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Pharm 202 > Anti Infective Drugs I > Flashcards

Anti Infective Drugs I Flashcards

1
Q

Medication that are used to treat bacterial infection

A

Antibiotic

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2
Q

Gram negative bacteria are much harder to destroy than gram positive

A

True

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3
Q

Antibiotic drugs depend on what the causative organism is, the severity of infection, age and host factors

A

True

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4
Q

Broad spectrum can

A

eradicate a large number of organisms

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5
Q

Narrow spectrum

A

kills only a certain type of organism

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6
Q

Bactericidal is preferred in what? What do they do?

A

preferred in more serious infection

kill the bacteria by targeting the cell membrane

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7
Q

Bacteriostatic

A

prevents bacteria from replicating targeting DNA/RNA inside the cell

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8
Q

General MOA of Anti Invectives

A

Interfere with bacterial cell wall synthesis, portion synthesis
Interfere with DNA/RNA replication
Interfere with cellular fx

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9
Q

General Adverse effects of anti infective

A 
N&V, diarrhea 
Allergic reaction 
Serum sickness- delayed "allergy" starting a week after 
Superinfection 
Immune suppression
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10
Q

what is a superinfection & what has happened

A

antibiotic reduce/ eliminate normal flora bacteria- without normal flora new infections can emerge such as thrush, yeast infection

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11
Q

Immune suppression is what happens

A

a primary infection leads to a new infection- common cold or cold sores can develop

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12
Q

Empiric Therapy

A

Based on experience

Physician prescribes antibiotic based Upton presenting info

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13
Q

Prophylactic Therapy

A

Prevention of transmission
Administered prior to invasive procedures
For immunocompromised pt

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14
Q

Definitive Therapy

A

Drug is selected upon C&S results

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15
Q

Combination Therapy

A

Indicated for infections that can be caused by multiple organisms
Microbes that are difficult to treat
Immunocompromised pt

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16
Q

When does antibiotic resistance occur

A

when microorganisms defeat the drugs designed to kill them

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17
Q

what are factors that cause Antibiotic resistance

A

Misuse & overprescribing of antibiotic
Pt failure to adhere to drug- not taking full course
Bacterial mutation
Sharing medications

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18
Q

What are some ways we can eliminate AR

A

Vaccinations
Not treating Viral infections with antibiotics
Obtain cultures

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19
Q

How to tell if Antibiotic therapy has worked

A

WBC normalized
Decreased fever
Less pain

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20
Q

Sulfonamides MOA

A

bacteriostatic- inhibits folic acid responsible for bacterial cellular biosynthese

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21
Q

Sulphonamides are effective against

A

Gram negative and Gram positive

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22
Q

Indication for Sulphonamide

A

UTI
Opportunistic infections
Community acquired staph aureus

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23
Q

Example meds of Sulphonamide

A

Bactrim

Septra

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24
Q

Adverse effects of Sulphonamide

A 
Immune related b/c drug is a antimetabolite 
Allergic reaction- fever, rash 
photo sensitivity 
GI, liver, renal dysfunction 
Thrombocytopenia- low platelet
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25
Q

Why wouldn’t we give Sulphonamides

A

Allergy
3rd trimester pregnancy
Cross allergenicity- is used with other sulpha drugs can cause allergic reaction

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26
Q

Other Drug interactions with Sulphonamides

A

Sulfonylurea- can cause hypoglycaemia
Phenytoin- toxicity
Warfarin- haemorrhage
Reduce efficiency of oral contraceptive

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27
Q

Beta Lactamas

aka penicillinase are what

A

enzymes secreted by some bacteria

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28
Q

what does beta lactamase enzyme do

A

the enzyme splits the beta lactic ring of the antibiotic destroying its antibacterial properties - bacterial resistance

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29
Q

ESBL stand for

A

Extended spectrum beta lactamas

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30
Q

what do we do with positive ESBL pt and why?

A

Isolate them so the enzyme cannot be transmitted

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31
Q

Beta Lactamase inhibitors are

A

drugs that inhibit the enzyme, therefore allowing the drug to still work.

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32
Q

What are some examples of Beta Lactamase inhibitors

A

Clavulanic acid/ Amoxicillin trihydrate

Piperancillin/ Tazobactam

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33
Q

Clavulanic acid and Tazobactam does what to prevent what?

A

binds with beta lactamase to prevent the enzyme from destroying penicillin
combining these drugs with penicillin reduce the resistance

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34
Q

Penicillin are generally____and well ___ group of medication

A

safe and tolerated

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35
Q

Those allergic to penicillin are very likely to be allergic to other beta lactams

A

True

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36
Q

Adverse effect of Penicillin

A

Allergy- urticaria, pruritus, angioedema, anaphylaxis
Rash
Gi upset

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37
Q

Adverse effect =

A

unexpected effect

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38
Q

Drug interactions of penicillin

unexpected side effect

A

NSAIDS
Oral contraceptive
Warfarin

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39
Q

Beta Lactam Antibiotic include

A

Penicillin, cephalosporins, carbapenems, monobactams

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40
Q

Beta Lactam Antibiotic General MOA

A

inhibits synthesis of bacterial cell wall- cells will lyse(breakdown)= kill bacteria cella

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41
Q

Beta Lactam Antibiotic

what is responsible for antibacterial activity

A

Beta Lactamamase ring

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42
Q

Narrow Spectrum- Natural Penicillin includes _______routes

A

IV
IM
Oral

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43
Q

Why would we use Narrow Spectrum- Natural Penicillin

A

Gram + bacteria

Gonorrhea and Syphilis

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44
Q

why is narrow spectrum the drug of choice for staph, strep, pneumococci

A

Drug of choice of streptococci, pneumococci, staphylococci bacteria that do NOT produce penicillinase

45
Q

Narrow Spectrum- Penicillinase Resistant Drugs

Indication for drug & examples

A

Gram + cocci bacteria
Effective against bacteria that release penicillinase
Cloxacillin & Oxacillin

46
Q

Broad spectrum- Aminopenicillians Indication

Ampicillin & Amoxicillin

A

gram - or + bacteria
skin infection, soft tissue, rest, GU
Prevention of bacterial endocarditis

47
Q

Extended Spectrum- penicillin

examples?

A

Piperacillin & piperacilllin

Tazobactum

48
Q

Extended Spectrum -penicillin

Indications

A

Gram - bacteria

treat pseudomonas but requires combination of drugs

49
Q

Carapenems
Imepenum/ Cilastin / Meropenem
What are these

A

broadest antibacterial action of all groups

These re for complicated infections in acutely ill

50
Q

Carapenems risk is

A

they can cause seizures

51
Q

Cephalosporins have how many generation of meds

A

5 but only 4 are offered in Canada

52
Q

What are Fisrt gen Cephalosporins used for

A

Gram +
Staphylococcal infection
Prevent surgical site infections
Treat upper rest infection

53
Q

example of Cephalosporins first gen medications

A

Cephalexin

Cefazolin

54
Q

What are 2nd gen Cephalosporins used for

A 
Gram + and some Gram - 
UTI
soft tissue 
Lower resp infection 
bone and joint infection
55
Q

example of Cephalosporins 2nd gen medications

A

Cefoxitin, Cefuroxime

these drugs are effective against drug resistant strains

56
Q

What are 3rd gen Cephalosporins used for

A

Potent against gram -

57
Q

3rd gen Cephalosporin drug used for

A

Ceftriaxone – able to pass the BBB so used to treat meningitis
Ceftazidime – used for hard to treat infections such as pseudomonas

58
Q

4th gen Cephalosporin use

ex. Cefepime

A

Enterobacter gram + and -

Treatment of UTI, skin infection & pneumonia

59
Q

Maceolides

MOA

A

Bacteriostatic- prevents portion synthesis within bacterial cells

60
Q

Maceolides Indication

A

streptococcus pyrogens
Resp infection
Spirochetal infection- Lyme disease

61
Q

why are maceolides unique

A

they are effective against bacterial that reproduces inside of cells

62
Q

examples of macrolides

A

Azithromycin

Clarithromycin

63
Q

Tetracyclines drug ex

A

doxycycline

64
Q

Tetracycline MOA

A

Bacteriostatic- inhibtit portion Synthese

Broad spectrum activity- gram +&-

65
Q

why would we use a tetracycline

A 
Acne 
Chlamydia 
Mycoplasma pneumonia 
Lyme disease 
Syphilis
66
Q

Adverse effects of Tetracycline

A

Vaginal candidiasis
GI upset
Photosensitivity

67
Q

What does Tetracycline have a strong affinity to & why could this be a issue in certain pt

A

Calcium; bone development children and fetal

discolouration of teeth

68
Q

What are we going to Assess prior to giving antibiotic

A 
Med history 
Allergies 
Lab results 
Immune status 
Hydration 
Physical assessment
69
Q

Antibiotics should be giving _____.

A

on time

70
Q

sulphonamides are to be taken with

A

with food

2-3 L while on therapy

71
Q

Penicillin is to be taken with

A

only water-

avoid juices due to acidity

72
Q

Cephalosporin; we need to watch for ____ and need to take with what?

A

penicillin allergy and take with food

73
Q

Macrolides are _____ protein bound and oral meds are absorbed better when?

A

highly protein bound - will cause interactions with other protein bound drugs - only so may sites
On a empty stomach

74
Q

Tetracyclines; we need to avoid and why

A

milk, iron preparations and antacids because of drug binding
Take with 180 ml of water

75
Q

Teach: all oral antibiotics are best absorbed when taken with ____-_____ml of ____

A

180-240ml of water

76
Q

cephalosporins may cause serious reaction when taken with ____

A

alcohol

77
Q

most common side effect of antibiotic is

A

N&V

Diarrhea

78
Q

Cefazolin or Ancef

A

admin 1-2 g 30-60 mins prior

drug of choice for surg

79
Q

Cefazolin common side effects

A

rash, diarrhea

Cdiff

80
Q

Antibiotic for heart to treat infections

A 
Aminoglycosides 
Ouinolones 
Vancomyocin 
Clindamycin
Metronidazole
81
Q

Aminoglycosides drugs

A

gentamicin, tobramycin, neomycin, amikacin, strepomycin

82
Q

Aminoglycosides MOA

A

bactericidal- preventing bacterial protein synthesis

83
Q

Aminoglycosides provide a synergist effect when combined with other antibiotics

A

true

84
Q

Why would we give Aminoglycosides

A

Serious gram - infections (pseudomonas, enterobacter)

some gram positive infections(staph)

85
Q

clinical use for Aminoglycosides

A

bacterial endocarditis resistant to other antibiotic

prophylaxis(prevent disease) to GI & GU

86
Q

Aminoglycosides

toxicity

A

nephron

ototoxicity- toxic to the ear

87
Q

what to do before aminoglycoside admin

A

creatinine clearance
monitor renal fx
therapeutic drug serum levels

88
Q

Contraindication for Aminoglycosides

A

Allergy, pregnancy, treat feeding

89
Q

Adverse effects of Aminoglycosides

A

headache, fever, vertigo, rash, paresthesia

90
Q

Drug interactions

Aminoglycosides & vacomiyocin, cyclosporine

A

Nephron toxicity when used

91
Q

Aminoglycoside and loop diruetic

A

increased risk of ototoxicity

92
Q

Quinolone drugs include

A

ciprofloxacin, levofloxacin, maxifloxacin

93
Q

Why would we use Quinolone’s

A 
Active against Gram - and Gram +
resp infection 
UTi
prostate
Bone/joint infection 
infection diarrhea 
Gonorrhea
94
Q

Adverse effects of Qunolones

A

CNS, GI, Skin
tendonitis
fever, chills
blurred vision

95
Q

Quinolones interactions

A

antacid, Ca, Mg, iron, Zinc

take interacting drug 1hr before or after taking quinolone

96
Q

Dairy products, Enteral tube feed, and oral anticoags are interacting drugs of Quinolones

A

true

97
Q

Clindamycin

misc classification

A

–

98
Q

Clindamycin MOA

A

bactericidal or bacteriostatic

99
Q

what is bactericidal and bateriostsic

A

Bactericidal - kill the bacteria (preferred in more serious infections), mostly target the cell membrane
Bacteriostatic -prevent bacteria from replicating, target the DNA and RNA inside the cell

100
Q

why would we use clindamycin drug

A 
it is active against gram + or -
Chronic bone infection 
UTI
Intra ABD infection 
Anerobic Pneumonia 
serious skin infection
101
Q

Adverse effect of Clindamycin

A

Cdiff

102
Q

Vancomycin

A 
is a misc class 
oral forms are poorly absorbed and distributed
103
Q

Vancomycin MOA

A

Binds to bacterial cell wall and inhibits cell wall synthesis= cell death
drug of choice for MRSA

104
Q

Indications of vancomycin

A

Oral: antibiotic induced colitis -cdiff

Given to prevent SSI(surgical site infection) in those allergic to cefazolin

105
Q

Adverse effects vancomycin

A 
Ototoxicity 
Nephrotoxicity 
HTN with rapid Iv admin 
Muscle spasm 
Dyspnea
106
Q

Nursing Care for vancomycin

A

monitor serum levels to ensure therapeutic level

Draw immediately before admin of next dose- optimal trough levels 15-20mcg

107
Q

Metronidazole MOA

A

Bactericidal

108
Q

Metronidazole Indication

A

Active against anaerobic microorganism
protozoal infection
intra ABD infection

Pharm 202 (2 decks)

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