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Pharmacotherapeutics > Antibiotics 2 > Flashcards

Antibiotics 2 Flashcards

Thanks Kol!

1
Q

Antibiotics that inhibit protein synthesis

A
  1. tetracyclines
  2. macrolides
  3. Clindamycin
  4. aminoglycosides
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2
Q

Antibiotics that inhibit folate synthesis

A

sulfonamides

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3
Q

antibiotics that disrupt DNA replication/cell division

A

Fluroquinolones

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4
Q

Antibiotics that work by inhibiting nucleic acid synthesis

A

Metronidazole

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5
Q

Identifying tetracylcines

A

ends with “cycline”

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6
Q

adverse effects of tetracyline

A
  • GI upset: nausea, vomiting, diarrhea
  • cause C Diff
  • photosensitivity
  • yellow/brown discoloration of teeth
  • superinfections
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7
Q

tetracyclines - w/ food or without?

A

food decrease GI upset BUT decreases absorption

-ideal w/o food

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8
Q

tetracycline and teeth

A
  • do not give to children under 8/pre women

- -> tetracycline binds to calcium in developing teeth and is irreversible color change

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9
Q

Superinfection w/ tetracyclines

A

candidiasis, C Diff

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10
Q

tetracyclines food drug interaction

A
  • Ca, Fe, Mg, Al – result in decrease drug absorption by 50%
  • avoid anatacids, anti-diarrheal, dairy products
  • take tetracyclines on empty stomach
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11
Q

macrolide function

A

inhibition of protein synthesis

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12
Q

macrolide prototype

A

erythromycin

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13
Q

identifying macrolides

A

end with “mycin”

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14
Q

ADR with erythromycin

A
  • GI upset – increase GI motility

- can be used w/ diabetic gastroparesis or passing small bore feeding tubes into small instestine

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15
Q

beneficial use of GI upset of erythromycin

A
  • GI upset – increase GI motility

- can be used w/ diabetic gastroparesis or passing small bore feeding tubes into small instestine

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16
Q

erythromycin drug drug interactions

A
  • QT prolongation (Cardiac Death)
  • CYP3A4 pathway (Ca channel blockers, antifungals, HIV protease inhibitors)
  • Toxic levels w/ theophylline, carbamazepine, warfarin
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17
Q

Suprainfection

A
  • C Diff

- Candidiasis

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18
Q

erythromycin dosing/route

A
  • continuous infusion preferred over intermittent

- oral

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19
Q

Clindamycin fxn

A

inhibit protein synthesis

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20
Q

clindamycin and C Diff

A
  • clindamycin can be fatal with C Diff

- if develop diarrhea on clindamycin, stop immediately

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21
Q

sxs of c diff

A
  • profuse watery diarrhea
  • abdominal pain
  • fever
  • leukocytosis
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22
Q

clindamycin infusion rate risks

A

(if give rapidly –> increase risk for cardiac death)

-IV,oral, topical

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23
Q

aminoglycosides fxn

A

inhibit protein synthesis by producing protein

  • -> bacterialcidal
  • BIG GUNS, stronger
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24
Q

aminoglycoside prototype

A

gentamicin

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25
Q

gentamicin links to

A

vancomycin

26
Q

identifying aminoglycosides

A

ends with “mycin” or “Cin”

27
Q

gentamicin route

A

IV or IM

28
Q

gentamycin ADR otoxicity

A
  • otoxicity - check trough levels
  • tinnitus: affect cochlea
  • vestibular area: headache 1st sign
  • can be reversible, risk increase with high dose or long term use
29
Q

gentamycin ADR

A
  • ototoxicity

- nephrotoxicity

30
Q

gentamycin nephrotoxicity + frequency

A

trough level check

  • 5-25 % of patients
  • labs: BUN/Creatinine/GFR
  • usually reversible
  • renal dose adjustment
31
Q

sulfonamides fxn

A

inhibit folate synthesis

32
Q

sulfonamide prototype

A

Trimethoprim/sulfamethoxazole

TMP/SMX

33
Q

TMP/SMX ratio

A

1:5

34
Q

TMP/SMX - together have _____ effect

A

synergist (1+1=3)

35
Q

how does inhibition of folate synthesis work?

A
  • all cells need folic acid to synth DNA/RNA/Protein
  • only effects bacteria b/c bacteria are unable to take up folate and instead must synthesize it from precursors
  • by inhibiting sythnesis of folate the bacterial cells die
  • human cells can take up folate from the environment and do not need precursors
36
Q

TMP/SMX prevalence and examples

A

common

-bactrim, cotrim

37
Q

TMP/SMX adverse effects

A

GI, rash, blood dyscrasias , crystaluria, photophobia, CNS disorder, kernicterus, risk of hyperkalemia

38
Q

TMP/SMX rash

A
  • full body

- if rash develop stop to prevent Stevens Johnson Syndrome

39
Q

TMP/SMX blood dyscrasias

A
  • develop hemolytic anemia (G6PD)

- increase risk for preg/alcoholic to develop bone marrow suppression

40
Q

TMP/SMX crystaluria

A

(can cause formation of crystals in urine)-

  • prevent: by increase hydration to 8-10 glasses/day
  • watch: BUN creatinine
41
Q

TMP/SMX and CNS

A

-can cause headache, depression, hallucinations

42
Q

TMP/SMX and pregnancy

A
  • fetal development of kernicterus (jaundice)
    risk: bilirubin is neurotoxic
  • do not use tmp/smx with preg, children <2 mo, breastfeeding
  • take preg taste before taking
43
Q

TMP/SMX allergy

A

-do not take if allergy to Sulfa drugs (thiazide diuretics, loop diurecic, Sulf DM meds)

44
Q

TMP/SMX hypersensitivity

A
  • steven johnson syndrome
  • look like burn victim
  • 25% mortality rate
45
Q

TMP/SMX drug drug interactions

A

-warfarin, dilantin

46
Q

fluroquinolones fxn

A

disrupt DNA replication/ cell division

47
Q

Abx to infuse over 1 hr

A
  1. vancomycin
  2. ciprofloxacin
  3. metronidazole
48
Q

fluroquinolones prototype

A

ciprofloxacin

49
Q

identifying fluroquinolones

A

ends with “oxacin”

50
Q

ciprofloxacin route

A
  • oral

- IV - infuse over 1 hr

51
Q

ciprofloxacin treats

A

uti, upper resp, anthrax

52
Q

ciprofloxacin ADR

A
  • GI upset
  • CNS
  • tendon rupture
  • photosensitivity
  • dysrhythmias
  • superinfection (C diff, candidiasis)
53
Q

ciprofloxacin tendon rupture, who is at risk?

A
  • tell nurse if pain in back of heal
  • highest risk = elderly + steroid use (COPD)
  • avoid in kids under 18
54
Q

ciprofloxacin cns

A

-dizziness, headache, confusion in elderly

55
Q

ciprofloxacin dysrhythmias

A

-can cause if ALREADY on anti-dysrhythmia meds

56
Q

ciprofloxacin drug food interaction

A

AL, Mg, Fe, Zinc, Ca
Milk/Dairy
-give drug 6 hours after or 2 hours before food
–> can reduce absorption by 90%

57
Q

ciprofloxacin drug drug interactions

A

-sucrelfate, theophylline, warfarin, tinidazole

58
Q

metronidazole fxn

A

inhibits nucleic acid synthesis

59
Q

metronidazole works on what kind of bacteria

A

-only taken up by anaerobic bacteria/protozoa
-converted to active form
-causes bacteriacidal
NO action against aerobic bacteria

60
Q

metronidazole treats conditions

A

C Diff

GI/Pelvic surgery

61
Q

metronidazole route

A
  • oral

- IV – infuse over 1 hr

62
Q

metronidazole ADR

A

-gi upset
-superinfection (candidiasis)
-no alcohol for up to 3 days after
(research does not support disulfiram rxn)
-urine change to dark reddish brown
-metallic taste

Pharmacotherapeutics (20 decks)

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