Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Exam 3 > ch 73 > Flashcards

ch 73 Flashcards

1
Q

Bacteriostatic inhibitors of protein synthesis

key note

A 
Tetracyclines
Macrolides
Clindamycin
Linezolid (Zyvox)
Tedizolid (sivextro)

cannot give to immune compromised pts. Wont work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tetracyclines are a ______-spectrum antibiotics

A

Broad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

-cline

A

Tetracyclines

Tetracycline
doxycycline
minocycline

demeclocycline
eravacycline
omadacycline
sarecycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tetracyclines are active against a wide variety of _______ and ______

A

gram positive and gram negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Organism sensitive to tetracyclines are

A 
Rickettsia
spirochetes
Brucella
chlamydia
mycoplasma
H.Pylori
Borrelia burgdorferi
Bacillus anthracis
Vibrio cholerae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tetracyclines are 1st line for

A 
rickettsial disease (Rocky mountain spotted fever)
Typhus fever
Q fever
infections caused by chlamydia trachomatis (trachoma, lymphogranuloma venereum, cervicitis
Brucellosis
cholera
Mycoplasma pneumoniae
lyme disease
anthrax
gastric infections with H. Pylori
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what 2 tetracyclines are used for Periodontal disease

A

doxycycline - orally and topically

minocycline - topical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

oral doxycycline benefit in periodontal disease

A

inhibits collagenase (destroys connective tissue in gums)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

topical therapy for periodonal disease does what

A

adjuncts to scaling and root planing to reduce pocket depth and bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

drug interactions with tetracyclines

A 
Calcium supplements
milk products (due to calcium)
iron supplements
magnesium containing laxatives
most antacids due to containing mag, aluminum or both

take 1 hour prior or 2 hours after

can increase digoxin or warfarin levels through increasing absorption in GI tract and increased INR by altering vit K producing flora in gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

does tetracyclines penetrate to CSF

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

adverse effects of tetracyclines

A

GI - epigastric burning, cramps, n/v/d - giving with food helps but can decrease absorption

esophageal ulceration - avoid dosing at bedtime

diarrhea - risk of c.diff - concern after 1 week

yellow or brown discoloration in teeth when taken by pregnant woman after 4th month gestation - stains deciduous teeth of infant - not perm teeth
if take 4months to 8 years - discolors perm teeth

in pregnancy - suppress growth of long bones in premature infants - reversible with d/c treatment

superinfection - c-diff or candida albicans in mouth pharynx vagina and bowel - symptoms vaginal, anal itching, inflammatory lesions, black furry tongue -> d/c tetracycline if possible or antifungal if not possible

can cause fatty infiltration of the liver - manifests as lethargy and jaundice

pregnant and postpartum or history of kidney disease are higher risk of hepatotoxicity

renal tox

increased sensitivity to sun - sunburn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which tetracyclines will food not decrease absorption

A

minocycline - no change

Doxycycline - some change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

if a pt has renal impairment, which tetracyclines would be used

A

doxycycline
minocycline
eliminated primarily by liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what 2 tetracyclines are the most dangerous in renal disease

A

tetracycline
demeclocycline

accumulate to toxic levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

can you give tetracyclines to pregnant woman

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

can you give tetracyclines to breastfeeding woman

A

no - teeth of infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

tetracyclines and older adults

A

can interact with drugs including digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Macrolides are ____ spectrum

A

broad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

-mycin except clindamycin

A

Macrolides

Azithromycin
Clarithromycin
Erythromycin

21
Q

Salmonella drug of choice

A

Ceftriaxone

22
Q

Drug of choice for whooping cough

A

macrolides

23
Q

drug of choice for Corynebacterium Diphtheriae / acute diphtheria

A

Erythromycin

24
Q

shared drug of choice for chlamydial infections such as urethritis , cervicitis with tetracyclines

A

Macrolides (Erythromycin)

25
Q

shared first line with tetracyclines for Mycobacterium pneumoniae

A

Macrolides (-mycin)

26
Q

what erythromycin base does food not decrease absorption and which 2 is affected

A

Erythromycin ethylsuccinate - not effected

Erythromycin base - is affected
Erythromycin stearate - affected

27
Q

which erythromycin is approved for IV use

A

erythromycin lactobionate

28
Q

can erythromycin cross placenta

A

yes but BBB is poor

29
Q

metabolism of erythromycin/ drug interactions

A

CYP3A4 - increases chance of cardiac death

CCB - verapamil, diltiazem
Azole antifungal drugs - ketoconazole, itraconazole
HIV protease inhibitors - ritonavir, saquinavir
nefazodone - antidepressant

don’t combine with - monitor for tox
theophylline
carbamazepine
warfarin

clindamycin and chloramphenicol -antagonizing antibacterial effects

30
Q

Adverse effects erythromycin

A

QT prolongation

GI - epigastric pain, n/v/d

31
Q

what bacteria that is sensitive to Clindamycin

A

Bacteroides fragilis - resistance can be a problem with this one
Fusobacterium species
clostridium perfringes
anaerobic streptococci

32
Q

what drug is good at targeting necrotic tissue

A

clindamycin

33
Q

Drug of choice for group a strep and gas gangrene (caused by c.perfringens)

A

Clindamycin

34
Q

adverse effects clindamycin

A

Clostridium difficile associated diarrhea (CDAD)

35
Q

antibiotics for oxazolidinone class

A

Linezolid (Zyvox)

Tedizolid (Sivextro)

36
Q

what abx is activity against multi drug resistant gram positive pathogens including Vancomycin resistant Enterococci (VRE) and HC-MRSA, Hospital acquired pneumonia both methicillin susceptible and resistant strains or S.pneumoniae (pennicillin-sucsceptible strains only) complicated skin infetions by S aureaus or S pyogenes

saved for VRE or MRSA

A

Linezolid (zyvox)

37
Q

adverse effects of Linezolid (zyvox)

A

diarrhea
nausea
headache

reversible myelosuppression - manifests as anemia, leukopenia, thrombocytopenia, pancytopenia
CBC counts weekly
special caution needed with preexisting myelosuppression if it worsens or new develops then d/c

neuropathy - reverses with d/c

38
Q

only give tetracyclines if there is ____with the abscess

A

cellulitis

39
Q

drug interactions Linezolid (zyvox) and Tedizolid

A

is a MAO - hypertensive crisis if combined with sympathomimetics (ephedrine, pseudoephedrine, methylphenidate, cocaine) or foods with tyramine (wine and cheese)

Combining with SSRI can increase risk for serotonin syndrome because of MAO increases serotonin syndrome. Pt using SSRI cannot take this med (examples - Proxetine - paxil, duloxetine -cymbalta)

40
Q

effective in treatment of MRSA, and bacterial skin and soft tissue infections caused by Staph and Strep (new drug class)

A

Tedizolid

41
Q

adverse effects of Tedizolid

A 
n/v/d
dizziness
headache
neuropathy 
myelosuppression
42
Q

How do you avoid esophageal ulceration in tetracyclines

A

do not take at night

43
Q

what class is used topically and orally for severe acne

A

topically and orally for severe acne vulgaris

44
Q

Doxycycline is _____ for staph __for strep

A

good for staph

bad for strep

45
Q

first choice Chlmydia

A

Azithromycin 1 gram by mouth 1 time to cure

46
Q

H pylori treated with

A

macrolides

47
Q

mycobacterium pneumonia treated with

A

macrolides

48
Q

what drug will you use for anaerobic infections outside of the CNS

A

Clindamycin

49
Q

CDAD can happen ________ after clindamycin withdrawal

A

4-6 weeks

Pharm Exam 3 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions