cephalosporin, Tetracycline, Macrolides And Aminoglycosides Flashcards
What is the Most widely used group of antibiotics?
Cephalosporins
What class of antibiotics activity increases with each generation
Cephalosporin
What are common adverse reactions to cephalosporin in both children and adults?
A maculopapular or mobile form rash
How are cephalosporin classified?
Through five major groups or generations based on their anti-microbial activity
Which generation of cephalosporin have good activity against aerobic, gram-positive organisms, and some community acquired gram-negative organisms?
First generation cephalosporin like Keflex
Which generation of cephalosporin have slightly extended spectrum against gram-negative bacteria, and are active against somegram-negative anaerobes
Second generation
Which generation of cephalosporin are active against many gram-negative bacteria
Third generation like Rocephin
Which generation of cephalosporin is considered more stable against beta-lactam and has little or no beta-lactamase inducing capacity
Fourth generation like Cefepime
Which generation of cephalosporin is uniquely active against MRSA and has gram-negative spectrum activity that is comparable to the third generation agents
Fifth generation like ceftatoline
What generation is cefoderocol and what is it used for?
Fifth generation Hospital acquired, bacterial pneumonia, and complicated UTI caused by gram-negative microorganisms
Which cephalosporin generations are used for otitis media, gonorrhea, COPD, meningitis, and limes disease
Second and third generation
Which generation of cephalosporin is typically used for skin and soft tissue infections or UTIs
First generation
Which generation of cephalosporin is typically used for bacteremia and intra-abdominal infections
Fourth generation
Which generation of cephalosporin is used for MRSA vancomycin resistant staph aureus hospital acquired pneumonia and negative complicated UTI
Fifth generation
What generation is uniquely used against MRSA
Fifth generation cephalosporin
What generation is more stable against beta lactamase
Fourth generation cephalosporin
What generation is cefepime from?
Fourth generation cephalosporin
What generation is ceftaroline from
Fifth generation cephalosporin
What generation is cephalexin from?
First generation cephalosporin
What generation is ceftriaxone from?
Third generation cephalosporin
What generation is cefaclor from?
Second generation cephalosporin
Which three antibiotic classes, inhibit protein synthesis
Tetracycline , macrolides, and aminoglycosides
How do tetracycline inhibit protein synthesis?
They attach to the ribosomes 50S and inhibit protein synthesis in bacteria
How do macrolides inhibit protein synthesis?
They prevent the continuation of protein synthesis by binding to the 50S sub unit of bacterial ribosomes
How do aminoglycosides inhibit protein synthesis?
They have an affinity for the bacterial 30 S ribosome subunit where it interrupts the initial steps required for peptides synthesis, which causes the misreading of messenger RNA
Which class of antibiotics is used to treat chlamydia and mycoplasma?
Tetracyclines
How is doxycycline dose differently than tetracycline
Doxy has a longer half-life of 18 to 22 hours so it can be dosed once daily due to its long half-life and touch or cycling is half-life is 6 to 10 hours
Is tetracycline, a broad spectrum or a narrow antibiotic?
Is a broad spectrum antibiotic
Why is doxycycline better to use in children than tetracycline
It can be dosed less frequently, and it binds to calcium which tetracycline does not so it can cause tooth, discoloration, and bone demineralization
What are the glycocyclines used for?
They are the first analogues to be approved and they are used to treat a broader spectrum of infections And are designed to overcome tetracycline resistance
What medication is used to treat rocky mountain spotted fever and lymes disease prophylaxis
Doxycycline
What are the adverse effects of tetracycline?
G.I. upset effects on bone and teeth super infection hepatotoxicity renal toxicity photosensitivity and CNS effects
Which tetracycline has a black box warning
Tigecycline
What substances can decrease the absorption of tetracycline
Minerals, antacids, dairy products, calcium
What medications do tetracycline increase the effects of
Anticoagulants digoxin, and isotrentinoin
What medications do tetracycline decrease the effects of
Insulin, oral, contraceptives and penicillin
What drugs decrease the action of tetracycline
Barbiturates carbamazepine, and hydantoins
What pregnancy category is tetracycline
Category D it has fetal toxicity and should not be used in children less than eight years old
Are macrolides bacteriastatic or baterciacidal
They are bacteriastatic at low doses and bacteriacidal at high doses
Why are macrolides like azithromycin sometimes better to treat chlamydia than doxycycline
One dose of a macrolide is a equivalent to seven day course of doxycycline
What is the first line of treatment for atypical pneumonia and mycobacterium avium complex?
The macrolide azithromycin
What are the most common adverse effects of erythromyosin?
G.I. super infection QT prolongation hearing loss and hepatoxicity
What drugs did the macrolides erythromycin and clarithromyosin increase the effects of?
Statins procainamide warfarin, benzos, buspirone, carbamazepine, cyclosporine, digoxin, and Theophyline
What drugs inhibit erythromycin metabolism
Verapamil diltiazem HIV Protease inhibitors azole antifungal drugs and nefazodone
Do you want to start your patient on a macrolide but she is currently taking at least five other drugs on a routine basis which macrolide would be the least likely to cause drug interactions
Azithromycin
What is the mechanism of action for macrolides?
Binds reversibly to the 50 S sub unit on the ribosomes
What type of antibiotics are most frequently prescribed by intramuscular or IV injection for serious infections caused by aerobic gram-negative infections
Amino glycosides, like gentamicin myosin, Tobramyosin and amikacin
What is the mechanism of action for aminoglycosides?
They bind to the 30 S ribosomal sub unit and cosmic reading of the genetic code and inhibition of translocation
What type of bacteria do aminoglycosides treat?
They are usually bactericidal against aerobic gram-negative bacilli
What is prolonged post antibiotic effect?
Persistent suppression of bacterial growth that occurs after the drug has been removed in vitro or cleared by drug metabolism and excretion in vivo
Which drug class has PAE effects
Aminoglycosides
Which drug class are poorly absorbed across the gut membrane and must be given parentally
Aminoglycosides
How are aminoglycosides excreted from the body?
99% of the administer dose is eliminated in urine by glomerular filtration and the half-life is one and a half to 3 1/2 hours
What are the adverse effects of aminoglycosides?
Nephrotoxicity auto toxicity muscular blockade, like myasthenia gravis and drug induced renal failure
Are aminoglycosides considered broad spectrum or narrow spectrum
Broad spectrum
What are the amino glycosides more effective and an aerobic or an anaerobic environment?
aerobic environment
What generation is keflex (cephalexin) and what does it treat
Gram positive first generation
What generation is cefaclor and what organisms and infections does it treat
Second generation of gram negative. Treats sinusitis, otitis, and URI
What are third generation and what for they treat
Gram negative organisms, cephtriaxone or rocephin is one.
What generation is cefepime and what does it treat
Fourth generation it is more resistant to betalactamase and it is used to treat pseudomonas aeriginosa
How do bacteria become resistant to tetracycline, macrolides, and clindamycin?
Efflux pump or mutation of ribosome
Which antibiotic is used for severe anaerobic infection
Clindamyocin in combo with aminoglycosides
What is the major side effect of clindamyocin?
C DIFF
What are amino-glycosides two most serious side effect?
Meds like gentomoycin can cause ototoxicity and renal toxicity
