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PHRM 865 > Exam 2 Continued > Flashcards

Exam 2 Continued Flashcards

1
Q

which tetracyline does not display cross resistance

A

minocycline

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2
Q

what is not affected by the major tetracycline resistant mechanisms

A

tetracyline analogs

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3
Q

tetracylines spectrum of activity gram-positive aerobes

A
  1. strep. pneumoniae- PSSP
  2. MSSA
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4
Q

do tetracyclines cover enterobacteriaceae

A

NO

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5
Q

what miscellaneous bacteria do tetracyclines cover

A
  1. legionella
  2. chlamydophila
  3. chlamydia
  4. mycoplasma
  5. ureaplasma
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6
Q

what gram positive aerobes do tetracycline analogs cover

A
  1. VSE
  2. VRE
  3. MSSA
  4. MRSA
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7
Q

what gram negative aerobes does tetracycline analogs specifically cover

A

stenotrophomonas maltophilia

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8
Q

what gram negative aerobes do tetracycline analogs not cover

A

proteus or p. aeruginosa

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9
Q

what anaerobe does tetracycline analogs cover

A

bacteroides

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10
Q

how is tetracyclines + analogs absorption impaired

A

by di- and trivalent cations

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11
Q

what tetracycline + analogs have the best bioavailbility

A

doxycycline and minocycline

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12
Q

tetracyclines + analogs distribution

A

widely distributed with good penetration into synovial fluid, prostate, seminal fluid

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13
Q

tetracyclines + analogs CSF penetration

A

minimal CSF penetation

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14
Q

tetracyclines + analogs elimination

A
  1. demeclocycline and tetracycline are excreted unchanged in the urine
    1. tetracyclines and analogs are minimally removed during hemogialysis
  2. doxycycline, minocycline, and tetracycline analogs are primary excreted by non-renal route
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15
Q

when are dosing adjustments needed for tetracyclines + analogs

A
  • renal insuffiency –> demeclocycline and tetracycline
  • liver disease –> tigecycline and eravacycline
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16
Q

GI AEs of tetracycline/tigecycline

A

N/V esp with tigecycline

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17
Q

can tetra/tigecycline cause photo senstivity

A

yes

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18
Q

tetra/tigecycline pregnancy category

A

D because of discoloration of permanent teeth and decreased bone growth in children

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19
Q

SMX MOA

A

inhibits dihydropteroate synthetase –> inhibits conversion of PABA to dihydrofolate

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20
Q

TMP MOA

A

inhibits dihydrofolate reductase –> prevents reduction of dihydrofolate to tetrahydrofolate

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21
Q

TMP-SMX displays what type of activity

A

each agent alone is bacteriostatic, however, the combination displays bactericida activity

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22
Q

what gram positive does bactrim cover

A

Staph aureus: incl some MRSA, CA-MRSA

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23
Q

what gram negative does bactrim cover

A

HENPEACKSSSS

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24
Q

what specific gram negative is sensitive to bactrim

A

sstentrophomona

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25
what gram negative is not affected by bactrim
pseudomonas
26
what other organisms is targeted by bactrum
pneumocystis carinii
27
does bactrim penetrate the CNS
yes
28
bactrim distribution
urine, prostate
29
TMP-SMX eliminaition and dose adjustments
* both are eliminated by the liver and kidney * dose adjustment required in patients with CrCl \< 30mL/min
30
batcrim hematologic AE
leukopenia, thrombocytopenia
31
bactrum hypersensitivity AE
rash
32
other bactrim AE
* crystalluria * hyperkalemia * increased creatinine
33
bactrim drug interaction
warfarin- causes increased anticoag effect
34
what drug is a polymyxin
colistin
35
polymyxins MOA
cationic detergents that binds to anionic lipopolysaccharide molecules in the outer cell membrane of gram negative bacteria causing displacement of Ca and Mg --\> induces changes in permeability and leakage of cellular contents, leading to cell death
36
what type of activity do polymyxins display
concentration-dependent bactericidal activity
37
polymyxins MOR
alteration of outer cell membrane
38
polymyxins SOA
* gram negative aerobic bacilli ONLY: PEEACKSSS
39
what are the two primary targets of polymyxins
acinetobacter and p. aeruginosa
40
what are polymyxins NOT active against
proteus, providencia, serratia
41
polymyxi absorption
not absorbed, only given IV, IM, inhalation
42
polymyxin distribution/ CSF
* limited extravascular distribution * limited in CNS
43
colistin and polymyxin B elimination
nonrenal routes
44
CMS elimination
eliminated unchanged by the kidney via glomerular filtation: requires dose adjustment in renal insufficiency
45
polymyxins AE
1. nephrotoxicity 2. neurotoxicity
46
colistin weight used for dosing
IBW
47
polymyxin B dosing weight
TBW
48
clindamycin MOA
inhibits protein synthesis by binding exclusively to the 50S ribosomal subunit --\> may cause competitive inhibition with macrlides and synercid
49
clindamycin displays what type of activity
bacteriostatic, but may be bactericidal when present at high concentrations against very susceptible organisms
50
clindamycin MOR
1. altered target sites 2. active efflux- but at low level
51
clindamycin SOA GPA
1. PSSP 2. MSSA 3. MRSA
52
Clindamycin SOA Anaerobes
* ADA * bacteroides
53
clindamycin distribution
1. good tissue penetration including bone 2. minimal csf penetration
54
clindamycin elimination
* primarily metabolized by the liver * not removed during hemodialysis
55
clindamycin AE
1. GI 2. C. diff colitis
56
metronidazole MOA
inhibits DNA synthesis
57
metronidazole MOR
1. altered growth requirements 2. altered ferredoxin levels
58
metronidazole SOA
* BDA * bacteroides * clostridiun
59
metronidazole pharmacology
well absorbed into body tissues and fluids; DOES penetrate the CSF
60
metronidazole elimination
primarily metabolized by the liver- removed during hemodialysis
61
Metronidazole AE
* stomatitis * metallic taste * peripheral neuropathy * avoid during pregnancy (category B) and breastfeeding
62
metronidazole interactions
1. warfarin --\> increased anticoagulant effect 2. alcohol --\> dissulfiram reaction

PHRM 865 (59 decks)

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