N509- Anti-Infectives

Front 1

Classification of Microorganisms (4)

Back 1

-Bacteria
-Fungus
-Virus
-Parasites

Front 2

Drugs that inhibit bacterial cell wall synthesis or activate enzymes that disrupt the cell wall (2 types)

Back 2

Penicillin & Cephalosporin

Front 3

Drugs that increase cell membrane permeability (effect)

Back 3

induce leakage of organelles

Front 4

Drugs that cause lethal inhibition of bacterial protein synthesis (2 types)

Back 4

gentomyacin & aminoglycosides

Front 5

Drugs that cause nonlethal inhibition of protein synthesis (effect)

Back 5

slow microbial growth so immune system can respond

Front 6

Drugs that inhibit bacterial synthesis of DNA and RNA or disrupt DNA function (1 type)

Back 6

Flouroquinolenes

Front 7

Antimetabolites (effect)

Back 7

Decrease synthesis of necessary metabolites

Front 8

Drugs that suppress viral replication (effect)

Back 8

Decrease DNA transcription

Front 9

Examples of highly resistant bacteria

Back 9

Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Klebsiella pneumoniae

Front 10

Pt factors to consider when selecting Ab therapy (10)

Back 10

-Host defenses (immune status)
-Penetration to site of infection
-Age
-Pregnancy/Lactation
-Genetic factors
-Dosage form and patient education
-Allergies to medications(Consider cross reactivity)
-Assessment of therapeutic failures
-Renal/liver function
-Concomitant drug therapy

Front 11

Drugs That Weaken the Bacterial Cell Wall (3)

Back 11

-Beta Lactams
-Vancomycin
-Fosfomycin

Front 12

Types of Beta Lactams (8)

Back 12

-Natural penicillins
-Penicillinase resistant penicillins
-Aminopenicillins
-Extended spectrum penicillins
-Combinations with Beta-Lactamase Inhibitors
-Cephalosporins
-Aztreonam
-Carbapenems

Front 13

Natural PCNs, narrow spectrum PCNase sensitive: (2)

Back 13

-Penicillin G
-Penicillin V

Front 14

PCNase-resistant PCNs, narrow spectrum: (5)

Back 14

-Dicloxacillin
-Oxacillin
-Cloxacillin
-Methicillin
-Nafcillin

Front 15

PCN oral preps best absorbed on an empty stomach (2)

Back 15

-PCN V
-Dicloxacillin

Front 16

Aminopenicillins, broad spectrum: (2)

Back 16

-Ampicillin
-Amoxicilin

Front 17

Extended spectrum penicillins, antipseudomonal PCNs: (2)

Back 17

-Carboxypenicillins (Carbenicillin, Ticarcillin)
-Ureidopenicillins (Azlocillin, Mezlocillin, Piperacillin)

Front 18

PCN Allergy Types

Back 18

Immediate (2 to 30 minutes)
Accelerated (1 to 72 hours)
Late (days or weeks)

Front 19

PCN Anaphylaxis Sx (3)

Back 19

-Laryngeal edema
-Bronchoconstriction
-Severe hypotension

Front 20

PCN Hypersensitivity Reactions (types)

Back 20

-Skin rash vs ampicillin rash
-Angioedema
-Fever, eosinophilia
-Interstitial nephritis

Front 21

PCN Adverse Effects

Back 21

-GI
-Phlebitis
-Neurotoxicity (e.g. seizures, confusion)
-Hematologic
-Superinfection with Candida spp.
-Pseudomembranous colitis (C. Difficile colitis)

Front 22

Beta-Lactamase Inhibitors (3)

Back 22

-Clavulanic acid
-sulbactam
-tazobactam

Front 23

First Gen Cephalosporins (FGC) (3)

Back 23

-Cefazolin
-cephalexin
-cefadroxil,

Front 24

Second Gen Cephalosporins (SGC) (5)

Back 24

-Cefuroxime
-cefaclor
-cefprozil
-loracarbef
-Anti-anaerobic (Bacteroides fragilis): Cefoxitin

Front 25

Third Gen Cephalosporins (TGC) (8)

Back 25

-Cefotaxime
-ceftriaxone
-cefditoren
-ceftizoxime
-cefixime
-ceftibuten
-cefdinir
-cefpodoxime

Front 26

Fourth Gen Cephalosporins (FrGC) (1)

Back 26

-Cefepime

Front 27

FCG (characteristics)

Back 27

-Good activity against gram positive organisms (exception: MRSA)
-Good activity against E.Coli, K. Pneumoniae & P. mirabilis, but less active against other gram negative organisms

Front 28

SGC (characteristics)

Back 28

-Good activity against gram positive organisms, but less active than 1st GC
-Good activity against gram negative organisms covered by 1st GC plus H. influenzae, but less active than 3rd GC
-Active against a variety of anaerobic bacteria including B. fragilis (cefoxitin & cefotetan only)

Front 29

TGC (characteristics)

Back 29

-Some activity against gram positive organisms but less active than 1st GC/2nd GC
-Very active against a wide variety of gram negative bacteria including Enterobacter, Serratia and other species generally resistant to 1st GC/2nd GC
-Activity against P. aeruginosa (cefoperazone and ceftazidime only)

Front 30

FrGC (characteristics)

Back 30

-Good activity against gram positive organisms; exception: MRSA & MRSE, enterococcus
-Very active against a wide variety of gram negative bacteria including Enterobacter, Serratia, and other species generally resistant to 1st GC/2nd GC.
-Activity against P. aeruginosa

Front 31

Cephalosporin distribution

Back 31

Widely distributed in the body although only 3rd GC and 4th GC can penetrate the CSF (better penetration with inflamed meninges)

Front 32

Cephalosporins: Adverse Effects (6)

Back 32

-Hypersensitivity reactions similar to PCNs
-Neutropenia, thrombocytopenia
-Bleeding
-Thrombophlebitis (IV), pain at injection site (IM)
-Elevated prothrombin time/bleeding
-GI effects

Front 33

Carbapenems (3)

Back 33

-Imipenem
-Meropenem
-Ertapenem

Front 34

Carbapenems (mech)

Back 34

-Beta Lactam, bactericidal

Front 35

Very Broad Spectrum Carbapenems (2)

Back 35

-Imipenem
-Meropenem

*not active against MRSA

Front 36

Broad Spectrum Carbapenems (1)

Back 36

-Ertapenem
Active against a wide variety of gram positive, gram negative, and anaerobic organisms
*Not active against MRSA, MRSE, Acientobacter baumanii, and P. aeruginosa

Front 37

Carbapenems - Adverse Effects (4)

Back 37

-Hypersensitivity reactions
Cross reactivity with other beta-lactams
-GI symptoms
Nausea, vomitting, diarrhea
-Seizure
-Suprainfections

Front 38

Vancomycin (action/use)

Back 38

-Inhibitor of cell wall synthesis
-Methicillin-resistant Staphylococcus aureus or Staph epidermidis

Front 39

Vancomycin - Adverse Effects (4)

Back 39

-Ototoxicity
-Thrombophlebitis
-Allergy
-Red man syndrome

Front 40

Aztreonam (characteristics)

Back 40

-Beta Lactam, bacteriacidal
-Narrow spectrum
-Highly beta-lacamase resistant

Front 41

Aztreonam - Adverse Effects (4)

Back 41

-Similar to other beta-lactams
-Cross sensitivity between beta-lactams and aztreonam has not been reported-interpret cautiously
-Pain and thrombophlebitis at injection site
-Liver enzyme elevations

Front 42

Cell Wall Synthesis Inhibitor (1)

Back 42

Fosfomycin

Front 43

Fosfomycin - Adverse Effects (4)

Back 43

-GI: Diarrhea, nausea
-Headache
-Vaginitis
-Abdominal pain