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Patho Pharm > Antibiotics- 38 > Flashcards

Antibiotics- 38 Flashcards

1
Q

Antiseptics

A

Inhibits growth of microorganisms

- applied to living tissue

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2
Q

Disinfectant

A

Kills microorganism

- used on non living objects

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3
Q

Empiric Therapy

A

Treatment of infection before specific culture information has been reported or obtained

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4
Q

Definitive Therapy

A

antibiotic therapy tailored to treat organisms identified with culture

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5
Q

Prophylactic Therapy

A

treatment with antibiotics to prevent an infection when there is a high possibility of microbial contamination

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6
Q

Therapeutic response

A

Decreased signs and symptoms of infection

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7
Q

Subtherapeutic response

A

Signs and symptoms of infection do not imporove

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8
Q

Superinfection

A

Occurs when antibiotics redue or completely eliminate normal flora (C diff, Vaginal yeast)

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9
Q

Symptoms of anaphylaxis (8)

A
  • Itching
  • Flushing
  • Hives & Rash
  • Wheezing bronchospasms
  • Anxiety
  • Hypotension
  • Swelling of tongue/throat (respiratory arrest)
  • Fast, irregular HR, Cardiac Arrest
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10
Q

Do not administer oral antibiotics with.. (5)

A 
Antacids
Calcium supplements
Iron Products 
Laxative containing magnesium 
some antilipemic drugs
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11
Q

When can hypersensitivity occur?

A
  • Up to 30 min after administration
  • 1-72 Hours after administration
  • > 72 hours after administration
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12
Q

Most common adverse effects

A

Nausea, Vomiting and Diarrhea

-Absorbed better if taken with at least 6-8 ounces of water

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13
Q

Examples of Sulfonamides

A
  • Bactrim (sulfamethoxazole + trimethoprim)

- Septra (or co trimoxazole)

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14
Q

Sulfonamides mechanism of Action

A

Bacteriostatic

-Prevents synthesis of folic acid (DNA)

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15
Q

Sulfonamides: Indication

A
  • Effective against both gram + and gram -
  • Treatment of UTI
  • Upper respiratory tract infections
  • Opportunistic infections in patients with HIV (prophylaxis & treatment)
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16
Q

Sulfonamides: Contraindication

A
  • Drug allergy (Sulfa allergy)
  • (Chemically related drugs are generally considered safe in patients with an allergy)
  • Typically cause a delayed cutaneous reactions–> 1. reactions begin w/ fever 2. Rash (mild to severe)
  • *Do not use cyclo-oxygenase- 2 inhibitor celecoxib (celebrex)**
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17
Q

Sulfonamides: Adverse Effects (integumentary,Blood)

A

Integumentary- photosensitivity (severe sunburn), exfoliative dermatitis, Steven-Johnson Syndrome (SJS), epidermal necrolysis

Blood- Hemolytic and aplastic anemia, agranulocytosis, thrombocytopenia

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18
Q

Sulfonamides: Adverse Effects (GI, other)

A

GI: nausea, vomiting, diarhhea, pancreatitis, hepatotoxicity

Other: Convulsion, crystalluria*, headache, peripheral, neuritis, urticaria, cough

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19
Q

Sulfonamides: Interactions

A
  • Reduces the efficacy of oral contraceptives
  • Potentiates the anticoagulation effects of warfarin
  • Potentiate the toxic effects of phenytoin
  • Potentiate hypoglycemic effects of sulfonylureas in diabetic treatment
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20
Q

Sulfonamides: Implementation

A

-Take with 2-3 L of fluid/24hr
-Take oral dose with food
-Instruct patients to report:
worsening abdominal cramps/stomach pain
Diarrhea
Blood in the urine
Rash: severe or worsening
SOB
Fever

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21
Q

Penicillin combonations

A

Unasyn (Ampicillin +subactam)
Augmentin (Amoxicillin +ckavulanic acid)
Timentin (Ticarcillin + clavulanic acid)
Zosyn (Piperacillin +tazobactam)

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22
Q

Penicillin: Mechanism of Action

A

Interfere with normal cell wall synthesis

-Bacteria cells die from cell lysis (rupture)

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23
Q

Penicillin: Indication

A
  • Prevention and treatment of infections caused by susceptible bacteria
  • Most natural Pn have little effect on gram-negative bacteria
  • Extended-spectrum penicillin have excellent g+,g- and anaerobic coverage
24
Q

Penicillin: Contraindications

A

-Only contraindication is known allergy

25
Q

Penicillin: Adverse Effects

A

-Cross reactivity between penicillin and cephalosproin is between 1% and 4%
-commonL N/V/D, taste alteration , Urticaria, pruritus & angioedema
Idiosyncratic:
-Maculopapular eruptions, eosinophilia, SJS, Exfoliative dermititis
Anaphylactic reaction

26
Q

Penicillin: Interactions

A 
NSAIDS:
-increases free and active penicillin 
-May be beneficial 
Oral Contraceptives:
-decrease efficacy of contraceptive
Warfarin:
-Enhanced anticoagulation effect
27
Q

Penicillin: Implementation

A

-Take oral doses with 6 oz of water (not juices)
If anaphylactic reaction to penicillin:
-stop infusion
-Epinephrine & other emergency drugs used as ordered
-Supportive treatment (O2) at all times
-Procain& Benzathine are thick (21 G needle)
-IM imipenem/cilastatin can be mixed with Plain lidocain (given in large muscle mass)

*Monitor patient taking penicillin for alergic reaction for at least 30 min after administration

28
Q

Cephalosporins: Mechanism of Action

A
  • Bactericidal action
  • Broad Spectrum
  • Not active against fungi and viruses
  • injectable drugs produce higher serum concentraions
29
Q

Cephalosporins: Indications (First Generation)

A
  • Good Gram POSITIVE
  • Poor Gram NEGATIVE
  • Used for prohylaxis and susceptible infections
  • parenteral and PO forms
30
Q

Cephalosporins: Indications (Second Generation)

A
  • Good gram POSITIVE
  • Better gram NEGATIVE than 1st generation
  • Anaerobic coverage found ONLY in 2nd generation
31
Q

Cephalosporins: Indications (Third generation)

A

-Most potent group against gram- negative bacteria

  • IV & IM only, long half life, once-a-day dosing
  • Easily passes meninges and diffused into CSF
32
Q

Ceftriaxone (Rocephin)

A
  • Third generation cephalosporin
  • IV & IM only, long half life, once-a-day dosing
  • Easily passes meninges and diffused into CSF
  • treats CNS infections (Meningitis)
  • Drug is metabolized in the intestine after biliary excretion
  • *do not give to patients with live function
33
Q

Cephalosporin: Indications (Fourth generation)

A

-Broader spectrum of antibacterial activity than third generation, especially against g+

34
Q

Cefepime (Maxipime)

A
  • Fourth generation Cephalosporin
  • Injectable form only
  • UTI
  • uncomplicated skin infections
  • Pneumonia
35
Q

Cephalosporin: Indications (Fifth generation)

A
  • Newest
  • Efective agianst wide variety
  • MRSA, Community acquired pneumonia
36
Q

Cephalosporins: Contradictions

A
  • PAtients who have shown hypersensitivity to ceph

- Patient with serious anaphylactic reaction to PCN should NOT be given cephalosporins

37
Q

Cephalosporins: Adverse Effects

A
  • Simliar to PNC

- Mild diarrhea, cramps, rash, pruritus, redness, edema

38
Q

Cephalosporins: Interactions

A
  • *ETHANOL**
  • Antiacids, iron (decreases absorption)
  • Oral contraceptives
39
Q

Cephalosporins: Assessment:

A
  • Assess for PCN allergy:may have cross alergy

- GI disease (May predisose the patient to colitis)

40
Q

Cephalosporins: IMplementaion

A
  • Given orally with food to decrease GI upset
  • ALCOHOL SHOULD BE AVOIDED
  • avoid antacids
41
Q

Carbapenems

A
  • broadest antibiotic to date
  • reserved for complicated body cavity and connective tissue infections
  • *May cause drug-induced seizure activity (Risk reduced with proper dosage with impaired patients
  • All given parenterally
  • Risk of cross allergy with PCN
42
Q

Carbapenems: Indications

A

-Used for treatment of bone, joint, skin and soft tissue infections

43
Q

Carbapenems: Assessment

A

Assess for PCN allergy

-Presences of seizure disorder

44
Q

Carbapenems: Implementation

A

MUST BE INFUSED OF 60 MINUTES

-monitor for seizure activity

45
Q

Macrolides: MOA

A
  • Prevents protien syntesis

- Bacteriostatic

46
Q

Macrolides: Indications

A
  • Strep infections
  • Mild to moderated URI, LRI
  • Spriochetal infections (shyphilis and lyme)
  • Gonorrhea, Chlamydia, Mycoplasma
47
Q

Macrolides: Contradictions

A
  • Drug Allergy

* Alertnative drug for patient with allergies to beta-lactam antibiotics

48
Q

Macrolides: Adverse Effects

A 
GI effects (Primarily with erythromycin)
-Most common V/D
49
Q

Macrolides: Interactions

A
  • Cyclosporines, digoxin, theophylline, warfarin (Enhanced effects and possible toxicity)
  • Oral contraceptive failure
50
Q

Tetracyclines: MOA

A
  • Inhibits protein sythn
  • Bacteriostatic
  • strong affinity and ability to bind to calcium and magnesium to form insoluble complexes
51
Q

Tetracyclines: Indications

A
  • Wide spectrum

- alternative for patients with PCN allergy

52
Q

Tetracyclines: Contraindications

A
  • Allergy

- Pregnant women, nursing women, children under 8

53
Q

Tetracyclines: Adverse Effects

A
  • Strong affinity for clalcium
  • discoloration of perm teeth
  • abnormal tooth enamel in both fetus and children
  • possible abnormal fetal skel development
  • Photosensitivity, coagulation irregularities, exacerbation of lupus
54
Q

Tetracyclines: Interactions

A
  • Oral abosroption is decreased by ….
  • Potentiates the affects of anticoagulates
  • Antagonizes oral contraceptive
55
Q

Tetracyclines: Implementation

A
  • 6-8 oz of fluid
  • no calcium, mg, iron
  • avoid milk
  • do not eat interacting food 2 hours before or 3 hours after
  • photosensitive (sunscreen)

Patho Pharm (2 decks)

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