Exam 2 Flashcards by allie see

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

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Common side effect of using a penicillin product for strep throat in a patient with mononucleosis is:

A maculopapular rash

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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)

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Which med is used to treat Trichomonas as well as BV?
A. Doxycycline 
B. Azithromycin 
C. Metronidazole 
D. Ciprofloxacin

C. Metronidazole

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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

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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

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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

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When comparing ACEs and ARBs what holds true between the two (they do similarly)

Contribute to some retention of K+

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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

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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)

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Use caution with this abx with patient that have fluid or sodium restrictions

Penicillin class

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Adverse Events:
Maculopapular rash and urticaria
GI upset
Renal dysfunction high doses can cause seizures and encephalopathy

Penicillin class

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Used for surgical prophylaxis, UTI, pneumococcal respiratory infections, gram + skin infections

1st generation Cephalosporins

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Used to treat caPNA, respiratory tract infection, skin infections

2nd generation Cephalosporins

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Abx for bacterial meningitis

3rd generation Cephalosporins

Ceftriaxone or cefotaxime

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Abx for nosocomial infections

4th generation
Ceftazidime (Fortaz)
Cefepime (maxipime)

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Ceftaroline fosamil (Teflaro) covers ….

MRSA

The only cephalosporin that covers

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Aztreonam (Azactam) a mobibactam is considered safer than what abx class

Aminoglycosides

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Aztreonam (monobactams) has a cross allergy specifically with what abx

3rd generation cephalosporin -Ceftazidime

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Abx used to treat CNS infections because it has a lower risk of causing seizures

Meropenem

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Well known effect of carbapenems….

Neurotoxicity cause seizure activity

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Are fluoroquinolones bacteriostatic or bactericidal?

Bactericidal

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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