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AGPCNP Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Tetracyclines (Category D)

Adverse Effects

A

Photosensitivity reaction (severe sunburns) from minimal sunlight exposure
permanent discoloration of teeth (yellow-brown to gray)
skeletal defects: last half of pregnancy, infancy, children less than 8 years old
esophageal ulceration

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2
Q

Tetracyclines

A

Doxycycline

Minocycline

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3
Q

Tetracyclines

A

Treat acne from age 13 to 14 years of age
1 st for moderate to severe acne, rosacea
Educate to throw away expired tetracycline pills

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4
Q

Minocycline (Minocin)

A

Common Side Effect

vertigo and dizziness (vestibular dysfunction)

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5
Q

Tetracyclines

A

take on a empty stomach
Binds with calcium, iron, magnesium and zine
Decrease the effectiveness of oral contraceptive pills
Decrease absorption of antacids, sucralfate, bile-acid sequestrates

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6
Q

Macrolides

A

They inhibit protein synthesis in bacteria by reversibly binding to the P site of the 50S unit of thee ribosome.
They mainly affect gram-positive cocci and intracellular pathogens such as mycoplasma, chlamydia, and legionella

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7
Q

Macrolides examples

A

Erthromycin
Azithromycin
Clarithromycin
Roxithromycin

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8
Q

Macrolides

Adverse Effects

A 
GI distress 
Ototoxicity, cholestatic jaundice
QTc prolongation (risk of tornadoes de pointes)
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9
Q

Macrolides

Drug Interactions

A

Antiocoagulants: warfarin
Benzos: Triazolam (Halcion), midazolam (Versed)
Asthma: Salmeterol (Serevent), theophylline
Anticonvulsants (carbamezapine, phenytoin), ergotamine, statins (rhabdomolysis), carbamexapne (Tegretol)

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10
Q

Cephalosporins (Category B)

A

Bactericidal. They bind to and block the activity of enzymes responsible for making peptidoglycan.
They are broad-spectrum
They are four generations
NO CEPHALOSPORINS IF ALLERGIC TO PCN

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11
Q

1 st Generation Cephalosporins

A

Treat gram-positive bacteria
Example: Cephalexin (Keflex)
Cellulitis, impetigo , mastitis, UTI (sensitive) pregnancy

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12
Q

2nd Generation

A

Broad-spectrum:
gram-positive & gram-negative bacteria
Citrobacter, Enterobacter, Haemophilus influenzae, Neisseria and Serratia species

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13
Q

2nd Generation Types

A

cefaclor (Ceclor), cefprozil (Cefzil),
cefonicid, cefuroxime axetil (Ceftin)
cefoxitin (Mefoxin),

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14
Q

2nd Generation Indications

A

ENT: Sinusitis, otitis media
Respiration: CAP, exac chronic bronchitis
Skin infection

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15
Q

3rd Generation

A

Better coverage for gram-negative bacteria

Less activity for gram-positive bacteria

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16
Q

3rd Generation Example

A 
cefdinir (Omnicef)
cefditoren (Spectracef)
cefixime (Suprax)
cefoperazone (Cefobid)
 cefotaxime ( Claforan)
 cefpodoxime (Vantin)
ceftazidime(Fortaz)
 ceftizoxime (Cefizox)
ceftriaxone (Rocephin)
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17
Q

3rd Generation Indications

A

STD: Gonorrhea cervicitis, PID, urethritis
ENT: AOM in children, acute sinusitis, OM
GU: Pyelonephritis
CAP

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18
Q

ceftriaxone (Rocephin)

A

3rd Generation cephalosporins
1st line treatment for gonorrheal infection

***when given parenterally, can cause biliary sludge with symptoms of cholecystitis and cholestatic jaundice

19
Q

Cephalosporins

“ DO NOT”

A

Used for MRSA skin infection (boils, abscesses) 1st line either trimethoprim-sulfa (bacterium) or clindamycin
True allergy to PCN more likely to have a reaction to celphalosporins
Anaphylaxis and angioedema: type 1 IgE-mediated reaction

20
Q

4th Generation

A

Example: cefepime (Maxipime)

are active against a wide range of both gram-positive and gram-negative organisms.

21
Q

Penicillins (Category B)

A

drug of choice for streptococcus viridans, Group A strep (strep pyogenes), and syphilis

22
Q

PCN Adverse Reaction

A

Diarrhea
C-diff-associated diarrhea (CDAD)
Vaginitis (usually candida)

23
Q

Benzathine Penicillin G

A

beta lactam antibiotic

IM and low plasma level concentrations are maintained for several weeks

24
Q

pseudomembranous colitis

A

potential complication

penicillin antibiotic develops clostridium difficile

25
Q

amoxicillin & ampicillin

A

extended-spectrum penicillins
effective against gram-positive & gram-negative bacteria

(+ve) streptococci, staphylococci, enterococcus

(-ve) enterobacteriaceae (e. coli, proteus), pseudomonas aeruginosa, and h. influenzae

26
Q

amoxicillin indications (common)

A

upper respiratory infections, included in h pylori treatment pack.
Example:OM

27
Q

amoxicillin and beta lactamase inhibitors clavulanate

“Common indications “

A

dog bite, UTI, community acquired pneumonia lymphadenitis.

28
Q

patient is given ampicillin and returns to office in a few days with a maculopapular skin rash what is their likely diagnosis

A

mononucleosis or viral infection

29
Q

Enterococcal is drug of choice for what infection

A

amoxicillin

30
Q

Examples of Penicillins

A 
PCN V
Amoxicillin
Amoxicillin + clavulanic acid (Augumentin)
Benzathine PCN
Dicloxacillin
31
Q

PCN Careful

A

avoid amoxicillin for mononucleosis (causes generalized rash not related to allergy)
use PCN VK in its place (if not allergic)

Dicloxacillin for penicillinase-producing staph skin infections, example: mastitis & impetigo

True allergy to PCN more likely to have a reaction to celphalosporins
Anaphylaxis and angioedema: type 1 IgE-mediated reaction

Women c/o candida vaginitis with amoxicillin recommend probiotic capsules or yogurt daily

32
Q

Fluoroquinolones (Quinolones)

A

(-ve) gram and atypical bacteria
treat bacterial infections in many different parts of the body.
They work by killing bacteria or preventing their growth.
will not work for colds, flu, or other virus infections.

33
Q

Fluoroquinolones Effective Against

A

Haemophilus influenzae, Moraxella catarrhalis
Mycoplasma sp, Chlamydia sp
Chlamydophila sp, Legionella sp
Enterobacteriaceae, Pseudomonas aeruginosa (particularly ciprofloxacin)
Mycobacterium tuberculosis
Some atypical mycobacteria
Methicillin-sensitive staphylococci

34
Q

Fluoroquinolones (Black Box Warning)

A

increased risk of tendinitis and tendon rupture (especially the Achilles tendon)

35
Q

What are the risk factors for tendon rupture?

A

over 60 years of age
taking steroids (corticosteroids)
a kidney, heart, or lung transplant recipient

36
Q

What are the signs and symptoms of possible tendon rupture?

A

Pain, swelling, inflammation, and tears of tendons including the Achilles, shoulder, hand, or other tendons

Tendons are the areas that connect your muscles to your joints.
The Achilles tendon is at the back of the ankle.

37
Q

When to stop taking your Quinolones immediately then call the provider?

A

a snap or pop in a tendon area
bruising right after an injury in a tendon area
inability to move the affected area or bear weight

38
Q

What conditions are contraindication for Quinolones?

A

Children (less than 18 years old)
Myasthenia graves
pregnant women
breast feeding mothers

39
Q

Are they other serious side effects of Quinolones?

If yes what are they?

A

Yes
seizures, hallucinations, depression, heart rhythm changes (QTc prolongation and torsade de points), and intestine infection with diarrhea

40
Q

Drug interactions with quinolone

A

avoid usage with:
QT-prolonging drugs-amiodarone, macrocodes, TCAs, antipsychotics
Electrolyte imbalance-hypermagnesemia, hypokalemia
Antacids-aluminum/magnesium/calcium, or sucralfate (they reduces effectiveness of quinolone)

41
Q

What is the diagnostic test to R/O Achilles tendon rupture?

A

US

42
Q

What are some names of Quinolones?

A

Older group: Ciprofloxacin, norfloxacin, and ofloxacin

Newer group: Gemifloxacin, levofloxacin, and moxifloxacin

ciprofloxacin (Cipro and generic ciprofloxacin), ciprofloxacin extended-release (Cipro XR & Proquin XR)
gemifloxacin (Factive)
levofloxacin (Levaquin)
moxifloxacin (Avelox)
norfloxacin (Noroxin)
ofloxacin (Floxin)]
43
Q

Quinolones Notes

A

Bioterrorism-related inhalation of Anthrax infection: Ciprofloxacin
Traveler’s diarrhea- Ciprofloxacin
Ciprofloxacin best activity against Pseudomonas aeruoginosa (-ve) gram
1st line against Pseudomonal pneumonia
Ciprofloxacin most effective with conditions below the belt.

AGPCNP Pharmacology (3 decks)

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