Pharmacology Lesson 3 Flashcards
1
Q
This class of infectious diseases are highly contagious
A
Bacterial infectious diseases
2
Q
What can you use to prevent bacterial infectious diseases?
A
preventive vaccines
3
Q
Name the 2 gram staining type that bacteria can be categorized as
A
Gram negative & gram positive
3
Q
Some Bacteria have different O2 requirement for survival. What are the different O2 requirements that bacteria present and what do each one mean?
A
- Aerobic - Needs O2
- Anaerobic - Thrive in low/no O2 environments
- Facultative - Can be in either
4
Q
What are the known distinctive category shapes of bacteria?
A
Bacilli, cocci, spirilla and vibrio
5
Q
When stained, what color will gram positive bacteria present?
A
- Blue-violet
6
Q
What color will Gram negative bacteria stain?
A
Red
7
Q
What are the causes that make a gram positive bacteria stain blue violet?
A
- Cell walls retain the stain
- The cell wall will resist decolorization from ETOH
8
Q
What is the reasons behind gram negative not staining blue violet?
A
Gram negative bacteria have thinner cell walls that won’t hold the stain once decolorized with ETOH, thus becoming unstained.
9
Q
Name the 7 gram positive bacteria
A
(My CC Less) Mycoplasma Corynebacterium Clostridium Listeria Enterococcus Staphylococcus Streptococcus
11
Q
Before giving Abs to a pt, what two things must a good PA do to a bacterial infected pt?
A
Culture & sensitivity testing
12
Q
If a pt who is sick with an bacterial infection, and is known to be on Abs, what test can you not give?
A
Throat culture.
13
Q
Bacteremia or septicemia are both commonly known as?
A
Sepsis
13
Q
What disease has a life threatening condition, high mortality rate, possible multiple organ failure and possible death?
A
Bacteremia, speticemia or sepsis
14
Q
What category type of bacteria usually cause sepsis?
A
Gram negative bacteria
15
Q
What are the signs and symptoms of sepsis?
A
High fever or tempature below 97, Leukocytosis greater than 12K or under 4K, Greater than 10% bands, Tachycardia, Tachypnea, Emisis, and eventually positive blood cultures for a bacteria.
16
Q
What medication is used to treat infections caused by susceptible bacteria?
A
- Antibiotics
17
Q
How many drugs can a sensitivity test on a bacteria at a time?
A
Several
18
Q
What does having greater than 10% bands indicate? And explain what these bands mean.
A
A response of the immune system to serious infection. It is related to sepsis. The body is sending out immature neutrophils (WBC) to fight the infection.
19
Q
What are required to be completed to identify the the pts bacterial bug and to correctly select the best antibiotic to use?
A
Culture & sensitivity test
20
Q
Why is it advantageous for a sensitivity test to have several drugs being tested at once on a bacteria from an infected pt?
A
So the clinician can select the best drug vs that microorganism
21
Q
What makes sensitivity testing important during the testing of microorganisms?
A
Helps determine microorganisms with resistant strains, thus clinicians can choose the best drug for use.
22
Q
What considerations must a PA give in selecting an antibiotic regiment for a pt?
A
- ID of the correct pathogen
- selection of the best and most effective drug vs pathogen
- Drug must have lowest side effect profile and still be most effective.
- safe for selected pt
- least expensive and still be most effective.
23
Q
This general category of antibiotic is effective only against a select few microorganisms w/ a very specific metabolic pathway or enzyme?
A
Narrow spectrum
24
This general category of antibiotic is effective against a wide variety of infections
Broad spectrum
25
This general type of antibiotic will cause the death of susceptible bacteria directly
Bactericidal
26
This general type of antibiotic will inhibits growth/reproduction of susceptible bacteria and it causes death indirectly
Bacteriostatic
28
Name the ways how bacteria develop resistance to an antibiotic
- Produce enzymes that deactivates the Abs
- Changes the cellular permeability that prevents drug from entering cell
- Alters transport systems to exclude drugs from active transport into cell
- Alter binding sites on membranes that no longer allow or accept the drug
- alter binding sites on ribosomes so they no longer accept the drug
- produce a chemical that acts as an antagonist vs the drug
28
Random mutations that occur during cell division are called?
- Survival mechanism
29
Do antibiotics create mutations?
Antibiotic does not create mutation
30
What will NOT cause a bacterial mutation?
- antibiotic
31
How can you prevent antibiotic resistance?
- Use antibiotics judiciously
- limit use of Abs to specific and sensitive pathogens
- Use adequately high doses and for the correct duration
- and be cautious about indiscriminate use of antibiotics
32
Combination of multiple antibiotics that increase in effectiveness is called
synergistic
33
Benefits of combination antibiotic therapy are?
- smaller doses of each drug
- they are synergistic
- microbes will/may respond differently to the different drugs
- Some treatment protocols require multiple antibiotic therapy
34
Which Infectious bacterial disease requires multiple antibiotic therapy?
TB
35
Describe what antibiotic prophylaxis is
- This is the taking of antibiotics before infection
36
Why would a pt use antibiotic prophylaxis?
- travel to an area of known infectious disease is an endemic
- Pre surgery for GI or GU
- pt has a known cardiac valve disease or prosthetic valves
- Known exposure life-threatening or chronic infections (tb and meningitis)
- Invasive procedures
37
Treating an infections before a specific culture information is know is called?
- Empiric antibiotic therapy
38
If a PA chooses a antibiotic drug that will cover the "most likely" pathogen(s) before knowing what they are, this is called?
- Empiric antibiotic therapy
39
A pt with GNID infection will normally be treated in what therapy fashion?
- Empiric antibiotic therapy
40
Today, what is done far less in non-life threatening infections?
- Culture & sensitivity testing
41
Why is less C&S's done today when a pt is infected with non-life-threatening infections
- Many newer antibiotics have excellent coverage of multiple bugs
42
Neisseri Gonorrhoeae, infects which cell?
- Neutrophils
43
What does GNID stand for?
- Gram Negative Intracelluar Diplococci
44
What adverse effects can antibiotics cause?
- Renal toxicity
- Gastrointestinal tract toxicity
- neurotoxicity
- Hypersensitivity reactions
- Superinfections
45
What stops the ability of super-infections of occurring?
- presence of normal flora prevent pathogenic bacteria from getting a foothold in a pt, thus they cannot flourish.
46
What can destroy a pts normal flora?
- antibiotics
47
If a pts normal flora is gone, what can occur?
- Bacteria that survived the antibiotic now proliferate, allowing opportunistic microbes to flourish.
48
The use of broad spectrum antibiotics or the chronic long term use of abs can cause
- super infections
49
What are the classes of antibiotics in use today?
(Some Punk Came To A Queen Mother Mary)
- Sulfonamides
- Penicillins
- Cephalosporins
- Tetracyclines
- Aminoglycosides
- Quinolones
- Macrolides
- Miscellaneous
50
What antibiotic was available for clinical use in 1935?
- Sulfonamides
51
What are the types of sulfa drugs?
- sulfadiazines
- sulfamethozazoles
- sulfisoxazoles
- sulfacetamide
52
What is the mechanism of action for Sulfonamides?
- Bacteriostatic
53
What does bacteriostatic mean and how does it effect bacteria?
- It prevents the synthesis of folic acid which is required for synthesis of purines and nucleic acid.
54
Sulfonamides do not effect the production of what in humans?
- folic acid
55
What are sulfonamides mostly used for in treating a pt?
- mostly used for UTI's
56
What are the indications for the use of a Sulfonamides?
- UTI
- pcp in hiv/aids pt
- shigellosis
- prophylaxis of travelers diarrhea
57
Since Sulfonamides have a lot of resistance, what would you have to use instead
- Cipro
58
Which sulfonamides Abs are used in the treat malaria and toxoplasmosis?
- Sulfadiazine (Microsulfon)
59
Which sulfonamide abs are used to treat burns and prevent secondary infections to burns?
- Silver sulfadiazine (silvadeen)
60
Which Sulfonamide abs are tropical creams?
- Silver sulfadiazine(silverdeen), Sulfamylon Topical (mafenide) and sulfacetamide ophthalmic (sulamyd)
61
Which sulfonamides is for use in pts who present UTI, PCP, OM or chrominc bronchitis of COPD?
- Sulfamethoxazole w/ trimethoprim (bactrim or Septra)
62
In sulfamethoxazole what two ingredients are synergistic?
Dihydrofolate reductase inhibitor and sulfamethoxazole
63
Which sulfonamides is used to treat children with OM?
- Pediazole (Sulfisoxazole w/ eyrthromycin)
64
Pediazole is the combination of?
- (Sulfisoxazole w/ eyrthromycin)
65
What kind of antibiotic is erythromycin?
- Macrolide antibiotic
66
A sulfisoxazole comes in which type of route of administration?
- only in a suspension
67
Which sulfonamides is used to treat bacterial eye infections or is used PPx in eye injuries?
- Sulfacetamide Ophthalmic (sulamyd)
68
Sulfacemide Ophthalmic (sulamyd), comes in what form and concentration?
- 10% ointment & 10, 15 or 30% solution
69
Which abs would you not give for viral Pink eye?
Sulfacemide Ophthalmic (sulamyd)
70
Which sulfonamides is used for burns that have infections present?
- Sulfamylon Topical (mafenide) & Silver Sulfadiazine (Silvadeen)
71
Sulfamylon Topical (mafenide) is similar to what family?
- sulfadiazines
72
Which sulfonamides class of drugs is not considered an antibiotic?
- Phenazopyridine (Pyridium)
73
Which sulfonamides drug is prescribed in conjunction with an Ab for UTI's?
- Phenazopyridine (Pyridium)
74
This drug turns your urine and contacts bright orange
- Phenazopyridine (Pyridium)
75
You would only prescribe this drug for 2 days
- Phenazopyridine (Pyridium)
76
What are the unique adverse effects of Sulfonamides?
- photosensitivity
- Steven- Johnson syndrome
- Exfoliative dermatitis
- Toxic epidermal necrolysis (TEN)
- Uticaria
77
What are the more common side effects of sulfonamides?
- pancreatits
- thrombocytopenic anemia
- Convulsions
- crystaluria
- Toxic nephrosis
- peripheral neuritis
- hemolytic anemia
- aplastic anemia
78
What is Steven-Johnson syndrome?
- Life-threatening hypersensitivity to an Abs that affects skin and mucus membranes. More often occurs in response to a drug
79
Who discovered Penicillins?
- Alexander Fleming
80
Penicillins abs have what type of mechanism of action on bacteria?
- bactericidal
81
how does a bactericidal abs work on a bacteria?
- it inhibits cell wall synthesis
82
Penicillins kill a wide variety of bacteria, thus they are know as?
- broad spectrum
83
Penicillins have a sub category class of abs called?
- beta lactams
84
The inhibition of cell wall synthesis does what to bacteria?
It directly kills them by breaking down bacteria cell walls, making the abs bacteriostatic
85
How does bactericidal penicillin work on bacteria?
- Penicillin enters bacteria cell wall, which it then binds to PCN-binding protein. This will then disrupt normal cell wall synthesis, killing the bacteria via lysis
86
Natural penicillins molecular structure normally include what in its chemical structure?
- A beta-lactam ring
87
what does a beta-lacta ring allow a penicillin abs to have?
- it allows it to be effective against a variety of bacteria
88
What defense do some bacteria have against penicillins?
- they have the ability to produce a betalactamase called penicillinase.
89
What does a betalactamase, like that of penicillinase, do vs a penicillin?
- the enzyme splits the beta-lactam ring, thus making the abs ineffective
90
What are the types of Penicillins?
(PNEA)
- Penicillianse-resistant penicillins
- natural penicillins
- aminopenicillins
- extended-spectrum penicillins
91
Which PCN would likely cause an allergic reactions?
- Natural penicillins
92
Which PCN has a lots of resistance now?
- Natural penicillins
93
What are all the natural penicillins?
- Penicillin G benzathine (Biciliin L-A)
- Penicillin G potassium (Pfizerpen)
- Penicillin G procaine
- Penicillin G sodium
- Penicillin G potassium (pen VK)
94
Which natural PCN abs can be administered via IM?
- Penicillin G benzathine (Biciliin L-A)
- Penicillin G potassium (Pfizerpen)
- Penicillin G procaine
- Penicillin G sodium
95
Which penicillin abs used the PO as a route of administration?
- Penicillin V potassium (pen VK)
96
What are the four penicillinase-resistant penicillins?
- Dicloxacillin
- Nafcillin
- Oxacillin (bactocill)
- Methicillin
97
What does MRSA stand for?
- Methicillin Resistant Staph Aureus
98
This bacteria is a virulent strain, effective vs penicillin, fast becoming resistant to other big gun abs and is a nosocomial infection?
MRSA
99
What are the sub classes of penicillins?
- Aminopenicillins & Extended-spectrum penicillins
100
What are the abs who make up the class of aminopenicillins?
- Amoxicillin and ampicillin
101
What are the abs who make up the class of Extended-spectrum penicillins?
- Piperacillin and Ticarcillin
102
Which class of penicillins are sometimes combined with a PCN inhibitor in a fixed dose combination?
- Aminopenicillins & Extended-spectrum penicillins
103
What chemicals are there that inhibit penicillinase?
- Clavulanic acid, Tazobactam, and sulbactam
104
How does Clavulanic acid, Tazobactam, and sulbactam inhibit penicillinase?
- It binds with penicillinase, which prevents it from splitting the penicillin ring
105
What are the aminopenicillins that are considered fixed dose penicillins?
- Amplicillin + sulbactam = Unasyn
| - Amoxicillin + clavulanic acid = Augmentin
106
What are the Extended-spectrums that are considered fixed dose penicillins?
- Ticarcillin + clavulanic acid = Timentin
| - piperacillin + tazobactam = Zosyn
107
Penicillins is primary used in what kind of infections?
Gram +
108
What are the Adverse effects of using penicillin?
- Possible allergic reactions in .7%-.8% of pt
- Urticaria
- maculopapular rash
- angioedema
109
10% of this drugs allergic reactions are life threatening
- Penicillins
110
.08% of pts who have an allergic reaction to this abs have a fatal reaction
- penicillin
111
These Abs are not penicillins, but are similar in structure
- Beta lactams
112
If you have a pt with a moderate to severe infection, and isnt allergic to PCN abs, you would give them
- A beta lactam
113
What are the classes of Beta lactims?
- Monobactams and Carbapenems
114
What are the monobactams?
- Aztreonam (Azactam)
115
What are the Carbapenems?
- Ertapenem (Invanz)
- Meropenem (merrem)
- Imipenem/cilastatin (Primaxin)
- Doripenem (Doribax)
116
All the beta lactams can all be administered via what route?
- IV
117
Which beta lactams can all be administered via IM?
- Ertapenem (Invanz)
- Imipenem/cilastatin (Primaxin)
- Aztreonam (Azactam)
118
If you prescribe an Aztreonam abs, you can expect it to have what kind of bacterial coverage on a pt?
- Narrow spectrum for aerobic gram Neg bacteria
119
A pt come in with a known bacterial infection from the genus of Listeria. Would you prescribe the Abs Aztreonam? if you say yes or no, state why or why not?
- No, Cause Aztreonam only work on gram neg bacteria. Listeria is a gram pos bacteria.
120
If a pt has a anaerobic bacterial infection. Would you prescribe the Abs Aztreonam? if you say yes or no, Why or why not?
- No, Cause Aztreonam only work on aerobic bacteria.Anaerobic bacteria do not have any issues with Aztreonam's
121
As a PA, Can you use Aztreonam(Azectam) for a patient with PCN allergy?
- yes because Aztreonam does not have an absolute contraindication to PCN
122
When you think of all the penicillins, Which of these abs has the most resistant to a majority of the beta lactamase enzymes?
- Carbapenems.
123
If a patient comes to your ER unit with general inflammation and leads to sepsis. The bacterial infection that the pt has is id'ed as being P. aeruginosa . Which penicillin would you give to this pt and why?
- A carbapenem, because it is indicated for moderate to severe infections and it is covers facilitative anaerobic bacteria's such as P. aeruginosa.
124
This PCN covers moderate to severe infections
- Carbapenems
125
Are Carbapenems contraindicated or not in PCN-allergic pt?
- It is contraindicated
126
Which class of abs are semisynthetic? and where are they derived from?
- Cephalosporins, from fungus
127
What kind of spectrum do Cephalosporins present with?
- Fairly broad spectrum
128
This type of Abs is structurally and pharmacologically similar to PCN's?
- Cephalosporins
129
While working in a medical setting, you will notice that one of the most widely prescribed antibiotics would be from this class?
- Cephalosporins
130
Which class of Abs has more than 20?
- Cephalosporins
131
This class of Abs would generally be considered to be superior to PCN's
- Cephalosporins
132
When looking at this Abs. you would base its classification based on their spectrum of activity into five "generations"
- Cephalosporins
133
What is the mechanism of action of cephalosporins?
- Bacteriocidal
134
Do the first generations cephalosporins have a beta-lactam ring?
- Yes
135
You have a pt come in to your office with a OM that is id'ed from a gram negative bacteria infection that is known to produce a betalactamase enzyme. Another PA wrote a script for a 1st generation cephalosporin. Is this the correct generation of cephalosporin to use and why or why not?
- No, cause 1st generations, while having a good gram pos coverage, they have a poor gram neg coverage while also being ineffective against betalactamase-producing bacteria.
136
What indications would a pt have to present for you to give a 1st generation cephalosporin?
- URI, OM and PPx for surgery
137
A pt has a nasty, superficial skin infection that is from a gram positive bacteria, Which abs would you give?
- 1st generation cephalosporin
138
Cefadrocil (duricef), Cephalexin (Keflex) and Cefazolin (Kefzol) are all what type of Abs?
- 1st Generation Cephalosporins
139
You have a Pt that needs Cefadrocil (duricef), as you are writing your script, you would put the possible routes of administration as?
- PO
140
You have a Pt that needs Cephalexin (keflex), as you are writing your script, you would put the possible routes of administration as?
- PO
141
You have a Pt that needs Cefazolin (Kefzol), as you are writing your script, you would put the possible routes of administration as?
- IM & IV
142
Which generation of cephalosporins are more potent than the 1st generation?
- 2nd generation
143
What improvement in coverage does the 2nd generation cephalosporins have over the 1st generation?
- it has better gram negative coverage
144
The 2nd generation Cephalosporins, just like the 1st gen, have good coverage vs which, gram negative, positive or both?
Good vs gram positive bacteria
145
Cefaclor (ceclor), Cefprozil (cefzil), Cefoxitin (mefoxin) Cefuroxime axetil (ceftin), Cefuroxime sodium (Zinacef) and Cefotetan (Cefotan) are all part of what class of Abs?
- 2nd generation cephalosporins
146
Which 2nd generation cephalosporins are administered via PO?
- Cefaclor (ceclor), Cefprozil (cefzil), and Cefuroxime axetil (ceftin)
147
Which 2nd generation cephalosporins are administered via IM?
- Cefoxitin (mefoxin), Cefuroxime sodium (Zinacef) and Cefotetan (Cefotan)
148
Which 2nd generation cephalosporins are administered via IV?
- Cefoxitin (mefoxin), Cefuroxime sodium (Zinacef) and Cefotetan (Cefotan)
149
You have a pt who is getting ready for surgery for removal of polyps in the stomach and colorectal areas. Before going into surgery, you would Rx which specific type of ab and what route of administration and why?
- Cefoxitin (Mefoxin), because it has a good anaerobic coverage
150
What generation of cephalosporins Abs has the longest duration of action?
- 3rd generation of cephalosporins
151
What generation of cephalosporins Abs is the most effective group against gram negative bacteria?
- 3rd generation of cephalosporins
152
What generation of cephalosporins Abs is the most resistant to beta lactamase producing bacteria?
- 3rd generation of cephalosporins
153
Cefpodoxime proxetil (Vantin), Ceftriaxone (Rocephin), Ceftibuten (Cedax), Cefditoren pivoxil (Spectracef), Cefotaxime (Claforan), Ceftazidime sodium (Fortaz), Cefdinir (omnicef) and Cefixime (Suprax) are all part of which class of abs?
- They are all 3rd generation Cephalosporins
154
Which Abs of the 3rd generation of cephalosporins are currently approved for GC?
- Cefpodoxime proxetil (Vantin), Ceftriaxone (Rocephin), Cefotaxime (Claforan) and Cefixime (Suprax)
155
If you were to administer a 3rd generation of cephalosporins via the route of PO, which ones can you pick from?
- Cefpodoxime proxetil (Vantin), Ceftibuten (Cedax), Cefditoren pivoxil (Spectracef), Cefdinir (omnicef) and Cefixime (Suprax)
156
If you were to administer a 3rd generation of cephalosporins via the route of IV, which ones can you pick from?
- Ceftriaxone (Rocephin), Cefotaxime (Claforan), and Ceftazidime sodium (Fortaz)
157
If you were to administer a 3rd generation of cephalosporins via the route of IM, which ones can you pick from?
- Ceftriaxone (Rocephin), Cefotaxime (Claforan), and Ceftazidime sodium (Fortaz)
158
A pt has a bacterial infection of the CSF, which generation (and name) of Abs would your Rx, What would the route of administration be, and how many times a day would the pt get this Abs?
- 3rd generation cephalosporins, Ceftiaxone (Rocephin), IV or IM, once a day.
159
What is Ceftraixone (Rocephin) distinction over other 3rd generation cephalosporin?
- It can easily cross over into the CSF
160
What new additional indication has Ceftraixone (Rocephin) been given?
- It is now indications for OM in children
161
A pt was sedated and ventillated in a hospital CCU for a week after having a heart attack. During the week of ventilation, the pt caught a secondary nosicomial pneumonia that was caused by a gram negative bacteria Pseudomonas aeruginosa. Which cephalosporin would you use on this pt?
- Ceftazidime sodium (Fortaz)
162
Versus what pathogens/infections would you Rx a 3rd generation Cephalosporin against?
- Pseudomonas, Klebsialla, Neisseria, Salmonella, Proteus, and Haemophilus influenza
163
How many 4th generation Cephalosporin are there? what is its name? what route of administration does it get delivered and where is it approved for use?
- One, Cefepime (Maxipime), IV & IM, and only in the US.
164
This cephalosporin is more effective vs bacterial that many bacteria have developed a resistance against other cephalosporins.
- Cefepime (Maxipime)
165
This abs has broad spectrum of activity, good coverage vs gram positive bacteria and ave excellent coverage of pseudomonas.
- Cefepime (Maxipime)
166
What indications would a pt need to present for you to Rx a 5th generation Cephalosporin?
- Community acquired pneumonia (CAP) and skin/skin structure infections
167
Ceftaroline fosamil (Teflaro) is what kind of Abs?
- Its a 5th generation cephalosporin
168
Which Abs has similar side effects of penicillins?
- Cephalosporins
169
what abs have similar adverse effect of those of penicillin?
- Cephalosporins
170
If a pt has PCN allergies, what abs group can you give to this pt?
- Cephalosporins w/ caution.
171
If a pt has a PCN reaction to Urticaria or anaphylaxis, you cannot give what class of Abs?
- Cephalosporins
172
If you give this abs class (name it) via injection, what must you require of the pt?
- Pcn & Cephalosporins, You must hold them for 20 minutes before allowing them to leave.
173
Which of the tetracyclines are administered via the route of PO?
- Demeclocycline (Declomycin), Tetracycline HCL (Sumcin), Doxycycline (Doryx), and Minocycline (minocin)
174
Demeclocycline (Declomycin), Tetracycline HCL (Sumcin), Doxycycline (Doryx), Minocycline (minocin) and Tigecycline (Tygacil) are all from which class of abs?
- Tetracyclines
175
Which of the tetracyclines are administered via the route of IV?
- Tigecycline (Tygacil)
176
Which of the tetracyclines are administered via the route of IM?
- None are IM
177
This kind of abs was first extracted from stretopyces, is natural and is semi synthetic
- Tetracyclines
178
This Abs was one broad spectrum, but from heavy use in the 50s & 60s, it now has a very limited therapeutic indications
- Tetracyclines
179
Tetrcyclines have a mechanism of action of?
- Bacteriostatic
181
Most Tetracyclnes have a route of administration that is PO, except for these two? Which one of these two has IV that has been labeled as "IV, not a common use"?
- Minocycline (not common use as IV) and Tigecycline (IV only)
182
What other products must you not allow a pt to take with Tetracyclines?
- Dairy products, antacids, calcium supplements, and iron supplements
183
If you have pts with Rickettsia, cholera, Lyme disease or chlamydia, what kind of abs will you prescribe?
- Tetracyclines
184
If you have a pt with SIADH, pleural and pericardial effusions, you will prescribe what abs?
- Demeclocycline (Declomycin)
185
While tetracyclines have now been bumped down the list of drug of choice for treating chlamydia, what two abs would be now considered front line treatment?
- Z-max or TCN are now front-line abs for chlamydia
186
You have a pregnant pt who is in her 1st trimester. She tests positive for having cholera. Would it be wise to place her on a Tetracycline to treat her cholera infection?
- No, TCN's may cause fetal skeletal development if taken during a pregnancy.
187
What are the common side effects do you expect a pt to present when on any tetracyclines?
- Diarrhea and upset GI
188
Is there an age restriction when prescribing tetracyclines?
- Yes, cannot give to age 8 or younger
189
What are the adverse effects you would expect a pt to present if given tetracyclines.
- Discoloration of permanent teeth and tooth enamel in fetus/children, enterocolitis, maculopapular rash, superinfections, photosensitivity during therapy. Also, this is a pregnancy category D drug.
190
You have a pt who has been dx'd with Chlamydia and Lyme disease while having a history of having heart burn. Pt has been treating his heart burn with Tums as needed. Would you give this pt a Tetracycline abs to cure his Chlamydia and Lyme disease? Why or why not?
- No. Tetracycines, while are the abs of choice to treat chlamydia and Lyme disease, they become insoluble complexes when mixed with Ca, Mg or Al ions. One will have to limit and modify a pt dietary habits when using tetracycines
191
Which type of Abs is rarely used via PO route of administration?
- Aminioglycosides
192
If an Aminoglycoside is used in a PO form, What would the justification be
- Pt would have an Aminoglycoside for a pre-op bowel cleanse
193
This abs is very potent and carries with it serious toxicities
- Aminoglycosides
194
This group of Abs has an chemical structure that contains an amino group and a sugar group.
- Aminoglycosides
195
Gentamicin (Garamycin), Kanamycin (kantrex), Neomycin sulfate, streptomycin, tobramycin (nebcin) amikacin (amikin) and paromomycin (humatin) are all part of what class of abs?
- Aminoglycosides
196
What are the Aminoglycosides that can be administered via IM?
- Gentamicin (Garamycin), Kanamycin (kantrex), streptomycin, tobramycin (nebcin), and amikacin (amikin)
197
What are the Aminoglycosides that can be administered via PO?
- Neomycin sulfate and paromomycin (humatin)
198
What are the Aminoglycosides that can be administered via IV ?
- Gentamicin (Garamycin), Kanamycin (kantrex), tobramycin (nebcin), and amikacin (amikin)
