-Johnson Syndrome
- hematologic effects (anemia, leukopenia, thrombocytopenia)
List 2 uses of trimethoprim/sulfamethoxazole
- UTI
- Pneumocystis Pneumonia (PCP)
Specify 2 adverse effects of trimethoprim
- hyperkalemia
- birth defects
