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136 Cards in this Set
- Front
- Back
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What are the 4 ways to classify bacteria?
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Gram stain, acid fast stain, oxygen requirement, and shape
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Be able to identify the following as Gram Positive cocci:
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Staphylococcus aureus
Enterococcus faecalis Viridans streptococci Streptococcus pneumoniae |
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To which antibiotic is it most common to have an adverse drug reaction?
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penicillin
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Be able to identify the following as gram negative rods:
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Enterobacteriacea:
Escherichia coli Klesiella pneumoniae Pseudomonas aeruginosa Acinetobacter spp Moraxella catarrhalis Bordatella pertussis Legionella pneuomophilia Haemophilis influenzae |
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What are the SPACE bugs and what are their significance?
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When you see these bacteria, you should automatically think to treat them with 2 antibiotics. Serratia
Pseudomonas Acinetobacter Citrobacter Enterobacter |
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What is Prophylactic therapy?
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Prevent the most likely pathogen of a potential infection
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What is empiric therapy?
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fight the most common pathogens at the site of an active infection
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Most likely infection in heart?
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Streptococci, Staphylocci
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Most likely infection in intra-abdominal tissues?
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E. coli, Enterococcus
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Most likely infection in the brain (meningitis)?
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S. pneumoniae, N. meningitidis
HIV co-infected: cryptococcus neoformans |
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Most likely infection in respiratory tract?
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S. pneumoniae, H. influenzae
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Most likely infection in skin and soft tissue?
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staphylococcus
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Most likely infection in urniary tract?
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E. coli
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Define bacteriostatic
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antibiotics that inhibit/arrest the growth of a bacterial population
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Define bacteriocidal
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antibiotics that kill at least 99.9% of a bacterial population
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What should we know about natural penicillins?
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-They are a cell wall/membrane agent.
-They penetrate CNS well with inflame meninges -can be given IV, IM, or oral -good against gram + (drug of choice against strep) -needs to be renaly adjusted |
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What should we know about antistaphylococcal penicillins?
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Example to know: Nafcillin
do NOT have to be renaly adjusted -excellent against MSSA (methicillin sensitive staphylococcus aureus) |
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What should we know about amino penicillins?
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-Good to use against H. pylori
-To treat strep use: amoxicillin or ampicillin |
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How are penicillins categorized?
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based on what bacterial they treat best
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What should we know about anti-pseudomonal penicillins?
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example: Zosyn
They are good to use against anaerobic bacteria -they do not have a PO option. All are IV/IM |
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What type of antibiotic are cephalosporins?
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work against the cell wall/membrane
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Example of First Generation Cephalosporins
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Cephalexin
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How many people who are allergic to penicillins are also alergic to cephalosporins?
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about 10% of the people are also allergic to cephalosporins
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What to know about Cephalosporins, in general?
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1st generation are good at treating gram positive bacteria, and only OK at treating gram negative As you go down the line to 4th generation, they get better at treating gram negative and worse at treating gram positive
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What are 2nd generation cephalosporins used most to treat?
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H influenzae (gram negative)
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What to know about 4th generation cephalosporins?
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they DO enter the CNS to treat inflame meninges
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What is a key adverse reaction to taking cephalosporins?
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C. dificile diarrhea
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What type of antibiotic are carbapenems?
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fight cejl wall/membrane of bacteria
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What to know about carbapenems?
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they are VERY broad spectrum. They penetrate well into body tissues and fluids, including CSF (good drug to treat meninges)
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What is a common adverse reaction to carbapenems?
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they have a 50% cross-reactivity in patients with penicillin allergy
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what kind of antibiotics are monobactams?
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fight cell wall/membrane of bacteria
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What to know about monobactams?
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Use to treat P. aeruginosa. They have NO penicillin/cephalosporin cross-reactivity
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what kind of antibiotic are glycopeptides?
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fight cell wall/membrane
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What to know about glycopeptides?
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they are a second line tratment for C. difficile infection ( PO only)
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What to know about Vancomycin?
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Vancomycin is a Glycopeptide. Use Vanco IV to treat MRSA. Use Vanco PO to treat C. difficile infection
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Adverse Reaction of Glycopeptides?
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Nephrotoxicity, Ototoxicity, Red Man Syndrome
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What kind of antibiotic is Clindamycin?
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Ribosomal binding agent
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What to know about Clindamycin?
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Excellent treatment for MSSA, strep. One of the worst to cause C. dif infection
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What kind of antibiotic are Macrolides?
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ribosomal binding agent
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Most commony used Macrolide?
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Azithromycin (Zithromax)
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Which Macrolide has the most drug interactions? Causes upset stomach?
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Ezythromycin
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Which Macrolide has the fewst drug interactions? And is used to treat pneumonia?
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Azythromycin
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Which Macrolide leaves a metallic taste in the patient's mouth?
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Clarithromycin
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What kind of antibiotic is Oxazolidinones?
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ribosomal binding agent
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Example of an Oxazolidinone?
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Linezolid
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Adverse reaction of Oxazolidinones?
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thrombocytopenia
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What type of antibiotic are aminoglycosides?
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ribosomal binding agent
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Which antibiotic do you monitor the peaks and troughs?
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aminoglycosides
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What are most common adverse reactions of aminoglycosides?
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nephrotoxicity, ototoxicity
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Which aminoglycoside is used for gut decomtamination before surgery?
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Neomycin
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What type of antibiotic are tetracyclines?
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ribosomal binding agent
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What is one atypical bacteria that a tetracycline, specifically doxycycline, is useful for treating? And one other treatment?
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Chlamydia (the atypical bacteria). Also used to treat acne
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What is a key adverse reaction of tetracyclines?
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photosensitivity (will get sunburn)
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Which antibiotic is a pregnancy category D teratogenic agent?
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Tetracycline
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Which antibiotic should never be used in children less than 8 years old?
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Tetracycline
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Which drug is useful in treating MRSA and VRE?
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Tigecycline
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Which antibiotic can only be used in adults? >18?
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Tigecycline
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What kind of antibiotic is Metronidazole?
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Agent with RNA/DNA action
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What is Metronidazole commonly used to treat?
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Trichomonas parasites
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Which antibiotic should you definitely avoid alcohol during treatment AND 72 hours after last dose?
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Metronidazole
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What kind of antibiotic are fluoroquinolones?
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Agent with RNA/DNA action
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What is an example of a 2nd generation fluoroquinolone?
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Ciprofloxacin
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Which fluoroquinolones ARE effective for respiratory infections?
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3rd and 4th generation fluoroquinolones (Levo and Moxi)
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One more antibiotic that should be avoided during pregnancy and in children <18 years old?
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fluoroquinolones
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What is the only fluoroquinolone that does not need renaly adjusted?
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Moxi
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What type of antibiotic is Rifampin?
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Agent with RNA/DNA action
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Which antibiotic is useful for treating tuberculosis?
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Rifampin
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Which antibiotic causes a red/orange discoloration of secretions?
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Rifampin
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Which type of antibiotics can cause Steven-Johnsons Syndrome?
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Sulfamethoxazole-Trimethoprim (sulfa drugs)
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What are sulfa drugs useful for treating?
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Urinary tract infections (E. coli)
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Which category of antibiotics are sulfa drugs included in?
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agents with RNA/DNA action
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Which antibiotics is MOST commonly used in urinary tract infections?
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Nitrofurantoin
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What “involves selecting an appropriate drug and optimizing its dose and duration to cure an infection while minimizing toxicity and conditions for selection of resistant bacterial strains”
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Antimicrobial stewardship
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Where does the BP effect top out for HCTZ?
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25 mg
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Adverse drug event for thiazides?
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hypokalemia
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Example of a loop diuretic
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Furosemide (Lasix)
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Adverse drug event of loops?
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hypokalemia (worse than when on thiazides)
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Example of potassium-sparing diuretic?
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triamterene/HCTZ (dyazide, maxzide)
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Side effect of potassium-sparing drugs?
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Hyperkalemia
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Example of an aldosterone antagonist?
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Spironolactone (smells like mint)
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Adverse drug event of Spironolactone?
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Hyperkalemia
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What is the ending for ACEI's?
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"pril"
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2 examples of ACEI's?
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Captopril, Enalapril
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What is the ending for ARB's?
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"sartan"
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Example of an ARB?
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Losartan, which is available generically
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2 adverse drug events of ACEI's?
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Hyperkalemia, dry cough from buildup of bradykinin
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Which 2 hypertension medications are renoprotective?
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ACEI's and ARB's
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Which 2 hypertension medications do you never give in pregnancy?
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ACEI and ARB
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1 example of a cardioselective beta blocker?
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Atenolol
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1 example of a nonselective beta blocker?
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Propranolol, which can cross BBB, so you get CNS symptoms
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1 example of a beta blocker with ISA? (intrinsic sympathomimetic activity)
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Acebutolol
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Ending for beta blockers?
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"olol"
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Which drug is a mixed alpha and beta blocker?
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Labetolol, which is primarily used in heart failure
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Which beta blocker is the most lipophilic?
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Propranolol
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Which beta blocker is the least lipophilic?
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atenolol
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2 adverse drug events of beta blockers?
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cold extremities, acute exacerbations of bronchospasm (asthma or COPD)
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Abrupt discontinuation of which drug may cause unstable angina, MI, rebound hypertension, or death?
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Beta Blockers
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Which type of drug causes peripheral vasodilation?
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calcium channel blockers
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Give an example of a dihydropyridine CCB?
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Amlodipine (norvasc)
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Give 2 examples of non-dihydropyridine CCBs?
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Diltiazem, Verapamil
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Which type of drug has better effect in African Americans?
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Calcium Channel Blockers
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What are 2 adverse drug events of dihydropyridine CCB's?
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peripheral edema and gingival hyperplasia
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What are 2 side effects of non-dihydropyridine CCB's?
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peripheral edema, CYP3A4 inhibition (lovastatin)
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What is an example of an alpha-1 blocker?
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doxazosin
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Which drug was taken out of the ALLHAT study because of ADR?
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Doxazosin
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Which type of drug can be given for symptomatic benefits in men wih BPH?
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Alpha-1 blockers
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Give 2 examples of alpha-2 agonists
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Clonidine (available in tablet or patch), and Methyldopa
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What is the main adverse drug event of Methyldopa?
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hepatitis
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Which drug is found in Rogaine?
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Minoxidil
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According to Dr. Smith's notes, which 2 drugs can be given for hypertension during pregnancy?
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Methyldopa, Labetalol
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What is it called when a patient is not at goal BP, despite use of 3 meds from different classes?
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Resistant HTN
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doctrinaire
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adj. unyeilding
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What is Adjuvant Therapy?
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Doing surgery or radiation to remove the macroscopic disease, then following with chemo to destroy microscopic malignant cells.
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What is Neoadjuvant Therapy?
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Chemotherapy is given PRIOR to surgery to shrink the tumor size
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What is palliative therapy?
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Chemo given to cure cancers that are incurable
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Many doses for chemotherapy are based on what?
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body surface area (BSA)
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What is Induction therapy?
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Produce a rapid reduction in the tumor cell burdon, thereby producing a symptomatic response in the patient
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What is consolidation therapy?
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seeks to complete or extend the initial ermission and often uses a different combination of drugs than those used for induction
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What is maintenance therapy?
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Used to sustain remission as long as psosible, may use less frequent courses of chemo
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Selection of chemo drugs is largely based on what?
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Clinical trials
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What are some signs of host toxicity in chemo patients?
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myelosuppression (bone marrow suppression), leukopenia, thrombocytopenia, anemia, nausea/vomiting, alopecia (hair loss)
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Which 2 chemo drugs cause cardiotoxicity?
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doxorubicin and anthracyclines
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Which 2 chemo drugs cause hemorrhagic cystitis?
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cyclophosphamide and ifosfamide
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Which chemo drug causes renal toxicity?
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cisplatin
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Which 2 chemo drugs cause pulmonary toxocity?
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The 2 B's: bleomycin and busulfan
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Which 5 drugs should we recognize as DNA synthesis inhibitors?
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methotrexate, mercaptopurine, fludarabine, cytarabine, hydroxyurea
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What are the 4 examples of chemo drugs that we need to recognize as drugs that cross-link DNA (alkylating agent?
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cyclophosphamide, cisplatin, carboplatin, oxaliplatin
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What is the DNA intercalating drugs that we should know?
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Anthracyclines: doxorubicin, daunorubicin
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Which chemo drug should NOT be given to somebody with cardiac problems?
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anthracyclines
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What are the 2 types of chemo drugs that are topoisomerase inhibitors?
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topoisomerase 1 (breaks and reseals single-stranded DNA), topoisomerase 2 (breaks and reseals double-stranded DNA)
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how do you recognize which chemo drugs are mitotic inhibitors?
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they end in "taxel" or start with "vin"
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How do you recognize which drugs are monoclonal antibodies?
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They end in "mab" or "monab"
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Which 2 chemotherapy regimes are used to treat hodgkin's lymphoma?
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MOPP and ABVD
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Which 2 chemotherapy regimes are used to treat colorectal cancer?
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FOLFIRI and FOLFOX
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Which chemotherapy regime is used to treat non-hodgkin's lymphoma?
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chop
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Which 2 chemotherapy regimes are used to traet breast cancer?
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CMF and TAC
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