Final Flashcards by shantae w

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

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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.

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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.

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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

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Bateria make folic acid out of PABA and this drug is structurally similar to PABA

Sulfonamides

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Adverse effects of sulfonamides include

sulfa allergy, crystalluria, delayed cutaneous reactions.. fever followed by a rash, epidermal necrolysis, photosensitivity and Stevens-Johnson syndrome

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The beta-lactam broad group of drugs includes four major subclasses:

penicillins, cephalosporins, carbapenems, and monobactams.

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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.

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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).

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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.

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Three extended-spectrum penicillins, with a wider spectrum of activity, are currently available:

carbenicillin, piperacillin, and ticarcillin.

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Both ticarcillin and piperacillin are available in fixed-combination products that include beta-lactamase inhibitors. These 2 drugs are

extended-spectrum penicillins

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cloxacillin, dicloxacillin, nafcillin and oxacillan are

penicillanase resistant drugs

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These neutralize stomach acid, promote gastic mucosa defense mechanism using barriers, bicoarbonate and prostaglandins

antacids

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What are the 4 types of antacids

There are 3 salts are magnesium, calcium and aluminum and sodium bicoarbonate

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Constipating effect the only recommended with renal deficient patients. Can be used to make combination product w/magnesium

aluminum salts (gel/jel)

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Aluminum carbonate and Hydroxide salt are

aluminum based

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Diarrhea effects, dangerous with renal failure patients bc they can excrete which leads to accumulation

magnesium salts (MOM)

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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

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Interferes with other drug absorption like tetracycline and quinolones and chelates increase stomach and urine PH

antacids

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Decrease absorption of acidic drugs and excretion of basic drugs

antacids

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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

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Produce impotence, gynecomastia and increase drug levels via P450

cimetidine

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Proton pump inhibitors end in prazole

L’ROPE

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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