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Antimicrobials 2 Flashcards

1
Q

11 Classes that Work by Inhibiting/Altering Protein Synthesis

A

Aminoglycosides

Lincosamides: clindamycin

Macrolides

Oxazolindinones

Streptogramins

Tetracyclines

Glycylcycline

Fluoroquinolones

Cycliclipopeptides

Sulfonamides

Metronidazole

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2
Q

3 Aminoglycoside drugs

A

gentamycin

amikacin

tobramycin

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3
Q

what does aminoglycosides work well on

A

gram neg bacteria

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4
Q

what are aminoglycosides used for

A

complicated infections:

UTIs/pyelonephritis, gynecological infections, peritonitis, endocarditis, PNA, osteomyelitis (DM related infections)

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5
Q

2 severe side effects of aminoglycosides

A

Nephrotoxicity - usually reversible

ototoxicity - usually permenant

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6
Q

how do we monitor aminoglycosides

A

therapeutically through peak and trough levels

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7
Q

MOA of aminoglycosides

A

inhibit bacterial ribosomes stopping transcription and translation

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8
Q

T/F aminoglycosides are used in pregnant women

A

FALSE

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9
Q

what is gentamycin not given with

A

Neuromuscular blockade

be careful, can cause PROFOUND respiratory distress [myasthenia gravis]

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10
Q

what CNS side effects are associated with gentamycin

A

confusion, depression, disorientation, numbness, and tingling

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11
Q

what damage is associated with gentamycin

A

cochlear damage

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

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12
Q

routes for gentamycin

A

IV; intrathecal for meningitis

Also available in ophthalmic drops, and topical ointments

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13
Q

route of amikacin

A

IV

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14
Q

what is amikacin used for

A

infactions resistant to tobramycin and gentamycin

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15
Q

routes of tobramycin

A

Inhalation for pulmonary infections (esp. CF patients)

Topical and ophthalmic solutions available

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16
Q

Lincosamide drug

A

clindamycin

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17
Q

is clindamycin Bactericidal or bacteriostatic–

A

can be either depending on concentration

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18
Q

MOA for clindamycin

A

binds to ribosomes and inhibits protein synthesis

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19
Q

7 indications of clindamycin

A

chronic bone infections,
GU tract infections, intraabdominal infections, anaerobic pneumonia, septicemia,
serious skin infections; prophylaxis for endocarditis

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20
Q

route of clindamycin

A

PO/IV

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21
Q

clindamycin primary use

A

treating pseudomembranous colitits

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22
Q

nursing considerations of clindamycin

A

Monitor use with neuromuscular blockade medications

Very toxic- monitor levels

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23
Q

2 macrolide drugs

A

erythromycin

azithromycin

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24
Q

S/E of macrolides

A

YUCK DRUGS

GI side effect profile intense

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25
MOA of macrolides
inhibit protein synthesis by binding to ribosomes
26
indications of macrolides
various infections of upper and lower respiratory infections, skin infections, soft tissue infections; STIs
27
what can be treated with macrolides
Legionnaire’s, Listeria, mycoplasma pneumonia
28
T/ F macrolides are Bacteriostatic in general, bactericidal in high enough concentrations
True
29
what benefits does erythomycin have
Has hypomotility benefits for diabetic gastroparesis & increase gastric motility and emptying
30
routes of erthromycin
PO & IV– IV is painful, oral absorption isn’t great Topical and ophthalmic also available
31
does erthromycin cross the BBB
NO
32
should you take erythomycin on an empty stomach
NO
33
does erythromycin have a lot of drug-drug interactions
YES
34
T/F azithromycin differs structurally from other macrolides
TRUE
35
Do you take a Z-pack with food
No, decreases absorption
36
T/F z-packs have Very good tissue penetration & long duration of action
True
37
Oxazolidinones drug
linezolid
38
MOA of linezolid
inhibits protein synthesis through non-selective monoamine oxidase (MAO) inhibitors
39
what is linezolid indicated for
healthcare-associated pneumonias and infections
40
what do we use caution in with linezolid
``` Hypertension Untreated thyroid disease Severe cardiac disease Cerebrovascular disease Pheochromocytoma ```
41
A/E of linezolid
headache nausea vommiting
42
routes of linezolid
po/iv
43
what do we watch for in linezolid
Watch platelet count = thrombocytopenia Can cause serotonin syndrome with use of SSRIs Avoid foods high in tyramine: wines, smoked meats, aged cheese, soy sauce
44
what is the streptogramin drug
quinupristin/dafopristin
45
what are quinupristin/dafopristin | used for
superbugs
46
why are quinupristin/dafopristin | given in combo
quinupristin/dalfopristin used in combination alone bacteriostatic, combination=bactericidal 16x the activity used alone
47
what must quinupristin/dafopristin be given IV with
D5W
48
what is the infections quinupristin/dafopristin are used for
Use for serious, life-threatening infections caused by VRE and complicated skin and skin structures, including MRSA
49
A/E of quinupristin/dafopristin
arthralgias, myalgias; painful/erythema/inflammation at IV site in 75%
50
3 Tetracycline drugs
tetracycline doxycycline minocycline
51
MOA of tetracyclines
bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes
52
Some infections treated by tetracyclines
``` Rickettsia (rocky mountain spotted fever) Chlamydia and trichomonas Lyme disease Cholera Pelvic inflammatory disease Mycoplasma pneumonia Acne ```
53
contraindications of tetracyclines
Pregnant and nursing women, children younger than 8
54
A/E for tetracyclines
discoloration of the permanent teeth and tooth enamel hypoplasia in fetuses and children, photosensitivity, many others
55
Is tetracycline bacteriostatic
yes, inhibits or retards the growth
56
A/E of tetracycline
N/V/D, headache, photosensitivity, dizziness Rare: anaphylaxis and angioedema
57
Route of tetracycline
PO
58
where does tetracycline concentrate
bone liver tumor spleen teeth
59
what is doxycycline used for
Chlamydial and mycoplasmal infections Prophylaxis for STIs Acne and other non-dangerous skin infections
60
what is minocycline used for
Neisseria meningitides Decreases symptoms of rheumatoid arthritis Solodyn is an extended release (ER) formula - acne
61
what is the glycylcyline drug
tigecycline
62
what is tigecycline effective against
Treats complicated skin and skin structure infections MRSA, VRE, extended-spectrum beta lactamases Peritonitis and other complicated abdominal infections
63
S/E of tigecycline
N/V
64
2 Fluoroquinolone drugs
ciprofloxacin levofloxacin
65
MOA of fluroquinolones
destroy bacteria by altering their DNA nterfere with the bacterial enzymes DNA gyrase and topoisomerase Mostly gram-negative and some gram-positive coverage
66
T/F fluroquinolones have good oral absorption
TRUE
67
what does ciprofloxacin treat
Used to treat UTIs, some STIs, upper and lower respiratory tract infections, gonorrhea, and other infections Also treats anthrax infection with Bacillus anthracis
68
route of cipro
po,iv,topical
69
A/E of cipro
arthropathy (joint disease), often irreversible avoid in patients under 18 and over 60
70
t/f cipro hasMinimal penetration of the BBB/CSF
true
71
route of levofloxacin
po iv 100% bioavailabiilty orally
72
side effects of levofloxacin
CNS disorders that predispose to seizures, kidney failure, can cause prolongation of QT interval, photosensitivity
73
where does levofloxacin have more activity
More activity against pneumococcal and other ‘atypical’ respiratory infections
74
cyclic lipopeptide drug
daptomycin
75
MOA of daptomycin
Not completely understood; binds to gram + cells in calcium-dependent process, disrupts the cell membrane potent
76
route of daptomycin
IV once per day
77
What does daptomycin treat
MRSA, VRE bacteremia, right-sided endocarditis, complicated skin & skin structure infections
78
what are the sulfonamide drug
sulfamethoxale + trimethoprim (Bactrim)
79
MOA of sulfonamide
don’t actually destroy bacteria but inhibit their growth= bacteriostatic by preventing the synthesis of folic acid needed for DNA synthesis
80
indications of sulfonamide
uncomplicated UTIs, respiratory infections, salmonella, shigellosis
81
caution with sulfonamide
sulfa allergies photosensivity
82
metronidazole is anti what?
Antiprotozoal & antibacterial
83
metronidazole is used to treat what
Crohn’s disease Antibiotic-associated diarrhea
84
MOA of metronidazole
inhibits DNA synthesis, similar to fluroquinolones
85
Caution with metronidazole
do not take with alcohol
86
A/E of metronidazole
N/V xerostomia vaginal candidasis
87
activity of metronidazole
anaerobic only

Pharm 1 (28 decks)

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