antibiotics mod 2 Flashcards

Question

``` Aminoglycosides Lincosamides: clindamycin Macrolides Oxazolindinones Streptogramins Tetracyclines Glycylcycline Fluoroquinolones Cycliclipopeptides Sulfonamides Metronidazole ```

Answer 1

``` All of these Drugs Work by Inhibiting/Altering Protein Synthesis: transcription - Nucleus - Messenger RNA - Cytoplasm ``` translation - Cytoplasm - Ribosomes - mRNA - Add amino acids - ----In a specific sequence - Protein synthesis

Answer 2

Potent antibiotics that work well on gram (–) bacteria Also work on gram + but need other anti-biotics for synergistic effect UTIs/pyelonephritis, gynecological infections, peritonitis, endocarditis, PNA, osteomyelitis (DM related infections) Severe side effect profile: Nephrotoxicity- 5-25%, usually reversible Ototoxicity- 3-14%, usually permanent Therapeutic drug monitoring - peak/trough levels Transitioned from 3x/day dosing to 1x/day dosing

Answer 3

Neuromuscular blockade - can cause PROFOUND respiratory distress [myasthenia gravis] Central nervous system side effects: confusion, depression, disorientation, numbness, and tingling Cochlear damage– ototoxicity, high-frequency hearing loss, high-pitched tinnitus

Answer 4

gentamycin: IV; intrathecal for meningitis Also available in ophthalmic drops, and topical ointments amikacin: Only IV Used for infections resistant to tobramycin and gentamycin tobramycin: Inhalation for pulmonary infections (esp. CF patients) Topical and ophthalmic solutions available

Answer 5

MOA: binds to ribosomes and inhibits protein synthesis Indications: chronic bone infections, GU tract infections, intraabdominal infections, anaerobic pneumonia, septicemia, serious skin infections; prophylaxis for endocarditis PO & IV available Primarily used to treat: pseudomembranous colitis Monitor use with neuromuscular blockade medications Very toxic- monitor levels - peaks and troughs

Answer 6

Bacteriostatic in general, bactericidal in high enough concentrations YUCK drugs - GI side effect profile intense (esp. erythromycin) MOA: inhibit protein synthesis by binding to ribosomes Indications: various infections of upper and lower respiratory infections, skin infections, soft tissue infections; STIs

Answer 7

Used to treat MANY infections Has hypomotility benefits for diabetic gastroparesis & increase gastric motility and emptying Does not cross BBB PO & IV– IV is painful, oral absorption isn’t great Topical and ophthalmic also available Don’t take oral on empty stomach– lots of GI upset Lots of drug-drug interactions

Answer 8

Differs structurally from other macrolides - has some advantages in coverage compared to erythromycin Less GI upset, still some Very good tissue penetration & long duration of action Taking food with drug decreases absorption, so try to take without food

Answer 9

MOA: inhibits protein synthesis through non-selective monoamine oxidase (MAO) inhibitors Initially created to treat MRSA and VRE ``` Use with caution: Hypertension Untreated thyroid disease Severe cardiac disease Cerebrovascular disease Pheochromocytoma ```

Answer 10

Common adverse effects: headache, nausea, vomiting Watch platelet count thrombocytopenia Available PO and IV Can cause serotonin syndrome with use of SSRIs Avoid foods high in tyramine: wines, smoked meats, aged cheese, soy sauce

Answer 11

``` Newest class for ‘superbugs’ quinupristin/dalfopristin used in combination alone bacteriostatic, combination=bactericidal 16x the activity used alone ``` Use for serious, life-threatening infections caused by VRE and complicated skin and skin structures, including MRSA IV only Adverse effects: arthralgias, myalgias (muscle pains); painful/erythema/inflammation at IV site in 75%

Answer 12

MOA: bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes ``` Some infections still commonly treated with tetracyclines: Rickettsia (rocky mountain spotted fever) Chlamydia and trichomonas Lyme disease Cholera Pelvic inflammatory disease Mycoplasma pneumonia Acne ``` Adverse effects: discoloration of the permanent teeth and tooth enamel hypoplasia in fetuses and children, photosensitivity, many others

Answer 13

``` Bacteriostatic Inhibits or retards the growth Not available parenterally Fasting – 75% - 77% absorbed Giving more decreases % absorption ``` Adverse effects: N/V/D, headache, photosensitivity, dizziness Rare: anaphylaxis and angioedema

Answer 14

doxycycline Chlamydial and mycoplasmal infections Prophylaxis for STIs Acne and other non-dangerous skin infections minocycline Neisseria meningitides Decreases symptoms of rheumatoid arthritis Solodyn is an extended release (ER) formula - acne

Answer 15

Newest form of tetracyclines Effective against many organisms resistant to the other tetracyclines Treats complicated skin and skin structure infections- MRSA, VRE, extended-spectrum beta lactamases Peritonitis and other complicated abdominal infections Nausea and vomiting occur in 20-30% of patients

Answer 16

Very potent, broad-spectrum antibiotics Very good oral absorption 1st & 2nd generations not used anymore due to abx resistance MOA: destroy bacteria by altering their DNA Interfere with the bacterial enzymes DNA gyrase and topoisomerase Mostly gram-negative and some gram-positive coverage

Answer 17

Used to treat UTIs, some STIs, upper and lower respiratory tract infections, gonorrhea, and other infections Also treats anthrax infection with Bacillus anthracis PO, IV, and topical Works well on rapid and slow growing organisms Prolonged post-antibiotic effects concentrated in the neutrophils Adverse effects: arthropathy (joint disease), often irreversible Avoid in patients under 18 and over 60

Answer 18

Most widely used quinolones Broad-spectrum of activity like cipro but advantages is once-daily dosing PO or IV- 100% bioavailability orally Less resistance More activity against pneumococcal and other ‘atypical’ respiratory infections Side effects: CNS disorders that predispose to seizures, kidney failure, can cause prolongation of QT interval, photosensitivity

Answer 19

MOA: Not completely understood; binds to gram + cells in calcium-dependent process, disrupts the cell membrane potential Long post-antibiotic effect Given IV once per day Used to treat: MRSA, VRE bacteremia, right-sided endocarditis, complicated skin & skin structure infections

Answer 20

MOA: don’t actually destroy bacteria but inhibit their growth= bacteriostatic by preventing the synthesis of folic acid needed for DNA synthesis Indications: uncomplicated UTIs, respiratory infections, salmonella, shigellosis ‘Sulfa allergies’; photosensivity

Answer 21

Antiprotozoal & antibacterial Crohn’s disease Antibiotic-associated diarrhea Anaerobic activity only MOA: inhibits DNA synthesis, similar to fluroquinolones DO NOT TAKE WITH ALCOHOL Adverse effects: N/V, xerostomia, vaginal candidiasis

Answer 22

``` penicillins cephalosporins carbapenems vancomycin aztreonam telavancin ```

Answer 23

gram coverage

Answer 24

``` aminoglycosides lincosamides macrolides oxazolindinones streptogramins tetracyclines glycylcycline flouroquinolones cycliclipopeptides sulfonamides metronidazole ```

Answer 25

``` penicillin cephalosporins carbapenems vancomycin Monobactam - aztreonam telavancin Teicoplanin ```

Answer 26

taken 30 minute after medication infusion is complete

Answer 27

taken 8-12 hrs after dose is complete