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Pharmacology > Antibiotics/Antivirals/Antifungals > Flashcards

Antibiotics/Antivirals/Antifungals Flashcards

0
Q

B-Lactams (class)

A

Inhibit cell wall synthesis
BACTERICIDAL
Synergist with aminoglycosides

Ex. Penicillins, cephalosporins, carbapenems, monobactams

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1
Q

Categories of Antibiotics (5)

A

B-Lactams (inhibit cell wall synthesis) BACTERICIDAL

Aminoglycosides (Inhibit RNA translation/destabilize cell wall) BACTERICIDAL

Tertracyclines (Inhibit RNA attachment to acceptor site) BACTERIOSTATIC

Macrolides (Dissociation of RNA from ribosome during elongation) BACTERIOSTATIC

Quinolones (Inhibit DNA synthesis)
BACTERICIDAL

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2
Q

Penicillins (B-Lactam)

A

End in “cillin”
Commonly used against P. aeruginosa, enterobacteriaceae, S. aureus

Hypersensitivity most common side effect

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3
Q

Cephalosporins (B-Lactam)

A

First generation- gram positive
Second generation- gram positive and some negative
Third generation- most gram negative
Fourth generation- extended negative and positive coverage (clinical)
NO ALCOHOL

Ex. Cefotetan, cefoperazone

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4
Q

Carbapenems (B-Lactam)

A

Broad spectrum antibiotic for gram negative and positive AND anaerobic bacterias like P. aeruginosa, MRSA, community and nosocomial pneumonias

Can cause seizures in patients with renal dysfunction

Ex. Imipenem-cilastatin (Primaxin), Meropenem, Entrapenem, Doripenem)

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5
Q 
Monobactams (L-Bactam)
aka Aztreonam (aerosolized)
A

Gram negative aerobic bacilli like Enterobacteriacae and P. aeruginosa
Rare rash as side effect

Aerosolized to treat pulmonary infections in CF, improves symptoms in CF patients with colonized P. aeruginosa, NOT indicated for children under 7.

2ml(75mg) vial mixed with 1mL sterile diluent
Pretreat w/ bronchodilator, TID 28days on/off, refrigerate
Side effects include bronchospasm and decrease in FEV1

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6
Q

Aminoglycosides (class)

A

BACTERICIDAL
Inhibit RNA translation, cell wall destabilization
Used clinically for gram negative nosocomial infections like Vent. associated pneumonia

Ototoxicity, nephrotoxicity

Ex. Gentamicin, Tobramycin (aerosolized), Netilmicin, amikacin

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7
Q

Tobramycin (aerosolized aminoglycoside)

A

Pulmonary infections in CF, to treat or prevent colonization with P. aeruginosa and to maintain current lung function or reduce rate of deterioration.

Dose; 300mgBID, 28days on/off
Administered with PARI LC Plus

(IV route) Ototoxicity, nephrotoxicity, NM blockade
Tinnitus and voice alteration (SVN)

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8
Q

Tetracyclines (class)

A

BACTERIOSTATIC
Inhibit attachment of RNA to acceptor site

Broad spectrum gram positive and negative
Used against rickettsiae, chlamydiae, mycoplasmas, spirochetes, PROTOZOA (first line), mycobacteria.

Contraindicated in pregnancy and breastfeeding mothers, and children under 8. Rare nausea, vomiting, diarrhea.

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9
Q

Tigecycline (Tetracycline)

A

BACTERIOSTATIC
Inhibits protein synthesis, even against tetracycline resistant organisms, bactericidal against S. pneumoniae

Used for complicated skin and intraabdominal infections

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10
Q

Macrolides (class)

A

BACTERIOSTATIC
Induce dissociation of RNA from ribosome during elongation
Clinical uses include rickettsiae, chlamydia (in pregnant women), mycoplasmas, LEGIONELLA

May increase concentration of drugs like Theophylline, Warfarin, Triazolam

Ex. Erythromycin, clarithromycin, azithromycin

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11
Q

Telithromycin (Macrolide)

A

Inhibits bacterial protein synthesis
Used for sinusitis and community acquired pneumonia

Adverse rxns; nausea, diarrhea, visual disturbances, prolonged Q-T interval

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12
Q

Quinolones (class)

aka Fluoroquinolones

A

BACTERICIDAL
Inhibit DNA synthesis
Used for upper/lower respiratory infections, GI infections, skin infections
Side effects, one of the safest, maybe GI issues, prolonged Q-T

Ex. Levofloxacin, Moxifloxacin (-xacin)…

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13
Q

TMP-SMX (specific)

A

BACTERIOSTATIC
blocks enzymes needed by bacteria
First-line drug for PCP

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14
Q

Clindamycin (specific)

A

BACTERIOSTATIC
Inhibits protein synthesis
Used against gram positive and anaerobic bacteria, MRSA

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15
Q

Metronidazole (specific)

A

BACTERICIDAL
Unknown mechanism
Used for anaerobic infections (C. difficile)
side effects include metallic taste, vomiting, peripheral neuropathy (long-term)

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16
Q

Vancomycin (specific)

A

Prevents formation of cell wall
BACTERICIDAL against gram positive
BACTERIOSTATIC against enterococci
Used against MRSA, oral for C. difficile
Side effects include ototoxicity, nephrotoxicity

17
Q

Quinupristin and Dalfopristin (specific)

A

Usually last treatment option because of side-effects
Inhibit protein synthesis
BACTERICIDAL against MRSA
BACTERIOSTATIC against VREF

18
Q

Linezolid (specific)

A

Prevents RNA translation

Used against VREF (last choice for treatment)

19
Q

Antimycobacterials

A

Used against mycobacterium tuberculosis (TB)
multiple antibiotic regiments for 6-12 months

4 drugs used in combination and a fifth added if need

First 4; Isonazid, Rifampin and Rifabutin, Pyrazinamide (first three BACTERICIDAL), Ethambutal (BACTERIOSTATIC)

20
Q

Isoniazid (antimycobacterial, TB)

A

Inhibits cell wall synthesis, BACTERICIDAL

Hepatotoxicity, neurotoxicity

21
Q

Rifampin and Rifabutin (antimycobaterial, TB)

A

Inhibit ENA polymerase, BACTERICIDAL

Hepatotoxicity, Fever, chills, nausea, vomiting

22
Q

Pyrazinamide (antimycobacterial, TB)

A

Unknown mechanism, BACTERICIDAL

Hapatotoxicity, nausea vomiting

23
Q

Ethambutol (antimycobacterial, TB)

A

BACTERIOSTATIC, decreases cell wall polysaccharides

Optic-neuropathy side effect

24
Q

Streptomycin (antimycobacterial, TB)

A

Added fifth drug if needed, similar to aminoglycosides

Nephrotoxicity, ototoxicity

25
Q

Antifungal Agents

A

Polyenes, Azoles, Echinocandins, “OTHER”

26
Q

Polyenes (amphotericin B and nystatin) (antifungal)

A

Fungicidal
Used against Aspergillosis (can digest lung tissue)
Severe adverse reactions may include flushing, fever, chills, renal impairment
Least safe of antifungals

27
Q

Azoles (antifungal)

A

Fungistatic against Candidiasis

Safest of the antifungals

28
Q

Echinocandins

A

Fungicidal or fungistatic depending on isolate
Used against Candida and Aspergillus
Reactions include fever, rash, flushing, thrombophlebitis
2nd safest antifungal
1st choice in patients with kidney dysfunction

29
Q

Flucytosine (“other” antifungal)

A

Inhibits fungal RNA formation
Fungistatic against Candida, Cryptococcus (only drug for treating this), Aspergillus
Adverse rxns, bone marrow supression

30
Q

Griseofluvin and Terbinafine (“other” antifungal)

A

Used for fungal infections of skin, hair, nails

31
Q

Antiviral agents

A

Acyclovir (HSV, HZV, VZV) and Valacyclovir

Gangciclovir (CMV) and Valganciclovir

Oseltamivir

32
Q

Acyclovir and Valacyclovir (Antiviral)

A

Terminate viral replication

Used for HSV, EBV, Cytomegalovirus (CMV), VZV

33
Q

Ganciclovir and valgangciclovir (antiviral)

A

Terminates viral DNA synthesis/replication
Used for HSV, VZV, CMV
Bone marrow supression

34
Q

Oseltamivir (antiviral)

A

Inhibits Influenza A and B, prevents virus from leaving host cell
Used to treat Influenza A and B
Nausea and vomiting may occur in first days of therapy.

35
Q

Aerosolized Antiinfective agents

A

Pentamidine, Ribavirin, Tobramycin, Aztreonam, Zanamivir

36
Q

Pentamidine (antiinfective)

A

Prevention of PCP and immunodeficient patients
Second line treatment for patients who could not tolerate oral TMP-SMX (1st line)
Brand name NebuPent, given 300mg inhalation once every 4 weeks, reconstituted in 6ml sterile water NOT SALINE.
Administered only with Respirgard II (5-7 L/min, 1-2MMAD)
Blocks RNA and DNA synthesis, inhibits oxidative phosphorylation

37
Q

Ribavirin (antiinfective)

A

Treatment of infants with severe lower respiratory tract infection caused by respiratory syncytial virus (RSV)
NOT recommended for routine RSV infection
20mg/mL delivered 12-18hrs/day for 3-7 days only with a SPAG-2 (1.3MMAD)

38
Q

Tobramycin (antiinfective)

A

Management of chronic P. aeruginosa in CF
300mgBID, 28days on/off
Given with PARI LC Plus

39
Q

Aztreonam (antiinfective)

A

Used for pulmonary infections in CF patients to improve symptoms in P. aeruginosa. Delivered with Altera Nebulizer system
TID for 28 days off/on

40
Q

Zanamivir (antiinfective)

A

Treatment of uncomplicated influenza in adults/children over 5.
Off label treatment of H1N1 influenza A

DPI (Diskhaler) 2 blisters, 2x’s a day for 5 days.

Pharmacology (14 decks)

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