5 Written questions
4 Matching questions
- Key concept
- Fluoroquinolones SE
- a Multiple drug therapies are needed in the treatment of tuberculosis, since the complex microbes are slow growing and commonly develop drug resistance.
- b Bacteria that contain a thick cell wall and retain a purple color after staining. Staphylococci, streptococci, and enterococci.
- c Nausea, diarrhea, vomiting, rash, restlessness, pain and
inflammation at injection site, local burning, stinging and
corneal irritation (ophthalmic)
**Anaphylaxis, tendon rupture, superinfections,
photosensitivity, pseudomembranous colitis
- d Nausea, vomiting, abdominal cramping, flatulence,
diarrhea, mild phototoxicity, rash, dizziness,
stinging/burning with topical applications
**Anaphylaxis, secondary infections, hepatotoxicity,
5 Multiple choice questions
- The action of bacteriocidal drugs.
- Resistance has limited the usefulness of once widely prescribed sulfonamides to urinary tract infections and a few other specific infections.
- The type of drug that is effective against a large number of different species of bacteria.
- • Similar in structure and function to penicillins
•Have beta-lactam ring; are bacteriocidal
•Widely prescribed anti-infective class
•More than 20 cephalosporins available
•Cross-sensitivity with penicillins (5-10% of population)
•Classified by generations
Generations of cephalosporins
-First (oldest): bacteria producing beta-lactamase are resistant
-Second: more potent, broader spectrum, more resistant to beta-lactamase
-Third: longer duration of action, even broader spectrum, resistant to beta-lactamase
-Fourth: effective against organisms that are resistant to earlier generations
-Third and fourth capable of entering CSF
- The advantage of using amoxicillin (Amoxil) over penicillin G.
5 True/False questions
Tetracycline → •Most effective against gram-positive bacteria
•Kill bacteria by disrupting cell wall with beta-lactam ring
•Beta-lactamase or penicillinase is enzyme allowing bacteria to be resistant
•New penicillins are penicillinase-resistant
-Examples: oxacillin and cloxacillin
•Combination drugs with beta-lactamase inhibitors
-Examples: clavulanate, sulbactam, tazobactam
•One of safest classes of antibiotic
•Allergy most common adverse effect
•If client allergic to penicillin, avoid cephalosporins
-Possibility of cross-hypersensitivity
•Other adverse effects
-Skin rash; decreased RBC, WBC, or platelet counts
Fluoroquinolones → *FIRST-GENERATION Fluoroquinolones
nalidixic acid (NeoGram) PO; Acute therapy: 1 g qid; PO; Chronic therapy: 500 mg qid
ciprofloxacin (Cipro, Septra) PO; 250-750 mg bid
lomefloxacin (Maxaquin) PO; 400 mg/day
norfloxacin (Noroxin) PO; 400 mg bid
ofloxacin (Floxin) PO; 200-400 mg bid
gatifloxacin (Tequin) PO; 400 mg tid
levofloxacin (Levaquin) PO; 250-500 mg/day
gemifloxacin (Factive) PO; 320 mg/day
moxifloxacin (Avelox) PO; 400 mg/day
trovafloxacin mesylate (Trovan) PO; 100-300 mg/day
penicillin-binding protein → Many bacterial cell walls contain this substance, that serves as a receptor for penicillin.
narrow-spectrum antibiotics → Drugs effective against only one or a restricted group of microorganisms.
Marcrolides → azithromycin (Zithromax) PO; 500 mg as single dose, then 250 mg/day for 4 days
clarithromycin (Biaxin) PO; 250-500 mg bid
dirithromycin (Dynabac) PO; 500 mg/day
erythromycin (E-Mycin, Erythrocin) PO; 250-500 mg bid or 333 mg tid
troleandomycin (Tao) PO; 250-500 mg q6h