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Patho 1 > Antimicrobial Drugs > Flashcards

Antimicrobial Drugs Flashcards

1
Q

Penicillins

A

Naturally occurring molds

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2
Q

Penicillins MOA

A

Disrupt synthesis of cell wall in bacteria that are growing and dividing- inhibit transpeptidases and activates autolysis

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3
Q

Penicillins indication

A

Many different organisms, outpatient settings (low toxicity); UTIs, STIs, sepsis, meningitis, pneumonia; gram +

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4
Q

PCNs adverse reactions

A

Low toxicity, but urticaria (rash often on kids), pruritus, angioedema (life-threatening allergy)

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5
Q

PCNs NC

A
  • Want to culture first
  • Drug interactions; NSAIDs, oral contraceptives, Warfarin
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6
Q

PCN G and PCN V classification and indication

A

Natural penicillins mostly for gram + bacteria and STDs

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7
Q

PCN G and PCN V adverse reactions and NC

A

Least toxic, rash to anaphylaxis
- 30 minute half-life
- can be used with aminoglycosides to disrupt protein synthesis
- often IV/IM, PO can be used

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8
Q

nafcillin classification

A

PCNase-resistant PCNs

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9
Q

nafcillin indications

A

Staph bacteria

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10
Q

nafcillin NC

A
  • IV only
  • good for bacteria that created penicillinase
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11
Q

Amoxicillin and ampicillin class

A

AminoPCNs

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12
Q

Amoxicillin and ampicillin indications

A

Ear, nose, throat, GU, skin infections (amoxicillin), gram -

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13
Q

Amoxicillin and ampicillin SE and NC

A

Diarrhea and rash (ampicillin), amoxicillin has fewer SE
- both combined with beta lactam bac
- ampicillin PO or IV
- amoxicillin only PO

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14
Q

Piperacillin (Zosyn) classification

A

Extended-spectrum PCNs

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15
Q

Piperacillin (Zosyn) indications

A

Pseudomonas infection

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16
Q

Piperacillin (Zosyn) SE and NC

A

Affect platelet function and renal dysfunction
- widest spectrum
- always given with beta lactamase inhibitor

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17
Q

Cephalosporins MOA

A

Inhibit cell wall synthesis through same PCN binding protein and autolysis

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18
Q

Cephalosporins indications

A

Broad coverage; often resistant to beta-lactamase bc bac secrete cephalosprinase, pregnancy

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19
Q

Cephalosporins SE and NC

A

Low toxicity, avoid if PCN anaphylaxis; mild diarrhea, ab cramps, RASH, pruritus, edema
- some cross-sensitivity with PCN allergy
- poor oral absorption

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20
Q

Cefazolin and cephalexin class and indications

A

Gram +, staph, NOT enterococca strep or CNS (can’t penetrate CSF), cefazolin surgical prophylaxis

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21
Q

Cefazolin and cephalexin NC

A
  • cefazolin IV only
  • Cephalexin both
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22
Q

Cefuroxime and cefotetan classification

A

2nd gen cephalosporins

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23
Q

Cefuroxime and cefotetan indications

A

Gram - and Gram +, NOT anaerobic bac

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24
Q

Cefuroxime and cefotetan NCs

A

IV and PO available

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25
Q

Cefriaxone, ceftazidime, cefotaxime classification

A

3rd gen cephalosporins

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26
Q

Ceftriaxone, ceftazidime, cefotaxime indication

A

Fights gram -, gram + only a little, CNS patients, pseudomonas (ceftazadine)

27
Q

Ceftriaxone, ceftazidime, cefotaxime NCs

A
  • IV/IM
  • NO liver failure
  • Ceftriaxone—very long lasting
28
Q

Cefepine class and indications

A

Grame - and +, very broad spectrum; UTIs, skin infections, pneumonias; crosses BBB

29
Q

Ceftaroline, Ceftazolone classification and indications

A

5th gen cephalosporins; MRSA, MSSA, some VRSA/VISA

30
Q

Ceftaroline, Ceftazolone NCs

A
  • only IV
  • must be renally dosed; monitor kidney levels
31
Q

Carbapenems MOA and indication

A

Imipenem/cilastin and meropenem; Bactericidal and cell wall inhibitor; broadest spectrum

32
Q

Carbapenems SE and NC

A

Drug-induced seizure (not super common)
- Last resort med
- IV
- infused over 60 minutes
- carbapenem-resistant bacterias are VERY deadly

33
Q

imipenem/cilastin indication

A

Most broad spectrum, can penetrate BBB and meninges, complicated infections

34
Q

imipenem/cilastin SE and NCs

A

seizures (esp in elderly and combined with other meds)
- combo of carbapenem with beta lactam inhibitor
- needs cilastin bc stops an enzyme that otherwise degrades imipenem in the kidneys

35
Q

Meropenem indications and SE

A

Pretty broad spectrum , gram + and - aerobes and anaerobes; less seizure activity, rash, and diarrhea

36
Q

Vancomycin class and MOA

A

Glycopeptide antibiotics; Work on cell wall, causes immediate cell wall death, but not by autolysis

37
Q

Vancomycin indications

A

Gram + (MRSA, PCN-resistant drugs), c.diff and pseudomembranous colitis (oral)

38
Q

Vancomycin SE

A

Ototoxicity with high levels (reversible), immune-mediated thrombocytopenia, nephrotoxic, red man syndrome (related to giving it fast) - flush, rash, pruritis, urticaria, tachy, hypotension; infuse slow and over longer times, usually NOT harmful

39
Q

Vancomycin NCs

A
  • doesn’t work on CNS
  • kidneys eliminate drug, decrease dose for renal dysfunction
  • has to be oral for c. diff and pseudomembranous colitis
  • monitor plt levels
  • watch with contrast and neuromuscular blockades
  • don’t give dose super fast
  • draw peak and trough levels
40
Q

Gentamycin, amikacin, tobamycin class

A

aminoglycosides

41
Q

Gentamycin, amikycin, tobamycin MOA

A

inhibit/alter protein synthesis; binds to bac ribosomes and prevents protein synthesis

42
Q

Gentamycin, amikacyin, tobamycin indications

A

Gram -, complicated infections like UTIs/kidney infx, gynecological infx, peritonitis, endocarditis, PNA, osteomyelitis (DM related)

43
Q

Gentamycin, amikacin, tobamycin SE and NC

A
  • Nephrotoxicity, ototoxicity (hearing); gentamycin–be careful when giving with neuromuscular blockade bc can cause myasthenia gravis (resp distress), CNS like confusion, depression, numbness, tingle, cochlear damage
  • need therapeutic monitoring–peak/trough levels
  • often dose according to renal function
  • wean from 3x/day to 1x/day
  • often used with vanc or beta lactamase (use before aminoglycosides)
44
Q

Clindamycin class and MOA

A

Lincosamides; Bactericidal or bacteriostatic; binds to ribosomes and inhibits protein synthesis

45
Q

Clindamycin SE and NC

A

Very toxic, can cause pseudomembranous colitis–deadly diarrhea
- PO and IV available
- Monitor use with neuromuscular blockade meds
- therapeutic drug monitoring
- does not work on people with CRE

46
Q

Erythromycin and azithromycin class and MOA

A

Macrolides; Bacteriostatic in general, but bactericidal in high concentrations; inhibit protein synthesis by binding to ribosomes

47
Q

Erythromycin and azithromycin indications

A

STIs (esp gonorrhea), resp infx, syn infections, soft tissue infections (Legionnaries, listeria, mycoplasma pneumonia)

48
Q

Erythromycin and azithromycin SE and NC

A

YUCK drugs - GI prob (esp erythromycin)–N/V/D, upset stomach

Erythromycin
- hypomotility benefit for diabetic gastroparesis and increases gastric motility and emptying
- does not cross BBB

49
Q

Tetracycline, doxycyclin, minocycline class and MOA

A

Bacteriostatic that inhibit protein synthesis by binding to ribosomes

50
Q

Tetracycline, doxycyclin, minocycline indications

A

Broad spectrum; STIs (doxycycline prophylactically), PID, acne and non-dangerous skin infx (doxycycline and minocycline), rheumatoid arthritis (minocycline)

51
Q

Tetracycline, doxycyclin, minocycline SE and NC

A

Not for pregnant women and kids under 8–cause permanent discoloration and tooth enamel hypoplasia in fetus and kids; yeast infection, photosensitivity

52
Q

Tetracycline SE and NC

A

N/V/D, HA, photosensitivity, dizziness; anaphylaxis, angioedema; can damage teeth
- can’t be IV
- fasting is best

53
Q

Fluroquinlones and MOA

A

Ciprofloxacin and levofloxacin; destroy bacteria by altering DNA–interfere with enzymes

54
Q

Ciprofloxacin indications

A

Treat UTIs, STIs, lower and upper resp infx, gonorrhea, other infx, anthrax

55
Q

Ciprofloxacin SE and NC

A

Arthropathy (joint disease), often irreversible; prolonged post-abx effect–concentrated in neutrophils
- PO, IV, topica
- minimal usage on BBB/CSF
- good for rapid and slow orgs
- avoid pt under 18 and over 60 (bc bones)

56
Q

Levofloxacin indications

A

Most widely used Fluoroquinolones, better for pneumococcal and other atypical resp infections

57
Q

Levofloxacin SE and NC

A

CNS dx that cause sz, kidney failure, can cause prolongation of QT interval, photosensitivity
- 100% oral bioavailable
- once daily dose
- less resistance

58
Q

Sulfamethoxazole + trimethoprim (Bactrim) class and MOA

A

Sulfonamides; inhibit growth of bacteria and prevent synthesis of folic acid

59
Q

Sulfamethoxazole + trimethoprim (Bactrim) indications

A

Uncomplicated UTIs, resp infx, salmonella, shigellosis; HIV

60
Q

Bactrim SE and NC

A
  • more common in pt with HIV
  • pt with Sulfa allergy can’t take
  • photosensitivity
61
Q

Metronidazole (Flagyl) MOA and indications

A

inhibit DNA synthesis; Candidiasis, h. pylori, crohn’s disease, c. diff

62
Q

Metronidazole (Flagyl) SE and NC

A

N/V, xerostomia (dry mouth), vaginal candidasis (yeast infection), abx-assoc diarrhea
- DON’T take with alcohol

63
Q

How are later generations of abx different?

A

increased/sepctrum/activity/ability to penetrate CSF

64
Q

Which drug class is cross-sensitive with PCNs?

A

Cephalosporins

Patho 1 (30 decks)

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