Exam 2 Flashcards
Allergy to Sulfonamides there will be a cross sensitivity to: A. Loop diuretics B. Sulfonylureas C. Thiazide diuretics D. All of the above
D. All off the above
Common side effect of using a penicillin product for strep throat in a patient with mononucleosis is:
A maculopapular rash
Which is the best med for a pt with liver dysfunction that has an infection that is best treated with a macrolide?
A. Azithromycin (Zithromax)
B. Telithromycin (Ketek)
C. Erythromycin (E-mycin)
D. None of the above
A. Azithromycin (Zithromax)
Which med is used to treat Trichomonas as well as BV? A. Doxycycline B. Azithromycin C. Metronidazole D. Ciprofloxacin
C. Metronidazole
Pt has a prolonged QT interval which medications should be avoided?
A. Ciprofloxacin
B. Azithromycin
C. Fluconazole
D. All of the above
D. All of the above
Sulfonamide mechanism of action
A. Inhibits folic acid synthesis
B. Enhance folic acid synthesis
C. Inhibits protein synthesis
D. Inhibits cellular replication of DNA
A. Inhibits folic acid synthesis
Calcium channel blockers help control blood pressure because it:
A. Decreases the amount of calcium inside the cell
B. Reduces stroke volume
C. Increases the activity of the Na+/K+/ATPase pump directly
D. Decreases heart rate
A. Decreases the amount of calcium inside the cell
When comparing ACEs and ARBs what holds true between the two (they do similarly)
Contribute to some retention of K+
Chronic administration of beta blockers to treat hypertension may contribute to:
A. Reduction in peripheral resistance
B. Vasoconstriction of coronary arteries due to beta stimulation
C. Reduction of the circulation of norepinephrine
D. Reduction of angiotensin II production
A. Reduction in peripheral resistance
Penicillin, beta-lactam, cephalosporin, monobactam and carbapenems mechanism of action
Inhibition of cell growth by interference with cell wall synthesis by binding to and inactivating the penicillin-binding proteins (PBPs)
Use caution with this abx with patient that have fluid or sodium restrictions
Penicillin class
Adverse Events:
Maculopapular rash and urticaria
GI upset
Renal dysfunction high doses can cause seizures and encephalopathy
Penicillin class
Used for surgical prophylaxis, UTI, pneumococcal respiratory infections, gram + skin infections
1st generation Cephalosporins
Used to treat caPNA, respiratory tract infection, skin infections
2nd generation Cephalosporins
Abx for bacterial meningitis
3rd generation Cephalosporins
Ceftriaxone or cefotaxime
Abx for nosocomial infections
4th generation
Ceftazidime (Fortaz)
Cefepime (maxipime)
Ceftaroline fosamil (Teflaro) covers ….
MRSA
The only cephalosporin that covers
Aztreonam (Azactam) a mobibactam is considered safer than what abx class
Aminoglycosides
Aztreonam (monobactams) has a cross allergy specifically with what abx
3rd generation cephalosporin -Ceftazidime
Abx used to treat CNS infections because it has a lower risk of causing seizures
Meropenem
Well known effect of carbapenems….
Neurotoxicity cause seizure activity
Are fluoroquinolones bacteriostatic or bactericidal?
Bactericidal
Fluoroquinolones cover gram positive and are known for treating….
S. pneumonia, ie caPNA
Streptococcus
Agent of choice for UTI coverage…
Fluoroquinolones
Abx that is best used for haPNA, nosocomial PNA
Cipro (Ciprofloxacin) or Levofloxacin (levaquin)
Abx used for meningococcal prophylaxis
Ciprofloxacin
Adverse events of fluoroquinolones
Prolonged QT interval
Tendon rupture
Tendonitis
Peripheral neuropathy
Fluoroquinolones Dx/Dx interactions
Inhibitor of P-450=increasing the effect of other meds such as: Theophylline Warfarin Tizanidine Propranolol
Corticosteroids will increase risk of tendonitis and tendon rupture
Hyper/hypoglycemic with insulin’s
Macrolides (-omycin)
Mechanism of action
Inhibition of bacterial protein synthesis by binding to 50S ribosomal subunit
Abx that covers Chlamydia, mycoplasma, legionella, rickettsia, mycobacteria, and spirochetes
Macrolides (-omycin)
Macrolides (-omycin)
Gram?
+/-
Telithromycin has limited uses due to its….
Hepatotoxicity
Known for liver and hepatic failure
Extremely high doses of IV erythromycin and oral Clarithromycin have been associated with….
Ototoxicity
Macrolides (-omycin) caution when given with other meds as it can
Prolong QT interval
Aminoglycosides (-mycin) major draw back
Nephrotoxicity and ototoxicity
Abx class used to treat TB
Aminoglycosides (-mycin)
Specifically streptomycin
Aminoglycosides (-mycin)
What do you need to monitor?
BUN
Creatinine
Serum levels
Risk of ototoxicity increases when aminoglycosides (-mycin) are administered with….
High dose loop diuretics, high-dose macrolide antibiotics or vancomycin
tetracyclines (-cycline) posses activity against ….
Gram +/- and atypical organisms
Should tetracyclines be taken on a full or empty stomach?
Empty
What abx is used to treat SIADH?
Tetracycline - demeclocycline
Adverse events with tetracyclines
Frequent side effects: Anorexia Nausea Vomiting Epigastric distress Photosensitivity
Hepatotoxicity is rare
Discolors bones such as teeth
Dairy products impair absorption
Phenytoin and carbamazepine, cyp inducers decrease half life
Change the efficacy of birth control
Food decreases absorption
Administer 1 hour before or after antacids, iron, cholestyramine and sucralfate as the can chelate
What class?
Tetracyclines
Only active against gram +
Glycopeptides (Vanco)
Macrolides (Erythromycin, Clarithromycin)
Fusidic acid
Nitrofurantoin
Bacteriostatic
Sulphonamides Trimethoprim Tetracyclines Macrolides (erythromycin, Clarithromycin) tetracyclines Chloramphenicol Lyncosamides (Clindamycin)
Sulfasalazine (Azulfidine) is used to treat what disease?
Ulcerative colitis
Magenide (sulfamylon) and silver sulfadiazine (silvadene) are used to treat what?
Topical agents used to treat burns
Combination of choice in treating UTI, P. jiroveci (PCP), toxoplasmosis….
Trimethoprim-Sulfamethoxazole (bactrim)
What abx class can cause hemolytic anemia in G6PD deficiency?
Sulfonamides
Sulfonamides potentiate the effect of….
Warfarin
Phenytoin
Hypoglycemic agents
Methotrexate
Due to its poor bioavailability this abx can be given orally to treat c.diff
Vancomycin
Drug of choice for MRSA
Vanco
What abx is usually used to treat Neutropenic fever, endocarditis, meningitis
Vanco
Oxazolidinones (Linezolid) is used to treat ….
MRSA
Penicillin-resistant streptococci
VRE
Oxazolidinones (linezolid) mechanism of action….
Bind to the 50S ribosomes distrupting bacterial protein synthesis
What labs should be monitored while giving linezolid, especially if it is given longer than 2 weeks?
CBC as it can cause anemia, leukopenia and pancytopenia
