Drugs

Question 1

Aminoglycocides general notes

Answer 1

Narrow spectrum antibiotics, used primarily against gram neg bacilli aerobes, cannot be absorbed from GI and entering CSF and therefore must be given parenterally, can damage kidneys and inner ear

Question 2

Aminoglycosides mechnaism of action

Answer 2

Disrupt bacterial protein synthesis by binding 30S ribosimal unit, causing abnormal or decreased protein synthesis, rapidly bactericidal

Question 3

Aminoglycosides most active against…

Answer 3

• E coli
• Klebsiella pneumoniae
• Serratia marcescens
• Proteus mirabilis
• Pseudomonas aeruginosa

Question 4

This drug class half lives decrease dramatically with kidney disfunction, and therefore it is essential to reduce dosage or increase dosing interval in patients with disease

Answer 4

aminoglycosides

Question 5

Postantibiotic effect

Answer 5

Continued bacterial cell kill even though plasma levels are subtherapeutic for a prolonged time between doses

Question 6

Aminoglycosides daily dose vs interval dosing monitoring, what determines these doses?

Answer 6

• Once a day, only trough levels are measured
• Interval dosing, both peaks and troughs are measured
• creatanine clearance test

Question 7

Aminoglycosides adverse effects

Answer 7

• Ototoxicity, disruption of balance
• nephrotoxicity, proteinuria, serum creatinine and BUN elevation (reversible)
• neuromuscular blockade (flaccid paralysis and respiratory depression)

Question 8

Aminoglycosides drug interactions

Answer 8

-PCNs can help facilitate action but do not want oto run in same IV solution

Question 9

Gentamicin

Answer 9

-used to treat serious infections caused by gram - bacilli, can be combined with vancomycin on certain gram + infections,

Question 10

Amikacin

Answer 10

Broadest spectrum of aminoglycosides against gram neg bacilli, used for aerobic gram - bacilli which are resistant to gentamicin/tobramycin

Question 11

Plazomicin (Zemdri)

Answer 11

New aminoglycoside for adults with complicated UTI’s, active against resistant enterobacteriaceae, reserved for no alternative treatments

Question 12

Neomycin

Answer 12

Most toxic of aminoglycosides, causes severe damage to kidneys and inner ear, used topically or orally

Question 13

Streptomycin

Answer 13

First aminoglycoside, used to treat TB and enterocccal endocarditis

Question 14

Paromomyci

Answer 14

Employ local effects in intestine, administered orally to treat intestinal amebiasis and tapeworm

Question 15

Fluoroquinolones general notes

Answer 15

Narrow spectrum antibiotic used only for UTI’s, side effects usually mild, potentially tendon rupture and mental health effects

Question 16

Ciprofloxacin

Answer 16

Can be given orally or intravenously, function to passively diffuse into cell and inhibit bacterial DNA replication and division (bacteriocidal), broad spectrum including MRSA, travelers diarrhea, divalent or trivalent cations chelate Cipro in gut, preventing absorption

Question 17

Ciproflaxin therapeutic uses

Answer 17

wide variety of infections, treating anthrax, avoided in pediatric populations

Question 18

Fluoroquinolones adverse effects

Answer 18

• Tendon rupture, arthropathy, sun damage

- peripheral neuropathy, severe hypoglycemia, CNS defect

Question 19

Ciproflaxin increases plasma levels of these 2 things

Answer 19

Theophylline and warfarin

Question 20

Norfloxacin and oxfloxacin

Answer 20

PO tablets fluoroquinolones similar to Cipro

Question 21

Metronidazole (flagyl)

Answer 21

Useful for protooal infections and anaerobes, acts with DNA causing strand breakage and loss of helical structure, employed for prophylaxis in some surgical procedures, treats Cdiff, treats trichmonas vaignalis

Question 22

Adverse effects of metronidazole

Answer 22

Nausea, unpleasant metal taste, darkening coloration of urine, neurologic effects

Question 23

Drug interactions with metronidazole

Answer 23

Reactions when taken with alcohol

Question 24

Rifampin

Answer 24

broad spectrum antibiotic primarily for treatment of TB and leprosy

Question 25

Bacitracin

Answer 25

Used as topical agent or parenteral use for serious toxicity systemic related infections, often used for topical treatment of infections

Question 26

Polymyxin B

Answer 26

Mainly used for topical treatment