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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Antibiotic Classes Gram Coverage? (Mnemonic)

A

“GLAM” - Effective against Gram Positive organisms

G:
Glycopeptides
Effective against Gram Positive organisms

L:
Lincosamides
Effective against Gram Positive organisms

A:
Ami(NO)glycosides - (NO)
Aminoglycosides
Effective against Gram Negative organisms

M:
Macrolides
Effective against Gram Positive organisms

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2
Q

Antibiotic Classes Gram Coverage? (Non Mnemonic)

A

NON-GLAM abx:
Effective against Gram Positive AND Negative organisms

Cephalosporins
Tetracyclines
Penicillins
Sulfonamides
Fluoroquinolones
Carbapenems

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3
Q

Antibiotic Classes Mechanism of Action? (Mnemonic Tutor)

A

“MALT” - Inhibit Protein Synthesis

M:
Macrolides

A:
Aminoglycosides

L:
Lincosamides

T:
Tetracyclines

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4
Q

Antibiotic Classes Mechanism of Action? (Mnemonic)

A

“Rated PG CoCO” - Inhibit Cell wall synthesis

P:
Penicillins

G:
Glycopeptides

C:
Cephalosporins

C:
Carbapenems

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5
Q

Antibiotics Mechanism of Action? (Non Mnemonic)

A

1- Sul(FO)namides - Inhibit (FO)late synthesis

Sulfonamides

2- Fluoro(QUIN)olones - Inhibit DNA synthesis - (QUIN)tuplets

Fluoroquinolones

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6
Q

How do antimicrobial drugs work?

A

Antimicrobial drugs work by killing bacteria or inhibiting their growth through various mechanisms, such as inhibiting cell wall synthesis, protein synthesis, nucleic acid synthesis, or metabolic pathways.

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7
Q

What are natural barriers to microbes?

A

Natural barriers include physical barriers (skin, mucous membranes), chemical barriers (stomach acid, antimicrobial peptides), and biological barriers (normal flora).

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8
Q

What are some additional factors that affect the ability to fight infection?

A

Factors include the immune status of the host, presence of chronic diseases, use of immunosuppressive medications, and presence of foreign bodies or comorbidities.

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9
Q

What are some considerations when selecting an antibiotic?

A

Considerations include the type of infection, causative pathogen, antibiotic susceptibility, patient allergies, potential side effects, drug interactions, and patient renal or hepatic function.

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10
Q

What is the difference between bactericidal and bacteriostatic antibiotics?

A

Bactericidal antibiotics kill bacteria, while bacteriostatic antibiotics inhibit bacterial growth, allowing the immune system to eliminate the bacteria.

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11
Q

What are adverse drug reactions?

A

Adverse drug reactions are unintended and harmful effects that occur at normal doses of a drug, including allergic reactions, toxicity, and interactions with other drugs.

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12
Q

What are opportunistic infections?

A

Opportunistic infections are caused by pathogens that take advantage of a weakened immune system or imbalanced normal flora.

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13
Q

What is the difference between true allergic reactions and sensitivities?

A

True allergic reactions involve an immune system response (e.g., anaphylaxis), while sensitivities may cause non-immune mediated reactions like nausea or rash.

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14
Q

What is Gram Positive Bacteria?

A

Usually cocci, sometimes rods
Thick Peptidoglycan layer
Sensitive to Beta Lactams

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15
Q

What is Gram Negative Bacteria

A

Usually rods, sometimes cocci
Thinner Peptidoglycan layer
External layer of Lipopolysaccharides that protects the peptidoglycan layer from Beta Lactam activity, so Gram Negative bacteria is more resistant to Beta Lactams

Produce Beta Lactamase that hydrolyze the Beta-Lactam ring of penicillins and cephalosporins, destroying their antibiotic activity

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16
Q

What Antibiotic classes affect Cell Wall Synthesis?

A

Beta-Lactams
Glycopeptides

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17
Q

What Antibiotic classes affect DNA Replication and Transcription?

A

Quinolones

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18
Q

What Antibiotic classes affect DNA-Dependent RNA Polymerase?

A

Fluoroquinolones*
*(Rifamycin)

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19
Q

What Antibiotic classes affect Folic Acid Antagonists?

A

Trimethoprim-sulfamethoxazole

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20
Q

What Antibiotic classes affect Protein Synthesis?

A

Aminoglycosides
Macrolides
Lincosamides (Streptogramins)
Tetracyclines

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21
Q

What Antibiotic classes affect Initiation of Protein Synthesis?
(In other words: Blocks translocation of step in protein synthesis)

A

Oxazolidinones
Ex: Linezolid / ZYVOX

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22
Q

What are beta-lactams?

A

Beta-lactams are a class of antibiotics that include penicillins, cephalosporins, and carbapenems. They work by inhibiting bacterial cell wall synthesis.

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23
Q

What are the major classes of beta-lactams?

A

Penicillins
Cephalosporins
Carbapenems.

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24
Q

How do beta-lactams work?

A

Beta-lactams inhibit cell wall synthesis by binding to penicillin-binding proteins and disrupting the formation of the bacterial cell wall.

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25
Q

What is the role of penicillin-binding proteins in beta-lactam action?

A

Penicillin-binding proteins are involved in cross-linking peptidoglycan in bacterial cell walls; beta-lactams inhibit these proteins, leading to cell wall disruption.

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26
Q

How does the presence of beta-lactamase affect beta-lactam antibiotics?

A

Beta-lactamase enzymes hydrolyze the beta-lactam ring of these antibiotics, rendering them ineffective.

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27
Q

What are beta-lactamase inhibitors?

A

Beta-lactamase inhibitors are substances added to beta-lactam antibiotics to counteract the effects of beta-lactamase enzymes.

Like Clavulanic Acid (added to Amoxicillin)
and
Tazobactam (added to Piperacillin)

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28
Q

What are the 3 Types (not classes) of Penicillins?

A

1- Narrow-Spectrum Penicillins:
Resistant to Beta Lactamase, but restrict spectrum of activity

2- Aminopenicillins:
Have an added amino group that makes the molecule more hydrophilic so able to cross the Lipopolysaccharide layers easily. This makes Aminopenicillin have greater Gram Negative coverage

3- Broad-Spectrum Penicillins:
Modifications of Aminopenicillins with nitrogen and carbon atoms added. This increases range of sensitivity. Often coadministered with a Beta Lactamase Inhibitor

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29
Q

How is Penicillin excreted?

A

80% cleared by kidneys within 4 hours

So need consistent dosing to keep concentration of drug

Dose MUST be adjusted for patients with Renal Dysfunction

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30
Q

What are some examples of penicillins?

A

IMPORTANT:
- Penicillin G (IV)
- Penicillin V (PO) / Penicillin VK

Aminopenicillins:
IMPORTANT:
- Amoxicillin / Amoxil trimox

Aminopenicillins:
Other:
Ampicillin

Narrow-Spectrum:
Cloxacillin
Oxacillin
Nafcillin

Broad-Spectrum:
Piperacillin
Ticarcillin

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31
Q

What are the side effects of penicillins?

A

Hypersensitivity reactions (Maculopapular rash, urticarial rash, anaphylaxis)

Nausea, vomiting, diarrhea, stinging (when IV) and potential cross-reactivity with other beta-lactams.

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32
Q

What are the generations of cephalosporins and their examples?

A

1st Generation:
IMPORTANT 1st GEN:
- Cephalexin / Keflex

Other 1st gen:
Cefazolin / Ancef
Cefadroxil / Duricef
Cephalothin
Cephapirin
Cephradine

2nd Generation:
IMPORTANT 2nd GEN:
- Cefaclor / Ceclor

Other 2nd Gen:
Cefuroxime / Ceftin
Cefoxitin
Cefamandole
Cefmetazole
Cefonicid
Cefotetan
Cefprozil / Ceftin
Loracarbef / Lorabid

3rd Generation:
IMPORTANT 3rd GEN:
- Ceftriaxone / Rocephin
- Cefdinir / Omnicef

Other 3rd Gen:
Ceftazidime
Cefixime / Suprax
Cefditoren
Cefoperazone
Cefotaxime
Cefpodoxime / Vantin
Ceftibuten
Ceftizoxime

4th Generation:
Cefepime

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33
Q

How is cephalosporin excreted?

A

Renal excretion
Except Ceftriaxone (50% hepatic, 50% renal)

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34
Q

What does 3rd Generation of Cephalosporins have as a unique feature?

A

Good CNS penetration
Penetrate BBB (against bacterial meningitis)

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35
Q

What is the mechanism of action for cephalosporins?

A

Cephalosporins inhibit cell wall synthesis by binding to penicillin-binding proteins, similar to other beta-lactams.

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36
Q

What are contraindications of Cephalosporins?

A

ABSOLUTE CONTRAINDICATION:
Anaphylaxis to Penicillins

Nonanaphylactic allergy to penicillin is a relative contraindication
Cross-reactivity 1-10%

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37
Q

What are the common side effects of cephalosporins?

A

Hematologic effects - Neutropenia, granulocytopenia

Nephrotoxicity - Occasional Interstitial Nephritis

Pseudomembranous colitis - (Clostridium difficile) caused because the gut flora is wiped out, so C. diff can colonize it. This is more common with Broad Spectrum antibiotics

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38
Q

What is 1st Gen Cephalosporins good for?

A

Skin infections

Prophylactic antibiotics prior to surgery to prevent wound infection

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39
Q

What is 2nd Gen Cephalosporins good for?

A

Intra-abdominal infections

Okay for mild infections with Gram Negative
(But use 3rd gen for severe infections)

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40
Q

What is 3rd Gen Cephalosporins good for?

A

Severe infections in combination with another drug of a different class (Different MOA)

41
Q

What is 4th Gen Cephalosporins good for?

A

reserved for severe Nosocomial infections

These have tendency to be resistant to multiple antibiotics, more severe infections, commonly due to Gram Negative

42
Q

What are carbapenems and their examples?

A

Carbapenems are a class of beta-lactam antibiotics including:

IMPORTANT??:
Imipenem
Meropenem
Ertapenem / Ivanz
Doripenem

“Mira Dori y MI-Erta”
- Meropenem, Doripenem, Imipenem, Ertapenem

43
Q

How are Carbapenems administered? Excreted? Dosage? Half-Life?

A

Administered by IV

Eliminated by kidneys

Imipenem is hydrolyzed by Renal Tubular Dipeptidase so always administered with Cilastatin which inhibits its breakdown

Meropenem and Ertapenem are not broken down so don’t need to add Cilostatin

Dose MUST be adjusted for patients with Renal Disease
Imipenem has higher risk of seizure for patients with Renal Dysfunction

Ertapenem has longer Half-Life and can be administered once daily

44
Q

How do carbapenems differ from other beta-lactams?

A

“Big Guns”
Carbapenems are generally reserved for severe infections for patients very sick with bacteria that are more resistant to beta-lactamase.

Not 1st line treatment

45
Q

What are Carbapenems contraindications?

A

Imipenem can cause seizures in 1.5% of patients

Should not be used in patient with seizure history

Other Carbapenems have replaced Imipenem

46
Q

What are Carbapenems side effects?

A

Nausea
Vomiting
Fever

Neurotoxicity with Imipenem
But not with Meropenem or Ertapenem

47
Q

What are glycopeptides and their examples?

A

IMPORTANT EXAMPLES:
- Vancomycin / Vancocin

Other examples:
Teicoplanin (Europe, not America)
Telavancin

48
Q

What is the mechanism of action for glycopeptides?

A

Glycopeptides inhibit cell wall synthesis by binding to peptidoglycan precursors, preventing their incorporation into the cell wall.

49
Q

What are Glycopeptides effective against?

A

Only Gram Positive bacteria
Because they target Peptidoglycan layer

50
Q

What is Glycopeptides resistance?

A

Change to end of Amino Acid precursor can result in drug not binding to precursor

Excess cell wall production by bacteria

Biofilm production:
Staphylococcus epidermidis can produce a film that blocks penetration

51
Q

What is Glycopeptides Half-Life? Absorption? Infection location and route? Excretion?

A

Vancomycin half-life is 6 hours

Glycopeptides are poorly absorbed from the GI Tract (this why used for C. diff)

If infection is anywhere else than GI Tract (like blood, soft tissues, heart, brain), then the drug needs to be administered via IV or IM

Renally cleared
MUST reduce frequency for patients with Renal Failure or Dysfunction

52
Q

What are fluoroquinolones and their examples?

A

IMPORTANT EXAMPLE:
- Ciprofloxacin / Cipro
- Levofloxacin / Levaquin
- Moxifloxacin / Avelox

Other examples:
Norfloxacin

53
Q

How do fluoroquinolones work?

A

Fluoroquinolones bind to and inhibit DNA gyrase and topoisomerase IV, preventing DNA replication and transcription.

DNA Gyrase in Gram Negative
Topoisomerase IV in Gram Positive

Bactericidal since DNA fragments accumulation kill bacteria

54
Q

What is Resistance to Fluoroquinolones?

A

Mutation in genes that encode Type II Topoisomerase result in enzyme not being inhibited

Alteration in membrane Porins or Efflux Pumps that actively pump the drug out of the bacterial cell results in lower drug levels inside bacteria

55
Q

What are common side effects of fluoroquinolones?

A

Generally well tolerated

Nausea, vomiting, diarrhea

Rare tendon ruptures (Achilles and shoulder) (unclear MOA)

56
Q

What is Fluoroquinolones absorption? Excretion

A

Fluoroquinolones can enter human cells

Absorbed very well from gut
Makes easier transition from IV to Oral form

Most cleared Renally
Dose MAY be adjusted for patients with Renal Impairments

EXCEPTION is Moxifloxacin, which is cleared by Liver and is contraindicated in patients with Hepatic Failure

57
Q

What are the contraindications for fluoroquinolones?

A

Pregnancy

Pediatric use (except otic/topical) for arthralgia and edema

Potential interactions with NSAIDs can make CNS toxicity and cause seizures

Theophylline (Fluoroquinolones will increase Theophylline).

58
Q

What factors contribute to antibiotic resistance?

A

Factors include genetic mutations, changes in drug targets, production of drug-inactivating enzymes, and changes in drug permeability or efflux.

59
Q

What is the role of beta-lactamase in resistance?

A

Beta-lactamase enzymes hydrolyze the beta-lactam ring, rendering beta-lactam antibiotics ineffective.

60
Q

Why are carbapenems considered “big guns” in antibiotic treatment?

A

Carbapenems are used for severe infections and resistant organisms due to their broad-spectrum activity and resistance to many beta-lactamases.

61
Q
  1. Oral Fluoroquinolones

Q: Are oral fluoroquinolones contraindicated in the pediatric population?

A

Yes, they are contraindicated in the pediatric population.

But Topical Fluoroquinolones are effective and safe
Approved for use in children and lack of Ototoxicity permits prolonged administration when necessary

Ofloxacin otic solution approved for Otitis Externa and Otitis Media with Perforated TM

Ciproflaxin otic suspension approved for Otitis Externa

Both can be used in patients 1+ year

62
Q
  1. Topical Fluoroquinolones

Q: Are topical fluoroquinolones safe for children?

A

Yes, topical fluoroquinolones are effective and safe for use in children.

63
Q
  1. Ofloxacin Otic Solution

Q: What conditions is Ofloxacin otic solution approved to treat?

A

Ofloxacin otic solution is approved for otitis externa and otitis media with a perforated tympanic membrane.

64
Q
  1. Ciprofloxacin Otic Suspension

Q: What condition is Ciprofloxacin otic suspension approved to treat?

A

Ciprofloxacin otic suspension is approved for the treatment of otitis externa.

65
Q
  1. Aminoglycosides - Examples

Q: Name three examples of aminoglycosides.

A

IMPORTANT EXAMPLE:
- Gentamicin (IV)

Other examples:
Tobramycin
Amikacin
Neomycin (only in creams and drops)
Streptomycin
Kanamycin
Paromomycin

66
Q
  1. Aminoglycosides - Mechanism of Action

Q: How do aminoglycosides inhibit bacterial protein synthesis?

A

Aminoglycosides irreversibly bind to the 30S ribosomal subunit, causing misreading of mRNA at low concentrations and halting protein synthesis at higher concentrations.

67
Q
  1. Aminoglycosides - Mechanisms of Resistance

Q: What are three mechanisms of resistance to aminoglycosides?

A

Ribosome alteration, decreased permeability, and inactivation by aminoglycoside modifying enzymes.

68
Q
  1. Aminoglycosides - Absorption and Administration

Q: How are aminoglycosides typically administered and why?

A

They are usually administered IV due to poor penetration of biologic membrane, and poor GI absorption

EXCEPTION: Proximal Tubule of Kidneys

Accumulate in kidney cells and cause potential nephrotoxicity.

Tobramycin can also be inhaled.

There are topical drops for ears or eyes

Rapidly excreted by Glomerular Filtration of kidneys

Kidney function MUST be measured BEFORE and THROUGHT therapy

69
Q
  1. Aminoglycosides - Side Effects

Q: What are common side effects and contraindications of aminoglycosides?

A

Contraindication:
Renal Dysfunction

Side Effects:
Ototoxicity
Caused by human mitochondrial ribosomes damaging hair cells of inner ear
Decrease hearing, tinnitus, vertigo

Nephrotoxicity
Drug accumulates in Proximal tubule cells
If creatinine levels rise, need stop drug IMMEDIATELY
Usually mild nephrotoxicity and reversible
Risk factors for renal adverse effects are HF, advanced age, and renal disease

70
Q
  1. Lincosamides - Examples

Q: Name two lincosamides.

A

IMPORTANT:
- Clindamycin

Other example:
Lincomycin.

71
Q
  1. Lincosamides - Mechanism of Action

Q: What is the mechanism of action of lincosamides?

A

Lincosamides inhibit protein synthesis by affecting ribosomal translation.

72
Q
  1. Lincosamides - Mechanisms of Resistance

Q: What are some mechanisms of resistance to lincosamides?

A

Mutation of the ribosomal receptor site, enzymatic inactivation, and efflux pumps.

Resistance to Clindamycin usually implies cross-resistance to Macrolides

73
Q

How are Lincosamides absorbed? Metabolized? Dose? Penetration?

A

Absorbed well orally

Metabolized by liver

Dose adjustment for severe Hepatic Dysfunction REQUIRED

Clindamycin penetrates bone and is effective for dental infections that may have bony involvement

74
Q

What are Lincosamides Contraindications and Side Effects?

A

No contraindications

Side Effects:
High incidence of developing C. diff

75
Q
  1. Tetracyclines - Examples

Q: Name three tetracyclines.

A

IMPORTANT EXAMPLES:
- Tetracycline
- Doxycycline / Oracea, Doryx
- Minocycline / Minocin

Other examples:
Demeclocycline
Tigecycline

76
Q
  1. Tetracyclines - Mechanism of Action

Q: How do tetracyclines work?

A

They inhibit protein synthesis by binding to ribosomes and preventing the addition of amino acids.

Bacteriostatic, since they stop protein synthesis, but when drug level falls, protein synthesis starts again

77
Q
  1. Tetracyclines - Resistance Mechanisms

Q: What are the main mechanisms of resistance to tetracyclines?

A

Efflux by Tetracycline specific pumps, ribosomal protection, and less common enzymatic inactivation.

78
Q

How should Tetracyclines be taken? Excreted?

A

Calcium and Magnesium supplementation interferes with the effectiveness of Tetracyclines because they bind and inactivates them

Should take on empty stomach

All excreted in urine

Dose Adjustment for patients with Renal Impairments

79
Q
  1. Tetracyclines - Contraindications

Q: What are the contraindications for tetracyclines?

A

Pregnancy, lactation, and children under 8 years old (except doxycycline).

80
Q

What are Tetracyclines Side Effects?

A

GI: nausea, vomiting, diarrhea

Mottling of teeth: because bind to calcium can permanently stain developing teeth in children

Photosensitivity: resembles severe sunburn

Super infection: Wide Spectrum

Diabetes Insipidus

Liver damage: liver enzymes can be increased from drug

Kidney damage: rare, Acute Tubular Necrosis

Headache: Pseudo Tumor Cerebri (increased ICP)

81
Q
  1. Doxycycline in Children

Q: Why is doxycycline used cautiously in children under 8 years old?

A

Due to potential for dental staining, but it’s used when benefits outweigh risks, especially for diseases like Lyme disease.

Between age 6-7 limited use

Only Doxycycline, since binds calcium to lesser extent than other Tetracyclines

82
Q
  1. Macrolides - Examples

Q: Name three macrolides.

A

IMPORTANT:
- Erythromycin / Ery-tab
- Azithromycin / Zithromax, Z-pak
- Clarithromycin / Biaxin

83
Q
  1. Macrolides - Mechanism of Action

Q: How do macrolides inhibit bacterial growth?

A

They inhibit protein synthesis by affecting ribosomal translation and can be bactericidal at high concentrations.

Erythromycin stimulates the Motilin receptors on GI smooth muscle, leading to increase forward transit of GI contents (helps with gastroparesis)

Clarithromycin and Azithromycin are commonly used for STI and Pneumonia

84
Q
  1. Macrolides - Mechanisms of Resistance

Q: What are common mechanisms of resistance to macrolides?

A

Increased efflux by active pumps, production of esterase that hydrolyze Macrolides (more common in Gram Negative Enteric bacteria), and cross-resistance among macrolides.

85
Q

What is Macrolides different features?

A

Axithromycin: distributed intra cellularly so long Half-Life (can be once daily)
Liver metabolized but not enzyme inhibitor

Erythromycin and Clarithromycin are significant CYP450 enzyme inhibitors and are liver metabolized, drug interactions should be monitored

Erythromycin is unstable in gastric acid, but Azithromycin and Clarithromycin are stable in gastric acid

Azithromycin has long duration of action, 5-day oral once daily is adequate

86
Q
  1. Oxazolidinones - Examples

Q: Name an example of an oxazolidinone.

A

Linezolid / ZYVOX

They are weak Monoamine Oxidase Inhibitors (MAOI)

87
Q
  1. Oxazolidinones - Mechanism of Action

Q: What is the mechanism of action for oxazolidinones?

A

They block the translocation step in protein synthesis and are bacteriostatic.

88
Q
  1. Oxazolidinones - Side Effects

Q: What are serious but rare side effects of oxazolidinones?

A

SERIOUS but RARE

Serotonin syndrome (for pt who take drugs that increase Serotonin in brain, SSRI most comonly, antidepressant)
Hyperlactatemia, metabolic acidosis, nerve damage, and bone marrow suppression (mild reversible in 4 weeks after stop).

89
Q
  1. Sulfonamides - Examples

Q: Name three sulfonamides.

A

IMPORTANT:
- Sulfamethoxazole
- Silver Sulfadiazine
- Sulfacetamide (topical)
- Trimethoprim (non sulfa)

Others:
Sulfadiazine
Sulfanilamide
Sulfacytine
Sulfamethizole
Pyrimethamine (non sulfa)

IMPORTANT COMBINATION:
- Sulfamethoxazole/Trimethoprim / Bactrim, Septra

90
Q
  1. Sulfonamides - Mechanism of Action

Q: How do sulfonamides work?

A

They inhibit folate synthesis, and trimethoprim is often combined with sulfonamides for enhanced efficacy.

91
Q
  1. Sulfonamides - Mechanisms of Resistance

Q: What are the mechanisms of resistance to sulfonamides?

A

Overproduction of PABA (p-aminobenzoic acid), enzyme mutations (reduced affinity for sulfas), and reduced drug levels inside the cell.

92
Q

What is Sulfonamides metabolism? excretion? dose?

A

Sulfonamides metabolized by liver

Excreted by kidney

Dose adjustment for pt with Advanced Renal Dysfunction

93
Q

What is Sulfonamides side effects? Contraindications?

A

Side Effects:
Steven-Johnson Syndrome - rare life threatening hypersensitivity involving skin and mucous membranes
Hemolytic anemia
Aplastic anemia
Granulocytopenia
Thrombocytopenia
Kernicterus (increase free Bilirubin and Jaundice in newborn)

Contraindication:
Allergy to Sulfa antibiotics
G6PD deficiency (Glucose-6 Phosphate Dehydrogenase Deficiency)

94
Q

What are common uses for Sulfonamides?

A

UTI

Respiratory infections: Community Acquired Pneumonia

PJP (Pneumocystic Jiroveci) Prophylaxis

Topical to prevent infection in burns and severe blistering diseases of skin

95
Q
  1. Metronidazole - Examples

Q: Name an example of a metronidazole formulation.

A

IMPORTANT:
- Metronidazole / Flagyl

Different formulations available, depending on what treating

Oral
Vaginal Gel (Bacterial Vaginosis)
«<Flagyl>>>
Topical (Metrogel to treat Rosacea)</Flagyl>

96
Q
  1. Metronidazole - Mechanism of Action

Q: What type of bacteria is metronidazole effective against?

A

It is effective against anaerobic bacteria and protozoa.

97
Q

What is Metronidazole route and metabolism? Dose?

A

Metronidazole oral and complete absorption

Metabolized by liver

Dose adjustment for Liver Metabolism

98
Q
  1. Metronidazole - Side Effects

Q: What are some side effects of metronidazole?

A

Nausea, metallic taste, CNS toxicity (rare as Ataxia, Encephalopathy, or seizure)

Rare:
Neutropenia, pancreatitis, peripheral neuropathy, and hepatitis.

99
Q
  1. Metronidazole - Contraindications

Q: What should metronidazole not be taken with?

A

Alcohol (due to Disulfiram reaction)
Can lead to severe nausea and vomiting

Contraindicated in pregnancy (causes tumor growth and crosses readily to placenta)

Pharmacology (5 decks)

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