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Pharmacology > Exam 4 - Sulfonamides, Aminoglycosides & Misc. > Flashcards

Exam 4 - Sulfonamides, Aminoglycosides & Misc. Flashcards

(54 cards)

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1
Q

How do sulfonamides work?

A

Broad spectrum antibiotics
Suppress bacterial growth by inhibiting folic acid

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2
Q

Primary use of sulfonamides

A

Urinary tract infections
(E. Coli)

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3
Q

Other uses of sulfonamides

A

Nocardiosis
Chlamydia trachomatis
Conjunction therapy for toxoplasmosis/malaria
Ulcerative colitis

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4
Q

Adverse effects of sulfonamides

A

Hypersensitivity reactions: Stevens-Johnson Syndrome
Hematologic effects
Kernicterus
Renal damage from crystalluria

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5
Q

Drug interactions with sulfonamides

A

Metabolism-related interactions
Cross-hypersensitivity

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6
Q

A topical creams used to suppress colonization in patients with second- and third-degree burns

A

Silver sulfadiazine
Mafenide

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7
Q

Between silver sulfadiazine and mafenide, which is painful and which is not?

A

Silver = pain free when applied
Mafenide = frequently painful when applied

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8
Q

Side effect of mafenide

A

Can cause acidosis

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9
Q

How does trimethoprim work?

A

Suppresses bacterial growth by inhibiting folic acid

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10
Q

*Primary use of trimethoprim

A

*Acute and uncomplicated urinary tract infections

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11
Q

Bacteria that trimethoprim can be used against

A

E. Coli
Proteus mirabilis
Kiebsiella pneumoniae
Enterobacter
Coagulase-negative staphylococcus

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12
Q

Adverse effects of trimethoprim

A

Hematologic effects
Hyperkalemia
Contraindicated for use in pregnancy and lactation

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13
Q

What is trimethoprim frequently combined with?

A

Sulfamethoxazole

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14
Q

Brand names of trimethoprim-sulfamethoxazole

A

Bacteria
Septra

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15
Q

How does trimethoprim-sulfamethoxazole work?

A

Inhibits sequential steps in bacterial folic acid synthesis, making it much more powerful than TMZ or SMZ alone

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16
Q

Uses of trimethoprim-sulfamethoxazole

A

*UTIs
*Otitis media
Bronchitis
Shigellosis
Pneumonia
GI infection

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17
Q

Patient teaching for trimethoprim-sulfamethoxazole

A

Important to drink a lot of water to flush renals
(8-10 glasses of water per day)

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18
Q

Adverse effects of bacteria and septra

A

GI issues: nausea and vomiting
Rash
Hyperkalemia
Hypersensitivity reactions (Stevens-Johnson syndrome)
- Blood dyscrasias
- Kernicterus
- Renal damage: crystalluria
Contraindicated during 1st and 3rd trimesters of pregnancy

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19
Q

What is crystalluria?

A

Bacteria and septra get caught in the renal area due to how it breaks down in the system
This is why it’s important to tell pts to drink a lot of water

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20
Q

What are aminoglycosides?

A

*Narrow spectrum antibiotics *that are Bactericidal
*Used for aerobic gram-negative bacilli

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21
Q

Most commonly used aminoglycosides

A

*Gentamicin
*Tobramycin
*Amikacin

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22
Q

What are aminoglycosides typically prescribed with?

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A

With beta lactam antibiotics to fight severe infection
*Need to be given in separate tubes

23
Q

How can aminoglycosides be administered?

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A

*IV or *IM
(Not absorbed from the GI tract)

24
Q

Main reasons you need to be careful when administering aminoglycosides

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A

*can cause serious injury to inner ear and kidney

25
Adverse effects of aminoglycosides
*Nephrotoxicity *Ototoxicity Hypersensitivity reactions Neuromuscular blockade Blood dyscrasias Vary rare but can cause paralysis or deadly respiratory depression
26
How do you monitor for nephrotoxicity when administering aminoglycosides?
Look at creatinine and BUN levels If high, know drug is damaging kidneys
27
How do you monitor for Ototoxicity when administering aminoglycosides?
Take total cumulative and *trough levels. Watch for ear issues in pt like vertigo
28
Beneficial drug interactions with aminoglycosides
Penicillins Cephalosporins and vancomycin (All used to enhance bacterial kill)
29
Adverse drug reactions with aminoglycosides
Ototoxic drugs Nephrotoxic drugs Skeletal muscle relaxants
30
Important things involved with dosing of aminoglycosides
Single large dose given each day or 2-3 smaller doses per day Monitoring of serum levels is common to monitor plasma levels (peak and trough levels)
31
When should *peak and *trough levels be taken?
*Peak levels should be taken 30 mins after giving IM injection or after a 30 minute IV infusion And 1 hour after an hour long infusion *Trough levels depends on the dosing schedule Ex: once daily doses: draw single sample 1 hour before next dose (value should be very low - close to zero)
32
In general, what is Gentamicin (Garamycin) used for?
To treat serious infections caused by aerobic gram-negative bacilli
33
Types of bacteria Gentamicin (Garamycin) is used for
*Pseudomonas aeruginosa (affects intubated pts in hospital, hard to kill) *E. Coli (hard to kill) Klebsiella Serratia Proteus mirabilis
34
Adverse effects of Gentamicin (Garamycin)
Nephrotoxicity Ototoxicity
35
Examples of other aminoglycosides
Tobramycin (Nebcin) Amikacin (Amikin) Neomycin Kanamycin (Kantrex) Streptomycin Paromomycin (Humatin)
36
What are fluoroquinolones?
Broad spectrum agents with multiple applications
37
How do fluoroquinolones work?
Disrupt DNA replication and cell division
38
How are fluoroquinolones administered?
Orally IV
39
Side effects of fluoroquinolones
Generally mild, but can cause *Tendon rupture (low risk) Usually affects Achilles tendon
40
Which patients are fluoroquinolones contraindicated for?
Younger than 18 *Older than 60 Those taking glucocorticoids Those who have undergone kidney, heart, or lung transplantation
41
Prototype of Fluoroquinolones
Ciprofloxacin (Citroen)
42
What type of bacteria (in general) is Ciprofloxacin (Ciprofloxacin) used for?
Gram negative and some gram positive
43
Uses of Ciprofloxacin (Ciprofloxacin)
Drug of choice for anthrax Respiratory infections UTI (if pt is allergic to sulfa drugs) GI infections Bone, joint, skin, and soft tissue infections
44
Bacteria that are resistant to Ciprofloxacin
Staphylococcus aureus Serratia marcescens Campylobacter jejuni Pseudomonas aeruginosa Neisseria gonorrhoeae
45
Adverse effects of Ciprofloxacin
GI: nausea/vomiting, diarrhea, abdominal pain CNS: dizziness, headache, restlessness, confusion, rarely seizures *Tendon rupture (Black Box Warning) *Phototoxicity Candida infections: pharynx and vagina Increased risk of C diff infection (CDI)
46
Adverse effects if Ciprofloxacin is given to older adults
Confusion Somnolence Psychosis Visual disturbances Can exacerbate myasthenia gravis
47
Drug and food interactions with Ciprofloxacin
Cationic compounds reduce absorption: - Aluminum antacids - Magnesium antacids - Iron salts, Zinc salts, Sucralfate - Milk and dairy products Elevation of drug levels: - Theophylline (used for asthma) - Warfarin (anticoagulant) - Tinidazole (antifungal)
48
Other types of fluoroquinolones
Oflaxacin Moxifloxacin Norfloxacin Levofloxacin Genifloxacin
49
What is metronidazole (Flagyl) used for?
Protozoan infections Infections caused by obligate anaerobes H. Pylori C diff infection Prophylaxis for pts having abdominal or colorectal surgery
50
Adverse effects of Flagyl
Neurotoxicity Allergy Superinfections
51
How does daptomycin (Cubicin) work?
Cylic lipopeptides active against gram positive bacteria
52
Uses of Daptomycin (Cubicin)
Bloodstream infections caused by staph aureus (MRSA) and other skin infections caused by staph Streptococcus
53
Adverse effects of Daptomycin (Cubicin)
GI related Headache Rash Myopathy (muscle pain/weakness)
54
How can you determine if a pt is having myopathy?
Can draw CPK lab work that would indicate if there’s been muscle injury

Pharmacology (16 decks)

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