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Advanced Drug Therapy > Week 2-Bugs/Drugs > Flashcards

Week 2-Bugs/Drugs Flashcards

1
Q

Cell Wall Inhibitor Medications

A

Beta-lacams
PCN–“Old PCN”-Pen G, Pen VK, Biacillin
–Antistaphloccal PCN–naphcillin, oxacillin, dicloxcillin
–Extended-spectrum PCN–Amoxil, Augmentin, ticacillin, pperacillin
Cephlosporins (4 generations)
Glycopeptides–Vancomycin & Teicoplanin
Daptomycin
Fosfomycin
Bacitracin

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2
Q

DNA Synthesis Inhibitor Medications

A

Fluoroquinolones (4 generations)
Nitrofurantoin
Rifampin
(Sulfas)

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3
Q

Folic Acid Production Inhibitor Medications

A

TMP/Sulfa

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4
Q

Protein/Production Synthesis Medications

A 
Tetracycline
Macrolids
Aminoglycosides
Linezolid (Zyvox)
Clindomycin (Cleocin)
Chloramphenicol
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5
Q

Cell Membrane Inhibitor Medications

A

Daptomycin
Polymyxin B
Colstin

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6
Q

What are the “Old PCNs” and what do you use them for?

A

Pen G, Pen VK, Biacillin
Use: gram + and susceptible bugs
NOT used for staph

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7
Q

What are the “Antistaphloccal PCNs” and what are they used for?

A

Naphcillin, oxacillin, dicloxcillin
Use: gram + organisms that are beta-lactamase producers
DO NOT WORK with MRSA

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8
Q

What are the “Extended-spectrum PCNs” and what are they used for?

A

Gram - activity: Amoxil, Augmentin

antipseudomal: ticacillin, piperacillin

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9
Q

What are things to remember when giving PCN?

A
  • give on empty stomach (except Amoxil)
  • renal elimination–decrease dose for creatine clearance
  • Clavulonic mg differs in each tablet
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10
Q

What is the DOC for strep throat and syphilis?

A

PCN

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11
Q

What are B-LI medications?

A

Clavulonic acid, subactam, & tazobactam

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12
Q

What are the 1st generation cephlosproins and what are they used for?

A

cephazolin, cefadroxil, cephalexin, cephradine.

Used for GAS, s. aureus, and PEK (proteus, E. Coli, & Klebsiella)

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13
Q

What are the 2nd and 3rd generation cephlosporins and what are they used for?

A

2nd: cefaclor, cefuroxime, cefprozil, loracarbef
3rd: cefixime, cefpodoxime, cefdinir, cefditoren, ceftibuten, rocephin
USES: pediatric respiratory pathogens (OM & sinusitis)

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14
Q

Which 2nd generation cephalosporin causes serum sickness–rash, fever, swollen joints?

A

cefaclor (ceclor)

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15
Q

Which 2nd generation cephalosporin has dosages that differ in tablets and oral suspension?

A

cefuxime (Ceftin)

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16
Q

Which 3rd generation cephalosporin is a good urinary antimicrobial but is hard to find?

A

Cefixime (Suprax)

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17
Q

The most common glycopeptide medication is

A

Vancomycin

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18
Q

What “bugs” is Vancomycin used for?

A

Gram + coverage ONLY (staph and strep)

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19
Q

What is the DOC for MRSA and MRSE?

A

Vancomycin

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20
Q

What are adverse reactions/side effects of Vancomycin?

A

-ototoxicity & nephrotoxicity (trough 10-15mcg/mL; peak

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21
Q

Which medication is used with a 3rd generation cephalosporin for bacteria meningitis?

A

Vancomycin

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22
Q

Which medication can be used for bone and joint infections?

A

Vancomycin

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23
Q

Which medication is used for surgery prophylaxis when the patient has a PCN allergy?

A

Vancomycin

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24
Q

Which medication is used in Vancomycin resistant organisms?

A

Daptomycin

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25
Q

What is an adverse reaction of Daptomycin?

A

myopathy, watch CPK levels

26
Q

What is Fofomycin used for and how often?

A

UTIs X 1 dose

27
Q

What are Fluoroquinolones typically used for?

A

UTIs & systemic (respiratory) agents; they block DNP production

28
Q

What are the 1st generation fluoroquinolones and what are they used for?

A

Nalidixic acid (no obsolute) for enterobacteracide

29
Q

What are the 2nd generation fluoroquinolones and what are they used for?

A

Gram - pseudomonas coverage
urinary agents–Norfloxacin, lomefloxacin, & enoxacin
system agents–Cipro (pseudomonas) & ofloxacin

30
Q

What are the 3rd generation fluoroquinolones and what are they used for?

A

gram + coverage (s. pneumonaie)
levofloxacin (a l-isomer of ofloxacin)
gatifloxacin (Tequin)–removed from market b/c of toxicity

31
Q

What are the 4th generation fluoroquinolones and what are they used for?

A

additional anaerobic coverage

moxifloxacin, gemifloxacin, trovafloxacin (removed b/c of toxicity)

32
Q

What are adverse reactions/contraindications of fluroquinolones?

A
  • used in “special circumstances” and with caution in kids–cartiloage toxicity
  • causes prolonged QT
  • avoid if on IA/III antiarrhythmics
  • renal adjustments (except monifoxacin)
  • avoid in pregnancy
33
Q

What are Sulfas/TMP used for?

A

UTI, prostatitis, & dysentery

34
Q

How does sulfas/TMP work to fight infection?

A

they both inhibit separate microbial enzymes that produce folic acid

35
Q

What medication is used to treat bacterial conjunctivitis?

A

Topical sulfa eye drops

36
Q

What are important patient considerations/adverse effects of Sulfa/TMP?

A
  • drink plenty of water to prevent hematuria & crystalluria
  • can cause aplistic anemia, thrombocytopenia, & leukopenia
  • Avoid in G6PD deficiency patients
  • Avoid in late pregnancy
  • Steven Johnsons syndrome
37
Q

What “bugs” are tetracyclines and macrolids used for?

A

extended spectrum (G+, G-, and anaerobes), chlamydia, rickettia, and mycoplasma

38
Q

What is the short-acting tetracycline and it’s half-life?

A

tetracycline t1/2~6h

39
Q

What is the intermediate tetracycline and it’s half-life?

A

demeclocycline t1/2~12h

40
Q

What is the long-acting tetracycline(s) and it’s half life?

A

doxycycline and minocycline t1/2~18h

41
Q

What are side effects and important information to tell your patient when giving them tetracycline?

A
  • Fe, Ca (milk), & Al–>impairs GI absorption
  • food can impair absorption (except long-acting)
  • avoid during pregnancy
  • avoid in children under 8–dental staining and bone growth
42
Q

What are the 3 Erythromycin families/forms?

A

Sterate (“Erythromycin”)
Estolate (Illosone”)
Succinate (“EES)

43
Q

What do you need to tell your patient who is taking a sterate (“Erythromycin”)?

A

food can decrease absorption

44
Q

What do you need to tell your patient who is taking a Estolate (“Ilosone”)?

A

Do not take if pregnant due to hypatotoxicity

45
Q

What are the 3 “expanded Spectrum” macrolides?

A

clarithromycin (Biaxin)
azithromycin (Zithromax)
telirithromycin (Ketek)

46
Q

How often do you dose clarithromycin (Biaxin)?

A

BID, it has fever GI side effects

47
Q

What are side effects of azithromycin?

A

has P450 issues

48
Q

What is telirithromycin (Ketek) used for and what are the side effects?

A
  • Used for respiratory infections.

- It can prolong QT interval and hepatic failure has been reported.

49
Q

What are side effects of Macrolides?

A

-GI upset & gastritis

50
Q

What is an adverse reaction to Erythromycin?

A

It can inhibit P450 causing increased drug levels of dig, warfarin, carbamazepine, and statins (Zocor & Lipitor)

51
Q

Macrolids are used as an alternative if a patient has an allergy to which medication?

A

PCN

52
Q

What are examples of aminoglycosides

A

gentamycin, tobramycin, streptomycin, neomycin, kanamycin, & sisomicin

53
Q

T/F: Aminoglycosides are rarely used as monotherapy?

A

True, aminoglycosides have been around for 50+ years and are used with other medications

54
Q

What are side effects of aminoglycosides?

A
  • renal elimination–decrease dose on creatine clearance

- ototoxicity & nephrotoxicity

55
Q

What are ototoxicity & nephrotoxicity risk facts when taking aminoglycosides?

A
  • high dose in elderly
  • renal failure
  • use of loop diruretics
  • vanco
  • amphotericin
56
Q

What “bugs” are aminoglycosides used for?

A
  • gram -, M. tuberculosis, staph, enterococcus, streptococci
  • UTIs, pyelo, & prostatitis
  • endocarditis-synergy
  • nosocomial pneumonia
  • cystic fibrosis
57
Q

Linezolid (Zyvox) is used for what “bug”?

A

synthetic, multidrug resistant G+ (MRSA & VRE)

58
Q

What are potential problems when taking Linezolid (Zyvox)?

A
  • bone marrow suppression (Reversible)

- optic neuritis & peripheral neuropathy with long courses

59
Q

clindomycin (Cleocin) is used for what “bugs”?

A
  • anaerobic infections (GI)

- skin/soft tissue infections cause by strep/staph

60
Q

What are side effects of clindomycin (Cleocin)?

A
  • sensitive caMRSA can become resistant fast

- C. diff & diarrhea

61
Q

Why is Chloramphenicol no longer used in the U.S.?

A

It causes anemia, aplastic anemia, and gray baby syndrome

Advanced Drug Therapy (1 decks)

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