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PHRM 865 > Exam 2 Continued > Flashcards

Exam 2 Continued Flashcards

1
Q

which tetracyline does not display cross resistance

A

minocycline

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2
Q

what is not affected by the major tetracycline resistant mechanisms

A

tetracyline analogs

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3
Q

tetracylines spectrum of activity gram-positive aerobes

A
  1. strep. pneumoniae- PSSP
  2. MSSA
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4
Q

do tetracyclines cover enterobacteriaceae

A

NO

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5
Q

what miscellaneous bacteria do tetracyclines cover

A
  1. legionella
  2. chlamydophila
  3. chlamydia
  4. mycoplasma
  5. ureaplasma
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6
Q

what gram positive aerobes do tetracycline analogs cover

A
  1. VSE
  2. VRE
  3. MSSA
  4. MRSA
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7
Q

what gram negative aerobes does tetracycline analogs specifically cover

A

stenotrophomonas maltophilia

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8
Q

what gram negative aerobes do tetracycline analogs not cover

A

proteus or p. aeruginosa

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9
Q

what anaerobe does tetracycline analogs cover

A

bacteroides

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10
Q

how is tetracyclines + analogs absorption impaired

A

by di- and trivalent cations

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11
Q

what tetracycline + analogs have the best bioavailbility

A

doxycycline and minocycline

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12
Q

tetracyclines + analogs distribution

A

widely distributed with good penetration into synovial fluid, prostate, seminal fluid

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13
Q

tetracyclines + analogs CSF penetration

A

minimal CSF penetation

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14
Q

tetracyclines + analogs elimination

A
  1. demeclocycline and tetracycline are excreted unchanged in the urine
    1. tetracyclines and analogs are minimally removed during hemogialysis
  2. doxycycline, minocycline, and tetracycline analogs are primary excreted by non-renal route
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15
Q

when are dosing adjustments needed for tetracyclines + analogs

A
  • renal insuffiency –> demeclocycline and tetracycline
  • liver disease –> tigecycline and eravacycline
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16
Q

GI AEs of tetracycline/tigecycline

A

N/V esp with tigecycline

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17
Q

can tetra/tigecycline cause photo senstivity

A

yes

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18
Q

tetra/tigecycline pregnancy category

A

D because of discoloration of permanent teeth and decreased bone growth in children

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19
Q

SMX MOA

A

inhibits dihydropteroate synthetase –> inhibits conversion of PABA to dihydrofolate

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20
Q

TMP MOA

A

inhibits dihydrofolate reductase –> prevents reduction of dihydrofolate to tetrahydrofolate

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21
Q

TMP-SMX displays what type of activity

A

each agent alone is bacteriostatic, however, the combination displays bactericida activity

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22
Q

what gram positive does bactrim cover

A

Staph aureus: incl some MRSA, CA-MRSA

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23
Q

what gram negative does bactrim cover

A

HENPEACKSSSS

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24
Q

what specific gram negative is sensitive to bactrim

A

sstentrophomona

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25
Q

what gram negative is not affected by bactrim

A

pseudomonas

26
Q

what other organisms is targeted by bactrum

A

pneumocystis carinii

27
Q

does bactrim penetrate the CNS

A

yes

28
Q

bactrim distribution

A

urine, prostate

29
Q

TMP-SMX eliminaition and dose adjustments

A
  • both are eliminated by the liver and kidney
  • dose adjustment required in patients with CrCl < 30mL/min
30
Q

batcrim hematologic AE

A

leukopenia, thrombocytopenia

31
Q

bactrum hypersensitivity AE

A

rash

32
Q

other bactrim AE

A
  • crystalluria
  • hyperkalemia
  • increased creatinine
33
Q

bactrim drug interaction

A

warfarin- causes increased anticoag effect

34
Q

what drug is a polymyxin

A

colistin

35
Q

polymyxins MOA

A

cationic detergents that binds to anionic lipopolysaccharide molecules in the outer cell membrane of gram negative bacteria causing displacement of Ca and Mg –> induces changes in permeability and leakage of cellular contents, leading to cell death

36
Q

what type of activity do polymyxins display

A

concentration-dependent bactericidal activity

37
Q

polymyxins MOR

A

alteration of outer cell membrane

38
Q

polymyxins SOA

A
  • gram negative aerobic bacilli ONLY: PEEACKSSS
39
Q

what are the two primary targets of polymyxins

A

acinetobacter and p. aeruginosa

40
Q

what are polymyxins NOT active against

A

proteus, providencia, serratia

41
Q

polymyxi absorption

A

not absorbed, only given IV, IM, inhalation

42
Q

polymyxin distribution/ CSF

A
  • limited extravascular distribution
  • limited in CNS
43
Q

colistin and polymyxin B elimination

A

nonrenal routes

44
Q

CMS elimination

A

eliminated unchanged by the kidney via glomerular filtation: requires dose adjustment in renal insufficiency

45
Q

polymyxins AE

A
  1. nephrotoxicity
  2. neurotoxicity
46
Q

colistin weight used for dosing

A

IBW

47
Q

polymyxin B dosing weight

A

TBW

48
Q

clindamycin MOA

A

inhibits protein synthesis by binding exclusively to the 50S ribosomal subunit –> may cause competitive inhibition with macrlides and synercid

49
Q

clindamycin displays what type of activity

A

bacteriostatic, but may be bactericidal when present at high concentrations against very susceptible organisms

50
Q

clindamycin MOR

A
  1. altered target sites
  2. active efflux- but at low level
51
Q

clindamycin SOA GPA

A
  1. PSSP
  2. MSSA
  3. MRSA
52
Q

Clindamycin SOA Anaerobes

A
  • ADA
    • bacteroides
53
Q

clindamycin distribution

A
  1. good tissue penetration including bone
  2. minimal csf penetration
54
Q

clindamycin elimination

A
  • primarily metabolized by the liver
  • not removed during hemodialysis
55
Q

clindamycin AE

A
  1. GI
  2. C. diff colitis
56
Q

metronidazole MOA

A

inhibits DNA synthesis

57
Q

metronidazole MOR

A
  1. altered growth requirements
  2. altered ferredoxin levels
58
Q

metronidazole SOA

A
  • BDA
    • bacteroides
    • clostridiun
59
Q

metronidazole pharmacology

A

well absorbed into body tissues and fluids; DOES penetrate the CSF

60
Q

metronidazole elimination

A

primarily metabolized by the liver- removed during hemodialysis

61
Q

Metronidazole AE

A
  • stomatitis
  • metallic taste
  • peripheral neuropathy
  • avoid during pregnancy (category B) and breastfeeding
62
Q

metronidazole interactions

A
  1. warfarin –> increased anticoagulant effect
  2. alcohol –> dissulfiram reaction

PHRM 865 (59 decks)

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