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44 Cards in this Set
- Front
- Back
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What is Cephalosporins, Imlpenem, and Vancomycin's mechanism of action?
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They inhibit wall synthesis or activate enzymes that disrupt cell walls. These drugs weaken the cell wall and promte bacterial lysis and death.
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What are 3 examples of antimicrobials who's mechanism of action is to inhibit DNA and RNA synthesis?
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1. Fluroquinolones 2. Metronidazole 3. Rifampin
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The 3 antimetabolites, Fluctosine, Sulfonamides, Trimethoprin's mechanism of action is to disrupt what? and this results in what?
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They disrupt specific biochemical reactions resulting in a decrease synthesis of essential cell constituents or a synthesis nonfunctional metabolites
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What 3 drug's mechanism of action is to increase cell wall permeability and allow leakage of intracellular material?
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1. Amphotericin B 2. Daptomycin 3. Ketoconazole
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Aminoglycosides (Gentamicin)'s mechanism of action includes something lethal. What is it?
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Cause lethal inhibition of bacterial protein synthesis
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What 4 drug's mechanism of action includes causing non-lethal inhibition of protein synthesis?
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1.Clindamycin 2.Erythromycin 3.Linexoloid 4.Tetracyclines
These slow microbial growth but do not kill bacteria |
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2 classifications of antimicrobials are Bactericidal and Bacteriostatic. What do these do?
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1. Bactericidal: directly lethal to bacteria at clinically achievable concentrations
2. Bacteriostatic:these slow bacteria growth but do not cause cell death |
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Describe the 2 types of microbial drug resistance are Spontaneous Mutation and Conjugation.
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1. Spontaneous Mutation: random changes in DNA (one drug resistance)
2. Conjugation: extra chromosomal DNA is transferred from one bacteria to another (multiple drug resistance) -Usually gram-neg bacteria |
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REMEMBER!!! IT IS THE MICROBE THAT BECOMES RESISTANT; NOT THE PATIENT.
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REMEMBER!!! IT IS THE MICROBE THAT BECOMES RESISTANT; NOT THE PATIENT.
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What role do broad spectrum drugs, new drugs, and antibiotics play in microbial drug resistance?
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1. Broad-spectrum drugs promote resistance because they kill off competing organisms
2. The more antibiotic is used the greater the resistance. 3.Save new drugs for special circumstances |
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What is a Suprainfection?
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A new infection that appears during the course of treatment for an infection
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1.What role do antibiotics play in Suprainfection?
2.Give an example? |
1. Use of antibiotics eliminates the inhibitory influence of the body's normal flora thus allowing for a secondary infection to flourish
2.Oral thrush/Candidiasis after a treatment of antibiotics |
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What 4 things can you do to help delay emerging drug resistance?
B. We should know when to say NO to what drug to save as a last resort? |
1. Vaccinate 2. Get catheters and other invasive devices out as soon as possible 3. Target/isolate the pathogen sesitivity testing is indicated when drug resistance is likely 4. Practice antimicrobial control helping clinicians chose correctly
B. Say NO to vancomycin till last resort |
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What 3 contraindications are of great importance when selecting antibiotics?
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1. Allergy (PCN is most common) 2. Elderly (drug toxicity) 3. Preg/lactating (cross placenta and breast milk)
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What are some reasons for antibiotic use?
(Ex. combination antibiotics/ prophylactic) |
Antibiotic Combinations-often used in Tx of TB.
Prophylactic use (30-50%) -Post surgery, bacterial endocarditis, neutropenia |
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How many layers do Gram- cells have?
Gram+? |
Gram- cells have 3 layers and is difficult for PCN to penetrate
Gram+ cells have 2 layers |
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Bactericidal is what?
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being able to kill bacteria
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Bacterioistatic is what?
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capable of inhibiting or retarding the growth and mulipllication of bacteria
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What makes PCN inactive?
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Beta-lactamase ring (enzymes)
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Penicillinases are synthesized by?
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Both Gram+ and Gram- bacteria
-Gram+ produce large amts of these enzymes and export them to surrounding medium -Gram- produce small amts and export these enzymes into teh periplasmic spaces of the bacterium |
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Penicillins are the most common cause of?
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drug allergy
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What PCN has 4 forms?
And is the 1st choice for? |
PCN G(Benzylpenicillin)
1st choice for sensitive Gram+ cocci (pneumonia, menegitis, and endocarditis) also for prophylactic Tx in syphilis and recurrent rheumatic fever |
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PCN G is eliminated ____?
how does it relate in terms of toxicity? high doses? |
Eliminated through renal
Least toxic antibiotic (only problem is allergies)High doses may cause hyperkalemia |
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Which drug is contraindicated with PCN and delays renal secretion of PCN?
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Probenecid
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Do aminoglycosides have good or bad reactions with PCN?
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Good interaction- PCN weakens the cell wall and aminoglycosides enter the cell (cannot mix IV or will inactivate each other)
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Name 2 broad spectrum PNCs (aminopenicillins)
What are their adverse effects? |
1. Ampicillin
2. Amoxicillin Adverse effects: rash, diarrhea |
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Wnat is Ampicillin preferred for?
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Prefered for strep- not preferred for PO dosing
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What is Amoxicillin preferred for?
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Preferred for PO dose- more acid resistant- most commonly prescribed
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Which has the broadest spectrum of all PCNs?
What risks are involved with this PCN? |
Ticarcillin
Risk of sodium overload, interferes with platelet function> monitor heart failure and bleeding |
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What is given for pseudomonas aeruginosa, is admin IV, and carries a lower risk of NA overload?
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Piperacillin -monitor BUN and creatinine levels
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In relation to PCNs mixed with beta lactamase inhibitors:
What is Unasyn a combo of? |
Ampicillin + sulbactam (Unasyn)
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In relation to PCNs mixed with beta lactamase inhibitors:
What is Augmentin a combo of? |
Amoxicillin + Clavulanic acid (Augmentin)
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In relation to PCNs mixed with beta lactamase inhibitors:
What is Timentin a combo of? |
Ticarcillin + clavulanic acid (Timentin)
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In relation to PCNs mixed with beta lactamase inhibitors:
What is Zosyn a combo of? |
Piperacillin + tazobactam (Zosyn)
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If allergic to PCN, do not switch to another PCN family. But may swith to the ______ family?
What can you use in the case of a mild PCN reaction? |
Mycin Family
May use cephalosporin if only mild reaction but best to avoid any Cillins |
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Cephalosporins produce bacteria ____ and ____?
Commonly used? |
Cephalosporins produce bacteria lysis and death!
Most widely used group of antibiotics. -Beta-lactam antibiotics |
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What are 3 adverse effects of Cephalosporins?
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1. Allergy (macular rash)
2. Bleeding (interference with Vit K synthesis) 3. Thrombophlebitis (w/ IV infusion) ROTATE SITES AND INFUSE SLOWLY |
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Cephalosporins have 3 drug interactions?
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1. Probenecid-delays excretion (good interaction is that delayed excretion prolongs the effects and level of drug.
2. ETOH-induced state ETOH intolerance 3.Drugs that promote bleeding |
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There are 4 classes of Cephalosporins:
What are the 1st generation Cephalosporins for? Give an example |
1st generation for staph and strep, Cephalexin (Keflex)
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What are the 2nd generation Cephalosporins for? Give an example
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2nd generation for upper respiritory, Cefactor (Ceclor)
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What are the 3rd generation Cephalosporins for? Give an example
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3rd generations are for meningitis adn nosocomial, Cefottaxime (Claforan)
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What are the 4th generation Cephalosporins for? Give an example
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4th generations are for ? (nothing on slide ;/)
Cefepime (Maxipime) |
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Vancomycin (Lyphocin) is used for?
Give 2 adverse effects |
Used for cell wall synthesis
1. Ototoxicity (evaluate hearing and balance) 2. Allergy |
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1.When do you draw levels for Vancomycin (Lyphocin)?
2. What is the Peak range? 3. What it the Trough Range? |
1. Levels shoudl be drawn 90-150 min after IV completed
2.Peak levels between 30-40mcg/ml 3. Trough levels between 5-10mcg/ml |
