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Resp Antiobiotic MOA Flashcards

1
Q

B Lactam MOA

A

Analog to D-Ala, D-Ala

Covalently bind to penicillin binding protein (PBP) inhibiting the last transpeptidaiton step in cell wall synthesis

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2
Q

B Lactam Resistance

A

Drug destruction and inactivation by B-lactamases primary mechanism

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3
Q

B Lactam Classes Include

A 
Penicillin 
Cephalosporins (Ceftraixone)
Carbapenems (Meropenem)
Monobactams 
B-Lactamase Inhibitors (Ampicillin-sulbactam) 
Glycopeptides (Vanco)
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4
Q

Penicillin Adverse Effects

A

Nausea, vomiting, mild to severe diarrhea

Psudeomembranous colitis

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5
Q

Cephalosporin Adverse Effects

A

Intolerance to alcohol
1% cross reactivity to penicillins
Diarrhea

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6
Q

Carbapenem Adverse Effects

A

Nausea, vomiting 1-20%

Seizures 1.5%

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7
Q

Ampicillin Drug Class & Admin

A

Aminopenicillin PO/IV/IM (BL)

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8
Q

Amoxicillin Drug Class & Admin

A

Aminopenicillin PO (BL)

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9
Q

Piperacilin Drug Class & Admin

A

Anti-pseudomonal Penicillins IV (BL)

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10
Q

Ceftriaxone Drug Class & Admin

A

Cephalosporin IV/IM (BL)

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11
Q

Ceftazidmine Drug Class & Admin

A

Cephalosporin IV/IM (BL)

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12
Q

Cefepime Drug Class & Admin

A

Cephalosporin IV/IM (BL)

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13
Q

Meropenem Drug Class & Admin

A

Carbapenem IV (BL)

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14
Q

Ertapenem Drug Class & Admin

A

Carbapenem IV/IM (BL)

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15
Q

Ampicillin-sulbactam Drug Class & Admin

A

B-lactamase Inhibitor IV (BL)

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16
Q

Amoxicillin-clavulanic acid Drug Class & Admin

A

B-lactamase inhibitor PO (BL)

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17
Q

Piperacillin-tazobactam Drug Class & Admin

A

B-lactamase inhibitor IV (BL)

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18
Q

Vancomycin Drug Class & Admin

A

Glycopetides PO/IV (BL)

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19
Q

Vancomycin Resistance

A

Alteration of target D-Ala-D-Ala

Intermediate resistance

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20
Q

Vancomycin Adverse Effects

A

Macular rash, chills, fever
Red man syndrome due to histamine release, extreme flushing, tachycardia and hypotension
Ototoxicity/Nephrotoxicity (33% initial tx)

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21
Q

Fluroquinolones MOA

A

Concentration dependent
Targets bacterial DNA gyrase and topoisomerase IV
Prevents relaxation of positive supercoils

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22
Q

FQ Resistance

A

Mutations in genes encoding DNA gyrase

Active transport out of cell

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23
Q

FQ Adverse Effects

A

Rash, photosensitivity, Achilles tendon rupture contraindicates in children
GI
CNS

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24
Q

Ciprofloxacin Drug Class & Admin

A

FQ PO/IV/Topical

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25
Levofloxacin Drug Class & Admin
FQ PO/IV/topical
26
Moxifloxacin Drug Class & Admin
FQ PO/IV/Topical
27
Gentamicin Drug Class & Admin
Aminoglycosides IV/IM/topical
28
Doxycycyline Drug Class & Admin
Tetracyclines/Glycylcylcines PO/IV
29
Azithromycin Drug Class & Admin
Macrolides/Ketolides PO/IV/Topical
30
Clindamycin Drug Class & Admin
Lincosamides PO/IV/Topical
31
Linezolid Drug Class & Admin
Oxazolidinones PO/IV
32
Oseltamivir Drug Class & Admin
TAMIFLU Antivirals PO Neuromindiase Inhibitor
33
Zanamirvir Drug Class & Admin
RELENZA Antiviral INH Neuromindiase Inhibitor
34
Fluconazole Drug Class & Admin
Antifungals PO/IV
35
Itraconazole
Antifungals PO
36
Voriconazole
Antifungals PO/IV
37
Aminoglycosides MOA
Gentamycin | 30S Inhibitor of protein synthesis
38
Aminoglycosides ADR
Ototoxicity Neuromuscular block Nephrotoxicity
39
Tetracyclines MOA
Doxycycline | 30S Inhibitor of protein synthesis
40
Tetracycline ADR
GI C.diff superinfection NO PEDS ADMIN photosensitivity, teeth discoloration
41
Macrolides MOA
Azithromycin | 50S Inhibitor of protein synthesis
42
Macrolides ADR
Arrhythmia | GI, hepatotoxicity
43
Lincosamides MOA
Clindamycin | 50S Inhibitor
44
Lincosamides ADR
Diarrhea, C.diff
45
Streptogramins MOA/ADR
Infusion pain, phlebitis | 50S inhibitor
46
Oxazolidinones MOA
Linezolid | 50S inhibitor
47
Oxazolidinones ADR
Myelosuppression | HA, rash
48
Oseltamivir/Zanamivir MOA
Neurominidase Inhibitors Analogs of sialic acid Interfere with release of progeny influenza virus from infected host cell
49
Oseltamivir ADR
Nausea, vomiting, abd pain Neuropsychiatric effects Approved for children >1 yr
50
Zanamir ADR
Cough, bronchospasms, decreased pulmonary function | Approved for children >7years
51
NMI Resistance
Point mutation in viral hemagglutinin or neuraminidase | Influenza A & B susceptible to both drugs
52
Azole MOA
Ergosterol in cell membrane of fungi Inhibits fungal cytochrome P450 reducing production of ergosterol Selective toxicity due to greater affinity for fungal v. human P450
53
Azole ADR
Minor Gi upset Liver enzyme abnormalities Drug/drug interactions with anti-statins, anti-convulsants and may increase INR of warfarin
54
Outpatient CAP Previously Healthy
Macrolide PO | Azithromycin
55
Outpatient CAP At Risk
``` FQ PO - Levofloxacin OR B-Lactam PO - HD Amoxicillin + Macrolide PO - Azithromycin ```
56
Inpatient CAP Non-ICU
``` FQ IV/PO - Levofloxacin OR B-Lactam IV - Ceftriaxone + Macrolide IV - Azithromycin ```
57
Inpatient CAP ICU
``` B-Lactam IV - Ceftriaxone + Macrolide IV - Azithromycin OR FQ IV - Levofloxacin ```
58
Pseudomonas
``` Anti-pseudomal B lactam IV Piperacillin-tazobactam Cefepime + FQ Ciproflaxin/Levoflaxacin OR Genatmicin + Azithromycin Gentamicin + Liproflaxacin/Levoflaxacin ```
59
MRSA/DRSP
Vancomycin IV or Linezolid
60
Pseudomonas Duration of Threrapy
15 day course
61
Pseudomonas Resistance
Due to multiple efflux pumps | Decreased expression of outer porin channel
62
Klebsiella Resistant to...
Ampicillin
63
Enterobacter resistant to...
Cephalosporin
64
Natural penicillin bottom line spectrum
Streptococcus | Syphilis
65
Anti-Staph Penicillins Bottom Line Spectrum
Staph aureus | Staph epidermidis
66
Aminopenicillins Bottom Line Spectrum
Extended spectrum Gram + and few gram _ Enterocci and listeria
67
Anti-pseudomonal penicillins Bottom Line Spectrum
``` Serious gram negative infections (Pseudomonas Enterobacter Klebsiella ) Anaerobes ```
68
First gen cephalosporins Bottom Line Spectrum
Gram + coverage
69
2nd gen cephalosporins Bottom Line Spectrum
More gram -
70
3rd Gen Cephalosporins Bottom Line Spectrum
Less gram + | Much more active against enterobacteriaceae
71
4th Gen Cephalosporins Bottom Line Spectrum
Good gram + and serious gram - like pseudomonas
72
Carbapenems Bottom Line Spectrum
Very broad spectrum Aerobic/anaerobic Gram + / Gram - Imipenem/Meropenem against Pseudomonas
73
Monobactam Bottom Line Spectrum
No gram + or anaerobic | Gram - effective Pseudomonas and Enterobacter
74
Glycopeptide Bottom Line Spectrum
No gram - or mycobacterium | Broad spectrum gram + including MRSA, MRSE and enterococci
75
FQ Bottom Line Spectrum
Good gram - (Cipro covers pseudomonas) MSSA Streptococcus by levofloxin
76
Aminoglycosides Bottom Line Spectrum
No anaerobic coverage Broad aerobic gram - coverage Tobramycin best against pseudomonas
77
Tetracyclins Bottom Line Spectrum
``` Wide aerobic/anaerobic gram + and gram - MRSA atypical bacteria Rickettsia Coxiella burnetti Syphilis NO PSEUDOMONAS ```
78
Macrolides Bottom Line Spectrum
Aerobic gram + cocci and bacillia Atypicals No gram - except H.influenzae, N.meningitidies, B.pertussis
79
Lincosamide Bottom Line Spectrum
Gram + S.pyogenes Streptocci MSSA CA-MRSA Anaerobes No aerobic gram -
80
Oxaxolidinone Bottom Line Spectrum
``` Gram + staph MSSA MRSA VRSA Streptococcus DRSP Enterococci VRE Gram + anaerobic cocci Gram + rods ```

General Pharm (5 decks)

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