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Pharm Week 3 Flashcards

0
Q

How are antimicrobials different from other classes of drugs

A

The exert their action on bacteria infecting the host not the host itself

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1
Q

How can you prevent resistance

A

Dual therapy= using two drugs with different mechanisms of action
Ex: TB, pseudomonas aeruginosa, and enterococcal endocarditis

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2
Q

Things to avoid when prescribing antimicrobials

A
  • misuse of anitbiotics
  • overuse of broad spectrum antibiotics
  • suprainfection (alterations of normal flora= yeast infection from too strong of an antibiotic)
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3
Q

Should you leave colonized flora in tact?

A

Yes

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4
Q

Pathogen

A

Organism causing active infection

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5
Q

Normal flora

A

Organisms normally found on the host: non pathogenic

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6
Q

Colonization

A

Presence of bacteria that are not causing disease

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7
Q

Do you culture otitis media, sinus infection, or UTI in otherwise healthy patients?

A

NO

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8
Q

How do you select your appropriate antimicrobial

A
  • Spectrum of activity
  • Effects on non-targeted microbial flora
  • Appropriate dose
  • Pharmacokinetic and pharmacodynamic properties
  • ADR’s
  • Drug interactions
  • Cost
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9
Q

What is Empirical Therapy

A

An educated guess based on patient and antimicrobial specific factors: anatomical location, pathogens associated with presentation, potential for ADR’s, and antimicrobial spectrum of activity

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10
Q

What are patient specific considerations in antimicrobial selections?

A
  • Recent previous antimicrobial exposure
  • anatomical location
  • Hx of drug allergies
  • Organ dysfunction affecting drug clearance
  • Immunosuppression
  • Pregnancy
  • Compliance
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11
Q

De-escalation

A

If you’re using a broad spectrum antimicrobial and you ID the pathogen with culture results, you narrow your antibiotic to something sensitive to the pathogen

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12
Q

What causes antimicrobial failure?

A
  • Inadequate diagnosis
  • Poor source control (removing catheters or draining an abscess)
  • Development of new infection with resistant organism
  • Non adherence
  • Insufficient dosing
  • Drug interactions
  • Suprainfections
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13
Q

MIC

A

Minimal Inhibitory Concentration: you have to be above the MIC to effectively kill the pathogen

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14
Q

Gram positive

A

Has a cell wall and cell membrane, will hold the purple stain

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15
Q

Gram Negative

A

Has cell wall, cell membrane, and outer envelope which inhibits pink stain from sticking

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16
Q

Atypical

A

Possess uncommon qualities, colorless after staining, not a typical cell wall, can replicate, they ARE common

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17
Q

Anaerobic

A

Do not require O2 to live

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18
Q

What are the types of bacterial classification?

A

Gram Positive
Gram Negative
Anaerobic
Atypical

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19
Q

B-Lactam Antibiotics

A

Selectively interfere with the synthesis of the peptidoglycan bacterial cell wall. They are divided based on chemical structure and spectrum of activity

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20
Q

Why do you dose antimicrobials around the clock? q4h

A

antibiotics work best if the drug dosing trough concentration remains above the MIC throughout the entire dosing interval

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21
Q

Penicillin

A

Founded by Alexander Flemming on accident in 1929. It is the least toxic drug known, members of the family differ by a single side chain (R group)

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22
Q

Penicillin mechanism of action

A

interfere with bacterial wall synthesis by binding to PBP’s (penicillin binding proteins) disrupting the peptidoglycan layer

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23
Q

Penicillin therapeutic uses

A

treatment for bacterial pathogens

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24
Q

Natural Penicillins

A

Penicillin G aqueous- INJ
Penicillin G procaine and benzathine- IM only
Penicillin V (PenVeeK, Vi-CillinK)- PO

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25
Q

Penicillin G Aqueous- INJ

A

Natural Penicillin

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26
Q

Penicillin G Procaine and Benzathine- IM only

A

Natural Penicillin

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27
Q

Penicillin V (PenVeeK, Vi-CillinK) PO

A

Natural Penicillin

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28
Q

Amino Penicillins

A

Amoxicillin (Amoxil)- PO

Ampicillin (Omipen)- INJ, PO

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29
Q

Amoxicillin (Amoxil) PO

A

Amino Penicillin

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30
Q

Ampicillin (Omipen) INJ, PO

A

Amino Penicillin

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31
Q

Antistaphylococcal Penicillins

A

Dicloxacillin (Dynapen)- PO
Nafcillin (Nafcil, Unipen)- INJ
Oxacillin (Prostaphlin)- INH, PO

32
Q

Dicloxacillin (Dynapen) PO

A

Antistaphylococcal penicillins

33
Q

Nafcillin (Nafcil, Unipen) INJ

A

Antistaphylococcal penicillin

34
Q

Oxacillin (Prostaphlin) INJ, PO

A

Antistaphylococcal penicillin

35
Q

Antipseudomonal Penicillins

A

Piperacillin (Piperacil) INJ

Ticarcillin (Ticar) INJ

36
Q

Piperacillin (Piperacil) INJ

A

Antipseudomonal Penicillin

37
Q

Ticarcillin (Ticar) INJ

A

Antipseudomonal penicillin

38
Q

B-Lactamase Inhibitor Combos (extended spectrum)

A

Ampicillin/Sulbactam (Unasyn)- INJ
Amoxicillin/clavulanate (Augmentin)- PO
Piperacillin/Tazobactam (Zosyn)- INJ
Ticarcillin/clavulanate (Timentin)- INJ

39
Q

Ampicillin/Sulbactam (Unasym) INJ

A

B-Lactamase Inhibitor Combos (extended spectrum)

40
Q

Amoxcillin/clavulanate (Augmentin) PO

A

B-Lactamase inhibitor combos (extended spectrum)

41
Q

Piperacillin/tazobactam (Zosyn) INJ

A

B-Lactamase inhibitor combos (extended spectrum)

42
Q

Ticarcillin/Clavulanate (Timentin) INJ

A

B-Lactamase inhibitor combos (extended spectrum)

43
Q

What are the types of Penicillins

A 
Natural
Amino
Antistaphylococcal
Antipseudomonal
B-Lacatamse inhibitor combos
44
Q

Name the types of Cephalosporins

A

1st, 2nd, 3rd, 4th generation

45
Q

Cefadroxil (Duricef) PO

A

1st generation cephalosporins

46
Q

1st generation cephalosporins

A

Cefadroxil (Duricef) PO
Cefazolin (Ancef, Kefzol) INJ
Cephalexin (Keflex) PO

47
Q

Cefazolin (Ancef Kefzol) INJ

A

1st generation cephalosporins

48
Q

cephalexin (Keflex) PO

A

1st generation cephalosporins

49
Q

2nd Generation cephalosporins

A 
Cefaclor (Ceclor) PO
Cefotetan (Cefotan) IV
Cefoxitin (Mefoxin) IV
Cefprozil (Cefzil) PO
Cefuroxime (Zinacef) INJ
Cefuroxime axetil (Ceftin) PO
50
Q

2nd Generation cephalosporins

A 
Cefaclor (Ceclor) PO
Cefotetan (Cefotan) IV
Cefoxitin (Mefoxin) IV
Cefprozil (Cefzil) PO
Cefuroxime (Zinacef) INJ
Cefuroxime axetil (Ceftin) PO
51
Q

Cefprozil (Cefzil) PO

A

2nd Generation cephalosporins

52
Q

Cefuroxime axetil (Ceftin) PO

A

2nd Generation cephalosporins

53
Q

3rd Generation Cephalosporins

A 
Cefdinir (Omnicef) PO
Cefditoren (Spectracef) PO
Cefixime (Suprax) PO
Cefotaxime (Claforan) INJ
Cefpodoxime (Vantin) PO
Ceftazidime (Fortaz) INJ
Cefibuten (Cedax) PO
Ceftriaxone (Rocephin) INJ
54
Q

Cefdinir (Omnicef) PO

A

3rd Generation Cephalosporins

55
Q

Cefditoren (Spectracef) PO

A

3rd Generation Cephalosporins

56
Q

Cefixime (Suprax) PO

A

3rd Generation Cephalosporins

57
Q

Cefpodoxime (Vantin) PO

A

3rd Generation Cephalosporins

58
Q

Cefibuten (Cedax) PO

A

3rd Generation Cephalosporins

59
Q

Cefotaxime (Claforan) INJ

A

3rd Generation Cephalosporins

60
Q

Ceftazidime (Fortaz) INJ

A

3rd Generation Cephalosporins

61
Q

Ceftriaxone (Rocephin) INJ

A

3rd Generation Cephalosporins

62
Q

Cefuroxime (Zinacef) INJ

A

2nd Generation Cephalosporins

63
Q

4th Generation Cephalosporins

A

Cefepime (Maxipime) INJ

64
Q

Penicillin Mechanisms of Resistance

A
  • B-lactamase/penicillinase: inactivate the drug’s B-Lactim ring
  • Modified PBPs: Decreased affinity for the penicillins
  • Decreased Permeability: gm-neg with modified external surfaces reduce drug permeability
65
Q

What kills mostly gram-positive cocci, strep viridans, strep pyogenes? Treats syphillis, endocarditis, Strep. pneumonia, strep throat, group B strep infections

A

Natural Penicillins!!!!!

66
Q

What treats otitis media & sinusitis (H. influenzae, Strep. pneumoniae) and simple UTIs?

A

Amino Penicillins!!!!

67
Q

Why is amoxicillin preferred to ampicillin?

A

Better absorption and less diarrhea

-Ampicillin is just Amoxicillin dissolved in water.

68
Q

What treats in any type of infection with documented pseudomonas aeruginose, serratia, of klebsiella (nosocomila pneumonia or UTI, complicated cellulitis, or abdominal infections

A

Antipseudomonal Penicillins!!!

69
Q

If you add a B-Lactamase inhibitor to an penicillin what will it do?

A

Enhance the gram negative and anaerobic coverage of the original antibiotic making it broad spectrum coverage

70
Q

What are B-Lactamase inhibitor combinations useful for?

A

Anaerobic infections or polymicrobial infections such as abscess, diabetic foot, abdominal infections, animal bites, fever of unknown origin, and sometimes refractory sinusitis/otitis media

71
Q

Stink places: mouth, feet, and gut

72
Q

What do antistaphylococcal penicillins treat?

A

Staph. aureus and other gram positive cocci

-useful in soft tissue and bone infections, endocarditis

74
Q

Cephalosporin

A
  • same mechanism as penicillins (attacking bacterial cell wall)
  • same mechanism of resistance (tend to be more resistant to B-Lactamase)
75
Q

Cefotetan (Cefotan) IV

A

2nd Generation Cephalosporins

76
Q

Cefoxitin (Mefoxin) IV

A

2nd Generation Cephalosporins

77
Q

What are some classes of antibiotics that have the mechanism of action: inhibits bacterial ribosomal protein synthesis?

A

Tetracyclines
Clindamycin(Cleocin)
Macrolides

78
Q

What are the three MACROLIDES?

A

clarithromycin (Biaxin) -PO

azithromycin (Z-pak, Zithromax) - PO,IV

erythromycin (multiple brands) -PO,IV, topical

79
Q

What antibiotic class do these antibiotics fall into?

  • clarithromycin (Biaxin)
  • azithromycin (Z-pak, Zithromax)
  • erythromycin (multiple brands)
A

Macrolides

Pharmacology (9 decks)

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