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Pharmacology > Wk 7. Antibiotics part 2 > Flashcards

Wk 7. Antibiotics part 2 Flashcards

1
Q
  1. How to tetracyclines inhibit the replication of bacteria?
A

Inhibits protein synthesis at ribosomes

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2
Q
  1. How long should a patient wait after taking tetracycline before he has a glass of milk?
A

2 hours

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3
Q
  1. Why are tetracyclines avoided in children younger than 8 years of age?
A

Discoloration and hypoplasia of teeth

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4
Q
  1. What precautions should patients take with tetracycline?
A

Sun protection for photosensitivity. Take with a full glass of water to prevent esophageal ulcerations.

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5
Q
  1. How does erythromycin increase the chance of drug interactions?
A

Inhibits hepatic drug metabolism by P450 system.

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6
Q
  1. What is the major risk of drug interactions with erythromycin?
A

QT prolongation, which places person at risk for Torsades de Pointes,

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7
Q
  1. How does erythromycin inhibit the replication of bacteria?
A

Inhibits protein synthesis at ribosomes

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8
Q
  1. What are common adverse effects of erythromycin? How can this be mitigated?
A

Nausea, vomiting, diarrhea, epigastric pain. Give ethylsuccinate or enteric-coated tablets with food.

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9
Q
  1. How does clarithromycin (Biaxin) inhibit the replication of bacteria?
A

Inhibits protein synthesis at ribosomes

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10
Q
  1. Which macrolide does not inhibit hepatic enzymes? What drug interaction is still significant with this drug?
A

Azithromycin (Zithromax). Raises warfarin (Coumadin) levels.

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11
Q
  1. Why is telethromycin (Ketek) only used for multidrug-resistant Streptococcus pneumonia?
A

Hepatoxicity.

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12
Q
  1. How do sulfonamides inhibit replication of bacteria?
A

Competes with PABA in synthesizing folic acid and inhibits enzyme (dihydrofolate reductase) used to synthesize folic acid

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13
Q
  1. Why are sulfonamides contraindicated for infants less than 2 months old?
A

Kernicterus

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14
Q
  1. Which antibiotic drug class is avoided in patients with G6PD deficiency? Why?
A

Sulfonamides may cause hemolytic anemia.

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15
Q
  1. What drugs should be used with caution if the person in allergic to sulfonamides? Should a person with anaphylaxis try these drugs?
A

Sulfonylureas (oral antidiabetic drugs), loop diuretics, thiazide diuretics, and Celebrex (COX-2 inhibitor). Absolutely not due to a higher risk of hypersensitivity.

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16
Q
  1. Why should a patient stop using a sulfonamide with a blistering, sunburn-like rash? What other skin reaction may occur
A

Risk for Stevens-Johnson Syndrome. Photosensitivity.

17
Q
  1. How do fluoroquinolones kill bacteria?
A

Inhibit synthesis of nucleic acids

18
Q
  1. Why should fluoroquinolones not be used in patients under the age of 18?
A

Tendon injury

19
Q
  1. For what type of bacteria are aminoglycosides given?
A

Aerobic gram negative bacilli

20
Q
  1. Fluoroquinolones are ordered to be given in the morning with a multivitamin with minerals. Why is this contraindicated?
A

Calcium, aluminum, magnesium, iron, zinc may combine with the fluoroquinolone and prevent its absorption. Give fluoroquinolones on an empty stomach.

21
Q
  1. Ciprofloxacin (Cipro) is given for what common disease processes?
A

UTIs, enteric organisms.

22
Q
  1. What are the two mechanisms of action for aminoglycosides?
A

Inhibit protein synthesis at ribosomes and insert abnormal proteins into the cell wall.

23
Q
  1. Instead of keeping the serum drug levels above the MIC (minimum inhibitory concentration), how do aminoglycosides kill bacteria?
A

Concentration-dependent kill with post-antibiotic effect.

24
Q
  1. Discuss the distribution of aminoglycosides.
A

Unable to cross cell membranes. Not absorbed orally and does not cross blood-brain barrier.

25
Q
  1. What two organs can be damaged by aminoglycosides?
A

Ears, kidneys

26
Q
  1. When are gentamicin peak and trough levels drawn?
A

Multiple doses: Peak level 30 min after IM or after 30-min IV infusion. Trough level immediately before next dose.
Daily dose: Trough level 1 hr before next dose. No need for peak level.

27
Q
  1. What two antibiotics are reserved mainly for anaerobic bacteria?
A

Clindamycin (Cleocin) and metronizadole (Flagyl).

28
Q
  1. What viruses does acyclovir (Zorivax) treat? Does it cure the disease?
A

Herpes simplex viruses (HSVs) – cold sores and genital infections, varicella-zoster virus (VZV) – chickenpox and shingles. The drug manages the symptoms, but does not cure or prevent transmission.

Pharmacology (25 decks)

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