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Pharmacology 3 > Antimicrobials > Flashcards

Antimicrobials Flashcards

0
Q

Antibiotic

A

A chemical produced by a microorganism, has ability to harm others.

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1
Q

Antimicrobial

A

Any agent that kills or suppresses microorgamisms

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2
Q

Selective Toxicity

A

Ability of a drug to kill or suppress infecting microorganisms without causing injury to host.

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3
Q

Use of antimicrobials.

A
  1. Treat infection
  2. Prophylactic use:
    a. Surgery
    b. bacterial endocarditis
    c. neutropenia
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4
Q

Misuses of antimicrobials.

A
  1. attempted treatment of untreatable infections
  2. treatment of fever of unknown origin
  3. improper dosage
  4. Improper drug for organism
  5. omission of surgical cleaning/drainage
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5
Q

Drug resistance

A

Microorganisms able to alter function or structure-changes in microbial DNA.

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6
Q

Mechanisms of Antimicrobial action

A

a. Inhibitors of Cell Wall synthesis.
b. Bacteriostatic inhibitors of protein synthesis
c. Bactericidal inhibitors of protein synthesis.

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7
Q

Inhibitors of cell wall synthesis.

A
  1. Penicillins
  2. Cephalosporins
  3. Carbapenems
  4. Vancomycin
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8
Q

Bacteriostatic inhibitors of protein synthesis.

A

Do not cause cell death, slows microbial growth.

  1. Tetracyclines
  2. Macrolides
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9
Q

Bactericidal inhibitors of protein synthesis

A
  1. Aminoglycosides; Gentamicin/ Garamycin
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10
Q

Narrow-spectrum, penicillinase sensitive

A

Penicillin G

Penicillin V

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11
Q

Narrow-spectrum, penicillinase resistant

A

Nafcillin/Nallpen
Dicloxacillin/Dynapen
Oxacillin/Bactocil
Methicillin (now obsolete)

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12
Q

Broad Spectrum Penicillin

A

ampicillin/pricipen

amoxicillin/Amoxil

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13
Q

Extended spectrum Penicillins

A

Piperacillin/Piparcil

ticarcillin/Ticar

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14
Q

Penicillin + Beta Lactamase inhibitors

A

Augmentin: amoxicillin + clavulanic acid
Unasyn: ampicillin + sulbactam

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15
Q

Penicillin G

A

MOA: Weakens bacterial cell wall by binding to penicillin-binding proteins –> allows water to enter cell, ruptures cell.
IND: Gram pos Bacteria, Gram neg cocci
AE: Pain at injection site, allergic reactions
DI: aminoglycosides
NURS: Medic alert bracelets, Dont mix with aminoglycosides

16
Q

1st Gen. Cephalosporins

A

Cefazolin/ Ancef, Kefzol
Cephalexin/ Keflex

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Gram pos - Strept, staph infections, Pre-surgery prophylactic.

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

17
Q

2nd Gen. Cephalosporins

A

Cefuroxime/ Ceftin
Cefoxitin/ Mefoxin

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Gram pos - Staph infections, Resp. infections, Sinus, Ear Infections

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

18
Q

3rd Gen. Cephalosporins

A

Ceftriaxone/ Rocephin
Cefixime/ Suprax

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Broad spectrum, Gram Neg, Reaches CSF.

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

19
Q

4th Gen Cephalosporins

A

Cefepime/ Maxipime

MOA: Bind to penicillin-binding proteins and inhibit bacterial cell wall synthesis –> weakens cell wall, causes lysis and death.

IND: Strongest, Reaches CSF easier.

AE: Allergic reactions, Bleeding, Thrombophlebitis

DI: Alcohol, Drugs that promote bleeding

NURS: Use cautiously in patients with penicillin allergy, Monitor PTT

20
Q

Carbapenem: Imipenem/ Primaxin

A

MOA: Binds to penicillin binding proteins –> weakens bacterial cell wall causing lysis, cell death. Mixed i combo with cilastatin

IND: Gram Pos, Gram Neg Bacteria
Resistant organisms, mixed infections, can reach CSF

AE: GI Effects, Allergic Reactions, suprainfections

21
Q

Vancomycin

A

MOA: Inhibits cell wall synthesis causing lysis and death. Binds to molecules that serve as precursors for cell wall synthesis.

IND: Serious Infections only- Gram Pos
Infection with MRSA
Antibiotic-associated pseudomembranous colitis: C. difficle

AE: Ototoxicity

22
Q

Bacteriostatic Inhibitors of Protein Synthesis

A

Do not cause cell death, Slows microbial growth.

23
Q

Tetracycline Types

A

tetracycline/ Sumycin
doxycycline/ Vibramycin
mincycline/ Minocin

24
Q

Tetracycline

A

MOA: Suppress bacteria growth by inhibiting bacterial protein synthesis. Bind to ribosomal subunits, inhibits binding of ttransfer RNA to ribosome complex.

IND: Broad spectrum against Gram Pos and Gram Neg
Tx of acne
Tx of infectious disease
Tx of PUD
Tx of Periodontal disease

AE: GI irritation, discoloration of developing bones and teeth, suprainfection, hepatotoxicity, Renal toxicity, Photosensitivity

DI: Metal ions: calcium, irono, magnesium, aluminum, and zinc.

CI: Not used for children <8 yrs
Not for use during pregnancy
Not for pts with renal disease

NURS: Instruct Pts to avoid sun and wear sunscreen,
Dietary restrictions

25
Q

Types of Macrolides

A

erythromycin/ E-mycin
azithromycin/ Zithromax
clarithromycin/ Biaxin
dirithromicin/ Dynabac

26
Q

Erythromycin/ E-mycin

A

MOA: suppress bacterial growth by inhibiting bacterial protein synthesis. Binds to ribosomal subunit, blocks addition of new amino acids to peptide chain.

IND: Alternative for pts with penicillin allergy: Gram Pos, Gram Neg, Strept infections, resp tract infections, endocarditis, legionnaires, pertussis, and diptheria.

AE: GI effects
Hepatotoxicity
Cardiotoxicity

DI: Theophylline, Tegretol, Warfarin, Verapamil, Diltiazem, -azoles, HIV protease inhibitors

27
Q

Gentamicin/ Garamycin

A

MOA: Binds to ribosomal unit and interferes with protein synthesis, causes production of abnormal proteins –> Gets inserted –>Weak points lead to cell death.

IND: aerobic gram neg bacilli - pseudomonas, E. coli. Klebsiella
Used in combo w/ Vanco to treat serious infections with gram pos

AE: Ototoxicity, Nephrotoxicity

CI: Pts with renal disease, Elderly

DI: Cephalosporins, Vancomycin, Penicillins, Ototoxic drugs, Nephrotoxic drugs.

NURS: Monitor drug levels
Monitor kidney function; BUN & Cr
Monitor for signs of Ototoxicity
Do not take for more than 10 days

28
Q

Sulfonamides

Trimethoprim + Sulfamethoxazole (TMP/SMZ)/ Bactrim, Septra

A

MOA: Both Meds disrupt synthesis of folic acid, needed for bacterial biosynthesis of RNA and DNA.

IND: Gram Pos, Gram Neg
Bacterial infections: UTIs, ear infections, bronchitis
Protozoal infections: pneumocyxtic carinii pneumonia

AE: Hypersensitivity reactions
Hematological effects
Kernicterus
Renal damage from crystalluria

DI: Warfarin, Dilantin, Oral hypoglycemics

CI: Pregnant women near term, breastfeeding, Children < 2 months

NURS: Observe for hypersensitivity reactions
Avoid sun, wear sunscreen
Periodic blood work
Increase fluids

29
Q

Fluoroquinlones:

Ciprofloxacin/ Cipro

A

MOA: Inhibits bacterial DNA enzyme –> prevents DNA replication

IND: Broad spectrum, aerobic Gram Neg & Gram Pos bacteria.
Infections: Resp tract, GI, UTI, bones, Skin, Joint Infections
Prevention of Anthrax

AE: GI effects, CNS effects, Candida infections, tendon rupture

DI: Theophylline, Warfarin, Antacids, Milk products, iron, Zinc

30
Q

Metronidazole/ Flagyl

A

MOA: Taken up by cell , causes DNA strand breakage

IND: Anaerobic organisms, Protozoal infections, GI Infections, GU infections

AE: CNS effects, GI effects

DI: Alcohol, Warfarin

Pharmacology 3 (5 decks)

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