Exam 4-2 Antibiotics Part 2 Flashcards
1
Q
Antibiotic Therapy: Concepts
A
- Multidrug resistance
- Therapeutic drug monitoring
- Minimum inhibitory concentration (MIC)
- Time-dependent killing
2
Q
Antibiotic Therapy: concepts-Concentration-dependent killing
A
- Once-daily vs. multi-daily dosing
- Peak and nadir (trough) blood levels
- Synergistic effects
- Post-antibiotic effect (PAE)
3
Q
Antibiotic Therapy: Toxicities- Ototoxicity
A
*Temporary or permanent hearing loss, balance problems
4
Q
Nephrotoxicity
A
- Varying degrees of reduced renal function
* Rising serum creatinine clearance
5
Q
Antibiotic Therapy: Monitor for:
A
- nadir levels every 5 to 7 days while on therapy as ordered
* serum creatinine levels at least every 3 days as an index of renal function
6
Q
Aminoglycosides:
A
- gentamicin (Garamycin)
- neomycin (Neo-fradin)
- tobramycin (Nebcin)
- amikacin (Amikin)
- kanamycin
- stretomycin
7
Q
Aminoglycosides: Characteristics
A
- Natural and semisynthetic
- Produced from Streptomyces
- Poor oral absorption; no PO forms
- Very potent antibiotics with serious toxicities
- Bactericidal; prevent protein synthesis
- Kill mostly gram-negative; some gram-positive
8
Q
Aminoglycosides: Indications
A
- Used to kill gram-negative bacteria such as Pseudomonas spp., E. coli, Proteus spp., Klebsiella spp., Serratia spp.
- Often used in combination with other antibiotics for synergistic effects
- Certain gram-positive infections that are resistant to other antibiotics
9
Q
Aminoglycosides are poorly-
A
absorbed through the GI tract and administered parenterally
- Exception: neomycin
- Given orally to decontaminate the GI tract before surgical procedures
- Also used as an enema for this purpose
10
Q
Aminoglycosides cause serious
A
toxicities
- nephrotoxicity (renal damage)
- ototoxicity (auditory impairment and bestibular eighth cranial nerve)
- Must monitor drug levels to prevent toxicities
11
Q
Fluoroquinolones
A
- ciprofloxacin (Cipro)
- norfloxacin (Noroxin)
- levofloxacin (Levaquin)
- moxifloxacin (Avelox)
12
Q
Fluoroquinolones: Characteristics
A
- Excellent oral absorption
- Absorption reduced by antacids
- Effective against gram-negative organisms and some gram-positive organisms
13
Q
Fluoroquinolones: Mechanism of Action
A
- Bactericidal
- Alter DNA of bacteria, causing death
- Do not affect human DNA
14
Q
Fluoroquinolones: Indications
A
- Gram negative bacteria such as pseudomonas
- Respiratory infections
- Bone and joint infections
- GI infections
- Skin infections
- Sexually transmitted diseases
- Anthrax
15
Q
Other Antibiotics
A
- clindamycin (Cleocin)
- linezolid (Zyvox)
- metronidazole (Flagyl)
- nitrofurantoin (Macrodantin)
- quinupristin and dalfoprisitin (Synercid)
- daptomycin (Cubicin)
- vancomycin (Vancocin)