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Pharmacology > Antibiotics, Antimicrobials, Anti-fungals, Anti-virals > Flashcards

Antibiotics, Antimicrobials, Anti-fungals, Anti-virals Flashcards

1
Q

Sulfonamides MOA

A

Inhibit synthesis of tetrahydrofolic acid

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2
Q

Sulfonamide: bacteriostatic or bactericidal

A

bacteriostatic

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3
Q

Sulfonamides meds

A

Sulfamethoxazole
Trimethoprim

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4
Q

Sulfonamides uses

A

UTIs - E.coli
GI infections
Pneumonia - Pneumocystis carinii
MRSA

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5
Q

Sulfonamides side effects

A

Hypersensitivity reactions
- Photosensitivity
- Stevens-Johnson syndrome
Hematologic: thrombocytopenia
Renal damage
Allergies: itching/rash

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6
Q

Sulfonamides Pertinent Teachings

A
  • Can intensify effects from warfarin and dilantin
  • decrease sun exposure/wear sunblock
  • increase water to prevent kidney damage
  • monitor BS in DM patients
  • Do not give to pregnant/nursing women or infants <2 months
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7
Q

Metronidazole MOA

A

inhibits bacterial DNA gyrase

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8
Q

Metronidazole Uses

A

CDI, H.Pylori, Trichomoniasis, Gardnerella vaginalis, CNS/bone/skin/soft tissue infections

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9
Q

Metronidazole Side Effects

A

Neurotoxicity, hepatotoxicity, metallic taste, urine discoloration

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10
Q

Metronidazole Pertinent Teachings

A

Avoid alcohol - Disulfiram like reactions

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11
Q

Fluoroquinolones MOA

A

Inhibits synthesis of DNA/RNA

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12
Q

Fluoroquinolones meds

A

ciprofloxacin, levofloxacin

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13
Q

Fluoroquinolones Uses

A

Respiratory tract infections, GI infections, UTI, Bone/skin/joint/soft tissue infections

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14
Q

Fluoroquinolones Side Effects

A

Tendon rupture, muscle weakness, photosensitivity, GI (n/v/d), headaches/dizziness, risk of CDI

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15
Q

Fluoroquinolones Pertinent Teachings

A
  • Contraindication to myasthenia gravis
  • Risk: elderly, transplants, glucocorticoids
  • Avoid milk + antacids + cationic compounds
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16
Q

Aminoglycosides MOA

A

Inhibit protein synthesis

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17
Q

Aminoglycosides: bactericidal or bacteriostatic?

A

Bactericidal

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18
Q

Aminoglycosides Use

A

Serious Gram (-) only: - enterobacteriaceae, P. aeruginosa
- VRE (+PCN)
- GI, urinary, respiratory, bone, skin infections

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19
Q

Aminoglycosides meds

A

Gentamicin

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20
Q

Aminoglycosides Side Effects

A

Ototoxicity, nephrotoxicity

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21
Q

Aminoglycosides Pertinent Teachings

A
  • Never mix with PCN in same IV
  • Monitor peaks and troughs
  • Daily IV preferred - decrease ototoxicity
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22
Q

Clindamycin MOA

A

Inhibits protein synthesis

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23
Q

Clindamycin class

A

Lincosomide

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24
Q

Clindamycin Use

A

Alternative to PCN, only anaerobic infections outside of CNS, MRSA

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25
Q

Clindamycin Side Effects

A

Can cause CDAD
Allergies: hypersensitivity, rash

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26
Q

Clindamycin Pertinent Teachings

A

Monitor liver function, educate on CDAD

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27
Q

Oxizolidinones MOA

A

Inhibits protein synthesis

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28
Q

Oxizolidinones bacteriostatic or bactericidal?

A

bacteriostatic

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29
Q

Linezolid Use

A

MRSA, VRE, healthcare/community associated pneumonia, skin infections

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30
Q

Linezolid Side Effects

A

diarrhea, nausea, headaches, myelosuppression

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31
Q

Linezolid Pertinent Teachings

A

Monitor blood count
Don’t take with tyramine, SSRIs, MAO inhibitors

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32
Q

Macrolides: bacteriostatic or bactericidal

A

bacteriostatic

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33
Q

Macrolides MOA

A

inhibit protein synthesis

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34
Q

Macrolides meds

A

Erythromycin
Azithromycin
Clarithromycin

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35
Q

Macrolides Uses

A

Respiratory tract infections
- pneumonia, sinus
skin infections
- chlamydia, ear
Alternative to PCN

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36
Q

Macrolides side effects

A

GI distress, QT prolongation, hepatotoxicity

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37
Q

Macrolides Pertinent Teachings

A
  • Avoid antacids + antidysrhythmic drugs
  • Administer w/food to avoid GI
  • Can increase half-lives of drugs
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38
Q

Tetracycline bacteriostatic or bactericidal?

A

bacteriostatic

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39
Q

Tetracycline meds

A

doxycyline, minocyline

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40
Q

Tetracycline MOA

A

inhibits protein synthesis

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41
Q

Tetracycline Uses

A

Chlamydia, rickettsia, H.pylori, Lyme disease, peridontal disease, acne, MRSA

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42
Q

Tetracycline side effects

A

Teeth discoloration, suppress bone growth, GI distress, superinfection (CDI), photosensitivity, nephrotoxicity, hepatotoxicity

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43
Q

Tetracycline pertinent teachings

A
  • Teratogenic (<8y/o + moms)
  • Do not give with calcium or antacids
  • protect against sun
  • Do not give to pt. with renal disease
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44
Q

Vancomycin bacteriostatic or bactericidal?

A

bactericidal

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45
Q

Vancomycin MOA

A

Weakens bacterial wall

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46
Q

Vancomycin uses

A

reserve for SEVERE infections
CDI, MRSA, alternative to PCN

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47
Q

Vancomycin side effects

A

Ototoxicity
Nephrotoxicity
Red person syndrome
Thrombophlebitis

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48
Q

Vancomycin pertinent teachings

A
  • infuse slowly
  • narrow range of 10-20mcg/mL
  • monitor kidneys and liver
  • PO with food/refridgerate
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49
Q

Cephalosporins bacteriostatic or bactericidal?

A

bactericidal

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50
Q

Cephalosporins MOA

A

weakens bacterial cell wall

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51
Q

Cephalosporin generations

A

increase activity to (-) bacteria, resistance to beta-lactamases, and ability to reach CSF with each new generation

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52
Q

Cephalosporin uses

A

3rd gen: meningitis
5th gen: MRSA
other: skin, urinary, respiratory, etc.

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53
Q

Cephalosporin Side effects

A

CEF THE GIANT
- Gi
- increase glucose
- anaphylaxis/alcohol
- nephrotoxicity
- thrombocytopenia

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54
Q

Cephalosporin pertinent teachings

A
  • ceftriaxone contraindicated for neonates IV
  • caution with renal disease
  • cross sensitivity with PCN
  • avoid bleeding by rotating IV sites
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55
Q

Metronidazole bacteriostatic or bactericidal?

A

bactericidal

56
Q

Mild to moderate CDI preferred drug

A

metronidazole

57
Q

Severe CDI preferred drug

A

Vancomycin

58
Q

Which drugs can treat MRSA?

A

5th gen cephalosporin, vancomycin, tetracyclines, linezolid, sulfonamides, rifampin

59
Q

Which drugs can treat VRE?

A

Linezolid, combination of PCN and gentamicin

60
Q

Alternatives to PCN

A

vancomycin, clindamycin, macrolides

61
Q

PCN bacteriostatic or bactericidal?

A

bactericidal

62
Q

PCN MOA

A

weakens cell wall

63
Q

PCN categories

A

Narrow spectrum (sensitive) - PCN G/V
Narrow spectrum (resistant) - nafcillin
Broad spectrum - ampicillin/amoxicillin
Extended spectrum: piperacillin

64
Q

PCN side effects

A

GI distress, anaphylaxis, rash, itching, hives
Broad-spectrum: rash/diarrhea

65
Q

PCN pertinent teachings

A
  • Contraindicated for hx of severe allergy
  • possible cross-allergy
  • keep epi/resp support nearby
  • take oral PCN with water 1 hr before or 2 hr after meals
  • PO/IM
66
Q

PCN uses

A

skin, ear, urinary, STIs, pneumonia, meningitis infections

67
Q

Isoniazid MOA

A

inhibits synthesis of mycolic acid in cell wall

68
Q

Isoniazid Use

A

Active TB, LTBI, prophylaxis

69
Q

Isoniazid side effects

A

Peripheral neuropathy, hepatotoxicity, anemia, optic neuritis

70
Q

Isoniazid pertinent teachings

A
  • Contraindicated w/liver disease
  • Increase vitamin B6
71
Q

Rifampin MOA

A

destroys TB microbe DNA/RNA

72
Q

Rifampin Use

A

TB, leprosy, MRSA

73
Q

Rifampin side effects

A

Hepatotoxicity, red/orange body fluids, GI distress

74
Q

Rifampin pertinent teachings

A
  • decrease efficacy of oral contraceptives
  • increase metabolism
  • take on empty stomach
75
Q

Pyraminizide MOA

A

inhibits fatty acid synthesis/decreases growth of mycobacterium

76
Q

Pyraminizide Side effects

A

Hyperuricemia, Hepatotoxicity, GI distress

77
Q

Pyriminizide pertinent teachings

A
  • Test every 2 weeks or every month
  • Contraindicated for liver disease
78
Q

Ethambutol MOA

A

inhibits arabinosyltransferase, impairs cell wall

79
Q

Ethambutol side effects

A

optic neuritis, hyperuricemia, allergies (itching), NO hepatotoxicity

80
Q

Ethambutol pertinent teachings

A

Contraindicated w/optic neuritis

81
Q

Ethambutol use

A

TB and resistant TB

82
Q

Pyraminizide Use

A

TB

83
Q

Amphotericin B MOA

A

increases cell permeability

84
Q

Amphotericin B Use

A

most serious systemic mycoses and superficial fungal infections

85
Q

Amphotericin B side effects

A

hypomagnesemia, hypokalemia, infusion reactions (nausea, fever, chills, headaches), nephrotoxicity, highly toxic

86
Q

Amphotericin B pertinent teachings

A
  • IV only
  • rotate IV site
  • infuse slowly
  • treat infusion reactions with acetaminophen and diphenhydramine
  • monitor urine output and give 1000mL of normal saline the day of meds
87
Q

Itraconazole/Fluconazole MOA

A

inhibits fungal cytochrome

88
Q

Itraconazole/fluconazole Use

A

systemic mycosis, candidiasis, tinea, alt/ampho-b, superficial fungal infections

89
Q

Itraconazole/fluconazole side effects

A

GI distress, headaches, hepatotoxicity, cardio suppression (decreased HR)

90
Q

Itraconazole/fluconazole pertinent teachings

A

Contraindicated for pimozide, quinidine, dofetilide, cisapride
- cause dysrhythmias

91
Q

AZT/Zidovudine MOA

A

inhibits synthesis of DNA by causing premature termination of DNA strand growth

92
Q

AZT/Zidovudine Use

A

HIV/AIDS

93
Q

AZT/Zidovudine side effects

A

severe anemia, neutropenia, hepatomegaly, lactic acidosis

94
Q

AZT/Zidovudine pertinent teachings

A

monitor CBC and liver

95
Q

Lopinavir/ritonavir, fosamprenavir MOA

A

cleaves bonds in polyprotein and the virus remains immature and noninfectious

96
Q

Lopinavir/ritonavir, fosamprenavir type

A

protease inhibitors

97
Q

Lopinavir/ritonavir, fosamprenavir use

A

HIV/AIDS

98
Q

Lopinavir/ritonavir, fosamprenavir side effects

A

Hyperlipidemia, hyperglycemia, lipodystrophy, GI, prolongation of PR and QT intervals

99
Q

Lopinavir/ritonavir, fosamprenavir implications

A
  • Take at night on empty stomach
  • Increased risk for dysrhthmias
  • High fat meals can increase toxicity
100
Q

Fosamprenavir special implication

A

do not give to pt. with sulfonamide sensativity

101
Q

Efavirenz MOA

A

binds to active center of reverse transcripterase to cause direct inhibition

102
Q

Efavirenz type

A

NNRTIs

103
Q

Efavirenz use

A

HIV/AIDS

104
Q

Efavirenz side effects

A

Derm-rash, insomnia, depression, teratogenic

105
Q

Efavirenz implications

A
  • do not give to pregnant/trying
  • take at night on empty stomach
  • high fat meals can increase toxicity
106
Q

Raltegravir MOA

A

inhibits HIV from integrating with DNA

107
Q

Raltegravir type

A

INSTIs

108
Q

Raltegravir use

A

HIV and resistant HIV

109
Q

Raltegravir side effects

A

insomnia, headaches, hepatotoxicity, hypersensitivity, elevation in serum amylase + lipase

110
Q

Raltegravir implications

A
  • Take with or without food
  • get plasma HIV RNA level and CD4 T-cell count
111
Q

Acyclovir (Zovirax) MOA

A

inhibits viral replication by suppressing synthesis of DNA

112
Q

Acyclovir routes

A

Topical, PO, IV

113
Q

Acyclovir uses

A

HSV, VZV, Cytomegalovirus

114
Q

Acyclovir side effects

A

IV: phlebitis, reversible nephrotoxicity

PO: GI distress, vertigo

Topical: stinging

115
Q

Acyclovir implications

A
  • infuse slowly and drink extra fluids
  • monitor BUN/creatinine
116
Q

Valacyclovir (valtrex) routes

A

PO only

117
Q

Valacyclovir class

A

prodrug of acyclovir

118
Q

Valacyclovir side effects

A

Thrombocytopenia purpura/hemolytic uremic syndrome (TTP/HUS) in immunocompromised

119
Q

3 types of influenza vaccines

A

IIV, RIV, LAIV

120
Q

Flu vaccine side effects

A
  • Injection site pain/redness
  • fever 1-2 days
  • LAIV - runny nose or congestion
  • Guillain barre syndrome
121
Q

Flu vaccine implications

A
  • protection 1-2wks post
  • Febrile illness - defer vaccine
  • Don’t give LAIV to immunocompromised
  • 6 months + should be vaccinated
122
Q

Flu medications MOA

A

inhibit neuraminidase

123
Q

Flu Vaccine meds

A

Oseltamivir, rimantadine, zanamivir

124
Q

Oseltamivir use

A

flu A + B, prophylaxis

125
Q

Rimantadine use

A

Flu A

126
Q

Zanamivir use

A

Influenza, prophylaxis

127
Q

Oseltamivir side effects

A

GI distress, severe hypersensitivity, neuropsychiatric effects in young

128
Q

Rimantadine side effects

A

CNS - dizzy, nervous, insomnia

129
Q

Zanamivir side effects

A

cough, sore throat

130
Q

Oseltamivir implications

A
  • start no later than 2 days after symptoms start
  • take with food
131
Q

ALL flu drugs

A

should not be given at same time as LAIV

132
Q

Take around meals

A

PCN

133
Q

Take with food

A

Cephalosporins, vancomycin, Oseltamivir

134
Q

Take without food

A
  • TB drugs
  • Efavirenz
  • lopinavir/ritonavir, fosamprenavir
135
Q

Take w/food if in GI distress

A

tetracyclines, macrolides

136
Q

With or without food

A

raltegravir

Pharmacology (3 decks)

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