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;
93 Cards in this Set
- Front
- Back
- 3rd side (hint)
Identify sites of infection that are not readily penetrated by many antimicrobial drugs
|
Central nervous system
bone prostate gland and ocular tissues |
|
|
Situations in which combination drug therapy with antibiotics is preferable to monotherapy
|
Mixed infections are usually treated with more than one drug
also to achieve synergy or additive effect |
|
|
When might you use prophylactic Abx?
|
Prevent endocarditis in pt with valvar heart ds: 2) prevent wound and tissue infections in surgical patients: 3) prevent transmission of influenza
malaria meningococcal ds and tuberculosis in those at risk |
|
|
The role of endotoxins in gram-negative sepsis
|
Activates the immunologic mechanisms that lead to fever
platelet aggregation increased vascular permeability and other adverse effects on tissues |
|
|
Most commonly used beta-lactam antibiotics
|
Penicillins
beta-lactamase inhibitors and cephalosporins |
|
|
What are the narrow spectrum pcns?
|
Pen G and Pen V
|
|
|
What are the penicillinase resistant pcns?
|
Dicloxacillin
nafcillin |
|
|
What are the extended spectrum pcns?
|
Amoxicillin
|
|
|
What PCN do you use for group A strep
syphilis gas gangrene. |
Pen G
|
|
|
What PCN do you use for group A strep pharyngitis?
|
Pen V
|
|
|
PCN IM injection that lasts 24 hrs.
|
Procaine pen G
|
|
|
PCN IM injection that lasts several weeks
|
Benzathine pen G
|
|
|
What beta lactam do you treat syphilis
endocarditis meningitis pneumonia with? |
Pen G
|
|
|
What beta lactam could you treat osteomyelitis
endocarditis pneumonia and skin/soft tissue infections with? |
Dicloxacillin aka oxacillin
|
|
|
What beta lactam could you treat upper respiratory infections
including OM sinusitis bronchitis and community acquired pneumonia with? What about adult UTI with drug resistant bugs? |
Amoxicillin
amox +clavulanate |
|
|
Hypersensitivity reactions mediated by ige leading to hives
anaphylactic shock serum sickness hepatitis skin rashes |
Pcns
|
|
|
Primarily used for skin and soft tissue infections caused by gram positive cocci and to treat uncomplicated utis
prophylaxis for surgical infections |
Cephalexin 1st gen
|
|
|
Tx otitis media when caused by H influenzae strains
|
Cefuroxime axetil 2nd gen
|
|
|
Single dose regiment for gonorrhea
otitis media pneumonia meningitis intra-abdominal or UTI and advanced Lyme Dz |
Ceftriaxone 3rd gen
|
|
|
Intra-abdominal and UTI infections and pneumonia
|
Cefepime 4th gen
|
|
|
Active against some strains of MRSA
Also used to treat infections caused by pcn resistant organisms including endocarditis and necrotizing fasciitis |
Vancomycin
|
|
|
Must be administered parenterally
unless you are treating C. Diff |
Vancomycin
|
|
|
Used for aerobic gram-negative bacilli and prophylaxis and treatment of serious infections. Can cause nephro and ototoxicity
|
Aminoglycosides (e.g. Gentamycin)
|
|
|
Poorly absorbed from the gut and must be used parenterally to tx systemic infections
|
Aminoglycosides
|
|
|
What aminoglycoside is the most nephrotoxic?
|
Neomycin
|
|
|
Broad spectrum
bacteriostatic that inhibit the growth of gram-positive gram-negative organisms: -Rickettsiae -Spirochetes -Mycoplasmas -Chlamydiae |
Tetracyclines
Static or Cidal? What classes of organisms: ? G- / G+ covers what Bugs 4ct: |
bacteriostatic that inhibit the growth of
-gram-positive & -gram-negative -Rickettsiae -Spirochetes -Mycoplasmas -Chlamydiae |
|
Use with aminoglycosides potentiates nephrotoxicity
|
Tetracyclines
|
|
|
Which drug class causes hepatotoxicity and photosensitivity?
|
Tetracyclines
|
|
|
What are drug class do doxycycline and minocycline belong to?
|
Tetracyclines
|
|
|
Active against Upper Respiratory Tract Infections and Pneumonia group A streptococci pneumococci chlamydiae M. Pneumoniae legionella pneumophila
|
Macrolides (erythromycin
azithromycin and clarithromycin) |
|
|
Bacteria achieve resistance to these drugs by decreasing their binding to the 50s ribosomal subunit
|
Macrolides
Name them 3ct |
Erythromycin
azithromycin clarithromycin |
|
Most commonly used agents to treat gram neg orgs
because they have become resistant to beta lactams and fluoroquinolones |
Aminoglycosides
|
|
|
Binds to motilin and causes GI upset
|
Erythromycin
|
|
|
Sinusitis
bronchitis community-acquired pneumonia Streptococcus pneumoniae Legionella Chlamydia H. Influenza M. Catarrhalis |
Ketolides (telithromycin)
|
|
|
Prolongs QT intervals
increased weakness in those with myesthesia gravis |
Ketolides (telithromycin)
|
|
|
Active against gram-positive cocci. Useful in treating infections caused by gram –positive cocci and anaerobes that are resistant to penicillin and other drugs
as well as MRSA |
Clindamycin
|
|
|
Causes a higher incidence of pseudomembranous colitis (from C. Diff superinfection) than do other antibiotics.
|
Clindamycin
|
|
|
Active against streptococci and staphylococci. Administered topically to treat impetigo and to eradicate nasal carriers of methicillin-resistant staphylococci
|
Mupirocin
|
|
|
Primarily used for
UTI |
Sulfonamides
Primarily used for |
UTI
|
|
Adverse effects: mild skin rashes
erythema multiform Stevens-Johnson syndrome crystalluria GI reactions headaches hepatitis and hematopoietic toxicity. In persons with glucose-6-phosphate dehydrogenase deficiency can cause hemolytic anemia |
Sulfonamides
|
|
|
Folate Reductase Inhibitors
|
Trimethoprim
|
|
|
When used alone = major clinical uses are bacterial prostatitis and vaginitis
|
Trimethoprim
|
|
|
Primarily used to treat utis
upper respiratory tract infections and infections caused by P. Carinii or N. Asteroids |
Combination of trimethoprim-sulfamethoxazole
|
|
|
Used to treat a variety of infections
including utis GI infections bone and joint infections skin infections and anthrax exposure |
Fluoroquinolones
|
|
|
Used to treat community-acquired pneumonia
|
Levofloxacin
|
|
|
Inhibit the metabolism of caffeine
|
Fluoroquinolones
|
|
|
A macrocrystalline formulation of the drug is usually used for uncomplicated utis
|
Nitrofurantoin
|
|
|
Included in first line defense against TB
|
Isoniazid and rifampin
|
|
|
Adverse effects include hepatitis and peripheral neuritis from b6 deficiency
|
Isoniazid
|
|
|
Used for isoniazid resistance
prophylactically for exposure to neisseria meningitidis Haemophilus influenzae B Also used for leprosy tubercular meningitis staph endocarditis legionella infections |
Rifampin
|
|
|
Never used alone because of likelihood that TB will develop resistance during course of therapy
also impairs liver function so need to monitor lfts |
Rifampin
|
|
|
Reddish-orange to reddish-brown discoloration of saliva
tears urine (stain contact lenses) |
Rifampin
|
|
|
Cytochrome P450 isozyme inducer --> accelerates metabolism of many other drugs
reduce their serum concentration and effectiveness (Ex. Macrolide Abx benzos Ca channel blockers digoxin estrogens sulfonylureas theophylline warfarin) |
Rifampin
|
|
|
Present with sx of soft tissue infection
UTI PNA meningitis septicemia (Ex. Aspergillus, Blastomyces, Candida) |
Systemic mycoses
|
|
|
Puncture wounds contaminated with soil fungi
|
Subcutaneous mycoses
|
|
|
Infections of nails
skin mucous membranes usually caused by dermatophytes or yeasts (Ex. Candida albicans) |
Superficial mycoses
|
|
|
Used for
-systemic mycoses -subcutaneous mycoses -superficial candida |
Amphotericin B
Used for : 3ct |
-systemic mycoses
-subcutaneous mycoses -superficial candida |
|
VERY renal toxic --> hypokalemia/ hypomagnesemia
azotemia.....MUST monitor electrolytes weekly (2) Can cause acute liver failure cardiac arrhythmias anemia leukopenia thrombocytopenia (3) Frequently causes chills fever headache nausea vomiting |
Amphotericin B
|
|
|
Some side effects can be mitigated by pretreatment with corticosteroids
antipyretic drugs and antihistamines |
Amphotericin B
|
|
|
Tx of Candida infection - usually as a cream
powder lozenge tablets and suspensions vaginal tablets |
Nystatin
|
|
|
Fungistatic or fungicidal (can be given topically
orally or IV) alternatives to amphotericin B |
Azole (fluconazole
voriconazole and clotrimazole) |
|
|
Fungal (cryptococcal) meningitis in pt w AIDS (only one that penetrates CSF)
(2) candidiasis (disseminated urinary or vaginal) |
Fluconazole
|
|
|
Effective against Aspergillus and candida
|
Voriconazole
|
|
|
1) topical for candida of mouth
throat vagina vulva (2) dermatophyte infections (except scalp or nails) |
Clotrimazole
|
|
|
Onychomycosis
(6 weeks for fingernails -12 weeks for toenails -daily oral Tx -Also Covers Candida |
Terbinafine
For what Dz? |
Onychomycosis
|
|
These are all nucleoside analogues used primarily in the treatment of herpesvirus infections
which includes herpes simplex virus (HSV) varicella-zoster virus (VZV) and cytomegalovirus (CMV). |
Acyclovir
famciclovir and valacyclovir |
|
|
Available for IV use for serious infections such as herpetic encephalitis or severe HSV and VZV in immunocompromised pts
|
Acyclovir
|
|
|
These 2 are neuraminidase inhibitors ....
in influenza A and B. Neuraminidase catalyzes reactions promoting flu viral spreading infection |
Oseltamivir and zanamivir
What Class? What 2ct Dz? |
Neuraminidase inhibitors
influenza A and B |
|
Can be used as prophylaxis or treatment of pts. > 1
decreasing symptom severity |
Oseltamivir
|
|
|
A nasal spray for pts. > 7.
|
Zanamivir
|
|
|
This inhibits hep B replication and is the first orally effective drug for hep B pts. It's also used for HIV. Acts on the reverse transcription of intermediate RNA of hep B.
|
Lamivudine
|
|
|
A broad-spectrum antiviral drug active against
Adenovirus Colorado tick fever virus Orimean-congo hemorrhagic fever virus Hantaan virus Hep A and C Herpes Virus INflu A and B Lassa virus Measles Metro Canyon fever virus mu |
Ribavirin
|
|
|
By inhalation can cause serious pulmonary and cardiovascular effects like apnea
pneumothorax and cardiac arrest. By IV can cause seizures |
Ribavirin
|
|
|
Active against hepatitis viruses and some papillomaviruses
mainly used in treatment of hep B C non-A non-B or non-C (chronic hepatitis) genital warts hairy cell leukemia Kaposi's sarcoma renal carcinoma malignant melanoma and multiple myeloma |
Interferon alpha
|
|
|
Hematologic toxicity
cardiac arrhythmias changes in BP central nervous dysfunction GI distress chills fatigue headache and myalgia |
Interferon alpha
|
|
|
Active against several anaerobic protozoa Trichomonas vaginalis. Also active against H pylori
c diff |
Metronidazole
|
|
|
Causes a disulfiram-like reaction? With ethanol so pts. Should avoid boozing' while undergoing treatment
|
Metronidazole
|
|
|
A single tx is effective against ectoparasites like lice and mites that cause pediculosis(lice) and scabies(mites)
|
Permethrin
|
|
|
Single dose treatment for chlamydial urethritis
|
Azithromycin (macrolide)
|
|
|
Most active drug against H. Pylori
|
Clarithromycin
|
|
|
Potentiates carbamazepine toxicity
|
Erythromycin or clarithromycin plus carbamazepine
|
|
|
Only use for telithromycin
|
Community acquired pneumonia caused by certain organisms
|
|
|
Tx for MRSA
necrotizing fasciitis gas gangrene. |
Clindamycin
|
|
|
Tx impetigo
|
Mupirocin
|
|
|
Adverse effects tendonitis
tendon rupture arthropathy osteochondrosis |
Fluoroquinolones
|
|
|
Used for utis
prostatitis pelvic inflammatory Dz Shigella salmonella Yersinia ETEC |
Ciprofloxacin
|
|
|
Used for drug resistant tuberculosis
|
Levofloxacin
|
|
|
Adverse effects include blood glucose disturbance
phototoxicity QT prolongation |
Fluoroquinolones
|
|
|
Used for post exposure to neisseria meningitis
Hib |
Rifampin
|
|
|
Drug with the greatest bactericidal activity against m leprae
Mycobacterium leprae, also known as Hansen's coccus spirilly, mostly found in warm tropical countries, is a bacterium that causes leprosy (Hansen's disease). -An acid fast Gram-positive bacterium, with a slow doubling time of 14 days. |
Rifampin
greatest bactericidal activity against |
Mycobacterium leprae leprosy (Hansen's disease). |
|
Used for invasive aspergillosis
esophageal candidiasis invasive candidiasis |
Voriconazole
|
|
|
Used to treat RSV
|
Ribavirin
|
|
|
Tx for rosacea
|
Metronidazole
|
|