antimicrobials Flashcards
(102 cards)
1
Q
natural penicillin
A
penicillin G aqueous
Penicillin G procaine
Penicillin G benzathine
Penicillin V (PO)
2
Q
Amino penicillin
A
amoxicillin
ampicillin
3
Q
antistaphylococcal penicillin
A
dicloxacillin
nafcillin
oxacillin
4
Q
Antipseudomonal penicillins
A
piperacillin
ticarcillin
5
Q
beta-Lactamase inhibitor combos
A
ampicilin/sulbactam
amoxacillin/clavulanate
piperacillin/tazobactam
ticarcillin/clavulant
6
Q
penicillin Mechanism of action
A
interfere with cell wall synthesis
7
Q
penicillin mechanism of reisistance
A
beta lactamase/penicillinase
modified penicillin binding proteins
decreased permeability
8
Q
natural penicillins treat
A
gram positive cocci
strep viridans
strep pyogenes (group A Strep)
9
Q
natural penicillins therapeutic uses
A
syphilis
group b strep infection
strep pneumonia
10
Q
amino penicillins treat
A
gram + and gram - haemophilus influenzae strep pneumonia e. coli proteus mirabilis enterococcus
11
Q
amino penicillins therapeutic uses
A
otitis media
sinusitis
12
Q
Antipseudomonal Penicillins treat
A
pseudomonas aeruginosa
serratia sp
klebsiella sp
13
Q
antipseudomonal penicillin therapeutic uses
A
nosocomial pneumonia and UTI
complicated cellulitis
abdominal infection
14
Q
Beta lactamase inhibitor combinations treat
A
gram - and anaerobic
15
Q
Beta lactamase inhibitor combinations therapeutic uses
A
abscess diabetic foot abdominal infection animal bites fever of unknown origin refractory sinusitis/otitis media
16
Q
Beta lactamase inhibitor combinations side effect
A
diarrhea
suprainfection
17
Q
Antistaphylococcal penicillins treat
A
gram +
staphylococcus aureus
18
Q
antistaphylococcal penicillins therapeutic uses
A
soft tissue
bone infections
endocarditis
19
Q
penicillins ADR
A
Hypersensitivity
20
Q
ampicillin ADR
A
Epstein-Barr Virus, cytomegalvirus, acute lymphocytic leukemia
non-allergic RASH
21
Q
1st generation cephalosporins
A
cefadroxil
cefazolin
cefalexin
22
Q
2nd generation cephalosporins
A
cefaclor cefotetin cefoxitin cefprozil cefuroxime cefuroxime axetil
23
Q
cephalosporins mechanism of action
A
interfere with cell wall synthesis
more resistant to Beta-lactamase
24
Q
1st generation ceph treat
A
gram +
streptococcus
staphylococcus
25
1st generation ceph therapeutic uses
soft tissue
bone infections
(cellulitis, osteomyelitis, surgical prophylaxis)
26
2nd generation ceph treat
anerobes
| some gram - and gram +
27
2nd genertraion ceph therapeutic uses
abdominal infections: abscess, pelvic, diverticulitis
| respiratory infections: sinusitis, otitis media, pneumonias
28
3rd generation ceph treat
gram -
| some gram + and anerobic
29
3rd generation ceph therapeutic uses
respiratory infections:
| pneumonia, otitis media, sinusitis, meningitis
30
cephalosporins ADR
hypersensitivity
31
Macrolides
azithromycin
clarithromycin
erythromycin
32
macrolides mechanism of action
inhibits bacterial ribosomal protein synthesis
33
macrolides treat
gram +
gram -
atypical
34
macrolides therapeutic uses
```
respiratory
genital
CAP
pelvic infection
acne
whooping cough
```
35
macrolides ADR
GI intolerance = non compliance
cholestatic jaundice
prolonged QT intervals
36
Clarithromycin ADR
abnormal taste sensations
37
macrolide drug interaction
erythromycin and clarithromycin metabolized by CYP 450
38
how should azithromycin be taken?
empty stomach
39
Macrolide caution
severe hepatic dysfunction
40
motilin agonist
erythromycin
41
tetracyclines
demeclocycline
doxycucline
minocycline
tetracycline
42
tetracycline mechanism of action
inhibits bacterial ribosomal protein synthesis
43
tetracycline treats
gram +
gram -
atypical
44
tetracycline therapeutic uses
```
CAP!!
Chlamydia trachomatis!!!
acne!!
CA-MRSA!!
lyme disease, Rocky Moutain Spotted Fever, Tularemia
```
45
tetracycline drug interaction
chelate with trivalent cations!!
metabolized in liver, excreted by kidneys
will cross the placenta
46
tetracycline ADR
GI intolerance
Photo-sensitivity
Teeth discoloration
47
tetracycline contraindicated
pregnancy
breast feeding
children <9
48
Clindamycin mechanism of action
inhibits bacterial ribosomal protein syntheses
49
Clindamycin treats
gram + and anerobes
50
Clindamycin therapeutic uses
Skin and soft tissue infections (cellulitis)
aspiration pneumonia
acne
CA-MRSA
51
Clindamycin ADR
hypersensitivity
| C-Diff
52
Antifolate
sulfamethoxazole
| trimethoprim
53
sulfa mechanism of action
use up the enzyme (dehydrofolate synthetase) needed to convert PABA to folic acid (necessary for bacteria to synthesize in order to live)
54
antifolate drug interaction
absorbed orally
metabolized in liver
excreted renally
highly protein
55
antifolate drug interaction
highly protein bound drugs
56
antifolate drug interactions
hypersensitivity- angioedema, stevens- johnson
nephrotoxicity
kernicterus
57
antifolate contraindicated
```
renal dysfunction
newborns (< 6 weeks old)
sulfasalazine
zonisamide
celecoxib
```
58
trimethoprim mechanism of action
dihydrofolate reductase inhibitor
| folic acid can not become active
59
Bactrim includes (co-trimoxazole)
sulfamethoxazole
| Trimethoprim
60
bactrim mechanism of action
synergy
| inhibits two sequential steps
61
bactrim therapeutic uses
```
UTI
prostate infection
otitis media
sinusitis
prophylaxis Pneumocystic jiroveci pneumonia
CA-MRSA
```
62
Fluoroquinolones (Quinolones)
```
ciproflofloxacin
gemifloxacin
levofloxacin
lomefloxacin
moxifloxacin
norfloxacin
ofloxacin
sparfloxacin
```
63
quinolones mechanism of action
inhibits the replication of bacteria via 2 enzymes
DNA gyrase
topoisomerase
64
quinolones therapeutic uses
```
concern: overuse and resistance
UTI
Prostate
pseudomonas
anthrax
skin and soft tissue
pelvic infection- chlamydia trachomatis
```
65
first line for CAP
levofloxacin
| moxifloxacin
66
quinolones pharmacokinetics
excellent oral absorption
distribution - bones
excreted by renally
some metabolism in liver
67
quinolones drug interaction
chelation
| CYP 450
68
how should quinolones be taken
empty stomach
69
quinolones ADR
CNS (older adults)
prolonged QT intervals
tendon rupture
70
quinolones precautioins
elderly
renally impaired
seizure risk
heart hx
71
quinolone contraindicated
pregnancy
breast feeding
children 12 months for second line tx)
72
metronidazole therapeutic uses
c. diff
73
metronidazole caution
liver impairment
| seizure hx
74
metronidazole drug interaction
alcohol (must avoid!)
75
nitrofurantoin mechanism of action
inhibits bacterial enzymes
| damages bacterial DNA
76
nitrofurantoin therapeutic uses
UTI (E.coli)
77
nitrofurantoin ADR
discolored urine
GI
pulmonary toxicity
78
nitrofurantoin contraindication
renal dysfunction
79
nitrofurantoin ADR
discoloration of urine
GI disturbance
hypersensitivity
pulmonary toxicity
80
Influenza antivirals
amantadine
remantadine
zanimivir
oseltamivir
81
resistant influenza antivirals
amantadine
| ramantadine
82
influenza antiviral approved to treat Parkinson's disease
amantadine
83
amantadine and rimantadine therapeutic uses
prophylaxis and treatment of Influenza A
84
amantadine and rimantadine ADR
Orthostatic hypotension
| amantadine- CNS
85
zanamivir and oseltamivir therapeutic uses
Prophylaxis and treatment of Influenza A and B
86
influenza antivirals reduce duration and symptoms by how long?
1.3 days
87
zanamivir and oseltamivir ADR
rare
| zanamivir- bronchospasm in asthma/COPD
88
flu vaccine contraindication
people with egg allergy
89
LAV flu vaccine can be administered in
2- 49 years old without immune dysfunction
90
Herpes Antivirals
acyclovir
valacyclovir
famciclovir
penciclovir
91
Herpes antivirals therapeutic uses
genital herpes
varicella-zoster Virus
Cold sores
92
herpes antiviral approved for HSV in neonates
acyclovir- to prevent transmission from + mother
93
herpes antiviral approved to reduces risk of transmission to uninfected partners
Valacyclovir
94
what two herpes antivirals are used in cold sores
topical acyclovir and penciclovir
95
Herpes Antiviral ADR
mild- headache, confusion, n/v, dizzy, drowsy
rash, itching
renal sufficiency, fever, arthralgias, thrombocytopenia
96
how are all episodes of genital herpes and HSV treated?
acyclovir
valcyclovir
famciclovir
97
newborns presenting with what symptoms should be tested for HSV in the first month
```
fever
poor feeding
lethargy
seizure
lethargy
```
98
Can someone still get chickenpox even if they have the vaccine?
yes (1- 10,000 do)
99
if chickenpox start, should herpes active antiviral drugs be started and if so how soon?
yes, within 24 hours of exantham
100
what is herpes zoster
reactivation of latent VZV in sensory ganglia
101
the zoster vaccine is recommended for who?
> 60 years old
102
should herpes active antivirals be used for people with shingles and why?
yes, reduce severity and duration of symptoms
| reduces incidence of post herpetic neuralgia
