Wk 7. Antibiotics part 2 Flashcards Preview

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Flashcards in Wk 7. Antibiotics part 2 Deck (28):
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1. How to tetracyclines inhibit the replication of bacteria?

Inhibits protein synthesis at ribosomes

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2. How long should a patient wait after taking tetracycline before he has a glass of milk?

2 hours

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3. Why are tetracyclines avoided in children younger than 8 years of age?

Discoloration and hypoplasia of teeth

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4. What precautions should patients take with tetracycline?

Sun protection for photosensitivity. Take with a full glass of water to prevent esophageal ulcerations.

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5. How does erythromycin increase the chance of drug interactions?

Inhibits hepatic drug metabolism by P450 system.

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6. What is the major risk of drug interactions with erythromycin?

QT prolongation, which places person at risk for Torsades de Pointes,

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7. How does erythromycin inhibit the replication of bacteria?

Inhibits protein synthesis at ribosomes

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8. What are common adverse effects of erythromycin? How can this be mitigated?

Nausea, vomiting, diarrhea, epigastric pain. Give ethylsuccinate or enteric-coated tablets with food.

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9. How does clarithromycin (Biaxin) inhibit the replication of bacteria?

Inhibits protein synthesis at ribosomes

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10. Which macrolide does not inhibit hepatic enzymes? What drug interaction is still significant with this drug?

Azithromycin (Zithromax). Raises warfarin (Coumadin) levels.

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11. Why is telethromycin (Ketek) only used for multidrug-resistant Streptococcus pneumonia?

Hepatoxicity.

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12. How do sulfonamides inhibit replication of bacteria?

Competes with PABA in synthesizing folic acid and inhibits enzyme (dihydrofolate reductase) used to synthesize folic acid

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13. Why are sulfonamides contraindicated for infants less than 2 months old?

Kernicterus

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14. Which antibiotic drug class is avoided in patients with G6PD deficiency? Why?

Sulfonamides may cause hemolytic anemia.

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15. What drugs should be used with caution if the person in allergic to sulfonamides? Should a person with anaphylaxis try these drugs?

Sulfonylureas (oral antidiabetic drugs), loop diuretics, thiazide diuretics, and Celebrex (COX-2 inhibitor). Absolutely not due to a higher risk of hypersensitivity.

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16. Why should a patient stop using a sulfonamide with a blistering, sunburn-like rash? What other skin reaction may occur

Risk for Stevens-Johnson Syndrome. Photosensitivity.

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17. How do fluoroquinolones kill bacteria?

Inhibit synthesis of nucleic acids

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18. Why should fluoroquinolones not be used in patients under the age of 18?

Tendon injury

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19. For what type of bacteria are aminoglycosides given?

Aerobic gram negative bacilli

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20. Fluoroquinolones are ordered to be given in the morning with a multivitamin with minerals. Why is this contraindicated?

Calcium, aluminum, magnesium, iron, zinc may combine with the fluoroquinolone and prevent its absorption. Give fluoroquinolones on an empty stomach.

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21. Ciprofloxacin (Cipro) is given for what common disease processes?

UTIs, enteric organisms.

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22. What are the two mechanisms of action for aminoglycosides?

Inhibit protein synthesis at ribosomes and insert abnormal proteins into the cell wall.

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23. Instead of keeping the serum drug levels above the MIC (minimum inhibitory concentration), how do aminoglycosides kill bacteria?

Concentration-dependent kill with post-antibiotic effect.

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24. Discuss the distribution of aminoglycosides.

Unable to cross cell membranes. Not absorbed orally and does not cross blood-brain barrier.

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25. What two organs can be damaged by aminoglycosides?

Ears, kidneys

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26. When are gentamicin peak and trough levels drawn?

Multiple doses: Peak level 30 min after IM or after 30-min IV infusion. Trough level immediately before next dose.
Daily dose: Trough level 1 hr before next dose. No need for peak level.

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27. What two antibiotics are reserved mainly for anaerobic bacteria?

Clindamycin (Cleocin) and metronizadole (Flagyl).

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28. What viruses does acyclovir (Zorivax) treat? Does it cure the disease?

Herpes simplex viruses (HSVs) – cold sores and genital infections, varicella-zoster virus (VZV) – chickenpox and shingles. The drug manages the symptoms, but does not cure or prevent transmission.