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pharmacology > Exam 4-2 Antibiotics Part 2 > Flashcards

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
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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)
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3
Q

Antibiotic Therapy: Toxicities- Ototoxicity

A

*Temporary or permanent hearing loss, balance problems

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4
Q

Nephrotoxicity

A
  • Varying degrees of reduced renal function

* Rising serum creatinine clearance

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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

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6
Q

Aminoglycosides:

A
  • gentamicin (Garamycin)
  • neomycin (Neo-fradin)
  • tobramycin (Nebcin)
  • amikacin (Amikin)
  • kanamycin
  • stretomycin
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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
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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
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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
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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
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11
Q

Fluoroquinolones

A
  • ciprofloxacin (Cipro)
  • norfloxacin (Noroxin)
  • levofloxacin (Levaquin)
  • moxifloxacin (Avelox)
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12
Q

Fluoroquinolones: Characteristics

A
  • Excellent oral absorption
  • Absorption reduced by antacids
  • Effective against gram-negative organisms and some gram-positive organisms
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13
Q

Fluoroquinolones: Mechanism of Action

A
  • Bactericidal
  • Alter DNA of bacteria, causing death
  • Do not affect human DNA
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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
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15
Q

Other Antibiotics

A
  • clindamycin (Cleocin)
  • linezolid (Zyvox)
  • metronidazole (Flagyl)
  • nitrofurantoin (Macrodantin)
  • quinupristin and dalfoprisitin (Synercid)
  • daptomycin (Cubicin)
  • vancomycin (Vancocin)
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16
Q

clindamycin (Cleocin)

A
  • Used for chronic bone infections, GU infections, intraabdominal infections
  • May cause pseudomembranous colitis
17
Q

linezolid (Zyvox)

A
  • New class; oxazolidinones
  • Used to treat vancomycin resistant Enterococcus faecium (VREF, VRE), hospital-acquired skin and skin structure infections, including those with MRSA
18
Q

metronidazole (Flagyl)

A
  • Used for anaerobic organisms
  • Intraabdominal and gynecologic infections
  • Protozoal infections
  • EtOH intolerance
19
Q

nitrofurantoin (Macrodantin)

A
  • Primarily used for UTI’s (E. coli, S. aureus, Klebsiella spp., Enterobacter spp.)
  • Use carefully if renal function is impaired
  • Drug concentrates in the urine
  • Keep patient well hydrated
  • May cause fatal hepatotoxicity
20
Q

quinupristin and dalfopristin (Synercid)

A
  • 30:70 combination, work synergistically
  • Used for bacteremia and infections caused by vancomycin-resistant Enterococcus (VRE) and other complicated skin infections
21
Q

daptomycin (Cubicin)

A
  • New class: lipopeptide

- Used to treat complicated skin and soft-tissue infections

22
Q

vancomycin

A
  • Natural, bactericidal antibiotic
  • Interferes with cell wall synthesis
  • Treatment of choice for MRSA and other gram-positive infections
  • Must monitor blood levels to ensure therapeutic levels and prevent toxicity
  • May cause ototoxicity and nephrotoxicity
  • Should be infused over 60 minutes
  • Rapid infusions may cause hypotension
23
Q

vancomycin may cause

A

Red man syndrome
-flushing/itching of the head, neck, face, upper trunk
-Antihistamine may be ordered to reduce these effects
Ensure adequate hydration (2 L fluids/24 hr) if not contraindicated to prevent nephrotoxicity

pharmacology (14 decks)

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