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Pharm Exam 3 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

what is another name for antibiotics?

A

antimicrobial

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2
Q

why is the use of antibiotics been decreasing?

A

to prevent resistance

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3
Q

what is the BEST way to prevent infection?

A

wash your hands

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4
Q

why is the use of foleys decreasing?

A

to prevent infection (taken out as soon as possible now)

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5
Q

what are ways to prevent infection?

A
  • hygiene
  • limit invasive procedures and use sterile technique
  • immunization
  • host defenses (physical and physiologic barriers)
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6
Q

what is the normal range for WBC count?

A

5,000-10,000

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7
Q

what are s/s of infection?

A
  • fever
  • increased WBC >10,000
  • chills, malaise
  • pus
  • redness
  • malodorous
  • irritation
  • edema
  • CONFUSION
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8
Q

what kind of patients may not exhibit signs of infection?

A

elderly and immunocompromised

  • might not even have a WBC count over 10,000
  • might not have a fever
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9
Q

what is selective toxicity?

A

the ability of a drug to injure a target cell or target organism without injuring other cells or organisms that are in close contact with the cell
- chose a drug that is as selective as possible and will do the least damage to the host cell

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10
Q

what are the 3 different mechanisms of actions of the host cell?

A
  • disrupt bacterial cell wall (bactericidal)
  • inhibit the conversion of an enzyme unique to bacteria (bacteriostatic)
  • disruption of protein synthesis in bacterial ribosomes (bacteriostatic)
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11
Q

what does bacteriostatic mean?

A

disrupts stasis - prevents the growth of bacteria

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12
Q

what does a narrow-spectrum antibiotic mean?

A

narrow focus and more specific to a type of bacteria (this is what we want because it causes less resistance and less damage to other cells)

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13
Q

what does broad-spectrum antibiotic mean?

A

not specific for the bug (will kill the broad type of bacteria we think it is - like gram negative or gram positive)

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14
Q

what is the empiric theory?

A

this is the process of choosing an antibiotic without identifying the type of infectious agent (would use a broad-spectrum antibiotic)

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15
Q

how do you match the bug to the drug?

A

1 - do a culture
2 - broad-spectrum antibiotic
3 - results
4 - narrow-spectrum antibiotic

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16
Q

what is done first, a broad-spectrum antibiotic or a culture?

A

culture

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17
Q

what is prophylactic antibiotic therapy? when is it given?

A

antibiotics givens when a patient is scheduled for a procedure with a strong possibility of microorganism presence

  • 30-60 minutes before incision time
  • possibly a couple of doses after
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18
Q

what kind of procedure/patient would need prophylactic antibiotics?

A
  • surgical patients
  • bacterial endocarditis - dental work with heart defects
  • neutropenia
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19
Q

when would antibiotics not be used?

A
  • viruses, cold, mumps, chickenpox, HIV, hyperthyroidism, autoimmune disease, a simple fever
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20
Q

what is one rule that is always needed when taking antibiotics?

A

finish out your antibiotics even if you feel better because of bacterial resistance

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21
Q

what does subtherapeutic mean?

A

antibiotic is not effective - dose is too low

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22
Q

what organs are antibiotics toxic to?

A

KIDNEYS and liver

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23
Q

what do bactericidal drugs do?

A

kills bacteria, directly lethal

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24
Q

what are examples of bactericidal drugs?

A
  • penicillins (any cillins)
  • cephalosporins
  • vancomycin
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25
Q

what is the action of penicillins?

A

bactericidal - kills gram+ and gram- bacteria by inhibiting bacterial cell wall synthesis (weakens cell wall)

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26
Q

what are penicillins typically used for?

A
  • syphilis
  • meningitis
  • streptococcus pneumonia
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27
Q

what are 2 new examples of newer penicillins?

A

newer stronger versions

  • augmentin
  • zosyn
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28
Q

what is a negative about penicillins?

A

they have been around for a while so there is a lot of resistance

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29
Q

what routes can penicillins be given?

A

IV, PO, IM

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30
Q

what are common side effects seen with penicillins?

A

minor rash to full-blown anaphylaxis

  • 10% of the population is allergic (most common)
  • treat with epinephrine
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31
Q

what are the s/s of anaphylaxis?

A

laryngeal edema, hypotension, bronchoconstriction

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32
Q

what type of patients need to be careful with the use of penicillins?

A

renal dysfunction patients because of kidney toxicity

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33
Q

what drug should not be given with penicillins?

A

aminoglycoside (gentamicin) - inactivates the aminoglycoside

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34
Q

what drug do penicillins increase the effect of?

A

probenecid (used for gout)

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35
Q

what creates an increased risk for bleeding with penicillins?

A

patients who are on anticoagulants

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36
Q

what happens if there is a mild allergic reaction to penicillins?

A

a patient can use cephalosporin orally

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37
Q

what happens if a patient has a severe allergic reaction (like anaphylaxis) to penicillins?

A

a patient would be considered allergic to cephalosporin

38
Q

what antibiotics can a patient take if they are allergic to penicillins and cephalosporin?

A

vancomycin, erythromycin, clindamycin

39
Q

what is the action of cephalosporins?

A

bactericidal - interferes with bacterial cell wall synthesis
- gram+ and gram-, some anaerobic bacteria

40
Q

what kind of cephalosporins are there?

A

1st - 5th generation, the higher the generation the newer and more resistant (stronger) the drug is again the beta-lactamases produced by bacteria

41
Q

what do cephalosporins all start with?

A

cef-

42
Q

what are cephalosporins normally used to treat?

A
  • streptococci

- staphylococci

43
Q

what side effects are common with cephalosporins?

A
  • mild diarrhea, abdominal cramping

- rash, pruritus, redness, edema

44
Q

what do cephalosporins interfere with?

A

vitamin k - increased risk for bleeding

45
Q

what should cephalosporins never be used with?

A

alcohol - disulfiram reaction

46
Q

what is vancomycin?

A

a potentially toxic drug used only for very serious infections

47
Q

what is vancomycin used for?

A
  • gram+ bacteria
  • MRSA
  • Cdiff
48
Q

what is the action of vancomycin?

A

bactericidal - interferes with bacterial cell wall synthesis
- bacterial cell lysis and death

49
Q

what patient needs a lower dose of vancomycin?

A

a patient with renal failure

50
Q

what are the adverse effects seen with vancomycin?

A
  • renal failure
  • ototoxicity
  • thrombophlebitis (an inflammatory process that causes a blood clot to form and block one or more veins)
  • red man syndrome
51
Q

what teaching is needed with vancomycin?

A

an IV dose of vancomycin is given over 60 minutes to prevent thrombophlebitis and red man syndrome

52
Q

what is seen with red man syndrome?

A

cause by an IV dose of vancomycin given to fast

  • red irritating rash
  • edema
  • drop of BP and tachycardia
53
Q

what are examples of bacteriostatic drugs?

A
  • tetracyclines
  • macrolides
  • aminoglycosides (gentamicin)
54
Q

what is the action of tetracyclines?

A

bacteriostatic - inhibits microbial protein synthesis

55
Q

what are tetracyclines used for?

A
  • chlamydia (STD)
  • mycoplasma pneumonia
  • rocky mountain spotted fever
  • acne control
  • Lyme disease
  • H. pylori - associated with stomach ulcers
56
Q

tetracyclines are used for what kind of alternative, allergic to what?

A

patients who are allergic to penicillins to treat gonorrhea and syphilis

57
Q

what side effects are seen with tetracyclines?

A
  • GI - take with food
  • binds to calcium in developing teeth - don’t give to kids or pregnant women
  • superinfection - an overgrowth of drug-resistant molecules (Cdiff)
  • PHOTOSENSITIVITY - exaggerated sunburn
  • increased BUN related to renal toxicity
58
Q

what should tetracyclines not be given with?

A
  • calcium - milk or other dairy products (teeth issues)
  • magnesium
  • iron
59
Q

what ending is seen with tetracyclines?

A

-cycline

60
Q

what ending is seen with macrolides?

A

-mycin

61
Q

what is the action of macrolides?

A

bacteriostatic but may become bactericidal in high enough doses

62
Q

are macrolides broad-spectrum or narrow-spectrum?

A

broad-spectrum

63
Q

what are macrolides used for?

A
  • UPPER AND LOWER RESPIRATORY INFECTIONS
  • skin and soft tissue infection
  • SYPHILIS
  • GONORRHEA
  • CHLAMYDIA
  • Lyme disease
  • legionella
64
Q

what are the side effects of macrolides

A
  • GI effects - take with food

- QT prolongation and sudden death (don’t take with cardiac drugs/antidysrhythmics - verapamil, diltiazem)

65
Q

what drugs do macrolides increase the levels of?

A
  • theophylline (also causes cardiac arrest)
  • Tegretol (seizures)
  • warfarin
66
Q

what drug is an example of aminoglycosides?

A
  • gentamicin
67
Q

what is aminoglycoside (gentamicin) often used with?

A

vancomycin for septic

68
Q

what is the action of aminoglycosides?

A

bacteriostatic - very potent and strong potential for toxicity (like vancomycin)

69
Q

what is the use like for aminoglycosides?

A
  • narrow-spectrum (gram-positive)

- serious infections like e. coli

70
Q

are aminoglycosides narrow-spectrum or broad-spectrum?

A

narrow-spectrum (gram-positive)

71
Q

what are the side effects of aminoglycosides?

A

like vancomycin

  • ototoxicity
  • nephrotoxicity
72
Q

what drug interaction is there with aminoglycosides?

A

increased risk for renal failure when administered with other nephrotoxic drugs?

  • cephalosporin
  • vancomycin
  • NSAIDS
73
Q

what are trough and peak levels?

A
  • nurses responsibility to coordinated
  • used for toxic antibiotics to see if the dose is high or low
  • trough is the lowest level, taken right before the next dose
  • peak - couple hours after the dose
  • if the trough is too high that can mean overdose
  • if the trough is too low that could mean ineffective
74
Q

what is the action of sulfonamides?

A

bacteriostatic - inhibit the synthesis of folic acid that bacteria needs to make RNA and DNA

75
Q

who should not take sulfonamides?

A

people with a sulfa allergy

76
Q

what are sulfonamides used for?

A

UTIs (E. coli)

77
Q

what adverse effects are seen with sulfonamides?

A
  • hypersensitivity reactions
  • hemolytic anemia
  • steven johnson syndrome
78
Q

what is the action of fluoroquinolones?

A

bactericidal, very potent broad-spectrum antibiotic

79
Q

what is the use of fluoroquinolones?

A
  • gram-negative
  • lower respiratory infections
  • bone and joint infections
  • infectious diarrhea
  • UTIs
  • skin infection
80
Q

what is the common ending of fluoroquinolones?

A

-floxacin

81
Q

what are the adverse effects of fluoroquinolones?

A
  • nausea
  • constipation
  • abdominal pain
  • fever
  • chills
  • blurred vision
  • headache
  • dizziness
  • fatigue
  • pseudomembranous colitis
  • GI
82
Q

what are the drug interactions with fluoroquinolones?

A
  • antacids/Carafate decreases the effectiveness of fluoroquinolones
  • increased toxic levels of theophylline when given with fluoroquinolones
  • increased risk of bleeding with anticoagulants
83
Q

what is the action of metronidazole (Flagyl)?

A

bacteriocidal - a primary drug for CDIFF

84
Q

what is metronidazole (Flagyl) used to treat?

A

protozoa - a primary drug for CDIFF

85
Q

what route is metronidazole (Flagyl) given?

A

PO because CDIFF is in the GI tract

86
Q

what are the side effects of metronidazole (Flagyl)?

A
  • NVD
  • may turn urine dark reddish-brown
  • don’t drink alcohol - disulfiram reaction
87
Q

what are 2 examples of antifungal drugs?

A
  • amphotericin B

- nystatin

88
Q

what is amphotericin B used for

A
  • antifungal
  • often seen in the ICU, not a pleasant med
  • broad-spectrum
  • dangerous
  • only used for potentially fatal fungal infections
89
Q

what is Nystatin used for?

A
  • used only to treat candidiasis (often seen with chemo or corticosteroids)
90
Q

what is the route for Nystatin?

A
  • topically or orally
91
Q

how is Nystatin given for oral candidiasis?

A

swish and swallow

Pharm Exam 3 (5 decks)

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