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Pharm 585 > MCP Antibiotics > Flashcards

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
Q

Azithromycin

A
  • 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
Q

Clarithromycin

A
  • **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
Q

Lincosamides: MOA and other info

A
  • Includes: Cindamycin
  • MOA:
    • inhibits bacterial protien biosynthesis-bacteriostatic
28
Q

Clindamycin

A
  • 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
Q

Tetracyclines: MOA and Other Info

A
  • 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
Q

Doxycycline

A
  • 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
Q

Fluoroquinolones: MOA and other information

A
  • 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
Q

Ciprofloxacin

A
  • **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
Q

Nitromidazoles: MOA and other information

A
  • Includes: Metronidazole
  • MOA
    • Inhibits DNA replication – bactericidal
  • Targeted, narrow-spectrum
    • Only active in cells with nitroreductase
      • –i.e. protozoa and anaerobic bacteria
34
Q

Metronidazole

A
  • 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
Q

Sulfonamides: MOA and Other Information

A
  • Includes: Sulfamethoxazole
  • MOA
    • Inhibits biosynthesis of folic acid – bacteriostatic
  • Due to long history of use – resistance is a problem
  • Common antibacterial allergy
36
Q

Sulfamethoxazole/Trimethoprim

A
  • 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
Q

Nitrofurans: MOA and other info

A
  • Includes: Nitrofurantoin
  • MOA:
    • Interferes with metabolism and inhibits protein and cell wall synthesis – bacteriostatic
  • Often used during pregnancy
    • category B
38
Q

Nitrofurantoin

A
  • 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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