Antibiotics, Antimicrobials, Anti-fungals, Anti-virals Flashcards
(136 cards)
1
Q
Sulfonamides MOA
A
Inhibit synthesis of tetrahydrofolic acid
2
Q
Sulfonamide: bacteriostatic or bactericidal
A
bacteriostatic
3
Q
Sulfonamides meds
A
Sulfamethoxazole
Trimethoprim
4
Q
Sulfonamides uses
A
UTIs - E.coli
GI infections
Pneumonia - Pneumocystis carinii
MRSA
5
Q
Sulfonamides side effects
A
Hypersensitivity reactions
- Photosensitivity
- Stevens-Johnson syndrome
Hematologic: thrombocytopenia
Renal damage
Allergies: itching/rash
6
Q
Sulfonamides Pertinent Teachings
A
- Can intensify effects from warfarin and dilantin
- decrease sun exposure/wear sunblock
- increase water to prevent kidney damage
- monitor BS in DM patients
- Do not give to pregnant/nursing women or infants <2 months
7
Q
Metronidazole MOA
A
inhibits bacterial DNA gyrase
8
Q
Metronidazole Uses
A
CDI, H.Pylori, Trichomoniasis, Gardnerella vaginalis, CNS/bone/skin/soft tissue infections
9
Q
Metronidazole Side Effects
A
Neurotoxicity, hepatotoxicity, metallic taste, urine discoloration
10
Q
Metronidazole Pertinent Teachings
A
Avoid alcohol - Disulfiram like reactions
11
Q
Fluoroquinolones MOA
A
Inhibits synthesis of DNA/RNA
12
Q
Fluoroquinolones meds
A
ciprofloxacin, levofloxacin
13
Q
Fluoroquinolones Uses
A
Respiratory tract infections, GI infections, UTI, Bone/skin/joint/soft tissue infections
14
Q
Fluoroquinolones Side Effects
A
Tendon rupture, muscle weakness, photosensitivity, GI (n/v/d), headaches/dizziness, risk of CDI
15
Q
Fluoroquinolones Pertinent Teachings
A
- Contraindication to myasthenia gravis
- Risk: elderly, transplants, glucocorticoids
- Avoid milk + antacids + cationic compounds
16
Q
Aminoglycosides MOA
A
Inhibit protein synthesis
17
Q
Aminoglycosides: bactericidal or bacteriostatic?
A
Bactericidal
18
Q
Aminoglycosides Use
A
Serious Gram (-) only: - enterobacteriaceae, P. aeruginosa
- VRE (+PCN)
- GI, urinary, respiratory, bone, skin infections
19
Q
Aminoglycosides meds
A
Gentamicin
20
Q
Aminoglycosides Side Effects
A
Ototoxicity, nephrotoxicity
21
Q
Aminoglycosides Pertinent Teachings
A
- Never mix with PCN in same IV
- Monitor peaks and troughs
- Daily IV preferred - decrease ototoxicity
22
Q
Clindamycin MOA
A
Inhibits protein synthesis
23
Q
Clindamycin class
A
Lincosomide
24
Q
Clindamycin Use
A
Alternative to PCN, only anaerobic infections outside of CNS, MRSA
25
Clindamycin Side Effects
Can cause CDAD
Allergies: hypersensitivity, rash
26
Clindamycin Pertinent Teachings
Monitor liver function, educate on CDAD
27
Oxizolidinones MOA
Inhibits protein synthesis
28
Oxizolidinones bacteriostatic or bactericidal?
bacteriostatic
29
Linezolid Use
MRSA, VRE, healthcare/community associated pneumonia, skin infections
30
Linezolid Side Effects
diarrhea, nausea, headaches, myelosuppression
31
Linezolid Pertinent Teachings
Monitor blood count
Don't take with tyramine, SSRIs, MAO inhibitors
32
Macrolides: bacteriostatic or bactericidal
bacteriostatic
33
Macrolides MOA
inhibit protein synthesis
34
Macrolides meds
Erythromycin
Azithromycin
Clarithromycin
35
Macrolides Uses
Respiratory tract infections
- pneumonia, sinus
skin infections
- chlamydia, ear
Alternative to PCN
36
Macrolides side effects
GI distress, QT prolongation, hepatotoxicity
37
Macrolides Pertinent Teachings
- Avoid antacids + antidysrhythmic drugs
- Administer w/food to avoid GI
- Can increase half-lives of drugs
38
Tetracycline bacteriostatic or bactericidal?
bacteriostatic
39
Tetracycline meds
doxycyline, minocyline
40
Tetracycline MOA
inhibits protein synthesis
41
Tetracycline Uses
Chlamydia, rickettsia, H.pylori, Lyme disease, peridontal disease, acne, MRSA
42
Tetracycline side effects
Teeth discoloration, suppress bone growth, GI distress, superinfection (CDI), photosensitivity, nephrotoxicity, hepatotoxicity
43
Tetracycline pertinent teachings
- Teratogenic (<8y/o + moms)
- Do not give with calcium or antacids
- protect against sun
- Do not give to pt. with renal disease
44
Vancomycin bacteriostatic or bactericidal?
bactericidal
45
Vancomycin MOA
Weakens bacterial wall
46
Vancomycin uses
reserve for SEVERE infections
CDI, MRSA, alternative to PCN
47
Vancomycin side effects
Ototoxicity
Nephrotoxicity
Red person syndrome
Thrombophlebitis
48
Vancomycin pertinent teachings
- infuse slowly
- narrow range of 10-20mcg/mL
- monitor kidneys and liver
- PO with food/refridgerate
49
Cephalosporins bacteriostatic or bactericidal?
bactericidal
50
Cephalosporins MOA
weakens bacterial cell wall
51
Cephalosporin generations
increase activity to (-) bacteria, resistance to beta-lactamases, and ability to reach CSF with each new generation
52
Cephalosporin uses
3rd gen: meningitis
5th gen: MRSA
other: skin, urinary, respiratory, etc.
53
Cephalosporin Side effects
CEF THE GIANT
- Gi
- increase glucose
- anaphylaxis/alcohol
- nephrotoxicity
- thrombocytopenia
54
Cephalosporin pertinent teachings
- ceftriaxone contraindicated for neonates IV
- caution with renal disease
- cross sensitivity with PCN
- avoid bleeding by rotating IV sites
55
Metronidazole bacteriostatic or bactericidal?
bactericidal
56
Mild to moderate CDI preferred drug
metronidazole
57
Severe CDI preferred drug
Vancomycin
58
Which drugs can treat MRSA?
5th gen cephalosporin, vancomycin, tetracyclines, linezolid, sulfonamides, rifampin
59
Which drugs can treat VRE?
Linezolid, combination of PCN and gentamicin
60
Alternatives to PCN
vancomycin, clindamycin, macrolides
61
PCN bacteriostatic or bactericidal?
bactericidal
62
PCN MOA
weakens cell wall
63
PCN categories
Narrow spectrum (sensitive) - PCN G/V
Narrow spectrum (resistant) - nafcillin
Broad spectrum - ampicillin/amoxicillin
Extended spectrum: piperacillin
64
PCN side effects
GI distress, anaphylaxis, rash, itching, hives
Broad-spectrum: rash/diarrhea
65
PCN pertinent teachings
- Contraindicated for hx of severe allergy
- possible cross-allergy
- keep epi/resp support nearby
- take oral PCN with water 1 hr before or 2 hr after meals
- PO/IM
66
PCN uses
skin, ear, urinary, STIs, pneumonia, meningitis infections
67
Isoniazid MOA
inhibits synthesis of mycolic acid in cell wall
68
Isoniazid Use
Active TB, LTBI, prophylaxis
69
Isoniazid side effects
Peripheral neuropathy, hepatotoxicity, anemia, optic neuritis
70
Isoniazid pertinent teachings
- Contraindicated w/liver disease
- Increase vitamin B6
71
Rifampin MOA
destroys TB microbe DNA/RNA
72
Rifampin Use
TB, leprosy, MRSA
73
Rifampin side effects
Hepatotoxicity, red/orange body fluids, GI distress
74
Rifampin pertinent teachings
- decrease efficacy of oral contraceptives
- increase metabolism
- take on empty stomach
75
Pyraminizide MOA
inhibits fatty acid synthesis/decreases growth of mycobacterium
76
Pyraminizide Side effects
Hyperuricemia, Hepatotoxicity, GI distress
77
Pyriminizide pertinent teachings
- Test every 2 weeks or every month
- Contraindicated for liver disease
78
Ethambutol MOA
inhibits arabinosyltransferase, impairs cell wall
79
Ethambutol side effects
optic neuritis, hyperuricemia, allergies (itching), NO hepatotoxicity
80
Ethambutol pertinent teachings
Contraindicated w/optic neuritis
81
Ethambutol use
TB and resistant TB
82
Pyraminizide Use
TB
83
Amphotericin B MOA
increases cell permeability
84
Amphotericin B Use
most serious systemic mycoses and superficial fungal infections
85
Amphotericin B side effects
hypomagnesemia, hypokalemia, infusion reactions (nausea, fever, chills, headaches), nephrotoxicity, highly toxic
86
Amphotericin B pertinent teachings
- IV only
- rotate IV site
- infuse slowly
- treat infusion reactions with acetaminophen and diphenhydramine
- monitor urine output and give 1000mL of normal saline the day of meds
87
Itraconazole/Fluconazole MOA
inhibits fungal cytochrome
88
Itraconazole/fluconazole Use
systemic mycosis, candidiasis, tinea, alt/ampho-b, superficial fungal infections
89
Itraconazole/fluconazole side effects
GI distress, headaches, hepatotoxicity, cardio suppression (decreased HR)
90
Itraconazole/fluconazole pertinent teachings
Contraindicated for pimozide, quinidine, dofetilide, cisapride
- cause dysrhythmias
91
AZT/Zidovudine MOA
inhibits synthesis of DNA by causing premature termination of DNA strand growth
92
AZT/Zidovudine Use
HIV/AIDS
93
AZT/Zidovudine side effects
severe anemia, neutropenia, hepatomegaly, lactic acidosis
94
AZT/Zidovudine pertinent teachings
monitor CBC and liver
95
Lopinavir/ritonavir, fosamprenavir MOA
cleaves bonds in polyprotein and the virus remains immature and noninfectious
96
Lopinavir/ritonavir, fosamprenavir type
protease inhibitors
97
Lopinavir/ritonavir, fosamprenavir use
HIV/AIDS
98
Lopinavir/ritonavir, fosamprenavir side effects
Hyperlipidemia, hyperglycemia, lipodystrophy, GI, prolongation of PR and QT intervals
99
Lopinavir/ritonavir, fosamprenavir implications
- Take at night on empty stomach
- Increased risk for dysrhthmias
- High fat meals can increase toxicity
100
Fosamprenavir special implication
do not give to pt. with sulfonamide sensativity
101
Efavirenz MOA
binds to active center of reverse transcripterase to cause direct inhibition
102
Efavirenz type
NNRTIs
103
Efavirenz use
HIV/AIDS
104
Efavirenz side effects
Derm-rash, insomnia, depression, teratogenic
105
Efavirenz implications
- do not give to pregnant/trying
- take at night on empty stomach
- high fat meals can increase toxicity
106
Raltegravir MOA
inhibits HIV from integrating with DNA
107
Raltegravir type
INSTIs
108
Raltegravir use
HIV and resistant HIV
109
Raltegravir side effects
insomnia, headaches, hepatotoxicity, hypersensitivity, elevation in serum amylase + lipase
110
Raltegravir implications
- Take with or without food
- get plasma HIV RNA level and CD4 T-cell count
111
Acyclovir (Zovirax) MOA
inhibits viral replication by suppressing synthesis of DNA
112
Acyclovir routes
Topical, PO, IV
113
Acyclovir uses
HSV, VZV, Cytomegalovirus
114
Acyclovir side effects
IV: phlebitis, reversible nephrotoxicity
PO: GI distress, vertigo
Topical: stinging
115
Acyclovir implications
- infuse slowly and drink extra fluids
- monitor BUN/creatinine
116
Valacyclovir (valtrex) routes
PO only
117
Valacyclovir class
prodrug of acyclovir
118
Valacyclovir side effects
Thrombocytopenia purpura/hemolytic uremic syndrome (TTP/HUS) in immunocompromised
119
3 types of influenza vaccines
IIV, RIV, LAIV
120
Flu vaccine side effects
- Injection site pain/redness
- fever 1-2 days
- LAIV - runny nose or congestion
- Guillain barre syndrome
121
Flu vaccine implications
- protection 1-2wks post
- Febrile illness - defer vaccine
- Don't give LAIV to immunocompromised
- 6 months + should be vaccinated
122
Flu medications MOA
inhibit neuraminidase
123
Flu Vaccine meds
Oseltamivir, rimantadine, zanamivir
124
Oseltamivir use
flu A + B, prophylaxis
125
Rimantadine use
Flu A
126
Zanamivir use
Influenza, prophylaxis
127
Oseltamivir side effects
GI distress, severe hypersensitivity, neuropsychiatric effects in young
128
Rimantadine side effects
CNS - dizzy, nervous, insomnia
129
Zanamivir side effects
cough, sore throat
130
Oseltamivir implications
- start no later than 2 days after symptoms start
- take with food
131
ALL flu drugs
should not be given at same time as LAIV
132
Take around meals
PCN
133
Take with food
Cephalosporins, vancomycin, Oseltamivir
134
Take without food
- TB drugs
- Efavirenz
- lopinavir/ritonavir, fosamprenavir
135
Take w/food if in GI distress
tetracyclines, macrolides
136
With or without food
raltegravir
