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Pharm 313 > Antibiotics 1 > Flashcards

Antibiotics 1 Flashcards

1
Q

drugs that weaken bacterial cell wall (4)

A
  1. penicillin
  2. cephalosporins
  3. Carbapenems
  4. other: vancomycin
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2
Q

cytolysis

A

cell wall wall disruption

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3
Q

cytolysis, what do the abx do?

A

drugs cause cytolysis
cell takes on H2O
cell burst
BACTERIACIDAL

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4
Q

When does cytolysis occur?

A

happens when bacteria is undergoing growth and division b/c thats when binding proteins are expressed

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5
Q

why don’t abx cause cytolysis in our normal cells?

A
  • normal human cells dont have cell walls

- bacterial cells have cell walls

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6
Q

Penicillin prototype

A

Penicillin G

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7
Q

Penicillin G discovered in

A

1928

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8
Q

what is a penicillin repository?

A
  • repository = absorbs slowly over a week or several weeks

result: produces blood levls that are persistent but low

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9
Q

How is penicillin given?

A

Usually IV or IM b/c penicillin is destroyed by stomach

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10
Q

Is penicillin toxic?

A

1 of the least toxic and safest antibiotics

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11
Q

4 kinds of penicillin salts

A
  1. Potassium Penicillin G
  2. Procaine Penicillin
  3. Benzathine Penicillin
  4. Sodium Penicillin
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12
Q

Penicillins that are repositories

A

Procaine Penicillin and Benzathine Penicillin

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13
Q

What to watch with Potassium Penicillin G and how is it given

A

Potassium, IV

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14
Q

What to watch with Sodium Penicillin?

A

Na

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15
Q

Most common cause of drug allergies

A

Penicillin G (.4-7% have allergic rxn)

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16
Q

Types of allergic reactions

A
  1. Immediate (2-30 min)
  2. accelerated (1-72 hr)
  3. late (days-weeks)
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17
Q

treatment for allergic rxn

A

epinephrine

-resp support, check O2 status, antihistamine

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18
Q

symptoms of anaphylaxis

A
  • laryngeal edema
  • hypotension
  • broncho constriction
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19
Q

Penicillins have cross sensitivity to

A

Cephalosporins

1% of ppl allergic to penicillin also allergic to cephalosporins

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20
Q

Mild Penicillin Allergy , cephalosporins?

A

oral cephalosporin’s okay

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21
Q

Severe penicillin allergy, cephalosporin?

A

no cephalosporin

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22
Q

2 ways to check for penicillin allergy, which is safer

A
  • skin test which can precipitate allergic rxn

- check for IgG antibodies = safest

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23
Q

desensitization to penicllin

A

done in ICU, give small dose every hours until up to full dose
-for patients who have to have pnc

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24
Q

special consideration with penicillin injection

A

-very viscose, use large bore (18) needle

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25
Q

what can happen if PCN injected into nerve?

A

-sensory nerve dysfxn

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26
Q

high blood levels of PCN cause

A

-neurotoxicity (seizure, hallucination)

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27
Q

what happens if inject PCN into artery

A
  • necrosis, gangrene

- –> Aspirate!

28
Q

High risk of what with Potassium PCN G

A

-hyperkalemia

29
Q

how do you identify penicillin?

A

-ends in cillin

30
Q

Beta lactamases, what are they?

A

-enzymes produced by bacteria itself that breaks down the beta lactam ring that is present in all PCN

31
Q

what causes PCN to be inactive?

A

Beta lactamases

32
Q

How are Beta lactamases transmitted?

A

-ability can be passed from one bacteria to another thru DNA

33
Q

PCN drug combos- what do you combine with?

A

combine antibiotic with beta lactamase inhibitor

34
Q

which has more adverse rxn- penicillin or beta lactamase inhibitor

A
  • penicillin has adverse effects

- beta lactamase inhibitors have minimal toxicity

35
Q

Benefit of penicillin with beta lactamase inhibitor

A

increase spectrum of covereage

allow penicillin to work

36
Q

zosyn, what is it? How long infuse?

A
  • penicillin with beta lactamase inhibitor

- IV infuse over 4 hours to extend the minimum inhibitory concentration and kills more bacteria

37
Q

how do cephalosporins fxn

A

weaken bacterial cell wall

-bacteriacidal

38
Q

3 types of beta lactam antibiotics

A
  1. penicillin
  2. cephalosporin
  3. carbapenems
39
Q

most widely used group of abx

A

cephalosporins

-very low toxicity

40
Q

cephalosporin route

how many are oral?

A

IV or IM

-only 10 are oral

41
Q

classification of cephalosporins

A

generation 1-5

5= stronger, better med

42
Q

class 5 cephalosporin

A

more able to fight gram - and anaerobic bac
increase resistance to destruction by beta lactamases
increase ability to reach cerebrospinal fluid

43
Q

identifying cephalosporins

A

start with “ceph” or “cef”

44
Q

Adverse effects of cephalsporins

A

1 = allergic (cross sensitivity with PCN)

#2= rash
GI distress
IM injection painful

45
Q

2 cephalosporins with increase risk of bleeding

A
  • cefotetan

- ceftriaxone

46
Q

2 cephalosporins that have alcohol intolerance

A
  • cefotetan

- cefazolin

47
Q

ceftriaxone

A
  • increase bleeding risk
  • dont mix with lactated ringers
  • eliminated by liver ( not given with liver disorder)
48
Q

disulfram effect

A

-with alcohol use makes you feel horrible

2 abx: cefotetan, cefazolin

49
Q

carbapenems fxn

A
  • weaken bacterial cell wall

- bacterialcidal

50
Q

carbapenem prototype

A

-impipenum/cilastatin

51
Q

why put imipenum and cilastatin together?

A

-prevent destruction of imipenum by renal enzymes

52
Q

imipenum and cilastatin route

A

IV or IM

53
Q

identifying carbapenums

A

ends in “penum”

54
Q

imipenum and cilastatin adverse effects

A
  • GI distress

- Allergy

55
Q

imipenum and cilastatin drug drug interaction

A
  • decrease effectiveness of valproate acid (antiseizure med)
  • –>increase seizures
56
Q

vancomycin fxn

A

weakens bacterial cell well

  • bacteriacidal
  • NOT A BETA LACTAM
  • -> inhibits synthesis of bacterial cell wall
57
Q

Vancomycin treats

A
  1. C Diff
  2. MRSA
    - used for serious, only Gram + infections
58
Q

Vancomycin route and infusion rate

A
  • IV - infuse over 60 minute

- *Oral for C Diff

59
Q

Vancomycin ADR

A
  1. Renal Toxicity
  2. Ototoxicity
  3. red man syndrome
  4. thrombophlebitis
60
Q

Vancomycin labs- trough level?

A

-monitor trough level

15-20 mcg/mL

61
Q

Vancomycin Renal toxicity

A
  • monitor Creatinine/ BUN/GFR
  • don’t give other nephrotoxic meds
  • if already decrease kidney fxn give renal dosing
62
Q

Vancomycin Ototoxicity

A
  • hearing loss that is reversible

- occurs with patients with prolonged treatment over several weaks

63
Q

Vancomycin and red man syndrome

A
  • happens if vancomycin infused too fast <60 min

- red from waist up, flush, rash, pruritis, tachycardia, hypotension

64
Q

Vancomycin and Thrombophlebitis

A
  • veins irritated and inflamed resulting in loss of IV site

- put in central line to avoid irritation in peripheral veins

65
Q

MRSA active infection vs carrier

A
  • active infection: IV vancomycin

- carrier: nasal swab PCR, intranasal application of mupirocin or retapamulin

66
Q

MRSA carriers concerns

A

-can become active if immunocompromised

Pharm 313 (26 decks)

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