Final Flashcards
Over time, bacteria can mutate to survive an attack by the antibiotic. The production of…. is one way in which bacteria can fend off the effects of antibiotics.
beta-lactamase
Antibiotics are classified into broad categories based on their chemical structure. SPAM, QTC
The common categories include sulfonamides, penicillins, cephalosporins, macrolides, quinolones, aminoglycosides, and tetracyclines.
What are the 4 mechanisms of antibiotic action
interference with bacterial cell wall and protein synthesis, replication of DNA and RNA and antimetabolite action that disrupts critical metabolic reactions inside the bacterial cell.
bacteriostatic broad spectrum of antibacterial that fight against both gram-positive and gram-negative organisms with high concentration in kidneys. It messes with the Folic acid pathway…
Drug name begin with Sulfa
Sulfonamides which treats UTI’s, PJP and URI’s
may be combined with sulfamethoxazole/trimethoprim
Bateria make folic acid out of PABA and this drug is structurally similar to PABA
Sulfonamides
Adverse effects of sulfonamides include
sulfa allergy, crystalluria, delayed cutaneous reactions.. fever followed by a rash, epidermal necrolysis, photosensitivity and Stevens-Johnson syndrome
The beta-lactam broad group of drugs includes four major subclasses:
penicillins, cephalosporins, carbapenems, and monobactams.
The penicillin can be divided into four subgroups based on their structure and the spectrum of bacteria they are active against; these subgroups are
natural penicillins, penicillinase-resistant penicillins, aminopenicillins, and extended-spectrum penicillins.
combinations of penicillin and beta-lactamase inhibitors are available and include
ampicillin/sulbactam (Unasyn), amoxicillin/clavulanic acid (Augmentin), ticarcillin/clavulanic acid (Timentin), and piperacillin/tazobactam (Zosyn).
Penicillins are indicated for the prevention and treatment of infections caused by gram-positive bacteria. Most natural penicillins (G and V) have little, if any, ability to kill
gram-negative bacteria.
Three extended-spectrum penicillins, with a wider spectrum of activity, are currently available:
carbenicillin, piperacillin, and ticarcillin.
Both ticarcillin and piperacillin are available in fixed-combination products that include beta-lactamase inhibitors. These 2 drugs are
extended-spectrum penicillins
cloxacillin, dicloxacillin, nafcillin and oxacillan are
penicillanase resistant drugs
These neutralize stomach acid, promote gastic mucosa defense mechanism using barriers, bicoarbonate and prostaglandins
antacids
What are the 4 types of antacids
There are 3 salts are magnesium, calcium and aluminum and sodium bicoarbonate
Constipating effect the only recommended with renal deficient patients. Can be used to make combination product w/magnesium
aluminum salts (gel/jel)
Aluminum carbonate and Hydroxide salt are
aluminum based
Diarrhea effects, dangerous with renal failure patients bc they can excrete which leads to accumulation
magnesium salts (MOM)
May cause kidney stones, constipation, longer duration may cause rebound and hyper acidity, marketed as dietary source
calcium salts, carbonate (may cause gas and belching) most commonly used
Interferes with other drug absorption like tetracycline and quinolones and chelates increase stomach and urine PH
antacids
Decrease absorption of acidic drugs and excretion of basic drugs
antacids
H2 antagonist reduce acid secretion by blocking receptors on the parietal cells and they end in “tidines” . Hint FRaNC
The Franc’s are…cime, niza, famo and rantidines
Produce impotence, gynecomastia and increase drug levels via P450
cimetidine
Proton pump inhibitors end in prazole
L’ROPE
Sucralfate maybe used in renal impaired bc it reduce phospate levels but may constipate. Good for stress ulcers
cytoprotective
Misoprostol is synthetic prostaglandin used for
NSAID ulcers
Simethicone is an
anti-gas medication as is activated charcoal
Adsorbents coat the walls of GI tract, bind to and excrete toxins examples are
bismuth subsalicylate, kaolin-pectin, charcoal and attapulgite
belladonna alkaloids, atropine, hyoscyamine slow the movement of GI tract these drugs are
Anticholenergics
paregoric, opium tinture, codeine, loperamide and diphenoxylate that cause constipation, reduce pain and spasms are
opioid antimotity antidiarrheals
L.acidophilus
intestinal flora modifiers
diphenoxylate and atropine is a
combination antidiarrhea
What kind of laxative is psyllium and methylcelluylose
bulk forming
docusate salts and mineral oil
emollients
sorbitol, glycerin, lactulose and polyethylene glycol
hyperosmotic which add water to feces
Saline puts water into bowels
MOM and magnesium citrate/hydroxide
senna and bisacodyl are
stimulants
HIV viruses are
retroviruses (RNA)
Amantadine and Rimantadine is a narrow spectrum antivirals that inhibit end coding of virus used against
Influenza A and Rimantadine has a longer half life
Rimantadine and Amantadine may cause
nausea, nervousness, insomnia and anorexia and light headedness
Acyclovir is a synthetic nucleoside analog it fights
HSV 1 and 2 and DOC for initial and recurrent treatment
Ganciclovir is a synthetic nucleoside analog it fights
cytomegalovirus and retinitis
Neuraminidase Inhibitors (amivir):
oseltamivir and zanamivir
should be given within 2 days and fights flu A and B by inhibiting new viral particles from host to reduce duration of illness.
Ribavirin is used for RSV in newborns it is a
synthetic analog not to be used in pregnant women
There are 4 stages of HIV infection and they suffer from HHV-8 or
Kaposi’s syndrome
HIV are HAART that include at least 3 medications to
reduce viral load
Antiretrovirus RTI’s block enzymes that affect new DNA production and they are
Nevirapine, tenofovir and zidovudine (bone marrow suppression)
Antiretrovirus PI’s inhibit protease so viruses can’t replicate are
indinavir 6-8 glasses of water
Fusion inhibitors inhibit fusion and replication and the medication is
enfuviritide
Entry inhibitors-CCR5 coreceptor antagonist
maraviroc
HIV integrase strand transfer inhibitors interfere with DNA
raltegravir
Antivirals fight
flu, HSV, VSV, CMV and Hepatitis ABC
methylnatrexone and alvimopan are used to treat constipation due to
opiod use and bowel resection therapy
Sodium bicarb is contraindicated in patients with
HF, high bp or renal problems and may cause metabolic alkalosis
Is Penicillin’s static or cidal?
bacteriacidal
prevent the enzymes from breaking down of beta lactams
clavulanic acid, tazobactam and sulbactam
aminoglycosides end in
amycin or cin. But not all that end this way are aminoglycosides
Gentamicin, neomycin, tobramycin, amikacin, kanamycin and streptomycin are. TAKNG
aminoglycosides
MIC is a measure of
potency
2 examples of multidrug resistance diseases are
MRSA and TB
What antibiotics are time dependent killers are combined with aminoglycosides?
beta lactams
What antibiotic therapy requires therapeutic drug monitoring?
aminoglycosides
What is the potent bactericidal produced from streptomyces that has poor oral absorption. It prevent protein synthesis and kills mostly gram negative
aminoglycosides
What aminoglycosides doesn’t have poor absorption in the GI tract?
neomycin
aminoglycosides cause serious
nephro/ototoxicity
Quinolones end in
floxacin
Antacids cause reduced absorption and chelation of quinolones and
tetracyclines
Quinolones have excellent oral absorption and kill gram
negative
Bacteriacidal that alter DnA by inhibiting toposomerase thus preventing the uncoiling
Quinolones
linezolid is an
oxazolidinones which treats skin infection VRE’s
clindamycin inhibit protein synthesis and is used for
bone , GU and intra abdominal infections,
flagyl kills
anaerobic organisms, intraabdominal and protozoal infection
Keep patients well hydrated with the UTI med
nitrofurantoin, hepatoxicity
The drugs ending PRISTIN are synergy drug combo that take care of
VRE and skin infections
daptomycin is a
lipopeptide
Vancomycin is a bacteriacidal that interferes with cell wall synthesis and is the DOC for
MRSA may cause oto/nephrotoxicity
Mold have branches and these have buds
yeast
These are systemic antifungals ACFK
Amphotercin B, caspofungin, fluconazole and ketoconazole
These are topical antifungals CMN
clotrimazole, miconazole and nystatin
The available third-generation cephalosporins include cefotaxime, cefpodoxime, ceftazidime, ceftibuten, cefdinir, ceftizoxime, and ceftriaxone (hepatic once a day).
They are the most potent of the first three generations of cephalosporins in fighting gram-negative bacteria, but they generally have less activity than first- and second-generation drugs against gram-positive organisms.
Cefepime (Maxipime) is the prototypical
fourth-generation cephalosporin.
Cefepime is indicated for the treatment of
uncomplicated and complicated UTIs, uncomplicated skin and skin structure infections, and pneumonia.
Ceftaroline (Teflaro) is a fifth-generation cephalosporin. It is effective against
MRSA.
Carbapenems have the broadest antibacterial action of any antibiotics to date; they are bactericidal and inhibit cell wall synthesis. They are often reserved for
complicated body cavity and connective tissue infections;
One hazard of carbapenem use is drug-induced seizure activity.
Carbapenems end in
PENEM
Imipenem/cilastatin good for
bone, joint,skin, and soft tissue… cilastatin prevent break down of Imipenem
Aztreonam (Azactam) is the only
monobactam antibiotic; it is a synthetic beta-lactam antibiotic
Aztreonam is a bactericidal antibiotic, destroying bacteria by
inhibiting bacterial cell wall synthesis; Aztreonam is indicated for the treatment of moderately severe systemic infections and UTIs.
Macrolides are considered bacteriostatic but in high enough concentrations they may be bactericidal to some susceptible bacteria. There are four macrolide antibiotics:
azithromycin, clarithromycin, dirithromycin, and erythromycin.
Infections inhibited by macrolides include
mild to moderate upper and lower respiratory tract infections caused by Haemophilus influenzae, spirochetal infections including syphilis and Lyme disease, various forms of gonorrhea, chlamydia, and mycoplasma infections.
Macrolides interfere with
protein sythesis by binding to rhibosomes
ketolides interfere with rhibosomes the only drug in this class is
telithromycin its associated with liver disease. has better acid stability and better antibacterial coverage than the macrolides.
Tetracyclines are natural and synthethic that love calcium and interfere with
protein synthesis by binding to ribosomes; aapnc
Cell cycle–specific drug classes include
antimetabolites, mitotic inhibitors, alkaloid topoisomerase II inhibitors, topoisomerase I inhibitors, and antineoplastic enzymes.
Several drugs are available that are classified as cytoprotective which mean
they help reduce the toxicity of various antineoplastics.
The alkylating drugs commonly used in clinical practice in the United States today fall into three categories:
the nitrogen mustards; nitrosoureas, and miscellaneous alkylators.
folic acid antagonist interfere with the pathway, thus DNA
trexates, methotrexate treat psoriasis and rheumatoid arthritis
purine/pyrimidine antagonist interfere with purine/pyrimidine, thus
DNA/RNA
antimetabolites kills
solid and liquid tumors
Mitotic inhibitors/periwinkle/dose limiting/WBC/CTZ
vinca and taxanes these drugs work shortly before or during mitosis, treats ball, lung, breast Kaposi and acute leukemia
Mitotic can cause
seizures and extravasion is treated w/helleronadase
Topo II inhibitors/mandrake treat lung and ball they
interfere with the untangling of DNA, they end POSIDE
Topo I (Campthothecins) interfere with DNA also during S phase
end with TECAN, good for ovarian and colorectal/lung
S phase cell cycle drugs are
antimetabolites and Topo I’s
G2 drugs Epip/Mis and
Taxanes
Taxanes and Vinca’s are
Mitosis/G2
G1 drugs are
Hormonal/Antineoplastics enzymes
irinotecan causes
diarrhea
The alkylating drugs work by preventing cancer cells from reproducing
deoxyribonucleic acid (DNA)
the miscellaneous alkylators
cisplatin, need hydration to prevent nephrotoxicity
3 Nitrosoureas
carmusine, cyclophosphamide and mechlorethamine
The cytotoxic antibiotics consist of natural substances produced by the mold Streptomyces as well as semisynthetic substances in which chemical changes are made in the natural molecule.
They have bone marrow suppression as a common toxicity. The one exception is bleomycin, which instead causes pulmonary toxicity (pulmonary fibrosis and pneumonitis).
Anthracyclines include
daunorubicin, doxorubicin, epirubicin, idarubicin, and valrubicin.
Other cytotoxic antibiotics include
bleomycin (which is actually a cell cycle–specific drug), dactinomycin, mitomycin, mitoxantrone, and plicamycin.
Cytotoxic antibiotics are used to treat a variety of
solid tumors and some hematologic malignancies as well.
There are currently two broad classes of cell cycle–nonspecific cancer drugs:
alkylating drugs and cytotoxic antibiotics.
CCNS antibiotics MOA
Intercalation, resulting in blockade DNA synthesis
Cardiomyopathy is associated with large amounts of
doxorubicin
bevoaxizumab an angiogenesis inhibitor works by
blocking blood supply to tumor
Dexrazoane is cytoprotective and decrease incidence of
toxicity
hydroxyurea make it harder to make DNA like
antimetabolites
