Antimicrobials - Quiz 7 Flashcards
Which Abx are Narrow-Spectrum?
PCN
Erythromycin
Clindamycin
What is the Post Antibiotic Effect?
The continued supression of Bacterial Growth even when the Abx is no longer detectable d/t Bacteria being weaker to leukocytes
What are some Bacterial Alterations that make them Resistant?
Decreased Abx Permeability
Increased Efflux Pumps
Abx Inactivation
Modify Abx
What are the treatments for C. Diff?
Oral Vanco
Fidaxomicin
Fecal Transplant
What is a Class I Wound?
Clean
Atraumatic
No Sterile Break
No Respiratory, GI, or GU Entry
What is a Class II Wound?
Clean-Contaminated
Surgery in Areas known to have Bacteria
No Spillage of Contents
What is a Class III Wound?
Contaminated
Major Sterile Break
Traumatic Wound Surgery
GI Spillage
Infected Billiary or GU Entry
What is a Class IV Wound?
Dirty-Infected
Pre-Existing Infection before Surgery
Old Wound
Perforated Viscera
What is the most common bacteria for Clean Wounds?
Staphylococcal
What is the problem with providing Prophylaxis for Fungal Infection?
No proven efficacy of prophylaxis
How should Ancef and Vanco be given as prophylaxis regarding timing?
Ancef: Within 60 minutes before incision
Vanco: Within 120 minutes before incision
What was found in the JAMA research about Abx Prophylaxis duration?
Longer Abx Duration = MORE C. Diff & AKI, but no additional SSI reduction
How do Beta Lactams work?
Binds to PCN Binding Protein and weakens Cell Wall
Which Abx are Beta-Lactamase Inhibitors?
Sulbactam
Tazobactam
Clavulanic Acid
Which Abx carries the highest risk for causing C. Diff?
Clindamycin
What do Oxacillin, Nafcillin, and Dicloxacillin cover?
Staph
How do Cephalosporins compare to PCNs?
Same MOA, but less susceptible to Penicillinases
What are Cephalexin & Cefazolin (1st Gen) used for?
MSSA
Staph
Strep
E Coli
Klebsiella
Salmonella
What is the advantage of using Cefazolin & Cephalexin?
Generally Safe
Cephalexin & Cefazolin have no effect against _______
Cephalexin & Cefazolin have no effect against H. Influenzae & Enteroccoi
What are Cefaclor, Cefuroxime, & Cefoxitin (2nd Gen) used for?
H. Influenzae
Enterobacter
Nesseria
How do 2nd Gen Cephalosporins compare to 1st Gen?
Also safe, but has less Gram Positive coverage than 1st Gen
What are Ceftazidime & Cefoperazone (3rd Gen) used for?
Anti-Pseudomonal
CNS Coverage (Ex: Meningitis)
Crosses BBB
Which Cephalosporin has the MOST Gram Negative coverage and destroys everything including Pseudomonas?
Ceftazidime (Fortaz) - 3rd Gen
Which Cephalosporin has the Good Gram Positive coverage (less than 1st Gen), but does not cover any Gram Negative like Pseudomonas?
Ceftriaxone
What are some concerns with using Ceftriaxone?
Diarrhea
Billiary Sludging
Incompatible w/ Calcium
What is Ceftaroline (Teflaro) (5th Gen) used for?
Gram Postive; MRSA
Broad Spectrum
What is the treatment of choice for ESBLs?
Carbapenems
Which class of Abx has a high risk for Seizures?
Carbapenems - (Primaxin)
How does Vanco work?
Stop cell wall synthesis via Peptidoglycan Inhibition
What are the Adverse Effects of Vanco?
Red Man
Nephrotoxicity
Ototoxicity
How does Linezolid work?
Binds to 50s Ribsome to stop Protein Synthesis
What are adverse effects of Linezolid?
Serotonin Syndrome
&
Myelosupression
How do Macrolides work?
Same of Linezolid - Binds 50S Ribosomal Subunit to stop Protein Synthesis
What is Azithromycin used for?
Gram Positives
Respiratory Infections
H. Pylori
Staph
What is the concern when using Azithromycin & Clarithromycin?
Prolonged QT & Torsades
Drug Interactions
(Azithromycin is Preferred)
What is the main concern with using Erythromycin?
Significant GI Toxicity
Which drugs are Macrolides?
Azithromycin
Clarithromycin
Erythromycin
How do Fluoroquinolones work?
Stops DNA Synthesis & Supercoiling
What are the safety concerns related to Fluoroquinolones?
Many Drug Interactions
Achilles Tendonitis & Rupture
QT Prolongation
Hypoglycemia
Neuro Effects
What is unique about Delafloxacin as a Fluoroquinolone?
Covers MRSA and NOT associated w/ Prolonged QT or Photosensitivty
How do Tetracyclines work?
Binds to 30s Ribosome to stop Protein Synthesis
What are the adverse effects of Tetracyclines?
Lots of Photosensitivty
Bone Issues in Preggos & Kids
Tooth Discoloration
Enamel Hypoplasia
Liver Toxicity
How do Aminoglycosides work?
Binds to 30S Ribosome to disrupt mRNA translations
&
Inteferes w/ Ca & Mg to damage cell wall
What are the adverse effects of Aminoglycosides?
Nephrotoxic
Ototoxic
Prolonged Neuro Muscular Block
How does Trimethoprim/Sulfamethoxazole (Bactrim) work?
Stops Folic Acid synthesis to starve Bacteria so they cant make DNA
What are the adverse effects of Bactrim?
Pancytopenia
Neutropenia
Thrombocytopenia
Steven-Johnsons
What is Nitrofurantoin (Macrobid) used for?
Urinary Pathogens
What are the adverse effects of Nitrofurantoin (Macrobid)?
Confusion
Neuropathy
Lung Problems
Blood Problems
Liver Damage
What is Clindamycin used for?
Gut Anaerobes
MRSA
How does Metronidazole (Flagyl) work?
Breaks DNA & Unwides Helix to kill the cell
What are the adverse effects of Metronidazole (Flagyl)?
Pancreatitis
Neuropathy
Ataxia
Confusion
Tremors
Which Abx are safe for Preggos?
PCN
Cephalosporins
Erythromycin
For Preggos, which Abx should only be used if necessary?
Aminoglycosides
&
Isoniazid
Which Abx should be AVOIDED in Preggos because it can hurt the fetus?
Flagyl
Ticarcillin
Rifampin
Trimethroprim
FQs
Tetracyclines
What happens when Tetracyline is given to Preggos?
Fatty Necrotic Liver
Pancreatitis
Renal Damage
What are the adverse effects of Antivirals?
Hallucinations
Tremors
Kidney Stones
What are the concerns with Antifungals?
Renal Failure
Infusion Rxns
HypoK
HypoMag
Drug Interactions for -azoles
Liver Damage