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Adv. Pharm > Antibiotics > Flashcards

Antibiotics Flashcards

Exam 3 (106 cards)

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1
Q

What drug classes are antibiotics?

A

Penicillin
Cephalosporin
Macrolide
Tetracycline
Fluoroquinolone
Sulfa
Aminoglycosides
Other (Nitrofurantoin, Metronidazole, Vancomycin, Linezolid

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2
Q

What drug classes are antifungal?

A

Azoles
Non-azoles

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3
Q

What drug classes are antivirals?

A

Anti-herpes virus
Anti-influenza
COVID antiviral
HIV therapy

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4
Q

What drugs are in the Penicillin class?

A

Amoxicillin
Amoxicillin/clavulanate
Penicillin G
Piperacillin/tazobactam

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5
Q

What drugs are in the Cephalosporin class?

A

Cephalexin
Ceftriaxone
Cefazolin
Cefdinir

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6
Q

What drugs are Macrolides?

A

Azithromyacin

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7
Q

What drugs are tretracyclines?

A

Doxycycline

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8
Q

What drugs are Fluoroquinalones?

A

Levofloxacin
Ciprofloxacin

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9
Q

What drugs are Sulfa?

A

Trimethoprim/sulfamethoxazole

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10
Q

What drugs are aminoglycosides?

A

Gentamicin

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11
Q

What antibiotic drugs are “other”?

A

Nitrofurantoin
Metronidazole
Vancomycin
Linezolid

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12
Q

What drugs are Azoles?

A

Ketoconazole
Fluconazole

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13
Q

What drugs are non-Azoles?

A

Terbinafine
Amphotericin B
Nystatin

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14
Q

What drugs are anti-herpes virus?

A

Acyclovir
Ganciclovir

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15
Q

What drugs are Anti-influenza?

A

Oseltamivir

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16
Q

What drug is a COVID antiviral?

A

Paxlovid

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17
Q

What drugs are for HIV therapy?

A

Reverse Transcriptase Inhibitors (Emtricitabine, Efavirenz)

Protease Inhibitor (Ritonavir)

Integrase Inhibitor (Bictegravir)

Fusion Inhibitor (Enfuvitride)

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18
Q

What drugs are Reverse Transcriptase Inhibitors?

A

Emtricitabine
Efavirenz

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19
Q

What drug is Protease Inhibitor?

A

Ritonavir

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20
Q

What drug is Integrase Inhibitor?

A

Bictegravir

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21
Q

What drug is Fusion Inhibitor?

A

Enfuvitride

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22
Q

What are the rash/skin adverse reactions common with Penicillins?

A

Steven-Johnsons Syndrome (SJS)
<10% BSA

Toxic Epidermal Necrolysis (TEN)
>30% BSA

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23
Q

Penicillins: MOA?

A

Inhibits bacterial cell wall synthesis -> weakened cell wall -> cell wall lysis

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24
Q

Penicillin- Indication?

A

Gram-positive bacteria (with thicker cell wall)
Examples:
Staphylococcus
Streptococcus
Pneumonia
Cellulitis
Cystitis
Otitis media (Amoxicillin first line if acute)

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25
Penicillin- side effects?
Increased seizure risk- w/ renal accumulation (renal failure- dose adjust) GI upset Rash (SJS/TEN)
26
Penicillin- monitoring?
Renal function Symptoms of anaphylaxis w/ 1st dose
27
Penicillin G
Antibiotic- Natural Penicillin IV or IM Narrow coverage
28
Amoxicillin
Antibiotic- aminopenicillin Medium Coverage PO First line for acute otitis media Endocarditis prophylaxis
29
Amoxicillin/clavulanate
Antibiotic- Penicillin/penicillinase inhibitor combination Broader coverage PO First line for acute otitis media Sinus infections
30
Piperacillin/tazobactam
Antibiotic- Penicillin/penicillinase inhibitor combo Broadest Coverage IV Pseudomonas (only penicillin that is)- ex. hospital acquired pneumonia
31
Cephalosporins- MOA?
Inhibits cell wall synthesis -> weakened cell wall -> cell death Excreted by kidneys- except ceftriaxone (1st gen.: Cephalexin, cefazolin) (3rd gen.: Ceftriaxone, cefdinir)
32
Cephalosporins- Indications?
Bacterial Infections Ex: Cellulitis Impetigo Pneumonia (1st gen.: Cephalexin, cefazolin) (3rd gen.: Ceftriaxone, cefdinir)
33
What is a gram positive bacteria?
One that needs oxygen Causes soft tissue infections (cellulitis, impetigo, etc.) Ex: Streptococcus, MSSA
34
What is a gram negative bacteria?
One that doesn't need oxygen (thicker cell wall) Causes UTI, gastroenteritis, pneumonia, etc. Ex: Non-PsA, Pseudomonas, Acinetobacter, E. coli
35
Cephalexin / Cefazolin- what generation and HENPECKS status?
1st gen: PEK Proteus, E. coli, Klebsiella (Strep, MSSA, some non-PsA- gram neg.)
36
What cephalosporins offer the most gram positive coverage?
Cephalexin Cefazolin (1st gen)
37
What cephalosporins offer coverage for gram positive and only PEK? (Proteus, E. coli, Klebsiella)
Cephalexin Cefazolin (1st gen.)
38
2nd Gen cephalosporin- HENPECKS status?
Gram positive and HNPEK Haemophilus Neisseria Proteus Klebsiella
39
1st gen Cephalosporin- HENPECKS status?
Gram positive and PEK Proteus, E. coli, Klebsiella (Cephalexin & Cefazolin)
40
3rd gen Cephalosporin- HENPECKS status?
Gram positive and HENPECKS Haemophilus, E.coli, Neisseria, Proteus, Enterobacter, Citrobacter, Klebsiella, Serratia (Ceftriaxone & Cefdinir)
41
What does HENPECKS stand for?
Haemophilus, E.coli, Neisseria, Proteus, Enterobacter, Citrobacter, Klebsiella, Serratia
42
Cephalosporins- side effects?
Type 1 penicillin allergy -> anaphylaxis Risk of seizures if accumulated ex. w/ renal failure GI upset, diarrhea, allergic reactions, rash (SJS/TEN) (1st gen.: Cephalexin, cefazolin) (3rd gen.: Ceftriaxone, cefdinir)
43
Cephalosporins- notes/monitoring?
Renal function, anaphylaxis w/ 1st dose, CBC, LFTs (1st gen.: Cephalexin, cefazolin) (3rd gen.: Ceftriaxone, cefdinir)
44
What drug is a glycopeptide?
Vancomycin
45
Vancomycin- indications?
Gram + bacterial infections only, including anaerobes MRSA Streptococci Enterococci C. difficile (PO only) Ex: sepsis, pneumonia, colitis
46
Vancomycin- MOA?
Inhibits cell wall synthesis -> Weakens cell wall -> lysis
47
Vancomycin- side effects?
Nephrotoxicity Ototoxicity Vancomycin infusion reaction (too fast): rash, hypotension, flushing, chills -(tx- slow down, add Benadryl to manage rx)
48
Vancomycin- formulations?
IV, PO, PR
49
What drug is a macrolide?
Azithromycin
50
Azithromycin- indications?
Atypical bacterial infections- Legionella Chlamydia Mycoplasma Ex: bronchitis, pneumonia, GU infections
51
Azithromycin- MOA?
Inhibits bacterial protein synthesis -> inhibits bacterial growth -> bacterial death
52
Azithromycin- side effects?
QT prolongation (caution & monitoring w/ methadone) Contraindicated w/ lovastatin or simvastatin Caution w/ Warfarin (increased INR)
53
What drug is a tetracycline?
Doxycycline
54
Doxycycline- indications?
Broad-spectrum, alt. to penicillin in syphilis Ex: Lyme disease, tick-borne illnesses, CAP, COPD exac., sinusitis, VRE (vancomycin resistant) UTI, STI
55
Doxycycline- side effects?
Photosensitivity Skin reactions GI inflammation/ulceration Contraindicated in: pregnancy breastfeeding children <8yeas can suppress bone growth, skeletal development, teeth discolorationD
56
Doxycycline- notes?
Sit upright >30min to avoid esophageal irritation Separate from antacids/polyvalent cations- multivitamins can inhibit absorption
57
What drug is an oxazolidinone?
Linezolid
58
Linezolid- indications?
Anaerobes and Gram + bacteria, alt. to penicillin Vancomycin-resistant enterococci (similar to vancomycin, plus VRE)
59
Linezolid- MOA?
Inhibits protein synthesis Binds to unique site, different than other antibiotics w/ similar MOA -> effective against bacteria resistant to other meds, ex: vancomycin & methicillin
60
Linezolid- side effects?
Serotonergic drug -> risk of serotonin syndrome (increased risk with SSRI use) Contraindicated: tyramine foods- aged cheese, soy beans, cure/smoked meats, dried fruits
61
Linezolid- formulations?
IV, PO
62
What drug is a folic acid inhibitor?
Trimethoprim (TMP) /Sulfamethoxazole (SMX)
63
Sulfamethoxazole (SMX) / Trimethoprim (TMP) - indications?
Gram - bacteria , Broader spectrum, opportunistic pathogens Ex: UTIs purulent SSTIs (oral MRSA covered) SBP (spontaneous bacterial peritonitis) prophylaxis PJP pneumonia (fungal)
64
Sulfamethoxazole (SMX) / Trimethoprim (TMP) - MOA?
Inhibits synthesis of proteins and nucleic acids -> kills bacteria
65
Sulfamethoxazole (SMX) / Trimethoprim (TMP) - side effects?
Skin reactions (SJS/TEN) Thrombocytopenic purpura (TTP) G6PD deficiency Photosensitivity Increased potassium Hemolytic anemiua Crystalluria (take w/ water) N/V/D Renal failure Increased INR w/ warfarin Contraindicated if sulfa allergy (bc sulfa drug)
66
Sulfamethoxazole (SMX) / Trimethoprim (TMP) - notes/monitoring?
Renal function Electrolytes CBC Folate
67
What drugs are quinolones?
Ciprofloxacin Levofloxacin
68
Ciprofloxacin & Levofloxacin - Indications?
Broad-spectrum, Gram +/-, atypical Ex: UTI, GI infections, Resp. infections,
69
Ciprofloxacin & Levofloxacin - side effects?
QT prolongation Hypo/hyperglycemia Photosensitivity Separate from antacids/polyvalent cations (multivitamins inhibit absorption) Contraindicated for pregnant/breastfeeding BBW: tendon inflammation/rupture Increased muscle weakness in pts w/ myasthenia gravis CNS effects: seizures, tremor, confusion, psychiatric disturbances Peripheral neuropathy- maybe irreversible
70
Ciprofloxacin & Levofloxacin - BBW?
Tendon inflammation/rupture Increased muscle weakness in pts w/ myasthenia gravis CNS effects: seizures, tremor, confusion, psychiatric disturbances Peripheral neuropathy- maybe irreversible
71
What drug is an aminoglycoside?
Gentamicin
72
Gentamicin- Indications?
Gram -: Pseudomonas aeruginosa, Proteus, E. coli Ex: pyelonephritis, GBS Acute and serious infections
73
Gentamicin- MOA?
Inhibits bacterial protein synthesis
74
Gentamicin- side effects?
GI upset Black tarry stools Blood in urine Back pain Renal damage
75
What drugs are anaerobic DNA inhibitors?
Metronidazole Nitrofurantoin
76
Metronidazole- Indications?
Anaerobes Protozoa Ex: bacterial vaginosis Trichomoniasis Intra-abdominal infections (combo antibiotics)
77
Nitrofurantoin- indications?
Uncomplicated UTI- cystitis only (not for skin/soft tissue)
78
Metronidazole & Nitrofurantoin- MOA?
Inhibits protein synthesis -> cell death
79
Metronidazole- side effects?
Contraindicated w/ alcohol / propylene glycol-containing products during/within 3days of treatment or d/c
80
Nitrofurantoin- side effects?
Brown urine Contraindicated if CrCl <60mL/min
81
Ciprofloxacin & Levofloxacin - MOA?
Inhibits DNA replication
82
Pneumonia bacterias?
CAP: Streptococcus pneumoniae Haemophilus influenzae Staphylococcus aureus Atypical: Legionella pneumophila
83
CAP (no comorbidities) regimen?
Amoxicillin Doxycycline Macrolide- azithromycin (if local resistance < 25%)
84
CAP (with comorbidities) regimen?
Amoxicillin/clavulanate Cephalosporin AND Macrolide (azithromycin) OR Doxycycline Monotherapy w/ respiratory fluoroquinolone (Levofloxacin)
85
General standard regimen for CAP, inpatient?
Penicillin OR Cephalosporin AND Macrolide (azithromycin) or Respiratory Fluroquinolone- levofloxacin
86
Bacterial rhinosinusitis- how long are Sx felt?
>10days w/o improvement
87
Bacterial rhinosinusitis- what bacteria causes?
Streptococcus pneumoniae Haemophilus influenzae
88
Bacterial rhinosinusitis- treatment?
First line: Amoxicillin/clavulanate (preferred) or Amoxicillin Penicillin allergy: Doxycycline (not for kids) 3rd gen cephalosporin (cefdinir- PO) Respiratory fluoroquinolone (levofloxacin)
89
Acute otitis media- what bacteria causes?
Streptococcus pneumoniae
90
Acute otitis media- treatment?
First line: Amoxicillin or Amoxicillin/clavulanate (if other recurrences/risk factors calling for broader coverage) Penicillin allergy: Cefdinir
91
UTI- what bacteria causes?
E. coli, other enterobacteria Staphylococcus saprophyticus Pseudomonas aeruginosa
92
Cystitis vs. Pyelonephritis Sx?
Cystitis (local): Increased frequency/urgency Nocturia Dysuria Hematuria Pyelonephritis (systemic): Flank pain Abdominal pain Nausea/Vomiting Fever Malaise
93
UTI/Cystitis- treatment?
First line: Trimethoprim (TMP) / Sulfamethoxazole (SMX) Nitrofurantoin Alternatives: Ciprofloxacin Levofloxacin B-Lactams
94
Skin and Soft Tissue Infections (cellulitis)- what bacteria causes?
Staphylococcus aureus Streptococcus pyogenes Pseudomonas aeruginosa
94
Pyelonephritis- treatment?
First line: Ciprofloxacin Levofloxacin Trimethoprim (TMP) / Sulfamethoxazole (SMX) Alternatives (not preferred): B-lactams MRSA coverage: Vancomycin or linezolid
95
Cellulitis, mild- treatment?
Penicillin PO Cephalosporin PO
96
Cellulitis, moderate- treatment?
Penicillin IV Ceftriaxone (3rd gen) Cefazolin (1st gen)
97
Cellulitis, severe- treatment?
Vancomycin AND Piperacillin/Tazobactam
98
C. diff- risk factors/testing?
New/Unexplained >3unformed stools in 24hr Prior antibiotics within 90days
99
C. diff- initial treatment?
Vancomycin Metronidazole
100
C. diff- first recurrence treatment?
Vancomycin
101
C. diff- further recurrent treatment?
Vancomycin Fecal Microbiota Transplantation "gold standard" for recurrences
102
C. diff- fulminant treatment?
Vancomycin AND Metronidazole
103
GBS- treatment?
Ampicillin Penicillin G Neonatal: ampicillin & aminoglycoside (gentamicin)
104
STI- bacteria that causes & treatment?
Chlamydia- Doxycycline (azithromycin, levofloxacin) Gonorrhea- Ceftriaxone Syphilis- Penicillin G (doxycycline- if true PG allergy) Trichomoniasis- Metronidazole Bacterial Vaginosis- Metronidazole (clindamycin)
105

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