Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Patho & Pharm > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

penicillin MOA

A

Cell Wall Synthesis Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

penicillin adverse effects

A

nephrotoxicity, allergic interstitial nephritis, seizures (toxic levels due to renal dysfunction), diarrhea, C. difficile infection (with broader spectrum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

penicillin ___ killing, half life

A

Time-dependent killing; most effective against microorganisms rapidly growing + dividing
* Very short half-life <2 hrs; dosed multiple times/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

penicillin for special population

A

safe for infants and pregnancy
dose adjustment for renal dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

penicillin has sensitivity to

A

cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

amoxicillin is __ spectrum

A

broad spectrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

cephalosporin MOA

A

Cell Wall Synthesis Inhibiton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

adverse effects of cephalosporin

A

GI intolerance, seizures (high doses), interstitial nephritis, rare
blood dyscrasias,
***C. difficile infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cephalosporin is ___ killing

A

Time-dependent killing; most effective against microorganisms rapidly growing + dividing

  • Renal elimination for all except ceftriaxone (liver) – adjust dose prn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CSF penetration of cephalosporin

A

1st + 2nd Gen: low CSF penetration – do not use for bacterial meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

special population for cephalosporin

A

Safe for use in infants/children (avoid ceftriaxone in neonates -> bilirubin displacement and kernicterus )
Crosses placenta + present in breastmilk Generally safe in pregnancy/breastfeeding
Adjust dose with renal dysfunction for older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CARBAPENEMS MOA

A

Cell Wall Synthesis Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

adverse effects of carbapenems

A

confusion, delirium, seizure, diarrhea, C. difficile infection anemia, ↑LFT’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

carbapenems ____ killing
_____ CSF

A

Time-dependent killing
* Post-antibiotic effect
* Penetrates CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drug interactions of carbapenems

A

valproic acid (reduced effect -> seizures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

monitoring for carbapenems

A

renal/liver/hematologic function periodically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

penicillin monitoring for

A

renal function with renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

cephalosporin monitoring for

A

c. diff symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

monobactams MOA

A

Cell Wall Synthesis Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

adverse effects of monobactams

A

thrombophlebitis at injection site, neutropenia + ↑lft’s in peds, C. difficile infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

monobactams are___ killing
____ CSF

A

Time-dependent killing
* Penetrates CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

beta lactam antibiotics metabolism and elimination
except

A
  • Minimal hepatic metabolism
  • Renal elimination (adjust dose prn)
    except ceftriaxone (liver) – adjust dose prn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

monobactams special population

A

Not recommended in pediatric CNS infections due to seizure risk
Crosses placenta + present in breastmilk Use only if safer alternative not available.
Adjust dose with renal dysfunction for older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

__ generations of cephalosporin

A

There are 5 generations and as they proceed from the 1st to the 5th generation, there is more gram negative and anaerobic coverage, less resistance to beta lactamases and more CSF penetration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

vancomycine MOA

A

Cell Wall Synthesis Inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

vancomycine is reserved for ___

A

Reserve for Gram (+) infections where B-lactams cannot be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

adverse effects of vancomycin

A

renal toxicity,
ototoxicity (tinnitus, hearing loss, vertigo/dizziness),
neurotoxicity, hypersensitivity/anaphylaxis,
C. difficile (IV use),
thrombocytopenia, neutropenia, pancytopenia, thrombophlebitis, infusion reaction with rapid administration (red man syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

pharmacokinetics of vancomycin
____ killing
metabolism and elimination

A

Time-dependent killing
* Post-antibiotic effect
* No B-lactam ring
* Poor GI absorption; minimal hepatic metabolism
* Renal elimination (adjust dose prn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

special population for vancomycin

A

Caution in neonates/infants due to renal immaturity
Crosses placenta + present in breastmilk. Limited data. Use only if safer alternative not available.
Caution with older adults due to nephrotoxicity, ototoxicity, + neurotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Drug of choice for MRSA and C. difficile and severe infections

A

vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

monitoring of vanco

A

renal function, serum drug levels, hydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Oral formulation of vanco only indicated for

A

C. Diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

FOSFOMYCIN
MOA
___ killing
____ metabolism and elimination

A

Concentration-dependent killing
* Bactericidal in the urine
* Minimal hepatic metabolism
* Renal elimination (adjust dose prn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

FOSFOMYCIN indication

A

Only indicated for acute uncomplicated cystitis in females >18 yrs caused by E. coli or E. faecalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

fosfomycin should be taken

A

take without food
can cause dizzy and drowsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Protein Synthesis Inhibitors
30s
antibiotics

A

Aminoglycosides
Tetracyclines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Protein Synthesis Inhibitors
50s
antibiotics

A

Macrolides
Lincosamides
Oxazolidinones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Aminoglycosides e.g.

A
  • gentamycin
  • tobramycin
  • neomycin
  • streptomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Aminoglycosides MOA

A

Binds bacterial 30S ribosomal subunit, causing production of abnormal protein synthesis + interruption of usual protein synthesis = cell death

40
Q

adverse effects of Aminoglycosides

A

nephrotoxicity, ototoxicity, neurotoxicity (neuromuscular blockade + respiratory paralysis

41
Q

drug interactions with Aminoglycosides

A

Drug Interactions: loop diuretics (↑ototoxicity), nephrotoxic drugs (i.e., NSAIDs, cephalosporins, vancomycin, cyclosporine, amphotericin B)

42
Q

drug monitoring Aminoglycosides

A

Monitoring: serum drug levels (peak levels high to kill bacteria, trough levels low to reduce oto/nephrotoxicity

43
Q

PK and PD of aminoglycosides
____ killing
_____ CNS penetration
elimination

A

Concentration-dependent killing
* Post-antibiotic effect
* Poor GI absorption + CNS penetration
* Renal elimination (adjust dose prn)
* Serum drug levels can vary widely between patients

44
Q

special population aminoglycosides

A

safe for children
not safe for pregnancy
caution for older adults with renal impairment

45
Q

TETRACYCLINES MOA

A

Binds bacterial 30S ribosomal subunits, causing cessation of usual protein synthesis to prevent bacterial growth + multiplication

46
Q

adverse effects of tetracycline

A

renal toxicity,
hepatoxicity
GI (esophageal irritation, n/v, diarrhea, abd pain),
C. difficile,
Teeth discolouration/enamel hypoplasia (binds to calcium in teeth), Photosensitivity

47
Q

PK/PD of tetracycline
____ killing
CNS penetration
elimination

A

Time-dependent killing
* Post-antibiotic effect
* Food may affect absorption (individual drug dependent)
* Poor CNS penetration
* Renal elimination (tetracycline) or hepatic elimination (doxycycline, minocycline)

48
Q

tetracycline can cause_____

A

esophageal irritation
take full glass of water and remain upright for 1-2 hours after

49
Q

special population consideration tetracycline

A

Avoid under 8 yrs: permanent teeth discolouration
Hepatotoxicity risk in pregnancy, crosses placenta -> staining of deciduous teeth of fetus, long bone growth suppression (reversible with discontinuation); use only if benefit >risks; avoid in breastfeeding
Dose adjustments prn with renal impairment

50
Q

examples of macrolides

A

erythromycin
* azithromycin
* clarithromycin

51
Q

MOA of macrolides

A

Binds bacterial 50S ribosomal subunits, causing blockage of new amino acids to the peptide chain to prevent bacterial growth + multiplication

52
Q

adverse effects of macrolides

A

sudden cardiac death from QT prolongation -> torsades de pointes (small risk with high drug concentrations), GI (epigastric pain, n/v, diarrhea), transient ↑ LFT’s

53
Q

contraindications of macrolides

A

hypersensitivity, congenital QT prolongation, antiarrhythmic drugs (class IA or III),
concurrent CYP3A4 inhibitors (i.e., Ca++ channel blockers,
Antifungals -> “azoles,” HIV protease inhibitors)

54
Q

PK/PD of macrolides
____killing
CNS penetration
metabolism and elimination

A
  • Time-dependent killing
  • Post-antibiotic effect
  • Food may affect absorption
  • Poor CNS penetration
  • Hepatic metabolization + elimination (toxicity rare): metabolism by CYP3A4 (isoenzyme of
    cytochrome P450)
55
Q

special population macrolides

A

Risk of infantile hypertrophic pyloric stenosis in neonates
Crosses placenta but no adverse fetal risks with erythromycin/azithromycin. Potential fetal adverse effects with clarithromycin. Low transfer to breastmilk, generally safe in breastfeeding
Potential for reversible ototoxicity (tinnitus, hearing loss) with large doses or renal/hepatic impairment

56
Q

LINCOSAMIDES e.g.

A

clindamycin

57
Q

MOA of lincosamides

A

Binds bacterial 50S ribosomal subunits, causing blockage of new amino acids to the peptide chain to prevent bacterial growth + multiplication

58
Q

PD/PK of lincosamides

A

Time-dependent killing
* Post-antibiotic effect
* No CNS penetration
* Hepatic metabolism + renal elimination (adjust dose prn hepatic dysfunction, no renal
dose adjustment required)
* Metabolism by CYP3A4 (isoenzyme of cytochrome P450) but not significant

59
Q

adverse effects with lincosamides

A

fatal C. Diff

60
Q

special population of lincosamides

A

Caution with severe hepatic impairment
Crosses placenta + present in breastmilk Generally safe in pregnancy + breastfeeding
Caution in older adults with renal or hepatic impairment

61
Q

OXAZOLIDINONES e.g.

A

linezolid
tedizolid

62
Q

MOA of oxazolinones

A

Binds bacterial 50S ribosomal subunits, causing blockage of new amino acids to the peptide chain to prevent bacterial growth + multiplication

63
Q

Drug interaction of oxazolinones

A

MAO inhibitors + sympathomimetic/vasopressive/dopaminergic drugs ->
hypertensive crisis, SSRIs/triptans/opiods -> ↑risk serotonin syndrome

64
Q

Reserve for treatment of MRSA and VRE to delay emergence of resistance

A

oxazolinones
e.g.
linezolid
tedizolid

65
Q

significant food interaction of

A

food/drinks high in tyramine, dopamine, tyrosine,
phenylalanine, tryptophan + caffeine -> hypertensive crisis or serotonin syndrome

66
Q

FLUOROQUINOLONES
e.g.

A

ciprofloxacin
* levofloxacin
* moxifloxacin

67
Q

FLUOROQUINOLONES MOA

A

Inhibits DNA gyrase + DNA topoisomerase IV enzymes to impair DNA replication + cell division = cell death

68
Q

contraindication of fluoroquinolones

A

myasthenia gravis -> neuromuscular blocking activity =death/respiratory failure

69
Q

adverse effects of fluoroquinolones

A

tendinopathy/tendon rupture (esp. Achilles)
QT prolongation
C. diff

70
Q

PK/PD of fluoroquinolones

A

Concentration-dependent killing
* Post-antibiotic effect
* Upper GI absorption
* CYP450 inhibition (Cipro)
* Minimal hepatic metabolism; renal elimination (adjust dose adjustments prn)

71
Q

special populations for fluoroquinolones

A

Avoid due to potential MSK toxicity (cartilage + joint damage)
Crosses placenta + present in breastmilk
Avoid (use only if safer alternative not available)
Caution in older adults due to risk altered mental status, psychosis, + vision disturbances

72
Q

NITROIMIDAZOLES e.g.

A

metronidazole

73
Q

MOA of NITROIMIDAZOLES

A

Enters bacteria through passive diffusion. Damages+breaks helical DNA structure, inhibiting DNA synthesis = cell death

74
Q

NITROIMIDAZOLES contraindications

A

Caution in CNS disease

75
Q

adverse effects of NITROIMIDAZOLES

A

potential carcinogen

76
Q

PK/PD of NITROIMIDAZOLES
______Killing
______ CNS penetration
metabolism and elimination

A

Concentration-dependent killing
* Post-antibiotic effect
* Good GI absorption with oral
* Penetrates CSF
* Extensive hepatic metabolism (adjust dose prn hepatic dysfunction)
* Renal elimination + small percentage fecal elimination (no dose adjustment required)

77
Q

what causes metalic taste and GI upset and should be taken with food?

A

NITROIMIDAZOLES
e.g. metronadazole

78
Q

NITROFURANTOIN e.g.

A

nitrofurantoin

79
Q

NITROFURANTOIN MOA

A

MOA: DNA/RNA Synthesis Inhibitor
Bacteriostatic (low concentrations) Bactericidal (therapeutic concentrations)

80
Q

contraindications for NITROFURANTOIN

A

G6PD deficiency, pregnancy, infants <1
month

81
Q

PK/PD of NITROFURANTOIN

A

Bactericidal in urine only at therapeutic concentrations
* Time-dependent killing
* Short post-antibiotic effect
* Good GI absorption
* Minimal hepatic metabolism; rapid renal elimination leading to high concentrations in urine

82
Q

special population for NITROFURANTOIN

A

Avoid in infants <1 month due to risk of hemolytic anemia
Potential teratogen. Contraindicated in 3rd trimester, during L+D, and breastfeeding in premature or <1 month of age infants due to risk of hemolytic anemia
Avoid in older adults with renal impairment

83
Q

it’s important to avoid ___ when taking NITROIMIDAZOLES

A

avoidance of alcohol during treatment and at least 72 hours following completion

84
Q

3 types of ABX DNA synthesis inhibitors

A

Fluoroquinolones
Nitroimidazoles
Nitrofurantoin

85
Q

Folic Acid Synthesis Inhibitors

A

Sulfonamides

86
Q

adverse effects of sulfonamides

A

photosensitivity, Stevens-Johnson syndrome, hemolytic anemia (with G6PD deficiency), megaloblastic anemia (with concurrent folate deficiency), renal damage,

87
Q

MOA of sulfonamides

A

Sulfonamides: Inhibits synthesis of tetrahydrofolate, causing inhibition of DNA, RNA, and protein synthesis to prevent bacterial growth + multiplication

88
Q

PK/PD of Folic Acid Synthesis Inhibitors

A

Time dependent killing
* Well absorbed orally
* Hepatic metabolism
* Renal elimination (adjust dose prn)

89
Q

special population for Folic Acid Synthesis Inhibitors

A

Avoid in infants <2 months due to kernicterus (potentially fatal)
Avoid in pregnancy: may cause birth defects (1st trimester) and kernicterus (near term)
Caution in breastfeeding: can cause kernicterus in breastfeeding infants <2 months
Caution in older adults due to more severe adverse effects (can be life-threatening)

90
Q

Cell Membrane Disruptor

A

daptomycin

91
Q

daptomycin MOA

A

Binds to cell membrane, causing rapid depolarization of membrane potential, disrupting vital intracellular processes (such as DNA, RNA + protein synthesis) = cell death

92
Q

adverse effects of daptomycin

A

DRESS (Drug Reaction with Eosinophilia + Systemic Symptoms), TIN (Tubulointerstitial nephritis), anaphylaxis, myopathy/↑CPK, peripheral neuropathy, GI upset, C. difficile

93
Q

drug interaction of daptomycin

A

statins

94
Q

“Last-resort” antibiotic

A

daptomycin

95
Q

Drug Interaction of sulfonamides

A

warfarin, phenytoin, sulfonylurea hypoglycemics (glipizide, glyburide) -> ↑ effect for all;
ACE inhibitors/ARBs -> hyperkalemia

Patho & Pharm (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions