Antibiotics Flashcards
What is prophylactic therapy? When would it be used?
treatment given to prevent an infection from occurring, often used in patients at high risk of infection
What is empiric therapy? How is this applied to clinical practice?
Treatment given when infection is suspected but the causative pathogen has not yet been identified, targets the likely pathogens. antimicrobial selection is guided by patient, infection, and drug factors.
What is targeted therapy? How is this applied to clinical practice?
Treatment given to target the specific organism causing the infection. Antimicrobial selection based on culture and sensitivity results.
What is pharmacodynamics?
What the body does to the drug, the movement of drugs within the body
What is pharmacokinetics?
What the drug does to the body, the biochemical and physiological effects of a drug
Which spectrum of antimicrobials increases the likelihood of antimicrobial resistance and C. diff associated diseases?
broad spectrum (empiric)
What are bacteriostatic antimicrobials and what are some examples?
Inhibits/ slows bacterial growth, requires a functioning immune system to clear the infection. Examples; macrolides, clindamycin, tetracyclines
What are bactericidal antimicrobials and what are some examples?
Kills the bacteria. Examples; beta-lactams, vancomycin, fluoroquinolones
What accelerates AMR?
The misuse and overuse of antimicrobials
What are the 4 risk factors for MDRO colonization/ infection?
- prior antibiotic exposure
- underlying disease
- prior hospitalization
- invasive procedures in health care settings
What is MDRO?
multidrug resistance organisms
What is ESBL?
extended-spectrum beta-lactamase
What is MRSA?
methicillin-resistant staphylococcus aureus
What is VRE?
vancomycin-resistant enterococcus
What is CRE?
carbapenem-resistant enterobacteriaceae
What is the first-line therapy antimicrobial?
beta-lactams, the tree of penicillins
How do beta-lactam antibiotics work?
deactivate penicillin binding protein which cross-links subunits of peptidoglycan, leading to osmotic cell lysis (bactericidal) time dependent killing
Which antibiotic that falls under beta-lactam is so broad spectrum it is only used for severe drug-resistant or hospital acquired infections?
carbapenems
What “bugs” does vancomycin target?
gram positive
What is the mechanism of action of vancomycin?
bactericidal
What are some common uses of vancomycin?
gram positive bloodstream infections, osteomyelitis, skin and soft tissue infections, MRSA, C. diff
What are the three different cell antibiotic targets?
- inhibits cell wall synthesis or function
- inhibit protein synthesis
- inhibit nucleic acid synthesis or function
What are side effects associated with vancomycin?
red man syndrome, nephrotoxicity
What is the mechanism of action of Daptomycin?
Bactericidal
In what case is Daptomycin used?
Only used in serious infections when vancomycin CANNOT be used
What gram bacteria can Daptomycin be used for?
gram positive only (MRSA, VRE)
What are some side effects associated with Daptomycin?
muscle side effects (myopathy, dark urine) monitor creatine kinase
What is the mechanism of action of Fluroroquinolones?
bactericidal (inhibition of DNA)
What gram bacteria is Fluoroquinolones used to treat?
both
Which antibiotic has a black box warning?
Fluoroquinolones
What are common uses of Fluoroquinolones?
pyelonephritis and pneumonia
What interferes with the absorption of fluoroquinolones?
metal cations (2 hours before or 4-6 hours after)``
Which antibiotic has tendonitis as a side effect?
Fluoroquinolones
Which antibiotic is to be avoided in pregnancy and not recommended in children?
Fluoroquinolones
What is the mechanism of action of sulfamethoxazole-trimethoprim?
bactericidal (fixed-combo only) inhibit folic acid synthesis
What is an alternative antibiotic for beta-lactam resistant organisms?
sulfamethoxazole-trimethoprim
What are some common uses of sulfamethoxzaole-trimethoprim?
skin infections and UITs
What antibiotic should you NOT use if G6PD deficiency or pregnant?
sulfamethoxazole-trimethoprim
What is a side effect of sulfamethoxazole-trimethoprim?
rashes (hypersensitivity) - steven johnson syndrome
What antibiotic is commonly used for intra-abdominal infections and bacterial vaginosis?
metronidazole
What “bugs” does metronidazole have an effect on?
anaerobic organisms only (c. diff)
What antibiotic leaves a metallic taste in the mouth?
metronidazole
What is a drug precaution with metronidazole?
alcohol during and within 3 days
What is the mechanism of macrolides?
bacteriostatic
What antibiotic is used to treat respiratory tract infections and sexually transmitted infections?
macrolides
What class of antibiotics has drug interactions with warfarin, cyclosporine and atorvastatin?
macrolides
What are some side effects of macrolides?
- nausea, diarrhea and abdominal pain
- QT prolongation (heart problems)
What “bugs” do macrolides exert an effect on?
streptococci, some gram negative, and some atypical (legionella)
What is the mechanism of action of clindamycin?
bacteriostatic (reversible binding)
What coverage does clindamycin offer?
gram positive and oral anaerobes
What antibiotic is used for skin and soft tissue infections and dental infections?
clindamycin
What antibiotic has side effects of nausea and vomiting and diarrhea all associated with C. diff?
clindamycin
What is the mechanism of action of aminoglyosides?
bactericidal
What antibiotic is used for very serious infections such as endocarditis and bacteremia?
aminoglycosides
What “bugs” do aminoglycosides exert an effect on?
gram negative, gram positive only in synergy with cell wall activated antibiotics (vancomycin and beta-lactams)
What are the side effects associated with aminoglycosides?
nephrotoxicity, neurotoxicity, ototoxicity (irreversible) must be closely monitored
Which antibiotic is used for the treatment of atypical organism coverage in the community acquired pneumonia, animal-borne illnesses, skin and soft tissue infections?
tetracyclines
What is a side effect associated with tetracyclines?
photosensitivity
Which antibiotic do you want to NOT prescribe for children under 8, pregnant women and those women breastfeeding?
tetracyclines
Are there any drug interactions with tetracyclines?
metal cations interfere with the absorption
