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Pharmacy AMH 2024 > Antibacterials > Flashcards

Antibacterials Flashcards

1
Q

Amikacin

A

Aminoglycoside

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2
Q

Gentamicin

A

Aminoglycoside
MOA: It inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, leading to the misreading of mRNA and subsequent inhibition of translocation.
I: Gram-negative bacteria (e.g. Escherichia coli, Klebsiella, and Pseudomonas aeruginosa)
D: Weight based and CrCl
C: IV or IM over a specific time
ADR:
- Nephrotoxicity: elevated serum creatinine and blood urea nitrogen, muslce weakness, paralysis, respiratory distress
- Ototoxicity: hearing loss, ringing, dizziness
PP:
- Empirical < 48hrs
- TDM

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3
Q

Tobramycin

A

Aminoglycoside

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4
Q

Ertapenem

A

Carbapenem

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5
Q

Meropenem

A

Carbapenem
MOA: inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). This action disrupts the construction of the bacterial cell wall, leading to cell death.
I: nosocomial infections and life-threatening infections, multi-resistant Gram-negative infections, Severe mixed aerobic and anaerobic infections, meningitis, febrile neutropenia
D: 0.5-2g TDS
C: IV
ADR: NV, diarrhoea, headache
- C.diff: itch, rash
PP: Renal fn, hepatic fn, FBC for prolonged treatment

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6
Q

Imipenem with cilastatin

A

Carbapenem

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7
Q

Cefaclor (Ceclor, Keflor)

A

Cephalosporin
- Moderate spectrum
MOA: Interfere with bacterial cell wall peptidoglycan synthesis by binding to penicillin-binding proteins, eventually leading to cell lysis and death; bactericidal.
I: Respiratory tract infections, otitis media, urinary tract infections, and skin and soft tissue infections
D: 250-500mg TDS OR 375-750mg CR BD
C: Best with food
ADR: NV, rash, dizziness, headache
- Serum sickness-like syndrome: skin eruptions, lymphadenopathy and arthralgia/arthritis; may last for 6–12 days. Full recovery usually occurs after stopping.
PP: renal fn, FBC for > 10 days

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8
Q

Cefalexin (Ibilex, Keflex)

A

Cephalosporin
- Moderate spectrum
MOA: It inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell wall disruption and bacterial cell death.
I: UTI, staph/strep infections
D: 250mg q6h or 500mg q6-12h
C:
ADR: NVD, rash, allergic reaction
PP:
- Less serious infections BD dosing may be used (strep throat, tonsillitis, UTI)
- UTI: Women for 5 days, Men for 7 days
- Monitor renal fn and FBC if longer than 10 days

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9
Q

Cefazolin

A

Cephalosporin
- Moderate spectrum

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10
Q

Cefepime

A

Cephalosporin
- Broad spectrum

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11
Q

Cefotaxime

A

Cephalosporin
- Broad spectrum

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12
Q

Cefoxitin

A

Cephalosporin
- Moderate spectrum

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13
Q

Ceftaroline

A

Cephalosporin
- Broad spectrum

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14
Q

Ceftazidime

A

Cephalosporin
- Broad spectrum

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15
Q

Ceftazidime with avibactam

A

Cephalosporin
- Broad spectrum

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16
Q

Ceftolozane with tazobactam

A

Cephalosporin
- Broad spectrum

17
Q

Ceftriaxone

A

Cephalosporin
- Broad spectrum

18
Q

Cefuroxime (Zinnat)

A

Cephalosporin
- Moderate spectrum
MOA: It inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell wall disruption and bacterial cell death.
I: Respiratory infections (H. influenzae), ear infections
D: PO
- >12yo: 250-500mg BD
- 2-12 yo: 15mg/kg BD
- 3m-2yo: 10mg/kg BD
C: Best with a light meal
ADR:
PP:
- Cefuroxime is preferred to cefaclor, particularly in children, as it is less likely to cause serum sickness-like syndrome and it is more active against S. pneumoniae
- renal fn and FBC if more than 10 days

19
Q

Teicoplanin

A

Glycopeptide

20
Q

Vancomycin

A

Glycopeptide
MOA: Bactericidal; inhibit bacterial cell wall synthesis by preventing formation of peptidoglycan polymers
I: Reserved for serious gram positive infections, MRSA, MRSE , C. diff,
D
C: weight based and renal function
D
C: IV no less over 60 minutes
ADR: phlebitis
- Nephrotoxicity: elevated creatinine
- Ototoxicity: affected hearing
- Red man syndrome: due to histamine release; they include fever, chills, erythema, facial and upper torso rash, which may be followed by hypotension, angioedema and itch
PP: Renal fn, hearing,
- steady state after 4 doses
- Target 15-20 mg/L

21
Q

Clindamycin (Dalacin)

A

Lincosamide
MOA: Bacteriostatic; It inhibits bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome, preventing the formation of peptide bonds.
I: Alternative to penicillins and cephalosporins, BV, anaerobic infections, PJP, malaria, acne
D:
- Dental infections: 300-500mg 18h for 5-7 days
- PJP treatment with primaquine PO 450mg q6-8h or 600mg q8h for 21 days
- Malaria treatment with primaquine 450mg q8h for 7 days
BV: 300mg BD for 7 days
C: Take with full glass of water.
ADR: NV, GI upset
- C. diff: Mild to severe diarrhoea
PP: renal fn, hepatic, FBC for prolonged treatment
- Complete cross-resistance between clindamycin and lincomycin

22
Q

Lincomycin

A

Lincosamide

23
Q

Azithromycin (Zithromax, Zedd, Zithro)

A

Macrolide
- Broad-spectrum antibacterials active against Gram-positive and some Gram-negative bacteria
MOA: inhibits bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome, interfering with the translocation process during protein synthesis.
I: chlamydial infection, CAP caused by Legionella pneumophila and M. pneumoniae, MAC, preferred for pertussis, Traveller’s diarrhoea,
D: 500mg for 3 days
- Chlamydial: 1g as a single dose
- CAP: 500mg OD
- MAC:
- Traveller’s diarrhoea: 1g as a single dose or 500mg d for 3 days
C: if baby is irritable or vomits when feeding
ADR: NVD, rash, GI upset
- Associated with the development of infantile hypertrophic pyloric stenosis
PP:
- Better tolerated than erythromycin
- cross resistance between macrolides and lincosamides

24
Q

Clarithromycin (Klacid, Kalixocin)

A

Macrolide
- Broad-spectrum antibacterials active against Gram-positive and some Gram-negative bacteria
MOA: inhibits bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome, interfering with the translocation process during protein synthesis.
I: Best against MAC, eradication of H. pylori use, preferred for pertussis, LRTI,
D: 250-500mg BD
C: Interacts with many drugs
ADR: Taste disturbance
- Prolong QT interval
PP:
- Better tolerated than erythromycin
- More drug interactions than azithromycin and roxithromycin
- cross resistance between macrolides and lincosamides

25
Q

Erythromycin (E-Mycin)

A

Macrolide
- Broad-spectrum antibacterials active against Gram-positive and some Gram-negative bacteria
MOA: inhibits bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome, interfering with the translocation process during protein synthesis.
I:
- Campylobacter enteritis
- Pneumonia caused by Legionella pneumophila and M. pneumoniae
- URTI and LRTI
- Acne
D:
C: Interacts with many drugs, L3B
ADR:
- Higher incidence of GI upset
- Prolong QT interval and increase risk of arrhythmia
- Associated with the development of infantile hypertrophic pyloric stenosis
PP:
- more drug interactions than azithromycin and roxithromycin
- cross resistance between macrolides and lincosamides

26
Q

Roxithromycin (Roxar, Roximycin)

A

Macrolide
- Broad-spectrum antibacterials active against Gram-positive and some Gram-negative bacteria
MOA: inhibits bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome, interfering with the translocation process during protein synthesis.
I: URTI and LRTI, CAP, skin infections
D:
- >40kg: 150mg BD or 300mg OD
- 6-40kg: 2.5-4mg/kg BD
C: best 15 minutes before food
ADR: NVD, GI upset, candidal infections
PP:
- cross resistance between macrolides and lincosamides

27
Q

Penicillins

A

Spectrum:
* Narrow: Benpen, phenoxymethylpenicillin. Inactive against Enterococcus due to lower tissue concentration. Dicloxacillin and flucloxacillin are interchangable - inactive against MRSA and E. faecalis
* Moderate: Amoxicillin and ampicillin are interchangable
* Broad: + clavulanic acid or + tazobactam

ADR:
* Rash is most common with amoxi and ampi
* NV with amoxi/clav
* Severe hepatic ADR with fluclox > diclox
* Renal ADR with diclox > fluclox

28
Q

Amoxicillin

A

Penicillin
MOA:
I:
D:
C:
ADR:
PP:

29
Q

Amoxicillin with clavulanic acid

A

Penicillin
MOA:
I:
D:
C:
ADR:
PP:

30
Q

Ampicillin

A

Penicillin

31
Q

Benzathine benzylpenicillin

A

Penicillin

32
Q

Benzylpenicillin

A

Penicillin

33
Q

Dicloxacillin

A

Penicillin
MOA:
I:
D:
C:
ADR:
PP:

34
Q

Flucloxacillin

A

Penicillin
MOA:
I:
D:
C:
ADR:
PP:

35
Q

Phenoxymethylpenicillin

A

Penicillin
MOA:
I:
D:
C:
ADR:
PP:

36
Q

Piperacillin with tazobactam

A

Penicillin

37
Q

Procaine benzylpenicillin

A

Penicillin

Pharmacy AMH 2024 (23 decks)

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