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Pharm 1 > Antimicrobials 2 > Flashcards

Antimicrobials 2 Flashcards

1
Q

11 Classes that Work by Inhibiting/Altering Protein Synthesis

A

Aminoglycosides

Lincosamides: clindamycin

Macrolides

Oxazolindinones

Streptogramins

Tetracyclines

Glycylcycline

Fluoroquinolones

Cycliclipopeptides

Sulfonamides

Metronidazole

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2
Q

3 Aminoglycoside drugs

A

gentamycin

amikacin

tobramycin

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3
Q

what does aminoglycosides work well on

A

gram neg bacteria

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4
Q

what are aminoglycosides used for

A

complicated infections:

UTIs/pyelonephritis, gynecological infections, peritonitis, endocarditis, PNA, osteomyelitis (DM related infections)

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5
Q

2 severe side effects of aminoglycosides

A

Nephrotoxicity - usually reversible

ototoxicity - usually permenant

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6
Q

how do we monitor aminoglycosides

A

therapeutically through peak and trough levels

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7
Q

MOA of aminoglycosides

A

inhibit bacterial ribosomes stopping transcription and translation

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8
Q

T/F aminoglycosides are used in pregnant women

A

FALSE

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9
Q

what is gentamycin not given with

A

Neuromuscular blockade

be careful, can cause PROFOUND respiratory distress [myasthenia gravis]

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10
Q

what CNS side effects are associated with gentamycin

A

confusion, depression, disorientation, numbness, and tingling

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11
Q

what damage is associated with gentamycin

A

cochlear damage

ototoxicity, high-frequency hearing loss, high-pitched tinnitus

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12
Q

routes for gentamycin

A

IV; intrathecal for meningitis

Also available in ophthalmic drops, and topical ointments

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13
Q

route of amikacin

A

IV

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14
Q

what is amikacin used for

A

infactions resistant to tobramycin and gentamycin

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15
Q

routes of tobramycin

A

Inhalation for pulmonary infections (esp. CF patients)

Topical and ophthalmic solutions available

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16
Q

Lincosamide drug

A

clindamycin

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17
Q

is clindamycin Bactericidal or bacteriostatic–

A

can be either depending on concentration

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18
Q

MOA for clindamycin

A

binds to ribosomes and inhibits protein synthesis

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19
Q

7 indications of clindamycin

A

chronic bone infections,
GU tract infections, intraabdominal infections, anaerobic pneumonia, septicemia,
serious skin infections; prophylaxis for endocarditis

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20
Q

route of clindamycin

A

PO/IV

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21
Q

clindamycin primary use

A

treating pseudomembranous colitits

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22
Q

nursing considerations of clindamycin

A

Monitor use with neuromuscular blockade medications

Very toxic- monitor levels

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23
Q

2 macrolide drugs

A

erythromycin

azithromycin

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24
Q

S/E of macrolides

A

YUCK DRUGS

GI side effect profile intense

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25
Q

MOA of macrolides

A

inhibit protein synthesis by binding to ribosomes

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26
Q

indications of macrolides

A

various infections of upper and lower respiratory infections,
skin infections,
soft tissue infections;
STIs

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27
Q

what can be treated with macrolides

A

Legionnaire’s,
Listeria,
mycoplasma pneumonia

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28
Q

T/ F macrolides are Bacteriostatic in general, bactericidal in high enough concentrations

A

True

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29
Q

what benefits does erythomycin have

A

Has hypomotility benefits for diabetic gastroparesis & increase gastric motility and emptying

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30
Q

routes of erthromycin

A

PO & IV–

IV is painful, oral absorption isn’t great

Topical and ophthalmic also available

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31
Q

does erthromycin cross the BBB

A

NO

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32
Q

should you take erythomycin on an empty stomach

A

NO

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33
Q

does erythromycin have a lot of drug-drug interactions

A

YES

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34
Q

T/F azithromycin differs structurally from other macrolides

A

TRUE

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35
Q

Do you take a Z-pack with food

A

No, decreases absorption

36
Q

T/F z-packs have Very good tissue penetration & long duration of action

A

True

37
Q

Oxazolidinones drug

A

linezolid

38
Q

MOA of linezolid

A

inhibits protein synthesis through non-selective monoamine oxidase (MAO) inhibitors

39
Q

what is linezolid indicated for

A

healthcare-associated pneumonias and infections

40
Q

what do we use caution in with linezolid

A 
Hypertension
Untreated thyroid disease
Severe cardiac disease
Cerebrovascular disease
Pheochromocytoma
41
Q

A/E of linezolid

A

headache

nausea

vommiting

42
Q

routes of linezolid

A

po/iv

43
Q

what do we watch for in linezolid

A

Watch platelet count = thrombocytopenia

Can cause serotonin syndrome with use of SSRIs

Avoid foods high in tyramine: wines, smoked meats, aged cheese, soy sauce

44
Q

what is the streptogramin drug

A

quinupristin/dafopristin

45
Q

what are quinupristin/dafopristin

used for

A

superbugs

46
Q

why are quinupristin/dafopristin

given in combo

A

quinupristin/dalfopristin used in combination alone bacteriostatic, combination=bactericidal 16x the activity used alone

47
Q

what must quinupristin/dafopristin be given IV with

A

D5W

48
Q

what is the infections quinupristin/dafopristin are used for

A

Use for serious, life-threatening infections caused by VRE and complicated skin and skin structures, including MRSA

49
Q

A/E of quinupristin/dafopristin

A

arthralgias, myalgias; painful/erythema/inflammation at IV site in 75%

50
Q

3 Tetracycline drugs

A

tetracycline

doxycycline

minocycline

51
Q

MOA of tetracyclines

A

bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes

52
Q

Some infections treated by tetracyclines

A 
Rickettsia (rocky mountain spotted fever)
Chlamydia and trichomonas
Lyme disease
Cholera 
Pelvic inflammatory disease 
Mycoplasma pneumonia 
Acne
53
Q

contraindications of tetracyclines

A

Pregnant and nursing women,

children younger than 8

54
Q

A/E for tetracyclines

A

discoloration of the permanent teeth and tooth enamel hypoplasia in fetuses and children, photosensitivity, many others

55
Q

Is tetracycline bacteriostatic

A

yes, inhibits or retards the growth

56
Q

A/E of tetracycline

A

N/V/D, headache, photosensitivity, dizziness

Rare: anaphylaxis and angioedema

57
Q

Route of tetracycline

A

PO

58
Q

where does tetracycline concentrate

A

bone

liver

tumor

spleen

teeth

59
Q

what is doxycycline used for

A

Chlamydial and mycoplasmal infections

Prophylaxis for STIs

Acne and other non-dangerous skin infections

60
Q

what is minocycline used for

A

Neisseria meningitides

Decreases symptoms of rheumatoid arthritis

Solodyn is an extended release (ER) formula - acne

61
Q

what is the glycylcyline drug

A

tigecycline

62
Q

what is tigecycline effective against

A

Treats complicated skin and skin structure infections MRSA, VRE, extended-spectrum beta lactamases

Peritonitis and other complicated abdominal infections

63
Q

S/E of tigecycline

A

N/V

64
Q

2 Fluoroquinolone drugs

A

ciprofloxacin

levofloxacin

65
Q

MOA of fluroquinolones

A

destroy bacteria by altering their DNA

nterfere with the bacterial enzymes DNA gyrase and topoisomerase

Mostly gram-negative and some gram-positive coverage

66
Q

T/F fluroquinolones have good oral absorption

A

TRUE

67
Q

what does ciprofloxacin treat

A

Used to treat UTIs, some STIs, upper and lower respiratory tract infections, gonorrhea, and other infections

Also treats anthrax infection with Bacillus anthracis

68
Q

route of cipro

A

po,iv,topical

69
Q

A/E of cipro

A

arthropathy (joint disease), often irreversible

avoid in patients under 18 and over 60

70
Q

t/f cipro hasMinimal penetration of the BBB/CSF

A

true

71
Q

route of levofloxacin

A

po iv

100% bioavailabiilty orally

72
Q

side effects of levofloxacin

A

CNS disorders that predispose to seizures, kidney failure, can cause prolongation of QT interval, photosensitivity

73
Q

where does levofloxacin have more activity

A

More activity against pneumococcal and other ‘atypical’ respiratory infections

74
Q

cyclic lipopeptide drug

A

daptomycin

75
Q

MOA of daptomycin

A

Not completely understood; binds to gram + cells in calcium-dependent process, disrupts the cell membrane potent

76
Q

route of daptomycin

A

IV once per day

77
Q

What does daptomycin treat

A

MRSA, VRE bacteremia, right-sided endocarditis, complicated skin & skin structure infections

78
Q

what are the sulfonamide drug

A

sulfamethoxale + trimethoprim (Bactrim)

79
Q

MOA of sulfonamide

A

don’t actually destroy bacteria but inhibit their growth= bacteriostatic by preventing the synthesis of folic acid needed for DNA synthesis

80
Q

indications of sulfonamide

A

uncomplicated UTIs, respiratory infections, salmonella, shigellosis

81
Q

caution with sulfonamide

A

sulfa allergies

photosensivity

82
Q

metronidazole is anti what?

A

Antiprotozoal & antibacterial

83
Q

metronidazole is used to treat what

A

Crohn’s disease

Antibiotic-associated diarrhea

84
Q

MOA of metronidazole

A

inhibits DNA synthesis, similar to fluroquinolones

85
Q

Caution with metronidazole

A

do not take with alcohol

86
Q

A/E of metronidazole

A

N/V

xerostomia

vaginal candidasis

87
Q

activity of metronidazole

A

anaerobic only

Pharm 1 (28 decks)

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