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NURP 422 - ex 2 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Very Fine Proficient At Cell Murder

A 
V - Vancomycin 
F - Fluoroquinolones
P - Penicillin 
A - Aminoglycosides
C - Cephalosporins 
M - Metronidazole
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2
Q 
Contraindicated in pregnancy
M
C
A
T
A

M - Metronidazole
C - Chloramphenicol
A - Aminoglycosides
T - Tetracyclines

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3
Q

ABX that inhibit bacterial folate synthesis

Stop That Pholate

S
T
P

A

S - Sulfonamides
T - Trimethoprim
P - Pyrimethamine

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4
Q

ABX that inhibit bacterial Cell Wall synthesis

I’M A Vixon @ Crushing People

A 
I’M - Imipenem/Meropenem
A - Aztreonam
V - Vancomycin
C - Cephalosporins 
P - Penicillin

Bacitracin
Isoniazid
Ethambutol

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5
Q

ABX that inhibit bacterial protein synthesis

My Abx Could Literally Stop That Crap

A 
M - Macrolides
A - Aminoglycosides 
C - Chloramphenicol 
L - Linezolid
S - Streptogramins
T - Tetracyclines 
C - Clindamycin
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6
Q

30s binders

A

Tetracyclines

Aminoglycosides

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7
Q

Contraindicated in pregnancy

Safe ct

A 
S - Sulfanomide
A - Aminoglycosides 
F - Fluroquinolones
E - Erithromycin
C - Chloramphenicol 
T - Tetracycline
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8
Q

Initial resistance

A

When bacteria always has resistance

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9
Q

Developed resistance

A

When mutations occurs over time

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10
Q

Acquired resistance

A

When the mother cell passed on mutation to daughter cell

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11
Q

Vertical transmission.

A

Mother to child; random mutation that passed on as cell replicates

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12
Q

Horizontal transmission

A

The transfer of plasma DNA to other bacteria

Bacterial can pass on resistance to other species of bacteria through transfer of plasmids

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13
Q

Inhibition of DNA or RNA synthesis

A 
Actinomycin
Nucleotide 
Analogs
Quinolone
Rifampin
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14
Q

Inhibition of general metabolic pathway

A

Sulfonamides

Trimetgoprim

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15
Q

Adverse effects for Cephalosporins

A

GI upset including c.diff
Combo with alcohol : disulfiram

Allergies: cross sensitivity is 10% of those allergic to penicillin
Less crossover with higher generations
Not recommended in pts with anaphylactic reaction to penicillin

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16
Q

Cephalosporin contraindications

A

Extended half-life with renal and hepatic insufficiency
Alterations in clotting
Nephrotoxicity with renal insufficiency (decrease dose by 50% if GFR <10
Superinfection

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17
Q

Cephalosporin drug interactions

A 
Probenecid 
Loop diuretics (increased nephrotoxicity risk)
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18
Q

Indication of use for Cephalosporins

A 
Surgery prophylaxis 
Respiratory infection 
Strep, pharyngitis, sinusitis 
Community acquired pneumonia 
Skin
Soft tissue
Bones and joints
UTI
STDs
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19
Q

About Vanco (glycopeptide)

A

Narrow-spectrum against gram positive (bactericidal)
Can cause red man syndrome
Penetrates CSF

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20
Q

Glycopeptides (Vanco) adverse effects

A

Nephrotoxic
Transient ototoxicity
Hypersensitivity
Phlebitis at injection site

Pregnancy B

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21
Q

Glycopeptides (vanco)

Clinical indication

A

Second line for c.diff
Staph enterocolitis
Gram positive infections such as MRSA resistant to first line antibiotics
Synergistic when combined with Rifampin or Ceftriaxone

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22
Q

Penicillin/aminopenicillin sensitivity

A

Aminopenicillin best against gram negative GI pathogens, e.coli, salmonella, flu type B

Take on empty stomach
30m prior or 2 hours after: oral, ampicillin, cloxacillin, dicloxacillin

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23
Q

Penicillin/aminopenicillin indications

A 
Acute otitis media
Pharyngitis
UTI (second line)
STD treponema pallium 
PNA
Augmentin
H.pylori
Bacterial endocarditis
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24
Q

Penicillin/aminopenicillin drug/drug interactions

A

Diuretics
Tetracyclines
Warfarin

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25
Q

Cephalosporin gen 1 use

A

Used for skin and soft tissue infections
Active against gram-positive
S.aureus and s.epidermidis

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26
Q

Cephalosporin gen 2

A

Active against s.aureus, s.epidermis, proteus, e.coli

27
Q

Cephalosporin gen 3

A

Used for broader spectrum

More active against gram negative

28
Q

Cephalosporin gen 4

A

Resistant to beta-lactamase

Primary active against gram positive

29
Q

Glycopeptides (Vanco)

Dx/Dx interactions

A

Aminoglycosides - risk of ototoxicity and neurotoxicity

Cholestyramine binds Vanco - needs to be given several hours apart

30
Q

About Macrolides

A 
Reversibly binds 50s
Inactivated by acid
Typically bacteriostatic 
Cross resistance with penicillin 
Given to people with allergies to penicillin
No beta-lactam ring
31
Q

Macrolides: Erythromicin

A 
Most important Macrolide
Bactericidal at high concentrations
Used for: mycoplasm, Chlamydia, upper resp infection,sinusitis, otitis, pertussis 
Poor CSF penetration
Pregnancy B
32
Q

Macrolides

Cautions and Adverse Effects and Dx/Dx interactions

A 
Prolong QT interval
Clarithromycin CCr <30mL/mob requires dosing to be cut in half
Pregnancy: Clarithromycin class C
Safe in lactation
Safe in >6 months old child 
GI upset
Severe explosive diarrhea 
Cholesteric hepatitis

Dx/Dx interactions: colochicine, warfarin,dig

33
Q

1st line treatment for MRSA

A

Lincosamides

34
Q

Lincosamide: cautions and adverse effects

A 
Asthma or severe allergies
Severe renal or liver impairment
Pregnancy B, present in breast milk, used in severe childhood infections 
GI upset
C.diff
35
Q

Oxazolidinones (Zyvox)

Cautions

A

Pregnancy C - excreted in milk.
Approved for children at birth
Indicated for MRSA and VRE
HTN: caution with sympathomimetics, vasopressors
Dopamine adrenegics, ADD, and anti seizure drugs
SSRI, tricyclics antidepressants, buspirone, methadone, tramadol
Can’t use within 2 weeks of MAOI

36
Q

Oxazolidinones (Zyvox)

Adverse drug reactions

A 
Myelosuppression
Peripheral neuropathy 
Serotonin Syndrome 
GI upset
Fever
37
Q

Tetracyclines bind to

A

30s subunits

38
Q

Tetracyclines

Indications for use

A

Chlamydia
Mycoplasma pneumonia
Rocky Mountain spotted fever, Lyme disease, nongonococcal urethritis
Acne

39
Q

Tetracyclines pharmacokinetics

A

No dairy, decreases absorption d/t calcium
Impaired by certain foods
Best taken on empty stomach (2 hours before/after meal)
Do not take with electrolytes
Pregnancy D - Passes into placenta and breast milk
Discoloration teeth in children under 8
Causes damage to tooth enamel
Used for acne

40
Q

Penicillins

Adverse effects

A 
Hypersensitivity 
Superinfection 
GI disturbances
Maculopapular Rash (amoxicillin and mono)
Changes in renal function
41
Q

Lincosamide (Clindamycin)

A 
Suppressed protein synthesis
Gram positive
Bacteriostatic
Metabolized in liver
Highly protein bound
42
Q

Macrolides

Dx/Dx interactions

A

Statins

Theophylline, benzodiazepines, colchicine, dig, warfarin

43
Q

C. Trachomatis, ureaplasma urealyticum, Lyme disease first line abx

A

Tetracyclines specifically doxycycline

44
Q

Oxazolidinones (linzeloid)

Indications

A

PNA
Complicated skin infections
Vanco-resistant enterococcus

45
Q

Fluoroquinolone

Pharmacokinetics

A

Cipro: impaired absorption with dairy
Norfloxacin: best on empty stomach

Food doesn’t affect distribution

46
Q

Fluoroquinolones

Cautions

A 
Renal dysfunction can increase 1/2 life
Pre-existing QT prolongation 
Seizures or other CNS disorders
Elderly: increased risk for tendon rupture 
Pregnancy C and avoid lactating mothers 
Not recommended in kids <18
47
Q

Fluoroquinolones

Adverse effects

A 
GI upset
CNS confusion dizziness mood change
Dysthymias serious side effect
Can effect blood sugar
Superinfection 
Skin
Photo toxicity
48
Q

Metronidazole (Flagyl)

Pharmacokinetics

A

100% bioavailability
Give with food
CNS and most tissues distributed
Hepatic metabolism (30-60%)

49
Q

Metronidazole (Flagyl)

Cautions and adverse effects

A 
Hx of seizures or other neuro disorders
Blood dyscrasias 
Severe hepatic dysfunction 
Renal disease
Pregnancy B
Extreme caution with lactation
50
Q

Fluoroquinolones

Dx/Dx interactions

A

Antacids - interfere with absorption
Can increase or decrease glucose
Can prolong QT when given in combo with Amiodarone orpace quinidine sotalol
Glucocorticoids increase risk of tendon rupture
Warfarin - increased anticoagulation

51
Q

Metronidazole (Flagyl)

Uses

A 
Trichomonas vaginal infections 
Giardia infections
C.difficile infections
Bacterial vaginosis
Amebiasis dysentery 
H.pylori duodenal infection
52
Q

Metronidazole (Flagyl)

Dx/Dx interactions

A

CYP450 inhibitor (cimetidine)
CYP450 inducer (phenytoin)
Warfarin
Lithium - increases lithium level

53
Q

Sulfonamides

About

A

Don’t affect microorganisms that don’t synthesize folic acid
Inhibit bacterial synthesis of folic acid
Alternative to penicillin
Broad spectrum
95% effective against e.coli
Bacteriostatic
Pregnancy C
Skin rash and itching
Caution: G6PD deficiency bone marrow issues renal insufficiency or stones. Folate deficiency

54
Q

Trimethoprim

About

A 
Antibacterial agent that interferes with bacterial folic acid synthesis (similar to Sulfonamides)
Requires increased fluid intake
Readily absorbed
First pass through liver
Bactericidal when combined with sulfa drug
<20% hepatic metabolism
Used in UTI s
Hyperkalemia
55
Q

Nitrofurantoin

About

A 
Inhibits protein, dna/rna and cell wall synthesis.
Aerobic metabolism 
Good with UTI
Body tissue metabolism 
Peripheral neuropathy
56
Q

Sulfonamides

Dx/Dx interactions

A 
Cyclosporine
Methotrexate 
Probenicid 
Uricosurics
Indomethacin
Thiazides diuretic
Warfarin
57
Q

Nitrofurantoin

Dx/Dx interactions

A

Antichinergics

Probenicid

58
Q

Trimethoprim

Dx/Dx interactions

A

ACE and ARBs increased risk of hyperkalemia

Phenytoin

59
Q

Meds not to be used in lactation

A 
Antineoplastics
Bromocriptine
Cyclophosphamide 
Cyclosporine 
Ergotamine
Lithium 
Methotrexate 
Radio pharmaceuticals
60
Q

Elderly ABCs: the A

A 
Anti arrhythmic 
Anti anxiety 
Anticholinergics
Anticonvulsants 
Antidepressants 
Antihistamines 
Antihypertensives
Antipsychotics and antispasmodic
61
Q

Elderly ABCs: the B

A 
Barbituates 
Benzos
Belladonna 
Blockers
B-lactams
62
Q

Meds of concern with elderly

A

Aminoglycosides
Quinolones, sulfonylureas (hypoglycemia, remind PT to eat)
Cholinesterase inhibitors (interact with P450 inhibitors)
Inotropics (dig, CNS cause dizziness and anorexia)
Tylenol and NSAIDS can cause fluid retention and GI bleeds

63
Q

Diuretics work by…

A

Increasing urine output, decreasing fluid volume

NURP 422 - ex 2 (3 decks)

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