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NURS 251 (Pharmacology 1) > Antibiotics Part 1 > Flashcards

Antibiotics Part 1 Flashcards

1
Q

What are the two types of bacteria

A

Gram negative and Gram positive

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2
Q

What is the difference between gram positive and gram negative bacteria

A

Gram-negative bacterium has a thin peptidoglycan layer and outer membrane
Gram-positive bacterium has a thick layer of peptidoglycan

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3
Q

What is a community-acquired infection?

A

An infection that is acquired by a person who has not been hospitalized or had a medical procedure within the past year

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4
Q

What are health care associated infections

A

Infections contracted in a health care facility that they didn’t have before admission

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5
Q

What are the 2 most common health care associated infections

A

MRSA
VRE

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6
Q

What are 3 ways to prevent healthcare associated infections and briefly describe each

A

Handwashing
Antiseptic
Disinfectants

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7
Q

What is the difference between bactericidal and bacteriostatic

A

Bactericidal kills bacteria (disinfectant)
Bacteriostatic prevents growth and eventually leads to death (antiseptic)

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8
Q

What is antibiotic empiric therapy

A

Treatment of an infection before a specific culture has been obtained

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9
Q

What is antibiotic definitive therapy

A

Antibiotic therapy tailored to a specific organism identified with a culture

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10
Q

What is antibiotic prophylactic therapy

A

Treatments with antibiotics to prevent an infection

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11
Q

What host factors influence antibiotic therapy

A

Age
Allergy
Kidney and liver function
Pregnancy status
Genetics
Site of infection
Host defences
G6PD deficiency and slow acetylation

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12
Q

What are the 8 classes of antibiotics

A

Sulfonamides
Penicillin
Cephalosporins
Carbapenems
Macrolides
Quinolones
Aminoglycosides
Tetracyclines

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13
Q

What is the general MOA of for all antibiotics

A

Interference with cell wall and protein synthesis
Interference with DNA replication
Acting as a metabolite to disrupt critical metabolic reactions inside the bacterial cell

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14
Q

Name 1 sulfonamide antibiotic

A

Sulfamethoxazole with Trimethoprim (septra) or SMX-TMP

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15
Q

What is the MOA of SMX-TMP

A

Prevents synthesis of folic acid required for synthesis of purines and nucleic acid
Does not affect human cells or certain types of bacteria, only organisms that synthesize their own folic acid

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16
Q

Are sulfonamides bacteriostatic or bacteriocidal

A

Bacteriostatic

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17
Q

What are the indications for sulfonamides

A

Gram positive and negative bacteria
UTIs
Upper respiratory tract infections
Staph infections due to high rate of MRSA in community

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18
Q

What are the contraindications of sulfonamides

A

Allergy
Pregnant
Infants under 2 months old

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19
Q

What are the interactions of sulfonamides

A

Sulfonylureas causes hypoglycemic effects
Phenytoin toxicity
Warfarin causes increased bleeding
Cyclosporine causes nephrotoxicity

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20
Q

What are the adverse effects of sulfonamides

A

Hemolytic and aplastic anemia
Agranulocytosis
Thrombocytopenia
Photosensitivity
Dermatitis
Pancreatitis
Crystalluria
Convulsions
Steven’s-Johnson syndrome

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21
Q

What is super important for patients to do when taking sulfonamides

A

Take with plenty of fluids and food to avoid crystalluria or precipitation in kidneys

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22
Q

What are the 4 types of B-Lactam Antibiotics

A

Penicillin
Cephalosporins
Carbapenems
Monobactams

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23
Q

What are the 4 types of penicillins

A

Natural penicillin’s
Penicillinase-resistant penicillin’s
Aminopenicillins
Extended-spectrum penicillin’s

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24
Q

Name 2 natural penicllins

A

Penicillin G
Penicillin V

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25
Q

Name 1 penicillinase-resistant drug

A

Cloxacillin sodium

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26
Q

Name 2 aminopenicillins

A

Amoxicillin
Ampicillin

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27
Q

What is the purpose of B-lactamase inhibitors and name 2

A

Antibiotics given with penicillin to prevent rapid breakdown of penicillin
Clavulanic acid
Tazobactam

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28
Q

Name 1 extended spectrum penicillin drug

A

Piperacillin sodium/tazobactam sodium (tazocin)

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29
Q

What is the MOA of penicillins

A

Enter the bacteria through the cell wall
Once inside they bind to penicillin-binding protein
Inhibit cell wall synthesis resulting in lysis of the cell
Does not affect other cells in the body

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30
Q

Are penicillin’s bactericidal or bacteriostatic

A

Bacteriocidal

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31
Q

What are the indications for penicllin

A

Prevent and treat infections from gram positive bacteria (strep, enterococcus, staph)

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32
Q

What are the contraindications for penicillins

A

Allergy
Not all names end in -cillin so med errors occur giving them to a patient with a penicillin allergy

33
Q

What are the adverse effects of penicillin

A

Allergic reactions (urticaria, pruritus, angioedema)
Diarrhea
Abdominal pain

34
Q

What are some interactions with penicillins

A

NSAIDs compete for protein binding (increase effect)
Oral contraceptives (decrease effect)
Potassium supplements (Hyperkalemia)
Probenecid (prolongs penicillin)
Rifampin (inhibit killing action)
Warfarin (longer bleeding)
Caffeine, citrus fruit/juice, tomato juice, Colas

35
Q

How many generations of cephalosporin drugs are there?

A

5 generations

36
Q

T/F: The 3rd generation is not available in Canada

A

False: The 5th generation is not available in Canada

37
Q

Are cephalosporins bactericidal or bacteriostatic?

A

Bactericidal

38
Q

What bacteria do first generation cephalosporins affect and what forms do they come in

A

Good gram positive coverage
Poor gram negative coverage
Parenteral and Oral forms

39
Q

Name 2 first generation cephalosporins, their forms and their indications

A

Cefazolin (IV or IM)
Cephalexin (oral)
Used for surgical prophylaxis and staph infections

40
Q

What bacteria do second generation cephalosporins affect

A

Good gram positive coverage
Medium gram negative coverage

41
Q

Name 2 second generations cephalosporins

A

Cefoxitin
Cefuroxime

42
Q

When is cefoxitin used and why

A

Used IV or IM prophylactically for abdominal or colorectal surgeries

43
Q

When is cefuroxime used and why?

A

Oral form used for surgical prophylaxis

44
Q

What is the difference between cefuroxime and cefoxitin

A

Cefuroxime does not kill anaerobes while cefoxitin does

45
Q

What bacteria do 3rd generation cephalosporins affect

A

Less active against gram positive
Most potent group against gram negative

46
Q

Name 2 third generations cephalosporins

A

Ceftazidime
Ceftriaxone

47
Q

What does ceftriaxone treat

A

Treats CNS infections because it easily passes meninges to enter the CSF

48
Q

What is the dosing for Ceftriaxone

A

Once a day IV/IM dose

49
Q

What is Ceftazidime used for

A

Used IV or IM for difficult to treat organisms such as pseudomonas spp.
Excellent coverage of gram negative bacteria

50
Q

What is a downfall of ceftazidime

A

Resistance is increasing, reducing its usefulness

51
Q

What bacteria does 4th generation cephalosporins treat

A

Broad spectrum of bacteria, especially gram positive bacteria

52
Q

What are the indications for 4th generation cephalosporins and name one

A

Treatment of UTIs
Cefepime HCL

53
Q

What are the adverse effects of cephalosporins

A

Mild diarrhea
Abdominal cramps
Rash
Pruritus
Redness
Edema

54
Q

What drug class has the broadest antibacterial action of any antibiotics to date?

A

Carbapanems

55
Q

What are the indications for carbapanems

A

Reserved for complicated body cavity and connective tissue infections in acutely ill patients

56
Q

Why should carbapenems be infused over 60 minutes

A

Because it may cause drug induced seizures

57
Q

Name a carbapenem antibiotic and what is the purpose?

A

Imipenem/cilastatin
Cilastatin inhibits the break down of imipenem so it can work better

58
Q

Name 3 macrolides

A

Erythromycin
Azithromycin
Clarithromycin

59
Q

What is the MOA of macrolides

A

Prevents protein synthesis within bacterial cells

60
Q

Are macrolides bacteriostatic or bactericidal

A

Bacteriostatic but with higher concentrations it may also be bactericidal

61
Q

What are the indications of macrolides

A

Strep infections
Mild to moderate upper and lower respiratory tract infections
Spirochetal infections (Syphilis and Lyme disease)
Gonorrhea/chlamydia
Mycoplasma

62
Q

What are the adverse effects of macrolides

A

Diarrhea
Hepatoxicity
Flatulence
Jaundice
Anorexia
Heartburn
Abnormal taste

63
Q

What is the difference in using erythromycin vs azithromycin or clarithromycin

A

Azithromycin and clarithromycin have fewer GI adverse effects, longer duration of action, better efficacy and better tissue penetration

64
Q

Name 2 tetracyclines

A

Doxycycline hyclate
Tigecycline

65
Q

Are tetracyclines bactericidal or bacteriostatic

A

Bacteriostatic

66
Q

What is the MOA of tetracyclines

A

Inhibiting protein synthesis and stops many other essential functions of the bacteria

67
Q

What ions do tetracyclines bind to and what does it form

A

Calcium, Magnesium and Aluminum to form insoluble complexes

68
Q

What can reduce the oral absorption of tetracyclines

A

Dairy products
antacids
iron salts

68
Q

T/F: tetracyclines can be used in kids younger than 8 or pregnancy

A

False: It should not be used because tooth discoloration will occur if the drug binds to the calcium in the teeth

69
Q

What are the adverse effects of tetracyclines

A

Teeth discoloration
Stunted fetal growth if taken during pregnancy
Vaginal candidiasis
Enterocolitis
Maculopapular rash

69
Q

What are the indications of tetracyclines

A

Wide spectrum
Gram positive and negative
Mycoplasma
Rickettsia
Chlamydia
Syphilis
Lyme disease
Acne

70
Q

Can a patient stop taking antibiotics as soon as they stop feeling better?

A

No, they should take it as prescribed for the length of time prescribed

71
Q

What are the signs and symptoms of superinfection

A

Fever, perineal itching, cough, lethargy, unusual discharge

72
Q

How much water is recommended to drink with antibiotics and why

A

At least 180ml because it’s better absorbed

73
Q

What are some considerations for sulfonamides

A

Take 2L - 3L of fluid every 24 hours

74
Q

What are some considerations for penicillins

A

Take oral doses with water not juice because acidic fluids may nullify the drug
Monitor patients for at least 30 minutes after admin because of an allergic reaction

75
Q

What is disulfiram and how is it related to cephalosporins

A

Disulfiram is acute alcohol intolerance
If cephalosporins are taken with alcohol it can cause a disulfiram reaction

76
Q

What are some considerations for tetracyclines?

A

Avoid milk products, iron salts and antacids to prevent chelation and drug binding
Take with at least 180 mL or water
Avoid sunlight and tanning beds to prevent photosensitivity

NURS 251 (Pharmacology 1) (20 decks)

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