Term
| An example of a post therapy superinfection |
|
Definition
| Clostridium difficile-Associated Diarrhea CDAD |
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Term
| Antimicrobial mechanisms of action (General) |
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Definition
1) Antifolates (sulfonamides, trimethoprim)
2) Inhibitors of cell wall synthesis (penicillins, cephalosporins, bacitracin, and vancomycin)
3) altering permeability of cell membrane (miconazole, nystatin, clotrimazole)
4) inhibitors of protein synthesis (chloramphenicol, aminoglycosides, tetracyclines, macrolides)
5) inhibitors of nucleic acid synthesis (fluoroquinolones, metrondizaole) |
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Term
| Prophylactic Antimicrobial drugs used in what 3 settings? |
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Definition
1) protect against specific organisms that they have been or will be exposed
2) prevention of secondary infections
3) prevent infections from various surgical procedures |
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Term
|
Definition
1) penicillins
2) chephalosporins
3) aminoglycosides
4) vancomycin |
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Term
| bacteriostatic antimicrobials |
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Definition
1) tetracyclines
2) clindamycin
3) macrolides
4) chloramphenicol
5) sulfonamides |
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Term
| rifampin causes what interaction with OTC |
|
Definition
| induces hepatic CYP 450 enzymes |
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Term
| tetracycline causes what OTC interaction? |
|
Definition
| interferes with enterohepatic circulation of estrogen |
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Term
| Sulfonamide mechanism of action |
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Definition
| competitive antagonist of PABA (necessary for folic acid synthesis)- this inhibits cell growth |
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Term
1-2) suflonamide Action
3) contraindicated in? |
|
Definition
1) bacteriostatic
2) Broad Spectrum of Activity
3) pregnancy/infants |
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Term
| sulfonamides compete with what protein? |
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Definition
| Bilirubin a plasma protein, decrease in folic acid can cause high levels in infants causing neural tube defects |
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Term
|
Definition
| excreted unchanged in glomerular filtration-good to treat UTI's |
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Term
1) serious side effects of Sulfonamides
2) how is it overcome? |
|
Definition
1) crystalline aggregates in urine
2) introduction of more acid-soluable form (sulfisoxazole (Gantrisin)) |
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Term
Sulfmethoxazole-Trimethoprim Combination
-Co-trimoxazole (Bactrim, Spetra) |
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Definition
| effect is additive and synergistic, blocks PABA conversion into DNA at two points |
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Term
| co-trimoxazole therapeutic uses (broader then sulfonamides) |
|
Definition
1) chronic/reccurent UTIs
2) Penumocystis
3) Otitis Media
4) bacterial respiratory tract infections
5) prostate infections |
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Term
| nitrofurantoin (Macrodantin, Furadantin) |
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Definition
| Urinary Tract Antiseptic that is effective in sulfonamides are not |
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Term
| Antibacterial spectrums of Pen G, Pen V, and penicillinase-resistant penicillins. What organisms do they affect? |
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Definition
| narrow spectrum, effect mainly gram-positive organisms |
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|
Term
| Pencillin mechanism of action |
|
Definition
| blocks cell wall synthesis by inhibiting step in cross-linking of peptidoglycan strands. |
|
|
Term
| primary basis for pencillin resistance? |
|
Definition
| production of penicillinase (beta lactamase) |
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|
Term
1) Pen G -administered?
2) Pen V - administered?
3) Amoxicillin -spectrum? |
|
Definition
1) parentally, food/gastric acid interferes w/absorption
2) administered orally
3) extended spectrum |
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|
Term
| effect of probenecid on penicillin? |
|
Definition
| blocks kidney tubular secretory mechanisms and prolongs duration of action of penicillin |
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|
Term
dicloxacillin (Methocillin)
1) resistance? |
|
Definition
| Penicillin family, MRSA (penicillinase resistant) |
|
|
Term
| common penicillin toxicity? |
|
Definition
| cation intoxication, hypersensitivity, safe in pregnancy |
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|
Term
| Cephalosporin generations |
|
Definition
1) 1st generation-similar to penicillinase resistant penicicllins but provides slight gram-negative protection
2) 2nd-best anaerobe coverage of all cephalosporins
3) 3rd-oral provide no anaerobe coverage
4) 4th-some gram-positive activity, value unknown |
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|
Term
| cephalosporin mechanism of action |
|
Definition
|
|
Term
|
Definition
1) Hypersenstivity similar to penicillin-some cross rxn does occur-1st gen.
2) gastrointestional complaints (superinfections)
3) disulfram-like rxn |
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|
Term
| Gonorrhea drug of choice? |
|
Definition
|
|
Term
|
Definition
1) Beta-lactamase inhibitor
2) Extends spectrum of activity for penicillin
3) Combined w/amoxicillin as oral preperation (Augmentin) |
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|
Term
Vancomycin (Vancocin)
1) use
2) Mechanism of Action
3) Toxicities |
|
Definition
1) for severe infections, use should be limited, oral-clostridium
2) inhibits cell wall synthesis (bactericidal)
3) red Neck, Red Man- rapid IV infusion-histamine release |
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Term
Erythromycin
1) class
2) Spectrum |
|
Definition
1) Macrolide Antibiotic
2) primarily bacteriostatic, limited spectrum similar to penicillin, active against chlamydia, mycoplasm, and legionella |
|
|
Term
1) erythromycin that causes live toxicities?
2) Erythromycin that is not affected by food? |
|
Definition
1) erythromycin estolate (llosone)
2) erythromycin ethylsuccinate (E.E.S.) |
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|
Term
|
Definition
1) cardiac arythmias
2) epigastric distres (30%)- most common in children
3) inhibits CYP450
4) drug interactions w/viagra, warfrin, and theophylline |
|
|
Term
clarithromycin (Biaxin)
1) SE |
|
Definition
Macrolide
1) same drug interactions as erythromycin, GI/abnormal taste most common complaints |
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|
Term
azithromycin (Zithromax, Z-pack)
1) SE |
|
Definition
macrolide with long T1/2- 1 dose regimen available
1) GI discomfort, does not inactivate CYP450 |
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Term
Clindamycin (Cleocin)
1) toxcities |
|
Definition
Alternative to penicillin, has GI SE, widely distributed-including bone, no CNS penetration,
1) GI-colitis -with black box warning- caused by clindamycin resistant Clostiridium, treated with vancomycin |
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|
Term
tetracyclines
1) spectrum
2) Phamracokinetics
3) Toxcities |
|
Definition
1) broadest available
2) chelation-chelates with Calcium-cannot be taken with dairy products, excreted in urine and bile
3) hepatic toxicity-pregnancy highly suceptible, Renal toxicity |
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|
Term
|
Definition
|
|
Term
Aminoglycosides
1) Spectrum
2) Mechanism of Action
3) Toxcities |
|
Definition
1) Broad Spectrum
2) inhibits protein synthesis, ribsomal S30 subunit
3) Ototoxicities-CNVIII, dose/time/pt related, neuromuscular blockade, nephrotoxicity |
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|
Term
fluroquinolone
1) class/spectrum
2) mechanism of action
3) Black Box Warning |
|
Definition
1) synthetic, broad spectrum, bactericidal
2) interferes enzyme DNA gyrase
3) associated with tendinitis and tendon rupture |
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|
Term
Ciproflaxacin (Cipro)
1) Toxicities |
|
Definition
fluroquinolone, widespread use
1) may damage growing cartilage, contraindicated in children <18 and pregnant women, increased risk for photosenstivity/photoxicity |
|
|
Term
|
Definition
| fluoroquinolone, respiratory fluoroquinolone, effective against streptococcus penumoniae |
|
|
Term
Neomycin
1) class
2) toxicity |
|
Definition
1) OTC topical aminoglycoside antibiotic, broad spectrum
2) if given systemic-sever toxicities, deafness, renal tubular necrosis |
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|
Term
Polymyxin B
1) class
2) Toxicity |
|
Definition
1) OTC topical antimicrobial, limited spectrum-gram negative
2) tubular necrosis, neurotoxicities |
|
|
Term
Bacitracin
1) class
2) toxicities |
|
Definition
1) OTC topical antimicrobial, limited spectrum for gram-positive
2) severe nephrotoxicity |
|
|
Term
|
Definition
-sulfacetamide, erythromycin-opthalmic
-Mupirocin (Bactroban)
-Retapamulin (Altabax) |
|
|
Term
Metronidazole (Flagyl)
1) spectrum
2) Toxicities
3) Drug Interactions |
|
Definition
1) obligate anaerobic bacteria, bactericidal
2) Oral (Stomatitis, black tongue, metallic taste), disulfram like rxns
3) alcohol, metabolism of warfrin is inhibited, avoid w/pts on lithium |
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|
Term
isoniazid (Nydrazid)
1) use
2) Mechanism of action
3) Toxicities |
|
Definition
1) TB treatment
2) inhibits cell wall synthesis
3) neurotoxic-give Vit. B6 to prevent, hepatotoxic |
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|
Term
Rifampin (Rifadin)
1) use
2) Mechanism of action
3) adverse rxns |
|
Definition
1) TB treatment
2) inhibits bacterial DNA-dependent RNA polymerase
3) hepatoxicity, orange-pink color to saliva, tears, urine, and sweat |
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|
Term
| One of the most common fungal infections in the US |
|
Definition
|
|
Term
Amphotericin B (Fungizone)
1) class
2) SE |
|
Definition
1) Polyene Antifunal Agent
2) renal damage |
|
|
Term
nystatin (Mycostatin)
1) class
2) SE |
|
Definition
1) Polyene Antifunal Antibiotic, effective against candida albicans
2) bitter/foul taste |
|
|
Term
| Azole Antifunal mechanism of action |
|
Definition
| broad spectrum of fungi, bind to CYP-450 and inhibit formation of ergosterol |
|
|
Term
|
Definition
| Azole Antifunal, imidazole group, |
|
|
Term
|
Definition
| Azole antifungal, imidzole group, oral use-once a day dosing |
|
|
Term
clotrimazole (Mycelex, Lotrimin)
1) class
2) spectrum |
|
Definition
1) Azole antifungal,
2) topical broad spectrum-candidiasis |
|
|
Term
|
Definition
| trizole group, synthetic w/broad spectrum, once-a-day dosing |
|
|
Term
griseofulvin (Fulvicin)
1) uses
2) long use |
|
Definition
1) dermatomycoses, no effect on candida species
2) deposited into keratin precursor cells, keratin becomes resistant to fungal infections |
|
|
Term
terbinafine (Lamisil)
1) mechanism of action
2) CYP-450 action |
|
Definition
1) prevents ergosterol synthesis-membrane dysfunction, accumulates in keratin
2) no CYP-450 effects |
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