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43 terms

Introduction to Antibiotics

STUDY
PLAY
AUC
the area under the curve (hint) which represents OVERALL drug exposure. Element of oral absorption
food
may enhance absorption and may decrease adverse drug events. Important element in antibiotic dosing (what is _____)
with or without
the following medications can be taken ? food: Sulfadrugs, Flouroquinilones, Penicillin VK, Amoxicillin, Augmentin, Cephalexin, Cephradine, Cefaclor, Cefixime, Cefprozil, Ketoconazole, Erythromycin, Biaxin, Acyclovir, Isoniazid
with
the following medications are taken ? food, cefuroxime axetil, cefpodoxime, cefditoren, Clarithromycin, Rifapentine, Itraconazole, Tinidazole, Valganciclovir, Ritonavir, Saquinavir
without
the following medications are take ? food, Dicloxacillin, ampicillin, tetracycline, ceftibuten, Erythromycin base/stearate, itraconazole, voriconazole, Rifampin, Doxycycline, Minocycline
intramuscular
the following agents are available as ? agents. Gentamicin, tobramycin, streptomycin, amikacin.
decreased
in the following populations, absorption is (increased/decreased) after IM administration. Little people and patients with long standing diabetes mellitus.
IV
in general, patients sick enough to be admitted to the hospital will receive antibiotics via the ? route
therapeutic concentrations
when choosing an antibiotic to treat an infection choose the antimicrobial agent which achieves the highest ? ? at the SITE OF INFECTION (very important in endocarditis, lung-pneumonia, UTI, CNS)
meningitis
to treat ? you would use cephalosporins and penicillins that penetrate the CNS in therapeutic concentrations.
meningitis
THIRD generation Cephalosporins such as ceftriaxone, cefotaxime, ceftazidime, ceftizoxime and FOURTH generations Cefepime are used to treat ......
third and fourth
which two generations of cephalosporins are used to treat meningitis?
penicillin
when normal, meningal levels of ? are very low, however inflammation increases penetration into the CNS. DO NOT DECREASE THE DOSE AS PATIENT IMPROVES. Penetration decreases as inflammation decreases
semisynthetic penicillins
these drugs have the BEST meningal penetration (oxacillin, nafcillin)
seizure
CARBAPENEMS such as MEROPENEM are used to treat meningitis but imipenem has an increased incidence of ? and is NOT approved for the treatment of meningitis
vancomycin
penetration is increased with inflammation (similar action to penicillin) in treatment of meningitis (v______)
amphotercin B
antifungal which is effective in LOW concentrations in combination therapy in the treatment of meningitis with FLUCYTOSINE and Fluconazole
meningitis
the following drugs can be used to treat ?, 3rd and 4th generation cephalosporins, penicillin, vancomycin, metronidazole, bactrim, and combo ampho b+flucytosine/fluconazole
metronidazole
antibiotic in which oral levels are similar to that of IV
poor penetration
the following antibiotics have ? ? into the cns and are NOT used for meningitis:
Clindamycin, (Aminoglycosides EXCEPT IN NEWBORNS), FIRST generation cephalosporin cephalexin, Zyvox (linezolid), and KETOCONAZOLE/ITRACONAZOLE
UTI
To treat a ? you would use the following drugs:
Aminoglycosides
ampicillin
Cephalosporins
Sulfonamides
Flouroquinilones
vancomycin
due to their high urine concentrations
UTI
you would NEVER treat a ? with the following drugs
Clindamycin
Chloramphenicol
Minocycline
due to LOW urine concentrations
prostate
the following drugs distribute to the ?, TRIMETHOPRIM and FLOUROQUINOLONES
p-glycoprotein
pumps medications out the organ, most commonly seen in the brain
nafcillin
73% eliminated by the liver, 27% kidney, semisynthetic penicillin. Use in caution if both liver and kidney function are abnormal. Very high blood levels could result in seizures.
oxacillin
54% eliminated by the liver and 46% by the kidney, use caution with liver and kidney abnormalities. Semisynthetic pen. least dependent on renal function for elimination dosage DOES NOT need to be adjusted in RENAL failure if LIVER FUNCTION IS NORMAL! use caution in hepatic/renal failure.
ceftriaxone
44% metabolized by the liver and 56% eliminated in the (kidney) urine. Patient could develop seizures due to renal failure. (C______one)
clindamycin
metabolized in the liver to a metabolite MORE active that the parent compound (C________)
famiclovir
is used to treat HSV I and II, and is metabolized in the liver to the active form PENCICLOVIR
voriconazole
metabolism and elimination by CYP450 liver enzyme. Antifungal (V_______)
p-glycoprotein
the following drugs are eliminated by both CYP450 and ?.
Erythromycin
Biaxin (Clarithryomycin)
Ketoconazole
Maraviroc and should be used in caution with patient on digoxin
p-glycoprotein
series of molecules that pump molecules OUT of organs in the body. mainly found in the CNS (brain). It is located in the KIDNEY, LIVER, GI, and BRAIN.
erythromycin
increases the ABSORPTION OF DIGOXIN by inhibiting the pump on the GI tract and toxicity may occur. (similar inhibition as ketoconazole)
ketoconazole
is a potent inhibitor of P-gly and should never be dosed with Biaxin or Erythromycin or digoxin (K______)
kidney
if the ? is a major route of elimination, you will need to adjust the dose based on function using BUN and CrCL or an increas in adverse events may occur
probenecid
is a drug to treat gout, but blocks the tubular secretion of drugs eliminated by this route.
tubular secretion
sulfonamides and penicillin G are all elimated by GFR and _____ s________
cidofovir
This antiviral medication MUST be given with probenecid to reduce nephrotoxicity. Inhibiting tubular secretion will keep ? in the urine and out of the blood at toxic levels (along with fluid treatments)
glomerular filtration
the major route of elimination for the following:
Ceftazidime
Cefixime
Vancomycin
Aminoglycosides
Aztreonam
Ethambutol
Pyrazinamide
Flucytosine
doxycycline
diffuses across the small bowel wall in the lumen where it is chelated by and eliminated by poo.
doxycline
ELIMINATION LEAST AFFECTED BY THE DEGREE OF KIDNEY FUNCTION! Can be give safely in patients with kidney failure. Eliminated by the fecal route
Rifampin
Mostly eliminated in the GI tract and used in combination with other antibiotics for staph infection and in TB
tissues
amphotercin B has an elimination route that is mostly in ______. Also renal, causes acute renal failure or some degree of renal failure in patients