Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 326-Pathopharm > Antimicrobial Drugs > Flashcards

Antimicrobial Drugs Flashcards

PCNs, Cephalosporins, Carbapenems, and others

1
Q

Drug classes that inhibit cell wall synthesis:
-Weaken the cell wall
-Influx of fluid into the cell
-Cell swells and burst
-Cell lysis and death

A

Penicillins
Cephalosporins
Carbapenems
Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The function of Beta-Lactam Antibiotics

A

Inhibit the synthesis of the bacterial peptidoglycan cell wall

Never given individually

Ex: Sulfabactam, clavulanic acid, tazobactam, avibactam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Penicillin MOA

A

Disrupt the synthesis of the cell wall

-Bacteria must be growing
-Inhibit transpeptidases (cell wall synthesis)
-Activates autolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Adverse effects of Penicillins

A

Uticaria (hives), pruritis (itching), angioedema (swelling under the skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indications for Penicillin

A

Works against many different organisms

Low toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

4 Different types of PCNs

A

-Natural PCNs (PCN G & V)
-Penicillinase-Resistant PCN (nafcillin)
-Aminopenicillins (amoxicillin & ampicillin)
-Extended-spectrum PCNs (piperacillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Natural PCNs and indication

A

Penicillin G & V
-Works well on gram +/- cocci, anaerobic bacteria, spirochetes
-Least toxic
-Can be used with aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PCN G&V route

A

Route: IV/IM (PO available)
-IM commonly used for STDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Natural PCNs AE/considerations

A

-1/2 life about 30 minutes (unless kidney dysfunction

-Allergy: Rash to anaphylaxis
Allergic to 1 PCN, allergic to ALL PCNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Penicillinase Resistant PCNs

Drug and Indication

A

Drug: Nafcillin

Indication: Drug of choice for Penillinase Resistant PCNs
-Can be used for staph bacteria (anti-staphylococcus PCN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nafcillin class and route

A

Class: Penicillinase
Route: IV ONLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Aminopenicillins

Drug and MOA

A

Ampicillin and Amoxicillin

Disrupt the synthesis of the cell wall
-Can work better against gram (-) because of the chemical structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ampicillin

Indication and Route

A

Indication: 1st broad spectrum
Route: IV or PO (if giving PO usually prefer Amoxicillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ampicillin

Adverse effects and considerations

A

AE: Diarrhea and rash are common

Considerations:
-Renal sensitive
-Stopping using ampicillin as much because of drug resistance
-Allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Amoxicillin

Indication and route

A

Indication:
-Very common in pediatric patients (doses are sometimes higher because of strep-resistant organisms)
-Common for ear, nose, throat, genitourinary and skin infections

Route: ONLY PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Amoxicillin

Adverse effects and considerations

A

AE: Diarrhea and rash (although less side effects compared to ampicillin)

Consideration: Allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Extended-spectrum PCN

Drug

A

Piperacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Piperacillin

Indication

A

Indication:
-Wider spectrum than other PCNs
-Anti-pseudomonal (especially piperacillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Piperacillin

Class and nursing considerations

A

Class: Extended-spectrum PCN

Nursing considerations:
-Affects platelet function
-Watch for patients with renal dysfunction

-always given with a beta lactamase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How many generations of cephalosporins?

MOA of Cephalosporins

A

5 Generations (later generations increase spectrum/activity/and ability to penetrate CSF)

MOA: Inhibit cell wall synthesis through PCN-binding protein (inhibit transpeptidase). Leads to autolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cephalosporin (general)

Indications

A

Same as PCNs: Gonorrhea, UTI, Peritonitis, Meningitis, Pneumonia, etc)

Low-toxicity
-Some cross-sensitivity with PCN allergy. Avoid if PCN anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cephalosporin (general)

AE and considerations

A

AE: mild diarrhea, abdominal cramps, rash, pruritis, redness, edema

Considerations:
-Pregnancy Category B (pretty safe, used during pregnancy)
-Poor oral absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

1st Generation Cephalosporins

Drug and indications

A

Drug: Cefazolin and Cephalexin

Indications:
-Works well for gram (+) bacteria
-Staph and non-enterococcal strep infections
-Cefazolin common for surgical prophylaxis

*DO NOT work in CNS infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cefazolin and Cephalexin

Route

A

Cephalexin: Either IV or PO

Cefazolin: ONLY IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

2nd Generation Cephalosporins

Drug and indications

A

Drug: Cefuroxime and Cefotetan

Indications: More gram (-) coverage AND gram (+) coverage

*Cefuroxime does NOT kill anaerobic bacteria but DOES work well on intestinal bacteria

*Both DO NOT work CNS or pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cefuroxime and Cefotetan

Route

A

IV and PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

3rd Generation Cephalosporins

Drug and Indications

A

Drug: Ceftriaxone, Ceftazidime, Cefotaxine

Indications: Most potent in fighting gram (-) bacteria BUT much less activity against gram (+)

Ceftriaxone is EXTREMELY long-acting (once per day dosing benefit)
-Able to cross the blood-brain barrier so effective in treating meningitis and other infections within the CNS

Ceftazidime works well for Pseudomonas (although becoming more resistant)

28
Q

Ceftriaxone, Ceftazidime, Cefotaxine

Route and considerations

A

Route: IV/IM only (other drugs are PO)

Considerations: Do NOT give Ceftriaxone to patients with liver failure (works well but hard on the liver)

29
Q

4th Generation Cephalosporins

Drug and Indications

A

Drug: Cefepime

Indications:
-Works against gram (-) and gram (+). Very broad spectrum
-Uncomplicated/complicated UTIs, skin infections, and Pseudomonas

Crosses the BBB (works well for CNS and Pseudomonas)

30
Q

5th Generation Cephalosporins

Drug and Indications

A

Drug: Ceftaroline

Indications:
-Treats MRSA and MSSA
-Works against some VRSA/VISA
-Mostly for nasty staph infection

*Does NOT work on enterobacter, pseudomonas, ESBL, Klebsiella coverage

31
Q

Ceftaroline

Route and considerations

A

Route: ONLY IV

Considerations: needs to be renally dosed (hard on kidneys)
-Monitor BUN/Creatinine

32
Q

Carbapenems

Drug and MOA

A

Drug:
-Imipenem/Cilastatin
-Meropenem

MOA: Binds to PCN-binding protein which inhibits cell wall synthesis
-Very resistant to Beta-lactamase

33
Q

Imipenem/Cilastatin

Indications and Route

A

Indications:
-BROADEST spectrum of ALL antibiotics
-Can penetrate BBB and meninges
-Used for complicated infections
-Combo of the carbapenem with the inhibitor of the enzyme that breaks down imipenem

Route: IV only (must be infused over 60 minutes

34
Q

Imipenem/Cilastatin

AE and considerations

A

AE: drug-induced seizure activity

Considerations:
-Monitor patients for seizures, especially in the elderly, and with other medications that can induce seizure

ALL are IV and must be INFUSED OVER 60 MINUTES

Cilastin helps inhibit dehydropeptidase that breaks down imipenem too quickly. Allows imipenem to stay in the system longer and work more effectively

Doesn’t work against CRE

35
Q

Meropenem

Indications and Route

A

Indications:
-A little less coverage than imipenem; but still gram (+) and (-) aerobes and anaerobes

Route: IV only (infused over 60 min)

36
Q

Meropenem

AE and considerations

A

AE:
-Less seizure activity than Imipenem/cilastatin
-Rash and diarrhea most common side effects

Considerations:
-Doesn’t degrade in kidneys
-Doesn’t work against CRE
-Must be INFUSED OVER 60 MINUTES

37
Q

Glycopeptide Antibiotic

Drug and MOA

A

Drug: Vancomycin

MOA: Destroys by binding to the bacterial cell wall, producing immediate inhibition of cell wall synthesis and death

38
Q

Vancomycin

Indications and Route

A

Indication:
-Works on gram (+) infections (including MRSA and PCN-resistant pneumococcus)

Route: IV (some PO for C.Diff and pseudomembranous colitis)

39
Q

Vancomycin

AE and considerations

A

AE:
Toxic side effects:
-Ototoxicity with high levels (can be reversible)
-Immune-mediated thrombocytopenia
-Nephrotoxic→ watch when using with other drugs (aminoglycosides, cyclosporin’s, IV contrast) that affect kidneys
-Watch with neuromuscular blockades (paralyzers)

Usually NOT harmful
-Red Man Syndrome: usually related to rapid infusion (flushing, rash, pruritus, tachycardia, hypotension)
-infuse slowly and over longer periods

Considerations:
Doesn’t work for CNS infections

Kidney eliminates drug: decrease doses for renal dysfunction
-Monitor kidney levels (not as much for PO)

Draw peak and trough levels (therapeutic)
-15 to 30 minutes after med is given (peak)
- 30 minutes before next dose (tough)

40
Q

Aminoglycosides

Drug and MOA

A

Drug: Gentamycin, Amikacin, Tobramycin

MOA: Inhibit bacterial ribosomes→ unable to make proteins

-Used in combination with beta-lactamase or vancomycin. Use other medicines first

41
Q

Gentamycin, Amikacin, Tobramycin

Indications and Route

A

Indications:
Used since 1944 for complicated infections: UTIs/pyelonephritis, gynecological infections, peritonitis, endocarditis, PNA, osteomyelitis (DM-related infections)

Potent antibiotics that work well on gram (–) bacteria
-Also work on gram + but need other anti-biotics for a synergistic effect

Route: Mostly IM but also ophthalmic and topical
*googled

42
Q

Gentamicin, Amikacin, Tobramycin

AE and considerations

A

AE:
Severe side effect profile:
-Nephrotoxicity: 5-25%, usually reversible
-Ototoxicity: 3-14%, usually permanent

Neuromuscular blockade → can cause PROFOUND respiratory distress (myasthenia gravis)

CNS side effects: confusion, depression, disorientation, numbness, and tingling

Cochlear damage- ototoxicity, high-frequency hearing loss, high-pitched tinnitus

Considerations:
Therapeutic drug monitoring
-Peak/Trough levels

Transitioned from 3x day dosing to 1x day dosing

43
Q

Lincosamides

Drug and MOA

A

Drug: Clindamycin

MOA: binds to ribosomes and inhibits protein synthesis

44
Q

Clindamycin

Indications and Route

A

Indications:
-Chronic bone infections, GU tract infections, intra-abdominal infections, anaerobic pneumonia, septicemia, serious skin infections, prophylaxis for endocarditis

Often used for anaerobic bacteria

Route: PO and IV

45
Q

Clindamycin

AE and considerations

A

AE: very toxic
-Can cause deadly pseudomembranous colitis

Considerations:
Monitor use with neuromuscular blockade medications→ respiratory distress

Therapeutic drug monitoring
-peak and though

All enterobacter bacteria are resistant to clindamycin (doesn’t work for VRE and CRE)

46
Q

Macrolides

Drug and MOA

A

Drug: Erythromycin and Azithromycin

MOA: Inhibit protein synthesis by binding to ribosomes

-Good at entering host cells

47
Q

Erythromycin

Indications and Route

A

Indications: used to treat MANY infections. Has hypomotility benefits for diabetic gastroparesis and increases gastric motility and emptying

Route: PO and IV (topical and ophthalmic also available)
-IV is painful, and oral absorption isn’t great

48
Q

Azithromycin

Indications and Route

A

Indications:
-differs structurally from other macrolides → has some advantages in coverage compared to erythromycin

-Very good at tissue penetration and long duration of action

Route: PO and IV

49
Q

Erythromycin and Azithromycin

AE and considerations:

A

AE: YUCK drugs (GI upset, especially erythromycin)

Considerations:
Erythromycin:
-Do NOT take on an empty stomach
-Lots of drug-drug interactions

Azithromycin:
-Take WITHOUT food; taking with food decreases absorption

50
Q

Macrolides

Indications (general)

A

Indications: various infections of upper and lower respiratory infections, skin infections, soft tissue infections; STIs
-Legionnaire’s, Listeria, and mycoplasma pneumonia can all be treated with macrolides

51
Q

Tetracyclines

Drug and MOA

A

Drug: Tetracycline, Doxycycline, Minocycline

MOA: bacteriostatic drugs that inhibit synthesis by binding to ribosomes

52
Q

Tetracycline, Doxycycline, Minocycline

Indications

A

Indication: Broad spectrum; major resistance has developed

Infections still commonly treated with tetracyclines:
-Rickettsia (Rocky Mountain spotted fever)
-Chlamydia and trichomonas
-Lyme disease
-Cholera
-Pelvic inflammatory disease
-Mycoplasma pneumonia
-Acne

53
Q

Tetracycline, Doxycycline, Minocycline

AE and considerations

A

Adverse effects: discoloration of the permanent teeth and tooth enamel hypoplasia in features and children, photosensitivity, and many others

Diarrhea, yeast infections

More serious: thrombocytopenia

Considerations:
Contraindications: Pregnant and nursing women, children younger than 8 (damage teeth)

Wear sunscreen

54
Q

Fluoroquinolones

Drug and MOA

A

Drug: Ciprofloxacin and Levofloxacin

MOA: destroys bacteria by altering their DNA (interfering with the bacterial enzymes DNA gyrase and topoisomerase)

55
Q

Fluoroquinolones

Indication (general)

A

Mostly gram (-) and some gram (+) coverage

Very potent, broad-spectrum antibiotics

Very good oral absorption

56
Q

Ciprofloxacin

Indication and Route

A

Indication: UTIs, some STIs, upper respiratory and lower respiratory tract infections, gonorrhea, and other infections
-Also treats anthrax→ infection with Bacillus anthracis

Minimal penetration of the BBB/CSF

Works well on rapid and slow-growing organisms

Route: PO, IV, and topical

57
Q

Ciprofloxacin

AE and considerations

A

AE: arthropathy (joint disease), often irreversible

-prolonged post-antibiotic effects→ concentrated in the neutrophils

Considerations: Avoid in patients under 18 and over 60

58
Q

Levofloxacin

Indication and Route

A

Indication: Most widely used quinolones
-Broad spectrum of activity like cipro but advantage is once-daily dosing

Less resistance

More activity against pneumococcal and other ‘atypical’ respiratory infections

Route: PO (100% bioavailability) or IV

59
Q

Levofloxacin

AE and considerations

A

AE: CNS disorders that predispose to seizures, and kidney failure, can cause prolongation of QT interval, photosensitivity

Considerations: Monitor kidney levels, wear sunscreen

60
Q

Sulfonamides

Drug and MOA

A

Drug: Sulfamethoxazole and Trimethoprim

MOA: don’t actually destroy bacteria but inhibit their growth=bacteriostatic by preventing the synthesis of folic acid needed for DNA synthesis

61
Q

Sulfamethoxazole and Trimethoprim

Indications and typical population

A

Indications: uncomplicated UTIs, respiratory infections, salmonella, shigellosis

Population: Often given to patients with HIV

62
Q

Sulfamethoxazole and Trimethoprim

AE and considerations:

A

AE: Sulfa allergies: usually start with fever and end with skin rash

Photosensitivity

Considerations: Adverse reactions are more common in patients with HIV

63
Q

Antiprotozoal and Antibacterial

Drug and MOA

A

Drug: Metronidazole

MOA: inhibit DNA synthesis
(destroys bacteria by altering their DNA- interfere with the bacterial enzymes DNA gyrase and topoisomerase)

64
Q

Metronidazole

AE and considerations

A

AE: N/V, xerostomia (dry mouth), vaginal candidiasis

Considerations:
DO NOT TAKE WITH ALCOHOL
-Cannot have had alcohol 24 hours before and 36 hours after. Can create toxic metabolic in the system

64
Q

Metronidazole

Indications

A

Indications: Anaerobic activity only
-Crohn’s disease
-Antibiotic-associated diarrhea or C-Diff
-Antiprotozoal and antibacterial

NUR 326-Pathopharm (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions