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Pharmacology > Antibiotics Part 1 > Flashcards

Antibiotics Part 1 Flashcards

1
Q

Drugs that weaken the bacterial cell wall? Are they bactericidal?

A

Penicillin, Cephalosporins, Carbapenems, Vancomycin

-Yes they cause lysis

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2
Q

Prototype for Penicillin

A

Penicillin G (-cillin) Least toxic of all penicillins

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3
Q

Penicillin MOA

A

Inhibition of bacterial cell wall

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4
Q

Penicillin #1 Adverse effect to look for!

A
  • Cause of most allergies
  • cross-sensitivity w/ cephalosporins
  • Immediate: 2-30 mins
  • Accelerated 1-72 hours
  • Late: days to weeks
  • Mild - Anaphlyaxis
  • No direct relationship btwn dose and size of allergic repsonse
  • must have 2nd exposure for allergic response
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5
Q

Other Penicillin Adverse Effects

A
  • Pain at injection site
  • sensory/ nerve dysfunciton
  • risk of hyperkalemia w/ potassium PCN- G
  • Neurotoxicity
  • gangrene/ necrosis w/ intra-arterial
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6
Q

Route of Penicillin

A

IV or IM

-some are repository form

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7
Q

Penicillin Interactions

A
  • Cross sensitivity with cephalosorins

- avoid using cephalosporins if pt has severe allergic rxn

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8
Q

How to treat a penicillin allergy?

A
  • Give epi, repository measures, n/v/d

- Skin tests for PCN

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9
Q

What is desensitization process?

A
  • When a patient needs PCN but are highly allergic
  • must be administered in ICU setting for risk of anaphylaxis
  • Given PCN in small doses every 60 mins until they reach full dose
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10
Q

What are beta-lactamases

A
  • combo of PCN + beta-lactam inhibitor
  • Amoxicillin + clavulanate
  • the inhibitor prevents the break down of the beta lactam ring and inhibition of PCN
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11
Q

Beta-lactamases MOA

A
  • Cell wall inhibitors
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12
Q

How long are beta lactamases administered for?

A

-Needs to be infused over 30 min or longer to extend MIC

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13
Q

What about adverse effects with beta-lactamases?

A
  • caused by penicillin aspect of combo
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14
Q

What are Cephalosporins and MOA?

A
  • Most widely used abx
  • low toxicity
  • They weaken the cell wall
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15
Q

Cephalosporin Route?

A

IV or IM

-some are oral

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16
Q

What are generations (1-5)?

A
  • Increase in activity from 1-5 against gram negative and anaerobes
  • Increase resistance to destruction from beta-lactamases and to reach CSF from 1-5
17
Q

Cephalosporin Adverse Effects

A
  • Allergy: cross-sensitivity to PCN
  • Rash most common (occurs several days after start of therapy)
  • GI distress: N/V/D, abdominal cramps
  • Anorexia
  • IM injections painful
18
Q

Cephalosporin Interactions

A
  • Cefotetan & Ceftriaxone have increased bleeding risk
  • Cefotetan& cefazolan have dilsufram effect w/ alcohol
  • Ceftriaxone: don’t mix w/ lactated ringers and is elminated by liver
19
Q

Carbapenems Prototype

A

Imipenum/Cilastin (Primaxin)

-combo prevents destruction of impipenum by renal enzymes

20
Q

Carbapenems MOA

A

Cell Wall inhibitor

21
Q

Carbapenem Adverse effects

A
  • GI distress

- Allergy

22
Q

Carbapenem Interaction

A
  • Valproate acid (seizure med)

- reduces level of this drug

23
Q

Vancomycin MOA

A

Cell Wall Synthesis inhibitor

  • Kills gram + only
  • MRSA, C-Diff, serious infections
24
Q

What is the drug of choice for MRSA?

A

Oral Vancomycin

25
Q

Adverse Effects Vancomycin

A
  • Potentially toxic
  • Renal toxicity
  • Ototoxicity (reversible)
  • Red man syndrome
  • Thrombophlebitis (tough on veins)
26
Q

What does red man syndrome look like?

A

flushing, rash, pruritis, tachycardia, hypotension

27
Q

Do not take vancomycin with which kind of drugs?

A

nephrotoxic drugs

28
Q

What labs to look for in vancomycin patients?

A
  • Monitor BUN, Creatinine, GFR
29
Q

What are considerations for vancomycin?

A
  • Renal dosing w/ decrease renal dysfunction
  • monitor tough levels ( trough 15-20 mcg/ml)
  • monitor for hearing loss usually in prolonged treatment
  • Careful w/ IV admin infuse slowly over at least 60 mins!!!
30
Q

For prolonged treatment consider?

A

Central line!

Pharmacology (14 decks)

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