Term
| What are three antibacterial drugs that only have renal activity and no systemic activity? |
|
Definition
Methenamine
Nitrofuratoin
Fosfomycin |
|
|
Term
| What is the major adverse effect of nitrofuatoin? |
|
Definition
| Chronic Pulmonary Fibrosis |
|
|
Term
| What type of treatment will aid in the development of chronic pulmonary fibrosis in treating with Nitrofuratoin? |
|
Definition
| Chronic prophylaxis (long term treatment) |
|
|
Term
Which of the following drugs cannot be used for upper UTI (pyelonephritis)?
Nitrofuratoin
Methenamine
Fosfomycin |
|
Definition
|
|
Term
| What is Penicillin mechanism of action? |
|
Definition
| binds to transpeptidase (acylates) and prevents it from building the bacteria wall |
|
|
Term
| Is Penicillin active against static bacterial? |
|
Definition
|
|
Term
| What are the most common gram negative causing UTI (4)? |
|
Definition
E. Coli
Klebsiella
Moganella
Proteus
|
|
|
Term
| What are the most common gram postive causing bacteria of UTI? |
|
Definition
Staph Siprophyticus (Cat. +)
Entercoccus (Cat. -) |
|
|
Term
| How can pipercilin be administered (route)? |
|
Definition
|
|
Term
| What is pipercillin usually combined with in administration? |
|
Definition
| B-lactamase inhibitor like tazobactum |
|
|
Term
| What class of Penicillin drug is pipercillin? |
|
Definition
|
|
Term
| What does pipercillin have activity against? |
|
Definition
|
|
Term
| What generation cephalosporin is ceftriaxone? |
|
Definition
|
|
Term
| What generation cephalosporin is ceftazidime? |
|
Definition
| 3rd w/ psuedomous activity |
|
|
Term
| What generation cephalosporin is cefipime? |
|
Definition
|
|
Term
| What is ceftazidime or ceftipime usually combined with in treating psuedomonus? |
|
Definition
| usually combined with an aminoglycoside |
|
|
Term
| What is cefipime active against? |
|
Definition
Gram -
Psuedomonus
B-lactamases |
|
|
Term
| How must Aztreonam be administered? |
|
Definition
|
|
Term
| What type of antibiotic is Aztreonam? |
|
Definition
|
|
Term
| What is Aztreonam active against? |
|
Definition
| only Gram - and pseudomonus |
|
|
Term
| What type of patient is it safe to give aztreonam in because of no risk of cross allergy? |
|
Definition
|
|
Term
| What class of antibiotic is imipenam in? |
|
Definition
|
|
Term
| What is imipenem combined with in its treatment and why? |
|
Definition
| combined with Cilistatin to prevent imipenam's deactivation in the proximal tubule of the kidney by dehydropeptidase-1 |
|
|
Term
| What is class of bacterias has resistance to Imipenem/Cilistatin? Give an example? |
|
Definition
Metalo-B-lactamases (Zn containing)
EX: Stenotrophomonus maltophilia |
|
|
Term
| If bacteria is resistant to imipenam/cilistatin, does that necessarily mean it is resistant to cephalosporins? |
|
Definition
|
|
Term
| Imipenem is not hydrolyzed by what type of bacteria? |
|
Definition
|
|
Term
| Why do you not want to treat Psuedomonus patients with Imipenem/cilistatin? |
|
Definition
| Psuedomonus quickly develops resistance |
|
|
Term
What is the adverse effect of imipenem?
What type of patients must have their dose adjusted to prevent this side effect? |
|
Definition
Seizures
Renal impaired patients |
|
|
Term
| What type of bacterial infections do you use Imipenem/Cilistatin for? |
|
Definition
| only the most severe when others fail |
|
|
Term
| What molecule are sulfanamides similar to? |
|
Definition
|
|
Term
| What is the mechanism of action of the sulfanomides? |
|
Definition
|
|
Term
| What is the mechanism of action of trimethoprim? |
|
Definition
| inhibit bacterial dihydrofolate reductase |
|
|
Term
| Why do humans not have folate deficiency with the use of TMP/SMZ? |
|
Definition
| Because humans get folate from diet. It does not need to be produced. |
|
|
Term
| How is resistance to sulfanomides mediated? |
|
Definition
|
|
Term
| What is the difference between the result of the bacteria when treated with Sulfanomides alone or the TMP/SMZ combo (bacterialcidal/bacteriastatic)? |
|
Definition
Sulfanomides are bacterialstatic
TMP/SMZ is bacterialcidal |
|
|
Term
| What is true of TMP/SMZ interaction with other drugs or compounds in the body? |
|
Definition
It interacts with drugs/compounds that bind to plasma proteins
Warfarin
Bilirubin |
|
|
Term
| What are the adverse effects of TMP/SMZ (4)? |
|
Definition
photosensitivity
allergy
Kernicterus
Hemolytic anemia
|
|
|
Term
| What disease that causes a severe rash is associated with the adverse effects of TMP/SMZ? |
|
Definition
|
|
Term
| What two bacteria are now very resistant to TMP/SMZ? |
|
Definition
ECOLI
Pneumocystits Jiroucci |
|
|
Term
| What is the mechanism of action of quinolones? |
|
Definition
| inhibit Topo IV and DNA gyrase |
|
|
Term
| Which mechanism of action of the quinolones is the primary action? |
|
Definition
|
|
Term
| What bacterias does the DNA gyrase inhibition in the quinolones target? |
|
Definition
|
|
Term
| Does quinolones act on static or actively dividing bacteria? |
|
Definition
|
|
Term
| How do bacteria become resistant to quinolones? |
|
Definition
| changing the binding of the quinolone to the DNA gyrase or the topo IV |
|
|
Term
| Which quinolone generation is not that active against Gram+ except Anthrax? |
|
Definition
| 1st generation (ciprofloxicin) |
|
|
Term
| What is ciprofloxicin best for in treating? |
|
Definition
| Gram -, psuedomonus, Anthrax |
|
|
Term
| What are the two major side effects of the quinolones? |
|
Definition
tendonitis
increased serum theophylline |
|
|
Term
| Can you give quinolones to children? |
|
Definition
|
|
Term
| What type of drugs can you not give with the quinolones? |
|
Definition
|
|
Term
| What antibacterial drug class can you not give with chelating agents? |
|
Definition
|
|
Term
What is the mechanism of action of the aminoglycosides?
What ribosome do they inhibit? |
|
Definition
oxygen dependent, active transport
they inhibit the 30S ribosome |
|
|
Term
| What are the aminoglycosides inhibited by? |
|
Definition
extracellular low pH
anaerobic conditions |
|
|
Term
| What is the most active aminoglycoside? |
|
Definition
|
|
Term
| What drugs do you often combine with aminoglycosides when treating pseudomonus? |
|
Definition
| Cephalosporins (cefiprim and ceftazadime) |
|
|
Term
| How is resistance acquired for the aminoglycosides (3 mechanisms)? |
|
Definition
| inhibition of the aminoglycoside binding by adenylylation, acetylation, phosphorylation |
|
|
Term
| How are aminoglycosides eliminated? |
|
Definition
|
|
Term
| What two drugs is it important to adjust dose in the renal impaired patient? |
|
Definition
|
|
Term
| What are the two most serious adverse effects of aminoglycosides? |
|
Definition
Ototoxicity
Nephrotoxicity |
|
|
Term
| What aspect of aminoglycoside treatment is associated with high troughs? |
|
Definition
|
|
Term
| What aspect of aminoglycoside treatment is associated with high peaks? |
|
Definition
|
|
Term
| How to you decrease the toxicity of the aminoglycosides while at the same time ensuring maximum efficacy? |
|
Definition
| Increase the dose and give it less often |
|
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