Pharmacotherapeutics > Antibiotics 2 > Flashcards

Antibiotics 2 Flashcards

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1
Q

Antibiotics that inhibit protein synthesis

A
  1. tetracyclines
  2. macrolides
  3. Clindamycin
  4. aminoglycosides
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2
Q

Antibiotics that inhibit folate synthesis

A

sulfonamides

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3
Q

antibiotics that disrupt DNA replication/cell division

A

Fluroquinolones

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4
Q

Antibiotics that work by inhibiting nucleic acid synthesis

A

Metronidazole

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5
Q

Identifying tetracylcines

A

ends with “cycline”

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6
Q

adverse effects of tetracyline

A
  • GI upset: nausea, vomiting, diarrhea
  • cause C Diff
  • photosensitivity
  • yellow/brown discoloration of teeth
  • superinfections
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7
Q

tetracyclines - w/ food or without?

A

food decrease GI upset BUT decreases absorption

-ideal w/o food

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8
Q

tetracycline and teeth

A
  • do not give to children under 8/pre women

- -> tetracycline binds to calcium in developing teeth and is irreversible color change

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9
Q

Superinfection w/ tetracyclines

A

candidiasis, C Diff

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10
Q

tetracyclines food drug interaction

A
  • Ca, Fe, Mg, Al – result in decrease drug absorption by 50%
  • avoid anatacids, anti-diarrheal, dairy products
  • take tetracyclines on empty stomach
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11
Q

macrolide function

A

inhibition of protein synthesis

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12
Q

macrolide prototype

A

erythromycin

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13
Q

identifying macrolides

A

end with “mycin”

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14
Q

ADR with erythromycin

A
  • GI upset – increase GI motility

- can be used w/ diabetic gastroparesis or passing small bore feeding tubes into small instestine

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15
Q

beneficial use of GI upset of erythromycin

A
  • GI upset – increase GI motility

- can be used w/ diabetic gastroparesis or passing small bore feeding tubes into small instestine

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16
Q

erythromycin drug drug interactions

A
  • QT prolongation (Cardiac Death)
  • CYP3A4 pathway (Ca channel blockers, antifungals, HIV protease inhibitors)
  • Toxic levels w/ theophylline, carbamazepine, warfarin
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17
Q

Suprainfection

A
  • C Diff

- Candidiasis

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18
Q

erythromycin dosing/route

A
  • continuous infusion preferred over intermittent

- oral

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19
Q

Clindamycin fxn

A

inhibit protein synthesis

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20
Q

clindamycin and C Diff

A
  • clindamycin can be fatal with C Diff

- if develop diarrhea on clindamycin, stop immediately

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21
Q

sxs of c diff

A
  • profuse watery diarrhea
  • abdominal pain
  • fever
  • leukocytosis
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22
Q

clindamycin infusion rate risks

A

(if give rapidly –> increase risk for cardiac death)

-IV,oral, topical

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23
Q

aminoglycosides fxn

A

inhibit protein synthesis by producing protein

  • -> bacterialcidal
  • BIG GUNS, stronger
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24
Q

aminoglycoside prototype

A

gentamicin

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25
gentamicin links to
vancomycin
26
identifying aminoglycosides
ends with "mycin" or "Cin"
27
gentamicin route
IV or IM
28
gentamycin ADR otoxicity
- otoxicity - check trough levels - tinnitus: affect cochlea - vestibular area: headache 1st sign - can be reversible, risk increase with high dose or long term use
29
gentamycin ADR
- ototoxicity | - nephrotoxicity
30
gentamycin nephrotoxicity + frequency
trough level check - 5-25 % of patients - labs: BUN/Creatinine/GFR - usually reversible - renal dose adjustment
31
sulfonamides fxn
inhibit folate synthesis
32
sulfonamide prototype
Trimethoprim/sulfamethoxazole | TMP/SMX
33
TMP/SMX ratio
1:5
34
TMP/SMX - together have _____ effect
synergist (1+1=3)
35
how does inhibition of folate synthesis work?
- all cells need folic acid to synth DNA/RNA/Protein - only effects bacteria b/c bacteria are unable to take up folate and instead must synthesize it from precursors - by inhibiting sythnesis of folate the bacterial cells die - human cells can take up folate from the environment and do not need precursors
36
TMP/SMX prevalence and examples
common | -bactrim, cotrim
37
TMP/SMX adverse effects
GI, rash, blood dyscrasias , crystaluria, photophobia, CNS disorder, kernicterus, risk of hyperkalemia
38
TMP/SMX rash
- full body | - if rash develop stop to prevent Stevens Johnson Syndrome
39
TMP/SMX blood dyscrasias
- develop hemolytic anemia (G6PD) | - increase risk for preg/alcoholic to develop bone marrow suppression
40
TMP/SMX crystaluria
(can cause formation of crystals in urine)- - prevent: by increase hydration to 8-10 glasses/day - watch: BUN creatinine
41
TMP/SMX and CNS
-can cause headache, depression, hallucinations
42
TMP/SMX and pregnancy
- fetal development of kernicterus (jaundice) risk: bilirubin is neurotoxic - do not use tmp/smx with preg, children <2 mo, breastfeeding - take preg taste before taking
43
TMP/SMX allergy
-do not take if allergy to Sulfa drugs (thiazide diuretics, loop diurecic, Sulf DM meds)
44
TMP/SMX hypersensitivity
- steven johnson syndrome - look like burn victim - 25% mortality rate
45
TMP/SMX drug drug interactions
-warfarin, dilantin
46
fluroquinolones fxn
disrupt DNA replication/ cell division
47
Abx to infuse over 1 hr
1. vancomycin 2. ciprofloxacin 3. metronidazole
48
fluroquinolones prototype
ciprofloxacin
49
identifying fluroquinolones
ends with "oxacin"
50
ciprofloxacin route
- oral | - IV - infuse over 1 hr
51
ciprofloxacin treats
uti, upper resp, anthrax
52
ciprofloxacin ADR
- GI upset - CNS - tendon rupture - photosensitivity - dysrhythmias - superinfection (C diff, candidiasis)
53
ciprofloxacin tendon rupture, who is at risk?
- tell nurse if pain in back of heal - highest risk = elderly + steroid use (COPD) - avoid in kids under 18
54
ciprofloxacin cns
-dizziness, headache, confusion in elderly
55
ciprofloxacin dysrhythmias
-can cause if ALREADY on anti-dysrhythmia meds
56
ciprofloxacin drug food interaction
AL, Mg, Fe, Zinc, Ca Milk/Dairy -give drug 6 hours after or 2 hours before food --> can reduce absorption by 90%
57
ciprofloxacin drug drug interactions
-sucrelfate, theophylline, warfarin, tinidazole
58
metronidazole fxn
inhibits nucleic acid synthesis
59
metronidazole works on what kind of bacteria
-only taken up by anaerobic bacteria/protozoa -converted to active form -causes bacteriacidal NO action against aerobic bacteria
60
metronidazole treats conditions
C Diff | GI/Pelvic surgery
61
metronidazole route
- oral | - IV -- infuse over 1 hr
62
metronidazole ADR
-gi upset -superinfection (candidiasis) -no alcohol for up to 3 days after (research does not support disulfiram rxn) -urine change to dark reddish brown -metallic taste
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