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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
Q

What do 4th GENERATION CEPHALOSPORINS treat?

A

P aeruginosa, enterorbacteriaeae, MSSA, S pneumonia, Haemophilus, Nisseria sp

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26
Q

What generation of CEPHALOSPORINS can treat brain infections?

A

3rd generation

4th generation

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27
Q

What should you avoid treating with Ceftriaxone (Rocephin)?

A

enterobacter due to resistance

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28
Q

What antibiotics are highly active against Enterobacter?

A

CARBAPENEMS

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29
Q

Name 4 CARBAPENEMS

A

Ertapenem (Invanz)
Doripenem
Imipenem
Meropenem (Merrem)

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30
Q

What does Imipenem require?

A

An inhibitor (cilastatin)

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31
Q

What CARBAPENEMS doe not require an inhibitor?

A

Doripenem

Meropenem

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32
Q

Name some GLYCOPEPTIDES

A 
Vancomycin
Bacitracin
Cycloserine
Telavancin
Dalbavancin
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33
Q

Name the only MONOBACTAM available in the U.S.

A

Aztreonam

34
Q

What does Aztreonam treat?

A

aerobic GRAM -

NO ACTIVITY against GRAM + or anaerobes

35
Q

What is vancomycin good for?

A

GRAM +
bloodstream infections
MRSA endocarditis

36
Q

What was the 1st (Cephalosporin) drug approved in the USA against MRSA?

A

Ceftaroline fosamil

37
Q

Name some beta-lactamase inhibitors

A

Clavulanic acid
Sulbactam
Tazobactam
Avibactam

38
Q

Name some CEPHALOSPORIN combinations with BETA-LACTAMASE INHIBITORS

A

ceftolozane-tazobactam

ceftazidime-avibactam

39
Q

What are CEPHALOSPORIN combinations with BETA-LACTAMASE INHIBITORS used for?

A

to combat resistant GRAM - infections

40
Q

What kind of drug is Daptomycin?

A

Lipopeptide

41
Q

Name some TETRACYCLINES

A 
Tetracycline
Demeclycycline
Doxycycline
Minocycline
Tigecycline
42
Q

What do the TETRACYCLINES treat?

A 
rickettsiae
Lyme
Rocky Mountain Spotted Fever
chlamydiae
spirochetes
H. pylori
syphillis with penicillin allergy
Mycoplasma pneumoniae
43
Q

What do the MACROLIDES treat?

A

GRAM +

some GRAM -

44
Q

Name some MACROLIDES

A

erythromycin
Clarithromycin
Azithromycin (Zithromax)
Fidaxomicin

45
Q

What is a major side effect of erythromycin?

A

increased GI motility –> GI side effects

46
Q

What big infection can Fidaxomicin treat?

A

C. Diff

47
Q

Name a Ketolide

A

Telithromycin (Ketek)

48
Q

What is Telithromycin used for?

A

nontuberculous mycobacteria

USA: only for bacterial CAP

49
Q

Name a Lincomycin

A

Clindamycin

50
Q

What is important to remember about Clindamycin?

A

GRAM - organisms are resistant

51
Q

Name a streptogramin

A

Quinupristin-dalfopristin (Synercid)

52
Q

What is important to remember about Quuinupristin-dalfopristin (Synercid)?

A

inhibits CYP3A4 –> drug interactions

53
Q

What adverse effects can Chloramphenicol cause?

A

irreversible aplastic anemia

gray baby syndrome

54
Q

Name some Aminoglycosides

A 
Streptomycin
Neomycin
Kanamycin
Amikacin
Gentamicin
Tobramycin
Sisomicin
Netilmicin
55
Q

What drugs have a synergistic effect with penicillin or vancomycin?

A

AMINOGLYCOSIDES

56
Q

What are the aminoglycosides most widely used to treat?

A

drug resistant organisims

57
Q

What is a post-antibiotic effect?

A

antibacterial activity exists beyond the time that there is measurable drug present

58
Q

What antibiotics exhibit post-antibiotic effect?

A

Aminoglycosides

59
Q

Name an oxazolidinone

A

Linezolid (Zyvox)

60
Q

What is linezolid used to treat?

A

off label: MDR tuberculosis

61
Q

What is important to remember about streptomycin?

A

used for 2nd line treatment against tuberculosis; ONLY USE with OTHER AGENTS!

62
Q

What is Gentamicin used for?

A

severe infections caused by GRAM - that are often resistant to other drugs

63
Q

What kind of dosing is typical for aminoglycosides?

A

single daily dose just as effective–and likely less toxic–that multiple smaller doses

64
Q

What are the major side effects of the aminoglycosides?

A

ototoxic and nephrotoxic

65
Q

What is Spectinomycin used to treat?

A

drug-resistant gonorrhea OR

gonorrhea in PCN-allergic patients

66
Q

What sulfonamides are oral and absorbable?

A

SULFAMETHOXAZOLE (only available as TRIMETHOPRIM-SULFAMETHOXAZOLE (Bactrim) in the US)

SULFADIAZINE + PYRMENTHAMINE

67
Q

What sulfonamide is oral and non-absorbable, and what does it treat?

A

sulfasalazine

tx: ulcerative colitis, enteritis, IBD

68
Q

What sulfonamides are topical?

A 
sodium slufacetamide
silver sulfadiazine (Silvadene)
69
Q

Why are the fluoroquinolone often dosed 1x daily?

A

long half lives

70
Q

Name 4 fluoroquinolones

A

Levofloxacin
Ciprofloxacin
Moxifloxacin
Gemifloxacin

71
Q

What major infection does ciprofloxacin treat?

A

anthrax

72
Q

What is unique about Moxifloxacin?

A

metabolized in liver; other fluoroquinolones metabolized in kidneys

73
Q

What to levofloxacin and ciprofloxacin treat?

A

excellent against GRAM -

good against GRAM +

74
Q

What are the advantages of moxifloxacin and gemifloxacin?

A

improved against GRAM +

75
Q

Name the respiratory fluororquinolones

A

Levoflaxacin
Gemifloxacin
Moxifloxacin

76
Q

What are some major adverse effects of the fluoroquinolones?

A

prolonged QT interval

can cause neuropathy that persists for months - years after stopped

77
Q

What does trimethoprim treat?

A

UTI

78
Q

What does PO Trimethoprim-Sulfamethoxazole treat?

A

UTI, pneumonia

most staph aureus (MSSA + MRSA)

79
Q

What does IV Trimethoprim-Sulfamethoxazole treat?

A

moderately severe to severe pneumocystis PNA

80
Q

What does PO pyrimethamine + sulfonamide treat?

A

toxoplasmosis

81
Q

Name some major adverse effects of the sulfonamides

A 
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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