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Advanced Pharm > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What is the first line medication choice for strep?

A

Penicillin

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2
Q

What is the second line medication choice for strep in a patient with a penicillin allergy?

A

1st generation Cephalosporin, if the PNC allergy is mild

Azithromycin/Erythromycin, if PNC allergy mod/severe

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3
Q

What is the first line medication for cellulitis related to a bite?

A

Penicillin, specifically amoxicillin/clavulanate

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4
Q

What is the second line medication choice for cellulitis related to a bite if the patient has a penicillin allergy?

A

Cipro or clindamycin

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5
Q

What is the first line medication for a soft tissue injury cellulitis?

A

1st generation cephalosporin such as Keflex

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6
Q

What is the first line treatment for MRSA?

A

Clindamycin

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7
Q

What is the first line treatment for an complicated UTI?

A

Cipro

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8
Q

What is the first line treatment for an uncomplicated UTI?

A

Bactrim

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9
Q

What medication is used for an open wound, soft tissue infection topically?

A

Silver sulfadiazine (but falling out of favor with increased EBP on it being no more effective then bacitracin)

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10
Q

What is the simple mechanism of action of the pencillins?

A

They break the cell wall to cause bacterial lysis

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11
Q

What are the adverse side effects of penicllin?

A

N/V/D, rash, allergic reaction, fungal growth, C. Diff

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12
Q

What drug combined with penicillin can increase the adverse effect of diarrhea?

A

Clavulanate

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13
Q

When does the allergic reaction to penicillin normally occur?

A

Within the first 30 minutes, but it can be delayed

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14
Q

What is the pregnancy category for pencillin?

A

Category B

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15
Q

If a patient has an allergy to one penicillin, can they take a different penicillin in the class?

A

No, they must not be prescribed others due to cross sensitivity among all penicillins in the class

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16
Q

What is the mechanism of action of the cephalosporins?

A

Similar to penicillin in that they also cause bacterial lysis

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17
Q

What is the adverse effects of the cephalosporins?

A

allergic reactions, rashes, blood dyscrasias, fever, seizures, renal/hepatic failure

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18
Q

What generations of cephalosporins treat gram-negative bacterias?

A

Some 3rd and almost all 4th/5th generations

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19
Q

What is a common 1st generation cephalosporin?

A

Keflex

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20
Q

What is a common 2nd generation cephalosporin?

A

Cefzil

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21
Q

What are common 3rd generation cephalosporins?

A

Rocephin, Vantin, Cefpoxidine, Ceftriaxone

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22
Q

What is the pregnancy category for cephalosporins?

A

Category B

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23
Q

What are common indications for cephalosporin use?

A 
Otitis media (not responsive to PNC)
1st generation for skin infections or strep
Chlamydia
Community acquired PNA
2nd line therapy for UTIs
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24
Q

What are common indications for PNC use?

A

Otitis media
Sinusitis
Strep
Skin infections (cellulitis)

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25
Q

When would you caution using a cephalosporin medicaiton?

A

In a patient with a severe allergic reaction to PNC as there can be a small chance of cross sensitivity and they could have a severe reaction to cephalosporins

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26
Q

What are the fluoroquinolone antibiotics?

A

Ciprofloxacin, Levofloxacin, and Moxifloxacin

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27
Q

What is the mechanism of action of the fluoroquinolones?

A

They inhibit bacterial synthesis

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28
Q

What type of bacteria do the fluoroquinolones work extensively on?

A

Gram-negative bacteria

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29
Q

What are the adverse effects of the fluoroquinolones?

A

drowsiness, dizziness, angina, A. Flutter, colitis, photosensitivity

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30
Q

Who are fluoroquinolones contraindicated in?

A

Patients with myasthenia gravis and pregnant women

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31
Q

What is the black box warning for fluoroquinolones?

A

Tendon rupture

32
Q

How long after the fluoroquinolones are discontinued can the tendon rupture occur?

A

up to 120 days after the medication has ended

33
Q

Who is at greatest risk for the tendon rupture adverse effect of fluoroquinolones?

A

The elderly

34
Q

What are the common indications for fluoroquinolone use?

A

Complicated UTIs
Chronic bronchitis exacerbation
Recurrent pneumonia
Penicillin resistant strains of skin infections and infectious diarrhea

35
Q

How should fluoroquinolones be administered?

A

On an empty stomach and with a full glass of water if possible, DO NOT take with dairy products if they cannot tolerate an empty stomach as they delay absorption

36
Q

What is the mechanism of action of clindamycin?

A

It inhibits protein synthesis, thus slowing growth

37
Q

What are the adverse effects of clindamycin?

A

rash, burning, itching, neutropenia, thrombocytopenia

38
Q

What is the black box warning for clindamycin?

A

severe colitis

39
Q

What bacteria does clindamycin work against?

A

gram-positive ONLY

40
Q

What is the pregnancy category for clindamycin?

A

Category B

41
Q

What are the common indications for clindamycin?

A

MRSA
Dental infections
Gram-positive bacteria with PNC allergic patients
Drug resistant strep

42
Q

When in clindamycin considered a first-line therapy?

A

Pregnant women, children, PNC allergic patients

43
Q

If a patient on clindamycin develops diarrhea, what is the next step?

A

Stop the medication as this is a BBW for severe colitis development

44
Q

What are the macrolide medications?

A

Azithromycin, erythromycin, clarithromycin (-mycins)

45
Q

What is the growing problem with the macrolides in this area?

A

Increasing drug resistance due to over-prescribing

46
Q

What is the mechanism of action of the macrolides?

A

They inhibit protein synthesis, slows bacterial growth

47
Q

What are the adverse effects of the macrolides?

A

N/V/D, QT prolongation, GI upset, hepatotoxic, ototoxic, SJS, C. Diff

48
Q

What are the common indications for macrolide use?

A 
PNC allergy alternative
1st line for community acquired pneumonia
Chlamydia
Pertussis
H. pylori
49
Q

What is the pregnancy category for macrolides?

A

Category B

50
Q

What is the mechanism of action of the sulfonamides?

A

Inhibits the synthesis of folic acid, bacteriostatic

51
Q

What is the primary sulfonamide in use today?

A

Trimethoprim-Sulfamethoxazole (Bactrim)

52
Q

What is the primary use of Bactrim?

A

UTI treatment

53
Q

What are the adverse effects of Bactrim?

A

GI upset, rash, hyperkalemia, SJS, blood dyscrasias, crystalluria

54
Q

What is the pregnancy category for Bactrim?

A

Category C

55
Q

What are the tetracycline medications?

A

Tetracycline, doxycycline, minocycline

56
Q

What is the mechanism of action of the tetracyclines?

A

Inhibits bacterial synthesis, bacteriostatic

57
Q

What are the adverse effects of tetracyclines?

A

GI upset, teeth discoloration, hepatotoxic, renal damage (excreted unchanged), superinfections (C. Diff, MRSA, increasing resistance)

58
Q

Can tetracyclines be given to children?

A

Only over the age of 8, should seek other options 1st

59
Q

Can tetracyclines be given to pregnant women?

A

No, they can cause permanent teeth discoloration in the fetus and have other teratogenic effects.

60
Q

What foods/supplements should be avoided with tetracyclines?

A

Iron supplements, magnesium supplements, calcium products, antacids

61
Q

How should tetracyclines be administered?

A

On an empty stomach as food delays absorption, DO NOT give with milk even if unable to tolerate on an empty stomach

62
Q

What is the common indications for tetracyclines?

A

Doxy: trachomatis, ureplasma
Tetracycline: P. acne, H. pylori, lyme disease

63
Q

What is the mechanism of action of vancomycin?

A

Inhibits cell wall synthesis

64
Q

What are the adverse effects of vancomycin?

A

Ototoxicity, nephrotoxicity, Red Man Syndrome

65
Q

What is the clinical indication for vancomycin?

A

Gram-positive bacteria resistant to other medications, specifically MRSA and C. Diff

66
Q

What are ways to prevent resistance?

A

Only use antibiotics for true bacterial infections
Try to prescribe for the narrowest spectrum possible
Obtain culture/sensitivities if possible
Follow CDC guidelines on resistance patterns

67
Q

Who is most susceptible to drug resistant organisms?

A

Children <2 y/o
Adults >65 y/o
Children and childcare workers in daycare settings
Families exposed to children at daycare settings
Patients with multiple comorbidites
Immunosuppressed patients
Recent antibiotic use

68
Q

What are patient education points to help prevent drug resistance?

A

Proper hand hygiene
Use antibiotics as prescribed and complete the whole dose as prescribed even if starting to feel better
Get vaccinated for specific illnesses if possible

69
Q

What is the mechanism of action of metronidazole?

A

bacteriostatic, treats bacterial and parasitic infections

70
Q

What are the adverse effects of metronidazole?

A

anorexia, N/V, dizziness, headache, metallic taste

71
Q

What are the common indications for metronidazole use?

A

Anaerobic bacteria infections
Bacterial vaginosis
H. pylori

72
Q

Can metronidazole be given in pregnancy?

A

Yes, after the first trimester

73
Q

What should patients taking metronidazole avoid?

A

Alcohol as it can cause a disulfarism reaction

74
Q

What is the first line therapy for CAP?

A

Azithromycin

75
Q

What is 2nd line therapy for CAP?

A

Cephalosporins

Advanced Pharm (15 decks)

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