Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NP Adv Pharm_S21 > Antibiotic Slide Deck > Flashcards

Antibiotic Slide Deck Flashcards

(54 cards)

Start Studying
1
Q

What are common causes of drug resistance?

A
    • Overuse of broad-spectrum abx.
    • Over prescription of abx. for viral illnesses
    • Use of abx in animals that enter the food chain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which type of bacteria has a cytoplasmic membrane surrounded by a touch rigid mesh cell wall?

A

Gram +

Ex: staph aureus, strep pneumoniae, clostridium - stain purple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which type of bacteria has a thin cell wall surrounded by a second lipid membrane?

A

Gram -

Ex: E. coli, pseudomonas, H. pylori, Neisseria, gonerrhea, salmonella - stain pink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of antibiotic stops the bacteria from growing but does not kill it?

A

Bacteriostatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of antibiotic kills the bacteria?

A

Bactericidal - important to use this type in patients that are immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Important factors to keep in mind when prescribing antibiotics:

A
    • immune system function
    • renal and hepatic function
    • Age
    • Pregnancy/lactation
    • Risk for multi-drug-resistance organisms
    • Patient adherence: lowest frequency for the shortest duration
    • cost effective - for kids: taste good and most concentrated dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the MOA of the penicillins?

A

Inhibit the biosynthesis of peptidoglycan bacterial cell wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Penicillin V and Penicillin G Benzathine are active against what type of organisms?

Are they narrow or broad-spectrum?

A

Narrow spectrum

Most effective against gram +

Mostly:

  • S. pneumoniae, Group A strep (GABHS) –> bactericidal Pen V (oral) is best for group A beta-hemolytic strep - strep throat/pharyngitis
  • syphilis infection (T. pallidum) –> Pen G (IV) best for
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Amoxicillin and Augmentin (Amox/Clavulanic Acid) are active against what type of organisms?

A

Broad spectrum, bactericidal

Gram +/-

  • Amoxicillin* - 1st line for AOM and sinusitis
  • Augmentin* (Amox/Clavulanic acid) - 1st line fx for bites, UTI in pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PCNs Adverse Drug Reactions (ADR)

A
  • serious allergic hx (anaphylaxis)
  • Rash - Stevens-Johnson syndrome
  • GI (N/V/D)
  • possible C.Diff associated diarrhea (CDAD)
  • Fungal overgrowth/candidiasis - Vaginitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cephalosporin MOA

A
  • Inhibit mucopeptide synthesis in the bacterial cell wall Bactericidal
  • 5 generation that is increasing in gram (-) coverage and less gm (+) coverage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Common Gm (+) and where the common infections they cause

A

•Staphylococcus aureus

  • Commonly causes skin infections
  • Can also cause endocarditis, sepsis, osteomyelitis, pneumonia
  • -Methicillin-resistant (MRSA) and methicillin-sensitive (MSSA)*

•Streptococcus Groups A,B,C,F,G

–Pyogenes (pharyngitis [GAS], impetigo, cellulitis)

–Pneumoniae (pneumonia, meningitis, sepsis)

–Agalactiae (meningitis, vaginitis [GBS], UTI, endocarditis, skin infection)

– Significant Macrolide resistance

•Enterococcus faecalis

–Anaerobic

–Can cause UTI, prostatitis, intra-abdominal infections, cellulitis, endocarditis

•Bacilli

–Lactobacilli -present in the mouth, vagina

–C. difficile

•Listeria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common Gm (-) organisms and the infections they cause

A

•Escherichia coli

–Found in the intestines of humans and animals

–Responsible for:

  • f_ood-borne illness (traveler’s diarrhea)_
  • UTI
  • cholecystitis, sepsis

•Pseudomonas aeruginosa

–Most common in hospitalized patients

–Can cause otitis externa, pneumonia, wound infection, UTI, sepsis

•Klebsiella pneumoniae

–Colonizes the human mouth and gut

–Commonly causes Pneumonia, UTI, sepsis

– Risks: ETOH use, DM

•Neisseria gonorrhoeae

•Haemophilus influenzae

–Pneumonia, bronchitis, otitis media, c_ellulitis, infectious arthritis_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the spectrum of activity differ between generations of Cephalosporins?

A

-Earlier generations have good gram + coverage and less gram - coverage

-Later generations have better gram - coverage and less gram + coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cephalosporins ADRs

A
  1. C. diff-associated infx in adults (Clostridioles)
  2. Hypersensitivity rx (most common) - cross rx PCN allergy (anaphylaxis, rash)
  3. Hemolytic anemia,
  4. Neutropenia, Leukopenia,
  5. Coagulation abnormalities (thrombocytopenia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cephalosporins cautions/CIs

A
  • hx of PCN allergy with anaphylaxis or hypersensitivity rx
  • -safe in pregnancy/lactation and pediatrics
  • The stronger the drug (later generation)-the more chance of a C. Diff infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What drug is in the glycopeptide class?

A

Vancomycin (PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vancomycin MOA and indication

A

MOA: inhibits cell wall synthesis by binding to the D-A1a-D-A1a protein in the cell wall; narrow, only Gm+

  • oral is not well absorbed so usually IV admin
  • stays in the GI tract

- used for C. diff. infection (given only orally for C.diff)

  • Corynebacterium, Listeria, Lactobicillus, Actinomyces, Clostridium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vancomycin (oral) ADRs

A
  • ototoxicity
  • nephrotoxicity

** monitoring for hearing and renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lincosamides Class (Clindamycin) active against/MOA

A

Clindamycin

narrow, Gm + , bacteriostatic

MOA: inhibits protein synthesis by binding to the 50S subunit of bacterial ribosome

Indications: MRSA skin infections, dental infections, acne (topical)

-Carries highest risk for C. Diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Clindamycin: education

A
  • take w/ full glass of water
  • sit or stand for 30 minutes after dose
  • call the clinic if diarrhea occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Macrolides: MOA/indications

Study These Flashcards
A

Azithromycin, Erythromycin, Clarithromycin

  • Gm + / - and atypical
  • Bacteriostatic @ low dose
  • Bacteriocidal @ high dose
  • Consider safe in pregnancy
  • Alternative to penicillin allergy
  • Consider macrolide-resistant S.pneumoniae if pt has taken a macrolide in the past 3 months
  • Convenient dosing (azithromycin[Z-pack]) only 5 days

MOA: inhibits RNA-dependent protein synthesis by binding to the 50S subunit

*Indications: *Think respiratory for this class**

  • 1st line CAP
  • 1st line pertussis
  • 1st line chlamydia (tx urethritis 2nd to chlamydia)

*

23
Q

Macrolides: ADRs

Study These Flashcards
A

- potent CYP450 inhibitor (esp erythromycin and Clarithromycin [Biaxin])

–> many major drug interactions

  • Interacts with Statins, Ca Channel blockers, antiretrovirals, colchicine, carbamazepine
  • -combination with statins (increase serum statins, risk of myopathy, rhabdomyolysis, hepatitis)
  • skin rash (urticaria, bullous eruptions, eczema, SJS)
  • GI distress (esp. Erythomycin)

Azithromycin is most common well-tolerated macrolides (rare GI effects) - the risk of QT prolongation (cautions with pts with Dysrhythmias)

24
Q

Tetracyclines: MOA/indications

Study These Flashcards
A

Tetracycline/Doxycycline

MOA: inhibit protein synthesis by reversibly binding to the 30S subunit of the bacterial ribosome

  • -Work against gm +/- and atypical
  • -BacterioSTATIC

Indications:

  • Doxy 1st line for Rocky Mountain spotted fever (RMSF) and Lyme dz
  • CAP (2nd line)
  • Mild to moderate respiratory tract infection (atypical), AECB, skin (acne, rosacea)
25
Tetracyclines: Cautions/CI/ADRs
- **Avoid in pregnancy (Cat D), lactation, and children \< 8 years old** * d/t **teeth discoloring** **- Avoid antacids** as they are ***Inactivated by Ca+ and aluminum*** _ADRs:_ * - nephrotoxic * - hepatotoxicity * - photosensitivity (use hat sunblock)
26
Tetracyclines: Education
* Take with a full glass of water * **Do not take with milk or milk products (binds to calcium**) * Best to take 1 hr before or 2 hrs after a meal * or Take on an empty stomach * Can cause **stomach upset/esophagitis** * ***May decrease effectiveness of oral contraceptives*** * Wear sunglasses, hats, sunblock when expose
27
Fluoroquinolones: MOA
**Ciprofloxacin, Levofloxacin** _MOA_: interferes with bacterial enzymes required for the **synthesis of bacterial DNA** - breakage of DNA strands/Inhibit DNA synthesis
28
Fluoroquinolones: INDICATIONS
Complicated severe infections * - pyelonephritis (1st line) * - complicated UTIs * CAP (3rd line) - * after tetracycline (2nd line)
29
Fluoroquinolones: cautions/CIs/ADRs
- **_BBW:_** * risk of **tendon rupture and tendonitis** * risk fo **aortic dissection** - risk of **QT prolongation** (avoid use with other QT-prolonging drugs like amiodarone, macrolides, TCA), **-dizziness, confusion, seizures, photosensitivity** - high risk of **superinfection** (C.Diff, candida) * Increasing resistance - not to be used for minor uncomplicated infections _Contraindications:_ * **children \< 18** (unless pyelonephritis, anthrax, allergies to other meds) * pregnancy (Cat C) and lactation * elderly * **hx of HTN, aneurysm, CVD** * myasthenia gravis
30
**Sulfonamides/Trimethoprim** (SMX/TMP) - MOA
Sulfonamides ***inhibit folic acid synthesis*** Trimethoprim ***inhibits DNA synthesis*** Excellent **Broad spectrum,** both **gm +/-**
31
Sulfamethoxazole and Trimethoprim (Bactrim) Indications
**- UTI** **-Community-acquired MRSA** -excellent gram - (E.coli, Klebsiella, H. flu) and gram + (staph and strep) coverage, **-pneumocystis, chlamydia**
32
Sulfonamides and Trimethoprim: Cautions/CIs
Common _hypersensitivity reactions:_ * rash, fever, SJS (more common in HIV + patients) _Contraindications_ * ***pregnancy (anti-folate effects)* - esp in 1st trimester** * pediatrics **\< 2 months old** (risk of hyperbilirubinemia) ***-Avoid concomitant** administration with **K+ sparing drugs*** (triamterene, ACE, ARB) d/t Hyperkalemia (reduces K+ excretion) **-Avoid with warfari**n (increase risk of bleeding, increase INR)
33
**Nitrofurantoin**: MOA/Indications
•Multifactorial MOA **•Bacteriostatic in low concentrations,** Bactericidal in higher concentrations -May *inhibit acetyl coenzymes -*-\> interferes with bacterial protein synthesis, cell wall synthesis, and aerobic energy metabolism Indications: _Indication:_ * **uncomplicated UTI (1st line),** * Not indicated in complicated infections/pyelonephritis
34
Nitrofurantoin ADRs
neuropathy, pulmonary reactions
35
Metronidazole [Flagyl]: MOA/Indications
_MOA_: Damage DNA structure -- causing strand breakage, inhibition of protein synthesis, and cell death * **BROAD**-spectrum (**gm +/- anaerobic bacteria and parasitic: protozoans, fungal)** * **Bacteriostatic** _Indications_: * C. diff, * **bacterial vaginosis,** * **stool infections,** * trichomoniasis (think below the belt infections), giardia
36
Metronidazole ADRs
* metallic taste * dark urine * **hepatotoxicity** * superinfections (rare)
37
Metronidazole: cautions/CIs/pt education
**- AVOID in the 1st trimester of pregnancy** - take **with food** - **Avoid ETOH** during and for 2 days after tx (**can cause _disulfiram_ rx:** N/V, H/A, flushing, dizziness, chest and abdominal discomfort) - **BBW:** p*otentially carcinogenic*
38
**Tinidazole:** MOA/indications
_MOA:_ thought to cause cytotoxicity by damaging DNA and preventing DNA synthesis **- newer, more expensive** _Indications_: bacterial vaginosis, trichomoniasis - **more for fungal, protozoan, parasitic infections** - not as much bacterial
39
Tinidazole cautions/CIs
**- Avoid in pregnancy** **- BBW:** potentially carcinogenic
40
Impetigo treatment
1. **Mupirocin** (Bactroban; monoxycarbolic acid class) **topically** 3x/day for 5-14 days for **up to 5 lesions** 2. **Cephalexin** [Keflex] or Cefadroxil [Duricef] (PO, *a cephalosporin 1st gen*) if there are ***5 or more impetigo lesions***
41
**Oral** medication options for **SKIN LESIONS**
* Cephalosporin 1st gen (Cephalexin, Cefadroxil), Augmentin, Bactrim (TMJ, SMZ) * ***moderate to severe impetigo (5 or more lesions)*, boils, perianal strep, cellulitis** * CBD (cephalexin, bactrim, doxycycline) * **Dicloxacillin If MRSA skin i**nfection is suspected
42
Oral **Candidiasis** treatment
Antifungal: * **nystatin or clotrimazole lozenges**
43
**Antifungal** agents
- used to **treat vulvovaginal yeast infections** - Topical * **Miconazole** and **clotrimazole** - Oral * **Fluconazole** oral (systemic) x 1 dose
44
**Topical** treatment of **tinea pedis** (athlete's foot) or tinea **corporis** (ringworm)
- thin layer of **terbinafine, miconazole, ketoconazole, clotrimazole** - use **BID** **- wash hands well before and after use**
45
Topical **HERPES** simplex (Shingles) treatment
- topical **acyclovir (**zovirax) , or **penciclovir** (denavir, and OTC docosanol (Abreva)) - s**tart as soon as possible**
46
**Fluconazole (Oral)** MOA/indications
- interferes with fungal CYP 450 activity - inhibits cell membrane formation **- broad-spectrum, antifungal, systemic effect** _Indications:_ **candidiasis (vaginal, oropharyngeal, esophageal)**
47
Fluconazole: cautions/CIs
**-Hard on liver** --\> Monitor hepatic function * CYP 3A4 and 2C9 inhibitor **-QT prolongation** --\> check EKG **-Avoid in pregnancy**
48
**Itraconazole** MOA/indications
* interferes with fungal CYPE 450 activity * - inhibits cell membrane formation * **broad-spectrum systemic** treatment _Indications:_ **onychomycosis** (nail fungus) but *Terbinafine/Ciclopirox (topical) is first-line for Onychomycosis*
49
**Itraconazole** cautions/CIs
- hard on the liver - QT prolongation **- avoid in pregnancy** **- BBW:** avoid in ***patients with HF/myocardial dysfunction***
50
**Terbinafine/Ciclopirox (topical)** : MOA/indications
* synthetic allylamine derivative * inhibits squalene eposidase enzyme (a key enzyme in sterol biosynthesis in fungi * results in fungal cell death * ***metabolized by CYP450*** _Indication_: **onychomycosis (1st line)** * _Off label:_ extensive ***tinea fungal infection***
51
**Terbinafine** cautions/CIs
**- arrhythmias (think QT)** **- hepatic** impairment **- avoid in pregnancy**
52
Terbinafine ADRs
* hepatotoxicity hepatic failure * blood dyscrasias
53
Amoxicillin
* **Broad** spectrum beta-lactam penicillin * both Gm +/- but **more effective against gram (-)** * **Bactericidal** * **PO 2-3x/day** * Against * *Group A strep, S. pneumo, staph, H. influenza*
54
**Amoxicillin/Clavulanic acid** [Augmentin]
For otitis media, sinusitis, lower RI, skin (cellulitis), bites

NP Adv Pharm_S21 (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions