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66 Cards in this Set
- Front
- Back
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Which classes of abx work by disrupting cell walls?
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Beta-lactams
Vancomycin Bacitracin |
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Which abx are beta-lactams?
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Penicillins
Cephalosporins Carbapenems Monobactam |
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Action of penicillins:
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Disrupt cell wall synthesis
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Adverse effects of penicillins:
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Allergies!
Some N/D |
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Fighting penicillinases:
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Add a beta-lactamase inhibitor (i.e. Zosyn's tazobactam)
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Administration of penicillin:
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Oral doses - full glass of water, 1hr before or 2hr after meals
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Avoid mixing penicillin with:
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Gentamicin/aminoglycocides
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Action of cephalosporins:
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Disrupt cell wall
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Which abx increase cell membrane permeability?
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Amphoteracin B
"azole" antifungals |
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Which abx alter protein synthesis?
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Aminoglycosides
Tetracyclines Macrolides Sulfonamides Linezolid |
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Which abx alter nucleic acid synthesis, replication, or repair?
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Fluoroquinolones
Rifampin Metronidazole Most antivirals |
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Spectrum of cephalosporins:
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Broad spectrum
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Toxicity of cephalosporins:
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Low! Widely used class
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Adverse effects of cephalosporins:
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Allergic reactions
Pain at IM site Thrombophlebitis C. difficile |
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Spectrum of carbapenems and monobactams:
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Extremely broad
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Toxicity of carbapenems and monobactams:
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Low toxicity
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Action of carbapenems and monobactams against MRSA:
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Not active against MRSA
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Action of vancomycin:
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Inhibits cell wall synthesis
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Dosing of vancomycin:
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Individualized with peak and trough levels
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Uses of vancomycin:
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Severe gram(+) infections, including MRSA and C. diff
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Adverse effects of vancomycin:
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Ototoxicity
Red man syndrome Thrombophlebitis (common) Thrombocytopenia Nephrotoxicity Allergy |
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Action of tetracyclines:
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Inhibits protein synthesis
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Uses of tetracyclines:
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Rickettsial disease, Chlamydia, brucellosis, Cholera, Lyme disease, Anthrax, H. pylori, Acne
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Adverse effects of tetracyclines:
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GI - burning, N/V/D, cramps
Discoloration of teeth Photosensitivity C. diff, candida Hepatotoxicity Renal toxicity |
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Avoid taking tetracycline with:
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Calcium, iron, magnesium, aluminum, zinc
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Antibiotics in the macrolides class:
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Erythromycin
Azithromycin Clarithromycin |
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Action of macrolides:
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Inhibit protein synthesis
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Spectrum of macrolides:
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Broad
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Use of macrolides:
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Similar to penicillins
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Adverse effects of erythromycin:
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GI - diarrhea, intense nausea, cramps
QT, SCD prolongation Interaction with carbamazepine, warfarin, theophylline |
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Other expensive MRSA abx:
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clindamycin (Cleocin)
linezolid (Zyvox) dalfopristin/quinupristin (Synercid) daptomycin (Cubicin) tigecycline (Tygacil) |
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Spectrum of aminoglycosides:
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Narrow
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Abx in the aminoglycosides class:
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Gentamicin
Tobramycin Amikacin |
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Adverse effects of aminoglycosides:
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Ototoxicity
Nephrotoxicity Hypersensitivity |
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Interactions with aminoglycosides:
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Penicillins (within same IV)
Ototoxic drugs (loop diuretics) Nephrotoxic drugs |
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Action of the sulfonamides:
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Inhibits folic acid synthesis
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Common sulfonamide combination:
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TMP-SMZ
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Spectrum of sulfonamides:
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Broad
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Uses of sulfonamides:
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UTI, PCP, MRSA
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Administration of sulfonamides:
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On an empty stomach, stay well hydrated
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Adverse effects of sulfonamides:
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Hypersensitivity
Rash, fever, photosensitivity SJS Hemolytic anemia Kernicterus |
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Spectrum of fluoroquinolones:
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Broad
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Action of fluoroquinolones:
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Disrupt DNA replication, cell division
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Strange adverse effect of fluoroquinolones:
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Tendon rupture
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Uses of fluoroquinolones:
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Anthrax drug of choice
Infections: resp, UTI, GI, bones, joints, skin, soft tissue |
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Adverse effects of fluoroquinolones:
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N/V/D/pain
Dizziness, headache, restlessness, confusion, seizures Candida Phototoxicity |
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Interactions with fluoroquinolones:
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Absorption reduced by aluminum, magnesium, iron, zinc, calcium
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Identifying fluoroquinolones:
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-floxacin
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Action of metronidazole:
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Interferes with DNA
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Use of metronidazole:
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Protozoal infections, anaerobes, C. diff, H. pylori, high risk GI
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Adverse effects of metronidazole:
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Nausea, headache, dry mouth, metallic taste, dark urine
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Important interaction with metronidazole:
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Don't drink alcohol!!
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Drug of choice for systemic fungal infections:
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Amphoteracin B
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Action of amphoteracin B:
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Binds to ergesterol on fungal cell membranes, makes them more permeable
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Adverse effects of amphoteracin B:
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Infusion reactions
Nephrotoxic Hypokalemia Phlebitis |
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Pretreat before amphoteracin B with:
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Benadryl
Tylenol |
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Major disadvantage of "azole" antifungals for systemic infections:
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Inhibits P450 enzymes, can increase levels of MANY other drugs
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Acyclovir (Zovirax) is only active against:
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Herpesvirus members
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First choice for HSV or VZV infections:
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Acyclovir (Zovirax)
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Administration of acyclovir (Zovirax):
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Infuse over an hour if IV
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Adverse effects of acyclovir (Zovirax):
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IV: phlebitis, nephrotoxicity
Oral: N/V/D, vertigo Topical: stinging |
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Drugs for influenza:
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osetlamivir (Tamiflu)
zanamivir (Relenza) |
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Four first-line TB drugs:
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isoniazid (INH)
rifampin pyrazinamide ethambutol |
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Major adverse effects of TB treatment:
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Hepatotoxicity
Optic neuritis Neuropathy Hyperuricemia GI Rash |
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When is a peak level drawn for gentomycin?
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30 minutes after infusion
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When is a trough level drawn for gentomycin?
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Immediately before next dose
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