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Alternatives- PHARM 2

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olola's version from 2016-09-20 10:14

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Question Answer
this class has wide antibiotic spectrum but is highly specific for PBP2 of GM+ and GM-Carbapenems
this class is broken down by B-Lactamase (bacterial defense enzyme) but lacks cross-allergic rxn with penicillin entirelyMonobactams
Azithromycin is excreted by the ____Liver
What is the 1st and 2nd most preferred AB for dental infection/fever especially if pt is systemically allergic to penicillin?Macrolides (1st choice) or Clindamycin (2nd)
cholestatic hepatitis and cardiac arrhythmia are contraindications for what class of antibiotics?Macrolides
What class antibiotics is used for Treating acquired bacterial pneumonia, chronic sinusitis, & asthma complications?Macrolides
This antibiotic acts synergistically with cephalosporins and aminoglycosidesVancomycin
nausea, neutropenia, pancreatitis, pseudomembranous colitis and alcohol intolerance are side-effects of what antibioticMetronidazole
Vancomycin is great against Gram _____Gram Pos (esp strep and staph... including MRSA!)
This drug has less GI problems associated with it than Erythromycin does and is mostly effective against GM+ anaerobesClarithromycin
_____ is used to prolong the effects of FluoroquinolonesCimetidine
this class of antibiotics has side-effects of Tendon rupture, arthralgia and joint swelling, renal crystals and prolonged QT interval (causes heart attack for patients with heart problems)Fluoroquinolones
NSAID or Probenacid will ____ (increase/decrease) penicillin half life.increase (decreases renal excretion)
Semi-synthetic penicillins do not target gram ______ bacteriaGram negative (more limited spectrum, no Gram neg activity)
Which penicillin drug is relatively resistant to B-Lactamase?Methicillin ((due to bulky side chains)
Prophylaxis for rheumatic fever or bacterial endocarditislong acting penicillin (procaine or benzathine penicillin - 28 days)
T/F - Beta Lactam antibiotics have the widest spectrum of antibiotic activityT
Most frequently used penicillin for oral infectionsPen V
T/F: Amoxicillin has superior pharmacokinetic, less GIT problems, and broad spectrum propertiesTrue
Penicillins should be avoided in those with previous allergic history or those taking _____Coumadin anticoagulants
____'s and ______ may inc serum ½ lives of penicillin by dec their renal excretionNSAIDs & Probenecid
T/F: Oral penicillin may be antagonized by bacteriostatic antibiotic (tetracycline, erythromycin, clindamycin)True
Penicillin with no Gram Neg activityMethicillin (2nd Gen)
Penicillin with small Gram Neg activityPenicillin G
60% absorbed - most frequently used dental infection antibioticPenicillin V
Only 20% absorbedPenicillin G
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Question Answer
Half life of tetracyclines is lower for patients on what two types of meds, due to microsomal enzyme inductionPhenytoin & Barbiturates
Two drugs for UTI that release ammonia and formaldehyde in urine causing acidic orange urineNitrofurantoin (macrobid) & methenamine
T/F: Tetracycline can be toxic to kidneys in patients with kidney diseasesTrue
Tetracycline is especially used for what bone tick-borne disease? Rickettsia
Aminoglycosides have a synergistic effect with ______ antibiotics and are most effective against gram ____ bacteriaB-Lactam; Gram Neg
Which Aminoglycoside is taken orally and used to treat GI infections?Neomycin
Fanconi syndromediabetes like symptoms from taking expired tetracyclines
Sulfonamides are readily absorbed via the _____ and _____ _____ stomach; small intestine
What are the 3 side effects of Aminoglycosides (streptomycin e.g.)ototoxicity, nephrotoxicity, & neuromuscular blockade
Tetracycline is especially used for what STD?Chlamydia
Sulfonamides are mainly used to treat ____ ____ infections and _______ infectionsUrinary tract; Respiratory
Do Aminoglycosides have high or low bio-availability?LOW, (which is why they stay local)
T/F: Sulfonamides inhibit DNA synthesis in patientsFalse (we don't manufacture folic acid with same pathway)
What antibiotics are often given to HIV patients because it has higher plasma protein binding and lasts longer in body?Sulfonamides
Which Aminoglycoside can be given as an injection or topically?GENTAmicin
What class antibiotics often given for "traveler's diarrhea"?Sulfonamides
Dairy products, Calcium, bismuth and _______ _______ can inhibit absorption of tetracyclinesAluminum hydroxide
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Some (but not all) Cephalosporin questions

Question Answer
What Cephalosporin crosses the CNS and is used to treat MENINGITIS?Cefuroxime (2nd gen) & Cefotaxime (3rd gen)
What Cephalosporin generation?: Cefamandole, Cefaclor, Lorbacef2nd gen
What Cephalosporin generation is Cefepime4th (IV, expensive, broad spectrum)
This Cephalosporin generation is mainly effective against Gram + bacteria1st (Cephalexin)
Cephalosporin generations given for Pseudomonas infection (depending on severity)3, 4 (4 being more sever)
Cephalosporin Generations given for Penicillin resistant strep pneumoniae3, 4
Cephalosporin generation given for MRSA, enterococci4
This Cephalosporin Gen is Like ALWAYS, like you know, given IV ... DUH!4 (3 is regularly)
Maculopapular rash, increased liver fxn, stop hemostasis (hypoprothrombinemia), alcohol interolance are adverse reactions of what antibiotic class?cephalosporin adverse rxns
Cephalosporins excreted by the _____kidney
______ lesions, penicillin cross allergy, and increased _____ function are adverse effects of cephalosporinsMaculopapular; Liver
______ intolerance and inhibited hemostasis ((hypoprothrombinemia... what a mouthful) are adverse effects of cephalosporinsAlcohol
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Which classes of antibiotics

Question Answer
Highly specific to PBP2Carbapenems (Imipenem, Meropenem)
Wide spectrum, Beta lactamase resistant, cross rxn penicillin, MRSACarbapenems
AztreonamMonobactam
These antibiotics lack cross-resistance with penicillinMonobactams (limited to aerobic gram negative, Beta lactamase sensitive, only injection, but at least it lack cross rxn penicillin)
Erythromycin, Clarithromycin, AzithromycinMacrolides
target 50S ribosomal subunit of bacteriaMacrolides & Clindamycin
target 30S ribosomal subunit of bacteriaTetracycline & Aminoglycosides
Microsomal enzyme inhibitorErythromycin & Clarithromycin
this Macrolide is special. it causes less GI problemsClarithromycin
Liver-bile-urine to excreteErythromycin
Liver & or Kidneys to excreteClarithromycin
antibiotics used to treat OsteomyelitisClindamycin, Fluoroquinolones
Inhibits carboxypeptidaseVancomycin
Very effective through IV... but orally has poor absorptionVancomycin
antibiotic used to treat Protozoal infectionMetronidazole
antibiotic used to treat ANUGMetronidazole
Increased CNS toxicity with Theophyine or NSAIDsFluoroquinolones
Adverse reactions for heart problem patientsFluoroquinolones, Macrolides
memorize

further questions (LOL we're only getting started)

Question Answer
this class of antibiotics (a penicillin alternative) is isolated from the fungus Acremonium chrysogenumCephalosporins
T/F: Cephalosporins are a B-Lactam drugTrue (and so inhibit cell wall synthesis)
T/F: Cephalosporins inhibit Bacterial DNA synthesisFalse (B-Lactam drug... inhibit cell wall synthesis)
Cephalosporins inhibit what?Cell wall synthesis (like B-Lactam drugs)
Are Cephalosporins absorbed well orally?Yes
Which specific cephalosporin is used to treat MENINGITIS because it can penetrate the CSF?Cefuroxime (2nd gen) or Cefotaxime (3rd gen)
Cephalosporins structure: a ______ ring and ________ ringB-Lactam ring & DIHYDROTHIAZINE ring (6 membered ring)
Cephalosporins have a B-Lactam ring & DIHYDROTHIAZINE ring... Dihydrothiazine is a _____ (#) membered ring6 membered ring
What enzymes do cephalosporins (like penicillins) target in order to inhibit cross-linking of peptidoglycan?transpeptidases & carboxypeptidases
Cephalosporin is a _____ nucleus with 2 side chains: R1 (antibiotic action) & R2 (kinetic modifier)Cepham nucleus (w/ 2 side chains: R1 & R2)
What class of drugs has a Cepham nucleus with 2 side chains?Cephalosporins (B-Lactam)
Different "generations" (classifications) of Cephalosporins are classified on the basis of their ______ activityAntimicrobial (GM+, GM-, pseudomonas, or wide spectrum)
What is the main First generation Cephalosporin?Cephalexin (also "main drug for orofacial infections")
What Cephalosporin is taken orally for soft tissue infection and surgical/endocarditis prophylaxis?Cephalexin(Gen1) (main drug for orofacial infection)
T/F: Cephalexin has the same dosage and regimen as PenicillinTrue
What is the half-life of Cephalexin (First Gen Cephalosporin)1 hour
Are Second generation Cephalosporins used commonly in dentistry?No (b/c mainly effective against Gram neg... which app isn't as big a concern in our realm)
What is the main second generation Cephalosporin?Cefamandole
Azithromycin is excreted by the ______Liver
memorize

Which cephalosporin generation?

Question Answer
drugs: Cefamandole, cefaclor, & lorbacefGen 2 (mainly GM-, more resistant to B-lactamse than Gen 1, rarely used in dentistry)
Taken orally for soft tissue infections caused by GM+ bacteria (mainly staph & strep)Gen 1 (Cephalexin)
drug: CephalexinGen 1 (GM+, soft tissue infections esp., B-Lactamase sensitive, taken orally)
VERY EXPENSIVE (apparently because of its broad spectrum)Gen 4 (e.g. Cefepime)
CefepimeGen 4 (expensive, broad spectrum, always IV route)
Generally taken parenterally for serious GM- bacteria infection (specifically effective against GM-) Gen 3 (cefotaxime)
Very sensitive to Beta-LactamaseGen 1 (Cephalexin... ; Gen 2-4 are resistant to B-Lacatamase)
Should patients with history of systemic penicillin reaction be given Cephalosporins?NO (unless specifically called for in life threatening situation such as meningitis and anaphylaxis antidote is available)
cefotaximeGen 3 (serious GM- infection, crosses CSF)
CefamandoleGen 2 (GM- effective, only mild effect against anaerobes)
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and other antibiotics still

Question Answer
What are the 3 Macrolide drugs?erythromycin, clarithromycin & azithromycin
this group Acts by binding to 50S ribosome unit → inhibit RNA-dependent protein synthesis by blocking translocationMacrolides (Clindamycin does too.. but its not a macrolide)
more effective against strep and staph than the other 2 MacrolidesAzithromycin
A Z pack is 6 tabs of 250 mg of what antibiotic?Erythromycin
BEST ALTERNATIVE for B-lactam allergic patient for acute orofacial infec***Macrolides***
cholestatic hepatitis and cardiac arrhythmia are contraindications for what class of antibiotics?Macrolides
This drug has less GI problems associated with it than Erythromycin does and is mostly effective against GM+ anaerobesClarithromycin
What class antibiotics is used for Treating acquired bacterial pneumonia, chronic sinusitis, & asthma complications?Macrolides
T/F: Clindamycin is a macrolideFalse (part of another family called Lindomycins)
T/F: Clindamycin, unlike Erythromycin, Azithromycin, and Clarithromycin, is not a macrolideTrue (Its a Lindomycin... which is a diff family)
What is the 1st and 2nd most preferred AB for dental infection/fever especially if pt is systemically allergic to penicillin?Macrolides (1st choice) or Clindamycin(2nd)
This antibiotic is known especially for its ability to penetrate into bonesClindamycin (and thus is great for Osteomyelitis)
This antibiotic acts synergistically with cephalosporins and aminoglycosidesVancomycin
Vancomycin is great against Gram _____Gram Pos (esp strep and staph... including MRSA!)
not an antibiotic... but anti-abuse drugs given for alcoholicsDisulfiram
Metallic taste and disulfiram-like interaction with alcohol (vomiting) are side-effects of this antibiotic**Metronidazole**
used to treat ANUG, anaerobic bacteria (staph) , and MAINLY PROTOZOAL infections**Metronidazole**
drug that Has a nitro group that gets reduced to metabolies that damage bacterial DNA**Metronidazole**
nausea, neutropenia, pancreatitis, pseudomembranous colitis and alcohol intolerance are side-effects of what antibiotic?**Metronidazole**
these antibiotics are a Fluorine derivative of nalidixic acidFluoroquinolones
___-floxacin named antibiotics are of what class?Fluoroqunilones
most common Fluoroquinolone antibiotic drug?Ceprofloxacin
what class is the drug Ceprofloxacin?Fluoroquinolone
First drug of Fluoroquinolone class, but had undesirable CNS stimulant effects and rapid development of bacterial resistanceNalidixic acid
dosage of Cipro (Ceprofloxacin, a Fluoroquinolone)250-500 mg BID
dosage of Levaquin (levofloxacin, a Fluoroquinolone)250, 500, or 750 mg, QD (1x/d)
dosage of Avelox (moxifloxacin, Gen 4 Fluoroquinolone)400 mg, QD
This class of antibiotics has interactions with anti-arrhythmia drugsFluoroquinolones
_____ is used to prolong the effects of FluoroquinolonesCimetidine
this class of antibiotics is used against UTIs, STDs (mainly syphilis and gonorrhea), GI infections, resp tract infec, bone/joint infections (including osteomyelitis)Fluoroquinolones
this class of antibiotics has side-effects of nausea, headaches, CNS side effects such as seizures and delirium (this is why gen 1 isnt used any more)Fluoroquinolones
this class of antibiotics has side-effects of Tendon rupture, arthralgia and joint swelling, renal crystals and prolonged QT interval (causes heart attack for patients with heart problems)Fluoroquinolones
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