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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Antibacterials/Antimicrobials vs Antibiotics

A
  • work on bacteria & other microorganisms
  • work only on bacteria
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2
Q

Bacteriostatic vs Bactericidal

A
  • inhibit growth
  • kill
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3
Q

Mechanisms of Antibiotic Action

A
  • inhibit bacterial cell wall synthesis
  • alter membrane permeability
  • inhibit protein synthesis
  • inhibit bacterial RNA/DNA synthesis
  • interferes with intracellular metabolism
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4
Q

Healthcare-acquired infections (HAIs)

A
  • CLABSI
  • CAUTI
  • SSI
  • Ventilator-associated pneumonia

commonly Cdiff, staph aureus, Ecoli, pseudomonas aeruginosa, klebsiella pneumoniae

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5
Q

Antibiotic Resistance

A
  • abx taken unnecessarily
  • abx taken incorrectly
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6
Q

Abx combo effects

A
  • additive –> effects of both meds increased
  • antagonistic –> bactericidal vs bacteriostatic; may reduce desired effects
  • potentiated –> one potentiates other w/ no increased effects of potentiating abx
  • synergism –> effect of both is increased exponentially

additive –> 2+2 = 4, synergistic –> 2+2=10

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7
Q

General adverse reactions to abx

A
  • allergic reactions/hypersensitivity
  • superinfections (candida, cdiff/CDAD, mrsa, vre, etc.)
  • organ toxicity (ear, liver, kidneys)
  • GI distress
  • headache, dizziness
  • lab changes
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8
Q

Superinfections

A
  • secondary infection when normal flora is killed
  • often Candidasis, C-Diff, MRSA, VRE
  • usually found in/on mouth, skin, resp tract, GU tract, intestines

VRE - vancomycin resistant enterococci

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9
Q

Spectrums & C&S testing

A
  • narrow spectrum –> primarily effective against one bacteria type
  • broad spectrum –> effective against gram +/-, often before specific organism identified
  • Culture & Sensitivity (C&S) –> should be sampled directly from site if possible; done to determine specific organism and gram + or -
  • C&S should be done before any abx given
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10
Q

Penicillins

A
  • beta-lactam ring structure
  • inhibits bacterial cell wall synthesis
  • static and cidal, depending on dose
  • four types –> basic, broad-spectrum, penicillinase-resistant, and extended-spectrum
  • SE: hypersensitivity, anaphylaxis, superinfection, tongue discoloration, stomatitis, GI distress, CDAD, liver impairment
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11
Q

Basic penicillins

A
  • G & V (rare, IM only)
  • narrow spectrum
  • for gram + and a few -
  • treats anthrax, tetanus, diphtheria, endocarditis, resp infx, syphilis
  • poorly absorbed PO

strep, clostridium species; neisseria, staph species

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12
Q

Broad-spectrum penicillins

A
  • Amoxicillin
  • gram + and -
  • treats infx of resp, skin, intra-abdominal, GU, otitis media, sinusitis

Ecoli, haemophilus influenzae, shigella dysenteriae, proteus mirabilis, salmonella spp.

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13
Q

Penicillinase-resistant penicillins

A
  • Dicloxacillin sodium
  • gram +
  • treats endocarditis, meningitis, bacteremia, skin, resp infx

penicillinase-producing staph spp. (penicillinase is an enzyme that some bacteria naturally produce that beraks down beta-lactam ring structure)

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14
Q

Extended-spectrum penicillins

A
  • gram +/-
  • treats resp, intra-abdomial, skin infx

pseudomonas aeruginosa, proteus spp., serratia spp., klebsiella pneumoniae, enterobacter spp., acinetobacter spp.

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15
Q

Beta-lactamase inhibitors

A
  • inhibit bacterial beta-lactamases, extending their antimicrobial spectrum
  • not given alone –> combined w/ penicillinase-sensitive penicillin
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16
Q

Cephalosporins

A
  • Ceftriaxone
  • inhibit bacterial cell wall synthesis
  • cidal
  • treats resp, GU, skin, bone, joint infx
  • 1st, 2nd, 3rd, 4th, 5th generations
  • SE: anaphylaxis, superinfection, headache, dysgeusia, GI distress, CDAD, bleeding, seizures, nephrotoxicity, SJS, elevated liver enzymes
  • Interacts with alcohol (disulfiram-like rxn), uricosurics (decrease ceph. excretion)

disulfiram reaction –> flushing, dizziness, headache, n/v, muscle cramps

17
Q

1st gen cephalosporins

A
  • mostly gram +, some -
  • staph, strep, klebsiella, proteus, salmonella, shigella spp., Ecoli
18
Q

2nd gen cephalosporins

A
  • gram +/-
  • staph, strep, klebsiella, proteus, salmonella, shigella, enterobacter spp., Ecoli, haemophilus influenzae, neisseria gonorrhoeae, neisseria meningitidis
19
Q

3rd gen cephalosporins

A
  • gram +/-
  • increased resistance to destruction by beta-lactamases
  • staph, strep, klebsiella, proteus, salmonella, shigella, enterobacter, serratia, acinetobacter spp., haemophilus influenzae, Ecoli, neisseria gonorrhoeae, neisseria meningitidis, pseudomonas aeruginosa
20
Q

4th gen cephalosporins

A
  • gram +/-
  • highly resistant to destruction by beta-lactamases
  • staph, strep, klebsiella, proteus, spp., Ecoli, pseudomonas aeruginosa
21
Q

5th gen cephalosporins

A
  • gram +/-
  • highly resistant to destruction by beta-lactamases
  • staph, strep, klebsiella, proteus spp., MRSA, Ecoli, pseudomonas aeruginosa
22
Q

Macrolides

A
  • Azithromycin, erythromycin, clarithromycin
  • binds to 50S ribosomal subunits and inhibits protein synthesis
  • broad spectrum
  • most gram +, some -
  • static, cidal w/ high doses
  • treats mild-moderate resp, sinus, skin, soft tissue, GI infections, diptheria, impetigo, STIs
  • SE: anaphylaxis, superinfection, tinnitus, ototoxicity, headache, seizures, dysgeusia, tooth discoloration, GI distress, CDAD, nephrotoxicity, hepatotoxicity, SJS
  • interactions: increases warfarin, theophylline, carbamazepine levels; fluconazole, ketoconazole, itraconazole, verapamil, ciltiazem, and clarithromycin increase erythromycin levels (can cause sudden cardiac death); antacids may decrease azithromycin levels
23
Q

Oxazolidinones

A
  • Linezolid
  • inhibits protein synthesis on 50S ribosomal subunit of bacteria
  • gram +
  • static and cidal (depends on dose)
  • treats bacteremia, sepsis, MRSA, VREF, resp, skin infx
  • SE: anaphylaxis, seizure, tongue/tooth discoloration, GI distress, peripheral neuropathy, headache, pancytopenia, CDAD, serotonin syndrome, SJS
24
Q

Lincosamides

A
  • Clindamycin
  • inhibits bacterial protein synthesis
  • most gram + (staph aureus, anaerobics)
  • static and cidal (depends on dose)
  • treats gyne, acne, bacteremia, septicemia, MRSA, resp, intra-abdominal, skin, bone, joint infx
  • SE: anaphylaxis, superinfections, xerosis, dysgeusia, glossitis, stomatitis, GI distress, CDAD, pancytopenia, SJS
  • clindamycin and lincomycin are incompatible with aminophylline, phenytoin, barbiturates, and ampicillin
25
Q

Glycopeptides

A
  • Vancomycin
  • inhibits cell wall synthesis
  • gram + (MRSA)
  • cidal
  • treats resp, skin, bone/joint infx, bacteremia, septicemia, endocarditis, MRSA, CDAD
  • draw peaks & troughs
  • SE: anaphylaxis, superinfection, red neck/red man syndrome, disulfiram-like rxn to alcohol, GI distress, peripheral edema, oto/nephrotoxicity, CDAD, SJS

red neck/red man –> IV too rapid, severe hypotension, red blotching of face, neck, chest, extremities

26
Q

Ketolides

A
  • Telithromycin
  • structurally related to macrolides
  • blocks bacterial protein synthesis
  • treats community-acquired pneumonia, MRSA, strep. pneumoniae, haemophilus influenzae
  • SE: anaphylaxis, dizziness, headache, visual disturbances, GI distress, dysgeusia, CDAD, hepatotoxicity, exacerbation of myasthenia gravis
  • interactions?
27
Q

Lipopeptides

A
  • Daptomycin
  • inhibits bacterial protein, DNA/RNA synthesis
  • gram + staph aureus, MRSA
  • treats complicated skin infx, septicemia, endocarditis
  • SE: anaphylaxis, superinfection, insomnia, dizziness, anemia, bleeding, chest pain, GI distress, peripheral neuropathy, hypo/hyper tension/kalemia/glycemia, rhabdomyolysis
  • interacts w/ statins, warfarin
28
Q

Tetracyclines

A
  • Doxycycline
  • inhibits protein synthesis
  • broad spectrum, gram +/-
  • treats helicobacter pylori, MRSA, acne, anthrax, plague, gingivitis, cholera, STIs, skin, urinary, resp infx
  • SE: anaphylaxis, superinfections, photosensitivity, diplopia, discoloration of permanent teeth (kids), stomatitis, glossitis, GI distress, CDAD, oto/hepato/nephrotoxicity, pancytopenia, SJS
  • interacts w/ milk products, antacids, oral contraceptives, penicillins, aminoglycosides

break down into toxic by products when expired

29
Q

Glycylcycline

A
  • Tigecycline
  • blocks protein synthesis in bacterial cells
  • static
  • synthetic tetracyclines
  • treats staph aureus, Ecoli, strep pyogenes, klebsiella pneumoniae, clostridium perfringens, complicated skin and intra-abdominal infx
  • SE: anaphylaxis, superinfection, photosensitivity, headache, dizziness, insomnia, GI distress, anemia, hyperglycemia, hypokalemia, CDAD, SJS
30
Q

Aminoglycosides

A
  • Gentamicin
  • inhibits bacterial protein synthesis
  • cidal
  • gram - Ecoli, proteus, pseudomonas spp.
  • treats serious resp, skin, urinary, bone/joint, intra-abdominal infx, plague (streptomycin), tularemia (streptomycin), bacteremia, septicemia, endocarditis, meningitis, hepatic encephalopathy, preoperative bowel antiseptic
  • peak and trough levels
  • SE: anaphylaxis, superinfection, seizures, photosensitivity, anemia, stomatitis, GI distress, oto/nephro/neurotoxicity, CDAD, SJS
  • interactions: penicillins decrease aminoglycoside effectiveness; increased action of oral anticoags; ethacrynic acid w/ aminoglycosides may lead to ototoxicity
31
Q

Fluoroquinolones

A
  • Ciprofloxacin, levofloxacin
  • interferes w/ enzyme DNA gyrase needed to synthesize bacterial DNA
  • gram +/-, S. pneumoniae, S. aureaus, H. influenzae, P. aeruginosa, salmonella, shigella spp.
  • cidal, broad spectrum
  • treats anthrax, skin, soft tissue, bone, joint, GU, intra-abdominal, resp infx
  • SE: anaphylaxis, superinfection, photosensitivity, eye damage, visual disturbances, GI distress, dysgeusia, tendinitis, tendon rupture, CDAD, SJS, nephrotoxicity
32
Q

Sulfonamides

A
  • Trimethoprim-sulfamethoxazole
  • inhibits bacterial synthesis of folic acid
  • static
  • gram -, proteus, klebsiella, chlamydia spp., Ecoli
  • treats otitis media, meningitis, malaria, resp, urinary infx
  • SE: anaphylaxis, photosensitivity, GI distress, stomatitis, insomnia, tinnitus, crystalluria, renal failure, blood dyscrasias, SJS
  • interacts with antacids

folic acid is essential for bacterial cell growth, but not naturally synthesized in humans, so selective for bacteria

33
Q

Nitromidazoles

A
  • disrupts DNA and protein syntheses in bacteria and protozoa
  • H. pylori, clostridium, giardia, gardnerella, prevotella, peptococcus spp., trichomonas vaginalis protozoa
  • treats CDAD, amebiasis, giardiasis, trichomoniasis, bacterial vaginosis, acne, meningitis, gyne, skin, intra-abdominal, resp infx
  • SE: anaphylaxis, superinfection, headache, dizziness, insomnia, weakness, dry mouth, dysgeusia, GI distress, tongue/tooth discoloration, peripheral neuropathy, seizures, leukopenia, disulfiram-like rxn, SJS

Pharmacology (16 decks)

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