Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
102 Cards in this Set
- Front
- Back
|
What is the mechanism of action for penicillins?
|
cell wall synthesis inhibition stage 3 bactericidal
|
|
|
How are penicillins excreted?
|
renal
|
|
|
What are the adverse reactions of penicillins?
|
anaphylaxis (Type I rare) rash (common) convulsions (very high doeses)
|
|
|
How do you administer penicillin G?
|
IM/IV - it is a poor oral drug
|
|
|
How do you administer penicillin V?
|
Good oral
|
|
|
What spectrum of bugs do penicillins cover?
|
Gram+ cocci, gram - cocci, gram+rods, and anaerobes (but not bacteroides)
|
|
|
What are three gram + cocci?
|
staph, strep and entero
|
|
|
What is our gram - cocci?
|
neisseria
|
|
|
What antibiotics can we use that are penicillinase - resistant
|
oxacillin, diclocacillin, methacillin, nafcillin
|
|
|
Which two penicillinase- resistant drugs can be given oral ?
|
oxacillin and dicloxacillin
|
|
|
What do you give penicillinase - resistant drugs for?
|
penicillinase - producing staph aureus (MSSA) - and non MRSA skin infections
|
|
|
All other penicillin classes are penicillinase suseptible unless combined with what two B-lactamase inhibitors?
|
amoxicillin/clavulanate
|
|
|
What are the extended spectrum penicillins?
|
amoxicillin and ampicillin
|
|
|
How are amoxicillin and ampicillin administered?
|
orally
|
|
|
Amoxicillin and ampicillin are extended spectrum to what bugs?
|
gram - rods and gram + cocci
|
|
|
What are 3 gram - rods?
|
H.flu, E.coli, M.Catarr
|
|
|
What are the adverse reactions to the extendend spectrum penicillins amoxicillin and ampicillin?
|
diarrhea and superinfection
|
|
|
What are the antipsuedomonal penicillins?
|
piperacillin and ticarcillin
|
|
|
What antipseudomonals should be given ?
|
IV only
|
|
|
What spectrum of bugs are antiseudomonal penicillins used for?
|
Pseudomonas and bacteroides (and other anearobes)
|
|
|
What is the mechanism of action for cephalosporins?
|
cell wall synthesis inhibition stage 3 - bactericidal
|
|
|
How are cephalosporins excreted?
|
renal
|
|
|
Cephalosporins work on what spectrum of drugs?
|
an extended spectrum... depending on generation
|
|
|
Are cephalosporins suseptible to penicillases
|
no
|
|
|
What are the adverse reactions associated with cephalosporins?
|
allergy (less severe than penicillin)
|
|
|
What percent of people that are allergic to penicillin will also be allergic to cephalosporins?
|
1-5%
|
|
|
What 1st generation cephalosporins can be given orally?
|
cephalexin and cephradine
|
|
|
1st generation cephalosporins are used against what?
|
gram+cocci, gram- rods
|
|
|
What is an adverse reaction to 1st generation cephalosporins?
|
diarrhea
|
|
|
Which 1st generation cephalosporins can be only given IV/IM?
|
cefazolin
|
|
|
What are three gram - rods that are suseptible to 1st generation cephalosporins?
|
proteus, e. coli, and klebsiella
|
|
|
What are the 1st generation cephalosporins?
|
cephalexin, cephradine, and cefazolin
|
|
|
What are the 2nd generation cephalosporins?
|
cefaclor, cefuroxime, cefoxitin
|
|
|
What 2nd generation cephalosporins are good given orally?
|
cefaclor, and cefuroxime
|
|
|
What 2nd generation cephalsporin can only be given IV/IM
|
Cefoxitin
|
|
|
2nd generation cephalosporins are used for what bugs?
|
extended gram rods and anaerobes (what cephalosporins do best)
|
|
|
2nd generation cephalosporins can cause what adverse reactions
|
enhancement of warfarin and superinfection
|
|
|
What are the 3rd generation cephalosporins?
|
cefotaxime, ceftriaxone,
|
|
|
Third generation cephalosporins can be given?
|
orally
|
|
|
3rd and 4th generation cephalosporins are known for what?
|
They have good CNS penetration
|
|
|
3rd and 4th generation cephalosporins are used for what bugs?
|
expanded gram - and less gram + and are ok as an antipseudomonal
|
|
|
What is an adverse reaction of 3rd and 4th generation cephalosporins?
|
superinfection
|
|
|
What is the 4th generation cephalosporin?
|
cefepime
|
|
|
What is the mechanism of action of vancomycin?
|
cell wall synthesis inhibition (stage 2) bacterialcidal
|
|
|
Vancomycin should not be given how?
|
orally
|
|
|
Vancomycin is excreted how?
|
renal
|
|
|
When to use vanco?
|
for narrow spectrum gram+ cocci if someone is allergic to penicillin.... and it works on MRSA! also enterococci, and the anaerobe C. difficile
|
|
|
What are the adverse reactions to vancomycin?
|
chills, fever, rash, ototoxicity, renal toxicity, - Monitor Cp levels
|
|
|
What are the 3 macrolides?
|
Erythromycin, Azithromycin, and clarithromycin
|
|
|
What is the mechanism of action for macrolides?
|
Protein synthesis inhibition (50S) bacteriostatic
|
|
|
What is the doesing intervals for macrolides?
|
Azithromycin (once a day), Clarithromycin (2 times a day), Erythromycin (4 times a day)
|
|
|
Where do macrolides concentrate?
|
in the lungs
|
|
|
Where are macrolides metabolized?
|
liver
|
|
|
What is important about clarithromycin metabolism
|
it metabolizes to an active metabolite.
|
|
|
What are macrolides used for?
|
extended spectrum: cocci/rods: gram+ (so good for PCN allergy) rods: some gram - bacilli (legionella, bordetella, h. pylori)...atypicals:mycoplasma/chlamydia pneumonia
|
|
|
What are the adverse reactions to macrolides?
|
GI ick! DD interactions due to inhibition of P450
|
|
|
What is the mechanism of action for tetracyclins?
|
protein synthesis inhibition (30s) bacteriostatic
|
|
|
What are the 3 tetracyclins?
|
tetracycline, doxycycline, and minocycline
|
|
|
Tetracycline is administered and excreted how?
|
orally, and renal
|
|
|
Doxycycline and minocycline are administered and excreted how?
|
orally and biliary
|
|
|
What would you use a tetracycline for?
|
broad spectrum... (uh oh many gram+/- are now resistant, choice in CA-MRSA . It has good activity for atypicals like chlamydia... also used against mycoplasma, rickettsia, spirochetes
|
|
|
What are the adverse reactions to tetracyclines?
|
abnormal bone/tooth development - avoid in pregnancy, gi stuff, fungal superinfection... DD with metal cations (antacids/dairy/iron) in stomach
|
|
|
What is the mechanism of action for clindamycin?
|
protein synthesis inhibition (50S) bacteriostatic
|
|
|
How can clindamycin be administered?
|
orally and IV
|
|
|
How is clindamycin metabolized?
|
hapatic
|
|
|
What is interesting about the pharmacokinetics of clindamycin?
|
it penetrates into bone!
|
|
|
What is clindamycin used for
|
narrow spectrum - fram+ cocci (PCN alternative), anaerobes, acne (topically) chaice in CA-MRSA
|
|
|
What are the adverse reactions caused by clindamycin?
|
severe diarrhea - pseudomembranous colitis
|
|
|
Aminoglycosides have what mechanism of action?
|
protein synthesis inhibition (30s) bactericidal
|
|
|
What are the three aminoglycosides?
|
tobramycin, gentamicin, neomycin
|
|
|
How are aminoglycosides excreted?
|
renal
|
|
|
How are aminoglycosides delivered?
|
IV, IM, or inh because the have poor oral absorption
|
|
|
Where do aminoglycosides located?
|
extracellular fluid, accumulates in kidney, inner ear
|
|
|
What do you use aminoglycosides for?
|
narrow spectrum: gram- aerobes (e.coli, pseudomonas) bowel sterilization presurgery (Neomycin)
|
|
|
What are the adverse reactions caused by aminoglycosides?
|
vestibular and auditory toxicity, nephrotoxicity - must monitor Cp levels
|
|
|
What is the mechanism of action for chloramphenical?
|
protein synthesis inhibition (50s) bacteriostatic
|
|
|
How can chloramphenicol be administered?
|
orally and IV
|
|
|
Where does chloramphenicol distribute?
|
CNS/CSF
|
|
|
How is chloramphenicol metabolized?
|
Glucuronidation
|
|
|
What is chloramphenicol used for?
|
broad spectrum: gram +/- cocci, H.flu, Neisseria, anaerobes,rickettsia
|
|
|
What are the adverse reactions to chloraphenicol?
|
bone marrow toxicity, gray baby syndrome, gi upset
|
|
|
Fluoroquinolones have what mechanism of action?
|
inhibition of DNA gyrase - bacteriostatic
|
|
|
Fluoroquinolones can be administered how?
|
oral and IV
|
|
|
Fluoroquinolones are used for what kinds of bugs?
|
extended spectrum
|
|
|
What are the three fluoroquinolones?
|
ciprofloxacin, levofloxacin, and mexifloxacin
|
|
|
What is the 2nd generation fluoroquinolone?
|
ciprofloxacin
|
|
|
What is the 3rd generation fluoroquinolone?
|
levoflocacin
|
|
|
What is the 4th generation fluoroquinolone?
|
Moxifloxacin
|
|
|
Which fluoroquinolone is excreted differently?
|
Moxifloxacin - 80% hepatic and 20% renal
|
|
|
What is ciprofloxacin used for?
|
gram- (psuedomonas and UTIs)
|
|
|
What is levofloxacin used for?
|
gram+/- (respiratory, UTIs)
|
|
|
What is moxifloxacin used for?
|
gram+/- (respiratory, plus some anaerobes/ atypical)
|
|
|
What are the adverse reactions brought about by fluoroquinolones?
|
well tolerated, gi ick, superinfections DD interactions: theophylline (decreased metabolism) and antacids (decreased absorption) rare: CNS disorders
|
|
|
What is the mechanism of action of Nitrofurantoin?
|
reduced in cell to intermediates that damage bacterial DNA - bactericidal
|
|
|
What happens with Nitrofurantoin?
|
rapid and complete GI absorption - rapid excretion via kidneys, a urinary antiseptic
|
|
|
When do you use nitrofurantoin?
|
2nd line in UTIs (used if TMP-SMX resistant (E.coli)
|
|
|
What are the adverse reactions due to nitrofurantoin?
|
gi side effects, macrocrystalline forms are better tolerated
|
|
|
What is the mechanism of action for metronidazole?
|
reduced intracellulary to active form; interference with DNA fxn- bactericidal
|
|
|
How is metronidazole metabolized?
|
hepatic
|
|
|
how is metronidazole administered?
|
oral
|
|
|
What is metronidazole used for?
|
anaerobic bacteria (C.diff) and protozoa (trichomoniasis, amebiasis giardiasis
|
|
|
What are the adverse reactions to metronidazole?
|
nausea, headache, antabuse like rxn, candidal superinfections
|
