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Pharm 1, Exam 3 > Exam Review > Flashcards

Exam Review Flashcards

1
Q

2 ways of Mechanism of Bacterial Resistance

A
  1. if the bacteria can prevent penicillin from getting to Penicillin Binding Protein, they will win
  2. Bacteria have developed defense against pencillins by creating BETA-LACTAMASES (aka penicillinase) which the bug makes, gets in and tears up the Beta Lactam Ring
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2
Q

Penicillin G

A

the golden standard, narrow spectrum, antibiotic of choice to this day

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3
Q

Penicillin G

Antimicrobial Spectrum

A

Gram+ bacteria; Gram- cocci! Still considered a narrow spectrum antibiotic meaning it’s going to do it’s job correctly without killing the good guys as well

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4
Q

Penicillin G

Therapeutic Use

A

pneumonias and different meningitis, pharyngitis; Used prophylactically in pts at risk for bacterial endocarditis, w/infected sex partners, and recurrent attacks of Rheumatic Fever

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5
Q

Penicillin G

Pharmacokinetics

A

well distributed, minimal metabolism via the kidney as unchanged drug;
1/2 life is about 30 minutes

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6
Q

Penicillin G

Potential SIde Effects

A

considered least toxic of all antibiotics; perhaps the safest if you have side effects it is usually do to the stuff that it’s compounded with;
Pain at the IM site—> biggest side effect

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7
Q

Penicillin G

Allergies

A

Don’t give to pt w/hx of allergies; nearly allergy free even though anaphylactic reactions occur more frequently w/penicillin that other antibiotics, the incidence is still very low;

VERY SAFE COMPARED TO OTHER ANTIBIOTICS; HAS MORE REACTIONS BUT IT HAS A VERY SMALL PERCENTAGE OF REACTIONS

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8
Q

Penicillin G

Drug Interactions

A

no alcohol, monitor I&O, not all drug interactions are bad

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9
Q

AMPICiLLIN

A

SEMI-SYNTHETIC PENICILLIN
broad spectrum penicillin; it has little additional amino acid; bacteria cell wall inhibitor….the additional amino acid allows it to be effective against more organism, it will kill more different types of bugs; works with the cell wall of trans peptidase

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10
Q

Ampicillin

Potential side effects

A

rash diarrhea, can be given PO and IV, may decrease the effective of contraceptives

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11
Q

4 pharmacologic targets

A

DNA synthesis, bacterial cell wall, folic acid, portent synthesis

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12
Q

Cephalosporine

A

broad spectrum, semi synthetic beta lactam antibiotic. beta lactam rings in cephalosporins are quite often beta lactamase (penicillinase) resistant

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13
Q

Cephalosporine

Mechanism of Action

A

bactericidal (destroying the cell walls); go to bind with PBP, which is a transport system (otherwise they won’t get to their target);; most effectives against cells that are active/growing/dividing

Given PO most are given parentally (IV)

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14
Q

Cephalosporine

Pharmacokinetics

A

distributie well, lungs, kidneys, and urine;

synovial, pleural and pericardial fluids; elimination via the kidneys–> not good to use if pt has kidney problems

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15
Q

Cephalosporine

Microbial Resistance

A

beta lactmases, but these drugs are a little stronger against beta lactamases

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16
Q

Cephalosporine

Cross Sensitivity

A

due to potential for cross sensitivity reactions in its allergic to penicillin, are generally not given cephalosporins because their chemical makeup is very similar; They

17
Q

Cephalosporine

Allergic Reaction

A

small chance of allergic reaction, pretty safe

18
Q

Cephalosporine

Potential Adverse Effects

A

can impair hemostasis so there is a risk of serious bleeding in patients that take this w/ an anticoagulant (BLOOD THINNER)

Greater risk for C. Diff

Risk for Thromnophletbitis (Seen with IV therapy)

All broad spectrum penicillins

19
Q

Cephalosporine

Drug Interactions

A

can’t be used with blood thinners or alcohol

20
Q

Three anticoagulants

A

ASA, warfarin, plavix, heparin

21
Q

FIRST GENERATION CEPHALOSPORINES

A

ANCEF(CEFAZOLIN)
KEFZOL(CEFAZOLIN)
KEFLEX (CEPHALEXIN)

22
Q

SECOND GENERATION CEPHALOSPORINES

A

CEFZIL (CEFPROZIL)
CECLOR (CEFACLOR)
CEFOTETAN (CEFOTAN)

23
Q

THIRD GENERATION CEPHALOSPORINES

A

OMINEF

ROCEPHIN (CEFTRIAXONE)–> WHEN COMBINED WITH CALCIUM IT IS FATAL, ESPECIALLY WITH NEONATES

SUPRAX (CEFIXIME)

24
Q

FOURTH GENERATION CEPHALOSPORINES

A

CEFEPIME (MAXIPIME)

CEFPIROME (CEFROM, KEITEN, BROACT)

25
Q

Carbapenems

A

block growth of bacterial cell wall

26
Q

Carbapenems

Mechanism of Action

A

destroy bacterial cell wall; weaken and then lyse it; BROAD SPECTRUM, low toxicity, all given parenterally, only used with patients that can’t be treated with more narrow spectrum drug

27
Q

CARBAPENEMS

IMIPENEM (PRIMAXIM)

A

always given with Cilastatin, inhibits cell wall synthesis, does pretty good again a lot of bacteria;

28
Q

Carbapenems- Imipenem (primaxim)

Pharmacokinetics

A

Not absorbed in the GI, administered IV and IM.

29
Q

Carbapenems-Imipenem(primaxim)

Metabolism/excretion

A

rapidly degraded by renal enzyme when administered alone, so it is always given with Cilastatin ; protects the renal tubules and the kidneys

30
Q

Carbapenems -Imipenem (primaxim)

Potential Adverse Effects

A

GI problems, pregnancy C

31
Q

Carbapenems

Meropenem (Merem)

A

good for bacterial meningitis in kids 3 or older; that’s good news; PREGNANCY B

32
Q

Carbapenems

ERTAPENEM (INVANZ)

A

given by injection into muscle or vein; 1 daily that’s pretty cool, pregnancy B

33
Q

Carbapenems- DORIPENEM (Doribax)

A

good for complicated intrabdominal infections and complicated UTIS, given IV, has a 1/2 life of 1 hour; pregnancy baker

34
Q

MONOBACTAMS

Azetreonam (Azactam)

A

only binds to PBP of gram - bacteria; has a single ring pretty stable again most beta lactamases

35
Q

Vancomycein

Miscellaneous Cell Wall Inhibitors

A

does not have a beta lactam ring, it is a glycopeptide antibiotic;
Good with gram +, C.diff, MRSA, and patients with serious infections that are allergic to penicillin;
will mess up synthesis

36
Q

Vancomycein

Potential adverse Effects

A

ototoxicity, loss of hearing, confusion, and hallucinations;
Serious side effects, pretty easily toxic; only used for serious infections not common infections!
if infused rapidly may cause infusion reactions–> sometimes called redneck syndrome;
Rashes, flushing, tachycardia, and hypotention, administered slowly over 60 minutes, pregnancy , also renal toxicity

37
Q

What three combination of medicines will enhance effectiveness?

A

Bling, potassium, probenicid

38
Q

Tetracycline

A

work by suppressing growth and replication rather than out right killing of the bug;
Not 1st line drugs, we don’t reach for these immediately.

39
Q

Tetracycline is used for?

A

rocky mountain spotted fever, typhus, Q fever cholera, some pneumonia, acne, rheumatoid arthritis, periodontal disease, also used for treatment/prevention of inflation anthrax

Pharm 1, Exam 3 (1 decks)

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