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Pharmacology ch 4
Antibiotics
| Question | Answer |
|---|---|
| Sulfonamides | Sulfa drugs, are the oldest antibiotics and are a group of bacteriostatic drugs. they block a specific step in the pathway for making the important biochemical folic acid (vitamin B9) which is needed in making the DNA. Humans obtain vitamin B9 from food |
| Nitrofurantoin (Macrobid, Macrodantin) | If patient is allergic to sulfas this is DOC, treats urinary tract infections.Works better when taken w/ food otherwise nausea is a side effect. May cause urine brown and cause false urine glucose tests. Most serious allergic reaction is Anaphylaxis |
| Penicillins | They kill bacteria by preventing them from forming the rigid cell wall needed for survival. The weakend cell wall allows excessive amounts of water into the bacterium through osmosis and then lyses (bursts). Humans don't have rigid cell walls |
| Penicillin G | Is the prototype but absorption from the gastrointestinal tract is incomplete; therefore, it is supplied only in injectible form. |
| Penicillin V | Drug of choice for strep throat. |
| Ampicillin | It will cause a skin rash in a high %of patients w/ mononucleosis. Dosed 4 times a day. |
| Amoxicillin | Is used orior to a dental procedure to provide prophalaxis. Dosed 3 times a day. |
| Cephalosporins | Like penicillins they impair the rigid cell wall and if a patient is allergic to penicillins there is a 1% chance they are allergic to cephalosporins. There are 1st,2nd,3rd, and 4th generation cephalosporins |
| First Generation Cephalosporins | Used for mild to moderate community acquired infections in ambulatory patients |
| Second Generation Cephalosporins | Have increased activity, especially against Haemophilus influenzae, an important pathogen in the pediatric group. They are also used for otitis media in children and for respiratory and urinary tract infections |
| Third Generation Cephalosporins | Most recently developed and has a wide spectrum of gram-negative organisms and are used in severe infections. Because of their long half-life they are used in ambulatory patients, especially in children for dosing before and after school. |
| Ceftriaxone (Rocephin) | Injectable form and is very painful, so it is usually mixed with lidocaine to diminish discomfort. It is frequently used in emergency room settings to treat STDs |
| Cefdinir (Omnicef) | Injectable form, and diabetic patients must be informed of the high sugar content. Oral suspension has a sugar content of 2.86 g per teaspoonsful |
| Fourth Generation Cephalosporins | Cefepime(Maxipime)it's considered to have a broad-spectrum coverage. Used for treating pneumonia, urinary tract infections, and sepsis caused by gram-negative organisms. Cefepime is as effective as Cefatazidime (Fortaz)but is more cost effective |
| Tetracyclines | Produced by soil organisms. These drugs are broad spectrum bacteriostatic antibiotics that inhibit protien synthesis in bacteria by binding to ribosomes. They surpress infection but they require phagocytes to complete the eradication of the bacteria |
| Macrolides | Antibiotics that are bacteriostatic agents used primarily to treat pulmonary infections caused bylegionella and gram positive organisms. Macrolides inhibit protein synthesis by combining with ribosomes. |
| Azithromiycin (Zithromax) (ZPAK) | is disspensed in a dose pack (ZPAK) and is the primary drug for pulmonary infections |
| Ketolides | Antibiotics that block protein synthesis by binding to ribosomal subunits and they may also inhibit the formation of newly forming ribosomes. Ketolides are used to treat bacterial infections in the lungs and sinuses. |
| Telithromycin (Ketek) | used for mild-moderate community acquired pneumonia, acute bacterial sinusitis, and acute exacerbation of chronic bronchitis. This drug can cause blurred vision. Serious side effect= arrhythmias (irregular heartbeat) |
| Quinolones | Antibiotics that have a strong rapid bactericidal action against most gram-negative and gram-positive bacteria. They antaganize the enzyme responsible for coiling and replicating bacterial DNA. Humans don't have this enzyme, their cells are unaffected |
| Streptogramins | Inhibit protein synthesis within the bacterial ribosomes. Provides an alternative to vancomycin. Accelerated approval by Food and Drug Administration for ability to treat life threatening conditions |
| Aminoglycosides | Drugs that are commonly used to treat life-threatining infections like sepsis (blood borne infections) After first dose, the dosage should be adjusted according to plasma concentration because Serious side affects are nephrotoxicity and ototoxicity |
| Cyclic Lipopeptides | Drugs that bind to bacterial membranes and cause the call membrane to depolarize, thus leading to an inhibition of DNA and RNA (ribonucleic acid) synthesis. Bacterial death follows. |
| Vancomycin (Vancocin) | Bactericidal drug that interfers with bacterial wall synthesis. Its used for staph infections (MRSA) Its the most overused drug and has strict guidelines from Centers for Disease Control (CDC) for handling and use if this drug |
| Metronidazole (Flagyl) | An antibiotic that is effective against fungi and protozoa as well as bacteria. A patient should not consume alcohol, they will become nauseated, causing vomiting, blood vessels dilate, causing flushed reaction and headache |
| Linezolid (Zyvox) | Was the first oxazolidinone to be approved by the FDA, inhibits bacterial protein synthesis. It's used to treat MRSA, VRE and other gram-positive infections. It should be protected form light |
| Drotrecogin alfa (Xigris) | Is not a antibiotic but is approved for specific indication of sepsis because of its natural anticoagulant properties (Activated Protein C, it prevents blood clotting)and anti-inflammatory |
| Clindamycin (Cleocin) | Is a broad-spectrum antibiotic that inhibits protein synthesis. It is used for serious gram-positive infections and ias a prophalaxis preceding abdominal surgery. Serious side effect= pseudomembranous colitis (bloody diarrhea) |
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