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95 Cards in this Set

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Name the type of antibiotic not used in immuno- compromised patients?
Bacteriostatics
Inhibits the growth of susceptible pathogenic bacteria
What adverse effects do tetracyclines have on children?
It may damage developing bone growth and cause permanent discoloration of teeth (mottling/staining).
Define inherent resistance.
Resistance to an antimicrobial agent that is due to the basic nature of the organism

(The organism has never been sensitive to a particular antimicrobial agent)
What type of antibiotic is Tetracycline and what does it treat?
Tetracycline is a broad spectrum antibiotic that treats bacterial infections such as Rocky Mountain spotted fever, upper respiratory tract infections (pneumonia), gonorrhea, and urinary tract infections.

It is also used to treat severe acne and some chronic eye infections like conjunctivitis (pinkeye).
Define acquired resistance.
Resistance to antimicrobial agents that develops in micro-organisms that were previously sensitive.

Organisms that have "acquired" an insensitivity.
Associated with over use of antimicrobial agents.
List 5 causes of antimicrobial failure.
1) Fever not due to infection
2) Improper dose
3) Improper selection of antimicrobial
4) Improper duration of therapy
5) Failure to utilize ancillary measures (incision and drainage of white blood cells).
Quinolones affect ______ in children.
tendons
True or false: If a patient is allergic to one penicillin, he/she will be alergic to all penicillins.
True
What agent is synergistic with the use of extended spectrum penicillins?
Aminoglycosides
Identify three examples of extended spectrum penicillins.
1) Piperacillin
2) Ticarcillin
3) Mezlocillin
Prolonged inappropriate use of broad spectrum anti-infective agents may lead to _______ with fungi or resistant bacteria.
Superinfection
The absorption of Tetracycline is affected by ________ such as _______, ________.
antacids containing aluminum, calcium or magnesium; Maalox, Mylanta.
Dicloxacillin (Dynapen)
Penicillinase Resistant (Penicillin)
Methicillin (Staphcillin)
Penicillinase Resistant (Penicillin)
Nafcillin (Unipen)
Penicillinase Resistant (Penicillin)
Oxacillin (Bactocil, Prostaphlin)
Penicillinase Resistant (Penicillin)
Ampicillin (Omnipen) and Ampicillin/Sulbactam (Unasyn)
Extended Spectrum (Penicillin)
Amoxicillin (Amoxil) and Amoxicillin/Clavulanate (Augmentin)
Extended Spectrum (Penicillin)
Ticarcillin (Ticar) and Ticarcillin/Clavulante (Timentin)
Extended Spectrum (Penicillin)
Piperacillin (Pipracil) and Piperacillin/Tazobactam (Zosyn)
Extended Spectrum (Penicillin)
Penicillin G Potassium (Pentids)
Penicillin G (Penicillin)
Procaine Penicillin G(Wycillin)
Penicillin G (Penicillin)
Penicillin V Potassium (Pen VK)
Penicillin G (Penicillin)
Some extended spectrum penicillins and cephalosporines may increase the risk of bleeding when taken with ______, _______, ______, or _______.
anticoagulants, thrombolytic agents, antiplatelet drugs, or NSAIDs.
Which penicillin is the prototype of the penicillinase resistant drugs?
Methicillin (Staphcillin)
Ampicillin and Amoxicillin are also referred to as _______ (3 words).
wider spectrum penicillins.
True or false: Tetracycline drugs can make you more prone to sunburn when you are in sunlight or ultraviolet light.
True
Doxycycline (Vibramycin)
Tetracycline
Define "antibacterial spectrum"
The range of bacteria that are susceptible to a particular antibiotic.
What bacteria are susceptible to Penicillin G's?
Strept pneumonia (respiratory, skin, otitis), anaerobic strept (respiratory), neisseria (STD), Trepenema pallidum (syphillis)
Meningitis, septicemia, and pneumonia are caused by the bacteria _______ (2 words).
Strept pneumonia (streptococci pneumoniae)
What are normal bacterial flora?
The bacteria that normally live on and in the skin, gut, mouth and upper respiratory tract of humans.

(Also called commensal organisms as they do not normally cause disease and provide some protection from infection).
Define the term "multi-resistance"
Multi-resistance referes to a microorganism that is resistant to two or more unrelated antimicrobials.
Define Prophylaxis.
Using an antimicrobial agent to prevent infection.
e.g. giving antimicrobial agents before gut surgery in order to prevent microorganisms in the gut spreading into the abdomen.
What illnesses are caused by the bacterium: anaerobic streptococci?
Usually respiratory tract infections such as sinusitis.
True or false: S pneumoniae is a normal member of the respiratory tract flora.
True.

Invasion results in pneumonia
Neisseria causes what type of infection(s)?
STD's such as gonorrhoea
Trepenema pallidum is associated with what STD?
Syphilis
Wider spectrum penicillins have the same spectrum as _______.
Penicillin G's
eg. Ampicillin, amoxicillin
How/when should Ampicillin be administered?
Ampicillin capsules should be taken with a full glass of water, a half hour before or 2 hours after a meal.
What are two common side effects of Ampicillin?
diarrhea, colitis (inflammation of the bowel)
Cephalexin (Keflex)
First generation oral (cephalosporin)
Cephradine (Anspor, Velosef)
First generation oral (cephalosporin)
Cephalothin (Keflin)
First generation cephalosporin (injected)
Cepharpirin (Cefadyl)
First generation cephalosporin (injected)
Cefazolin (Kefzol, Ancef)
First generation cephalosporin (injected IM)
Cefaclor (Ceclor)
Second generation oral (cephalosporin)
Cefuoxime (Ceftin)
Second generation oral (cephalosporin)
Cefadroxil (Durifec)
Second generation oral (cephalosporin)
Decribe the mechanism of action of first generation cephalosporins.
Binds to bacterial cell wall membrane, causing cell death (bactericidal).
Describe the spectrum of first generation cephalosporins.
Active against gram-positive cocci including Strept pneumonaie, penicillinase-producing staphylocci.
Name a CNS, GI and Hemat adverse reaction of first generation cephalosporins.
CNS: seisures (high doses)
GI: colitis, diarrhea, cramps
Hemat: Hemolytic anemia (abnormal breakdown of red blood cells)
Decribe the mechanism of action of second generation cephalosporins.
Binds to bacterial cell wall membrane, causing cell death (bactericidal).
Same as first generation
Describe the spectrum of second generation cephalosporins.
Similar to first-generation cephalosporins but have increased activity against gram-negative pathogens including: Neisseria gonorroeae (including penicillnase-producing strains), E. coli, and H. influenzae.
What are the specific side effects associated with ceftazidime and cefotetan?
ceftazidime can cause jaundice and cefotetan may increase bleeding.
What drug-natural products can increase the risk of bleeding with cefotetan?
garlic, ginger, ginkgo, ginseng
What are the spectrum differences between second and third generation cephalosporins?
Third-generation cephalosporins are less active against staphylococci, but are more active against gram-negative pathogens (even for organisms resistant to first- and second-generation agents).
Which generation of cephalosporins cross the blood brain barrier (BBB)?
All third-generation cephalosporins cross BBB.

First-generation do not cross BBB, only cefuroxime of second-generation crosses BBB.
What forms of erythromycin are available?
1) Base - oral, poorly absorbed
2) Stearate - well absorbed, causes GI upset
3) Estolate - well absorbed, little GI upset, but associated with cholestatic hepatitis
4) Gluceptate, Lactobionate - IV use, cannot give IM
When is erythromycin used?
Penicillin allergy to gram positive cocci for treating respiratory, otitis, and syphilis.

It is also used topically for acne, and infections caused by the bacterium Legionella pneumophila (Legionnaire's disease)
Azithromycin (Zithromax)
Macrolide (anti-infectives)
Clarithromycin (Biaxin)
Macrolide (anti-infective)
classified with -mycin's
Clindamycin treatment is limited to ____ days at most.
7; pseudomembranous colitis can result ifn use is extended
Is Clindamycin bacteriostatic or bacteriocidal?
Bacteriostatic (inhibits growth)
Using expired tetracycline medication cause lead to ______(2 words).
Fanconi Syndrome
Chloramphenicol is used to treat:
Meningitis, Anaerobic infections
Does Cloramphenicol cross the brain blood barrier?
YES
Name two potential types of toxicities associated with Aminoglycosides.
1) Nephrotoxic (kidney)
2) Ototoxic (ears)
Which aminoglycosides are reserved for resistance to gentamicin?
Tobramycin and Amikacin
Which drug class ends in -thromycin?
Macrolides
Which drug class ends in -micin or -mycin?
Aminoglycosides
Which drug class ends in -oxacin?
Quinolones
Urinary tract anti-infectives end in ?
-oxazole with the exception of Methenamine and Nitrofurantion.
Method of action of Alkylating agents?
causes abnormal pairing of DNA strands
Side effects of Amphotericin B use?
Renal impairment (nephrotoxicity), heachache, chills, fever, thrombophlebitis, hypokalemia
The oral form of nystatin is used to treat?
Candida (thrush)
Terbinafine is used to treat?
nail infections (fungal)
Tuberculosis therapy (minimal to moderate disease) requires ____ drugs for ____ years.
two drugs; two years
Tuberculosis therapy (advanced/diseminated disease) requires _____ drugs for _____ years.
three drugs; three years
True or false: some viral infections cannot be cured
True (HIV, Herpes)
Some viral therapy agents may ______(3 words) while some may ______(2 words).
stop flare ups; hasten recovery
What is the typical duration of prophylactic therapy for healthy positive converters?
9 to 12 months
Precautions for Cisplatin use:
Cisplatin is extremely toxic to kidneys, must use fluids and diuretics to protect kidneys
True or false: Effective chemotherapy treatment kills 99.9% of tumor cells
True
Name two toxicities associated with doxorubicin use?
1) Bone marrow aplasia
2) Delayed cardiotoxicity leading to CHF
MOA of Methotrexate:
Interfers with activiation of folic acid to tetrahydrofolate.
A neurological toxicity of vincristine?
numbness and weakness
Bone marrow depression in cancer/chemotherapy patients is treated with ____.
Filgrastim (Neupogen)
Cardiovascular (H1 effects of histamine) are?
1) Cerebral vessel dilation
2) Capillary dilation
3) Increased capillary permeability
Gastrointestinal (H2 effects of histamine) are?
Secretagogue (increased gastric acid section, direct effect on parietal cells)
H1 histamine receptor is blocked by:
antihistamines
H2 histamine receptor is blocked by:
anti-ulcer H2 antagonists
Normal histamine physiology (3 functions):
1) Regulate microcirculation
2) Tissue growth and repair
3) Gastric acid secretion
Side effects of histamine:
sedation, anticholinergic
Diet corrections to constipation (list 3).
1) Increase fluids
2) Increase fibers
3) Increase exercise