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Antibiotics Flashcards

(75 cards)

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1
Q

What is the first line medication choice for strep?

A

Penicillin

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2
Q

What is the second line medication choice for strep in a patient with a penicillin allergy?

A

1st generation Cephalosporin, if the PNC allergy is mild

Azithromycin/Erythromycin, if PNC allergy mod/severe

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3
Q

What is the first line medication for cellulitis related to a bite?

A

Penicillin, specifically amoxicillin/clavulanate

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4
Q

What is the second line medication choice for cellulitis related to a bite if the patient has a penicillin allergy?

A

Cipro or clindamycin

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5
Q

What is the first line medication for a soft tissue injury cellulitis?

A

1st generation cephalosporin such as Keflex

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6
Q

What is the first line treatment for MRSA?

A

Clindamycin

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7
Q

What is the first line treatment for an complicated UTI?

A

Cipro

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8
Q

What is the first line treatment for an uncomplicated UTI?

A

Bactrim

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9
Q

What medication is used for an open wound, soft tissue infection topically?

A

Silver sulfadiazine (but falling out of favor with increased EBP on it being no more effective then bacitracin)

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10
Q

What is the simple mechanism of action of the pencillins?

A

They break the cell wall to cause bacterial lysis

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11
Q

What are the adverse side effects of penicllin?

A

N/V/D, rash, allergic reaction, fungal growth, C. Diff

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12
Q

What drug combined with penicillin can increase the adverse effect of diarrhea?

A

Clavulanate

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13
Q

When does the allergic reaction to penicillin normally occur?

A

Within the first 30 minutes, but it can be delayed

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14
Q

What is the pregnancy category for pencillin?

A

Category B

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15
Q

If a patient has an allergy to one penicillin, can they take a different penicillin in the class?

A

No, they must not be prescribed others due to cross sensitivity among all penicillins in the class

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16
Q

What is the mechanism of action of the cephalosporins?

A

Similar to penicillin in that they also cause bacterial lysis

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17
Q

What is the adverse effects of the cephalosporins?

A

allergic reactions, rashes, blood dyscrasias, fever, seizures, renal/hepatic failure

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18
Q

What generations of cephalosporins treat gram-negative bacterias?

A

Some 3rd and almost all 4th/5th generations

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19
Q

What is a common 1st generation cephalosporin?

A

Keflex

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20
Q

What is a common 2nd generation cephalosporin?

A

Cefzil

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21
Q

What are common 3rd generation cephalosporins?

A

Rocephin, Vantin, Cefpoxidine, Ceftriaxone

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22
Q

What is the pregnancy category for cephalosporins?

A

Category B

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23
Q

What are common indications for cephalosporin use?

A 
Otitis media (not responsive to PNC)
1st generation for skin infections or strep
Chlamydia
Community acquired PNA
2nd line therapy for UTIs
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24
Q

What are common indications for PNC use?

A

Otitis media
Sinusitis
Strep
Skin infections (cellulitis)

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25
When would you caution using a cephalosporin medicaiton?
In a patient with a severe allergic reaction to PNC as there can be a small chance of cross sensitivity and they could have a severe reaction to cephalosporins
26
What are the fluoroquinolone antibiotics?
Ciprofloxacin, Levofloxacin, and Moxifloxacin
27
What is the mechanism of action of the fluoroquinolones?
They inhibit bacterial synthesis
28
What type of bacteria do the fluoroquinolones work extensively on?
Gram-negative bacteria
29
What are the adverse effects of the fluoroquinolones?
drowsiness, dizziness, angina, A. Flutter, colitis, photosensitivity
30
Who are fluoroquinolones contraindicated in?
Patients with myasthenia gravis and pregnant women
31
What is the black box warning for fluoroquinolones?
Tendon rupture
32
How long after the fluoroquinolones are discontinued can the tendon rupture occur?
up to 120 days after the medication has ended
33
Who is at greatest risk for the tendon rupture adverse effect of fluoroquinolones?
The elderly
34
What are the common indications for fluoroquinolone use?
Complicated UTIs Chronic bronchitis exacerbation Recurrent pneumonia Penicillin resistant strains of skin infections and infectious diarrhea
35
How should fluoroquinolones be administered?
On an empty stomach and with a full glass of water if possible, DO NOT take with dairy products if they cannot tolerate an empty stomach as they delay absorption
36
What is the mechanism of action of clindamycin?
It inhibits protein synthesis, thus slowing growth
37
What are the adverse effects of clindamycin?
rash, burning, itching, neutropenia, thrombocytopenia
38
What is the black box warning for clindamycin?
severe colitis
39
What bacteria does clindamycin work against?
gram-positive ONLY
40
What is the pregnancy category for clindamycin?
Category B
41
What are the common indications for clindamycin?
MRSA Dental infections Gram-positive bacteria with PNC allergic patients Drug resistant strep
42
When in clindamycin considered a first-line therapy?
Pregnant women, children, PNC allergic patients
43
If a patient on clindamycin develops diarrhea, what is the next step?
Stop the medication as this is a BBW for severe colitis development
44
What are the macrolide medications?
Azithromycin, erythromycin, clarithromycin (-mycins)
45
What is the growing problem with the macrolides in this area?
Increasing drug resistance due to over-prescribing
46
What is the mechanism of action of the macrolides?
They inhibit protein synthesis, slows bacterial growth
47
What are the adverse effects of the macrolides?
N/V/D, QT prolongation, GI upset, hepatotoxic, ototoxic, SJS, C. Diff
48
What are the common indications for macrolide use?
``` PNC allergy alternative 1st line for community acquired pneumonia Chlamydia Pertussis H. pylori ```
49
What is the pregnancy category for macrolides?
Category B
50
What is the mechanism of action of the sulfonamides?
Inhibits the synthesis of folic acid, bacteriostatic
51
What is the primary sulfonamide in use today?
Trimethoprim-Sulfamethoxazole (Bactrim)
52
What is the primary use of Bactrim?
UTI treatment
53
What are the adverse effects of Bactrim?
GI upset, rash, hyperkalemia, SJS, blood dyscrasias, crystalluria
54
What is the pregnancy category for Bactrim?
Category C
55
What are the tetracycline medications?
Tetracycline, doxycycline, minocycline
56
What is the mechanism of action of the tetracyclines?
Inhibits bacterial synthesis, bacteriostatic
57
What are the adverse effects of tetracyclines?
GI upset, teeth discoloration, hepatotoxic, renal damage (excreted unchanged), superinfections (C. Diff, MRSA, increasing resistance)
58
Can tetracyclines be given to children?
Only over the age of 8, should seek other options 1st
59
Can tetracyclines be given to pregnant women?
No, they can cause permanent teeth discoloration in the fetus and have other teratogenic effects.
60
What foods/supplements should be avoided with tetracyclines?
Iron supplements, magnesium supplements, calcium products, antacids
61
How should tetracyclines be administered?
On an empty stomach as food delays absorption, DO NOT give with milk even if unable to tolerate on an empty stomach
62
What is the common indications for tetracyclines?
Doxy: trachomatis, ureplasma Tetracycline: P. acne, H. pylori, lyme disease
63
What is the mechanism of action of vancomycin?
Inhibits cell wall synthesis
64
What are the adverse effects of vancomycin?
Ototoxicity, nephrotoxicity, Red Man Syndrome
65
What is the clinical indication for vancomycin?
Gram-positive bacteria resistant to other medications, specifically MRSA and C. Diff
66
What are ways to prevent resistance?
Only use antibiotics for true bacterial infections Try to prescribe for the narrowest spectrum possible Obtain culture/sensitivities if possible Follow CDC guidelines on resistance patterns
67
Who is most susceptible to drug resistant organisms?
Children <2 y/o Adults >65 y/o Children and childcare workers in daycare settings Families exposed to children at daycare settings Patients with multiple comorbidites Immunosuppressed patients Recent antibiotic use
68
What are patient education points to help prevent drug resistance?
Proper hand hygiene Use antibiotics as prescribed and complete the whole dose as prescribed even if starting to feel better Get vaccinated for specific illnesses if possible
69
What is the mechanism of action of metronidazole?
bacteriostatic, treats bacterial and parasitic infections
70
What are the adverse effects of metronidazole?
anorexia, N/V, dizziness, headache, metallic taste
71
What are the common indications for metronidazole use?
Anaerobic bacteria infections Bacterial vaginosis H. pylori
72
Can metronidazole be given in pregnancy?
Yes, after the first trimester
73
What should patients taking metronidazole avoid?
Alcohol as it can cause a disulfarism reaction
74
What is the first line therapy for CAP?
Azithromycin
75
What is 2nd line therapy for CAP?
Cephalosporins

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