Antibiotics Part 2 Flashcards

1
Q

What is the Mechanism of Action for Tetracyclines?

A
  • Inhibit protein synthesis
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2
Q

Tetracycline examples

A

Democycline, Doxycycline, Minocycline

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3
Q

Tetracyclines Treat?

A

RMSF, Typhus, cholera, Lyme disease, H.Pylori, chlamydia, acne

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4
Q

Tetracycline Adverse Effects

A

-N/V/D
-Photosensitivity
- Yellow brown discoloration in teeth in children under 8 and pregnant women
- Superinfection common
( C-Diff and Candidiasis)

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5
Q

Tetracycline teaching

A
  • Calcium, Iron, Mg, Al decrease drug absorption by 50%
  • Avoid antacids, anti diarrheals, dairy products
  • 1 hour before or 2 hours after seperation of those food drugs
  • best on empty stomach
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6
Q

Macrolides Prototype

A

Erythromycin

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7
Q

Other Macrolides

A

Clarithromycin (Biaxin)

Azithromycin (ZPACK)

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8
Q

Macrolide Mechanism of Action

A

Inhibit Protein Synthesis

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9
Q

Adverse Effects of Erythromycin

A
  • GI upset
  • Affects the motility of the GI tract (motilin)- used with gastroparesis; passing feeding tubes
    -Drug-Drug interactions: QT prolongation and cardiac death!
  • CYP3A4 ( CCB, antifungals, HIV, Protease Inhibitors)
    -Toxic Levels: Theophylline, carbamazepine, warfarin
    Superinfection
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10
Q

Routes for Erythromycin

A
  • Continuous infusion is perferred

routes: IV or PO

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11
Q

Clindamycin MOA

A

inhibition of protein synthesis

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12
Q

Clindamycin Adverse Reactions

A
  • Biggest Risk C.Diff associated diarrhea

Stop clindamycin treat CDIFF

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13
Q

If C-Diff is suspected

A
  • Symptoms are profuse, watery diarrhea, abd pain, fever, leukocytosis
  • Contact precautions
  • Handwashing only
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14
Q

Clindamycin Admin

A
  • No rapid IV

- given slowly

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15
Q

Aminoglycosides MOA

A
  • They do inhibit protein synthesis but also produce abnormal proteins
  • THEY ARE STONGER!!! BACTERIACIDAL
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16
Q

Aminoglycosides Prototype

A

Gentamicin

17
Q

Other Aminoglycosides

A

Tobramycin, Amikacin, Kanamycin, Neomycin, Paromycin, Streptomycin

18
Q

Aminoglycosides Route

A

IV or IM

19
Q

Adverse Effects of Aminoglycosides

A

Ototoxicity- tinnitus vestibular toxicity headache 1st sign
Nephrotoxicity- 5-25% of patients, monitor BUN/ Creatinine, usually reversible

(TOO HIGH OF trough levels)

20
Q

Sulfonamides MOA

A

Inhibition of folate synthesis

21
Q

Sulfonamide Prototype

A

Trimethoprim/Sulfamethoxazole (TMP/SMX)

22
Q

Does this affect human cell Sulfonamides?

A

NO

23
Q

TMP/SMX is a combo drug 1:5 because

A

The two have a synergist effect

24
Q

Other names for TMP/ SMX

A

Bactrim, Cotrim, Septra, co-trimoxazole

25
Q

Adverse effects for TMP/SMX

A
  • GI (N/V)
  • Rash can lead to Steven-Johnson syndrome
  • Blood Dyscrasias : Hemolytic anemia due to G6PD deficiency. Bone marrow suppression (check CBC)
  • Crystalluria- increase hydration
  • Photophobia- sun protection
  • CNS effects (headaches)
26
Q

Stop the drug if someone is on..

A

TMP/SMX

27
Q

TMP/ SMX Risk

A

Kernicterus risk & birth defects

  • Should not be used in pregnancy
  • breast-feeding or in children under the age of 2
28
Q

Sulfa Allergy?

A
  • Do not take thiazide diuretics, loop diuretics, sulfa- DM meds
  • Causes Steven Johnson syndrome
29
Q

Sulfonamides Drug-Drug interaction

A
  • Warfarin, Dilantin
  • 68% protein bound
  • Risk of hyperkalemia
30
Q

Flurorquinones MOA

A

Disrupt DNA Rep/ Cell Division

31
Q

Fluroquinone Prototype

A

Ciprofloxacin

32
Q

Other Fluroquinone

A

ofloxacin, Moxifloxacin, Levofloxacin, Levofloxacin, Gemifloxacin

33
Q

Route Ciprofloxacin

A
  • Oral or IV

- Infuse over 1 hour (IV)

34
Q

Adverse effects Fluroquinones

A
  • GI upset
  • CNS effects( eldely)
  • Tendon rupture:
  • High risk: elderly and steroid use
  • Avoid in kids under 18
  • Causes Photosensitivity
  • Dysrthymias if on anti- dysrthymia agents
  • Suprainfections
35
Q

Ciprofloaxacin Drug- Food intearctions

A
  • Al, Mg, iron, zinc, Ca
  • Milk/dairy products
  • Give drugs 6 hours after or 2 hours before these food/supplements
  • reduces absoprtion by 90%
36
Q

Ciprofloaxcin Drug-Drug interactions

A

Sucralfate, theophylline, warfarin, tinidazole

37
Q

Metronidazole (flagyl) MOA

A

Coverage
-Protozoa and anaerobic bacteria
-No action against aerobic bacteria
MOA: Inhibition of nucleic acid synthesis

38
Q

Route for Flagyl

A

IV infuse over 1 hour

39
Q

Adverse effects for flagyl

A
  • superinfection
  • Gi upset
  • No alcohol for 3 days: Research doesn’t support this may have disulfram reaction
  • Urine turns dark reddish- brown
  • Metallic taste