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Pharmacotherapeutics > Antibiotics 1 > Flashcards

Antibiotics 1 Flashcards

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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

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

Penicillin toxicity

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

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

how to manage penicillin injection pain

A

-very viscose, use large bore (18) needle

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25
what can happen if PCN injected into nerve?
-sensory nerve dysfxn
26
high blood levels of PCN cause
-neurotoxicity (seizure, hallucination)
27
what happens if inject PCN into artery
- necrosis, gangrene | - --> Aspirate!
28
High risk of what with Potassium PCN G
-hyperkalemia
29
how do you identify penicillin?
-ends in cillin
30
Beta lactamases, what are they?
-enzymes produced by bacteria itself that breaks down the beta lactam ring that is present in all PCN
31
what causes PCN to be inactive?
Beta lactamases
32
How are Beta lactamases transmitted?
-ability can be passed from one bacteria to another thru DNA
33
PCN drug combos
combine antibiotic with beta lactamase inhibitor
34
which has more adverse rxn- penicillin or beta lactamase inhibitor
- penicillin has adverse effects | - beta lactamase inhibitors have minimal toxicity
35
Benefit of penicillin with beta lactamase inhibitor
increase spectrum of covereage | allow penicillin to work
36
zosyn
- penicillin with beta lactamase inhibitor | - IV infuse over 4 hours to extend the minimum inhibitory concentration and kills more bacteria
37
how do cephalosporins fxn
weaken bacterial cell wall | -bacteriacidal
38
3 types of beta lactam antibiotics
1. penicillin 2. cephalosporin 3. carbapenems
39
most widely used group of abx
cephalosporins | -very low toxicity
40
cephalosporin route
IV or IM | -only 10 are oral
41
classification of cephalosporins
generation 1-5 | 5= stronger, better med
42
class 5 cephalosporin
more able to fight gram - and anaerobic bac increase resistance to destruction by beta lactamases increase ability to reach cerebrospinal fluid
43
identifying cephalosporins
start with "ceph" or "cef"
44
Adverse effects of cephalsporins
#1 = allergic (cross sensitivity with PCN) #2= rash GI distress IM injection painful
45
2 cephalosporins with increase risk of bleeding
- cefotetan | - ceftriaxone
46
2 cephalosporins that have alcohol intolerance
- cefotetan | - cefazolin
47
ceftriaxone
- increase bleeding risk - dont mix with lactated ringers - eliminated by liver ( not given with liver disorder)
48
disulfram effect
-with alcohol use makes you feel horrible | 2 abx: cefotetan, cefazolin
49
carbapenems fxn
- weaken bacterial cell wall | - bacterialcidal
50
carbapenem prototype
-impipenum/cilastatin
51
why put imipenum and cilastatin together?
-prevent destruction of imipenum by renal enzymes
52
imipenum and cilastatin route
IV or IM
53
identifying carbapenums
ends in "penum"
54
imipenum and cilastatin adverse effects
- GI distress | - Allergy
55
imipenum and cilastatin drug drug interaction
- decrease effectiveness of valproate acid (antiseizure med) - -->increase seizures
56
vancomycin fxn
weakens bacterial cell well - bacteriacidal - NOT A BETA LACTAM - -> inhibits synthesis of bacterial cell wall
57
Vancomycin treats
1. C Diff 2. MRSA - used for serious, only Gram + infections
58
Vancomycin route
- IV - infuse over 60 minute | - *Oral for C Diff
59
Vancomycin ADR
1. Renal Toxicity 2. Ototoxicity 3. red man syndrome 4. thrombophlebitis
60
Vancomycin labs
-monitor trough level | 15-20 mcg/mL
61
Vancomycin Renal toxicity
- monitor Creatinine/ BUN/GFR - don't give other nephrotoxic meds - if already decrease kidney fxn give renal dosing
62
Vancomycin Renal toxicity
- hearing loss that is reversible | - occurs with patients with prolonged treatment over several weaks
63
Vancomycin and red man syndrome
- happens if vancomycin infused too fast <60 min | - red from waist up, flush, rash, pruritis, tachycardia, hypotension
64
Vancomycin and Thrombophlebitis
- veins irritated and inflamed resulting in loss of IV site | - put in central line to avoid irritation in peripheral veins
65
MRSA active infection vs carrier
- active infection: IV vancomycin | - carrier: nasal swab PCR, intranasal application of mupirocin or retapamulin
66
MRSA carriers concerns
-can become active if immunocompromised

Pharmacotherapeutics (20 decks)

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