antimicrobials Flashcards

1
Q

natural penicillin

A

penicillin G aqueous
Penicillin G procaine
Penicillin G benzathine
Penicillin V (PO)

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2
Q

Amino penicillin

A

amoxicillin

ampicillin

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3
Q

antistaphylococcal penicillin

A

dicloxacillin
nafcillin
oxacillin

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4
Q

Antipseudomonal penicillins

A

piperacillin

ticarcillin

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5
Q

beta-Lactamase inhibitor combos

A

ampicilin/sulbactam
amoxacillin/clavulanate
piperacillin/tazobactam
ticarcillin/clavulant

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6
Q

penicillin Mechanism of action

A

interfere with cell wall synthesis

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7
Q

penicillin mechanism of reisistance

A

beta lactamase/penicillinase
modified penicillin binding proteins
decreased permeability

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8
Q

natural penicillins treat

A

gram positive cocci
strep viridans
strep pyogenes (group A Strep)

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9
Q

natural penicillins therapeutic uses

A

syphilis
group b strep infection
strep pneumonia

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10
Q

amino penicillins treat

A
gram + and gram -
haemophilus influenzae
strep pneumonia
e. coli
proteus mirabilis
enterococcus
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11
Q

amino penicillins therapeutic uses

A

otitis media

sinusitis

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12
Q

Antipseudomonal Penicillins treat

A

pseudomonas aeruginosa
serratia sp
klebsiella sp

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13
Q

antipseudomonal penicillin therapeutic uses

A

nosocomial pneumonia and UTI
complicated cellulitis
abdominal infection

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14
Q

Beta lactamase inhibitor combinations treat

A

gram - and anaerobic

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15
Q

Beta lactamase inhibitor combinations therapeutic uses

A
abscess
diabetic foot
abdominal infection
animal bites
fever of unknown origin
refractory sinusitis/otitis media
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16
Q

Beta lactamase inhibitor combinations side effect

A

diarrhea

suprainfection

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17
Q

Antistaphylococcal penicillins treat

A

gram +

staphylococcus aureus

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18
Q

antistaphylococcal penicillins therapeutic uses

A

soft tissue
bone infections
endocarditis

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19
Q

penicillins ADR

A

Hypersensitivity

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20
Q

ampicillin ADR

A

Epstein-Barr Virus, cytomegalvirus, acute lymphocytic leukemia
non-allergic RASH

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21
Q

1st generation cephalosporins

A

cefadroxil
cefazolin
cefalexin

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22
Q

2nd generation cephalosporins

A
cefaclor
cefotetin
cefoxitin
cefprozil
cefuroxime
cefuroxime axetil
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23
Q

cephalosporins mechanism of action

A

interfere with cell wall synthesis

more resistant to Beta-lactamase

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24
Q

1st generation ceph treat

A

gram +
streptococcus
staphylococcus

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25
Q

1st generation ceph therapeutic uses

A

soft tissue
bone infections
(cellulitis, osteomyelitis, surgical prophylaxis)

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26
Q

2nd generation ceph treat

A

anerobes

some gram - and gram +

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27
Q

2nd genertraion ceph therapeutic uses

A

abdominal infections: abscess, pelvic, diverticulitis

respiratory infections: sinusitis, otitis media, pneumonias

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28
Q

3rd generation ceph treat

A

gram -

some gram + and anerobic

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29
Q

3rd generation ceph therapeutic uses

A

respiratory infections:

pneumonia, otitis media, sinusitis, meningitis

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30
Q

cephalosporins ADR

A

hypersensitivity

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31
Q

Macrolides

A

azithromycin
clarithromycin
erythromycin

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32
Q

macrolides mechanism of action

A

inhibits bacterial ribosomal protein synthesis

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33
Q

macrolides treat

A

gram +
gram -
atypical

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34
Q

macrolides therapeutic uses

A
respiratory 
genital
CAP
pelvic infection
acne
whooping cough
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35
Q

macrolides ADR

A

GI intolerance = non compliance
cholestatic jaundice
prolonged QT intervals

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36
Q

Clarithromycin ADR

A

abnormal taste sensations

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37
Q

macrolide drug interaction

A

erythromycin and clarithromycin metabolized by CYP 450

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38
Q

how should azithromycin be taken?

A

empty stomach

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39
Q

Macrolide caution

A

severe hepatic dysfunction

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40
Q

motilin agonist

A

erythromycin

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41
Q

tetracyclines

A

demeclocycline
doxycucline
minocycline
tetracycline

42
Q

tetracycline mechanism of action

A

inhibits bacterial ribosomal protein synthesis

43
Q

tetracycline treats

A

gram +
gram -
atypical

44
Q

tetracycline therapeutic uses

A
CAP!!
Chlamydia trachomatis!!!
acne!!
CA-MRSA!!
lyme disease, Rocky Moutain Spotted Fever, Tularemia
45
Q

tetracycline drug interaction

A

chelate with trivalent cations!!
metabolized in liver, excreted by kidneys
will cross the placenta

46
Q

tetracycline ADR

A

GI intolerance
Photo-sensitivity
Teeth discoloration

47
Q

tetracycline contraindicated

A

pregnancy
breast feeding
children <9

48
Q

Clindamycin mechanism of action

A

inhibits bacterial ribosomal protein syntheses

49
Q

Clindamycin treats

A

gram + and anerobes

50
Q

Clindamycin therapeutic uses

A

Skin and soft tissue infections (cellulitis)
aspiration pneumonia
acne
CA-MRSA

51
Q

Clindamycin ADR

A

hypersensitivity

C-Diff

52
Q

Antifolate

A

sulfamethoxazole

trimethoprim

53
Q

sulfa mechanism of action

A

use up the enzyme (dehydrofolate synthetase) needed to convert PABA to folic acid (necessary for bacteria to synthesize in order to live)

54
Q

antifolate drug interaction

A

absorbed orally
metabolized in liver
excreted renally
highly protein

55
Q

antifolate drug interaction

A

highly protein bound drugs

56
Q

antifolate drug interactions

A

hypersensitivity- angioedema, stevens- johnson
nephrotoxicity
kernicterus

57
Q

antifolate contraindicated

A
renal dysfunction
newborns (< 6 weeks old)
sulfasalazine
zonisamide
celecoxib
58
Q

trimethoprim mechanism of action

A

dihydrofolate reductase inhibitor

folic acid can not become active

59
Q

Bactrim includes (co-trimoxazole)

A

sulfamethoxazole

Trimethoprim

60
Q

bactrim mechanism of action

A

synergy

inhibits two sequential steps

61
Q

bactrim therapeutic uses

A
UTI
prostate infection
otitis media
sinusitis
prophylaxis Pneumocystic jiroveci pneumonia
CA-MRSA
62
Q

Fluoroquinolones (Quinolones)

A
ciproflofloxacin
gemifloxacin
levofloxacin
lomefloxacin
moxifloxacin
norfloxacin
ofloxacin
sparfloxacin
63
Q

quinolones mechanism of action

A

inhibits the replication of bacteria via 2 enzymes
DNA gyrase
topoisomerase

64
Q

quinolones therapeutic uses

A
concern: overuse and resistance
UTI
Prostate
pseudomonas
anthrax
skin and soft tissue
pelvic infection- chlamydia trachomatis
65
Q

first line for CAP

A

levofloxacin

moxifloxacin

66
Q

quinolones pharmacokinetics

A

excellent oral absorption
distribution - bones
excreted by renally
some metabolism in liver

67
Q

quinolones drug interaction

A

chelation

CYP 450

68
Q

how should quinolones be taken

A

empty stomach

69
Q

quinolones ADR

A

CNS (older adults)
prolonged QT intervals
tendon rupture

70
Q

quinolones precautioins

A

elderly
renally impaired
seizure risk
heart hx

71
Q

quinolone contraindicated

A

pregnancy
breast feeding
children 12 months for second line tx)

72
Q

metronidazole therapeutic uses

A

c. diff

73
Q

metronidazole caution

A

liver impairment

seizure hx

74
Q

metronidazole drug interaction

A

alcohol (must avoid!)

75
Q

nitrofurantoin mechanism of action

A

inhibits bacterial enzymes

damages bacterial DNA

76
Q

nitrofurantoin therapeutic uses

A

UTI (E.coli)

77
Q

nitrofurantoin ADR

A

discolored urine
GI
pulmonary toxicity

78
Q

nitrofurantoin contraindication

A

renal dysfunction

79
Q

nitrofurantoin ADR

A

discoloration of urine
GI disturbance
hypersensitivity
pulmonary toxicity

80
Q

Influenza antivirals

A

amantadine
remantadine
zanimivir
oseltamivir

81
Q

resistant influenza antivirals

A

amantadine

ramantadine

82
Q

influenza antiviral approved to treat Parkinson’s disease

A

amantadine

83
Q

amantadine and rimantadine therapeutic uses

A

prophylaxis and treatment of Influenza A

84
Q

amantadine and rimantadine ADR

A

Orthostatic hypotension

amantadine- CNS

85
Q

zanamivir and oseltamivir therapeutic uses

A

Prophylaxis and treatment of Influenza A and B

86
Q

influenza antivirals reduce duration and symptoms by how long?

A

1.3 days

87
Q

zanamivir and oseltamivir ADR

A

rare

zanamivir- bronchospasm in asthma/COPD

88
Q

flu vaccine contraindication

A

people with egg allergy

89
Q

LAV flu vaccine can be administered in

A

2- 49 years old without immune dysfunction

90
Q

Herpes Antivirals

A

acyclovir
valacyclovir
famciclovir
penciclovir

91
Q

Herpes antivirals therapeutic uses

A

genital herpes
varicella-zoster Virus
Cold sores

92
Q

herpes antiviral approved for HSV in neonates

A

acyclovir- to prevent transmission from + mother

93
Q

herpes antiviral approved to reduces risk of transmission to uninfected partners

A

Valacyclovir

94
Q

what two herpes antivirals are used in cold sores

A

topical acyclovir and penciclovir

95
Q

Herpes Antiviral ADR

A

mild- headache, confusion, n/v, dizzy, drowsy
rash, itching
renal sufficiency, fever, arthralgias, thrombocytopenia

96
Q

how are all episodes of genital herpes and HSV treated?

A

acyclovir
valcyclovir
famciclovir

97
Q

newborns presenting with what symptoms should be tested for HSV in the first month

A
fever
poor feeding
lethargy
seizure
lethargy
98
Q

Can someone still get chickenpox even if they have the vaccine?

A

yes (1- 10,000 do)

99
Q

if chickenpox start, should herpes active antiviral drugs be started and if so how soon?

A

yes, within 24 hours of exantham

100
Q

what is herpes zoster

A

reactivation of latent VZV in sensory ganglia

101
Q

the zoster vaccine is recommended for who?

A

> 60 years old

102
Q

should herpes active antivirals be used for people with shingles and why?

A

yes, reduce severity and duration of symptoms

reduces incidence of post herpetic neuralgia