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Pharmacology - Block II (VER 2.0) > Pharm Block II - Antimicrobials > Flashcards

Pharm Block II - Antimicrobials Flashcards

1
Q

prophylaxis

A

treating pts who are not yet infected or have not yet developed disease.

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2
Q

empiric therapy

A

use of antibiotics to tx an infection before the specific causative organism has been identified w/ lab test

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3
Q

definitive therapy

A

use of specific antibiotics based on a previously identified identifying organism

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4
Q

normal flora

A

organisms that live symbiotically on or w/in the human hose but rarely cause disease

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5
Q

colonization

A

the process of a newly introduced microorganism that successfully competes w/ normal flora

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6
Q

infection

A

a disease caused by microorganisms, esp those that release toxins or invade body tissue

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7
Q

superinfection

A

a new infection occurring in a pt already having an infection (usually caused by opportunistic microorganisms resistant to the antimicrobial agents used in tx of the first infection)

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8
Q

contamination

A

the introduction of pathogens or infectious material into or on normally clean or sterile objects, spaces, or surfaces

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9
Q

bactericidal

A

capable of killing bacteria

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10
Q

bacteriostatic

A

inhibition or retardation of the growth of bacteria w/out their destruction

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11
Q

Minimum inhibitory concentration (MIC)

A

the lowest concentration antibiotic that inhibits bacterial growth

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12
Q

minimum bactericidal concentration

A

the lowest concentration of antibiotic that kills 99.9% of bacteria

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13
Q

Susceptible

A

Infection caused by organism likely to respond to treatment with this drug at recommended dosages

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14
Q

Intermediate susceptibility

A

Antibiotic can be used for tx at high doses (b/c low toxicity or concentrated focus of infection)

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15
Q

Resistant

A

Organism not expected to respond to given drug

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16
Q

Site of infection

A

Gives clues on bacteria involved and type of drug needed

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17
Q

penetration & concentration of abx in CSF is a result of

A

lipid solubility, molecular weight of drug, protein binding of drug

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18
Q

Severity of infection

A

Need to decide dosage, route, bacteriostatic vs bacteriocidal depending on severity

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19
Q

7 things to consider about host characteristics

A

Immune system (immunocompromised); renal (inappropriate accumulation); liver funciton (drugs may not be properly eliminated); perfusion (preventing distribution); age (young and old); pregnancy (categories - X worst); lactation.

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20
Q

6 things to consider about antibiotic characteristics

A

Kinetics (ADME); dynamics (what drug does to body); spectra of activity (another card); cost; interactions; adverse reactions (pt education).

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21
Q

Spectra of activity

A

Narrow (acts against single or limited group of microorgs); extended (acts against gram + and -); broad; bactericidal (kill target organism, chosen for critically ill); bacteriostatic (inhibit/delay bacterial growth limitinig spread of infection until immune system can take over)

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22
Q

Additive combination drug response

A

The response elicited by combined drugs is equal to the combined responses of the individual drugs if they were taken separately (1+1=2)

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23
Q

Synergistic combination drug response

A

The response elicited by combined drugs is greater than the combined response of the individual drugs if they were taken separately (1+1=3) (eg Clavulanic acid with penicillins)

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24
Q

MOA for aminoglycosides

A

ribosomal protein synthesis inhibitor – bactericidal

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25
Q

Coverage for aminoglycosides

A

Gram negs; gram pos (enterococcus) when used synergistically with B-lactams; not anaerobes

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26
Q

gentamicin, streptomycin, neomycin are examples of which class of antibiotic?

A

aminoglycosides

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27
Q

Adverse reactions for aminoglycosides

A

Nephrotoxicity

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28
Q

Coverage for penicillins

A

Must be able to reach penicillin binding protein; gram pos b/c cell was easily crossed; gram neg if porins permit transmembrane entry; some anaerobes

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29
Q

what are the 2 subclasses within beta-lactams?

A
  • penicillins- cephalosporins
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30
Q

MOA of PCNs

A

inhibits cell wall synthesis

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31
Q

Adverse reactions for penicillins

A

Hypersensitivity (up to anaphylaxis)

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32
Q

MOA of cephalosporins

A

beta lactam binds PCN-binding-proteins and inhibits cell wall synthesis

33
Q

Name of first generation cephalosporins and coverage

A

Cefazolin, Cephalexin; (mostly gram pos) strep, MSSA, E coli, Kleb, oral anaerobes; skin infections some respiratory

34
Q

Name of second generation cephalosporins and coverage

A

Cefuroxime, Cefoxitin, Cefaclor; (better than first gen with gram neg weaker with gram pos) H flu, Neisseria, Cefoxitin covers B fragilis

35
Q

Name of third generation cephalosporins and coverage

A

Ceftriaxone, cefixime, cefotaxime, ceftazidime; (inferior MSSA activity than first gen, but enhanced against gram neg) Drugs of choice for meningitis, ceftazidime covers P aeruginosa, only oral anaerobes; repiratory infections and serious infections

36
Q

Name of fourth generation cephalosporin and coverage

A

Cefepime; strep, MSSA, aerobic gram neg (P aeruginosa), oral anaerobes; serious hospital infections

37
Q

Adverse effects for cephalosporins

A

Anaphylaxis/hypersensitivity

38
Q

MOA of nucleoside analogs (antiviral)

A

inhibits DNA polymerase and incorporates into viral DNA

39
Q

3 drugs to treat headlice/scabies/crabs

A
  1. lindane (topical use only)2. permethrin3. pyrethrins
40
Q

clinical use for aminoglycoside antibiotics

A

Gram - infections (including pseudomonas)

41
Q

major PCN spectrum of activity

A

gram +

42
Q

1st generation cephalosporins (keflex, cefazolin) major spectrum of activity

A

Gram +

43
Q

2nd generation cephalosporins (cefuroxime, cefaclor) major spectrum of activity

A

mediocre coverage for both Gram + and Gram –

44
Q

3rd generation cephalosporins (ceftriaxone, cefixime) major spectrum of activity

A

Gram –

45
Q

4th generation cephalosporins (cefepime) major spectrum of activity

A

good for both Gram + and Gram – (typically used for serious, hospitalized infections)

46
Q

macrolides (erythromycin, clarithromycin, azithromycin) mech of action

A

inhibition of ribosomal function, therefore, no protein synthesis

47
Q

macrolide spectrum of activity

A

Gram +

48
Q

Macrolide adverse reactions

A

GI upset, phlebitis

49
Q

tetracyclines (doxycycline, tetracycline, minocycline) MOA

A

protein synthesis inhibition(broad spectrum)(adverse rxns: photosensitivity, tooth discoloration in children)

50
Q

Tetracyclines (doxycycline, tetracycline, minocycline) coverage

A

Gram pos: strept, MSSA; Gram neg: H flu; Anaerobe: Mosty oral

51
Q

Tetracylines adverse effects

A

Photosensitivity, GI upset, tooth discoloration in peds

52
Q

quinolones (ciprofloxican, norfloxican) MOA

A

inhibits DNA replication

53
Q

quinolones spectrum of activity

A

both Gram + and Gram –; UTI, anthrax, GI infections, atypical resp infections

54
Q

quinolones adverse effects

A

GI upset, dizziness, insomnia

55
Q

sulfa drugs (trimethoprim-sulfamethoxazole) MOA

A

inhibits synthesis of bacterial dihydrofolic acid(broad spectrum)

56
Q

Sulfa drugs coverage

A

Gram + and gram - (most enterobacteria); UTI, GI infections, PCP pneumonia

57
Q

Sulfa drugs adverse effects

A

Rash, fever, GI upset

58
Q

Nucleoside analog examples

A

acyclovir, vacyclovir, ribavirin

59
Q

Nucleoside analog MOA

A

Inhibit viral DNA synthesis

60
Q

Nucleoside analog coverage

A

Herpes viruses during acute phase, varicella-zoster, Epstein-Barr

61
Q

Nucleoside analog adverse effect

A

Topical - local irritation; PO = headache, N/V/D, renal dysfunciton

62
Q

Other antiviral examples

A

amantadine, interferon, oseltamivir

63
Q

Amantadine MOA

A

Prevents viral nucleic acid release into host cell

64
Q

Amantadine coverage

A

Treats/prevents influenza a

65
Q

Amantagine adverse effect

A

Orthostatic hypotension, edema, depression

66
Q

Interferon MOA

A

Probably induce host cell enzyme that inhibit viral RNA translation

67
Q

Interferon coverage

A

Hep B/C, condylomata acuminata, some cancers.

68
Q

Interferon adverse effect

A

Flu-like symptoms, GI disturbance, fatigue

69
Q

Oseltamivir MOA

A

Inhibiting viral neuraminidase

70
Q

Oseltamivir coverage

A

Influenza A/B

71
Q

Oseltamivir adverse effect

A

GI discomfort and nausea

72
Q

Lidane coverage and route

A

Scabies, head/crab lice; topical

73
Q

Permethrin coverage and route

A

Scabies, head lice; topical

74
Q

Pyrethins coverage and route

A

Head, body, pubic lice and eggs; topical

75
Q

metronidazole indications & adverse effects

A

ind:treatment of amebic infectionsAE: metallic taste, yeast infections (esp in mouth), dizziness, vertigo; oral

76
Q

mebendazole coverage and route

A

wide spectrum use against nematodes; oral

77
Q

Cross sensitivity risks between beta lactam antibiotics

A

Although not always the case, beta lactams have a beta lactam ring that IgE antibodies can bind. If a patient shows hypersensitivity to one beta lactam, it is possible they will have the same reaction with a different beta lactam.

78
Q

Response to antibiotic therapy

A

Assessed using clinical or laboratory methods, including: reduction in symptoms, dropping WBC count, reduction in consolidation pneumonia, watching for persistent bacteremia.

79
Q

Reasons for failed treatment

A

Viral infection, lack of definitive therapy, misidentification of infective agent, failed to exceed/reach MIC/MBC, failure in tx duration, failure to reach infection, drug-drug interactions.

Pharmacology - Block II (VER 2.0) (6 decks)

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