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Pathopharm 1 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What are the class of drugs that inhibit cell wall synthesis

A
  1. Penicillin’s
  2. Cephalosporins
  3. Carbapenems
  4. Vancomycins
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2
Q

How do drugs that inhibit cell wall synthesis work?

A
  1. Weaken/damage the cell wall
  2. Influx of fluid into the cell
  3. Cell swells and bursts
  4. Cell lysis and death
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3
Q

What are the ‘beta-lactam’ antibiotics?

A
  1. Penicillin’s
  2. Cephalosporins
  3. Carbapenems
  4. Vancomycin
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4
Q

How do ‘beta-lactam’ antibiotics work?

A

They inhibit the synthesis of the bacterial peptidoglycan cell wall

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5
Q

What needs to happen if the bacteria produces beta lactamase?

A

Will need to combine the beta lactase antibiotic with a beta lactamase inhibitor

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6
Q

What is the mechanism of action of PCNs

A
  1. Disrupts the synthesis of the cell wall
  2. Inhibits transpeptidase (essential for cell wall synthesis)
  3. Activates autolysis (bacteria’s enzymes destroy the bacteria)
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7
Q

What are the adverse effects of PCNs

A
  1. Urticaria (hives)
  2. Pruritus (itching)
  3. Angioedema (hives under the skin)
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8
Q

What are the clinical indications for PCN

A
  1. Gonorrhea
  2. Peritonitis (inflammation of the lining of the abdomen)
  3. UTIs
  4. Pneumonia and other respiratory infections
  5. Septicemia (blood poisoning by harmful microorganisms)
  6. Meningitis
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9
Q

What are the different types of natural PCNs?

A

PCN G and PCN V

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10
Q

What type antibiotic can work with natural PCNs?

A

Aminoglycosides

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11
Q

What is the name of the penicillinase resistant penicillin that we are studying?

A

Nafcillin

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12
Q

Can Nafcillin be given IM and PO?

A

No, it can only be given IV

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13
Q

What type of bacteria is Nafcillin most commonly used on?

A

Staph bacteria (“anti-staphylococci med”)

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14
Q

What are the different types of aminopenicillins?

A

Ampicillin and Amoxicillin

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15
Q

What are the adverse effects of ampicillin?

A

Diarrhea and rash

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16
Q

Can ampicillin be given IM?

A

No, it can only be given PO and IV

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17
Q

What other antibiotic is ampicillin commonly used with?

A

Sulbactam, the combined drug is Unasyn

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18
Q

What types of infections is amoxicillin commonly used to treat?

A

Ears, nose, throat, gastrourinary, and skin infections

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19
Q

What is the name of the extended spectrum penicillin that we are studying?

A

Piperacillin

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20
Q

How often is piperacillin given with beta lactamase inhibitors

A

Always

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21
Q

What are the nursing considerations for piperacillin?

A
  1. Affects platelet function
  2. Hard on the kidneys –> monitor patients with renal dysfunction
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22
Q

Are cephalosporins usually resistant to beta-lactamase?

A

yes

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23
Q

What are the adverse effects of cephalosporins?

A

rash (most common)
Mild diarrhea
Abdominal cramps
pruritus
edema

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24
Q

What pregnancy category level is cephalosporins?

A

Category B

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25
Q

What are the indications for using cephalosporins?

A

(same indications as PCNs)
Gonorrhea
2. Peritonitis (inflammation of the lining of the abdomen)
3. UTIs
4. Pneumonia and other respiratory infections
5. Septicemia (blood poisoning by harmful microorganisms)
6. Meningitis

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26
Q

What are the 1st generation cephalosporins?

A

Cefazolin and cephalexin

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27
Q

What types of bacteria do 1st generation cephalosporins work on?

A

Gram +
Skin
UTIs
Staph
Nonenterococcal strep

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28
Q

What situations would 1st generation cephalosporins not work on?

A

Enterococcal strep
CNS infections and meningitis

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29
Q

Is cephazolin used prophylactically for surgical procedures?

A

yes

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30
Q

What are the 2nd generation cephalosporins?

A

Cefuroxime and cefotetan

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31
Q

What routes can 2nd generation cephalosporins be given?

A

IV and PO

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32
Q

What kinds of bacteria can cefuroxime NOT work on?

A

Anaerobic bacteria
CNS infections

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33
Q

What are the 3rd generation cephalosporins?

A

Ceftriaxone, ceftazidime, cefotaxime

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34
Q

What kinds of bacteria do 3rd generation cephalosporins work well on?

A

Gram -
Doesn’t work well on gram +

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35
Q

What routes are 3rd generation cephalosporins given?

A

IV and IM

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36
Q

How often is ceftriaxone given?

A

Extremely long acting –> once per day

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37
Q

What kinds of infections does ceftriaxone work well on?

A

CNS infections

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38
Q

What kind of organ dysfunction should ceftriaxone not be given?

A

Liver failure

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39
Q

What kind of bacteria does ceftazidime work well on?

A

Psuedomonas

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40
Q

What is the only 4th generation cephalosporin?

A

Cefepime

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41
Q

What kind of infection/bacteria does cefepime work well on?

A

Gram + and -
Uncomplicated/complicated UTIs
Skin infections
Pneumonias
CNS infections

42
Q

What is the only 5th generation cephalosporin that we are studying?

A

Ceftaroline

43
Q

What kinds of bacteria/infection does Ceftaroline work well on?

A

MRSA and MSSA
Some kinds of VRSA/VISA
Staph infections

44
Q

What kinds of bacteria does Ceftaroline not work on?

A

Enterobactar
Psuedomonas
ESBL
Klesbella

45
Q

What organ is ceftaroline hard on?

A

Kidneys. Needs to be renally dosed if it is given

46
Q

What route is ceftaroline given?

A

IV only

47
Q

What are the different types of cabapenems?

A

Imipenem/cilastatin and meropenem

48
Q

How broad spectrum are carbapenems

A

Very broad. The broadest even.

49
Q

What is the adverse effect of carbapenems?

A

Drug-induced seizures (not common)

50
Q

What route and for what duration are carbapenems given?

A

IV only, given over 60 minutes

51
Q

What route is imipenem given?

A

IV only

52
Q

What type of infection does imipenem work well on?

A

CNS and meninges infections

53
Q

What must be monitored for when giving imipenem?

A

Seizures?

54
Q

What demographics must be monitored when giving imipenem?

A

The elderly and seizure prone patients

55
Q

Does meropenem degrade in the kidneys?

A

no

56
Q

What are the side effects for meropenem?

A

Rash and diarrhea

57
Q

What kind of bacteria do nurses need to watch for when giving any kind of carbapenem?

A

CRE (carbapenem-resistant enterobacteriacae)

58
Q

What kind of bacteria does Vancomycin work well on?

A

Gram +
MRSA
PCN resistant pneumococcus
C. Diff
Pseudomembranous colitis

59
Q

What kind of infections does Vancomycin NOT work well on?

A

CNS and meninges infections

60
Q

What are the toxic side effects of Vancomycin?

A
  1. Hearing loss with increased doses
  2. Decreased platelets
  3. Nephrotoxic
  4. Compounds the effects of neuromuscular blockades (paralyzers)
61
Q

Which medication is associated with ‘Red man syndrome’?

A

Vancomycin

62
Q

Why does red man syndrome occur?

A

Giving vancomycin too fast

63
Q

What are s/s of red man syndrome?

A

Flushing
rash
pruritus
urticaria
tachycardia
hypotension

64
Q

What can the nurse do to prevent/stop red man syndrome

A

Infuse vancomycin slower and over a longer period of time

65
Q

Is red man syndrome harmful

A

No, not usually

66
Q

When is the best time to draw a peak?

A

15-30 minutes after giving the med

67
Q

When is the best time to draw a trough?

A

15-30 minutes before the next dose

68
Q

What is the MOA of tetracyclines?

A

Bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes

69
Q

What diseases do tetracyclines work on?

A
  1. Rickettsia
  2. Chlamydia and trichomonas
  3. Lyme disease
  4. Cholera
  5. Pelvic inflammatory disease
  6. Mycoplasma pneumonia
  7. Acne
70
Q

What are the contraindications for tetracyclines?

A

Pregnant and nursing women
Children < 8 years old

71
Q

What are the adverse effects of tetracyclines?

A
  1. Discoloration of teeth
  2. Tooth enamel hypoplasia in fetuses and children
  3. Photosensitivity
72
Q

What route is tetracycline given?

A

PO, should be given while fasting to increase absorption

73
Q

Where does tetracycline concentrate

A

Bones, liver, tumors, spleen, and teeth

74
Q

What are the adverse effects of tetracycline?

A

N/V/D
headache
Photosensitivity
Dizziness
Anaphylaxis and angioedema (rare)

75
Q

What diseases does doxycycline work on?

A

Chlamydia
Mycoplasma infections
Acne and other nondangerous skin infections

76
Q

When is doxycycline prophylactically given?

A

STIs

77
Q

What disease does minocycline work on?

A

Meningitis

78
Q

What is the extended release version of minocycline called, and what it is used to treat?

A

Solodyn, treats acne

79
Q

What are the medications in the tetracycline class of drugs?

A

Tetracycline, doxycycline, minocycline

80
Q

What are the medications in the fluoroquinolones drug class

A

Ciprofloxacin, levofloxacin

81
Q

Are the fluoroquinolones drugs broad spectrum?

A

yes

82
Q

What is the MOA of Fluoroquinolones

A

Destroys bacteria by altering DNA and interferes with the bacterial enzyme DNAha

83
Q

What bacteria is fluoroquinolones work well on?

A

Gram -, less coverage against gram +

84
Q

What diseases does ciprofloxacin work well on?

A

UTIs
Some STIs
Upper/lower respiratory infections
Gonorrhea
Anthrax

85
Q

What routes can ciprofloxacin be given?

A

IV, PO, topically

86
Q

What is ciprofloxacin NOT good at treating

A

CNS infections

87
Q

Does the growing speed of microorganisms effect how well ciprofloxacin work

A

No

88
Q

What is the adverse effect of ciprofloxacin?

A

Arthroplasty (joint disease), irreversible

89
Q

What age groups should you avoid giving ciprofloxacin to?

A

<18, >60

90
Q

How often should levofloxacin be given to achieve therapeutic effects?

A

once per day

91
Q

What does levofloxacin work on?

A

Pneumococcal and other respiratory infections
Ex: sinusitis, chronic bronchitis exacerbations by infections, community acquired PNA

92
Q

What are the side effects of levofloxacin?

A

Seizures
Kidney failure
Prolonged QT interval (dysrhythmias)
Photosensitivity

93
Q

What medications are sulfamides?

A

sulfamethoxazole/trimethoprim (Bactrim)

94
Q

What is the MOA of Sulfamides?

A

Bacteriostatic by preventing synthesis of folic acid needed for DNA synthesis

95
Q

What are the indications for using sulfamides?

A

Uncomplicated UTIs
Respiratory infections
Salmonella
Shigellosis

96
Q

What are the adverse effects for sulfamides?

A

Sulfa allergies
Photosensitivity

97
Q

What microorganism classes does metronidazole work on?

A

Antiprotozoal and antibacterial

98
Q

What diseases does metronidazole work on?

A

Crohn’s disease
C. Diff
Anaerobic bacteria

99
Q

What is the MOA of metronidazole?

A

Inhibits DNA synthesis

100
Q

What is the nursing consideration for metronidazole?

A

Do not use alcohol 24 hours before, or 36 hours after taking metronidazole

101
Q

What are the adverse effects of metronidazole?

A

N/V
Xerostomia (dry mouth)
Vaginal candiasis

Pathopharm 1 (2 decks)

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