1.
aminoglycosides: -inhibits bacterial protein synthesis
-gram - bact
-reserved for serious infections
-not absorbedvia GI tract; does not cross BBB
-IM/IV only
-gentamycin, tobramycin, amikacin, streptomycin
-s/e: ototoxicity, nephrotoxicity, superinfection
-peak levels drawn to monitor toxicity
-troug levels to monitor maintenance of therapeutic drug levee
2.
avelox: -more active against s. pneumoniae than levaquin is
3.
cipro: -broad spectrum of action; lower respitory infections, UTIs, bone, skin
4.
common examples of Fluoroquinolones: -cipro
-levaquin
-avelox
5.
common macrolide agents: -erthromycin (iv)
-clarithromycin
-azithromycin (long 1/2 life) (iv)
-dirithromycin
6.
extended macrolides: -all inhibit protein synthesis
-clarithromycin: 2x a day (BID)
-azitromycin: QD x 5 days; t-1/2= 50 hours
7.
Fluoroquinolones: -interferes with enzyme DNA gyrase- needed to synthesize bacterial DNA
-bactericidal on gram + and -
-mainly used for tx of UTI, bone, joint infect; bronchitis, pneumonia, gastroenteritis, gonorrhea
-high tissue distribution
-food/antacids slow absorption rate
8.
glycopeptides: -sub cat of macrolide
-focus of vancomycin
-bactericidal
-used against drug-resistant s.aureus and cardiac surf prophylaxis w pt with PCN allergy
9.
intermediate acting Tetracyclines: -PO only
-declomycin
10.
ketolides: -structurally related to macrocodes
-ketek: (18+) treats mild to moderate CAP
-adverse rxn: may lead to an exacerbation of myashenia gravis
-many drug interactions
11.
levaquin: -primarly treats URIs, acute sinusitis, chronic bronchitis, UTIs.
-may cause dysrhythmias
12.
lincosamides: -sub cat of macrolide
-bacteriostatic/cidal
-clindamycin: activate against most gram + and anaerobic org., absorbed better than lincocin vis gi tract, maintains a higher serum drug conc and fewer toxic effects
-lincomycin
-s/e: gi upset, rash
-adverse rxn: colitis, anaphylactic shock
-drug interactions: aminophyline, dilantin, barbiturates, ampicillin
13.
long acting tetracyclines: -PO and IV
-Vibramycin
-minocin
14.
macrolide drug interactions: may increase serum levels of:
-theophyline
-carbamazepine
-warfarin
-do not administer with antacids bc may increase peak levels of macrolide
15.
macrolides: -bacteriostatic; with high doses can be bactericidal
-used as pen sub.; diff in structure of pen
-broad spectrum
-used to treat mild-moderate infection of reps tract, sinuses, gi tract, skin, soft tissue, impetigo and STI
-PO, slow IV
-e-mycin drug of choice for Legionnaires mycoplasmal pneumonia
16.
other pcn sub., along w macrocodes: -lincosamides
-gylcopeptides
-ketolides
17.
pharmacodynaamics of ketolides: -inhibits protein synethsis in m.o by binding to ribosomal RNA which leads to bacterial cell death
-peak action 1 hr
18.
pharmacodynamics of aminoglycosides: -bactericidal
-preg cat. C
-onset of action: immediate
-peak action: 1-2 hrs
19.
pharmacodynamics of Fluoroquinolones: -inhibits bacterial DNA synthesis by inhibiting the enzyme DNA gyrase
-effect of oral hypoglycemics, theophylline and caffeine are increased with concurrent use of a Fluoroquinolones
-peak con: 1-2 hrs
20.
pharmacodynamics of glycopeptides: inhibits cell wall synthesis; active against several gr + bacteria; peaks 30min after IV infusion
21.
pharmacodynamics of macrocodes: -bacteriostatic
-oral prepL onset of action 1 h, peak conc is 4 hrs and duration is 6hrs
22.
pharmacokinetics of aminoglycosides: -IM/IV
-shot half life; given 3-4 days daily
-excreted via urine
23.
pharmacokinetics of glycopeptides: -oral: treats antibiotic associated pseudomembranous colitis due to c.diff
-IV: treats severe infections due to MRSA; septicemia; bone, skin, lower reps tract infect that are resistant to other antibiotics
-t-1/2 life: 6 hrs
-excretion via urine
24.
pharmacokinetics of ketolides: -orally: absorption by GI tract
-not affected by food intake
-excreted through feces, urine
-t-1/2: 10 hrs
25.
pharmacokinetics of macrolides: -readily absorbed from the GI tract; excretion in bile, feces, urine
-only a small amy is excreted in urine, therefore renal insufficiency is not a contraindication for macrolide use
26.
pharmcokinetics of Fluoroquinolones: -well absorbed from GI tract
-low protein binding effect
-moderate half life: 6-8 hrs
-excreted via urine
27.
photosensitivity: -increase risk with declomycin and long acting forms.
-get sun-burnt 10x worse than average
28.
red neck (man) syndrome: - due to too rapid of an infusion of glycopeptide
-red blotching of face/neck/chest
-toxic not allergic rxn
-no need to stop infusion, lower infusion rate
29.
short acting tetracyclines: -PO only
-Sumycin
30.
side effects and adverse effects to tetracyclines: -gi disturbances, photosensitivity, teratogenic effects (1st and 3rd), nephrotoxicity, superinfection, oral contraception may be decreased
31.
side effects of glycopeptide: -vanocomycin
-s/e: nephrotoxicity, ototoxicity damage (8th cranial nerve) can be permanent or temp, chills, dizziness, fever, rash, n/v
32.
side effects/adverse run of macrolide: -gi n/v/d/ abdominal cramping
-allergic rn are rare
-when combined with other hepatotoxic drugs leads to hepatotoxicity; usually reversible when the drug is discnt.
33.
Tetracyclines: -bacteriostatic
-used in combination to treat h.pylori
-resistance has increased in treatment of pneumococcal and gonococcal infections
-orally use mainly
-available in IV/IM- rare cause of pain
-not to be taken with magnesium/aluminum antacid preparations, calcium containing products.- prevents absorption
