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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What makes mycobacterial infections like TB difficult to treat?

A

Slow-growing and resistant microbes - require prolonged treatment

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2
Q

Tuberculosis
Treatment regimen

A

Determine drug sensitivty
At least 2 drugs
6 month course for active TB

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3
Q

TB
Diagnosis

A

Chest x-ray
Sputum culture

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4
Q

Why is active TB treated with multiple antibiotics?

A

Some infecting bacilli are inherently resistant

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5
Q

How do you test for latent TB?

A

-TB skin test (PPD test)
-QuantiFERON-TB blood test

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6
Q

Standard treatment for latent TB

A

Isoniazid

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7
Q

Isoniazid
Uses

A

-Part of combo therapy for active TB
-Latent TB

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8
Q

Isoniazid
Adverse effects

A

Risk of liver damage
Neuropathy (tx is Vit B6 pyroxidine)
Optic neuritis (inflammation of optic nerve)

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9
Q

Pyrazinamide
Ethambutol

Use

A

Antituberculosis drugs
(active TB)

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10
Q

Rifampin
Use

A

Broad spectrum antibiotic
TB

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11
Q

Rifampin
Adverse effects

A

-Liver damage
-Discoloration of body fluids (turns body fluids red) - not serious

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12
Q

Pyrazinamide
Use

A

Active TB

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13
Q

Pyrazinamide
Adverse effects

A

Liver damage

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14
Q

Ethambutol
Use

A

Active TB

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15
Q

Ethambutol
Adverse effect

A

Optic neuritis

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16
Q

Penicillin
Family

A

Beta-lactam

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17
Q

What antibiotics are in the beta-lactam family?

A

-cillins
-Cephalosporins
-Carbapenems (Imipenem)

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18
Q

Penicillin
Main adverse effect

A

Low toxicity, main adverse effect is allergic reaction

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19
Q

Penicillin
Mechanism of action

A

Weaken the cell wall, causing bacteria to take up excessive water and rupture

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20
Q

Beta-lactamase (e.g. penicillinase)

A

Mechanism of bacterial resistance where bacterial enzymes inactivate penicillin

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21
Q

Penicillin is active against gram ______ bacteria

A

positive

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22
Q

Gram negative bacteria have an extra ____ that make it difficult for antibiotics to penetrate

A

envelope / membrane

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23
Q

Penicillin and Nafcillin are ____ spectrum antibiotics

A

narrow

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24
Q

Ampicillin (Principen) and amoxicillin (Amoxil) are _____ spectrum penicillin

A

Broad

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25
Q

Piperacillin/tazobactam is a _____ spectrum penicillin

A

extended

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26
Q

Penicillin G (Benzylpenicillin)
Use

A

-Strep
-Kills a number of gram-positive organisms and some gram-negative organisms

27
Q

Penicillinase-Resistant Penicillins effective against most Staph (but NOT MRSA)

A

Nafcillin
Oxacillin
Dicloxacillin

28
Q

Broad-spectrum Penicillin
(Ampicillin, Amoxicillin)
Adverse effects

A

Rash
Diarrhea

29
Q

What does the Tazobactam in piperacillin/tazobactam do?

A

Beta lactamase inhibitor

30
Q

Clavulanic acid
Class

A

Beta-lactamase inhibitor

31
Q

What antibiotic can be prescribed if patient has mild penicillin allergy?

A

Cephalosporin

32
Q

Can you prescribe cephalosporin in a patient with history of anaphylaxis from penicillin?

A

NO (only in mild allergy)

33
Q

Anaphylaxis
Signs and symptoms

A

Severe hypotension
Systemic hives (urticaria)
Laryngeal edema
Wheezing

34
Q

Fluoroquinolones
Use

A

Broad spectrum agents

35
Q

Fluoroquinolones
Route

A

IV
PO

36
Q

Fluoroquinolones
Mechanism

A

Disrupt replication and cell division

37
Q

Fluoroquinolones
Adverse effects

A

Can cause tendon rupture (low risk) - usually affects Achilles tendon

38
Q

Who is at greatest risk of tendon rupture from fluroquinolones?

A

-Patients older than 60
-Patients taking glucocorticoids

39
Q

Fluoroquinolones
end in -

A

Floxacin

40
Q

Ciprofloxacin
Class

A

Fluoroquinolone

41
Q

Ciprofloxacin
Uses

A

BROAD SPECTRUM

Ex: anthrax, respiratory, UTI, GI, bones, joints, skin, soft tissue

42
Q

Ciprofloxacin
Adverse effects

A

CNS: dizziness, headache, restlessness, confusion
Tendon rupture
Increased risk of C. Diff

43
Q

Ciprofloxacin
Interactions

A

-Food/drugs that have ionic compounds / salts
-Absorption reduced by antacids
-Milk and dairy products
-Can elevate levels of other drugs

44
Q

Metronidazole [Flagyl]
Uses

A

C. diff
Anaerobes
Protozoal infections (e.g. Giardia)

45
Q

Metronidazole [Flagyl]
Interaction

A

Antabuse-type reaction

46
Q

What antibiotics have cross-reactivity with penicillin?

A

Cephalosporin
Carbapenem

47
Q

Cephalosporin
Class

A

beta-lactam antibiotics (like penicillin)

48
Q

Cephalosporin abx have what in their name?

A

Prefix of ceph or cef

49
Q

Cephalosporin
Toxicity

A

Like penicillin, toxicity is low

50
Q

Cephalosporin
Route

A

Usually IV
Also available PO

51
Q

Cephalosporin
Mechanism

A

Bind to penicillin-binding proteins disrupt wall synthesis and cause cell lysis

52
Q

How do drugs grow resistance towards Cephalosporin?

A

Beta-lactamases (cephalosporinases)

53
Q

1st generation Cephalosporin are commonly used for _____ in the hospital

A

prophylaxis

54
Q

Advantages to later generations of Cephalosporin
(like 3rd on)

A

-Broader spectrum
-Can kill more gram negative bacteria
-Can kill Bacteria that make beta-lactamase
-at 3rd generation - can penetrate blood brain barrier like meningitis

55
Q

Which cephalosporin is active against MRSA?

A

5th generation
Ceftaroline

56
Q

What can 4th generation cephalosporin kill that earlier generations cannot?

A

Pseudomonas

57
Q

Cefotetan (a cephalosporin)
Interactions

A

-Combination with alcohol causes antabuse-like reaction
-Warfarin (increased risk for serious bleeding)

58
Q

Celphalosporin
Adverse effects

A

Allergy
Thrombophlebitis

59
Q

Carbapenems (e.g. Imipenem [Primaxin])
Spectrum

A

Extremely broad spectrum

60
Q

Carbapenems
(e.g. Imipenem [Primaxin])
Use

A

Severe, hard to treat infections
but NOT MRSA

61
Q

Vancomycin
Spectrum

A

Narrow spectrum
Only gram-positive bacteria (e.g. staph, strep)

62
Q

Vancomycin
Uses

A

Severe infections (IV)
Pts with penicillin allergy
MRSA (IV only)
C. Diff (PO)

63
Q

Vancomycin
Adverse effects

A

-Nephrotoxicity
-Ototoxicity
-Thrombophlebitis
-“Red” syndrome - caused by histamine release when a pt takes too much too fast - signs are fever, tachycardia, itchiness (but no wheezing, or hypotension) - can treat with antihistamine

Pharmacology (21 decks)

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