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MCP Antibiotics Flashcards

1
Q

Antimicrobials

A

inclusive term for antibacterial, antifungal, and antiviral agents

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2
Q

Antibacterials

A

agents that inhibit or kill bacterial growth

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3
Q

Antibiotics

A

natural products that inhibit or kill bacteria by metabolic action. Technically does not include synthetic agents (ie. chemically synthesized such as metronidazole)

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4
Q

Antiseptics

A

topical agents that are used to kill pathogens (i.e. alcohol)

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5
Q

Bacterialcidal

A
  • capable of killing bacteria directly
  • may cause disruption of cell membrane or cell wall
  • may interfere with DNA replication or transcriptions
  • may interefere with certain aspects of protein synthesis
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6
Q

Bacteriostatic

A
  • capabable of inhibiting growth or reproduction of, but not killing, bacteria
  • May interfere with synthesis of proteins or other molecules required for metabolism
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7
Q

Beta-Lactams

A

penicillin, amoxicillin, amoxicillin/clavulanate, cephalexin, cefdinir

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8
Q

Macrolides

A

azithromycin, clarithromycin, erythromycin

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9
Q

Lincosamides

A

Clindamycin

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10
Q

Tetracyclines

A

Doxycycline, minocycline, tetracycline

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11
Q

Fluoroquinolones

A

Ciprofloxacin, levofloxacin, moxifloxacin

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12
Q

Sulfonamides

A

Sulfamethoxazole/trimethroprim (TMP/SMX)

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13
Q

Nitromidazole

A

Metronidazole

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14
Q

Nitrofurans

A

Nitrofurantoin

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15
Q

General Antibiotic Counseling Pearls: Time to affect and adherence

A
  • Time to effect
    • Time to initial effect: commonly 24 – 72 hours
  • Adherence
    • Complete the full course of therapy
      • Incomplete therapy may fail to completely eliminate an infection
      • –Intermittent or shortened exposure of bacteria to antimicrobials selects for resistant strains to develop
    • What if they miss a dose?
      • ​Take next dose as soon as they remember it. If close to time of next dose, skip missed dose (do not take 2 doses at same time)
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16
Q

General Anitbacterial Counseling Peals: Common Side Effects

A
  • Upset stomach, nausea/vomiting
    • –Take with food (if appropriate for the given agent)
  • Diarrhea
    • –Should last only a few days
    • –Non-pharmacologic: BRAT diet, fluids, avoid foods high in fiber or greasy, eat smaller meals
    • –OTC antidiarrheals (ie. loperamide, bismuth subsalicylate)
      • –Avoid if accompanied by fever or blood in stool
    • –Probiotics??
  • Yeast infection
17
Q

Does the use of antimicrobials decrease oral contraceptives effectiveness?

A
  • Evidence supports interactions with only a few specific antimicrobials
  • safe practice is to advise use of backup methods during entire course of antimicrobial therapy and for at least 7 days after completion of therapy or the whole cycle depending where patient is in cycle, with no interruption of oral contraceptive use
18
Q

Beta-Lactams: MOA and other information

A
  • Includes: penicillins, cephalosporins (other classes not covered here: carbapenems and monobactams)
  • MOA:
    • Inhibits cell wall synthesis – bactericidal
  • Allergic reaction cross-reactivity among beta-lactams
    • Cephalosporins <5%
    • Carbapenems, monobactams <1%
  • When should you re-challenge?
    • –Rash/hives vs. anaphylaxis
19
Q

Penicillin V

A
  • Brand Name
    • Veetids, Pen-Vee K
  • Indications
    • ​Acute pharyngitis
  • Couseling Pearls
    • ​Take on empty stomach to maximize absorption
      • 1 hours before or 2 hours after food
    • Inform patients of allergic rxn sign
    • Refridgerate suspension
20
Q

Amoxicillin

A
  • **Brand name: **
    • Amoxil
  • Indications:
    • Acute otitis media
    • Acte bacterial sinusitis
  • Counseling Points/Other Info:
    • ​Refridgerate suspension for taste
    • Part of penicillin class
21
Q

Amoxicillin/Clavulanate

A
  • Brand Name:
    • Augmentin
  • Indications:
    • Acute bacterial sinusitis
  • Counseling points/other info:
    • ​Not usually 1st line therapy
    • Clavulanic acid causes more GI side effects
      • Take with food
    • Refridgeration suspension
22
Q

Cephalexin

A
  • Brand Name:
    • Keflex
  • Indiciations:
    • Cellulitis
  • Counseling Points/Other info:
    • ​1st generation cephalosporin
    • Refridgerate suspension
23
Q

Cefdinir

A
  • Brand Name:
    • ​Omnicef
  • Indications:
    • Acute otitis media
    • Community acquired pneumonia
  • Counseling Points/Other info:
    • ​Store suspension at room temp (or else thicken)
    • No Fe supplements or antacide with 2 hours of dose
    • Expire 10 days after reconsitution
    • 3rd generation cephalosporin
24
Q

Macrolides: MOA and Other information

A
  • Includes: Azithromycin, Clarithromycin, Erythromycin
  • MOA:
    • Inhibits bacterial protein synthesis – bacteriostatic
  • Potential (rare) for QTc prolongation (heart arrhythmia) with all agents:
    • Use with caution in patients with cardiac risk or on concurrent QTc prolonging drug
25
Azithromycin
* **Brand Name:** * ​Zithromax, Z-pak * **Indications** * **​**Community acquired pneumonia * Traveler's diarrhea * Gonorrhea * **Counseling Points/Other Information:** * ​Can take with/without food * Avoid use with antacids * Store suspension at room temperature
26
Clarithromycin
* **Brand Name: ** * Biaxin * **Indications:** * Community acquired pneumonia * H. pylori * **Counseling Points** * **​**Take XR tablet with food * Abnormal metalic taste * Suspension at room temp * watch drug-drug interactions
27
Lincosamides: MOA and other info
* Includes: Cindamycin * **MOA:** * inhibits bacterial protien biosynthesis-bacteriostatic
28
Clindamycin
* **Brand Name** * **​**Cleocin * **Indications** * ​Cellulitis * Bacterial vaginosis * **Counseling Points** * ​Take with full glass of water to minize esophageal ulcerations * Do not lie down for 30 min after taking medication * **Black Box Warning: **Can causes severe (possibly fatal) colitis. Higher risk for C. dif diarrhea. Use with caution in patients with GI disease
29
Tetracyclines: MOA and Other Info
* Includes: Doxycycline, Minocycline, Tetracycline * **MOA**: * Inhibits bacterial protein synthesis – bacteriostatic * **Special considerations:** * Avoid use in children – permanent teeth discoloration and slows bone development * Avoid use in pregnant women * –Category D
30
Doxycycline
* **Brand Name:** * **​**Vibramycin * **Indications** * **​**Community acquired pneymonia * Gonorrhea * acne * **Couseling Points** * **​**Take with full glass of water and remain uprights for 30 min * Photosensitivity (all tetracyclines) * Take 2 hours before or 4-6 hours after antacids, iron supplements, zinc and dairy
31
Fluoroquinolones: MOA and other information
* Includes: Ciprofloxacin, Levofloxacin, Moxifloxacin * **MOA:** * Interferes w/ bacterial DNA supercoiling - bacteriostatic * Generally well-tolerated * Heavily used drugs – fear of resistance due to overuse * **Black Box Warning**: Achilles tendonitis, tendon rupture * Increased risk: age \>60, female, corticosteroid use, transplant patients * **Special considerations:** * Avoid use in \<18 years old – reports of bone/joint problems * Avoid use in pregnant women (category C) * Absorption interfered with metal ions
32
Ciprofloxacin
* **Brand Name: ** * **​**Cipro * **Indications:** * **​**Urinary tract infection * Community acquired pneumonia * Traveler's diarrhea * **Counseling Points:** * ​Take 2 hrs before or 4-6 hrs after antacids, Fe, Zn, and dairy * Photosensitivity
33
Nitromidazoles: MOA and other information
* Includes: Metronidazole * **MOA** * Inhibits DNA replication – bactericidal * Targeted, narrow-spectrum * Only active in cells with nitroreductase * –i.e. protozoa and anaerobic bacteria
34
Metronidazole
* **Brand Name:** * **​**Flagyl * **Indications** * **​**C. difficile associated diarrhea * Bacterial vaginosis * **Counseling/Other info** * **​**Topical can be absorbed systemically * Metallic taste * Discolored/dark urine * Rare neuropathy * Avoid alcohol for duration of therapy and **3 days** after stopping medication * Disulfram-like reaction: nausea, vomiting, flushing, hypotension, palpitations, chest pain * Also alchol containing products
35
Sulfonamides: MOA and Other Information
* Includes: Sulfamethoxazole * **MOA** * Inhibits biosynthesis of folic acid – bacteriostatic * Due to long history of use – resistance is a problem * Common antibacterial allergy
36
Sulfamethoxazole/Trimethoprim
* **Brand Name:** * **​**Bactrim, Septra * **Indications;** * **​**Urinary Tract Infection * **Counseling Points** * **​**Take with full glass of water and maintain hydration * Photosensitivity * Store suspension at room temp * Rare SJS/TEN: flu-like symptoms, spreading red rash, skin/mucous blistering
37
Nitrofurans: MOA and other info
* Includes: Nitrofurantoin * **MOA**: * Interferes with metabolism and inhibits protein and cell wall synthesis – bacteriostatic * Often used during pregnancy * category B
38
Nitrofurantoin
* **Brand Name:** * **​**Macrobid, Macrodantin * **Indications:** * **​**Urinary Tract Infection * **Counseling Points** * **​**Take with food: increases absorbtion * Discoloration of urine (brown/orange) * Do not crush * Good at concentrating in urine

Pharm 585 (13 decks)

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