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Pharmacology > Miscellaneous Antibiotics > Flashcards

Miscellaneous Antibiotics Flashcards

1
Q

What class of antibiotics are….

  • Gentamicin
  • Tobramycin
  • Amikacin
  • Streptomycin
  • Neomycin
A

Aminoglycosides

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2
Q

Amnioglycosides

  • Extremely good for gram __________
  • bind 30S ribosome inhibiting protein _________
  • __________ activity
  • _________ dependent
  • Requires intense _______ monitoring
A
  • Extremely good for gram NEGATIVE
  • bind 30S ribosome inhibiting protein SYNTHESIS
  • BACTERICIDAL activity
  • CONCENTRATION dependent
  • Requires intense LEVEL monitoring
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3
Q

Aminoglycosides — Spectrum

  • Benefit = _________ has not developed
  • ______, gram negative rods (GNRs)
  • _________ = best option in class d/t decreased MICs and lower required doses
  • S. aureus (do not use as __________)
  • __________ = often reserved for tob/gent resistant bugs (most nephrotoxic)
A
  • Benefit = RESISTANCE has not developed
  • AEROBIC, gram negative rods (GNRs)
  • TOBRAMYCIN = best option in class d/t decreased MICs and lower required doses
  • S. aureus (do not use as MONOTHERAPY)
  • AMIKACIN = often reserved for tob/gent resistant bugs (most nephrotoxic)
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4
Q

Aminoglycosides

  • 100% ______ eliminated (requires monitoring)
  • Very hydro______ which limits distribution in tissues
  • Narrow ________ window, _________ dosing
A
  • 100% RENALLY eliminated (requires monitoring)
  • Very HYDROPHILIC which limits distribution in tissues
  • Narrow THERAPEUTIC window, INDIVIDUALIZED dosing
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5
Q

Aminoglycosides — Clinical Uses

  • used for ________ infections
  • only use monotherapy for ______
  • Gram _______ sepsis, HCAP, bactermia
  • Not great for skin __________ (hydrophilic)
  • Gram _________ used as synergy
A
  • used for HOSPITALIZED infections
  • only use monotherapy for UTIs
  • Gram NEGATIVE sepsis, HCAP, bactermia
  • Not great for skin INFECTIONS (hydrophilic)
  • Gram POSITIVE used as synergy
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6
Q

Aminoglycosides — ADRs

  • Primary reason people like to avoid the drug = _________
    - occurs ______ days after start of therapy
    - Generally mild AKI and ____________
  • ____________ (very rare, but often irreversible); associated /c accumulation not excessive dosing
A
  • Primary reason people like to avoid the drug = NEPHROTOXICITY
    - occurs 5 - 7 days after start of therapy
    - Generally mild AKI and REVERSIBLE
  • OTOTOXICITY (very rare, but often irreversible); associated /c accumulation not excessive dosing
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7
Q

Trimethoprim / Sulfamethoxazole (Bactrim)

  • ______ antibiotic
  • _______, gram _________ organisms
  • ________ spectrum
  • Used alot in ____/________ and some ________
  • Great drug for community acquired _______
  • _________ = resistance increasing steadily such that use not recommended when strep is suspected pathogen
  • ________, gram __________ organisms
A
  • UTI antibiotic
  • AEROBIC, gram POSITIVE organisms
  • BROAD spectrum
  • Used alot in AIDS/HIV and some CANCERS
  • Great drug for community acquired MRSA
  • STREPTOCOCCI = resistance increasing steadily such that use not recommended when strep is suspected pathogen
  • AEROBIC, gram NEGATIVE organisms
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8
Q

Trimethoprim / Sulfamethoxazole (Bactrim)

  • _________ eliminated
  • Significant drug interaction /c ___________
A
  • RENALLY eliminated
  • Significant drug interaction /c WARFARIN (COUMADIN)
    - Bacterium blocks metabolism of warfarin so it stays in the system longer (nose bleeds, gum bleeds, bruising)
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9
Q

Trimethoprim / Sulfamethoxazole (Bactrim) — ADRs

  • ________/ ________/________ (NVD)
  • Anorexia
  • Hematologic: _________, _________, ____________ (seen /c larger doses, reversible)
  • ____________ (/c high doses)
  • more prone to ___________
A
  • NAUSEA/ VOMITING/DIAHRREA (NVD)
  • Anorexia
  • Hematologic: NEUTROPENIA, THROMBOCYTOPENIA, ANEMIA (seen /c larger doses, reversible)
  • HYPERKALEMIA (/c high doses)
  • more prone to SUNBURNS
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10
Q

Tetracyclines — Spectrum

  • ________ spectrum
  • __________ = inhibits further growth
  • _________ is high
  • Gram ____________ coverage
  • used for ________ (treats pneumonia in adults and children)
  • Good for ______ borne disease and ______ disease
  • some gram ________ coverage
A
  • BROAD spectrum
  • BACTERIOSTATIC = inhibits further growth
  • RESISTANCE is high
  • Gram POSITIVE coverage
  • used for ATYPICALS (treats pneumonia in adults and children)
  • Good for TICK borne disease and LYME disease
  • some gram NEGATIVE coverage
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11
Q

Tetracycline — ADRs

  • _______/_______/________ (NVD)
  • Binds to __________ cations
  • ___________ (i.e. sunburns)
  • Decreased ___________ activity
  • ____________ of teeth and bone (permanent)
  • Retardation of ________ development
A
  • NAUSEA/VOMITING/DIAHRREA (NVD)
  • Binds to DIVALENT cations
  • PHOTOSENSITIVITY (i.e. sunburns)
  • Decreased ORAL CONTRACEPTIVE activity
  • DISCOLORATION of teeth and bone (permanent)
  • Retardation of BONE development
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12
Q

Tetracyclines — Clinical Uses

  • Community acquired __________, ______ infections
  • _______ disease
  • Acne
  • _________ infections (i.e. COPD, pneumonia)
  • ______ related infections
  • Downside = _________ is an issue
A
  • Community acquired MRSA, SKIN infections
  • LYME disease
  • Acne
  • ATYPICAL infections (i.e. COPD, pneumonia)
  • TICK related infections
  • Downside = RESISTANCE is an issue
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13
Q

Metronidazole (Flagyl)

  • Use: _______ & ________ antibiotic
  • MOA: binds to and disrupts _____ and _________ synthesis
  • ________ (kills bacteria)
  • ________ dependent
  • only __________ coverage (under the diaphragm)
  • Gram ________
A
  • Use: GUT & URINARY antibiotic
  • MOA: binds to and disrupts DNA and NUCLEIC ACID synthesis
  • BACTERICIDAL (kills bacteria)
  • CONCENTRATION dependent
  • only ANAEROBIC coverage (under the diaphragm)
  • Gram NEGATIVE
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14
Q

Metronidazole (Flagyl) — ADRs

  • _______/_________/__________
  • Pancreatitis
  • ______ complications
  • Disulfiram reaction (violent nausea) — avoid /c _________
A
  • NAUSEA/VOMITING/DIAHRREA
  • Pancreatitis
  • CNS complications
  • Disulfiram reaction (violent nausea) — avoid /c ALCOHOL (EtOH)
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15
Q

Metronidazole (Flagyl)

  • F:1 = good ___________
  • Well distributed in tissues (including _______)
  • First line option for _______ colitis
  • Add on therapy for ________ infections (below the diaphragm anaerobic coverage)
  • Bacterial __________
A
  • F:1 = good BIOAVAILABILITY
  • Well distributed in tissues (including C. DIFF)
  • First line option for ABDOMINAL colitis
  • Add on therapy for ANAEROBIC infections (below the diaphragm anaerobic coverage)
  • Bacterial VAGINOSIS
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16
Q

Clindamycin (Cleocin)

  • for ________ above the diaphragm
  • Gram ________ only
  • ________ (oxygen requiring)
A
  • for ANAEROBES above the diaphragm
  • Gram POSITIVES only
  • AEROBES (oxygen requiring)
17
Q

Clindamycin (Cleocin)

  • Resistance /c _______ use
  • Great __________
  • ADR: _____ intolerance, antibiotic associated ______ (diarrhea)
A
  • Resistance /c SUSTAINED use
  • Great ABSORPTION
  • ADR: GI intolerance, antibiotic associated COLITIS (diarrhea)
18
Q

Clindamycin (Cleocin) — Clinical Uses

  • Community acquired _______, ______
  • _________ outside of the CNS
  • Ance
  • Encephalitis
  • ___________ in AIDS patients /c bactrim allergy
  • Bacterial __________
  • “above the diaphragm” __________
A
  • Community acquired MRSA, SSTI
  • ANAEROBES outside of the CNS
  • Ance
  • Encephalitis
  • PNEUMONIA in AIDS patients /c bactrim allergy
  • Bacterial VAGINOSIS
  • “above the diaphragm” ANAEROBES
19
Q

Fosfomycin (Monurol)

  • Some use for ______
  • Concentrates well in _______ and maintains adequate ______
A
  • Some use for UTI’s

- Concentrates well in URINE and maintains adequate URINE

20
Q

Fosfomycin (Monurol) — ADR’s

  • ______ tolerated
  • H_________
  • ______/_________/________
A
  • WELL tolerated
  • HEADACE
  • NAUSEA/VOMITING/DIAHRREA
21
Q

Nitrofurantonin (Macrobid)

  • use for ________
  • requires good ______ function
A
  • use for UTI

- requires good RENAL function

22
Q

Nitrofurantoin (Macrobid)

  • requires functioning _________ for efficacy
  • Uses: ______, ______ prophylaxis, acute _______
A
  • requires functioning KIDNEYS for efficacy

- Uses: UTI, UTI prophylaxis, acute CYSTITS

23
Q

Fluoroquinolones — MOA

  • For gram ________ & ________ bacteria
  • _________ dependent
  • ________ (rapid)
A
  • For gram POSITIVE & NEGATIVE bacteria
  • CONCENTRATION dependent
  • BACTERICIDAL (rapid)
24
Q

Fluoroquinolones — Spectrum

  • Very ________ spectrum: good to use out of the gate
  • Good gram ________ coverage
  • _______ gram ________ coverage
  • __________ (moderate activity)
  • _________ (very active)
    • does NOT cover ________ well
A
  • Very BROAD spectrum: good to use out of the gate
  • Good gram NEGATIVE coverage
  • AEROBIC gram POSITIVE coverage
  • MYCOBACTERIA (moderate activity)
  • ATYPICALS (very active)
    • does NOT cover ANAEROBES well
25
Q

Fluoroquinolones

  • Use for _______ infection, not for _______ infection
  • What are 3 drug interactions?
A
  • Use for LUNG infection, not for UTI infection

- (1) ANTIACIDS, (2) WARFARIN, (3) FOOD

26
Q

Fluoroquinoloes — ADRs

- What are 4 ADRs of Fluoroquinolones?

A

(1) Nausea/vomiting/diahrrea
(2) Rash
(3) QTc prolongation
(4) Achiles tendon reupture

27
Q

What population should Fluoroquinolones be avoided in?

A

Children < 18 y.o. d/t arthropathies notes in animal studies

28
Q

Fluoroquinolones — Clinical uses

  • Cover everything except __________
  • for nasty ________ infections (upper and lower)
  • _______ tract infection
  • _________ infections
  • S_____
  • O_________
  • overuse leads to _________
A
  • Cover everything except ANAEROBES
  • for nasty RESPIRATORY infections (upper and lower)
  • URINARY tract infection
  • ABDOMINAL infections
  • SKIN
  • OSTEO
  • overuse leads to RESISTANCE
29
Q

What class of antibiotics are…

  • Azithromycin (Zithromax)
  • Erthromycin
  • Clarithromycin (Biasing)
  • Fidaxomicin (Dificid)
A

Macrolides

30
Q

Macrolides — MOA

  • bind to _____ ribosome to inhibit _______ — dependent protein syntehsis
  • _________ dependent
  • Slowly _________ or ________
A
  • bind to 50S ribosome to inhibit RNA — dependent protein syntehsis
  • TIME dependent
  • Slowly BACTERICIDAL or BACTERIOSTATIC
31
Q

Macrolides — Spectrum

  • _______ spectrum
  • Really good for _________ (walking pneumonia)
  • _________ pathologies
  • Strep and __________
A
  • BROAD spectrum
  • Really good for ATYPICALS (walking pneumonia)
  • GENITAL pathologies
  • Strep and STAPH
32
Q

Macrolides — Kinetics

  • Less absorbed/effective at ______ pH
  • Very large, extensive tissue _________ and _______ intracellular concentrations
  • Azithromycin = ______ half life
    - allows for popular ____ pack or ____ pack –> leads to drug being below MIC after this so ________ is developed
A
  • Less absorbed/effective at ACIDIC pH
  • Very large, extensive tissue PENETRATION and HIGH intracellular concentrations
  • Azithromycin = 66 half life
    - allows for popular Z pack or TRI pack –> leads to drug being below MIC after this so RESISTANCE is developed
33
Q

Macrolides — ADRs

- What are 3 ADRs?

A

(1) Nausea/vomiting/Diarrhea
(2) Taste disturbances –> Clarithromycin (drug)
(3) QTc prolongation

34
Q

Macrolides

- _________ is most used b/c it has the fewest drug interactions

A
  • AZITHROMYCIN is most used b/c it has the fewest drug interactions
35
Q

Macrolides — Clinical Uses

  • upper and lower ________ infections
  • ______ bacteria infections
  • _________ (chlamydia trachomatis)
  • H. _______
A
  • upper and lower RESPIRATORY infections
  • ATYPICAL bacteria infections
  • STDs (chlamydia trachomatis)
  • H. PYLORI

Pharmacology (10 decks)

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