Brainscape's Knowledge GenomeTM

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


See full index

Pharm II Final > Antimicrobial Therapy > Flashcards

Antimicrobial Therapy Flashcards

1
Q

What is anesthesia’s role in antibiotic therapy?

A

The anesthetic provider plays an important role in timely administration of antibiotics
Contributes to our reimbursement for quality care

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

What are potential adverse reactions from antibiotic therapy?

A

Hypersensitivity reaction
Direct organ toxicity
Potential for superinfection

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

What is a common misconception regarding hypersensitivity reactions with antibiotics?

A

They are dose independent meaning you can give any amount (test dose or not) and still have a reaction

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

Why do we give antibiotics prophylactically?

A

The surgeon exposes and transects parts of the body that have bacteria all the time
Exposing certain parts of the body to flora that is not normal in that area

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

What antibiotic covers majority of the organisms we expose the body to?

A

Cefazolin

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

What antibiotics should be used with caution in pregnancy?

A

Aminoglycosides (ototoxicity) and Clindamycin (colitis)

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

What antibiotics are contraindicated in pregnancy?

A

Tetracyclines –> tooth discoloration in babies

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

How are antibiotics categorized?

A

Bactericidal

Bacteriostatic

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

What does it mean if an antibiotic is considered to have bactericidal properties?

A

It can kill the susceptible bacteria

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

What does it mean if an antibiotic is considered to have bacteriostatic properties?

A

It reversibly inhibits growth of the bacteria

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

If bacteriostatic drugs cannot kill bacteria how do they get rid of a bacterial infection?

A

They allow cellular and humoral defense mechanisms to eradicate the bacteria

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

What type of antibiotics are penicillins?

A

Bactericidal

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

What is the mechanism of action of penicillins?

A

They interfere with synthesis of peptidoglycans, which are components of bacterial cell wall

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

What type of antibiotics are cephalosporins?

A

Bactericidal

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

What is the mechanism of action of cephalosporins?

A

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins

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

What class of antibiotics have the highest reported rate of allergy?

A

Penicillins (up to 10%)

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

What two types of reactions are associated with penicillin allergy?

A 
Delayed = maculopapular rash
Immediate = anaphylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why is there a high likelihood of cross sensitivity between penicillins and cephalosporins?

A

They share a common beta-lactam ring

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

What is a side effect of high dose penicillins?

A

Affect platelet aggregation

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

What superinfections can result with cephalosporin use?

A

Enterococci
Enterobacter
Candida

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

How many generations of cephalosporin drugs are there?

A

Four

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

What type of antibiotic is Vancomycin?

A

Bactericidal for most gram positive bacteria

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

What is the mechanism of action of Vancomycin?

A

Inhibits cell wall synthesis by inhibiting peptidoglycan synthetase

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

What infections is Vancomycin typically reserved to treat?

A

MRSA
Endocarditis due to strep, viridans or enterococci
Patients allergic to beta lactams

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

Why is it important to administer Vancomycin slowly?

A

To prevent a massive histamine leading to Red Man’s Syndrome

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

Why is it important to check the IV site prior to administering Vancomycin?

A

It is phlebosclerotic causing damage to the tissues if infiltration occurs

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

What organ systems can Vancomycin affect?

A

Kidneys, nephrotoxicity when given with other nephrotoxic drugs
Ototoxicity increased risk if giving with aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What symptoms usually accompany Red Man Syndrome?

A

Profound hypotension

Flushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why have aminoglycosides lost favor in patient administration?

A

It has an extensive list of significant side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What kind of antibiotic is Gentamicin?

A

Bactericidal Aminoglycoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What side effects are typically seen with aminoglycoside use?

A

Ototoxicity
Nephrotoxicity
Muscular Weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What drugs used in combination with aminoglycosides can increase the risk of ototoxicity?

A

Lasix

Mannitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What renal impairment are aminoglycosides known to cause?

A

Acute tubular necrosis

34
Q

What mechanism causes muscle weakness in aminoglycoside use?

A

Aminoglycosides inhibit the prejunctional release of Ach and decreases post-synaptic sensitivity
Pre-exisitng musculoskeletal diseases may be potentiated by these efects

35
Q

How would aminoglycoside use impact administration of neuromuscular blockade?

A

Aminoglycosides are associated with potentiation of Non depolarizing NMBA
Not effectively reversed by neostigmine

36
Q

What other anesthetic drug is affected by aminoglycosides?

A

Lidocaine, it enhances the neuromuscular blocking activities

37
Q

How would dose of NMBA be adjusted if the patient is currently taking aminoglycosides?

A

Decrease the amount given

38
Q

What class of antibiotics are useful in patients with allergies to PCN and cephalosporins?

A

Macrolides

39
Q

What two Macrolide antibiotics are commonly used?

A

Erythromycin

Azithromycin

40
Q

What is the most common complaint with Macrolide use?

A

GI intolerance

41
Q

How do Macrolides affect the GI tract?

A

Prokinetic effect on GI tract and increases the tone of the LES

42
Q

What effect do Macrolides have on the cardiovascular system?

A

Prolongs cardiac repolarization (prolong QT)

Can cause Torsades and sudden cardiac death

43
Q

What drug is most commonly used in female GU surgeries?

A

Clindamycin

44
Q

Why is Clindamycin’s use so limited?

A

Severe GI complications limit its used to infections that are difficult to treat

45
Q

What other antibiotic has an affect on neuromuscular blockade?

A

Clindamycin, produces pre and post junctional effects at the NMJ that cannot be readily antagonized

46
Q

What ailments are fluoroquinolones useful in treating?

A

Respiratory infections
GI upset
Anthrax

47
Q

What type of antibiotics are sulfonamides?

A

Antimicrobial

48
Q

What is the mechanism of action of sulfonamides?

A

Prevent normal use of PABA by bacteria to synthesize folic acid

49
Q

What antibiotic is used most often in pediatric patients for ear infections?

A

Sulfonamides

50
Q

What is a negative effect of using sulfonamides?

A

High incidences of allergic reactions

51
Q

What is a virus?

A

Obligate intracellular parasites

52
Q

How do we target a virus without killing our own cells?

A

Some host cell surface receptors are unique for viruses and this gives a location for potential drug therapy

53
Q

What is Acyclovir used to treat?

A

Used to treat herpes

54
Q

What side effects can be seen with the use of Acyclovir?

A

May cause renal damage if infused rapidly
Thrombophlebitis
Headache

55
Q

If a patient reports being on triple therapy what disease process are they more than likely fighting?

A

HIV

56
Q

What are the six classes of HIV antiretrovirals?

A 
Nucleoside/nucleotide reverse transcriptase inhibitors
Protease inhibitors
Fusion inhibitors
CCR5 receptor antagonists 
Integrase inhibitors
57
Q

What should the anesthetic provider be assessing in the operative patient on triple therapy?

A

Existence of adverse effects (organ damage, neuropathy, weakness)
Interactions with other medications (PPI and cimetidine) can affect CYP causing increased available medications leading to toxicity

58
Q

If a healthcare worker is exposed to HIV with a high viral load what precautions should be taken?

A

Prophylaxis with three or more antiretroviral drugs (two if the patient had a low viral load)

59
Q

How long should a healthcare provider be followed if exposed to HIV?

A

For at least six months after exposure

60
Q

When does most mother to child transmission of HIV occur?

A

At the time of labor and delivery (both mom and baby should receive AZT every six hours for six weeks after birth)

61
Q

What antiretroviral drug should the HIV positive mother receive after the first trimester of pregnancy?

A

AZT

62
Q

What microbial agents do first generation cephalosporins have the greatest effect on?

A

Strep pneumoniae
Gram positives
(little effect on gram negative)

63
Q

What microbial agents do second generation cephalosporins have the greatest effect on?

A

Equally effective against gram positive, gram negative and strep pneumoniae

64
Q

What microbial agents do third generation cephalosporins have the greatest effect on?

A

Gram negative
Strep pneumoniae
(little effect on gram positive)

65
Q

What microbial agents do fourth generation cephalosporins have the greatest effect on?

A

Gram negative
Strep pneumoniae
(moderate effect on gram positive)

66
Q

What other drug is almost always used in combination with aminoglycosides?

A

Almost always used along with a cell wall synthesis inhibitor

67
Q

What is the mechanism of action of aminoglycosides?

A

Irreversible inhibition of protein synthesis 30s (O2 dependent transport)

68
Q

What pregnancy category are aminoglycosides?

A

C

69
Q

What lab values should you base your dose of aminoglycosides on?

A

Creatinine

Serum concentration

70
Q

What is significant about azithromycins half life?

A

The half life is three days, 1g dose provides 7 days of coverage

71
Q

What is the mechanism of action of macrolides?

A

Bind to 50s and block translocation step in protein synthesis

72
Q

What type of antibiotics are macrolides?

A

Bacteriostatic

73
Q

How can macrolides affect metabolism of other drugs?

A

P450 Inhibitor, increasing the concentration of other drugs

Can also cause liver toxicity

74
Q

What type of antibiotic is Clindamycin?

A

Bacteriostatic

75
Q

If a sulfa allergy is present, what two drugs can be used to treat toxoplasmic encephalitis?

A

Clindamycin and pyrimethomine

76
Q

What two GI disturbances can occur with Clindamycin use?

A

Cdiff

Enterocolitis

77
Q

What is the mechanism of action of fluoroquinolones?

A

Inhibits DNA gyrase and topoisomerase

78
Q

What type of antibiotic are fluoroquinolones?

A

Bacteriocidal

79
Q

What pregnancy category are fluoroquinolones?

A

C

80
Q

What are some adverse effects of fluoroquinolone use?

A 
Tendon rupture
QT prolongation
seizure
Dizziness
Confusion
Photosensitivity
81
Q

Why shouldn’t children under 18 take fluoroquinalones?

A

Interferes with cartilage formation

82
Q

How is cefazolin typically dosed?

A

Usually 1g, but increase to 2g when over 80kg

Pharm II Final (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions