MT2 Flashcards
Classes of anti-infective drugs
Cephalosporins
Carbapenems
Macrolides
Penicillin’s
Sulfomides
Amino-glycosides
Fluoroquinolones
Tetracyclines
Post ABX effect
Certain tissues bind the drug tightly, renal excretion may be prolonged for up to 20 days after discontinuation, serum drug levels may fall but they still may exhibit minimal antibiotic activity. This is called the Post abx effect
Direct Thrombin and Factor Xa inhibitors
i.e. Apixaban
Direct Oral Anticoagulants (DOAC)
Newer drugs in the prevention and TX of venous thromboembolism and pulmonary emboli.
- Requiring no monitoring, and has fewer drug interaction therefore advantage over Warfarin
Major AE is bleeding with no antidote
Anticoagulants to know
Heparin
LMWH
Warfarin
Factor Xa Inhibitors (Apixiban)
Heparin
Enhances antithrombin activity
Decreases thrombin activity (Inhibits)
Decreases prothrombinase activity (Inhibits Xa)
For thromboembolic disorders or prohylaxis after surgery or in immobility etc.
Antidote is Protamine Sulfate
Test for serum levels is PTT
AE is HIT
LMWH
Same degree/mech of activity as heparin
Advantages:
Less likely to cause HIT
2-4x duration of heparin
More stable response
Less follow ups required
Client can be trained to give SC at home
Warfarin
Anticoagulant
Inhibiting enzymes that use Vit K to produce clotting factors
AE osteoperosis, microemoblie (PTS), bleeding
Serum levels measured by PT
Describe platlet activation/aggregation
At wound site, platlets adhere to vessel wall and become activated
Activation causes aggreagation of the platlets to form clumps, and promotes clotting
Antiplatlet drugs
Asprin
- Reducing formation of thromboxanes (promote activation of platlets)
- therefore platlets remain unactivated
ADP receptor antagonists
Clopidogrel
Antiplatlet drug - ADP Receptor antagonist
Preventing platlets aggregating by blocking receptor that promotes this activity - extending clotting times
Indicated to
Reduce CVA/MI risk
Reducing thrombolytic events post CVI/MI
Preventing DVT
Preventi thrombus formation in unstable angina
AE
Flu like ss
Diarrhea
Bruising
Upper resp infections
Alteplase
Fibrinolytic
For Thrombotic CVA
MoA: Conveting plasminogen to plasmin which breaks down fibrin in clot
Lowers circulating fibrinogen and plasminogen
AE: Angioedema, IC Bleed
Aminocaproic Acid (Amicar)
Antifibrinolytic
Used in acute hemmorrhages and prevention of post op bleed
MoA: Inactivates plasminogen precursors for plasmin that digests the fibrin clot
Tranexamic Acid
Antifibrinolytic
Mild AE
Penicillins
Target G+/Narrow spec
MoA: The beta -lactam ring structure of penicillin binds PBPs (penicillin-binding proteins) causing lysis of growing bacteria by damaging cell walls
Bacteriostatic
Penicillin G K+
Piperacillin/tazobactam
Serious super infections
Antibiotic associated pseudomembranous colitis
Cephalasporins
Target G-/For allergies to penicillin
Quite safe
MoA: Inhibits bacterial wall synthesis by binding to specific PBPs
- Same as Penicillins
Ceftriaxone
Cefotaxime
Carbapenems
G- AND serious Multi-Drug-resistant-Infections/Broad spect
MoA: Inhibits bacterial wall synthesis by binding to specific PBPs
- Same as Penicillins
“The Big Guns”
Meropenem
Doripenem
Tetracyclines Class
G+ & G- / BROADEST SPECTRUM
Inhibits bacterial protein synthesis
- Bacteriostatic
Decreases effectiveness of birth control
Widespread resistance exists
Tetracycline
Doxycycline
Macrolides
G+
Inhibits protein synthesis
Considered bacteriostatic, but may be bacteriocidal in high doses
Erythromycin
Azithromycin
Aminoglycosides
Reserved for serious infections caused by aerobic Gram-negative bacteria
Inhibits protein synthesis BUT bacteriocidal
Gentamicin
streptomycin
Fluoroquinolones
activity on all Gram-negative bacteria, with some activity on Gram-positive bacteria
work by preventing DNA replication, bactericidal
Favourable safety profile
Ciprofloxacin
Levofloxacin
Super infections, examples and ss
fever, perineal itching, cough, lethargy, or any unusual discharge
Sulfonamides
Inhibit DNA replication
Trimethoprim-Sulfamethoxazole
Pip Taz/Penicillin B K+ AE
Anaphylaxis, insomnia, C. Diff
AE of Ceftriaxone
SJS, TEN, rash
Carbepenem AE
Low incidence of AE
Tetracycline adverse effects
Decrease in birth control effectiveness, bacterial resistance (superinfections), photosensitivity
Aminoglycoside AE
Many serious effects including nephrotoxicity, ototoxicity, neuromuscular blockade
Narrow thereapeutic index
Macrolide AE
Hepatotoxicity
Anaphylaxis
Otoxicity (hearing loss, vertigo, dizziness)
Cardiotoxicity
Fluoroquorolone AE
CNS: Dizziness, headache,s and sleep disturbances)or
Sulfonomide AE
Crystals in urine, hypersensitivity , or anemia
Indications for Penecillin
(B K+) Gonorrhea and syphyliss, sepsis
Indications for cephilasporin
Ceftriaxone
skin, respiratory, soft tissue, urinary tract, and ear/nose/throat infections caused by bacteria.
it is often reserved for harder-to-treat cases
Carbebenem used to treat
Bone and joint infections
Pneumonia (including nosocomial pneumonia)
Sepsis
Meningitis (meropenem only)
