Respiratory Antibiotics Flashcards Preview

RESP II Exam 2 > Respiratory Antibiotics > Flashcards

Flashcards in Respiratory Antibiotics Deck (74):
1

amoxicillin

aminopenicillin
PO

2

ampicillin

aminopenicillin
PO, IV, IM

3

piperacillin

anti-pseudo penicillin
IV

4

ceftriaxone

third generation cephalosporin
IV, IM

5

ceftazidime

third generation cephalosporin
IV, IM

6

cefepime

fourth generation cephalosporin
IV, IM

7

meropenem

carbapenem
IV

8

ertapenem

carbapenem
IV, IM

9

beta-lactamase inhibitors

sulbactam
clavulinic acid
taxobactam

often given with the PCNs

10

ciprofloxacin

FQ
PO, IV, topical

11

levofloxacin

FQ
PO, IV, topical

12

moxifloxacin

FQ
PO, IV, topical

13

gentamicin

aminoglycosides
IV, IM, topical

14

doxycycline

tetracycline
PO, IV

15

azithromycin

macrolide
PO, IV, topical

16

clindamycin

lincosamide

17

linezolid

oxazolidinone
PO, IV

18

oseltamivir

anti-viral
-PO

19

flucanozole

antifungal
PO, IV

20

intraconazole

antifungal
PO

21

voriconazole

antifungal
PO, IV

22

penicillin resistance

drug destruction and inactivation by beta-lactamases

23

aminopenicillins

extended-spectrum

gram positive, gram negatives

24

upper resp infections with strep pyogenes, strep pneumoia, h flu

ampicillin
amoxicillin

25

hospital acquired pneumonia

pseudomonas

piperacillin

26

DOC for serious gram negatives

third gen cephalospirins
-ceftriaxone and ceftazidimine

27

pseudomonas coverage

cefepime
-4th gen cephalosporin

28

glycopeptide MOA

vancomycin

inhibit cell wall synthesis binding to D-Ala-D-Ala terminal

cannot penetrate cell wall of gram negatives

29

vancomycin

glycopeptide
IV***

monitor levels closely

30

clostridium dificile tx

oral vancomycin

31

red man syndrome

vancomycin adverse effect - due to rapid infusion - flushing, tachycardia, hypotension

also - macular rash, chills, fever, rash

32

fluoroquinolone MOA

bacterial DNA gyrase and topoisomerase IV

bactericidal - concentration dependent

33

ciprofloxacin

covers pseudomonas

34

respiratory FQs

levofloxacin
moxifloxacin
gemifloxacin

35

gonorrhea DOC

ceftriaxone

36

adverse with cephalosporins

GI sx
achilles tendon rupture in children

37

achilles tendon rupture in children

side effect of cephalosporins

38

aminoglycoside MOA

bind 30S ribosome subunit
-interfere initiation of protein synthesis

alter membrane permeability

39

tetractcycline MOA

binding 30S ribosome
-prevent access of aminoacyl tRNA to acceptor A site on mRNA ribosome complex

40

all strains pseudomonas

resistant to tetracyclines

41

macrolide MOA

reversibly bind 50S subunit

inhibit translocation where newly synthesized peptidyl tRNA molecule moves from acceptor site on ribosome to peptidyl donor site

42

atypical pneumonia tx

macrolides
-azithromycin

43

CYP3A4 inhibition

macrolides

44

lincosamide MOA

50S binding and suppress protein synthesis

clindamycin

45

oxazolidinones MOA

linezolid

inhibit protein synthesis - bind 50S subunit
-prevention formation of alrger fmet-tRNA complex that initiates protein synthesis

46

linezolid use

only MDR organisms

47

risk fx for drug resistance strep pneumonia

beta-lactam use within 3 months
age < 2 or > 65
alcoholic
immunosuppressive therapy
exposure to day care child

48

underlying bronchopulmonary disease

h flu
moraxella catarrhalis

49

outpatient CAP

strep pneumo
mycoplasma pneumo
h flu
chlamydophila pneumo
resp viruses

50

hospitalized CAP

strep pneumo
mycoplasma pneumo
h flu
chlamydophil pneumo
resp viruses
legionella
aspiration

51

ICU CAP

strep pneumo
staph aureus
legionella
gram negative bacilli
h flu

52

outpatient tx CAP previously healthy

macrolide PO

or

doxycycline PO

53

outpatient tx CAP at risk for DRSP

resp FQ PO
-levo, moxi, gemi

or

beta-lactam PO + macrolide PO
-amoxicillin

54

inpatient, non ICU CAP tx

resp FQ IV or PO

or

beta-lactam IV + macrolide IV

55

inpatient, ICU pt CAP tx

beta-lactam IV + azithromycin IV

or

resp FQ

56

risk fx for pseudomonas

structural lung disease
COPD exacerbation
frequent corticosteroids and antibiotic use

57

tx pseudomonas CAP

anti-pseudo beta-lactam IV + cipro (or levofloxacin)
-piperacillin,cefepime

or

beta-lactam + aminoglycoside + azithromycin

or

beta-lactam + aminoglycoside + anti-pseudo FQ

58

risk fx for MRSA

ESRD - on dialysis
IV drug use
prior influenza
prior antibiotics

59

tx MRSA

add vancomycin IV or linezolid

panton-valentine leucocidin necrotizing pneumonia - add clindamycin or use linezolid

60

CAP therapy

minimum 5 days
must be afebrile 48-72 hours

exception - pseudomonas - 8 day course led to more relapse than 15 day course**

61

hospital acquire pneumonia bugs

pseudomonas
E. coli
klebsiella
acinetobacter
MRSA - in ICU, head trauma

62

pseudomonas resistance

efflux pumps
decreased porin channels
beta-lactamases

63

MRSA resistanace

reduced PBP affinity for beta-lactams

64

oseltamivir MOA

neurominidase inhibitor
-interferes with release of progeny influenza virus from infected cells

influenza A and B

65

oseltamivir adverse effects

N/V/D, psych sx

66

influenza prophylaxis

oseltamivir

67

HSV and VZV tx

acyclovir
-inhibit step 1 virus specific thymidine kinase

68

CMV tx

ganciclovir
-guanosine analog - requires activation by tri-P before inhibiting DNA polymerase

69

azole MOA

inhibit fungal CYP450 - reducing production of ergosterol

flucanazole, itraconazole, voriconazole

lots of drug interactions**

70

candida, blastomycosis, coccidiomycosis, histoplasmosis coverase

azoles

71

strep pneumo resistance

PBP reduced affinity

72

staph aureus resistance

PBP reduced affinity

73

gram positive resistance

reduced PBP affinity

74

gram negative resistance

beta-lactamase production