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Drugs IDIT > drugs > Flashcards

drugs Flashcards

1
Q

Carbapenems

A 
A class of drugs that are the broadest spectrum of beta-lactams. G+/G-
reserved for resistant infections.
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2
Q

Imipenem

A 
-Class: Cardapenems
given with Cilastatin (primaxin) IV/IM
-resists most Beta-lactamases. 
-Increase the risk of C.difficile infection
-seizure (1.5%)
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3
Q

Cilastatin (a drug given with imipenem)

A

inhibits a non beta-lactamase, dehydropeptidase, in kidney proximal tubules that normally metabolizes imipenem. This increases the levels of imipenem and prevents generation of a nephrotoxic metabolite

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4
Q

Meropenem

A

Class: Carbapenems
not metabolized by dehydropeptidase
Fewer seizures (0.5%)

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5
Q

Ertapenem

A

Class: Carbapenem

once a day dosing

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6
Q

Doripenem

A

Class: carbapenem
injection for complicated intra-abdominal infections & UTIs.
NOT to be used for pneumonia; increased risk of death and decrease cute rates compared to imipenem/cilastatin

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7
Q

General uses of Carbapenems

A

resistant infections:

  • UTIs
  • bone, joint and skin infections
  • intra-abdominal & gynecological infections, bacterial septicemia
  • lower respiratory tract infections
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8
Q

What is Carbapenem-resistant Klebsiella pneumonia (CRKP)?

A

an infection that is being found in nursing homes and such that are effecting the elderly. (particularly patients on ventilators).

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9
Q

Rx interactions for Carbapenems

A

decreases levels of valproic acid which increases the risk of seizures!

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10
Q

Aztreonam

A

class: misc. Beta-lactams and other inhibitors of cell wall synthesis
- a monobactam with a stand alone b-lactam ring. Active only against G- aerobes.
- Resists most b-lactamases of G- organisms

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11
Q

Mechanism of aztreonam

A

binds PCN-binding protein-3 (PBP-3) of G- bacteria creating long unstable filamentous bacteria that lyse.

  • IV/IM excreted unchanged in urine
  • adjust dose for renal failure.
  • crosses inflamed meninges
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12
Q

Vancomycin

A

class: misc. Beta-lactams and other inhibitors of cell wall synthesis
- IV for MRSA or nonresistant Staph if allergic to B-lactams.
- Not absorbed orally but has been used for local action for pseudomembranous colitis.

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13
Q

Mechanism of Vancomycin

A

Binds to D-ala-D-ala terminus and prevents removal of terminal D-ala of pentapeptide chain attached to N-acteylmuramic acid residues of peptidoglycan.

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14
Q

Side effects of Vancomycin

A

Ototoxicity
Nephrotoxicity
Red man syndrome- after rapid IV–>flushing upper body and face, hypertension, tachycardia and shock.

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15
Q

Telavancin

A

class: misc. Beta-lactams and other inhibitors of cell wall synthesis
derived from vancomycin given IV as one time does for hospital acquired and ventilator-associated bacterial pneumonia from S.aureus only and for G+ complicated skin and skin structure infections.

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16
Q

Mechanisms of Telavancin

A
  1. inhibits cross linking
  2. disrupts bacterial membrane potential and increases membrane permeability
    Net effect: Lysis
    potentially teratogenic. Avoid in pregnant women
17
Q

Oritavancin

A

class: misc. Beta-lactams and other inhibitors of cell wall synthesis
- single IV dose over 3 hrs for adults with acute bacterial skin and skin structure infections (ABSSSI) from susceptible G+ organisms including MRSA

18
Q

Mechanisms of Oritavancin

A
  1. binds stem peptide of peptidoglycan precursors thus inhibiting polymerization
  2. binds peptide brigding segments of cell wall thus inhibiting cross linking
  3. disrupts membrane integrity…depolarization, increases permeability and cell death!
19
Q

Side effects of Oritavancin

A

headache, nausea, vomiting, diarrhea, limb and SQ abscesses.
Watch for C.diff induced colitis.

20
Q

Dalbavancin

A

class: misc. Beta-lactams and other inhibitors of cell wall synthesis
a cidal semisynthetic lipoglycopeptide for ABSSSI, Binds D-alanyl-D-alanine terminus of pepitdoglycan, prevents cross linking.

21
Q

Side effects of Dalbavancin

A

nausea, diarrhea, and headache.

22
Q

Bacitracin

A

class: misc. Beta-lactams and other inhibitors of cell wall synthesis
Vidal against various G+ cocci & bacilli
Nephrotoxic

23
Q

Mechanism of Bacitracin

A

lipid carrier transports the NAG/NAM complex to the outside of the cell where it is attached to the growing end of the peptidoglycan chain.

24
Q

Uses of Bacitracin

A

Topical for minor cuts and scrapes.

Ophthalmic ointment for ulcerative blepharitis and bacterial conjunctivitis due to various Gram +/- organisms.

25
Q

Fosfomycin

A

class: misc. Beta-lactams and other inhibitors of cell wall synthesis
for short course
treatment for uncomplicated UTIs in women

26
Q

Mechanism of Fosfomycin

A

Inhibits enolpyruvate transferase blocking the addition of phosphoenolpyruvate to UDP-N-acetylglucoasmine. The 2nd step in the synthesis of the Park Nucleotide
Net effect: inhibition of the cell wall synthesis.

27
Q

Aminoglycosides

A 
Class of drugs
Amino sugars attached in glycoside links to an aminocyclitol ring. 
very polar
given through IV
some given orally to clean out bowel.
28
Q

Mechanisms of Aminoglycosides

A

enter periplasmic space for gram negative bacteria through porin channels. Pass through inner membrane by flowing down their electrochemical gradient.

  1. inhibit initiation of protein synthesis
  2. cause misreading got mRNA creating faulty proteins that insert into the membrane causing leakage and creating pores that facilitate Rx uptake
29
Q

Are Aminoglycosides effective against anaerobes?

A

No, because they pass through the inner cells membrane by flowing down their electrochemical gradient created by the ETC. As anaerobes they do not have an ETC and thus cannot pass through the cell membrane.

30
Q

Mechanism of Aminoglycosides Syngergism

A

inhibiting cell wall synthesis, B-lactams facilitate penetration of ahminoglycosides
Mostly vs. G-
and G+ coverage.
b-lactams for synergism

31
Q

Gentamicin

A

Class of aminoglycosides
topical cream/ointment for burns, wounds and prevent catheter infections.
ophthalmic for superficial ocular infections.

32
Q

Tobramycin

A

Class of ahminoglycosides
generally interchangeable with gentamicin. possibly less ototoxic than gentamicin
IV.

33
Q

Amikacin

A

Class of amino glycoside
Enzyme resistant.
IV: For nosocomial infections that resist gentamicin and tobramycin

34
Q

Streptomycin

A

Class of aminoglycosides…IV

35
Q

Kanamycin

A

Class of ahminoglycosides

rarely used….IV

36
Q

Neomycin

A

Class of aminoglycosides….oral.
Oral prep for bowel surgery.
topical antiinfectant

37
Q

Parmomycin

A

to kill cysts of Entamoeba histolytic which cause amebic dysentery

38
Q

Side effects of Aminoglycosides

A

can cause NEUROMUSCULAR Block leading to respiratory paralysis during anesthesia when also using a neuromuscular blocker.

Drugs IDIT (1 decks)

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