Pharm-Lung infections

Question 1

What do macrolides end in?

Answer 1

mycin

Question 2

Which two classes of penicillins are used in treating pulmonary infections?

Answer 2

Natural and aminopenicillins

Question 3

What are the natural penicillins?

Answer 3

G and V

Question 4

What are the aminopenicillin drugs?

Answer 4

Ampicillin and amoxicillin

Question 5

Penicillin V is used for which pathogens specifically?

Answer 5

Strep A, B, C, G, Actinomyces, Corynebacterium (PENISillin - SAC)

Question 6

Aminopenicillins are used for which pathogens specifically?

Answer 6

Strep pneumo
H influenzae
E coli
Listeria

Question 7

Natural penicillins are effective for which types of bacteria?

Answer 7

G+ cocci and bacilli; some G- cocci; Spirochetes

Question 8

Aminopenicillins are effective for which types of bacteria?

Answer 8

G+ cocci and bacilli; some G- cocci; Spirochetes;

ALSO some G- rods and bacilli (natural penicillins not useful for those)

Question 9

Do natural penicillins work against Staph?

Answer 9

No

Question 10

Pen V administration constrictions

Answer 10

1 hr before or 2 hrs after meal

Question 11

How is penicillin mostly excreted?

Answer 11

90% tubular secretions

Question 12

What are the third generation cephalosporins?

Answer 12

Ceftriaxone

Question 13

Ampicillin - major side effect to think of!

Answer 13

Diarrhea

Question 14

How can penicillin affect electrolytes?

Answer 14

• It’s an acid, so in large doses, it can cause water retention (think about people with HTN or CHF)
• In kidney, penicillin is non-absorbable that’s secreted; K+ moves in in exchange for H+ out, which can exacerbate hypokalemia

Question 15

What bacteria do 3rd-gen cephalosporins target?

Answer 15

Enteric G-

Question 16

Describe what cephalosporins 3rd gen are used for

Answer 16

G-
Very serious infections only
Crosses BBB
H influenza, Serratia

Question 17

What is the drug of choice for gonorrhea?

Answer 17

Ceftriaxone

Question 18

Do 3rd gen cephalosporins work on enterococci?

Answer 18

NO

Question 19

What is the deal with cephs and renal dysfunction?

Answer 19

Dose adjustment! Supplemental doses needed after dialysis except for Ceftriaxone

Question 20

What are the major ceph AEs?

Answer 20

Diarrhea and GI disturbance

Question 21

Carbapenems belong to this class of antibiotics

Answer 21

Beta-lactams (subclass)

Question 22

What is the MOA of beta lactams

Answer 22

Binds transpeptidase proteins and blocks cross-linking of peptidoglycan strands

Question 23

What is so great about carbapenems?

Answer 23

Highly resistant to beta lactamases

Question 24

Which beta lactam has the broadest spectrum?

Answer 24

Imipenem

Question 25

Erythromycin and clarithro MOA

Answer 25

Reversibly binds 50S

Question 26

What does imipenem target?

Answer 26

Broad - empiric - G+ and G-, anaerobes, and P aeruginosa

Question 27

What drug is C/I for patients with CNS seizures?

Answer 27

Imipenem!

Question 28

Which drug must be co-administered with cilastatin and why?

Answer 28

Imipenem; it inhibits renal toxicity and breakdown of imipenem

Question 29

Macrolides excretion elim

Answer 29

Bile and feces

Question 30

Meropenem salient facts

Answer 30

Less likely to cause seizures | Less effect on G+

Question 31

Erythromycin static or cidal?

Answer 31

Static

Question 32

Azithromycin and clarithromycin static or cidal?

Answer 32

Depends on concentration

Question 33

What would be a good drug for prostatic infections?

Answer 33

Erythromycin - diffuses well into prostate

Question 34

FQs don't go well with:

Answer 34

Antacids and iron and zinc

Question 35

FQs excretion

Answer 35

unchanged in urine and also bile

Question 36

FQs AEs

Answer 36

GI, Head, phososensitivity, QT prolongation, articular cartilage erosion (AVOID IN PREGOS)

Question 37

FQs interactions?

Answer 37

Inhibits P450A2 (cipfo and levo do)

Question 38

Describe the coverage of FQs

Answer 38

Broad G- coverage!

Question 39

Describe the coverage of tetracyclines

Answer 39

BROAD

Question 40

Tetracyclines static or cidal

Answer 40

static - ribosome binding is reversible

Question 41

Sulfonamides AEs

Answer 41

Urinary aggregates; hematologic disorders with G6PD; allergy, displacing plasma binders

Question 42

Resistance of tetracyclines?

Answer 42

Resistance to one means resistance to all

Question 43

Discuss important tetracycline ADME

Answer 43

Abs is inhib by di/trivalent cations so do not take with dairy or antacids

Question 44

Doxy excretion?

Answer 44

hepatic - bile - so no dosing adjustment needed

Question 45

Tetracycliens - ok for pregos?

Answer 45

No - crosses over and deposits into developing bones

Question 46

Most toxic effects of tetracyclines are due to

Answer 46

The effect the drug has on normal gut flora, especially candidiasis infections of the GI tract

Question 47

Tetracyclines common AEs and doxy specifics

Answer 47

avitaminosis, superinfections, gut flora chgs, bone growth depression, complexing with Ca2+ Vestibular toxicity Doxy - photosensitivity

Question 48

Specific indications for tetracyclines?

Answer 48

Atypical pneumonia - mycoplasma, legionella, chlamydia

Question 49

Sulfonamides MOA

Answer 49

Inhibit use of PABA in folic acid synthesis pathway

Question 50

Sulfonamides alone static or cidal?

Answer 50

static

Question 51

Sulfonamides excretion

Answer 51

renal

Question 52

FQ MOA?

Answer 52

Topo II inhibitor

Question 53

FQs end in?

Answer 53

oxacin