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NURS 804: Pharmacology > Unit 3: Overview > Flashcards

Unit 3: Overview Flashcards

1
Q

Name 3 ways antibiotics fight against bacteria

A
  1. Attacking the cell wall
  2. Interfering with protein synthesis (in the ribosomes)
  3. Interfering with nucleotide synthesis and DNA replication
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2
Q

Name some antibiotic groupings that attack the cell wall

A
  1. Beta-Lactams:
    a. Penicillins
    b. Cephalosporins
    c. Carbapenems
  2. Others
    a. Glycopeptides (like vancomycin)
    b. Lipopeptides (like Daptomycin)
    c. Monobactams (Aztreonam)
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3
Q

What enhances the action of some penicillins and cephalosporins?

A

Beta-lactamase inhibitors

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4
Q

Name some groups of antibiotics that interfere with ribosomes and/or protein synthesis

A
  1. 30s Ribosome:
    a. Tetracyclines
    b. Aminoglycosides
  2. 50s Ribosome:
    a. Macrolides
    b. Lincomycins (Clindamycin)
    c. Streptogramins (Synercid)
    d. Chloramphenicol
  3. Other
    a. Spectinomycin (aminocyclitol antibiotic)
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5
Q

Name some antibiotic groupings that interfere with Nucleotide Synthesis and/or DNA Replication

A
  1. Folate Production inhibition
    a. Sulfonamides
  2. DNA inhibition
    a. Trimethoprim + Mixtures
    b. Fluoroquinolones
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6
Q

Name the Beta-Lactam groups

A

a. Penicillins
b. Cephalosporins
c. Carbapenems

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7
Q

What groups of antimicrobial drugs interfere with the 30s ribosome?

A

30s Ribosome:

a. Tetracyclines
b. Aminoglycosides

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8
Q

What drugs/groups of antimicrobial drugs interfere with the 50s ribosome?

A

50s Ribosome:

a. Macrolides
b. Lincomycins (Clindamycin)
c. Streptogramins (Synercid)
d. Chloramphenicol

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9
Q

What group of antimicrobial drugs inhibits folate production?

A

Folate Production inhibition

a. Sulfonamides

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10
Q

What groups of antimicrobial drugs inhibit DNA?

A

DNA inhibition

a. Trimethoprim + Mixtures
b. Fluoroquinolones

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11
Q

Name 2 penicillins

A

Penicillin G

Penicillin V

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12
Q

Name 5 Antistaphylococcal Penicillins

A 
Nafcillin
Oxacillin
Cloxacillin
Dicloxacillin
Methicillin
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13
Q

What is the advantage of ANTISTAPHYLOCOCCAL PENICILLINS?

A

they are resistant to beta-lactamases

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14
Q

Name 5 extended spectrum penicillins

A 
Amoxicillin
Amoxicillin/Potassium Clavulanate
Piperacillin/Tazobactam
Ampicillin
Ampicillin/Sulbactam
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15
Q

Amoxicillin/Potassium Clavulanate is known as…

A

AUGMENTIN

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16
Q

Piperacillin/Tazobactam is known as…

A

ZOSYN

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17
Q

Ampicillin/Sulbactam is known as…

A

UNASYN

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18
Q

What is the advantage of extended spectrum penicillins?

A

increased activity against GRAM - rods

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19
Q

What is the disadvantage of extended spectrum penicillins?

A

susceptible to beta-lactamase

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20
Q

What is the advantage of the CEPHALOSPORINS over PENICILLLINS?

A

similar to penicillins
more stable to beta-lactamases
broader spectrum

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21
Q

Classify each CEPHALOSPORIN generation as narrow, intermediate, or broad spectrum

A

1st: NARROW
2nd: INTERMEDIATE
3rd: BROAD
4th: BROAD

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22
Q

What do 1st GENERATION CEPHALOSPORINS treat?

A

GRAM+ cocci

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23
Q

What do 2nd GENERATION CEPHALOSPORINS treat?

A

same as 1st generation

extended GRAM - coverage

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24
Q

What do 3rd GENERATION CEPHALOSPORINS treat?

A

expanded GRAM -

SOME CROSS THE BLOOD-BRAIN BARRIER

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25
What do 4th GENERATION CEPHALOSPORINS treat?
P aeruginosa, enterorbacteriaeae, MSSA, S pneumonia, Haemophilus, Nisseria sp
26
What generation of CEPHALOSPORINS can treat brain infections?
3rd generation | 4th generation
27
What should you avoid treating with Ceftriaxone (Rocephin)?
enterobacter due to resistance
28
What antibiotics are highly active against Enterobacter?
CARBAPENEMS
29
Name 4 CARBAPENEMS
Ertapenem (Invanz) Doripenem Imipenem Meropenem (Merrem)
30
What does Imipenem require?
An inhibitor (cilastatin)
31
What CARBAPENEMS doe not require an inhibitor?
Doripenem | Meropenem
32
Name some GLYCOPEPTIDES
``` Vancomycin Bacitracin Cycloserine Telavancin Dalbavancin ```
33
Name the only MONOBACTAM available in the U.S.
Aztreonam
34
What does Aztreonam treat?
aerobic GRAM - | NO ACTIVITY against GRAM + or anaerobes
35
What is vancomycin good for?
GRAM + bloodstream infections MRSA endocarditis
36
What was the 1st (Cephalosporin) drug approved in the USA against MRSA?
Ceftaroline fosamil
37
Name some beta-lactamase inhibitors
Clavulanic acid Sulbactam Tazobactam Avibactam
38
Name some CEPHALOSPORIN combinations with BETA-LACTAMASE INHIBITORS
ceftolozane-tazobactam | ceftazidime-avibactam
39
What are CEPHALOSPORIN combinations with BETA-LACTAMASE INHIBITORS used for?
to combat resistant GRAM - infections
40
What kind of drug is Daptomycin?
Lipopeptide
41
Name some TETRACYCLINES
``` Tetracycline Demeclycycline Doxycycline Minocycline Tigecycline ```
42
What do the TETRACYCLINES treat?
``` rickettsiae Lyme Rocky Mountain Spotted Fever chlamydiae spirochetes H. pylori syphillis with penicillin allergy Mycoplasma pneumoniae ```
43
What do the MACROLIDES treat?
GRAM + | some GRAM -
44
Name some MACROLIDES
erythromycin Clarithromycin Azithromycin (Zithromax) Fidaxomicin
45
What is a major side effect of erythromycin?
increased GI motility --> GI side effects
46
What big infection can Fidaxomicin treat?
C. Diff
47
Name a Ketolide
Telithromycin (Ketek)
48
What is Telithromycin used for?
nontuberculous mycobacteria | USA: only for bacterial CAP
49
Name a Lincomycin
Clindamycin
50
What is important to remember about Clindamycin?
GRAM - organisms are resistant
51
Name a streptogramin
Quinupristin-dalfopristin (Synercid)
52
What is important to remember about Quuinupristin-dalfopristin (Synercid)?
inhibits CYP3A4 --> drug interactions
53
What adverse effects can Chloramphenicol cause?
irreversible aplastic anemia | gray baby syndrome
54
Name some Aminoglycosides
``` Streptomycin Neomycin Kanamycin Amikacin Gentamicin Tobramycin Sisomicin Netilmicin ```
55
What drugs have a synergistic effect with penicillin or vancomycin?
AMINOGLYCOSIDES
56
What are the aminoglycosides most widely used to treat?
drug resistant organisims
57
What is a post-antibiotic effect?
antibacterial activity exists beyond the time that there is measurable drug present
58
What antibiotics exhibit post-antibiotic effect?
Aminoglycosides
59
Name an oxazolidinone
Linezolid (Zyvox)
60
What is linezolid used to treat?
off label: MDR tuberculosis
61
What is important to remember about streptomycin?
used for 2nd line treatment against tuberculosis; ONLY USE with OTHER AGENTS!
62
What is Gentamicin used for?
severe infections caused by GRAM - that are often resistant to other drugs
63
What kind of dosing is typical for aminoglycosides?
single daily dose just as effective--and likely less toxic--that multiple smaller doses
64
What are the major side effects of the aminoglycosides?
ototoxic and nephrotoxic
65
What is Spectinomycin used to treat?
drug-resistant gonorrhea OR | gonorrhea in PCN-allergic patients
66
What sulfonamides are oral and absorbable?
SULFAMETHOXAZOLE (only available as TRIMETHOPRIM-SULFAMETHOXAZOLE (Bactrim) in the US) SULFADIAZINE + PYRMENTHAMINE
67
What sulfonamide is oral and non-absorbable, and what does it treat?
sulfasalazine | tx: ulcerative colitis, enteritis, IBD
68
What sulfonamides are topical?
``` sodium slufacetamide silver sulfadiazine (Silvadene) ```
69
Why are the fluoroquinolone often dosed 1x daily?
long half lives
70
Name 4 fluoroquinolones
Levofloxacin Ciprofloxacin Moxifloxacin Gemifloxacin
71
What major infection does ciprofloxacin treat?
anthrax
72
What is unique about Moxifloxacin?
metabolized in liver; other fluoroquinolones metabolized in kidneys
73
What to levofloxacin and ciprofloxacin treat?
excellent against GRAM - | good against GRAM +
74
What are the advantages of moxifloxacin and gemifloxacin?
improved against GRAM +
75
Name the respiratory fluororquinolones
Levoflaxacin Gemifloxacin Moxifloxacin
76
What are some major adverse effects of the fluoroquinolones?
prolonged QT interval | can cause neuropathy that persists for months - years after stopped
77
What does trimethoprim treat?
UTI
78
What does PO Trimethoprim-Sulfamethoxazole treat?
UTI, pneumonia | most staph aureus (MSSA + MRSA)
79
What does IV Trimethoprim-Sulfamethoxazole treat?
moderately severe to severe pneumocystis PNA
80
What does PO pyrimethamine + sulfonamide treat?
toxoplasmosis
81
Name some major adverse effects of the sulfonamides
``` Stevens Johnson Syndrome hemolytic or aplastic anemia granulocytopenia thrombocytopenia hemolytic reaction in people with a G6PD deficiency ```

NURS 804: Pharmacology (42 decks)

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