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93 Cards in this Set

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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