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NR566 - Advanced Pharmacology for Care of the Family > Week 1 - Antibiotics > Flashcards

Week 1 - Antibiotics Flashcards

1
Q

Common pathogens of Community Acquired Pneumonia

A
  • S. pnuemoniae
  • Mycoplasma spp
  • H influenzae
  • Staphylococcus aureus
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2
Q

First line treatment for community acquired pneumonia for previously healthy adults

A
  • Amoxicillin
  • Doxycycline
  • Macrolides
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3
Q

What to give for community acquired pneumonia if first line treatments weren’t effective?

A

For resistant strains:

a cephalosporin like ampicillin

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4
Q

What is the treatment for M. Pneumonaie in a pediatric patient?

A

Macrolides
- Erythromycin
- Azithromycin
- Clarithromycin

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5
Q

How is community acquired pneumonia treated in pregnancy?

A

A combination of amoxicillin or amoxicillin/clavulanate (augmentin) plus azithromycin

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6
Q

If someone has been treated with an antibiotic in the previous 90 days of contracting community acquired pneumonia what would they be treated with?

A

A quinolone

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7
Q

Examples of penicillins

A

Narrow-spectrum penicillinase sensitive:
- Penicillin G and V

Narrow-spectrum penicillinase resistant:
- nafcillin, oxacillin, dicloxacillin

Broad spectrum:
- ampicillin, amoxicillin

Extended spectrum:
- piperacillin

Penicillin/Beta-Lactamase combinations:
- ampicillin/sulbactam (unasyn),
- amoxicillin/clavulanate (augmentin),
- piperacillin/tazobactam (zosyn)

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8
Q

Examples of Cephalosporins

A

1st Gen – Cephalexin (Keflex)
2nd Gen – Cefoxitin (Mefoxin)
3rd Gen – Cefotaxiime (Clarforan)
4th Gen – Cefepime (Maxipeme)
5th Gen – Ceftaroline (Teflaro)

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9
Q

Examples of Fluoroquinolones

A
  • Ciprofloxacin
  • Ofloxacin
  • Levofloxacin
  • Moxifloxacin
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10
Q

Examples of Tetracyclines

A
  • Tetracycline
  • Doxycycline
  • Demeclocycline
  • Ervacycline
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11
Q

Examples of Macrolides

A
  • Azithromycin
  • Erythromycin
  • Clarithromycin
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12
Q

Examples of Sulfonamides

A
  • Sulfadiazine
  • Sulfamethoxazole
  • Trimethoprim
  • Nitrofurantoin
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13
Q

Examples of Aminoglycosides

A
  • Amikacin
  • Gentamycin
  • Tobramycin
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14
Q

Examples of Carbepenems

A
  • Ertapenem
  • Imipenem
  • Doripenem
  • meropenem
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15
Q

Treatment of chlamydial pneumonia in infants

A

Erythromycin (macrolides)

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16
Q

When to use a broad spectrum antibiotic

A

Use a broad spectrum when it is a common pathogen or before it is identified

17
Q

When to use a narrow spectrum antibiotic

A

If you have done a culture/sensitivity then use the drug that the microbe is sensitive to (narrow spectrum)

18
Q

What are empiric antibiotics?

A

Broad spectrum antibiotics used as first line of therapy before the microbe is identified and therapy can be tailored to the appropriate pathogen.

19
Q

When do we prescribe empiric antibiotics?

A

When symptoms of an infection are severe and treatment needs to start before culture/sensitivity results are determined.

20
Q

How do we treat Clostridium difficile diarrhea?

A

Stop the antibiotic the person is taking that is causing the infection and start either:
- vancomycin
- Fixaxomicin

OR
- Narrow spectrum macrolide or metronidazole (if oral vanco of Fidaxomicin are not available)

21
Q

What drug classes are known to promote development of C. diff?

A
  • Clindamycin
  • Second and third generation cephalosporins
22
Q

Patients with penicillin allergies may have cross-sensitivity reactions to which drug class?

A

All other penicillins and cephalosporins.

23
Q

When can we prescribe penicillin for pregnant patients?

A

Cannot prescribe in the second or third trimester due to fetal risk.

24
Q

What patient education should be given when prescribing a cephalosporin?

A
  • Must not take alcohol in any form, can cause disulfiram effect)
  • Interfere with drugs that promote bleeding (NSAIDS, anticoagulants, thrombolytics, antiplatelet agents)
25
Q

What cephalosporins are appropriate for pregnant patients?

A
  • cefaclor
  • cephalexin
26
Q

What patient education is needed when prescribing tetracyclines?

A
  • Avoid prolonged sun exposure, wear protective clothing, apply sunscreen
  • avoid taking antacids/supplements - Ca, Mg, Fe, milk as these will interfere with medication
27
Q

What are the concerns for prescribing tetracyclines for pregnant patients?

A

Tetracyclines are contraindicated for pregnant women.

When taken after the fourth month of gestation they can cause yellow/brown staining of deciduous teeth of the infant (will not affect permanent teeth)

28
Q

What patient education is needed when prescribing macrolides?

A

Taken on an empty stomach, if taken with food it decreases drug absorption.

29
Q

What patient education is needed when prescribing aminoglycosides?

A

Stop taking if you have tinnitus, persistent headache or both (risk for irreversible ototoxicity) – report hearing changes to doctor immediately

30
Q

What patient education is needed when prescribing sulfonamides?

A
  • Drink at least 8-10 glasses of water per day (can cause buildup in the kidneys)
  • Avoid prolonged exposure to sunlight, wear protective clothing, apply sunscreen, avoid tanning beds
31
Q

What risks are associated with prescribing sulfonamides to pregnant women?

A

May cause birth defects in the first trimester

If taken near term the infant may develop kernicterus
- Deposition of bilirubin in the brain

Do not administer to pregnant women after 32 weeks of gestation

32
Q

What renal adjustments are needed when prescribing gentamicin?

A

Use in caution with decreased renal function, can bind to renal tissues leaving levels 50 times higher than in the serum.

33
Q

Bacteriostatic

A

Inhibits bacterial proliferation and the host’s immune system kills the bacteria

34
Q

Bactericidal

A

Directly kills bacteria

35
Q

Which antibiotics are safe during pregnancy?

A
  • PCNs
  • Cephalosporins
  • Erythromycin

NR566 - Advanced Pharmacology for Care of the Family (8 decks)

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