Antibiotics II & III Flashcards by Sarah Sanchez

what is topoisomerase II also called and what is it primarily for?

DNA gyrase
gram -

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what is topoisomerase IV primarily for?

gram +

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which fluoroquinolone has intrinsic affinity for topoisomerase II?

2G ciprofloxacin

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which fluoroquinolone has intrinsic affinity for topoisomerase IV?

4G moxifloxacin

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what is the spectrum of activity of fluoroquinolones?

gram +
gram -
atypical (intracellular organisms)

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what is the MOA of fluoroquinolones?

inhibit DNA synthesis (topo II and topo IV) = bactericidal

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1st gen fluoroquinolone

nalidixic acid

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name the 2nd gen fluoroquinolones (4) and what they cover?

Ciprofloxacin
Ofloxacin
Norfloxacin
Enoxacin

gram -
atypical

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name the 3rd gen fluoroquinolone and what it covers?

levofloxacin

gram -
gram +
atypical

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name the 4th gen fluoroquinolones (3) and what they cover?

moxifloxacin
delafloxacin
gemifloxacin

gram -
gram +
atypical
anaerobes

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what decreases the absorption of fluoroquinolones and should be avoided?

calcium

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how is most levofloxacin excreted?

kidney

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how is most ciprofloxacin excreted?

kidney

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how is most moxifloxacin excreted?

liver

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how should FQ’s be dosed and why?

QID/BID

long T 1/2

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what medications have an increased DDI with ciprofloxacin due to its inhibition of CYP1A2? (2)

theophylline
caffeine

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what is the only FQ used for enterococcus and MRSA?

delafloxacin

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what are the names of the possible 5th generation FQs?

nemonoxacin
zabofloxacin

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what are 4 ADR of FQs?

Skin rash/Sun sensitivity
Prolonged QT/Peripheral Neuropathy
Ruptured tendon
Increased risk of C. difficile
Neuro
GI disturbances

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what patients are FQ contraindicated/not recommended in? why?

pregnancy
children

weakens cartilage

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what is an ADR specific to ciprofloxacin?

photosensitivity

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what 2 FQs + their generation cause tendonitis/tendon rupture, leading to a BBW?

ofloxacin (2G)
levofloxacin (3G)

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if a patient has a history of cardiac complications, what ADR should we consider with the use of FQs? (2)

aortic dissection
aneurysm

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which 2 FQs can be used for UTI?

ciprofloxacin (2G)
levofloxacin (3G)

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which 2 FQs can be used for respiratory tract infections?

levofloxacin (3G) moxifloxacin (4G)

since FQs are good for mycobacteria, they can help treat _______

multi-drug resistant tuberculosis

which FQ is considered a treatment for MRSA?

delafloxacin

what are the uses for ciprofloxacin? (4)

UTI anthrax traveler's diarrhea typhoid fever

what is the spectrum of activity of metronidazole?

gram - some gram + anaerobes intra-abdominal infections brain abscess 2nd line for pseudomembranous colitis H. pylori for PCN allergy

what are 2 ADR of metronidazole?

metallic taste disulfiram reaction with alcohol

sulfa- and MOA

sulfonamides folate antagonists

what drugs do sulfonamides have a DDI with? (3) why?

warfarin phenytoin methotrexate all bind to albumin

sulfonamides have a cross-sensitivity to which 4 medications/classes?

thiazides loop diuretics acetazolamide sulfonylureas

what are the ADR of sulfonamides? (4)

Steven-Johnsons Syndrome Skin rashes S - low solubility = crystalluria Serum albumin displacement = kernicterus

in which patients do sulfonamides cause hemolytic anemia?

G6PD deficient patients

what are 2 main ADRs of trimethoprim?

hyperkalemia megaloblastic anemia

to avoid megaloblastic anemia in a patient by giving them trimethoprim, what can we add to their treatment?

folinic acid

what are 7 uses for trime-sulfa?

UTI pneumonia in AIDS toxoplasmosis outpatient MRSA (SSTI) prostatitis norcardia infection sepsis/meningitis

a urinary tract anti-infective agent that goes through excretion where 25% of the dose is unchanged in the kidney

nitrofurantion

what is nitrofurantoin used for?

uncomplicated UTI

in which patients is nitrofurantoin CI in? (2)

CrCl < 40 elderly

what is a special ADR of nitrofurantoin?

brown urine N/V/D headache abdominal pain

what is the spectrum of activity for polymyxin B and E (colistin)?

gram - bacteria

what is polymyxin B used for?

bacteremia

what is polymyxin E used for?

UTI

what kind of antibiotics are aminoglycosides synergistic with?

cell wall inhibitors

why do aminoglycosides have little activity against anaerobes?

they transport into cells that are partially dependent on oxygen

what is the most toxic aminoglycoside?

neomycin

what is the spectrum of activity of aminoglycosides?

Gram - bacteria

what is the main organism that aminoglycosides treat?

severe pseudomonal infections

aminoglycosides are combined with beta-lactam antibiotics to treat what?

severe enterococcal infections

what is the elimination of aminoglycosides?

renal

what is topical neomycin used for?

eye, ear, skin infections

what is oral neomycin used for?

bowl sterilization prior to bowel sx

what is streptomycin used for? (2)

TB enterococcal endocarditis

what is plazomicin used for?

complicated, unresponsive UTI

what is paromomycin used for? (2)

tape worms intestinal amebiasis

which ribosomal subunit do aminoglycosides bind to?

30S

what are the 4 major ADR of aminoglycosides?

cross placenta nephrotoxicity ototoxicity neuromuscular blockade

in regards to ototoxicity, which aminoglycoside causes auditory problems?

amikacin

in regards to ototoxicity, which aminoglycosides cause vestibular impairment? (3)

gentamicin tobramycin streptomycin

what is inhaled tobramycin used for?

cystic fibrosis

what is the administration rout of aminoglycosides?

IV only

which 2 meds cannot be used with aminoglycosides?

ethacrynic acid cisplatin

a patient who is taking an aminoglycoside presents with muscle paralysis. how can this be reversed? (2)

neostigmine Ca gluconate

-cycline

tetracyclines

what is the spectrum of activity of tetracyclines?

gram + and gram -

what products cause a decreased absorption of tetracyclines? (4)

Ca, Mg, Fe, and Al

how are tetracyclines eliminated?

renal

how do tetracyclines become resistant?

over-expression of efflux pump

what does doxycycline specifically treat? (2)

CAP Malaria

what does minocycline specifically treat?

acne (oral or topical)

what does tetracycline specifically treat?

H. pylori

what are 2 general uses for tetracyclines?

infections by atypical (intracellular) organisms SSTI by MRSA, MSSA in patients with PCN allergy

what are the ADRs of tetracyclines? (5)

Bone defects Liver damage Abdominal pain Skin rash/Sun sensitivity Teeth discoloration

which patients should not use a tetracycline?

pregnancy lactation children less than 8 yo

-thromycin

macrolides

what is the spectrum of activity of macrolides?

gram +, some gram - intracellular (atypical) organisms

what ribosome subunit do macrolides bind to?

50S

how are macrolides eliminated?

liver

what are 3 therapeutic uses for macrolides?

strep pneum if PCN allergy atypical CAP

what is a specific use for azithromycin? how is it used?

H. flu once daily dosing

how is clarithromycin used?

BID

which macrolide does not have good oral absorption since it is acid labile?

erythromycin

what are some ADR of macrolides?

GI metallic taste QT prolongation

to avoid inhibiting P450 enzyme, which macrolide should we use since it interferes the least with P450?

azithromycin

what is the DOC for atypical pathogens in CAP?

erythromycin

what is the spectrum of activity of lincosamides (clindamycin)?

gram +

what ribosome subunit do lincosamides bind to?

50S

how are lincosamides eliminated?

liver

what is the distribution for lincosamides? where is it not distributed?

tissue bone NOT in CNS

what are 3 ADR of lincosamides (clindamycin)?

diarrhea BAD super-infection pseudomembranous collitis

in which patients should we avoid lincosamides?

patients with history of collitis

what are 5 therapeutic uses for lincosamides (clindamycin)?

aspiration pneumonia SSTI MRSA osteomyelitis topical for acne

-zolid

oxazolidinones

what ribosome subunit do oxazolidinones bind to?

50S

what is the spectrum of activity for oxazeolidinones?

gram +

what are 2 uses specific for tedizolid?

MRSA Linezolid-resistant MRSA

what are 5 uses for oxazolidinones?

MRSA VRE SSTI CAP nosocomial pneumonia

what are 2 ADR of oxazolidinones?

cheese reaction hypertensive crisis

a patient presents with serotonin syndrome. what drug class is the SSRI/SNRI interacting with? (2)

Oxazolidinone

name the streptogramin and it's spectrum of activity

quinupristin-dalfopristin Gram +

MOA of streptogramins?

protein synthesis inhibitor

what enzyme does streptogramin inhibit?

CYP3A4

what are ADR of streptogramins?

C. difficile angioedema

Antibiotics II & III Flashcards

(105 cards)