Week 2- Antibiotics Flashcards
(130 cards)
1
Q
What are Beta-Lactams
A
Penicillins and Cephalosporins
2
Q
What class is Penicillin V and Penicillin G?
A
Beta Lactam, natural penicillin
3
Q
How is Penicillin V taken?
A
PO
4
Q
What is Penicillin V used for?
A
pharyngitis, dental abscesses, URI, pneumonia
5
Q
Is Pencillin V effective against Staph Aureus?
A
No
6
Q
Mechanism of Action of Pencillin V and Penicillin G?
A
Beta-lactam, inhibits biosynthesis of bacterial cell wall, peptidoglycan… binds to transpeptidase
7
Q
What are the PharmK and PharmT of Penicillin V and Penicillin G?
A
Negligible metabolism, excreted unchanged in urine, high urinary concentration
8
Q
Is Penicillin V safe in pregnancy?
A
Yes
9
Q
Penicillin allergies
A
IgE mediated, less than 1%, cross allergies to cephalosporins and carbapenems
10
Q
Adverse effects with Penicillin V
A
Rash, GI upset, potential for c. diff infection if inappropriately used
11
Q
Food/ Med interactions of Pencillin V
A
Food decreases absorption, could decrease potency of contraceptives
12
Q
How is Penicillin G taken?
A
IM
13
Q
Uses of Penicillin G?
A
syphillis, meningitis
14
Q
Major adverse reactions of penicillin G?
A
Allergic reactions, same as pencillin V, neurotoxicity at high doses
15
Q
Are beta-lactams (penicillins and cephalosporins) bacteriostatic or bacteriocidal?
A
bacteriocidal
16
Q
What drug class is amoxicillin?
A
Beta Lactam- Penicillin
17
Q
Mechanism of action of amoxicillin?
A
Inhibits cell wall synthesis
18
Q
What bacteria does amoxicillin target?
A
broad spectrum: gram + and gram - bacteria
19
Q
what is amoxicillin used for?
A
otitis media, sinusitis and UTIs
20
Q
Major adverse reactions to amoxicillin
A
rash, diarrhea, superinfection
21
Q
what class is amoxicillin/clavulanate?
A
beta lactam- penicillin
22
Q
mechanism of action amoxicillin/clavulanate
A
inhibits cell wall synthesis
23
Q
what is amoxicillin/clavulanate used for?
A
respiratory and skin infections
24
Q
adverse reactions of amoxicillin/clavulanate?
A
diarrhea, potential for hepatotoxicity
25
difference between amoxicillin and amoxicillin/clavulanate?
spectrum is increased to include beta-lactamase-producing strains as well as broadening the coverage to include other bacterial species (overcomes abx resistant strains!)
26
what is clavulanate acid?
mechanism-based β-lactamase inhibitor
27
what drug class are cephalosporins?
beta-lactams
28
what are cephalosporins often used for?
acute otitis media, sinusitis, Group A Strep, pneumonia, chronic bronchitis
29
what are the first-generation cephalosporins?
cephalexin and cefazolin (IM/IV)
30
what are second generation cephalosporins?
cefuroxime
31
what are third generation cephalosporins?
cefdinir, cefpodoxime, ceftriaxone
32
unique differences for first generation cephalosporins?
fairly narrow spectrum, can be used by individuals allergic to penicillin
33
unique difference for second generation cephalosporins?
less active against gram-+ cocci than first generation oral cephalosporinsu
34
unique differences for third generation cephalosporins
more resistance to beta-lactamase
35
drug class of cephalexin
beta lactam- first generation cephalosporin
36
how does cephalexin work?
inhibits cell wall synthesis
37
what does cephalexin work against?
skin infections, UTIs (works against s. aureus)
38
side effects of cephalexin
diarrhea, hypersensitivity reactions
39
food/drug monitoring considerations with cephalexin
well absorbed in GI tract, food delays absorption, renal function impairment significantly impacts the half life
40
Adverse reaction for all cephalosporins?
type 1 reaction/ serum sickness-like reactions: erythema multiforme, skin rashes, arthralgia, fever
41
route of cefazolin?
IM/IV
42
what class is cefazolin?
beta lactam- cephalosporin, first generation
43
how does cefazolin work?
inhibits cell wall synthesis, works against some gram + cocci, some gram negative rods
44
what do we use cefazolin for?
surgical prophylaxis and infections
45
adverse reactions for cefazolin?
hypersensitivity, potential for nephrotoxicity
46
what class is cefuroxime
beta lactam- second generation cephalosporin
47
how does cefuroxime work?
it inhibits cell-wall synthesis
48
what does cefuroxime work against?
it is broad spectrum, includes anarobes-- used for bronchitis and lyme disease (h. influenzae)
49
common side effects of cefuroxime?
diarrhea, rash, cns effects
50
what class is cefdinir
third generation cephalosporin/beta lactam
51
how does cefdinir work?
it inhibits cell wall synthesis
52
what does cefdinir work against?
otitis media, sinusitis, respiratory infections (broad spectrum), MSSA, gonorrhea and h. influenzae
53
common side effect of cefdinir
diarrhea, allergic reactions
54
what class is ceftriaxone?
beta lactam- 3rd generation cephalosporin
55
how is ceftriaxone delivered?
IV/IM
56
what does ceftriaxone fight against?
severe bacterial infections, meningitis, gonorrhea
57
how does ceftriaxone work?
it inhibits cell wall synthesis
58
side effects of ceftriaxone?
biliary sludging, pseudolithiasis
59
what drugs are in the fluoroquinolone class?
ciprofloxacin and levofloxacin
60
are fluoroquinolones (cipro and levofloxacin) bacteriostatic or bacteriocidal?
bacteriocidal
61
how do fluoroquinolones work?
inhibits DNA gyrase... interferes with enzymes required for the synthesis and repair of bacterial DNA
62
what is the different between ciprofloxacin and levofloxacin?
levofloxacin is the newer generation, cipro is older
63
what does ciprofloxacin fight against?
broad spectrum including gram negative bacteria, UTIs and gastrointestinal infections
64
what does levofloxacin fight against?
broad spectrum including gram negative bacteria AND atypical pathogens- respiratory infections, UTIs
65
BLACK box warning with fluoroquinolones
cipro and levofloxacin may cause tendon rupture/tendonitis-- higher likelihood with older patients, steroid use, h/o transplant
66
what impacts fluoroquinolone (cipro and levofloxacin) absorption?
dairy products and antacids
67
adverse effects of fluoroquinolones?
may exacerbate muscle weakness w/ myasthesnia gravis, prolonged QT, photosensitivity, neurologic adverse effects
68
what people should stay away from fluoroquinolones?
pregnant people, under 18, renal function impairment
69
drug interactions of fluoroquinolones?
*** inhibits CYP3A4 and CYP1A2
70
what drug class is clindamycin?
lincosamide
71
how does clindamycin work?
Binds to 50S subunit of bacterial ribosome; Suppresses protein synthesis
72
what is clindamycin used for?
good for penicillin ax alternative- bacterial endocarditis, pnuemococcal pneumonia, skin and tissue infections, drug resistant pneumococcal, BV?
73
is clindamycin bacteriocidal or static?
bacteriostatic
74
adverse effects of clindamycin
highest risk of c. diff and severe diarrhea!!!!! also: n/v, dizziness, cardiac arrhythmias, hypotension, dizziness, metallic taste *
75
what drugs are in the macrolide/ azalide class?
macrolide: erythromycin and clarithromycin
azalide: azithromycin * preferred medication
76
are macrolides/azalides bacteriostatic or bacteriocidal
the MYCINs are bacteriostatic
77
How do macrolides work?
reversibly binds to P site of the 50S ribosomal subunit of the susceptible organism and *inhibit RNA dependent protein synthesis*
78
what is erythromycin best used for?
atypical bacteria, gram positive cocci
79
what are azithromycin and clarthromycin best used for?
broad spectrum- atypical pathogens
80
side effects of macrolides?
GI upset, hepatotoxicity, QT prolongation, abnormal taste w/ clarithomycin
81
what is erythromycin best used for?
respiratory infections/skin infections (community acquired pneumonia)
82
what is azithromycin best used for?
respiratory infections like CAPI, STIs (chlamydia)
83
what is clarithomycin best used for?
resp infections (CAP), h. pylori
84
which macrolides have the bost drug interactions?
erythromycin and clarithromycin-b/c strong inhibitors of CYP enzymes
85
what drug should be stopped with clarithromycin?
statins- risk of severe myopathy or rhabdomyolysis
86
what drug is in the oxazolidinones class?
linezolid
87
what is linezolid used for?
MRSA, VRE, severe skin infections/pneumonia- reserve ABX
88
what to watch out for with linezolid
serotonin syndrome w/ MAOIs, monitor CBCs weekly
89
What drug is in the nitrofuran class?
Nitrofurantoin
90
how does nitrofurantoin work?
it is bactericidal- it damages bacterial DNA
91
what does nitrofurantoin work against?
UTIs- e.coli and other UTI pathogens
92
Adverse reactions with nitrofurantoin?
pulmonary reactions and hepatotoxicitym, neuropathy
93
what class of drug is sulfamethoxazole/trimethoprim?
sulfonamide
94
how does sulfamethoxazole/trimethoprim work?
inhibits folic acid synthesis
95
is sulfamethoxazole/trimethoprim bacteriostatic or bacteriocidal?
cidal
96
what does sulfamethoxazole/trimethoprim work against?
UTIs and resp infections,never really given as monotherapy (otitis media, PIP, cholera, VAP too)
97
black box warning with sulfamethoxazole/trimethoprim
Can cause stevens-johnson syndrome, instant death in patients with blood dyscrasias, epidermal necrolysis
98
adverse reactions with sulfamethoxazole/trimethoprim
hypersensitivity reactions, hematologic changes
99
what class of drug is fosfomycin?
phosphonic acid
100
how does fosfomycin work?
inhibits cell wall synthesis
101
what does fosfomycin work against?
gram - UTIs, only is for UTIs
102
possible side effects with fosfomycin?
diarrhea, headache
103
what drugs are in the tetracycline class?
doxycycline and tetracycline
104
how does the tetracycline class work?
inhibits protein synthesis
105
is the tetracycline class bacteriostatic or bacteriocidal?
bacteriostatic
106
what is doxycycline used for?
respiratory infections, acne and lyme disease
107
what is tetracycline used for?
acne, respiratory infections
108
what are some drug interactions/considerations with tetracyclines?
caution with children younger than 8, renal/hepatic impaired patients, pregnant women
109
what drugs do tetracyclines interact with?
antacids, salts, magnesium, zinc, increases effect of warfarin
110
risks of using tetracyclines
phototoxicity and superinfection, can stain teeth
111
what drug class is vancomycin in?
glycopeptide
112
how is oral vancomycin used?
only for c. dif treatment!
113
how does vancomycin work?
inhibits cell wall synthesis
114
caution with vancomycin (PO)
nephrotoxic, skin rash, ototoxicity
115
why is vancomycin used PO for c. dif
poor GI absorption
116
what drugs are used for tuberculosis
rifampin, isoniazid, pyrazinamide and ethambutol (RIPE!)
117
how does rifampin work?
inhibits RNA synthesis
118
is rifampin static or cidal
cidal
119
adverse effects of rifampin?
hepatitis, orange-red discoloration of body fluids (can stain)
120
how does isoniazid work?
inhibits mycolic acid synthesis
121
risk factors with isoniazid?
hepatotoxicity, peripheral neuropathy
122
how does pyrazinamide work?
it disrupts mycobacterial cell membrane metabolism
123
is pyrazinamide bacteriostatic/cidal?
cidal
124
adverse effects of pyrazinamide
hepatotoxicity, hyperuricemia
125
how does ethambutol work?
inhibits arabinosyl transferase
126
is ethambutol bacteriostatic/cidal
static
127
adverse effects of ethambutol
optic neuritis (risk of being blind), peripheral neuropathy
128
factors that contribute to antibiotic resistance
increase populations of immunocompromised patients, increased # and complexity of medical procedures, inappropriate use of antimicrobials, increased survival of patients with chronic disease
129
what is bacteriostatic
inhibits an increase in bacterial growth (clindamycin, tetracylcines, linezolid, macrolides)- relies on good immune system
130
what is bacteriocidal
kills bacteria (99.9% dead w/i 24 hrs)- vancomycin, fluoroquinolones, beta-lactams
