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Pharm Exam 1 > antibiotics and anti infectives > Flashcards

antibiotics and anti infectives Flashcards

(140 cards)

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1
Q

Penicillin MOA

A

weakens the cell wall causing bacteria to take up extra water and rupture
affects the beta lactam ring

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2
Q

Penicillin Use

A 
pneumonia
pharyngitis
endocarditis
meningitis
syphilis
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3
Q

Amoxicillin Use

A

same as penicillin but safe for pregnancy

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4
Q

Penicillin A/E

A

N/V/D
rash
allergic reaction

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5
Q

Penicillin drug interactions

A

Aminoglycosides- Gentamicin
Bacteriostatic abx- Tetracyclines
Probenicine- delays excretion from kidneys

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6
Q

Penicillin G

A

Broad spectrum
lasts for 30 days
IM- painful
least toxic

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7
Q

Amoxicillin reduce dose in

A

renal impairment

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8
Q

Penicillin anaphylaxis management

A

airway

give epi IV/IM

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9
Q

Penicillin allergy

A

anaphylaxis- don’t give cephalosporin

mild allergic reactions- give cephalosporin

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10
Q

Nafcillin

A

absorption in GI tract is poor– give IV/IM

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11
Q

Extended spectrum penicillin combos

A

Amoxicillin/Clavulanate (Augmentem)

Piperacillin/ Tazobactam (Zosyn)

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12
Q

Cephalosporin MOA

A

Very similar to penicillin

binds to PBP, disrupts cell wall synthesis and causes cell lysis (most effective during active growth and division)

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13
Q

Cephalosporin A/E

A

hypersensitivity reaction
bleeding tendencies– interferes with Vit K reaction
thrombophlebitis

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14
Q

Cephalosporin Drug interactions

A

Probenecid
Drugs that promote bleeding (Warfarin)
ETOH

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15
Q

Cephalosporin 1st Gen Drug

A

Cephalexin

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16
Q

Cephalexin Use

A

Prophylaxis against infections during surgical procedures

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17
Q

Cephalosporin 1st –> 5th generation

A

increase ability to reach CSF
increase ability to treat resistant infections
increase activity against Gram -

1-2 no CSF
3-5 CSF

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18
Q

Cephalosporin 2nd generation Drug

A

Cefoxitin

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19
Q

Cefoxitin Use

A

mostly skin infections

rarely used against active infections

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20
Q

Cephalosporin 3rd generation Drug

A

Cefotaxime, Ceftriaxone, Ceftazidime

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21
Q

Cefotaxime Use

A

gram - infections, penetrate CSF

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22
Q

Ceftriaxone Use

A

gonorrhea

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23
Q

Ceftazidime Use

A

P. aeruginosa

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24
Q

Ceftazidime A/E

A

watery diarrhea– Pseudomembranous Colitis (severe abdominal pain, fever, bloody diarrhea)

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25
Cephalosporin 4th generation Drug
Cefepime
26
Cefepime use
treat hospital acquired pneumonia
27
Cephalosporin 5th generation Drug
Ceftaroline
28
Ceftaroline Use
MRSA
29
Cephalosporin Nursing implementations
Poorly absorbed in the GI tract Cause superinfection eliminated by the kidneys-- reduce dose for renal impairment highly resistant
30
Vancomycin MOA
Inhibit cell wall synthesis bactericidal causes lysis
31
Vancomycin Use
MRSA C. diff -- severe infection meningitis V strong abx
32
Vancomycin A/E
Red man syndrome (when infusion is too fast <1hr, renal impairment) -feeling of ants all over the patient, red skin Thrombocytopenia Thrombophlebitis
33
Vancomycin Toxicity
ototoxic (reversible) | nephrotoxic
34
Vancomycin route
PO - rare- erratic absorption | IV - most common, best absorption
35
Vancomycin Monitoring
``` BUN Cr Platelets Blood level Peak and trough levels ```
36
Tetracyclines MOA
inhibit protein synthesis bacteriostatic suppresses bacterial growth
37
Tetracycline DOC
Rickets lyme disease Anthrax Rocky mountain spotted fever
38
Tetracycline Other Uses
``` acne PUD Periodontal disease anthrax mycoplasma pneumonia ```
39
Tetracycline A/E
GI irritation superinfections Effects on bone and teeth (yellow- brown coloration)
40
Tetracycline Toxicity
Nephrotoxic | Hepatotoxic
41
Tetracycline Contraindications
<8y/o- due to binding to Ca and cause discoloration | Pregnancy/ breastfeeding
42
Tetracycline Drug interactions
decreases absorption with Ca supplements, dairy, iron supplements, any antacids
43
Macrolide drugs
Erythromycin | Clindamycin
44
Erythromycin MOA
inhibits protein synthesis bacteriostatic can be bactericidal
45
Erythromycin Use
``` broad spectrum when allergic to PCN and cant take Ceph. Chlamydia diphtheria M. pneumonia Group A strep. ```
46
Erythromycin DOC
Whooping cough (Bordetella pertussis)
47
Erythromycin A/E
``` GI - upper gastric pain QT prolongation Sudden cardiac death super infections thrombophlebitis Hearing loss ```
48
Erythromycin Drug interactions
P450 drugs Theophylline AED/ bipolar drugs Warfarin
49
Erythromycin patient educations
take on an empty stomach with a full glass of water
50
Clindamycin MOA
Inhibit protein synthesis
51
Clindamycin Use
wound infections | alternative to Penicillin
52
Clindamycin route
normally topical
53
Clindamycin A/E
CDAD - C. diff associated diarrhea Blood dyscrasia - agranulocytosis, leukocytosis, thrombocytopenia... all of the anemias Diarrhea Rash (hypersensitivity reactions)
54
Clindamycin Toxicity
hepatotoxicity | C. diff- stop immediately and report diarrhea
55
Minocycline DOC
RA
56
Linezolid MOA
Bacteriostatic | inhibit protein synthesis
57
Linezolid Use
VRE MRSA multidrug resistant pathogens
58
Linezolid Dose
can be given long term -5mo
59
Linezolid long term A/E
optic neuropathy | peripheral neuropathy
60
Linezolid A/E
Most common: --N/V/D Most severe: --myelosuppression (will reverse when stopped)
61
Linezolid Drug interactions
MAOIs
62
Linezolid Monitoring
CBC before, during and after
63
Aminoglycoside drugs
Gentamicin | Amikacin
64
Aminoglycosides
bactericidal
65
Aminoglycosides Use
narrow spectrum
66
Amikacin use
broadest aminoglycoside | resistance present
67
Aminoglycoside A/E
Blood dyscrasias | hypersensitivity reactions
68
Aminoglycoside Toxicity
Ototoxic (irreversible) | Nephrotoxic (renal tubules, decrease dose)
69
Aminoglycosides Drug interactions
PCN Other ototoxic drugs (Vanc) Other nephrotoxic drugs Skeletal muscle relaxants
70
Aminoglycoside antidote
Ca gluconate-- binds to aminoglycoside and prevents action and stops A/E
71
Aminoglycoside PO
not absorbed well in the GI tract, give PO only if infection is in the GI tract
72
Aminoglycoside Mornitoring
Peak and Trough levels dose can differ depending on the therapeutic range also needs to be safe for the Kidneys Gentamicin will be the fist aminoglycoside given
73
Sulfonamide Drug
Silver Sulfadiazine | Trimethoprim/Sulfamethoxazole
74
Sulfonamide MOA
inhibits synthesis of (tetrahydrofolic acid) folic acid, suppressing growth of bacteria
75
Sulfonamide DOC
UTI- r/t E. coli
76
Silver Sulfadiazine Use
burns, suppresses growth of bacterial colonization in patients with 2nd and 3rd degree burns
77
Silver Sulfadiazine A/E
blue green discoloration of the skin, do not use on the face
78
Sulfonamides A/E
``` hypersensitivity reactions SJS-- rare hematological effects (AA, Mediterranean people) kernicterus (bilirubin in the brain) renal damage from Crystalluria ```
79
Sulfonamides Contraindication
Not given after 32 wk gestation -passed to the baby and causes kernicterus <2 mo age breastfeeding until baby is >2mo
80
Sulfonamides excretion
by the kidneys
81
Trimethoprim/Sulfamethoxazole DOC
Acute UTI
82
TMP/SMZ other uses
ear infections bronchitis pneumonia - recurrent and/or chronic
83
TMP/SMZ A/E
``` N/V rash hyperkalemia HA depression hallucinations kernicterus renal damage SJS blood dyscrasias ```
84
TMP/SMZ contraindications
allergy to sulfa drugs
85
Nitrofurantoin Use
UTI
86
Nitrofurantoin dosing
low: bacteriostatic high: bactericidal
87
Nitrofurantoin A/E
``` Brown discoloration of urine GI (anorexia, N/V/D-- take with food) Pulmonary reactions Hematological reactions (hemolytic anemia) HA ```
88
Nitrofurantoin Toxicity
Hepatotoxicity | Nephrotoxicity
89
Nitrofurantoin Contraindications
Pregnancy: birth defects | < 1 mo age: due to hemolytic anemias
90
Nitrofurantoin monitoring
LFTs, skin color
91
Fluoroquinolones MOA
Disrupt DNA replication and cell division
92
Fluoroquinolones Use
Broad spectrum | Resistant Acute cystitis
93
Fluoroquinolones A/E
Achilles tendon rupture -- if there is ankle pain, stop immediately exacerbation of Myasthenia Gravis
94
Fluoroquinolones Drugs
Ciprofloxacin
95
Ciprofloxacin MOA
inhibits bacterial DNA gyrase and topoisomerase 2
96
Ciprofloxacin DOC
Severe UTI | anthrax
97
Ciprofloxacin other uses
respiratory GI bones, joints, skin, soft tissue
98
Ciprofloxacin A/E
``` N/V/D abdominal pain superinfections -candidiasis in the mouth and vagina Tendon rupture Older adults -confusion, visual disturbance, hallucinations -Exacerbation of Myasthenia Gravis ```
99
Ciprofloxacin Toxicity
Phototoxicity
100
Ciprofloxacin Drug interactions
``` Ca, dairy, zinc, antacids - decrease absorption theophylline warfarin tinidazole -increase levels of these drugs ```
101
Metronidazole MOA
bactericidal
102
Metronidazole DOC
Mild/ Moderate C. Dif | prophylactically for surgery
103
Metronidazole A/E
metallic taste: give with food
104
Metronidazole Toxicity
neurotoxic
105
Metronidazole Drug interactions
ETOH
106
Amphotericin B MOA
binds to components of the fungal cell membrane, increasing permeability
107
Amphotericin B Use
antifungal | only for progressive and deadly fungal infections
108
Amphotericin B DOC
most systemic mycosis
109
Amphotericin B A/E
``` fever chillin shakes HA hypokalemia bone marrow suppression ```
110
Amphotericin B Toxicity
highly toxic - infusion reaction | nephrotoxic
111
Amphotericin B Drug interactions
other nephrotoxic drugs | K sparing diuretics
112
Amphotericin B Nursing implementations
Premedicate for infusion reactions stop infusion and treat reaction and restart infusion Give with at least 1 L NS for kidneys Promote PO hydration
113
Amphotericin B Monitoring
BUN Cr K CBC
114
Amphotericin excretion
can be up to 1 year so need to be monitored for the year
115
Azoles drugs
Itraconazole Ketoconazole Fluconazole Clotrimazole
116
Itraconazole MOA
inhibit synthesis of ergosterol = increased permeability and leakage of cellular components
117
Itraconazole Use
fungal infections
118
Itraconazole A/E
``` N/V/D (common) *Cardiac Suppression (severe)* HA rash abdominal pain edema ```
119
Itraconazole Toxicity
Liver injury, lower than Amphotericin B
120
Itraconazole Patient needs prior
Echocardiogram
121
Ketoconazole Use
fungal infections superficial infections (dermatitis) systemic mycosis
122
Ketoconazole A/E
``` N/V/D -- give with food sex hormones rash itching dizziness fever chills constipation ```
123
Ketoconazole Toxicity
Hepatotoxicity
124
Ketoconazole Drug interactions
CYP3A4-- increase levels of other drugs | like warfarin
125
Ketoconazole Monitoring
LFTs before during after
126
Fluconazole Use
``` #1 Azole given antifungal ```
127
Fluconazole A/E
N/V/D abdominal pain rash
128
Fluconazole Contraindications
Pregnancy - 1st trimester: birth defects
129
Fluconazole Drug interactions
CYP3A4 inhibitors
130
Clotrimazole DOC
Topical admin for skin fungal infections
131
Clotrimazole A/E
``` *stinging* erythema edema urticaria pruritus peeling *burning * ```
132
Nystatin DOC
intestinal/ mouth candidiasis infection
133
Nystatin Other use
Skin, skin fold fungal infections: use powder or cream
134
Nystatin route
PO Swish and swallow Swish and spit
135
Nystatin A/E
N/V/D
136
PO Penicillin DOC
Amoxicillin
137
Pipracillin A/E
Bleeding tendencies
138
Cephalosporin toxicity
Nephrotoxic
139
Metronidazole MOA
Inhibits DNA synthesis
140
Nystatin MOA
Inhibits fungal membrane synthesis

Pharm Exam 1 (2 decks)

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