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Pharm 2 final > Contemporary Antibiotics part 2 > Flashcards

Contemporary Antibiotics part 2 Flashcards

1
Q

cephalosporins have what type of configuration?

A

beta-lactam

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2
Q

how does cephalosporins increase resistance to B-lactamase?

A

by addition of “R” groups

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3
Q

T/F: cephalosporins are “custom” abx

A

true

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4
Q

mechanism of action of cephalosporin

A

cell wall inhibition

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5
Q

is cephalosporins bacterioCIDAL or bacterioSTATIC?

A

cidal

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6
Q

T/F: cephalosporin has a more extensive spectrum in comparison to PCN and is more expensive than PCN

A

true

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7
Q

spectrum of 1st generation cephalosporins

A
  1. streptococcus
  2. staphylococcus (MSSA, NOT MRSA)
  3. E. coli
  4. proteus mirabilis
  5. klebsiella
  6. oral anaerobes
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8
Q

indications for 1st generation cephalosporins

A
  1. community acquired staph infection
  2. surgical wound prophylaxis with skin incision
  3. odontogenic infection in PCN allergic patient
  4. SBE and total joint replacement (TJR) prophylaxis
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9
Q

what percent of the population with PCN allergy will have cephalosporin allergy?

A

1-10%

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10
Q

T/F: avoid cephalosporin in patient with severe PCN allergy, probably okay if allergy is mild

A

true

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11
Q

T/F: avoid any PCN when documented cephalosporin allergy is present

A

true

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12
Q

macrolide abx mechanism of action

A

irreversibly bind 50s ribosomal unit

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13
Q

what does macrolide abx inhibit?

A

RNA dependent protein syntehsis

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14
Q

selective uptake by phagocytic cells serving as repository with macrolide use leads to what?

A

high levels at infection relative to blood levels

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15
Q

T/F: macrolide abx don’t have post-antibiotic effect

A

false, has significant PAE because they’re bacterioSTATIC

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16
Q

pros of clarithromycin (it’s a macrolide abx)

A
  1. less resistance
  2. better H. influenza coverage
  3. BID dosing
  4. less GI distress
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17
Q

con of clarithromycin (it’s a macrolide abx)

A
  1. need to take 1h before or 2h after eating

2. expensive

18
Q

indications for clarithromycin (it’s a macrolide abx)

A
  1. sinus infection
  2. mild to moderate odontogenic infection in PCN allergic pt
  3. SBE prophylaxis in PCN allergic patient as alternative to Clindamycin
  4. pneumonia/bronchitis
19
Q

which macrolide abx is better than clarithromycin to tx mild to moderate odontogenic infection in PCN allergic pt?

A

azithromycin

20
Q

azithromycin (also macrolide abx) has similar spectrum to clarithromycin but is better for what?

A

strep and gram negative anaerobes

21
Q

indications for azithromycin (also macrolide abx)

A
  1. pneumonia/bronchitis

2. SBE prophylaxis

22
Q

pros of azithromycin (also macrolide abx)

A
  1. daily dosing/improved compliance (i.e. Z-pack)
  2. not require dosing around meals (unlike clarithromycin)
  3. less GI distress
23
Q

cons of azithromycin

A

expensive

24
Q

macrolide abx adverse effects

A
  1. GI distress
  2. ototoxicity
  3. cholestatic jaundice (hepatitis)
  4. long Q-T interval/Torsades de Pointes
  5. increased activity of digitalis
  6. potentiation of oral anticoagulants such as coumadin
  7. myopathy in patients taking statins for elevated cholesterol
25
Q

which macrolide abx has the worst GI distress?

A

erythromycin

26
Q

examples of lincosamides

A
  1. clindamycin

2. lincomycin

27
Q

which lincosamide abx is currently the only one used in US?

A

clindamycin

28
Q

mechanism of action of lincosamides

A

bind 50s ribosome leading to bacteriostatic inhibition of protein synthesis

29
Q

spectrum of bacteria treated by clindamycin

A
  1. streptococcus
  2. staphylcoccus
  3. actinomyces
  4. anaerobes
30
Q

clindamycin is bacteriostatic except when?

A

at high doses

31
Q

cons of clindamycin

A
  1. higher toxicity than some (pseudomembranous colitis)

2. expensive

32
Q

T/F: clindamycin can penetrate bone

A

true

33
Q

indications for clindamycin

A
  1. chronic recurrent infection
  2. osteomyelitiis
  3. odontogenic infection in immunocompromised patient with severe PCN allergy
  4. some increased use in routine odontogenic infection due to increasing resistance to PCN by oral anaerobes
  5. total joint replacement (TJR) prophylaxis in PCN allergic patient
  6. SBE prophylaxis in PCN allergic patient
34
Q

is metronidazole cidal or static?

A

cidal

35
Q

characteristics of metronidazole

A
  1. oral dose equivalent to parenteral
  2. mild toxicity
  3. disulfuram effect
  4. inexpensive
36
Q

mechanism of action of metronidazole

A

disrupts DNA in anaerobic environment

37
Q

indications for metronidazole

A
  1. chronic anaerobic infection
  2. particularly effective bone penetration
  3. in combo with PCN or cephalosporin in serious odontogenic infection
38
Q

are tetracyclines cidal or static?

A

static

39
Q

mechanism of action of tetracyclines

A

30s ribosomal inhibition

40
Q

characteristics of tetracyclines

A
  1. high resistance
  2. inexpensive
  3. broad spectrum
41
Q

indications for tetracycline

A
  1. early adjunctive tx of peri-implantitis
  2. resistant hospital acquired infections
  3. helicobactor related gastric and peptic ulcer due to increasing resistance to metronidazole
  4. topical therapy
  5. dry socket prevention
42
Q

what happens when tetracycline is used to treat odontogenic infection

A

may result in deformity of developing teeth

Pharm 2 final (10 decks)

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