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Pharmacology 4 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Beta-Lactams MOA?

A
  • Bind to penicillin binding proteins and inhibit cell wall synthesis causing cell death
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2
Q

Beta-Lactams Drugs?

A

Natural Penicillins
- Penicillin VK + G

Aminopenicilins

  • Ampicillin
  • Amoxicillin

Penicillinase-resistant Penicillin

  • Dicloxacillin,
  • Nafcillin,
  • Oxacillin,
  • Methacillin

Extended-spectrum Penicillins

  • Ticarcillin/clavulanate
  • Piperacillin/tazobactam

B-Lactamase Inhibitors

  • Clavulanate
  • Tazobactam
  • Sulbactam
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3
Q

Natural Penicillins?

A

Penicillin VK + G

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4
Q

Penicillin VK + G

A

Spectrum:

  • Streptococcus pyogenes
  • Treponema Pallidum

Uses:

  • Pharyngitis,
  • Erysipelas,
  • Syphillis

Other:
- Probenicid ↓ the renal tubular secretion of PCNs co-administration causes ↑ abx serum levels

OC interaction:
- Rifampin ↓ levels of ethinyl estradiol and norethindrone by ↑ metabolism thru liver enzymes

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5
Q

Aminopenicilins?

A
  • Ampicillin

- Amoxicillin

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6
Q
  • Ampicillin

- Amoxicillin

A

Uses:

  • URI
  • DRUG OF CHOICE for susceptible Enterococcal infections
  • Skin inf, UTI, CAP, lymphadenitis (Augmentin)

Adverse Effects:
- GI upset / Diarrhea (especially augmentin)

  • MC w/ ampicillin and in nearly all pts w/ mono:
    Maculopapular/urticarial rash
    Anaphylaxis + Angioedema
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7
Q

Penicillinase-resistant Penicillin?

A
  • Dicloxacillin,
    • Nafcillin,
    • Oxacillin,
    • Methacillin
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8
Q
  • Dicloxacillin,
    • Nafcillin,
    • Oxacillin,
    • Methacillin
A

Spectrum:
- Staph + Strep

Uses:

  • DRUG OF CHOICE for B-lactamase producing staph
  • Cellulitis + Endocarditis
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9
Q

Extended-spectrum Penicillins

A
  • Ticarcillin/clavulanate

- Piperacillin/tazobactam

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10
Q
  • Ticarcillin/clavulanate

- Piperacillin/tazobactam

A

Spectrum:

  • Gram (+), Staph + Strep
  • Gram (-): Enterobacteriaceae
  • Anaerobes: Bacteroides

Uses:

  • Nosocomial PNA, intra-abdominal infections
  • Skin and soft tissue infections
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11
Q

B-Lactamase Inhibitors

A
  • Clavulanate
    • Tazobactam
    • Sulbactam
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12
Q
  • Clavulanate
    • Tazobactam
    • Sulbactam
A

Other: Booster

-Enhances antimicrobial activity against certain B-lactamase producing orgs, extending the abx antimicrobial spectrum

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13
Q

Cephalosporins

A

Adverse Effects
- Similar effects to PCN

  • Cefotetan (2nd):
    • MTT side chain → hypoprothrombinemia + bleeding + disulfiram like reaction

Other:

  • Earlier generations = better gram (+) coverage
  • Later generations = better gram -coverage
  • Use in caution w/ pts who have PCN allergy
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14
Q

1st Generation Cephalosporins?

A
  • Cephalexin – oral

- Cefazolin – IV

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15
Q
  • Cephalexin – oral

- Cefazolin – IV

A

Spectrum:

  • SPEcK:
  • Strep (+), Proteus, E. coli, Kleb

Uses:
- Mild skin / soft tissue inf

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16
Q

2nd Generation Cephalosporins?

A

Cefuroxime – oral

Cefoxitin – IV

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17
Q

Cefuroxime – oral

Cefoxitin – IV

A

Spectrum:

  • HM-SPEcK:
  • Haemophilus flu, Moraxella,
  • Strep (+), Proteus, E. coli, Kleb

Uses:
- Cefoxitin: anaerobic coverage i.e. bacteroides

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18
Q

3rd Generation Cephalosporins?

A

Cefpodoxime – oral

Ceftriaxone – IV

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19
Q

Cefpodoxime – oral

Ceftriaxone – IV

A 
Spectrum:
 MESH:
  - Moraxella
  - Enterobacteriaceae (-)
  - Strep PNA (+)	
  - H. flu

Uses:

  • CAP,
  • otitis media,
  • URI
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20
Q

4th Generation Cephalosporins?

A

Cefepime – IV

Ceftaroline – IV

21
Q

Cefepime – IV

Ceftaroline – IV

A

Spectrum:
- Gram (+), (-), anaerobes

Uses:
- Nosocomial infections

22
Q

Carbapenems

A

MOA:

  • Binds to PCN binding protein
    • Inhibits cell wall synthesis
    • Cell Death

Spectrum:
- Srep, Staph, Listeria, Gram (-), Anarobes, Pseudomonas (Except Entrapenem)

Uses:

  • DRUG OF CHOICE for infections caused by ESBLs (extended spectrum beta lactamases)
  • UTI, Resp inf, Skin tissue, Bone

Side Effects:
- N/V , Seizures

Other:

  • Cross sensitivity w/ PCN allergy
  • Renal done adjustment
23
Q

Fosomycin

A

Spectrum
Gram (-) + (+) coverage

Uses:
- UTIs in women

Other:
- One-time 3 gram dose

24
Q

Bacitracin

A

Uses:

  • Topical use ONLY
  • Surface skin lesions, irrigation of wounds + joints

Other:
- Highly nephrotoxic when administered IV

25
Q

Cycloserine

A

Spectrum:
- Gram (+) + (-) coverage

Uses
- MC resistant TB

Other:
- Serious adverse effects: HA, tremors, acute psychosis

26
Q

Tetracycline,
Minocycline,
Doxycycline

A

Spectrum:
- S. PNA, S. Pyogens, Atypicals

Uses
- Respiratory infections + CA-MRSA

27
Q

Macrolides
Erythromycin,
Clarithromycin,
Azithromycin

A 
Spectrum:
 ASH  
  - Atypicals
  - Strep, 
  - H. flu,

Uses:
- CAP

Other:
- Alternative for PCN allergies

28
Q

Clindamycin

A

Spectrum:
- Anaerobes, CA-MRSA

Uses:
- Skin, soft tissue and anaerobic infections
CA-MRSA

Other:
-Alternative for dental prophylaxis in PCN allergies

29
Q

Vancomycin (IV)

A

Spectrum
- Gram (+)

Uses:
- MRSA

30
Q

Linezolid (PO)

A

Spectrum:
- Gram (+)

Uses:

  • Resistant infecitons
    i. e. MRSA or Vancomycin resistant E. faecium
31
Q

Aminoglycosides
Gentamicin,
Tobramycin,
Amikacin

A

Spectrum:
- Gram (-) bacilli

Other:
- Benefits of extended interval dosing

32
Q

Sulfonamides

A

Uses:

  • UTI
  • Sulfamethoxazole-trimethoprim = 1st line for CA-MRSA, PCP tx + px
33
Q

Fluoroquinolones (floxin)

  • Cipro
  • Oflo
  • Norflo
A

Spectrum:
- Gram (-) enterobacteriaceae

Uses:
- Complicated + uncomplicated UTIs

34
Q

Fluoroquinolones (floxin)

  • Levo
  • Moxi,
  • Gati optho only*
A 
Spectrum:
MESH-P
  - Moraxella catarrhalis
  - Enterobacteriaceae,
  - S. PNA,   
  - H. flu,
  - Pseudomonas (Levo)

Uses:
- Similar to 2nd generation +:
CAP + URI

Other:
- * Moxi NOT used for UTIs

35
Q

Metronisazole

A

Spectrum:
- Protozoa + anaerobes-Bacteroides group, C. dif

Uses:

  • Intra-abdominal,
  • gynecologic infections
  • Pseudomembranous colitis d/t C. dif
36
Q

Nitrofurantoin

A

Uses

- UTI

37
Q

Infection

A

The isolated organisms are form the specimen and causing the infection

38
Q

Colonization

A

The isolated organisms are from the specimen, but are NOT causing symptoms

39
Q

Contamination

A

The isolated organisms came from the patients’ skin or the environment

40
Q

Minimum inhibitory concentration MIC

A

The lowest antimicrobial concentration that prevents visible growth of an organism

41
Q

Susceptible

A

You can get enough drug into the patient to treat the infection (MIC < attainable serum levels)

42
Q

Intermediate

A

You may not be able to get enough drug into the pt to treat the infection unless the drug is safe enough to give in high doses or the drug concentrates exceptionally well at the infection site (MIC = attainable serum levels)

43
Q

Resistant

A

You cannot get enough drug into the pt to treat the infection (MIC > attainable serum levels)

44
Q

Drug factors (examples)

A

Antimicrobial spectrum, cost, routes of admin, DIs, efficacy, safety

45
Q

Patient factors (examples)

A 
Age, 
hepatic/renal impairment, 
allergies, 
pregnancy, 
cost, 
route of admin, 
DIs, compliance
46
Q

Intrinsic resistance

A

Naturally occurring resistance (i.e. drug cannot penetrate org cell wall)

47
Q

Acquired resistance

A

A normally sensitive organism becomes resistant

48
Q

Mechanisms of acquired resistance

A

Detoxifying enzymes, alteration in abx target site, decreased cellular accumulation of antibiotics

49
Q

Daptomycin

A

MOA:
- Cell wall or membrane activity

Spectrum:
- Similar to Vanco + VRE & VRSA

Uses:
- Skin, Soft tissue, Bacteremia, Endocarditis, NOT PNA

Side Effects:
- Inj site rxn, Fever, chills, N/V, muscle. cramps + weakness

Other:

  • Renal Dose adj
  • Monitor CPK

Pharmacology 4 (3 decks)

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