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Flashcards in Antibiotics Drugs Deck (18)
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1

 

Sulfonamides

  • Bacteriostatic 
    • ​Inhibits bacterial growth by inhibiting folic acid synthesis
  • Broad spectrum 
    • Gram +/-
  • Eliminated in the kidneys
    • Commonly used for UTIs
  • Can be used in opportunistic infections r/t HIV & output tx of MRSA
  • CI = Allergy
  • S/E = allergic rxn
  • Interaction: diabetes tx & oral contraceptives
    • potentiates hypoglycemic effect 
  • Sulfamethoxazole/ trimethoprim (Bactrim) 

2

 

Penicillins 

  • 1st derived from mold
  • Bactericidal 
    • kills gram +/- bacteria 
    • but mostly gram +
  • Interferes with wall synthesis
  • Mostly safe & overall well tolerated
  • S/E= allergic reaction
    • Includes urticarial, pruritus, angioedema
  • CI = allergy
  • Interactions: NSAIDs, oral contraceptive, Warfin 
  • Amoxicillin, Ampicillin, Penicillin G

3

 

Cephalosporins 

  • Semi-synthetic and r/t penicillin 
  • Bacteriocidal 
    • Interferes with wall synthesis
  • Broad spectrum 
  • 5 different generations
    • 1st gen = > gram + 
    • With each subsequent generation > gram - & anaerobic 
  • Cross sensitivity with penicillin
  • S/E: similar to penicillins
  • Cefazolin (Ancef); Cefoxitin (Mefoxin) 

4

 

Macrolides 

  • Bacteriostatic
    • ​Inhibits protein 
  • Used in upper/lower respiratory tract; skin & soft tissue infections 
  • Syphillis, gonorrhea, chlamydia (STDs); Lyme disease
  • CI= allergy
  • S/E: GI r/o especially N/V
    • Azithromycin & Clarithromyocin has less GI S/E than others
  • Interactions: Highly protein bound & metabolized by liver
    • > risk of interactions 
  • Erythromyocin, Azithromycin, Clarithromycin 

5

 

Quinolones 

  • Potent bacteriocidal 
    • ​Destroys bacteria by altering DNA
  • Broad spectrum (mostly gram - and some gram +)
    • Pseudomonas; pneumococcus; E.coli
  • Excreted primarily by kidney as unchanged drug
  • Used for: complicated UTI, respiratory, skin, GI, bone & joint infections
  • S/E: HA, dizziness, insomnia, nausea, constipation, flatulence, rash; prolonged QT segment 
  • Interation: Antacid, Ca, Mg, Fe, Zinc
    • Decreases absorption so take 1 hr before/ after
  • Ciprofloxacin (Cipro) 

6

 

Aminoglycosides

 

  • Bacteriocidal 
    • ​Prevents bacterial synthesis 
  • Often used in conjection with other antibx
  • Very potent; Gram - and some gram +
  • Pneumonia, meningitis 
  • CI: allergy; pregnant women (life threatening only) 
  • S/E: ototoxicity, nephrotoxicity 
  • For short term only 
  • Interactions: other nephrotoxic meds, vanco, cyclosporins, loop diurectics (> ototoxic risk) 
  • Gentamicin 

7

 

Tetracyclines

  • Bacteriostatic
    • Inhibits protein synthesis
  • Gram +/- & Protozoans 
    • ​Chlamydia; mycoplasma; acne
  • Don't give w/milk, antacids, iron salts = decreased absorption
  • Tooth discoloration r/t affinity for Ca
  • Don't use in pregnant or nursing mothers 
  • S/E: teeth staining; photosensitivity; diarrhea; vaginal infections
  • Interaction + > anticoagulant effect 
  • Tetracycline, Doxycycline 
  •  

8

 

Clindamycin 

  • Semi-synthetic 
  • Bacteriostatic or bacteriocidal (depending on concentration) 
    • Inhibits protein synthesis
  • Gram + & anaerobic
  • Uses: chronic bone infections, GU tract & intra-abdominal infections, septicemia, staphylococci
  • CI= Allergy, ulcerative colitis, enteritis
  • S/E= GI upset (N/V), abdominal pain, diarrhea, anorexia 

9

 

Vancomycin 

  • Bacteriocidal 
    • ​Inhibits cell wall synthesis = death 
  • Not active against gram -, fungi, yeast
  • Used to tx MRSA, colitis
  • CI= allergy, renal dysfunction 
  • S/E: nephrotoxicity, ototoxicity (like aminoglycosides) 
    • "Redman Syndrome" = flushing & itching of upper body most commonly associated with rapid infusion
      • Also decreases BP
  • Toxic- so specific drug levels must be monitored with therapy for safety 

10

 

Metronidazole 

  • Antimicrobial 
  • Interferes with DNA synthesis (like quinolones)
  • Good against anaerobic
  • Uses: intra-abdominal & gynecologic infections
  • Usually an oral prep
  • S/E: dizziness, HA, GI discomfort, nasal congestion
  • CI: alcohol (increases intolerance)
  • Avoid alcohol 24 hours prior and 36 hours after therapy completion
  • Interaction: lithium, benzodiapines, cyclosporins, calcium channel blockers, antidepressants

11

 

Insulins

  • Functions as replacement for endogenous insulin
  • Restores ability to metabolize carbos, fats & proteins
    • storage of glucose in liver; convert to glycogen to fat stores
  • "Bandaid" → doesn't fix underlying problem 
  • Used in DMI and DMII
  • CI: NKDA; Hypoglycemia
  • Alwys test BS prior to administration 
  • A/E: hypoglycemia (fast & urgent) leading to potential brain damage, shock & death 
  • Given using "sliding scale" 

12

 

Rapid Insulin 

  • Onset ~15 min
  • Peak 40 min to 60 min
  • Duration 24 hours
  • Give within 15 minutes of meals
  • Humalog (Insulin lispro), Novalog 

13

 

Short Insulin 

  • Onset ~30 to 60 min
  • Peak 2.5 hrs
  • Duration 4-6 hours
  • Regular insulin
    • Humulin R, Novolin R

14

 

Intermediate Insulin 

  • Onset 2-4 hrs
  • Peak 4-8 hr
  • Duration 16-20 hr
  • Cloudy appearance
  • NPH (insulin isophane) 

15

 

Long Insulin 

  • Onset 1-2 hr
  • Peak 3-9 hr or continous
  • Duration 24 hours
  • Lantus (insulin glargine) 

16

 

Meglitinides 

  • Oral anti-diabetics
  • Glinides 
  • Increase release of insulin from pancreatic beta cells
  • Fast acting with short duration 
  • Taken before each meal
  • Pandin, Starlix 

17

 

Thiazolidinediones 

  • Oral anti-diabetics
  • Regulates genes involved in glucose & lipid metabolism
  • Insulin sensitizing
  • CI: heart failure (may exacerbate)
  • A/E: peripheral edema, wt. gain
  • Actos, Avandia 

18

 

Sulfonylureas 

  • Oral anti-diabetic medication
  • Oldest group
  • Binds to receptors of beta cells of pancrease to stimulate release of insulin 
    • Secondary = decrease glucagon secretion 
  • Not used in DMI
    • Used in early stage DMI
  • A/E: wt gain (r/t insulin secretion), skin rash, nausea, heartburn 
  • Glipizide (Glucatrol) 
  • Onset = rapid ~1 hour
  • Peak 1-3 hours
  • Duration 6-8 hours