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Therapeutics Exam 2 - antibiotics:( > Sulfa drugs through anti-anaerobic > Flashcards

Sulfa drugs through anti-anaerobic Flashcards

1
Q

MOA of sulfamethoxazole and trimethoprim

A

interferes with bacterial folic acid synthesis

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2
Q

main uses of SMX-TMP and its RoA

A

staph (MRSA MSSA)
listeria (after ampicillin)
nocardia
aeroPEK
stenotrophomonas maltophilia
pneumocystis jiroveci
toxoplasmosis

IV and po

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3
Q

avoid using SMX-TMP in

A

gut anaerobes
atypical organisms

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4
Q

important pharmacokinetics of TMP-SMX

A

highly protein bound

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5
Q

ADR of SMX-TMP

A

GI - N, V, abdominal pain
hypersensitivity
rash - SJS and toxic epidermal necrolysis
fever
blood dyscrasias “penias”
photosensitivity
hyperkalemia

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6
Q

drug of choice for treatment and prevention of PJP/PCP peumonia (pneumocystis jiroveci) in immunocompromised infections

A

SMX-TMP

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7
Q

highly effective against skin infections caused by community acquired MRSA

A

SMX-TMP

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8
Q

colistimethate RoA

A

IV

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9
Q

what can colistimethate treat

A

MDR gram negative organisms

E. coli
acinetobacter
pseudomonas
klebsiella pneumoniae
enterobacter (klebsiella aerogenes)

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10
Q

ADR of colistimethate

A

nephrotoxicity
neurotoxicity

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11
Q

what infection does mycoplasma pneumonia cause

A

upper and lower respiratory tract infections

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12
Q

what does chlamydophilia infections cause

A

trachomatis - STI
pneumonia - respiratory tract infection

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13
Q

which atypical bacteria is generally an opportunistic infection affecting immunocompromised patients

A

mycobacterium avium

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14
Q

fluoroquinolones and their RoA

A

ciprofloxacin (iv, po)
moxifloxacin (IV, po)
levofloxacin (IV, po)
delafloxacin (IV, po)
ofloxacin (po only)

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15
Q

moa of fluoroquinolones

A

inhibits DNA gyrase and promotes cell death

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16
Q

what type of killing do fluoroquinolones exhibit

A

concentration dependent

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17
Q

which fluoroquinolones are respiratory fluoroquinolones

A

moxifloxacin
levofloxacin

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18
Q

which fluoroquinolones have MRSA activity

A

delafloxacin

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19
Q

which fluoroquinolones have activity against pseudomonas and which one is more active?

A

ciprofloxacin > levofloxacin

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20
Q

do fluoroquinolones have activity against acinetobacter

A

no, activity against atypical pathogens

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21
Q

avoid using fluoroquinolones when

A

MRSA
acinetobacter
enterococcus

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22
Q

which fluoroquinolone is NOT a reliable UTI drug

A

moxifloxacin

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23
Q

ADR of fluorquinolones

A

TENDON RUPTURE
N/D
photosensitivity
CNS side effects: sedation, mental status changes
QTC prolongation

24
Q

what are respiratory FQ’s engineered to treat?

A

strep pneumo

25
Q

what indications should FQ’s be reserved for if patients have no other treatment options (last line)

A

acute bacterial sinusitis
acute bacterial exacerbation of chronic bronchitis
uncomplicated UTI

26
Q

macrolides and their RoA’s

A

erythromycin (IV, oral)
azithromycin (IV, oral)
clarithromycin (IV, oral)

27
Q

MOA of macrolides

A

inhibits RNA dependent protein synthesis at the chain elongation step that binds to 50S ribosomal subunit resulting in blockage of transpeptidation

28
Q

main uses of macrolides

A

strep
H. flu
M. catarrhalis
Neisseria
legionella

ATYPICALS
mycoplasma
chlamydophilia
mycobacterium
treponema pallidum
borrelia burgdorferi

29
Q

What did we swear to professor Tuoy?

A

that we will never use a cephalosporin to treat an enterococcus infection

30
Q

avoid use of macrolides in

A

staph
enterococcus
most gram negatives
gut anaerobes
blood stream infections
UTI’s

31
Q

ADR’s of macrolides

A

Diarrhea (erythro)
metallic taste clarithromycin)
QTc prolongation (erythro, clarithro >azithro)

32
Q

macrolides are second line drugs for

A

strep (URTI’s)
syphillis
N gonorrhea
tissue infections (URTI)

33
Q

which antibiotic is used as an adjunct to metoclopramide for gastroparesis treatment

A

erythromycin

34
Q

antibiotics and drugs with a high what are more likely to have a metallic taste?

A

volume of distribution

35
Q

what is a big reason tetracyclines are contraindicated in children?

A

cause gray teeth

36
Q

MOA of tetracyclines

A

inhibits protein synthesis by binding to the 30S (and possibly 50S) ribosomal subunit of susceptible bacteria and may cause alterations in the cytoplasmic membrane

37
Q

what dosage form is
doxycycline
minocycline
omadacycline
ervacycline
tetracycline

A

d - IV, po
m - IV, po
o - IV, po
e - IV
t - po

38
Q

main uses of tetracyclines

A

gram positive
limited gram negative
atypicals - mycoplasma, chlamydophilia, rickettsia

39
Q

which tetracyclines have strep pneumo and community acquired MRSA activity

A

doxycycline
minocycline

40
Q

ADR’s of tetracyclines

A

gi - N/V even with IV
photosensitivity
hepatotoxicity
CDAD

41
Q

oral dosage forms of tetracyclines do what

A

chelate cations (Al, Mg, Ca) and dairy products

42
Q

indications of doxycycline

A

atypical infections

43
Q

use of outdated tetracyclines can lead to

A

fanconi’s syndrome

44
Q

which tetracycline is used in CAP and skin and soft tissue infections

A

omadacycline

45
Q

which tetracycline is indicated for complicated intra-abdominal infections

A

eravacycline

46
Q

moa of glycylcycline and tigecycline

A

binds to the 30s ribosomal subunit and inhibits protein synthesis

47
Q

main uses of glycylcycline and tigecycline

A

gram positive (MRSA and MSSA)
VRE
gram negative
E. coli
stenotrophomonas maltophilia
gut anaerobes
atypicals

probably won’t be the answer

48
Q

Anti-anaerobic agents and their RoA

A

metronidazole IV, po
tinidazole po
secnidazole po
clindamycin IV, oral

49
Q

main uses of metronidazole

A

gut anaerobes
c difficile
trichomoniasis (UTI)
bacterial vaginosis or vaginitis

50
Q

ADR of metronidazole

A

N/V
HA
metallic taste * Vd probably
urine discoloration
peripheral neuropathy
disulfuram interaction with alcohol

51
Q

rule of thumb for metronidazole

A

treats below the diaphragm anaerobes

52
Q

what do tinidazole and secnidazole treat

A

bacterial vaginosis
trichomoniasis

53
Q

main uses of clindamycin

A

MRSA/MSSA
mouth anaerobes
gut anaerobes
allergies
bacterial vaginosis

no gram negative

54
Q

ADR clindamycin

A

N/V
CDAD and colitis with prolonged use**

55
Q

rule of thumb for clindamycin

A

used for above the diaphragm anaerobes

Therapeutics Exam 2 - antibiotics:( (7 decks)

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