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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

Chapter 9

1
Q

What is gentamicin?

A

Amino glycosides

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2
Q

Describe what group Aminoglycosides are given to?

A

-Used to treat infections caused by primarily aerobic gram-negative bacilli.
-Inhibit protein synthesis in susceptible strains
cause cell death

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3
Q

What are pharmokinetics of gentamicin?

A

Aminoglycosides

-poorly absorbed from the GI tract but rapidly absorbed after intramuscular (IM) injection
-Highly effective antibiotics with significant potential for adverse effects.
-Mostly iv
-Good for severe infections when PCN allergies

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4
Q

What are adverse affects if gentamicin?

A

*Aminoglycosides

Sever toxicity likee:
-Nephrotoxicity(BBW): Direct drug toxicity in the glomerulus

-Ototoxicity: accumulates in inner ear, damages cochlea, vestibular paralysis due to effect on auditory nerve (BBW)
-CNS – numbness, tingling, balance concerns
-Some bone marrow suppression, leading, for example, to immune suppression and resultant infections.

others:
GI: n/v/d, weight loss, stomatitis
CV: palpitations, hypotension, and hypertension. Hypersensitivity reactions include purpura, rash, urticaria, and exfoliative dermatitis.

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5
Q

What are contras/cautions when taking gentamicin?

A

*Aminoglycosides

-Children/pregnancy – Neonates at risk due to immature renal function. Only if benefit outweight risk
-RENAL DZ

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6
Q

What are drug to drug interactions with gentamicin?

A

*Aminoglycosides

-Amino glycosides with loop diuretics; this increases the incidence of ototoxicity
-Diuretics and anesthetic agents will cause increased affects
- antibiotics are given with anesthetics, increased neuromuscular blockade with paralysis is possible.

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7
Q

What is ertapenem?

A

Carbapenems

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8
Q

What are indications of ertapenem?

A

Carbapenems

Reserved for complicated body cavity and connective tissue infections
-Treatment of community-acquired pneumonia, complicated GU infections, acute pelvic infections, complicated intra-abdominal infections, skin and skin structure infections
-Gram negative bacteria

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9
Q

What are pharmokinetics ertapenem?

A

IM, IV

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10
Q

What are adverse affects of ertapenem?

A

Carbapenems
GI effects – N/V/D  watch for dehydration
Nephrotoxic
CNS effects – HA, dizziness
Assess for seizure history
Superinfections

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11
Q

What are contras cautions with ertapenem?

A

**Carbapenems
-Allergy against carbapenems, beta-lactams
-Safety not established for pregnancy, and lactation
-Test renal function regularly b/c toxic affect it can have on kidney

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12
Q

What are drug-drug interactions w ertapenem?

A

*Carbapenems
antibiotic treatment if a patient is on valproic acid. Combination of these drugs can cause serum valproic acid levels to fall and increase the risk of seizures

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13
Q

What is penicillin G, Amoxicillin?

A

PCN &Penicillinase Resistant Antibiotics

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14
Q

What are indications of penicillin G, Amoxicillin

A

PCN &Penicillinase Resistant Antibiotics
-PCN –first antibiotic introduced for clinical use

-Resistance-bacteria synthesized enzyme penicillinase to counter PCN effects
-Penicillinase resistant antibx-used for bacteria resistant to PCN
-Indicated for strep, endocarditis, meningococcal meningitis (many gram positives)

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15
Q

What are adverse affects of penicillin G, Amoxicillin?

A

PCN &Penicillinase Resistant Antibiotics
-GI – N/V/D, stomatitis, furry tongue,
-Rash, urticaria
-Hypersensitivity
-Super infections, like yeast is common

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16
Q

What are cautions/contras with penicillin G, Amoxicillin?

A

PCN &Penicillinase Resistant Antibiotics
-pregnancy and lactation
-Allergy to other PCNs or cephalosporins
-caution in patients with renal disease

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17
Q

What are drug to drug interactions with penicillin G, Amoxicillin?

A

PCN &Penicillinase Resistant Antibiotics

-when the parenteral forms of penicillins and penicillinase-resistant drugs are administered in combination with any of the parenteral aminoglycosides, inactivation of the aminoglycosides occurs. These combinations should also be avoided.
(This med is normally given orally)
-Reduces effectiveness of contraceptives
-Increase bleeding with warfarin

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18
Q

What is *Cefazolin, *Cefepime?

A

Cephalosporin

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19
Q

what are indications *Cefazolin, *cefepime?

A

Cephalosporin

-Structurally and pharmacologically related to penicillins*
-Broad spectrum – gram positive/negative but effectiveness varies with each generation

Cefepime: Broad spectrum – gram positive/negative but effectiveness varies with each generation

Cefazoline: Treatment of pharyngitis, tonsillitis, otitis media, sinusitis, secondary bronchial infections, and skin infections

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20
Q

what are adverse affects *Cefazolin, *cefepime?

A

Cephalosporin
-GI-N/V/D-colitis potential
-CNS symptoms- headache, dizziness, lethargy, and paresthesia
-Disulfiram reactions could be caused by alcohol
-Nephrotoxicity-. (with existing dz and amino glycosides)
-superinfections( Death of normal flora)

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21
Q

What are contras/cautions *Cefazolin, *cefepime?

A

Cephalosporin
-Allergy to PCN
-Renal/hepatic impairment( Toxic to kidneys and can mess with metabolism)
-Unknown effect on pregnancy

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22
Q

What are drug-drug interaction *Cefazolin, *cefepime?

A

-Increase effect of warfarin( increased bleeding)
-Aminoglycosides (cephalosporins with aminoglycosides increases the risk for nephrotoxicity.)

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23
Q

What is ciprofloxacin(cipro)?

A

Fluoroquinolones

-Relatively new, broad spectrum
-Also called “quinolones”

24
Q

What are indications ciprofloxacin(cipro)?

A

Fluoroquinolones
-they interfere with the action of DNA enzymes necessary for the growth and reproduction of the bacteria
-Effective against gram-negative organisms
GU, respiratory, skin, anthrax
-absorbed through Gi tract excellent oral absorption

25
Q

What are adverse effects ciprofloxacin(cipro)?

A

Fluoroquinolones
-GI upset(include nausea, vomiting, diarrhea, and dry mouth)
-CNS – HA, dizziness
-Photosensitivity
-Tendonitis/ rupture (BBW)

26
Q

What are contras/cautions effects ciprofloxacin(cipro)?

A

Do not use in pregnancy – risk unknown
Renal dysfunction
Seizure history

27
Q

What are drug -drug interactions ciprofloxacin(cipro)?

A

Fluoroquinolones
-CNS effects ↑ with NSAIDs
-Antacids, iron preps reduce effectiveness (4 hr. apart)
-Potential for long QT if used with drugs that increase interval

28
Q

What is cotrimoxazole (Septra, Bactrim)

A

Sulfonamides
Combination sulfamethoxazole and trimethoprim
One of the first groups of antibiotics

29
Q

What are indications of cotrimoxazole (Septra, Bactrim)

A

Sulfonamides
UTIs, Pneumocystis jiroveci pneumonia (PJP)

30
Q

What are adverse affects of cotrimoxazole (Septra, Bactrim)

A

Sulfonamides
-Bone marrow suppression
-Dematological effects ( photosensitivity and Stevens-Johnson syndrome)
-GI (N/V/D)
-CNS
-Renal

31
Q

What are contra/cautions cotrimoxazole (Septra, Bactrim)

A

-allergy to sulfa drugs or thiazide diuretics
-Pregnancy/ lactation –> kernicterus
Renal dz/ kidney stones

32
Q

What are drug interactions cotrimoxazole (Septra, Bactrim)

A

-Hypoglycemia with glyburide, glipizide (antidiabetic agents)

hyperkalemia when these medications are combined with other medications that have the same risk, like ace inhibitors, and potassium sparing diuretics.
-sulfonamides are taken with cyclosporine, the risk of nephrotoxicity rises.

33
Q

What is **tetracycline (Sumycin)
**doxycycline?

A

Tetracyclines

Older broad spectrum, not used extensively due to resistance (esp gram negs)
Useful when PCN allergy present

34
Q

What are indications for **tetracycline (Sumycin)
**doxycycline?

A

Tetracyclines
STDs –> Chlamydia, PID
Acne

35
Q

What are adverse effects for **tetracycline (Sumycin)

A

Tetracyclines
-Photosensitivity
-Superinfections

36
Q

What are contras/cautions for **tetracycline (Sumycin)?

A

Tetracycline
Do not use in children < 8yrs  teeth discoloration, delays bone growth
Do not use with pregnancy
Caution with renal/hepatic dz

37
Q

What are drug to drug intercations for **tetracycline (Sumycin)?

**doxycycline

A

Absorption affected by food and calcium
Decreases effectiveness of PCN and contraceptives

38
Q

What is erythromycin?

A

Macrolides

39
Q

What are indications of erythromycin?

A

Mild to moderate URIs, STDs, otitis media
Prophylaxis for endocarditis

40
Q

What are adverse affects of Erythromycin?

A

Macrolides
GI – N/V/D (primarily with erythromycin)including abdominal cramping, anorexia, diarrhea, vomiting, and pseudomembranous colitis

Fewer GI problems with azithromycin and clarithromycin:
longer duration of action, better efficacy, better tissue penetration (may take with food)

41
Q

What are cautious affects of Erythromycin?

A

Macrolides
Renal/hepatic dysfunction
Pregnancy/ lactation

42
Q

What are drug to drug interactions of Erythromycin?

A

-Increases effects of some drugs – may need to dose reduce while on antibx
digoxin, warfarin (Coumadin), steroids, lipid meds (Zocor)

when oral anticoagulants, carbamazepine, are administered concurrently with macrolides, the effects of these drugs reportedly increase as a result of metabolic changes in the liver.

43
Q

What is clindamycin (Cleocin)?

A

lincosamides
short half life, dose three-four times daily

44
Q

What are indications of clindamycin (Cleocin)?

A

lincosamides
Very similar to macrolides – used in more severe infections
When PCN can not be used

45
Q

What are adverse effects of clindamycin (Cleocin)?

A

Lincosamides
Severe GI reactions, including fatal pseudomembranous colitis,

46
Q

What are contrs/cautions with lincosamides?

A

Hepatic/renal

47
Q

What is vacomycin?

A

Lipoglycopeptides

48
Q

What are indications of vacomycin?

A

Treatment of choice for MRSA, and other gram-positive infections
Oral preparation to tx c-diff colitis and enterocolitis

49
Q

What are adverse affects of vacomycin?

A

Must monitor blood levels to ensure therapeutic levels and prevent toxicity

May cause ototoxicity and nephrotoxicity
Ensure adequate hydration!
“Red Man Syndrome” may occur with IV admin
Flushing/itching of head, neck, face, upper trunk
Antihistamine (diphenhydramine) may be ordered to reduce these effects
Reaction to iv infusions
Will see hypotension than a rash!

50
Q

What is **isoniazid (INH), **rifampin (Rifadin),

A

Antimycobacterials

51
Q

Descrieb myobacteria

A

pathogens which cause
TB (mycobacterium tuberculosis)
Leprosy
Pathogens able to survive for long periods due protective acid coating
Treatment duration months/years due to this pathogen

52
Q

Describe tb

A

TB – not just in the lungs!
GU, bones, meninges
TB meds dosed in combination (active) to affect bacteria at various stages – decreases resistance

53
Q

What is indications of isoniazid(INH)?

A

Drug of choice for latent TB (6-9 months)

54
Q

What are adverse affects of antimycorbacterials?

A

CNS and peripheral neuropathy (pyridoxine B6)
**rifampin: orange discoloration of urine, sweat, tears

55
Q

What are contras/cautions of isoniazid (INH), **rifampin (Rifadin)

A

Antimycibacterial
Do not use in pregnancy if possible
Renal/hepatic failure
Esp. if INH, rifampin used together

56
Q
A

Pharmacology (39 decks)

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