Chapter 23 Deck 2

Question 1

Fluoroquinolones phamacodynamic

Answer 1

interfere with the bacterial enzymes required for the synthesis of bacterail DNA. Noted for extensive gram-negative activity

Question 2

Fluoroquinolones not recommended for

Answer 2

children younger than 18

Question 3

Result of overprescribing of Fluroquinolones

Answer 3

Can no longer be used for gonorrhea, resistant to TB

Question 4

Fluroquinolones are narrow or broard

Answer 4

narrow

Question 5

Fluroquinolones are best taken on

Answer 5

an empty stomach. They are well absorbed in the GI tract

Question 6

Fluoquinolones ADR

Answer 6

Black Box warning to avoid when less toxic alternatives available

Tendon rupture:
Older adults at higher risk
Can have delayed onset, 120 days to months after administration

Question 7

Fluroquinolones should be avoided in

Answer 7

pregnancy

Question 8

Fluorquinolnes ADRs continued

Answer 8

GI: pseudomembranous colitis
Central nervous system (CNS): sleep disorders, dizziness, acidosis
Renal/hepatic failure
Cardiovascular: angina, atrial flutter
Increased risk of aortic aneurysm or dissection
Should be avoided in pregnancy
Not prescribed for children younger than 18 years of age

Question 9

Fluoroquinolones uses? Are they first line? why?

Answer 9

No longer first line because of resistance and ADRs

Complicated UTI, pyelonephritis infections, chronic bacterial prostatitis

Pneumonia/chronic bronchitis exacerbation

PCN-resistant S. pneumoniae, skin infections, bone/joint infections, complicated intraabdominal, infectious diarrhea

Question 10

Prlonged use of Fluoroquinolnes monitor

Answer 10

ECG in at risx patients before giveing moxifloxacin

Question 11

avoid what with Fluroquinolnes

Answer 11

alcohol use

Question 12

Fluroquinolnes patient education

Answer 12

Food delays absorption.
Many drug interactions occur.
Take with full glass of water.
Drugs may cause dizziness. 
If tendon tenderness occurs, stop medication and notify provider.

Question 13

Fluoroquinolone drug names

Answer 13

ciprofloxacin, ofloxacin, gemifloxacin, levofloxacin, moxifloxacin and delafloxacin.

The most popular brand name drugs in the class are: Cipro and Cipro XR (ciprofloxacin) Avelox (moxifloxacin)

Question 14

Lincosamide Drug name

Answer 14

clindamycin

Question 15

lincosamide pharmacodynamics

Answer 15

inhibits protein synthesis (50S) ribosoal unit

Question 16

lincosamide use

Answer 16

No gram-negative activity

Gram-positive activity: Corynebacterium acnes, Gardnerella vaginalis, some MRSA

Question 17

Lincosamide pharmacokinetics

Answer 17

oral dosing completely absorbed; not affected by gastric acid

Question 18

Lincosamide ADr

Answer 18

Black Box warning for severe colitis; dermatological: rash, burning, itching, erythema; transient eosinophelia, neutropenia, thrombocytopenia

Question 19

Lincosamide Clinical use and dosing

Answer 19

First-line therapy for MRSA in some areas
Infections in PCN-allergic patients
Drug-resistant Streptococcus pneumoneae infections
Dental infections

Question 20

Lincosamide rational drug selction

Answer 20

Considered second-line therapy; narrow spectrum of aerobic activity

**First-line therapy in special populations (pregnant women and children)

Question 21

Clindamycin has a

Answer 21

broad spectrum for infections in the mouth

Question 22

Clindamycin monitoring

Answer 22

Monitoring
Stop medication if significant diarrhea occurs.

Patient education
Finishing therapy
ADRs: diarrhea

Question 23

recomendation when taking an antibiotic

Answer 23

take a probiotic for about 30 days

Question 24

Macrolides and Azalides drug names

Answer 24

erythromycin, azytrhomycin respectivley

Question 25

Erythromycin (macrolines) is inactived by

Answer 25

acid. comes in an enteric coated form

Question 26

Macrolide pharmacodynamics

Answer 26

Inhibits RNA-dependent protein synthesis

Question 27

macrolines increase in

Answer 27

alkaline media

Question 28

What is useptibale to macrolides

Answer 28

Atypical and intracellular organisms commonly resistant to beta-lactam antibiotics are often susceptible

Question 29

Macrolides are well absorbed from teh

Answer 29

duodenum

Question 30

Macrolides taken with statins may increase the risk of

Answer 30

myopathy (mucles fibers do not function poperly)

Question 31

Macrolides exhibit what? this leads to?

Answer 31

Exhibit enterohepatic recycling, which can lead to buildup in the system and can cause n/v; tissue levels are higher than serum levels

Question 32

Macrolides are safe in

Answer 32

pregnancy

Question 33

Azithromycin may cause

Answer 33

QT prolonged interval and torsades de points

Question 34

Macrolides ADR

Answer 34

ADRs Dose-related GI: n/v, abdominal pain, cramping, diarrhea Skin: urticaria, bullous eruptions, eczema, Stevens-Johnson syndrome Drug interactions Inhibitors of CYP3A4

Question 35

Stephen Johnson Syndrome

Answer 35

A rare, serious disorder of the skin and mucous membranes. A medical emergency, this is often a reaction to medication or an infection. Flu-like symptoms appear first. A painful rash that spreads and blisters follows. Emergency treatment aims to eliminate the underlying cause and control symptoms and complications.

Question 36

ETOH and Macrolides will cause an increased risk of

Answer 36

prolonged QT

Question 37

macrolides clinical use and dosing

Answer 37

Clinical use and dosing Drug of choice for community-acquired pneumonia (mycoplasma) Chlamydia Pertussis Helicobacter Pylori infections (clarithromycin) chronic bronchitis

Question 38

Macrolides Drug Selection

Answer 38

Often as alternatives for patients with PCN allergies Increasing resistance Not appropriate for treating AOM or sinusitis

Question 39

Macrolides Monitoring

Answer 39

``` Monitoring For altered response to concurrent medications metabolized by CYP3A4 or CYP2C9 Hepatic/renal impairment Hearing loss Patient education ADRs Drug interactions ```

Question 40

Fidaxomicin name and class

Answer 40

Dificid 18 ring macrolide

Question 41

Fadaxomicin pharmcodynamics

Answer 41

active against C. diff, rare resistance

Question 42

contraindications for fadaxomicin

Answer 42

safe in pregnancy | not established for safety in persons younger than 18

Question 43

Fidaxomicin drug interactions

Answer 43

rifampin, rifaximin

Question 44

clincial use for fidaxomicin

Answer 44

C. Diff Only.