Overview of antimicrobial pharm Flashcards
What drugs are cell wall synthesis inhibitors?
Penicicillins, cephalosporins, vancomycin
Penicillins: PO, IV, or both? Penicillin V Penicillin G Dicloxacillin Amoxicillin Ampicillin amox/clav Pip/tazo
Penicillin V - PO Penicillin G - both Dicloxacillin - PO Amoxicillin - PO Ampicillin - both amox/clav - PO Pip/tazo - IV
What are two 1st generation cephalosporins?
PO or IV?
Cephalexin - PO
Cefazolin - IV
What is a 2nd generation cephalosporin?
PO or IV?
Cefuroxime - IV only
What is a 3rd generation cephalosporin? PO or IV or IM?
Ceftriaxone - IV and IM
Is vancomycin PO or IV?
IV for systemic infections
PO for local GI infections
What are the macrolides? PO or IV?
Azithromycin, clarithromycin, erythromycin
PO and IV
What are the tetracyclines?
PO or IV?
Doxycycline, tetracycline
PO and IV
Is clindamycin PO or IV or both?
Both
What are the aminoglycosides? PO or IV?
Tobramycin, gentamycin. IV for systemic infections
PO for local GI infections
What is the mechanism of action for macrolides, tetracyclines, clindamycin, and aminoglycosides.
Protein synthesis inhibition
What are the inhibitors of DNA function?
Fluoroquinalones, Nitrofurantoin, Metronidazole
What are the fluoroquinolones? PO or IV or both?
Ciprofloxacin, levofloxacin, moxifloxacin
PO and IV
Nitrofurantoin. PO or IV?
PO only
Metronidazole. PO or IV
Both
What are the inhibitors of intermediary metabolism?
PO or IV or Both?
Sulfonamides
TMP-SMX - both
TMP - PO
Do cell wall inhibitors work on atypical bugs? Why?
No, atypical bacteria do not have cell walls, so cell wall inhibitors don’t do anything to them
What antibiotics are eliminated by non renal mechanisms?
D CRIMES Doxycycline Clindamycin Rifampin Isoniazid Erythromycin-like (macrolides) Sulfonamides (TMP-SMX)
Antibiotics eliminated by non-renal mechanisms have what complications?
Potential for drug drug interactions
Genetic polymorphisms in metabolizing enzymes
Potential for hepatotoxicity
What antibiotic mechanisms are bactericidal?
Inhibition of cell wall synthesis
Disruption of cell membrane function
Interference with DNA function or sythesis
What antibiotic mechanisms are bacteriostatic?
Inhibition of protein synthesis (except for aminoglycosides, they’re bactericidal)
Inhibition of intermediary metabolic pathways
What are the gram + cocci?
Streptococci, staphylococci, enterococci
What are the gram - cocci?
Neisseria (meningitidis, gonorrhoeae) and M. catarrhalis
What are the gram - rods?
E. coli, pseudomonas, H. influenzae
What is a gram + rod?
Listeria
What anaerobes are of most concern?
Gram + rods = C. diff, H. pylori
Gram - rods = Bacteroides fragilis
What are the atypical bacteria?
Chlamydia, Mycoplasma, Rickettsia
What does it mean to be narrow spectrum?
Effective against either gram + OR gram -
What does it mean to be extended spectrum?
Effective against gram + AND gram -
What does it mean to be broad spectrum?
Effective against gram + AND gram - AND atypical
Some drugs selectively accumulate. Where do the following accumulate and is it good or bad? Clindamycin Macrolides Tetracyclines Nitrofurantoin Aminoglycosides
Clindamycin - Bone, good for osteomyelitis
Macrolides - lungs, good for URIs/pneumonia
Tetracyclines- gingiva and sebum (good for periodontitis and acne). Also Ca++ in a bad way that is bad for bone development and teeth in children
Nitrofurantoin - Urine, good for UTIs
Aminoglycosides- Inner ear and renal brush border, bad(causes ototoxicity and nephrotoxicity)
