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Pharmacology > Antibiotics, Antifungals, & Antivirals > Flashcards

Antibiotics, Antifungals, & Antivirals Flashcards

1
Q

What class of antiobiotics will be the most commonly used?

A

Beta lactams

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2
Q

What antibiotics inhibit cell wall synthesis?

A

Beta lactams (PCN, cephalosporins, carbapenems, aztreo)

Vancomycin

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3
Q

What antibiotics inhibit ribosomal protein synthesis?

A

Aminoglycosides
Clindamycin
Macrolides
Tetracycylines

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4
Q

What antibiotics inhibit DNA synthesis?

A

Fluoroquinolones

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5
Q

What antibiotics inhibit folate?

A

Sulfonamides

Trimethoprim

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6
Q

What do the beta lactam meds have in common?

A

Beta lactam ring

Even a monobactam has this beta lactam ring

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7
Q

About how many people will retain a PCN allergy into adulthood?

A

10%

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8
Q

What is the narrowest beta lactam?

A

Natural PCN

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9
Q

What is natural PCN used for?

A

Strep pharyngitis/Endocarditis

Syphilis

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10
Q

Pen G is what formulation?

A

IV/IM

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11
Q

Pen V is what formulation?

A

PO

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12
Q

Natural PCN can also be used for dental surgery prophylaxis?

A

Because it does cover some oral anaerobes (Peptostreptococcus and Clostridia tentani)

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13
Q

What bugs does Natural PCN cover?

A

Gram pos - strep pyogenes, strep agalactiae, listeria monocytogenes (CNS infections)

Gram neg - Neisseria meningitidis (not often used), Pasteurella multocida (animal bites)

Anaerobes - Peptostreptococcus (mouth flora), Clostridia tetani

Spirochetes - Treponema pallidum (Syphilis)

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14
Q

PCN half life

A

~ 30min

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15
Q

What can help to increase PCN concentrations/effects?

A

Adding Probenecid (antigout med)

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16
Q

What is the long-acting PCN? How long does it last?

A

Benzathine PCN

Effects can be seen up to 1 month

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17
Q

What are some ADRs to natural PCN?

A

Hypersensitivity, AKI

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18
Q

What are some anti-staph PCN?

A

Nafcillin (IV)
Oxacillin (IV)
Dicloxacillin (PO)

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19
Q

What coverage does anti-staph PCNs cover?

A

strep + syphilis + staph

*Does NOT cover MRSA (but it does cover staph aureus)

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20
Q

If a bug is resistent to Nafcillin and Oxacillin, what does that mean?

A

MRSA

Because methycillin was an old version of these drugs

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21
Q

What are anti-staph PCN used for?

A

SSTI, endocarditis

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22
Q

What drugs are aminopenicillins?

A

Ampicillin

Amoxicillin

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23
Q

What do aminopenicillins cover?

A

Gram pos - Staph, strep, listeria, enterococcus

Gram neg - shigella, E coli (most common), H. flu, proteus mirabilis, pasteurella multocida

24
Q

What diseases are aminopenicillins used for?

A

URIs (even pneumonia, if it’s caused by H flu), otitis media
Enterococcus
Dental prophylaxis

25
Q

ADR for aminopenicilins?

A

Maculopapular rash (from mono)

26
Q

How can we increase our coverage for aminopenicillins?

A

Add a beta lactamase inhibitor

27
Q

Beta lactams combined with beta lactamase inhibitors make what?

A

Amoxicillina/Clavulanate (Augmentin)

Ampicillin/Sulbactram (Unasyn)

Piperacillin/Tazobactam (Zosyn)

28
Q

Dose administration used by Augmentin, Unasyn, Zosyn?

A

Augmentin - PO
Unasyn - IV
Zosyn - IV

29
Q

What do beta lactam/beta lactamase inhibitors cover?

A

Broad spectrum gram pos/neg

Anaerobes

30
Q

In addition to other beta lactam/beta lactamase inhibitors, what does Zosyn also cover?

A

Pseudomonas aeruginosa

31
Q

What are beta lactam/beta lactamase inhibitors used for?

A

Intra-abdominal infections, pneumonia, mixed infections, bite wounds, gynecologic infections, DM foot infections

32
Q

Unasyn is basically the IV version of what?

A

Augmentin

33
Q

What do beta lactamase inhibitors do?

A

Prevent the beta lactam ring from being broken down by bacteria

They don’t do anything in terms of killing the bacteria, but allows coverage expansion

34
Q

PCN ADRs

A 
Hypersensitiviy
GI - N/V/D
Thrombocytopenia/neutropenia (rare)
Nephrotoxicity/Hepatotoxicity
Electrolyte abnormalities (because PCN has Na/K salt)
35
Q

PCNs are eliminated how?

A

renally eliminated

36
Q

T or F: if someone has a PCN allergy, you should never use PCN to treat them.

A

F - if absolutely needed, you can desensitize the pt to PCN

37
Q

Cross sensitivity risk of PCN with other beta lactams?

A

Studies show as high as 11%, but really it’s probably 3-5%

38
Q

What are first generation cephalosporins?

A

Cephalexin (Keflex)
Cefazolin (Ancef)
Cefadroxil (Duricef)

39
Q

What are some second generation cephalosporins?

A

Cefoxitin (Mefoxin)
Cefuroxime (Zinacef)
Cefotetran (Cefotan)

40
Q

What are 3rd generation cephalosporins?

A

Cefotaxime (Claforan)
Ceftazidime (Fortaz)
Cefdinir (Omnicef)
Ceftriaxone (Rocephin)

41
Q

What are fourth generation cephalosporins?

A

Cefepime (Maxipime)

42
Q

5th generation Cephalosporins?

A

Ceftaroline (Teflaro)

43
Q

As you increase your cephalosporin generation, what happens?

A

You gain more gram neg coverage

44
Q

What does Cefepime (Maxipime) (4th gen cephalosporin) also cover?

A

Pseudomonas

45
Q

What does Ceftaroline (Teflaro) additionally cover?

A

MRSA

46
Q

Are cephalosporins bactericidal or bacteriostatic?

A

Bactericidal

47
Q

Which cephalosporin has the broadest coverage?

A

Cefepime (4th gen)

48
Q

Cefazolin (Ancef) is basically the IV version of what?

A

Cephalexin (Keflex)

49
Q

Which generation of cephalosporins has the highest risk of cross-sensitivity in PCN allergies?

A

1st gen

50
Q

What are 1st gen cephalosporins mostly used for?

A

SSTIs, UTIs, surgical prophylaxis

51
Q

Which 1st gen cephalosporin will be seen a lot for surgical prophylaxis?

A

Cefazolin

52
Q

What do second gen cephalosporins cover?

A

H flu, Neisseria, Moraxella, E coli, Kelbsiella, proteus

53
Q

What are second gen cephalosporins used for?

A

otitis media, URIs, PNA

Bowel surgery prophylaxis

54
Q

Which second gen cephalosporins have anaerobic activity?

A

Cefoxitin (Mefoxin)

Cefotetan (Cefotan)

55
Q

What do 1st gen cephalosporins cover?

A

Gram pos - staph and strep

Gram neg - E coli, Klebsiella, proteus

56
Q

What do 3rd gen cephalosporins cover?

A

Increased gram neg coverage, but decreased gram pos coverage

Covers strep well, but we may loose a little bit of staph coverage

57
Q

What 3rd gen cephalosporins cover pseudomas?

A

Ceftazidime (Fortaz)

Pharmacology (6 decks)

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