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Pharm Exam 1 > antibiotics > Flashcards

antibiotics Flashcards

1
Q

Where in the cell are the receptors that are activated by most anesthetic drugs?

A

phospholipid bilateral/cell membrane

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2
Q

What drugs act on intracellular proteins?

A

caffeine, insulin, steroids

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3
Q

What drug effects circulating proteins?

A

Anti-coagulants

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4
Q

What’s an example of a drug that doesn’t target a receptor at all?

A

Antacids

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5
Q

What is an agonist?

A

something that binds to a receptor and achieves a full response/high efficacy

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6
Q

What is a partial agonist?

A

binds to and activates receptor but no as much as a full agonist/low efficacy

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7
Q

What is an inverse agonist?

A

binds at the same site as an agonist but produces an opposite effect (turns off receptor)

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8
Q

What is an antagonist?

A

binds to and inactivated receptor (turns off)/prevents action

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9
Q

what is the surgical classification of a cyst removal?

A

clean

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10
Q

a Bronchoscopy is technically a _______ procedure

A

clean-contaminated

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11
Q

what’s the difference between clean-contaminated and contaminated?

A

major break in sterility, spillage/acute inflammation

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12
Q

What’s an example of “dirty or infected” surgical classification

A

fecal peritonitis, perforated bowel, purulent material visible

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13
Q

What is the difference between the cellular structure of a gram negative and positive bacterium?

A

gram negative has a thin will with a outer membrane. these are more chalking to treat and cause more side effects with their destruction/sepsis more likely
gram positive has a thick wall with NO membrane, easier to kill

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14
Q

Gram negative bacteria that are most likely to cause a surgical site infection are:

A

e. coli, Klebsiella

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15
Q

What is a common bacteria for respiratory infections?

A

Pseudomonas

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16
Q

what are patient controlled risk factors for SSI?

A

extreme ages
poor nutrition
obesity
diabetes/hyperglycemia
PVD
tobacco use
current infection
immunosuppression

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17
Q

provider affected risk factors of SSI:

A

Steroid use
skin prep
length of preop stay
technique (open vs laparoscopic)
duration of procedure
hospital environment
periop normothermia

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18
Q

When should an individual stop smoking before surgery?

A

IDEALLY 3-6 months but at least 4-8 weeks indications 50% less risk of infection

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19
Q

Why is hypothermia not preferred for surgical patients?

A

vasoconstriction, decreased WBC in tissues

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20
Q

What temperature is ideal for surgical patients?

A

36°

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21
Q

What is our glucose goal?

A

less than 200

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22
Q

4 Anesthesia performance measures:

A

abx in 1 hour
correct abx for procedure
BG control
temp control

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23
Q

in what cases are bactericidal antibiotics preferred?

A

endocarditis, meningitis, osteomyelitis, and neutropenia

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24
Q

What antibiotic classes are Beta-lactams?

A

Penicillins
cephalosporins
carbapenems
monobactams

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25
Q

how do beta lactams and glycoproteins work?

A

inhibit peptidoglycan synthesis in bacterial cell wall

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26
Q

example of a glycopeptide:

A

vancomycin

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27
Q

example of a aminoglycoside:

A

gentamicin

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28
Q

example of a macrolide:

A

azithromycin

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29
Q

example of a quinolone:

A

ciprofloxacin

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30
Q

how do aminoglycosides work?

A

target ribosomal subunit 30s

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31
Q

how do macrolides work?

A

target bacterial ribosomal subunit 50s

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32
Q

how do quinolones work?

A

inhibit DNA replication

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33
Q

How do Sulfonamides work?

A

inhibit folate synthesis

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34
Q

How does the beta lactam ring work?

A

inhibits transpeptidase which is used for cell wall synthesis

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35
Q

What is beta-lactomase?

A

an enzyme bacteria can develop or have naturally that breaks down the beta lactam ring causes abx resistance

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36
Q

What bacteria do beta lactams target?

A

gram positive and gram negative

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37
Q

Which three beta lactams are not effected by beta lactamase?

A

Methicillin, oxacillin, dicloxacillin

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38
Q

What are the three beta lactamase inhibitors?

A

Clavulanic acid, tazobactam, sulbacta
Clavulanic acid (augmentin: amox-clav)
Zosyn (piperacillin + tazobactam

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39
Q

What antibiotic is commonly prescribed for dental prophylaxis?

A

Penicillin

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40
Q

Bad side effects of penicillin:

A

neurotoxicity and hyperkalemia in CKD
IM preferred bc long half life and large vd

41
Q

What drug is the reason we have many false penicillin allergies?

A

ampicillin

42
Q

What causes the ampicillin skin rash?

A

protein impurities in the drug formulation

43
Q

What antibiotic class is most common in surgery?

A

Cephalosporins

44
Q

Side effect of cephalosporins:

A

thrombophlebitis/expensive

45
Q

What antibiotic class can penetrate into joints and cross the placenta?

A

cephalosporins

46
Q

what first generation cephalosporin is the best choice for preventing SSI?

A

Cefazolin

47
Q

What is the only 4th generation cephalosporin?

A

Cefepime

48
Q

What generation of Cephalosporins treat MRSA?

A

5th

49
Q

Why would we use a 2nd gen rather than a 1st?

A

to treat drugs resistant/also have extended activity against gram negative

50
Q

What antibiotic is frequently given for prostate biopsy?

A

Cefoxitin

51
Q

What drug can penetrate CSF to treat meningitis?

A

Ceftriaxone

52
Q

What antibiotic class is best at treating ventilator associated pneumonia?

A

Carbapenems

53
Q

Why should carbapenems never be users for simple prophylaxis?

A

they’re the “heavy hitters” last antibiotic option to treat resistant bacteria

54
Q

IgE penicillin reaction:

A

laryngeal edema, bronchospasm, cardiopulmonary collapse

55
Q

Type A drug reaction:

A

side effects such as diarrhea, nausea

56
Q

Type B 1 drug reaction:

A

IgE mediated: mild urticaria to severe cardiopulmonary collapse
onset minutes to 2 hours

57
Q

Type B Type 2 medication reaction:

A

antibody dependent cytotoxicity: hemolytic anemia, thrombocytopenia

58
Q

Type III drug reaction:

A

immune complex, serum sickness
weeks after

59
Q

Type IV drug reaction:

A

T-cell mediated
rash, steven johns syndrome
48H-weeks

60
Q

What is the antibiotic of choice for colorectal surgery?

A

cefazolin and metronidazole

61
Q

What is the antibiotic of choice for appendectomy?

A

Cefotetan or Cefoxitin

62
Q

Dosage for Cefazolin:

A

2 grams, >120 kg 3 grams

63
Q

(T/F) Vanomycin is good for gram negative

A

FALSE

64
Q

What is the target bacteria for flagyl?

A

Anaerobic gram negative

65
Q

What antibiotic class has unique anti inflammatory effects?

A

Macrolides

66
Q

Vancomycin dosage:

A

15-20mg/kg: 1 g, 1.5 g, 2g

67
Q

What is red man syndrome?

A

Histamine release reaction due to vancomycin- give antihistamines

68
Q

What’s the difference between Anaphalaxis and Anaphalctoid reactions?

A

Anaphylaxis: Ige
Anaphactoid: mast cells, basophils (NOT IgE) also receives hydroxyzine

69
Q

What’s a high risk side effect of aminoglycosides:

A

neurotoxicity, otoxixity, vertigo- meniere’s syndrome, skeletal muscle weakness

70
Q

Organ perfusion rank:

A

kidneys
liver
heart
brain

71
Q

What drug is given to overcome skeletal muscle side effects?

A

Calcium

72
Q

In what population should tetracycline not be given?

A

pregnancy and children

73
Q

what is an indication for a glycopeptide (vancomycin)?

A

BL allergy or MRSA outbreak

74
Q

What physiological changes occur with histamine release?

A

increase myocardial contractility
venodialation
decrease LV filling

75
Q

What antibiotic class has the highest occurance of resistance?

A

Macrolides

76
Q

What are the most common side effects of erythromycin?

A

prolonged QT leads to torsades
- sudden cardiac death
GI side effects

77
Q

What’s an off label use of erythromycin?

A

increase of lower esophageal sphincter tone (decreases aspiration)

78
Q

What is the antibiotic of choice in BL allergy?

A

Clindamycin/ vancomycin ONLY in MRSA

79
Q

Side effect of Clindamycin:

A

significant diarrhea

80
Q

Clindamycin dosage:

A

900mg

81
Q

What does Rifampin treat?

A

TB

82
Q

What bacteria does metronidazole treat?

A

Anaerobic gram negative and clostridium

83
Q

metronidazole dosage:

A

500mg

84
Q

what cannot be given with sulfonamides?

A

anticoagulants, methotrexate, sulfonylurea, and thizides

85
Q

When before surgery should antibiotics be given?

A

1 hour before incision

86
Q

What is MIC?

A

minimum inhibitory concentration - tissue concentration to prevent bacterial growth

87
Q

dosing for Cefoxitin:

A

2 grams

88
Q

Dosing for Cefotetan:

A

2g

89
Q

Dosing for Ceftriaxone:

A

2G

90
Q

Dosing for Gentamicin:

A

5mg/kg

91
Q

Dosing for piperacillin-tazobactam (zosyn):

A

3.375

92
Q

What are the antibiotics of choice for urinary procedures?

A

cefazolin and cipro

93
Q

IM epinephrine dosage for anaphylaxis

A

0.01mg/kg OR 0.5mg max Q5-15min
1:1,000

94
Q

IV Epinephrine Dose for Anaphylaxis:

A

50-100mcg over 1-10 minutes
1:10,000

95
Q

Apart from Epinephrine, what are other treatment options for anaphylaxis?

A

remove inciting cause
call for help
supine position (unless airway swelling)
supplemental oxygen
IV Fluids

96
Q

What antibiotics are safe in pregnancy?

A

PCN and cephalosporins

97
Q

Elderly considerations w/ ABX:

A

decrease GI motility and acidity
increased fat & decreased albumin
decreased hepatic blood flow
decreased GFR

98
Q

what antibiotic class causes tendon rupture

A

fluroquinolones

Pharm Exam 1 (4 decks)

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