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Final Exam: 313 Pharm > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What is Selective Toxicity?

A

It kills the bugs without harming the human host

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2
Q

Bacteriostatic:

A

Slows down bacterial growth

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3
Q

Bacteriocidal

A

Kills the bacteria

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4
Q

What are the 3 ( and “other”) abx that disrupt the cell wall?

A

Penicillin (+beta-lactams), Cephalosporin, Carbapenems, (and Vancomycin inhibits cell wall synthesis)

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5
Q

When would you use abx prophylactically?

A

Pre-surgery for serious surgeries like heart valves, rheumatic fever, and immunosuppressed. Broad spectrum, 2 hours pre incision

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6
Q

What is empiric theory?

A

Using best judgement to choose treatment

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7
Q

Where would you find anaerobic bacteria?

A

Deep wounds, tissues, abscess formation

(C. diff, botulism, tetanus). Use Flagyl or Clindamycin

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8
Q

Host considerations (age, etc.)

A

Infants = high risk for toxicity
Penetration = meningitis, abscess, more difficult to treat
Children = don’t give tetracycline
Preg/lactating = Hearing loss (gentamicin), Kernicterus (Sulfas)
Older adults = heightened drug sensitivity
Genetic factors = G6PD deficiency with Sulfas

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9
Q

What are 3 signs an abx is working?

A

Decreased S&S of fever
Decreased WBC
Peak/trough levels for toxicity

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10
Q

What is the best way to prevent MDROs (Multi drug resistant organisms)?

A

Isolation Precautions

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11
Q

What abx’s make the bacteria take on H2O?

A

Penicillin, Carbapenems, Cephalosporins

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12
Q

What abx inhibits cell wall synthesis?

A

Vancomycin

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13
Q

What are the admin routes and considerations for PCN?

A

IV, IM
IM = painful injection site, viscous fluid, large bore needle
K+ PCN = risk for hyperkalemia

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14
Q

Beta-Lactamase. Explain.

A

bacteria enzyme that breaks down beta-lactamase rings in PCN. need drug combo.

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15
Q

List the 4 BL drug combos

A

Amoxicillin + clavulanate = Augmentin
Ticarcillin + clavulanate = Timentin
Ampicillin + sulbactam = Unasyn
Pipercillin + tazobactam = Zosyn

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16
Q

What are the admin routes for Cephalosporin?

A

IV, IM, oral

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17
Q

What is so interesting about Cephalosporin? (hint: 1-5)

A

It has 5 generations. The higher the generation, the more ability it has to fight off gram - anaerobic bacteria, and the more ability it has to reach cerebral spinal fluid

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18
Q

What is the relationship between PCN and Cephalosporin?

A

Cross-Sensitivity. 1% have it.

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19
Q

Ceotetan:

A

increase bleeding risk, intolerance to alcohol

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20
Q

Cephatriaxone

A

Increase bleeding risk, don’t mix with beta-lactamases, eliminated by the liver

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21
Q

Cefazoline

A

Intolerance to alcohol

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22
Q

Carbapenem, routes of admin

A 
IV, IM
Combo drug (Imipenem, Cilastatin), second drug prevents Carbapenem from being destroyed by renal enzymes
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23
Q

Carbapenem, drug-drug interaction

A

Carbapenem + Valproate acid = seizures

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24
Q

Vancomycin MOA

A

Inhibits cell wall synthesis

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25
Q

Vancomycin, routes of admin

A

IV, oral (only for c. diff)

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26
Q

Use Vancomycin for:

A

Only Gram +

C. diff, MRSA, serious infections

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27
Q

Biggest AE of Vancomycin

A

Ototoxicity, nephrotoxicity
If pushed too quickly = Red Man Syndrome….Infuse SLOWLY, over 60 min
Thrombophlebitis, check trough levels

28
Q

Abx that Inhibit Protein Synthesis:

A

Tetracycline, Macrolides, aminoglycoside (gentamicin) (other: clindamycin)

29
Q

Tetracycline treats:

A

RMSF, typhus, cholera, Lyme disease, H. Pylori, chlamydia, acne

30
Q

REMEMBER Tetracycline teaching

A

Photosensitivity, Teeth discoloration (<8 years), Superinfections; No calcium, iron, Mg, Al, ant-acids, anti-diarrheal, dairy products (1 hour before, 2 hours after), best on an empty stomach

31
Q

Macrolides: Erythromycin

A

Biaxin, Z-pack
Fire belly, GI upset!
Increase GI motility (sometimes used for this SE)
QT prolongation = cardiac death

32
Q

Most important erythromycin teaching:

A

-Fire belly, QT prolongation

33
Q

Macrolides drug-drug interactions

A
  • CYP3A4 (CCB, antifungals, HIV protease inhibitors)

- Toxicity: theophylline, carbamazepine (Tegretol, anti-seizure adjuvant) Warfarin, Superinfections

34
Q

Clindamycin Biggest Risk:

A

C. diff. Cease use immediately.

35
Q

Abx inhibition of protein synthesis: Producing Abnormal Proteins

A

Gentamicin (Aminoglycosides)

36
Q

Gentamicin, Admin routes

A

IV, IM

37
Q

Considerations for Gentamicin:

A

Ototoxicity (tinnitus), Nephrotoxicity (usually reversible), monitor peak/trough, BUN, and creatinine

38
Q

Abx Inhibition of Folate Synthesis:

A

Sulfonamides (TMP/SMX)

Bactrim, Septra, co-trimoxazole

39
Q

Special consideration for TMP/SMX:

A

Prescribed prophylactically for HIV patients to prevent PCP (Pneumocystis pneumonia), usually high incidence of adverse effects in these patients

40
Q

Specific AE for TMP/SMX

A 
Stevens-Johnson Syndrome
Blood dyscrasias (hemolytic anemia) G6PD
Bone Marrow Suppression (Watch CBC)
CRYSTALURIA (Keep pt hydrated)
Photophobia 
CNS problems in older adults 
Nursing mothers- Kernicterus in nursing infants (<2 months)
41
Q

TXP/SMX + _________ = Stevens-Johnson Syndrome

A

Loop diuretics, thiazide diuretics, sulfa-DM meds

42
Q

TXP/SMX drug-drug interactions

A

Warfarin, dilantin (68% protein bound), Risk for hyperkalemia

43
Q

Abx Disrupt DNA replication/ cell division

A

Fluoroquinolones: Ciprofloxacin

44
Q

Fluoroquinolones: Admin routes

A

Oral, IV (same dosage)

Infuse over 1 hour

45
Q

Special considerations for Cipro

A
  • Tendon rupture, don’t give to kids < 18 yo
  • CNS effects in older adults
  • Dysrhythmia if taken with dysrhythmia agents
46
Q

Don’t take Cipro with:

A

Ca, Al, Mg, Iron, Zinc, Milk/dairy,

2 hours before, 6 hours after

47
Q

Drug-drug interactions for cipro

A

Sucralfate, theophylline, warfarin, tinidazole

48
Q

Abx. Inhibition of Nucleic Acid Synthesis

A

Metronidazole (Flagyl)

49
Q

Coverage for Flagyl:

A

Protozoa, Anaerobic

No action against aerobic

50
Q

Use Flagyl for:

A

C. Diff

GI, Pelvic surgery, infuse over 1 hour

51
Q

Superinfections caused by Flagyl

A

Candidiasis

52
Q

Unusual SE for Flagyl

A

Dark red urine, Metallic taste, Alcohol intolerance (3 days)

53
Q

Photosensitivity:

A
  1. Fluoro (Cipro)
  2. Tetracycline
  3. Sulfa
54
Q

Infuse over 1 hour

A
  1. Fluoro (Cipro)
  2. Flagyl
  3. Vanco
55
Q

Oto/ Nephrotoxic

A
  1. Vanco

2. Genta (Tinnitus)

56
Q

Oral Admin

A
  1. Ceph

2. Vanco

57
Q

CNS Effects

A
  1. Fluoro (Cipro)

2. Sulfa

58
Q

Anaerobic Killing Machines

A
  1. Metro (Flagyl)
  2. Ceph (Gram -)
  3. Vanco (Gram +)
59
Q

Alcohol Antabuse

A
  1. Ceotetan, Cefazoline

2. Flagyl

60
Q

Best for C. Diff

A

Flagyl

61
Q

Best on an empty stomach

A

Tetraycycline

62
Q

GI upset

A

Erythromycin

63
Q

Combo drugs

A
  1. PCN
  2. Carbapenems
  3. Sulfa
64
Q

QT Prolongation

A

Erythromycin

65
Q

Allergy and cross-sensitivity

A

PCN and Cephalosporins

66
Q

Sulfa AE:

A 
SJS (loop diuretics, thiazide diuretics, Sulfa DM meds)
Blood dyscrasias (hemolytic anemia)
Bone marrow suppression
Kernicterus
Crystaluria
67
Q

Cipro AE:

A

Tendon Rupture, dysrhythmias

Final Exam: 313 Pharm (7 decks)

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