Week 2-Bugs/Drugs Flashcards by Amy Herbst

Cell Wall Inhibitor Medications

Beta-lacams
PCN–“Old PCN”-Pen G, Pen VK, Biacillin
–Antistaphloccal PCN–naphcillin, oxacillin, dicloxcillin
–Extended-spectrum PCN–Amoxil, Augmentin, ticacillin, pperacillin
Cephlosporins (4 generations)
Glycopeptides–Vancomycin & Teicoplanin
Daptomycin
Fosfomycin
Bacitracin

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DNA Synthesis Inhibitor Medications

Fluoroquinolones (4 generations)
Nitrofurantoin
Rifampin
(Sulfas)

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Folic Acid Production Inhibitor Medications

TMP/Sulfa

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Protein/Production Synthesis Medications

Tetracycline
Macrolids
Aminoglycosides
Linezolid (Zyvox)
Clindomycin (Cleocin)
Chloramphenicol

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Cell Membrane Inhibitor Medications

Daptomycin
Polymyxin B
Colstin

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What are the “Old PCNs” and what do you use them for?

Pen G, Pen VK, Biacillin
Use: gram + and susceptible bugs
NOT used for staph

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What are the “Antistaphloccal PCNs” and what are they used for?

Naphcillin, oxacillin, dicloxcillin
Use: gram + organisms that are beta-lactamase producers
DO NOT WORK with MRSA

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What are the “Extended-spectrum PCNs” and what are they used for?

Gram - activity: Amoxil, Augmentin

antipseudomal: ticacillin, piperacillin

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What are things to remember when giving PCN?

give on empty stomach (except Amoxil)
renal elimination–decrease dose for creatine clearance
Clavulonic mg differs in each tablet

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What is the DOC for strep throat and syphilis?

PCN

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What are B-LI medications?

Clavulonic acid, subactam, & tazobactam

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What are the 1st generation cephlosproins and what are they used for?

cephazolin, cefadroxil, cephalexin, cephradine.

Used for GAS, s. aureus, and PEK (proteus, E. Coli, & Klebsiella)

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What are the 2nd and 3rd generation cephlosporins and what are they used for?

2nd: cefaclor, cefuroxime, cefprozil, loracarbef
3rd: cefixime, cefpodoxime, cefdinir, cefditoren, ceftibuten, rocephin
USES: pediatric respiratory pathogens (OM & sinusitis)

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Which 2nd generation cephalosporin causes serum sickness–rash, fever, swollen joints?

cefaclor (ceclor)

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Which 2nd generation cephalosporin has dosages that differ in tablets and oral suspension?

cefuxime (Ceftin)

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Which 3rd generation cephalosporin is a good urinary antimicrobial but is hard to find?

Cefixime (Suprax)

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The most common glycopeptide medication is

Vancomycin

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What “bugs” is Vancomycin used for?

Gram + coverage ONLY (staph and strep)

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What is the DOC for MRSA and MRSE?

Vancomycin

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What are adverse reactions/side effects of Vancomycin?

-ototoxicity & nephrotoxicity (trough 10-15mcg/mL; peak

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Which medication is used with a 3rd generation cephalosporin for bacteria meningitis?

Vancomycin

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Which medication can be used for bone and joint infections?

Vancomycin

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Which medication is used for surgery prophylaxis when the patient has a PCN allergy?

Vancomycin

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Which medication is used in Vancomycin resistant organisms?

Daptomycin

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What is an adverse reaction of Daptomycin?

myopathy, watch CPK levels

What is Fofomycin used for and how often?

UTIs X 1 dose

What are Fluoroquinolones typically used for?

UTIs & systemic (respiratory) agents; they block DNP production

What are the 1st generation fluoroquinolones and what are they used for?

Nalidixic acid (no obsolute) for enterobacteracide

What are the 2nd generation fluoroquinolones and what are they used for?

Gram - pseudomonas coverage urinary agents--Norfloxacin, lomefloxacin, & enoxacin system agents--Cipro (pseudomonas) & ofloxacin

What are the 3rd generation fluoroquinolones and what are they used for?

gram + coverage (s. pneumonaie) levofloxacin (a l-isomer of ofloxacin) gatifloxacin (Tequin)--removed from market b/c of toxicity

What are the 4th generation fluoroquinolones and what are they used for?

additional anaerobic coverage | moxifloxacin, gemifloxacin, trovafloxacin (removed b/c of toxicity)

What are adverse reactions/contraindications of fluroquinolones?

- used in "special circumstances" and with caution in kids--cartiloage toxicity - causes prolonged QT - avoid if on IA/III antiarrhythmics - renal adjustments (except monifoxacin) - avoid in pregnancy

What are Sulfas/TMP used for?

UTI, prostatitis, & dysentery

How does sulfas/TMP work to fight infection?

they both inhibit separate microbial enzymes that produce folic acid

What medication is used to treat bacterial conjunctivitis?

Topical sulfa eye drops

What are important patient considerations/adverse effects of Sulfa/TMP?

- drink plenty of water to prevent hematuria & crystalluria - can cause aplistic anemia, thrombocytopenia, & leukopenia - Avoid in G6PD deficiency patients - Avoid in late pregnancy - Steven Johnsons syndrome

What "bugs" are tetracyclines and macrolids used for?

extended spectrum (G+, G-, and anaerobes), chlamydia, rickettia, and mycoplasma

What is the short-acting tetracycline and it's half-life?

tetracycline t1/2~6h

What is the intermediate tetracycline and it's half-life?

demeclocycline t1/2~12h

What is the long-acting tetracycline(s) and it's half life?

doxycycline and minocycline t1/2~18h

What are side effects and important information to tell your patient when giving them tetracycline?

- Fe, Ca (milk), & Al-->impairs GI absorption - food can impair absorption (except long-acting) - avoid during pregnancy - avoid in children under 8--dental staining and bone growth

What are the 3 Erythromycin families/forms?

Sterate ("Erythromycin") Estolate (Illosone") Succinate ("EES)

What do you need to tell your patient who is taking a sterate ("Erythromycin")?

food can decrease absorption

What do you need to tell your patient who is taking a Estolate ("Ilosone")?

Do not take if pregnant due to hypatotoxicity

What are the 3 "expanded Spectrum" macrolides?

clarithromycin (Biaxin) azithromycin (Zithromax) telirithromycin (Ketek)

How often do you dose clarithromycin (Biaxin)?

BID, it has fever GI side effects

What are side effects of azithromycin?

has P450 issues

What is telirithromycin (Ketek) used for and what are the side effects?

- Used for respiratory infections. | - It can prolong QT interval and hepatic failure has been reported.

What are side effects of Macrolides?

-GI upset & gastritis

What is an adverse reaction to Erythromycin?

It can inhibit P450 causing increased drug levels of dig, warfarin, carbamazepine, and statins (Zocor & Lipitor)

Macrolids are used as an alternative if a patient has an allergy to which medication?

PCN

What are examples of aminoglycosides

gentamycin, tobramycin, streptomycin, neomycin, kanamycin, & sisomicin

T/F: Aminoglycosides are rarely used as monotherapy?

True, aminoglycosides have been around for 50+ years and are used with other medications

What are side effects of aminoglycosides?

- renal elimination--decrease dose on creatine clearance | - ototoxicity & nephrotoxicity

What are ototoxicity & nephrotoxicity risk facts when taking aminoglycosides?

- high dose in elderly - renal failure - use of loop diruretics - vanco - amphotericin

What "bugs" are aminoglycosides used for?

- gram -, M. tuberculosis, staph, enterococcus, streptococci - UTIs, pyelo, & prostatitis - endocarditis-synergy - nosocomial pneumonia - cystic fibrosis

Linezolid (Zyvox) is used for what "bug"?

synthetic, multidrug resistant G+ (MRSA & VRE)

What are potential problems when taking Linezolid (Zyvox)?

- bone marrow suppression (Reversible) | - optic neuritis & peripheral neuropathy with long courses

clindomycin (Cleocin) is used for what "bugs"?

- anaerobic infections (GI) | - skin/soft tissue infections cause by strep/staph

What are side effects of clindomycin (Cleocin)?

- sensitive caMRSA can become resistant fast | - C. diff & diarrhea

Why is Chloramphenicol no longer used in the U.S.?

It causes anemia, aplastic anemia, and gray baby syndrome

Week 2-Bugs/Drugs Flashcards

(61 cards)