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Flashcards in Antimicrobials Deck (56):
1

_______ have a bacteriostatic action, but are bactericidal in nature

Aminoglycosides

2

Antimicrobial: Favorable distribution into bone

Clindamycin

3

Antimicrobial: Favorable distribution into CSF

Ceftriaxone, Chloramphenicol, Metronidazole

4

Antimicrobial: Favorable distribution into gingival fluid

Tetracyclines

5

Antimicrobial: Favorable distribution into lungs

Macrolides

6

Antimicrobial: Favorable distribution into sebum

Tetracyclines

7

Antimicrobial: Favorable distribution into urine/kidneys

Aminoglycosides, Fluoroquinolones, Nitrofurantoin

8

Antimicrobial: Unfavorable distribution into a fetus

Aminoglycosides, Chloramphenicol, Tetracyclines, Fluoroquinolones, Metronidazole

9

Antimicrobial: Unfavorable distribution into bone

Tetracyclines

10

Antimicrobial: Unfavorable distribution into breast milk

Macrolides, Clindamycin

11

Antimicrobial: Unfavorable distribution into kidneys

Aminoglycosides

12

Antimicrobial: Unfavorable distribution into teeth

Tetracyclines

13

Bind and decrease absorption of cations, especially calcium

Fluoroquinolones, Tetracyclines

14

Examples of Fluoroquinolones (3)

Ciprofloxacin, Levofloxacin, Moxifloxacin

15

In bactericidal mechanisms MIC __ MBC

=

16

In bacteriostatic mechanisms MIC __ MBC

<<

17

Indications for bactericidal therapy (3)

Meningitis, Endocarditis, Suppressed/Deficient Immune System

18

Inhibitors of P450

Fluoroquinolones, Erythromycin, Clarithromycin

19

IV only antimicrobials (5)

Piperacillin/Tazobactam, Vancomycin, Ceftriaxone, Carbapenems, Aminoglycosides

20

Lowest concentration of antibiotic that kills 99.9% of the original inoculum

Minimum Bactericidal Concentration (MBC)

21

Lowest concentration of antibiotic that prevents visible bacterial growth

Minimum Inhibitory Concentration (MIC)

22

Mechanism of Action: Beta-lactamase inhibitor

Clavulanate, Tazobactam

23

Mechanism of Action: Decrease DNA function

Fluoroquinolones, Nitrofurantoin, Metronidazole

24

Mechanism of Action: Decrease protein synthesis

Macrolides, Tetracyclines, Clindamycin, Chloramphenicol, Aminoglycosides

25

Mechanism of Action: Inhibit Cell Wall Synthesis- Stage 2

Vancomycin

26

Mechanism of Action: Inhibit Cell Wall Synthesis- Stage 3 (Anti-pseudomonal)

Piperacillin/Tazobactam

27

Mechanism of Action: Inhibit Cell Wall Synthesis- Stage 3 (Extended Spectrum)

Amoxicillin +/- Clavulanate, Ampicillin

28

Mechanism of Action: Inhibit Cell Wall Synthesis- Stage 3 (penicillinase-resistant)

Dicloxacillin

29

Mechanism of Action: Inhibit Cell Wall Synthesis- Stage 3 (prototype, acid-stable)

Penicillin G, Penicillin V

30

Only obtain fluid cultures from drains or catheters if _____.

they are newly placed

31

Protected Locations/Infections that complicate antibiotic treatment (6)

Meningitis, Bone, Endocarditis, Intracellular, Abscesses, Foreign bodies

32

Side Effects: Antabuse-like effect: abdominal distress, headache, and vomiting with consumption of alcohol due to inhibition of aldehyde dehydrogenase

Metronidazole

33

Side Effects: can intensify oral anticoagulants (Ex. warfarin)

Cephalosporins

34

Side Effects: Drug-drug interactions with antacids and iron supplemens

Tetracyclines

35

Side Effects: encephalopathy or convulsions at high dose

Penicillin

36

Side Effects: increased risk of tendon rupture and arthropathies

Fluoroquinolones

37

Side Effects: ototoxicity, nephrotoxicity, and infusion-related symptoms

Vancomycin

38

Side Effects: pseudomembranous colitis

Clindamycin

39

Side Effects: QT interval prolongation

Macrolides, Fluoroquinolones (rare)

40

Side Effects: supferinfection

Extended spectrum penicllins, cephalosporins, fluoroquinolones, Nitrofurantoin (candida), tetracyclines (fungal)

41

Side Effects: Vestibulocochlear Nerve Damage (irreversible) and nephrotoxicity

Aminoglycosides

42

Side Effects:drug-drug interactions: inhibits metabolism of theophylline (earlier generations), antacids reduce oral absorption

Fluoroquinolones

43

Spectrum: can be treated only with ceftriaxone of the cephalosporins

Neisseria gonorrhoeae

44

Spectrum: Can be used to treat Bacteroides fragilis

Amoxicillin +/- Clavulanate, Piperacillin/Tazobactam, Carbapenems, Clindamycin, Nitrofurantoin

45

Spectrum: Can be used to treat Chlamydia and Mycoplasma

Macrolides, Tetracyclines, and Fluoroquinolones

46

Spectrum: can be used to treat Klebsiella with KPC or NDM-1

Fluoroquinolones and Aminoglycosides

47

Spectrum: can be used to treat Neisseria Gonorrhoeae

Ceftriaxone, Macrolides, Tetracyclines

48

Spectrum: Can be used to treat Pseudomonas

Piperacillin/Tazobactam, 4th/5th Cephalosporins, Carbapenems (exc. Ertapenem), Aminoglycosides, Fluoroquinolones (Cipro, Levo)

49

Spectrum: Can treat Clostridium difficile

Metronidazole and Vancomycin (oral only)

50

Spectrum: Can treat E coli, except for when E coli has TEM-1, ESBL, or SHV-1

Amoxicillin, Ampicillin

51

Spectrum: Effective for E coli and E coli with TEM-1, but not for E coli with ESBL

Cephalosporins

52

Spectrum: Good coverage of gram-negative, poor coverage of gram-positive

Aminoglycosides

53

Spectrum: only effective for anaerobes (Clostridium and Bacteroides)

Metronidazole

54

Spectrum: only used for isolates recovered from urine

Nitrofurantoin

55

When to obtain specimens and from where

Before start of therapy; tissues or fluids, especially deeper specimens

56

When to use empiric antibiotic treatment.

Life threatening conditions; outpatient setting