Chapter 23 deck 3

Question 1

Oxalodinones name

Answer 1

Nlinezolid

Question 2

Oxalodinones pharmacodynamics. Action, what is it effective against

Answer 2

Inhibitors of bacterial ribosomal protein synthesis

Most effective against aerobic gram-positive bacteria
Resistance emerging

Question 3

Oxalodinones pharmacokinetics

Answer 3

Well absorbed orally

Does not use CYP450 enzymes

Question 4

Oxalodinones ADR

Answer 4

Diarrhea, headache, nausea

Myelosuppression has been reported; resolves with discontinuation of drug

Question 5

Linezolid (oxalodinone) clincial use

Answer 5

MRSA pneumonia
Uncomplicated skin infections
Use less expensive drugs first

Question 6

Oxalodinone linezolid can be used in

Answer 6

vancomycin resistant enterocacus.

Question 7

Vancomycin is

Answer 7

exepensive, but oral form is less expensive than IV

Question 8

Sulfonamides block

Answer 8

folic acid synthesis

Question 9

trimethoprim inhibits

Answer 9

dna synthesis

Question 10

nitrofurantoin may inhibit

Answer 10

acetyl coenzymes

Question 11

Sulfonamides, trimethoprim, nitrofurantoin and fosfomycin all

Answer 11

inhibit both gram-positive and gram negative bacteria

. coli, S. pyogenes, S. pneumoniae, H. influenzae, and some protozoa

Question 12

What is an issue with sulfonamides, trimethoprim, nitrofurantoin, and fosfomycin

Answer 12

resistance

Question 13

Sulfonimide example

Answer 13

bactrim

Question 14

ADR for Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin

Answer 14

ADRs: GI – anorexia, n/v, diarrhea, stomatitis; rashes, increased hypersensitivity reactions, photosensitivity; CNS – headache, dizziness, drug interactions
Avoid in glucose-6-phosphate dehydrogenase (G6PD) deficiency
Use cautiously in renal impairment

Question 15

Clinical use for Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin

Answer 15

Most commonly used in UTI infections

MRSA is susceptible in some areas

Question 16

Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin rational for drug selection

Answer 16

Low-cost alternative in children older than 2 months and in those with PCN allergies

Question 17

Monitoring for Sulfonamides, Trimethoprim, Nitrofurantoin, and Fosfomycin

Answer 17

Control and status if treating UTI
Long-term use: check complete blood count (CBC)
Chest x-ray in patients who develop a cough when on nitrofurantoin

Question 18

Chest x-ray in patients who develop a cough when on

Answer 18

nitrofurantoin

Question 19

Tetracyclines and Doxycycline drug class

Answer 19

Tetracycline

Question 20

Tetracycline pharmacodynamics

Answer 20

Bind reversibly to the 30S subunit of the bacterial ribosome

Question 21

What decreases absorbtion with tetracycline

Answer 21

food

especially milk and calcium. Don’t take a multivitamin with it

Question 22

Precautions and contraindications

Tetracyclines

Answer 22

Do not prescribe to pregnant women (category D), lactating women, or children age less than 8 years.
Drug interactions: many

Question 23

Tetracyclines

Clinical use and dosing

Answer 23

Doxycycline is considered first-line therapy for C. trachomatis and Ureaplasma urealyticum.
Tetracycline and minocycline are used to treat P. acnes

Question 24

Tetracyclines

Rational drug selection

Answer 24

Doxycycline and minocycline can be taken with food. still no calcium

Question 25

Tetracyclines | Patient education

Answer 25

Administration, ADRs, avoiding pregnancy

Question 26

Glycopeptides name

Answer 26

Vancomycin

Question 27

Vancomycin pharmacodynamics

Answer 27

Vancomycin, telavancin (Vibativ), dalbavancin (Zeven) Used for severe gram-positive infections, such as MRSA resistant to first-line antibiotics Inhibits cell wall synthesis

Question 28

Pharmacokinetics | Vancomycin

Answer 28

Poor oral absorption, given IV

Question 29

Vancomycin ADR

Answer 29

Ototoxicity (transient or permanent) Nephrotocity “Red Man” syndrome if infused too fast ******

Question 30

Vancomycin Clinical use and dosing

Answer 30

Serious gram-positive infections resistant to other medications Oral vancomycin is used to treat C. difficile infection

Question 31

Vancomycin monitoring

Answer 31

``` Monitoring Hearing and renal function Patient education Administration ADRs ```

Question 32

Mycobacteria

Answer 32

Grow slowly and are relatively resistant to drugs that are largely dependent on how rapidly cells are dividing Have a lipid-rich cell wall relatively impermeable to many drugs Are usually intracellular and inaccessible to drugs that do not have good intracellular penetration Have the ability to go into a dormant state Easily develop resistance to any single drug

Question 33

Antimycobacterials | Names

Answer 33

Isoniazid Rifampin Ethambutol

Question 34

Isoniazid action

Answer 34

(INH) and ethambutol inhibit synthesis of mycolic acids.

Question 35

Rifampin action

Answer 35

binds to the beta subunit of mycobacterial DNA–dependent RNA polymerase and inhibits RNA synthesis.

Question 36

Ethambutol action

Answer 36

inhibits synthesis of arabinogalactan, an essential component of mycobacteria cell walls.

Question 37

Pharmacokinetics Antimycobacterials

Answer 37

Well absorbed orally | Metabolism of isoniazid highly variable and dependent on acetylator status

Question 38

Antimycobacterials ADRS

Answer 38

INH: peripheral neuropathy INH, rifampin, and pyrazinamide: hepatotoxicity Ethambutol: optic neuritis Streptomycin and capreomycin: ototoxicity Rifabutin: neutropenia and thrombocytopenia

Question 39

Antimycobacterials Drug Interactions

Answer 39

Many drug interactions | Rifampin: an inducer of CYP450 enzyme

Question 40

Take home of antimycobacterials

Answer 40

Used to treat a tougher bacteria. ADRs. Well absorbed orally, but genetics can have an impact Used to treat TB

Question 41

Antimycobacterials | Clinical use and dosing

Answer 41

Follow Centers for Disease Control and Prevention (CDC) guidelines. Active TB requires four-drug therapy. Preventive therapy includes INH.

Question 42

Antimycobacterials Rational and monitoring

Answer 42

Rational drug selection Follow CDC guidelines. Monitoring Directly observed therapy