Pharmacology - Week 12 - Antibiotics

Front 1

What two antibiotic drugs should be avoided taken together due to possible losses in hearing?

Back 1

aminoglycosides and vancomycin; both have ototoxic effects

Front 2

What is G6PD?

Back 2

glucose 6 phosphate deficiency; genetic disorder in which hemolysis occurs if taken with certain antibiotics

Front 3

Compare Unasyn and Augmentin

Back 3

Unasyn and Augmentin are combination drugs - a penicillin + beta-lactamase inhibitor; Unasyn = ampicillin + sublactam; Augmentin = amoxicillin + clavulanic acid

Front 4

What is the purpose of tazobactam?

Back 4

tazobactam is a beta lactamase inhibitor (sublactam, clavulanate also)

they inactivate beta lactamases

Front 5

Compare administration and adverse effects of Amoxicillin and Ampicillin

Back 5

although they have similar actions, amoxicillin is taken only orally, whereas ampicilllin may be taken IM, IV or oral

Also, amoxicillin results in less diarrhea

Front 6

What is Probenecid?

Back 6

drug that prevents uric acid reabsorption; also increases effect of antibiotics

Front 7

What are adverse effects of Cephalosporins?

Back 7

inc bleeding due to interference with Vit K metabolisml allergy; thrombophlebitis with IV use

Front 8

How are Carbapenems administered?

Back 8

IV only

Front 9

When is Vancomycin used?

Back 9

as a "last resort" when others aren't effective; also used to treat MRSA

Front 10

How is Vancomycin administered?

Back 10

IV usually, unless being used for intestinal infections (poorly absorbed in intestines)

Front 11

What drug produces the Red Man syndrome?

Back 11

red man syndrome = flushing, rash, tachycardia, hypotension

Vancomycin

Front 12

How is Red man syndrome avoided

Back 12

infuse vancomycin slowly over 60 min

Front 13

Compare adverse effects of vancomycin and aminoglycosides

Back 13

both are ototoxic --> hearing loss, vertigo; vancomycin may also produce red man syndrome; aminoglycosides may also produce nephrotoxicity (related to toxic levels)

Front 14

When should peak blood levels be measured for vancomycin?

what are appropriate peak levels?

Back 14

1-2 hours after completion of infusion; between 30-40 mcg/ml

Front 15

What are tetracyclines used to treat?

Back 15

acne, H. pylori, Chlamydia, Rocky Mountain Spotted Fever, Lyme disease

Front 16

What drug has altered absorption with food and supplements?

Back 16

tetracycline absorption is affected by food; also forms insoluble chelates with Ca, Mg, Fe, Zn; so--> avoid milk producs, calcium and iron supplements, antacids, and magnesium containing laxatives

Front 17

A patient is diagnosed with Rocky Mountain Spotted Fever. He also has decreased renal function. What would you suggest he take?

Back 17

tetracyclines are usually excreted renal, however long acting tetracycline such as minocycline is eliminated by the liver

Front 18

What antibtiotic can cause tooth discoloration?

Back 18

tetracycline, in children under 8

Front 19

What are the adverse effecets of tetracycline?

Back 19

tooth discoloration in children under 8; photosensitivity; hepatotoxicity with high IV dosing

Front 20

Compare the adverse effects of the different Macrolides

Back 20

Both Azithromycin and Clarithromycin have similar actions with erythromycin, but with less GI effects

Front 21

What is a Z pack?

Back 21

2 initial tablets of azithromycin + 1 tablet for next 4 days

Front 22

What antibiotic utilizes CYP3A4?

Back 22

Erythromycin; troubling because concurrent antihistamines, thephylline, and warfarin use may affect metabolism

Front 23

This antibiotic can also be used for tapeworms

Back 23

ORAL aminoglycosides; IV or IM for antibiotic use

Front 24

What are the adverse effects of gentamycin?

Back 24

gentamycin class = aminoglycosides; ototoxic; nephrotoxic

Front 25

gentamycin should not be mixed with ______ in IV solution

Back 25

penicillin

Front 26

It is important for nurse to encourage patient to do what when he/she is taking gentamycin

Back 26

drink at least 1 liter of fluid a day

Front 27

When should you monitor peak and trough levels of gentamycin?

Back 27

peak - 30min to 1 hr after infusion is complete; trough - 18 hr after infusion is complete or prior to next dose

Front 28

What is the mechanism of Bactrim?

Back 28

Bactrim and Septra = Sulfonamide class; mech = inhibit synth of folic acid, necessary component for all cells (inclu bact)

Front 29

Septra is primarily used for what?

Back 29

Bactrim and Septra = Sulfonamide class; primarily urine infections; but also otitis media and URI

Front 30

A person with sulfa allergies should not use which drug?

Back 30

bactrim and septra (sulfonamides)

Front 31

Bactrim is contraindicated in

Back 31

folate deficiency (anemia); also - may cause Jaundice in late preg or nursing mothers

Front 32

This antibiotic may cause blood dyscrasias and peripheral neuropathy

Back 32

nitrofurantoin

Front 33

What is nitrofurantoin used for?

Back 33

urine infections

Front 34

What are the adverse effects of nitrofurantoin?

Back 34

blood dyscrasias, peripheral neuropathy; hypersensitivity, GI effects

Front 35

Ciprofloxacin is what class? mechanism?

Back 35

fluroquinolones; inhibits enzyme needed for DNA replication

Front 36

What are signs of hypersensitivity to cipro? When do they occur?

Back 36

fever tachycardia anorexia; may occur 3-8 weeks into treatment

Front 37

What drug is used to treat anthrax? What else does it treat

Back 37

Ciprofloxacin; respiratory, urinary bone, joint infections as well

Front 38

Patient is experiencing hepatitis, exfoliative dermatitis and blood dyscrasias while taking Cipro. How could this have been avoided?

Back 38

is manifestation of hypersensitivity reaction; avoided if discontinued cipro treatment when hypersensitiviy signs were present; (anorexia, fever, tachycardia)

Front 39

What decreases absorption of Cipro?

Back 39

milk and dairy, iron sucralfate, magnesium

Front 40

What drugs levels are increased by Cipro?

Back 40

Warfarin and Theophylline

Front 41

What are side effects of Cipro?

Back 41

Achilles Tendon Rupture; suprainfection

Front 42

What drug causes Achilles tendon rupture?

Back 42

Ciproflaxin --> should not be administered to children under 18

Front 43

What drug is effective against anaerobes and protozoa?

Back 43

metronidazole; also treats H pylori

Front 44

Pt is taking Metronidazole. What are expected advrese effects?

Back 44

darker urine; CNS symptoms - ataxia, numbness, seizures

Front 45

This drug is used for herpes

Back 45

Acyclovir

Front 46

What drugs are used for Influenza?

Back 46

amantadine, rimantadine, oseltamivir; used for post exposure prophylaxis; oseltamivir should be used 2 days post exposure

Front 47

WHat are adverse effects of amantadine?

Back 47

nausea, nervousness, lightheadness, difficulty concentrating

Front 48

What are Azoles used to treat?

Back 48

fungal infections

Front 49

Common side effect of Azoles?

Back 49

skin rash, nausea, vomiting, diarrhea

Front 50

Fluconazole inhibits this hepatic cytochrome system

Back 50

p450

Front 51

This drug's use ranges from one 150 mg dose for vaginal fungual infection to 4 weeks for severe systemic infection

Back 51

fluconazole

Front 52

this is a topical antifungal agent

Back 52

terbinafine (lamisil)

Front 53

what is onychomycosis?

Back 53

fungal nail infection; treated with terbinafine

Front 54

When is amphotericin B used?

Back 54

reserved for life threatening fungal infections, because highly toxic

Front 55

What are adverse effects of amphotericin B?

Back 55

Hypokalemia, Nephrotoxic, Thrombophlebitis, Fever chills headache

Front 56

What should you do before an infusion with amphotericin B?

Back 56

premedicate with antipyretic, antihistamine, and antiemetic

treats infusion reactions of fever, chills and headache