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Pathopharmacology I > Wk 2 Antimicrobials II > Flashcards

Wk 2 Antimicrobials II Flashcards

1
Q

What is included in transcription?

A

Nucleus
Messenger RNA
Cytoplasm

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2
Q

What is included in translation?

A

Cytoplasm
Ribosomes
Amino acids
Protein synthesis

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3
Q

What are the three drugs in the class aminoglycosides?

A

Gentamycin
Amikacin
Tobramycin

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4
Q

Aminoglycosides are potent antibiotics that work well on what type of bacteria?

A

Gram-negative

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5
Q

Aminoglycosides also work on gram-positive, but they need…

A

Other antibiotics for synergistic effect

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6
Q

Aminoglycosides have been used for more complicated infections since 1944 such as…

A 
UTIs, 
gynecological infections, 
peritonitis, 
endocarditis, 
PNA, 
osteomyelitis
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7
Q

What is PNA?

A

Pneumonia

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8
Q

What are two notable side effects of aminoglycosides?

A

Nephrotoxicity

Ototoxicity

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9
Q

If a patient develops ototoxicity on aminoglycosides it is usually…

A

permanent

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10
Q

Becuase of the nephrotoxicity of aminoglycosides, we monitor kidney function through

A

peak and trough levels

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11
Q

When are trough levels typically drawn?

A

8-12 hours after the dose is completed

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12
Q

Aminoglycosides are not intended for __ women

A

teratogenic, pregnant

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13
Q

What class are aminoglycosides for pregnant women?

A

Class C or D

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14
Q

Dosing aminoglycosides is transitioned from…

A

three times a day to once per day

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15
Q

What type of drug is gentamycin?

A

aminoglycoside antibiotic

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16
Q

What type of drug is amikacin?

A

aminoglycoside antibiotic

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17
Q

What type of drug is tobramycin?

A

aminoglycoside antibiotic

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18
Q

What is the MOA of aminoglycoside antibiotics?

A

Inhibits bacterial ribosomes, stops transcription and translation

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19
Q

What type of drug do you not give with gentamycin?

A

Neuromuscular blockades

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20
Q

What can happen if you give gentamycin with a neuromuscular blockade?

A

Profound respiratory distress

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21
Q

What are the CNS side effects of gentamycin?

A

confusion, depression, disorientation, numbness, tingling

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22
Q

Gentamycin is associated with __ damage

A

Cochlear

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23
Q

What does cochlear damage cause?

A

High-frequency hearing loss, high pitched tinnitus

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24
Q

What routes are available for gentamycin?

A

IV
Intrathecal for meningitis
Ophthalmic drops
Topical ointments

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25
Q

What routes is amikacin used?

A

Only IV

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26
Q

What is amikacin used for?

A

Infections resistant to tobramycin and gentamycin

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27
Q

What routes is tobramycin available?

A

Inhalation, topical, and ophthalmic solutions

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28
Q

What is tobramycin typically used for?

A

Pulmonary infections, especially CF

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29
Q

What type of drug is clindamycin?

A

Lincosamide

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30
Q

Clindamycin can be either __ or __

A

Bactericidal or bacteriostatic

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31
Q

What is the MOA for lincosamides (clindamycin)

A

Binds to ribosomes and inhibits protein synthesis

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32
Q

Clindamycin is most often used for __ infections

A

anaerobe

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33
Q

Clindamycin is not used for __ infections

A

Enterobacter

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34
Q

What are some indications for clindamycin? (7)

A 
Chronic bone infections
GU infections
Intraabdominal infections
Anaerobic pneumonia 
Septicemia 
Serious skin infections
Prophylaxis for endocarditis
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35
Q

What is clindamycin primarily used for?

A

Pseudomembranous colitis

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36
Q

What is pseudomembranous colitis?

A

swelling or inflammation of the large intestine (colon) due to an overgrowth of Clostridioides difficile (C difficile) bacteria

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37
Q

What routes are available for clindamycin?

A

PO and IV

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38
Q

What drug should you be very careful with when using in combination with clindamycin?

A

Neuromuscular blockade medications

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39
Q

What two drugs are macrolides?

A

Erythromycin

Azithromycin

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40
Q

Macrolides are generally __

A

bacteriostatic

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41
Q

Macrolides are bactericidal in…

A

high enough concentrations

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42
Q

Why are macrolides known as the “yuck” drugs?

A

GI side effect profile is pretty intense, especially with erythromycin

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43
Q

What is the MOA of macrolides?

A

Inhibit protein synthesis by binding to ribosomes

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44
Q

What are the indications of macrolides?

A

Upper/lower respiratory infections
Skin infections
Soft tissue infections
STIs

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45
Q

When using macrolides to treat STIs, especially gonorrhea, what must be used?

A

A secondary antibiotic because of resistance

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46
Q

3 pathologies that can be treated with macrolides

A

Legionnaire’s disease
Listeria
Mycoplasma pneumonia

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47
Q

What does erythromycin not do?

A

Cross the blood brain barrier

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48
Q

What routes is erythromycin available?

A

PO and IV

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49
Q

IV erythromycin is __

A

painful

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50
Q

PO erythromycin is…

A

not absorbed really good

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51
Q

Teach patients not to take erythromycin…

A

on an empty stomach

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52
Q

Erythromycin has a lot of what interactions?

A

drug-drug

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53
Q

Erythromycin has hypomotility benefits for __ __

A

diabetic gastroparesis

54
Q

Erythromycin can INCREASE what?

A

Motility and emptying of the stomach

55
Q

What is a common name for azithromycin?

56
Q

What is different about azithromycin compared to erythromycin?

A

Less GI side effects and some benefits in coverage

57
Q

What are two benefits of azithromycin?

A

Good tissue penetration

Long duration of action

58
Q

Taking azithromycin with food __ absorption

59
Q

What drug is an oxazolidinone?

60
Q

What is the MOA of linezolid?

A

Inhibits protein synthesis through non-selective monoamine oxidase inhibitors

61
Q

Oxazolidinones were originally created to treat __ and __

A

MRSA and VRE

62
Q

What is linezolid indicated for?

A

Healthcare associated pneumonias and infections

63
Q

Use linezolid with caution in patients with these 5 disorders

A 
Hypertension
Untreated thyroid disease
Severe cardiac disease
Cerebrovascular disease
Pheochromocytoma
64
Q

What are adverse effects of linezolid?

A

headache
nausea
vomiting
thrombocytopenia

65
Q

What routes can linezolid be given?

66
Q

What can happen if given linezolid with SSRIs?

A

Serotonin syndrome

67
Q

What are foods to avoid when taking linezolid?

A

Foods high in tyramine - wines, smoked meats, aged cheese, soy sauce

68
Q

What drug belongs to the class streptogramins?

A

quinupristin/dafopristin

69
Q

Streptogramins is a newer class used for

A

“super bugs”

70
Q

Quinupristin/dafopristin is used in a __/__ combo

71
Q

Quinupristin/dafopristin used alone is __

A

bacteriostatic

72
Q

When used in combination, quinupristin/dafopristin is…

A

bactericidal, 16x the activity used alone (big synergistic effect)

73
Q

What are indications for streptogramins?

A

Serious, life-threatening infections with VRE, MRSA

Complicated skin infections

74
Q

What routes are quinupristin/dafopristin available?

75
Q

What are the adverse effects of streptogramins?

A

Arthralgias
myalgia
painful inflammation at IV site, 75%

76
Q

What must quinupristin/dafopristin be infused with?

77
Q

What must you be aware of that quinupristin/dafopristin can cause?

78
Q

What dangerous side effect can quinupristin/dafopristin cause?

A

Angioedema

79
Q

What are the three tetracyclines?

A

Tetracycline
Doxycycline
Minocycline

80
Q

What is the MOA of tetracyclines?

A

Bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes

81
Q

What is the problem with tetracyclines?

A

Major resistance has developed since used early in time, been around a while

82
Q

What are conditions that are treated with tetracyclines? (7)

A 
Rickettsia
Chlamydia and trich
Lyme disease
Cholera
PID
Mycoplasma pneumoniae 
Acne
83
Q

What are contraindications for tetracyclines?

A

Nursing and pregnant women, children younger than 8

84
Q

What are adverse effects of tetracyclines? (3)

A

Discoloration of teeth, tooth enamel hypoplasia, photosensitivity

85
Q

Tetracycline is not available

A

parenterally

86
Q

Tetracycline is best taken on an…

A

empty stomach, good bioavailablilty

87
Q

Where does tetracycline concentrate at?

A

Bones, liver, tumors, spleen, and TEETH

88
Q

Tetracycline can cause teeth damage in children…

A

under 8 years old

89
Q

What are adverse effects of tetracycline? (6)

A 
N/V/D
Headache
Photosensitivity
Dizziness
Anaphylaxis
Angioedema
90
Q

Which tetracycline is most commonly used to treatment or prophylaxis of STIs?

A

Doxycycline

91
Q

What else is doxycycline used for?

A

Acne and other skin infections

92
Q

What type of meningitis is Minocycline used for?

A

Neisseria meninitides

93
Q

What does minocycline decrease the symptoms of?

A

rheumatoid arthritis

94
Q

What is an ER form of minocycline used to treat acne?

95
Q

What type of drug is tigecycline?

A

Glycylcylines

96
Q

Glycylcylines are the newest form of tetracyclines and are…

A

effective against tetracycline resistant orangisms

97
Q

Tigecycline is typically used for…

A

Skin infections
Peritonitis
Abdominal infections

98
Q

Glycylclines side effects

A

nausea and vomiting

99
Q

What two drugs are fluoroquinolones?

A

Ciprofloxacin

Levofloxacin

100
Q

Fluoroquinolone have very good __ __

A

oral absorption

101
Q

What is the MOA of fluoroquinolones?

A

Destroy bacteria by altering their DNA

102
Q

What 2 bacterial enzymes do fluoroquinolone interfere with?

A

gyrase and topoisomerase

103
Q

What bacteria do fluoroquinolones cover?

A

Mostly gram-negative with some gram-positive

104
Q

What is really good about fluoroquinolones?

A

Since they have really good oral absorption, patients can go home on these antibiotics without a CVC

105
Q

What is ciprofloxacin used to treat?

A

UTIs
STIs - gonorrhea
Respiratory tract infections
Anthrax

106
Q

What routes is ciprofloxacin given?

A

PO, IV, or topical

107
Q

Ciprofoxacin has minimal penetration of the…

A

blood brain barrier

108
Q

What is commonly used before ciprofloxacin to treat UTIs?

109
Q

Where is ciprofloxacin concentrated?

A

Neutrophils

110
Q

What age groups should you avoid ciprofloxacin in?

A

under 18 or over 60

111
Q

What is an adverse effects of ciprofloxacin?

A

arthropathy, but often reversible

112
Q

What is the most widely used fluoroquinolone?

A

levofloxacin

113
Q

How often do you take levofloxacin?

A

Once a day

114
Q

What routes are levofloxacin?

115
Q

Levofloxacin has __% bioavailability PO

116
Q

What are side effects to levofloxacin? (4)

A

CNS disorders
kidney failure
prolonged qt interval
photosensitivity

117
Q

What type of drug is daptomycin?

A

cyclic lipopeptide

118
Q

What is the MOA of cyclic lipopeptide?

A

Unknown; binds to gram positive cells in calcium-dependent process, disrupts the cell membrane potential

119
Q

With daptomycin, it has a long…

A

post-antibiotic effect

120
Q

How often is daptomycin given?

A

IV once per day

121
Q

What is daptomycin/ cyclic lipopeptides used to treat?

A

MRSA
VRE
endocarditis
complicated skin infections

122
Q

Why can’t daptomycin be used to treat pneumonia?

A

It is inactivated by lung surfactant

123
Q

What drug is a sulfonamide?

A

Sulfamethoxale + trimethoprim (bactrim)

124
Q

What is the MOA of sulfonamide?

A

Don’t destroy bacteria, but inhibit their growth, bacteriostatic. Prevent synthesis of folic acid needed for DNA synthesis

125
Q

Adverse reactions to bactrim are much more common in which patients?

126
Q

4 indications for bactrim

A

UTI
Respiratory infection
Salmonella
Shigellosis

127
Q

What does metronidazole work on?

128
Q

What is the MOA of metronidazole?

A

Inhibits DNA synthesis

129
Q

What are the adverse effects of metronidazole?

A

N/V
Xerostomia
Vaginal yeast

130
Q

What is metronidazole most often used to treat?

A

C diff but there is some resistance now

131
Q

What is zerostomia?

Pathopharmacology I (33 decks)

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