Antibiotics Flashcards

Question

Aminoglycosides

Answer 1

bacteriocidal, very potent, little resistance severe SE all IV or nebulized Gentamycin, Tobramycin SE OTOTOXICITY, RENAL TOXICITY, can progress to renal failure, elderly more susceptible, dose and duraiton related CNS - irreversible deafness, confusion, depression, numbness, tingling, weakness, paralysis HEMA - bone marrow suppression,, immune suppression, super-infection WEAR SUNSCREEN, photosensitivity, rash/urticaria, exfoliative dermatitis Cardiac - palpitations, hypotension or HTN drug-drug- Diuretics Synergistic, with PCN

Answer 2

``` Azythromycin (bronchitis, COPD) Clarithromycin (H. pylori protocol only, cheap) Erythromycin (OB prefer this) Streptococcal infection Mycoplasma infection Listeria GROUP A BETA HEMOLYTI strep infection ```

Answer 3

caution with hepatic dysfunction, lactating women/pregnancy CI - allergy to any macrolide AE - GI, abd cramping, diarrhea, vomitting, anorexia, pseudomembranous colitis HEPATOTOXICITY - if taken with other hepatotoxic drugs CNS - confusion, abnormal thinking, uncontrollable emotions

Answer 4

more toxic than macrolides, but similar | CLINDAMYCIN - most commonly assoc with C.diff, lots of GI SE

Answer 5

long acting- DOXYCYCLINE - good for MRSA, bronchitis, URI MINOCYCLINE - Derm likes, antiinflammatory Not recommended in preg/lactation Avoid in kids < 8 AE - Photosensitivitiy and rash, GI-N/V/D, abd pain, glossitis, dysphagia. FETAL hepatotoxicity. SKELETON - weakening of bone/teeth, staining, pitting DRUG-DRUG; PCN (dec. PCN) decreased effectiveness of OCPs DIGOXIN toxicity dairy binds to it, unabsorbable take on empty stomach, 1h before food or 2-3 h after meal or meds

Answer 6

Broad spectrum of activity good bioavailability tissue penetration, prolonged half-lives RESISTENCE is a major issue CIPROFLOXACIN (older) PO, IV, complicated UTI, second line or sulfa allergy, abd infection, below diaphragm LEVOFLOXACIN - (newer) PO, IV, excellent for resp, $$ AE- GI, n/v/d/dyspepsia, CNS- HA, agitation, insomnia, dizzy, seizures (elderly), rare hallucinations Hepatotoxicty - LFT elevation Variable QTc complex

Answer 7

zinc, iron, ca, aluminum, mag, antacids, sucralfate, ENTERAL FEEDINGS will impair oral absorption, CLINICAL failure, 2 to 4 h interval Theophylline and cyclosporine, inhib metabolism, inc levels, inc toxicity WARFARIN - idiosyncratic

Answer 8

Erythromycin, narrow spectrum, short 1/2 life, poor GI SE, | Clarithromycin and azithromycin - broader spectrum, longer half-life, availability, more toleratework d

Answer 9

anaerobes (upper airway) atypical bacteria - legionella, Chlamydia, Mycoplasma, campylobacter, borrelia, bordetella, pasteurella SE - GI, most common with erythro, QTc prolongation

Answer 10

gram +, C. diff, GI SE gram + aerobes, MSSA, Strep pneumoniae- resistence is starting Group and viridans streptococci most freq caused c diff colitis (treat with metrondazole), N/v/d/d rare hepatotoxicity and allergy

Answer 11

used for anaerobes GI-n/v, stomatitis, metallic tast CNS- MOST SERIOUS, peripheral neuro (if used long term), encephalopathy, seixures. caution with preexisting CNS d/o Mutagenicity, carcinogenicity, avoid preg, commonly used with BF

Answer 12

``` warfarin, inc aticoag effect etoh - disulfiram rxn Phenytoing - inc phenytoin conc Lithium, inc lithium conc Phenobarbital, dec. metro conc Rifampin - dec, metro conc ```

Answer 13

``` Different moeities Sulfazalazine, sulfamethoxazole, sulfadiazine, sulfixoxazole prevents the synthesis of folic acid CI, thiazide diuretic allergy CI in pregnancy, lactation ```

Answer 14

GI, n/v/d/abd pain, anorexia, stomatitis, hepatic injury d/t direct irritation of GIT RENAL - crystalluria / proteinuria, hematuria --> can cause nephrotic syndrome (drink tons of water), dizzy, vertigo, ataxia, convulsions, depression (effects nerves) HEMA-bone marrow depression DERM - photosensitivity and rash and hypersensitivity Take with food, no etoh

Answer 15

isoniazid (liver tox, rx with B6, or else peripheral neuritis) rifampicin (lots of drug-drug, stain contacts, hepatitis, red-orange discoloration of secretions) pyrazinamide (uric acid goes up, gout/preg prec) ethambutol (optic neuritis, eye exam, not kids < 6 yo) worry about liver impairment with all of these, check LFT periodically multiple drugs to prevent resistence

Answer 16

PCN, cephalosporing, erythromycin base

Answer 17

CAUTION Bactrim (dong give 1st and 3rd), Metronidazole, Aminoglycosides (could probably give), chloramphenicol (no, no) CI tetracyclines, erythromycin estolate, fluoroquinolones

Answer 18

``` antiviral - inhibs strains of Influenza A also used for parkinsons must adjust for renal can cause confusion, not commonly used high conc in renal secretions ```

Answer 19

host species specific lmw proteins made my mammals in response to viral infections produced by recombinant genetic techniques

Answer 20

``` renders cells resistant to many viruses used for Hep B and C Hairy cell leukemia Karpsoi's sarcoma IV AE; flu-like sx, depression, (responds to SSRI, should have MH care, caution if SI), hypotension Hep C tx, combined with ribavirin, depends on virus genotype long-acting; pegylated, once weekly ```

Answer 21

HSV>VZV>CMV>EBV, herpes viruses differ in their degree of sensitivity to ACV inhibits DNA polymerase and blocks replication 200-400 mg HSV (very sensitive, suppression tx if >6/year) VZV needs high dose 800 mg 4x/day encephalitis IV only 700-800 mg (low absorption, IV to get to CNS) drug resistence in immunocompromised hosts drug resistent strains less virulent topical doesn't work toxicity - well-tolerated, safe in pregnancy, hydration imp if taking high doses, LOTS of WATER, could crystalize in high doses

Answer 22

dont' rx this, get ID consult, nephrotoxicity - dec GFR, renal tubular acidosis, dec renal conc ability, hypoK, hypoMAG infusion-related rxns - chills/rigors, fever, n/v, cardiorespiratory rxn, phlebitis drug of choice for systemic fungal infection.

Answer 23

tons of drug-drug, P450 very active

Answer 24

cutaneous injury - catheters, burns, surgery mucosal injury - mucositis, GI surgery, GI perf FUNGAL factors - proteinases, phospholipases, lipases

Answer 25

C. albicans, C. tropicalis, NO C. krusei/Aspergillus Renal clearance (80%) Clearance - renal (80%) AE N&V, hepatic

Answer 26

used to treat Aspergillus | AE: N/V, visual dist, hepatic, rash, QTC prolongation

Answer 27

very safe, lon inc of hepatotoxicity, only IV small drug-drug micafungin more commonly used used mostly in transplant or renal patient anidulafungin - lots of etoh in each dose