Antibiotics

Question 0

What are common Gm- antibiotics?

Answer 0

Tetracyclines
Sulfonamides
3rd gen cephalosporins

Question 1

What are common Gm+ antibiotics?

Answer 1

Penicillins
1st and 2nd gen Cephalosporins
Macrolides

Question 2

What are 4 common beta-lacy am drug categories?

Answer 2

Penicillins
Cephalosporins
Mononactams
Carbapenems

Question 3

Which antibiotics act by targeting cell walk?

Answer 3

PCNs
Cephalosporins
Carbapenems
Inhibit cell wall synthesis

Question 4

Which abx act by inhibiting enzymes essential for bacterial growth and replication?

Answer 4

Sulfonamides

Question 5

Which abx act by adversely affecting bacterial protein synthesis?

Answer 5

Tetracyclines
Macrolides
Amino glycosides

Question 6

Which abx act by impairing bacterial DNA or RNA synthesis?

Answer 6

Fluoroquinolones

Question 7

What’s the relationship between oral contraceptives and abx?

Answer 7

Rifampin impairs effectiveness.

Tetracycline and PCN may reveal decreased level of OC in some.

Question 8

What are 4 ways in which bacteria can develop resistance to block otherwise damaging effects of antibiotics?

Answer 8

Develop ways to prevent/reduce drug receptor binding.
Develop ways to stop drug uptake process for abx that pass through cell wall to access receptor site.
Develop enzymes that break down abx.
Develop way to synthesize metabolites

Question 9

How do super-infections develop?

Answer 9

When the “good” bacteria are decreased with abx therapy, other microbes use opportunity to multiply - opportunistic infections - take opportunity & multiply.

Common superinfection - yeasts

Question 10

What characteristics describe 1st line antibiotics?

Answer 10

Greater efficacy
Few adverse effects
Narrow spectrum if activity for target organism 
Adequate access to site of infection 
Reasonable cost

Question 11

Why choose 2nd or 3rd line antibiotic?

Answer 11

Allergy to 1st choice drug
Inability of 1st choice drug to reach infection site at effective concentration
Unusual toxic response to 1st choice drug

Question 12

In the case of immunosuppression, should a bacteriostatic or bactericidal abx be used? Why?

Answer 12

In the case of immunosuppression, the body may not be able to mount a sufficient response if bacteriostatic drugs are used; therefore a bactericidal drug may be indicated.

Question 13

Which diagnoses lead to inappropriate and unnecessary Rx?

Answer 13

Ear infections 30%
Sore throat 50%
Sinusitis 50%
Bronchitis 75-80%
Common cold 100%

Question 14

When is it okay to combine abx?

Answer 14

Initial tx of severe infection, organism unknown
Infection of more than one organism
TB or other infection require combo therapy

Question 15

Why the need for antibiotic prophylaxis?

Answer 15

For routine teeth cleaning and dental procedures. Those with prosthetics and/or with history of rheumatic heart disease are at greater risk of fam developing bacterial endocarditis. Because oral cavity has bacteria that can lead to systemic infection if enters systemic circulation.

Question 16

What’s the danger of nonadherence?

Answer 16

When ppl feel better, S&S dissipate, they quit taking antibiotic without completing full course and being “cured.”
Side effects also contribute to premature termination of therapy. This has potential to continue or worsen infection and risk killing off weaker more vulnerable bacteria, allowing strong bacteria to survive, may make infection worse.

Question 17

Which antibiotic is recommended as 1st line therapy for streptococcal pharyngitis?

Answer 17

Amoxicillin

Question 18

If there is an allergy to amoxicillin, which antibiotic should be prescribed?

Answer 18

Erythromycin 1st line therapy for streptococcal pharyngitis when allergy to PCN.

Question 19

When educating parents, why is it impt. To have them return to clinic if child is not improved in 2-3 days?

Answer 19

Strep throat associated with dangerous sequelae including glomerular nephritis and rheumatic fever, which can damage heart valves.
May also be failure to respond to treatment.