Wk 2 Antimicrobials II Flashcards
(131 cards)
1
Q
What is included in transcription?
A
Nucleus
Messenger RNA
Cytoplasm
2
Q
What is included in translation?
A
Cytoplasm
Ribosomes
Amino acids
Protein synthesis
3
Q
What are the three drugs in the class aminoglycosides?
A
Gentamycin
Amikacin
Tobramycin
4
Q
Aminoglycosides are potent antibiotics that work well on what type of bacteria?
A
Gram-negative
5
Q
Aminoglycosides also work on gram-positive, but they need…
A
Other antibiotics for synergistic effect
6
Q
Aminoglycosides have been used for more complicated infections since 1944 such as…
A
UTIs, gynecological infections, peritonitis, endocarditis, PNA, osteomyelitis
7
Q
What is PNA?
A
Pneumonia
8
Q
What are two notable side effects of aminoglycosides?
A
Nephrotoxicity
Ototoxicity
9
Q
If a patient develops ototoxicity on aminoglycosides it is usually…
A
permanent
10
Q
Becuase of the nephrotoxicity of aminoglycosides, we monitor kidney function through
A
peak and trough levels
11
Q
When are trough levels typically drawn?
A
8-12 hours after the dose is completed
12
Q
Aminoglycosides are not intended for __ women
A
teratogenic, pregnant
13
Q
What class are aminoglycosides for pregnant women?
A
Class C or D
14
Q
Dosing aminoglycosides is transitioned from…
A
three times a day to once per day
15
Q
What type of drug is gentamycin?
A
aminoglycoside antibiotic
16
Q
What type of drug is amikacin?
A
aminoglycoside antibiotic
17
Q
What type of drug is tobramycin?
A
aminoglycoside antibiotic
18
Q
What is the MOA of aminoglycoside antibiotics?
A
Inhibits bacterial ribosomes, stops transcription and translation
19
Q
What type of drug do you not give with gentamycin?
A
Neuromuscular blockades
20
Q
What can happen if you give gentamycin with a neuromuscular blockade?
A
Profound respiratory distress
21
Q
What are the CNS side effects of gentamycin?
A
confusion, depression, disorientation, numbness, tingling
22
Q
Gentamycin is associated with __ damage
A
Cochlear
23
Q
What does cochlear damage cause?
A
High-frequency hearing loss, high pitched tinnitus
24
Q
What routes are available for gentamycin?
A
IV
Intrathecal for meningitis
Ophthalmic drops
Topical ointments
25
What routes is amikacin used?
Only IV
26
What is amikacin used for?
Infections resistant to tobramycin and gentamycin
27
What routes is tobramycin available?
Inhalation, topical, and ophthalmic solutions
28
What is tobramycin typically used for?
Pulmonary infections, especially CF
29
What type of drug is clindamycin?
Lincosamide
30
Clindamycin can be either __ or __
Bactericidal or bacteriostatic
31
What is the MOA for lincosamides (clindamycin)
Binds to ribosomes and inhibits protein synthesis
32
Clindamycin is most often used for __ infections
anaerobe
33
Clindamycin is not used for __ infections
Enterobacter
34
What are some indications for clindamycin? (7)
```
Chronic bone infections
GU infections
Intraabdominal infections
Anaerobic pneumonia
Septicemia
Serious skin infections
Prophylaxis for endocarditis
```
35
What is clindamycin primarily used for?
Pseudomembranous colitis
36
What is pseudomembranous colitis?
swelling or inflammation of the large intestine (colon) due to an overgrowth of Clostridioides difficile (C difficile) bacteria
37
What routes are available for clindamycin?
PO and IV
38
What drug should you be very careful with when using in combination with clindamycin?
Neuromuscular blockade medications
39
What two drugs are macrolides?
Erythromycin
| Azithromycin
40
Macrolides are generally __
bacteriostatic
41
Macrolides are bactericidal in...
high enough concentrations
42
Why are macrolides known as the "yuck" drugs?
GI side effect profile is pretty intense, especially with erythromycin
43
What is the MOA of macrolides?
Inhibit protein synthesis by binding to ribosomes
44
What are the indications of macrolides?
Upper/lower respiratory infections
Skin infections
Soft tissue infections
STIs
45
When using macrolides to treat STIs, especially gonorrhea, what must be used?
A secondary antibiotic because of resistance
46
3 pathologies that can be treated with macrolides
Legionnaire's disease
Listeria
Mycoplasma pneumonia
47
What does erythromycin not do?
Cross the blood brain barrier
48
What routes is erythromycin available?
PO and IV
49
IV erythromycin is __
painful
50
PO erythromycin is...
not absorbed really good
51
Teach patients not to take erythromycin...
on an empty stomach
52
Erythromycin has a lot of what interactions?
drug-drug
53
Erythromycin has hypomotility benefits for __ __
diabetic gastroparesis
54
Erythromycin can INCREASE what?
Motility and emptying of the stomach
55
What is a common name for azithromycin?
z-pack
56
What is different about azithromycin compared to erythromycin?
Less GI side effects and some benefits in coverage
57
What are two benefits of azithromycin?
Good tissue penetration
| Long duration of action
58
Taking azithromycin with food __ absorption
decreases
59
What drug is an oxazolidinone?
Linezolid
60
What is the MOA of linezolid?
Inhibits protein synthesis through non-selective monoamine oxidase inhibitors
61
Oxazolidinones were originally created to treat __ and __
MRSA and VRE
62
What is linezolid indicated for?
Healthcare associated pneumonias and infections
63
Use linezolid with caution in patients with these 5 disorders
```
Hypertension
Untreated thyroid disease
Severe cardiac disease
Cerebrovascular disease
Pheochromocytoma
```
64
What are adverse effects of linezolid?
headache
nausea
vomiting
thrombocytopenia
65
What routes can linezolid be given?
PO and IV
66
What can happen if given linezolid with SSRIs?
Serotonin syndrome
67
What are foods to avoid when taking linezolid?
Foods high in tyramine - wines, smoked meats, aged cheese, soy sauce
68
What drug belongs to the class streptogramins?
quinupristin/dafopristin
69
Streptogramins is a newer class used for
"super bugs"
70
Quinupristin/dafopristin is used in a __/__ combo
70/30
71
Quinupristin/dafopristin used alone is __
bacteriostatic
72
When used in combination, quinupristin/dafopristin is...
bactericidal, 16x the activity used alone (big synergistic effect)
73
What are indications for streptogramins?
Serious, life-threatening infections with VRE, MRSA
| Complicated skin infections
74
What routes are quinupristin/dafopristin available?
IV only
75
What are the adverse effects of streptogramins?
Arthralgias
myalgia
painful inflammation at IV site, 75%
76
What must quinupristin/dafopristin be infused with?
D5W
77
What must you be aware of that quinupristin/dafopristin can cause?
C diff
78
What dangerous side effect can quinupristin/dafopristin cause?
Angioedema
79
What are the three tetracyclines?
Tetracycline
Doxycycline
Minocycline
80
What is the MOA of tetracyclines?
Bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes
81
What is the problem with tetracyclines?
Major resistance has developed since used early in time, been around a while
82
What are conditions that are treated with tetracyclines? (7)
```
Rickettsia
Chlamydia and trich
Lyme disease
Cholera
PID
Mycoplasma pneumoniae
Acne
```
83
What are contraindications for tetracyclines?
Nursing and pregnant women, children younger than 8
84
What are adverse effects of tetracyclines? (3)
Discoloration of teeth, tooth enamel hypoplasia, photosensitivity
85
Tetracycline is not available
parenterally
86
Tetracycline is best taken on an...
empty stomach, good bioavailablilty
87
Where does tetracycline concentrate at?
Bones, liver, tumors, spleen, and TEETH
88
Tetracycline can cause teeth damage in children...
under 8 years old
89
What are adverse effects of tetracycline? (6)
```
N/V/D
Headache
Photosensitivity
Dizziness
Anaphylaxis
Angioedema
```
90
Which tetracycline is most commonly used to treatment or prophylaxis of STIs?
Doxycycline
91
What else is doxycycline used for?
Acne and other skin infections
92
What type of meningitis is Minocycline used for?
Neisseria meninitides
93
What does minocycline decrease the symptoms of?
rheumatoid arthritis
94
What is an ER form of minocycline used to treat acne?
Solodyn
95
What type of drug is tigecycline?
Glycylcylines
96
Glycylcylines are the newest form of tetracyclines and are...
effective against tetracycline resistant orangisms
97
Tigecycline is typically used for...
Skin infections
Peritonitis
Abdominal infections
98
Glycylclines side effects
nausea and vomiting
99
What two drugs are fluoroquinolones?
Ciprofloxacin
| Levofloxacin
100
Fluoroquinolone have very good __ __
oral absorption
101
What is the MOA of fluoroquinolones?
Destroy bacteria by altering their DNA
102
What 2 bacterial enzymes do fluoroquinolone interfere with?
gyrase and topoisomerase
103
What bacteria do fluoroquinolones cover?
Mostly gram-negative with some gram-positive
104
What is really good about fluoroquinolones?
Since they have really good oral absorption, patients can go home on these antibiotics without a CVC
105
What is ciprofloxacin used to treat?
UTIs
STIs - gonorrhea
Respiratory tract infections
Anthrax
106
What routes is ciprofloxacin given?
PO, IV, or topical
107
Ciprofoxacin has minimal penetration of the...
blood brain barrier
108
What is commonly used before ciprofloxacin to treat UTIs?
Bactrim
109
Where is ciprofloxacin concentrated?
Neutrophils
110
What age groups should you avoid ciprofloxacin in?
under 18 or over 60
111
What is an adverse effects of ciprofloxacin?
arthropathy, but often reversible
112
What is the most widely used fluoroquinolone?
levofloxacin
113
How often do you take levofloxacin?
Once a day
114
What routes are levofloxacin?
IV or PO
115
Levofloxacin has __% bioavailability PO
100%
116
What are side effects to levofloxacin? (4)
CNS disorders
kidney failure
prolonged qt interval
photosensitivity
117
What type of drug is daptomycin?
cyclic lipopeptide
118
What is the MOA of cyclic lipopeptide?
Unknown; binds to gram positive cells in calcium-dependent process, disrupts the cell membrane potential
119
With daptomycin, it has a long...
post-antibiotic effect
120
How often is daptomycin given?
IV once per day
121
What is daptomycin/ cyclic lipopeptides used to treat?
MRSA
VRE
endocarditis
complicated skin infections
122
Why can't daptomycin be used to treat pneumonia?
It is inactivated by lung surfactant
123
What drug is a sulfonamide?
Sulfamethoxale + trimethoprim (bactrim)
124
What is the MOA of sulfonamide?
Don’t destroy bacteria, but inhibit their growth, bacteriostatic. Prevent synthesis of folic acid needed for DNA synthesis
125
Adverse reactions to bactrim are much more common in which patients?
HIV
126
4 indications for bactrim
UTI
Respiratory infection
Salmonella
Shigellosis
127
What does metronidazole work on?
anaerobes
128
What is the MOA of metronidazole?
Inhibits DNA synthesis
129
What are the adverse effects of metronidazole?
N/V
Xerostomia
Vaginal yeast
130
What is metronidazole most often used to treat?
C diff but there is some resistance now
131
What is zerostomia?
dry mouth
