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Pharmacology > Antibiotic I/II > Flashcards

Antibiotic I/II Flashcards

(110 cards)

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1
Q

Antimicrobial therapy takes advantage of what kind of differences between microorganisms and humans

A

Biochemical

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2
Q

What occurs when Abx can kill or injure invading organisms without becoming harmful to the host

A

Selective toxicity

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3
Q

Selective toxicity is considered ________ (meaning some people actually could have reactions)

A

Relative

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4
Q

What 6 things are considered when selecting an abx

A
  • identity of organism
  • susceptibility to particular agent
  • site of infection
  • specific host/pt factors
  • safety and efficacy of agent
  • cost of therapy
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5
Q

What type of direct microscopic visualization allows you to identify the characteristics of the organism fast

A

Gram staining

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6
Q

Gram positive bacteria stains what color

A

Purple

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7
Q

Gram negative bacteria stains what color

A

Red

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8
Q

Why would an organism not gram stain?

A

Abnormal cell wall, might need an acid fast stain or other options

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9
Q

Gram staining is used to differentiate groups of bacteria based on their different ________

A

Cell walls

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10
Q

Gram positive cell walls have ______ peptidoglycan

A

Thick

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11
Q

Gram negative cell walls have _____ pepidoglycan

A

thin

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12
Q

What is a way to grow more of an unknown bacteria and test how is responds to different abx to identify it

A

culture and sensitivity

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13
Q

What kind of abx therapy involves giving abx when the cause of the infection is yet to be determined

A

empiric therapy

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14
Q

What four broad things should be considered when undergoing empiric therapy

A

severity of illness
suspected pathogen
pt hx and prior therapy
relevant epidemiologic factors

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15
Q

What kind of abx therapy involves the basis of predicted identification of pathogen, susceptibility profile, and establishment of extent of infxn

A

directed therapy

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16
Q

What word means inhibition of bacterial growth or replication

A

bacteriostatic

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17
Q

What three things of the pathogen does a bacteriostatic therapy target

A

cell wall
protein synthesis
metabolic pathways

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18
Q

Bacteriostatic therapy is considered only when the patient’s host defenses are _________ enough to eradicate the infecting pathogen

A

sufficient

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19
Q

What therapy results more directly in cell death (actually kills)

A

bactericidal

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20
Q

Bactericidal therapy is preferred in what two kinds of patient cases

A

immunosuppression (neutropenia)

areas with limited host defenses immune (meningitis, endocarditis)

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21
Q

What is the term for the loweest antimicrobial concentration that prevents growth of an organism after 24 hrs

A

minimum inhibitory concentration (MIC)

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22
Q

What term is the lowest concentration of an antimicrobial agent that results in 99.9% decline in colony count after an overnight incubation

A

minimum bactericidal concentration (MBC)

— not really used clinically

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23
Q

What are 4 sites of infection that are difficult to reach

A

prostate/testes
vitreous body
abscess/osteomyelitis
CNS

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24
Q

For pts with immune function problems or asplenia, how should you treat an initial infection

A

early and broadly

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25
In asplenic pts, treatment should include coverage of what kind of organisms
S. pneumo
26
Pregnancy is associated with increased risk of certain infections like ... (2)
listeria toxoplasmosis
27
Most abx fall into what pregnancy category
B/C
28
When taking a detailed abx Hx, what two questions do you ask
when was the allergy? what was your reaction?
29
What 4 abx interact with warfarin (coumadin)
ciprofloxin (cipro) levofloxacin (levaquin) TMP-SMX (bactrim) metronidazole (Flagyl)
30
the least toxic abx interfere with the _____________ unique to the organism
site/function
31
What 3 abx are inhibitors of cell wall synthesis
PCNs cephalosporins vancomycin
32
what two abx are Inhibitors of protein synthesis
doxycycline azithromycin (Zithromax)
33
What 2 abx are beta lactams
PCNs Cephalosporins
34
What class is doxycycline in?
tetracycline
35
what class is azithromycin
macrolides
36
What 3 abx are bactericidal
ciprofloxacin levofloxacin metronidazole
37
What class are cipro and levaquin in
quinolones and fluroquinolones
38
What are the two categories of penicillins
natural broad/extended spectrum
39
What are the two natural penicillin's
Penicillin G Penicillin VK
40
Which natural penicillin is given parenteral (IV) or short acting IM
penicillin G
41
Which natural penicillin is given orally
penicillin VK
42
natural Penicillin is highly active against gram ____ bacteria
positive (+ cocci, +rods)
43
What is a gram+ cocci natural penicillin works against
streptococcus agalactiae
44
What are some exceptions of resistance for natural penicillin's (2)
some staphylococci strep pneumo
45
whats a gram + rod natural penicillin works against
listeria
46
What gram - cocci responds to natural penicillin
Neisseria meningitidis
47
Natural penicillins do not work against gram- bacilli because poor penetration of ______ channels
porin
48
What bacteria is a major cause of sepsis and meningitis in neonates
Group B Streptococcus (s. agalactiae)
49
What helps reduce group b strep in neonates
prenatal screening of mother (35-37 weeks)
50
If a mom has group b strep before birth she is given a prophylactic treatment of which 2 abx
PCN G or cefazolin
51
What can broad PCNs target
gram- and gram +
52
What are the two 4th gen broad PCNs used for sepsis in hospitals
piperacillin zosyn
53
What are "easy" gram - that ampicillin and amoxicillin cover
e coli proteus h. influenza h. pylori shigella klebsiella
54
what two abx are first line for otitis media, sinusitis, and minor oral infections
ampicillin amoxicillin
55
What class has little intrinsic antibacterial activity, but work to inhibit activity of beta lactamase enzymes produced by certain bacteria
beta lactamase inhabitants
56
what are the 3 beta-lactamase inhibitors
clavulanate sulbactam tazobactam
57
What are used in resistant otitis media and sinusitis, lower resp infxns, UTI
b-lactam inhibitors combo with other abx (aka Augmentin)
58
What is the 1st line in dog bites
Augmentin (AUGGY for the doggy, dAUGmentin)
59
What is the gram- bacteria in dogs mouth that causes cellulitis
pasturella multocida
60
What populations are at greater risk for pasturella multocida
infants elderly immunocompromised
61
If you get a dogbite and are PCN allergic, what do you use?
quinolones (levaquin)
62
all Pcns have a risk for what hypersensitivity caused by mast cell release
IgE
63
if you have this sickness and take a PCN you will get a rash
mono/EBV
64
Augmentin is the #1 med that has the risk of causing what injury
acute hepatitis (DILI)
65
early generations of cephalosporins have what kind of coverage
gram+
66
What do higher generations are cephalosporins cover
gram- (3rd gen) pseudomonas (4/5th)
67
what are the 2 first gen cephalosporins that are used for prophylaxis in surgery and common for skin infections (cellulitis/folliculitis)
cefazolin cephalexin
68
What should 1st gen cephalosporins not be used for
resp infxns animal bites colon surgeries
69
what 2nd gen cephalosporin is effective for resp infxns caused by strep pneumo, h influenza, and m cattarhalis
cefuroxime
70
cefuroxime (2nd gen) can cover GAS and staph aureus but not what
MRSA
71
What 3rd gen cephalosporins cover staph, non-enterococcal strep, gram negs like gonorrhea, and oral anaerobes -- BUT NOT pseudomonas
cefotaxime ceftriaxone (rocephin)
72
What 3rd gen cephalosporin covers pseudomonas but not as good with gram+ or anaerobes
ceftazidime
73
3rd gen cephalosporins treat epiglottitis which is caused by what bacteria
haemophilus influenza
74
epiglottitis in children 2-7 causes what symptoms
sore throat fever drooling airway obstruction
75
What is the 1st line tx for h flu
cephalosporins 3rd gen
76
Ceftriaxone can cause what to build up (what side effect)
biliary sludge
77
T/F cephalosporins do not have cross reactivity with PCN allergy
F
78
What is a glycopeptide abx with no beta lactam ring that is a huge chemical structure
vancomycin
79
vancomycin only works against gram ____ bacteria
+
80
Vancomycin is the first line agent for what infection
c diff
81
T/F if you have C diff, an IV of vancomycin will not work in treating
T
82
What is a gram+ bacteria that forms spores, transmits via fomites, and ROA is fecal-oral
c diff
83
What are 3 risk factors for c diff
recent abx within 2 months recent hospitalization chronic gastric acid suppression
84
What abx if taken within 2 months prior put you at risk for c diff
fluroquinolone clindamycin cephalosporin PCNs
85
what infection results in watery diarrhea, abdom cramping, nonbloody stool, low grade fever, and leukocytosis
c diff colitis
86
Vancomycin for c diff only works if its given what way
PO
87
What is a side effect for vancomycin used IV
red man syndrome --- IV flushing =histamine release`
88
What drug class has activity against aerobic gram+ and gram-, as well as atypical things like mycoplasma and chlamydia
tetracyclines
89
What tetracycline works against MRSA
doxy
90
What is first line for tick born illness
doxy
91
What disease is from Dermacentor dog tick with rash that starts on limbs and moves to trunk that can cause limb loss, MSOF, and Death (rickettsia rickettsii)
Rocky mountain spotted fever
92
Doxy is preferred for what populations with rock mountain spotted fever
ALL (except preg)
93
What are bad effects of doxy
tooth discoloration bony growth retardation photosensitivity diarrhea /N/V
94
who should not take doxy
<8y/old pregnant
95
What class is used for broad spectrum against gram+ and atypical pathogens
macrolides
96
What is azithromycin often used to treat
B pertussis
97
What drugs can macrolides interact with
statin === myopathy warfarin
98
Side effects of macrolides (4)
drug interactions QT prolongation GI upset hepatotoxicity
99
What disease does b pertussis cause
whopping cough
100
What class blocks movement of the DNA replication apparatus and generates breaks in double strand
quinolones/ FQs
101
What quinolone covers most aerobic gram- including pseudomonas and is able to penetrate the CNS, prostate, and lungs
ciprofloxacin
102
What FQ is great for respiratory pathogens and enteric gram-, atypicals, and pseudomonas
levofloxacin
103
cautions for quinolone/FQs are what (3)
Tendon Rupture QT prolonged CNS toxicity
104
Quinolones/FQs in kids can cause what
articular cartilage damage
105
What abx only works on anaerobic bacteria and anaerobic protozoa (NO AEROBES
metronidazole (flagyl)
106
what 3 infections are metronidazole used for
parasites (giardia) bacterial vaginosis anaerobes in the gut (bacteroides)
107
What is the most common intestinal parasite in the world from contaminated drinking water
giardia lamblia
108
what is the incubation period of giardiasis
1-3 weeks
109
What is cautioned for metronidazole
reduced dosing in liver disease increase the effect of warfarin
110
side effects of metronidazole (8)
nausea, GI toxic anatabuse rxn w/ etoh HS seizure peripheral neuropathy dry mouth metallic taste

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