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Pharm Exam 1 > antibiotics and anti infectives > Flashcards

antibiotics and anti infectives Flashcards

1
Q

Penicillin MOA

A

weakens the cell wall causing bacteria to take up extra water and rupture
affects the beta lactam ring

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2
Q

Penicillin Use

A 
pneumonia
pharyngitis
endocarditis
meningitis
syphilis
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3
Q

Amoxicillin Use

A

same as penicillin but safe for pregnancy

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4
Q

Penicillin A/E

A

N/V/D
rash
allergic reaction

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5
Q

Penicillin drug interactions

A

Aminoglycosides- Gentamicin
Bacteriostatic abx- Tetracyclines
Probenicine- delays excretion from kidneys

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6
Q

Penicillin G

A

Broad spectrum
lasts for 30 days
IM- painful
least toxic

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7
Q

Amoxicillin reduce dose in

A

renal impairment

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8
Q

Penicillin anaphylaxis management

A

airway

give epi IV/IM

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9
Q

Penicillin allergy

A

anaphylaxis- don’t give cephalosporin

mild allergic reactions- give cephalosporin

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10
Q

Nafcillin

A

absorption in GI tract is poor– give IV/IM

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11
Q

Extended spectrum penicillin combos

A

Amoxicillin/Clavulanate (Augmentem)

Piperacillin/ Tazobactam (Zosyn)

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12
Q

Cephalosporin MOA

A

Very similar to penicillin

binds to PBP, disrupts cell wall synthesis and causes cell lysis (most effective during active growth and division)

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13
Q

Cephalosporin A/E

A

hypersensitivity reaction
bleeding tendencies– interferes with Vit K reaction
thrombophlebitis

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14
Q

Cephalosporin Drug interactions

A

Probenecid
Drugs that promote bleeding (Warfarin)
ETOH

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15
Q

Cephalosporin 1st Gen Drug

A

Cephalexin

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16
Q

Cephalexin Use

A

Prophylaxis against infections during surgical procedures

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17
Q

Cephalosporin 1st –> 5th generation

A

increase ability to reach CSF
increase ability to treat resistant infections
increase activity against Gram -

1-2 no CSF
3-5 CSF

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18
Q

Cephalosporin 2nd generation Drug

A

Cefoxitin

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19
Q

Cefoxitin Use

A

mostly skin infections

rarely used against active infections

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20
Q

Cephalosporin 3rd generation Drug

A

Cefotaxime, Ceftriaxone, Ceftazidime

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21
Q

Cefotaxime Use

A

gram - infections, penetrate CSF

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22
Q

Ceftriaxone Use

A

gonorrhea

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23
Q

Ceftazidime Use

A

P. aeruginosa

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24
Q

Ceftazidime A/E

A

watery diarrhea– Pseudomembranous Colitis (severe abdominal pain, fever, bloody diarrhea)

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25
Q

Cephalosporin 4th generation Drug

A

Cefepime

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26
Q

Cefepime use

A

treat hospital acquired pneumonia

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27
Q

Cephalosporin 5th generation Drug

A

Ceftaroline

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28
Q

Ceftaroline Use

A

MRSA

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29
Q

Cephalosporin Nursing implementations

A

Poorly absorbed in the GI tract
Cause superinfection
eliminated by the kidneys– reduce dose for renal impairment
highly resistant

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30
Q

Vancomycin MOA

A

Inhibit cell wall synthesis
bactericidal
causes lysis

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31
Q

Vancomycin Use

A

MRSA
C. diff – severe infection
meningitis

V strong abx

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32
Q

Vancomycin A/E

A

Red man syndrome (when infusion is too fast <1hr, renal impairment)
-feeling of ants all over the patient, red skin

Thrombocytopenia
Thrombophlebitis

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33
Q

Vancomycin Toxicity

A

ototoxic (reversible)

nephrotoxic

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34
Q

Vancomycin route

A

PO - rare- erratic absorption

IV - most common, best absorption

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35
Q

Vancomycin Monitoring

A 
BUN
Cr
Platelets 
Blood level
Peak and trough levels
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36
Q

Tetracyclines MOA

A

inhibit protein synthesis
bacteriostatic
suppresses bacterial growth

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37
Q

Tetracycline DOC

A

Rickets
lyme disease
Anthrax
Rocky mountain spotted fever

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38
Q

Tetracycline Other Uses

A 
acne
PUD
Periodontal disease 
anthrax
mycoplasma pneumonia
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39
Q

Tetracycline A/E

A

GI irritation
superinfections
Effects on bone and teeth (yellow- brown coloration)

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40
Q

Tetracycline Toxicity

A

Nephrotoxic

Hepatotoxic

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41
Q

Tetracycline Contraindications

A

<8y/o- due to binding to Ca and cause discoloration

Pregnancy/ breastfeeding

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42
Q

Tetracycline Drug interactions

A

decreases absorption with Ca supplements, dairy, iron supplements, any antacids

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43
Q

Macrolide drugs

A

Erythromycin

Clindamycin

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44
Q

Erythromycin MOA

A

inhibits protein synthesis
bacteriostatic
can be bactericidal

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45
Q

Erythromycin Use

A 
broad spectrum
when allergic to PCN and cant take Ceph.
Chlamydia
diphtheria
M. pneumonia
Group A strep.
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46
Q

Erythromycin DOC

A

Whooping cough (Bordetella pertussis)

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47
Q

Erythromycin A/E

A 
GI - upper gastric pain 
QT prolongation 
Sudden cardiac death
super infections
thrombophlebitis
Hearing loss
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48
Q

Erythromycin Drug interactions

A

P450 drugs
Theophylline
AED/ bipolar drugs
Warfarin

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49
Q

Erythromycin patient educations

A

take on an empty stomach with a full glass of water

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50
Q

Clindamycin MOA

A

Inhibit protein synthesis

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51
Q

Clindamycin Use

A

wound infections

alternative to Penicillin

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52
Q

Clindamycin route

A

normally topical

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53
Q

Clindamycin A/E

A

CDAD - C. diff associated diarrhea
Blood dyscrasia - agranulocytosis, leukocytosis, thrombocytopenia… all of the anemias
Diarrhea
Rash (hypersensitivity reactions)

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54
Q

Clindamycin Toxicity

A

hepatotoxicity

C. diff- stop immediately and report diarrhea

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55
Q

Minocycline DOC

A

RA

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56
Q

Linezolid MOA

A

Bacteriostatic

inhibit protein synthesis

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57
Q

Linezolid Use

A

VRE
MRSA
multidrug resistant pathogens

58
Q

Linezolid Dose

A

can be given long term -5mo

59
Q

Linezolid long term A/E

A

optic neuropathy

peripheral neuropathy

60
Q

Linezolid A/E

A

Most common:
–N/V/D
Most severe:
–myelosuppression (will reverse when stopped)

61
Q

Linezolid Drug interactions

62
Q

Linezolid Monitoring

A

CBC before, during and after

63
Q

Aminoglycoside drugs

A

Gentamicin

Amikacin

64
Q

Aminoglycosides

A

bactericidal

65
Q

Aminoglycosides Use

A

narrow spectrum

66
Q

Amikacin use

A

broadest aminoglycoside

resistance present

67
Q

Aminoglycoside A/E

A

Blood dyscrasias

hypersensitivity reactions

68
Q

Aminoglycoside Toxicity

A

Ototoxic (irreversible)

Nephrotoxic (renal tubules, decrease dose)

69
Q

Aminoglycosides Drug interactions

A

PCN
Other ototoxic drugs (Vanc)
Other nephrotoxic drugs
Skeletal muscle relaxants

70
Q

Aminoglycoside antidote

A

Ca gluconate– binds to aminoglycoside and prevents action and stops A/E

71
Q

Aminoglycoside PO

A

not absorbed well in the GI tract, give PO only if infection is in the GI tract

72
Q

Aminoglycoside Mornitoring

A

Peak and Trough levels
dose can differ depending on the therapeutic range
also needs to be safe for the Kidneys
Gentamicin will be the fist aminoglycoside given

73
Q

Sulfonamide Drug

A

Silver Sulfadiazine

Trimethoprim/Sulfamethoxazole

74
Q

Sulfonamide MOA

A

inhibits synthesis of (tetrahydrofolic acid) folic acid, suppressing growth of bacteria

75
Q

Sulfonamide DOC

A

UTI- r/t E. coli

76
Q

Silver Sulfadiazine Use

A

burns, suppresses growth of bacterial colonization in patients with 2nd and 3rd degree burns

77
Q

Silver Sulfadiazine A/E

A

blue green discoloration of the skin, do not use on the face

78
Q

Sulfonamides A/E

A 
hypersensitivity reactions 
SJS-- rare
hematological effects (AA, Mediterranean people)
kernicterus (bilirubin in the brain)
renal damage from Crystalluria
79
Q

Sulfonamides Contraindication

A

Not given after 32 wk gestation
-passed to the baby and causes kernicterus
<2 mo age
breastfeeding until baby is >2mo

80
Q

Sulfonamides excretion

A

by the kidneys

81
Q

Trimethoprim/Sulfamethoxazole DOC

82
Q

TMP/SMZ other uses

A

ear infections
bronchitis
pneumonia - recurrent and/or chronic

83
Q

TMP/SMZ A/E

A 
N/V
rash
hyperkalemia
HA
depression
hallucinations 
kernicterus
renal damage 
SJS
blood dyscrasias
84
Q

TMP/SMZ contraindications

A

allergy to sulfa drugs

85
Q

Nitrofurantoin Use

86
Q

Nitrofurantoin dosing

A

low: bacteriostatic
high: bactericidal

87
Q

Nitrofurantoin A/E

A 
Brown discoloration of urine
GI (anorexia, N/V/D-- take with food)
Pulmonary reactions 
Hematological reactions (hemolytic anemia) 
HA
88
Q

Nitrofurantoin Toxicity

A

Hepatotoxicity

Nephrotoxicity

89
Q

Nitrofurantoin Contraindications

A

Pregnancy: birth defects

< 1 mo age: due to hemolytic anemias

90
Q

Nitrofurantoin monitoring

A

LFTs, skin color

91
Q

Fluoroquinolones MOA

A

Disrupt DNA replication and cell division

92
Q

Fluoroquinolones Use

A

Broad spectrum

Resistant Acute cystitis

93
Q

Fluoroquinolones A/E

A

Achilles tendon rupture – if there is ankle pain, stop immediately
exacerbation of Myasthenia Gravis

94
Q

Fluoroquinolones Drugs

A

Ciprofloxacin

95
Q

Ciprofloxacin MOA

A

inhibits bacterial DNA gyrase and topoisomerase 2

96
Q

Ciprofloxacin DOC

A

Severe UTI

anthrax

97
Q

Ciprofloxacin other uses

A

respiratory
GI
bones, joints, skin, soft tissue

98
Q

Ciprofloxacin A/E

A 
N/V/D
abdominal pain
superinfections
-candidiasis in the mouth and vagina 
Tendon rupture 
Older adults
-confusion, visual disturbance, hallucinations
-Exacerbation of Myasthenia Gravis
99
Q

Ciprofloxacin Toxicity

A

Phototoxicity

100
Q

Ciprofloxacin Drug interactions

A 
Ca, dairy, zinc, antacids
- decrease absorption 
theophylline 
warfarin
tinidazole 
-increase levels of these drugs
101
Q

Metronidazole MOA

A

bactericidal

102
Q

Metronidazole DOC

A

Mild/ Moderate C. Dif

prophylactically for surgery

103
Q

Metronidazole A/E

A

metallic taste: give with food

104
Q

Metronidazole Toxicity

A

neurotoxic

105
Q

Metronidazole Drug interactions

106
Q

Amphotericin B MOA

A

binds to components of the fungal cell membrane, increasing permeability

107
Q

Amphotericin B Use

A

antifungal

only for progressive and deadly fungal infections

108
Q

Amphotericin B DOC

A

most systemic mycosis

109
Q

Amphotericin B A/E

A 
fever
chillin
shakes
HA
hypokalemia
bone marrow suppression
110
Q

Amphotericin B Toxicity

A

highly toxic - infusion reaction

nephrotoxic

111
Q

Amphotericin B Drug interactions

A

other nephrotoxic drugs

K sparing diuretics

112
Q

Amphotericin B Nursing implementations

A

Premedicate for infusion reactions
stop infusion and treat reaction and restart infusion
Give with at least 1 L NS for kidneys
Promote PO hydration

113
Q

Amphotericin B Monitoring

114
Q

Amphotericin excretion

A

can be up to 1 year so need to be monitored for the year

115
Q

Azoles drugs

A

Itraconazole
Ketoconazole
Fluconazole
Clotrimazole

116
Q

Itraconazole MOA

A

inhibit synthesis of ergosterol = increased permeability and leakage of cellular components

117
Q

Itraconazole Use

A

fungal infections

118
Q

Itraconazole A/E

A 
N/V/D (common)
*Cardiac Suppression (severe)* 
HA
rash
abdominal pain
edema
119
Q

Itraconazole Toxicity

A

Liver injury, lower than Amphotericin B

120
Q

Itraconazole Patient needs prior

A

Echocardiogram

121
Q

Ketoconazole Use

A

fungal infections
superficial infections (dermatitis)
systemic mycosis

122
Q

Ketoconazole A/E

A 
N/V/D -- give with food 
sex hormones
rash
itching
dizziness
fever
chills
constipation
123
Q

Ketoconazole Toxicity

A

Hepatotoxicity

124
Q

Ketoconazole Drug interactions

A

CYP3A4– increase levels of other drugs

like warfarin

125
Q

Ketoconazole Monitoring

A

LFTs before during after

126
Q

Fluconazole Use

A 
#1 Azole given 
antifungal
127
Q

Fluconazole A/E

A

N/V/D
abdominal pain
rash

128
Q

Fluconazole Contraindications

A

Pregnancy - 1st trimester: birth defects

129
Q

Fluconazole Drug interactions

A

CYP3A4 inhibitors

130
Q

Clotrimazole DOC

A

Topical admin for skin fungal infections

131
Q

Clotrimazole A/E

A 
*stinging* 
erythema
edema
urticaria
pruritus
peeling
*burning *
132
Q

Nystatin DOC

A

intestinal/ mouth candidiasis infection

133
Q

Nystatin Other use

A

Skin, skin fold fungal infections: use powder or cream

134
Q

Nystatin route

A

PO
Swish and swallow
Swish and spit

135
Q

Nystatin A/E

136
Q

PO Penicillin DOC

A

Amoxicillin

137
Q

Pipracillin A/E

A

Bleeding tendencies

138
Q

Cephalosporin toxicity

A

Nephrotoxic

139
Q

Metronidazole MOA

A

Inhibits DNA synthesis

140
Q

Nystatin MOA

A

Inhibits fungal membrane synthesis

Pharm Exam 1 (2 decks)

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