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Flashcards in Drugs for PNA Deck (41)
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1

The fluoroquinolone, Ciprofloxacin, inhibiys what enzyme? 

DNA Gyrase

important in killing Gram - bacteria (pseudomonas) 

2

Fluoroquinolones that block Topo IV is important for killing which type of organisms?

Gram +

(streptococcus respt. infections) 

3

Are fluoroquinolones a first choice drug or a last resort drug for CAP? 

Last resort for CAP

4

Should penicillins and aminoglycosides be combined in the same IV?

 

 

NO! 

5

What is the MOA of Amoxicilin?

 

What step of peptidoglycan synthesis is inhibited?

 

Is it effective against G+ and G-? 

inhibits bacterial cell wall synthesis by binding to PBP 

 

the final transpeptidation step is inhibited 

 

Yes

6

Does Amoxicillin +/- Clavulanate kill Pseuodomonas? 

 

What is this combination used for?

No! 

 

CAP 

7

what are the main adverse effects of Amoxicillin +/- Clavulanate?

Anaphylactic Rxn

C. Diff

In Mono-rash 

8

What is the MOA of Piperacillin?

 

What is the MOA of Tazobactam?

 

Is it active against Pseudomonas?

inhibits bacterial cell wall synthesis 

 

Inhibits beta-lactamases 

 

Yes! 

9

Piperacillin + Tazobactam kill which types of pathogens?

Gram + and Gram - aerobic and anaerobic, including those who produce beta-lactamases  

10

What are the main indications for Piperacillin + Tazobactam?

CAP and HAP/VAP 

11

What is the benefit of using Ceftriaxone in patients with kidney diseases?

It is not eliminated by the kidney, so the dose does not need to be adjusted for renal impairment 

12

What class of drugs can cause bleeding tendencies?

Cephalosporins 

(cefmetazole, cefoperazone, cefotetan, ceftriaxone) 

13

What are the third and fourth generation parenteral cephalosporins?

Ceftriaxone (3rd) 

Cefepime (4th) 

14

What are the third generation oral cephalosporins

Cefditoren

Cefpodoxime-Proxetil 

15

What are the clinical applications for Cefpodoxime? 

COPD

OM

CAP outpatient tx 

16

What are the clinical applications for Cefditoren?

exerbation of chonric bronchitis 

CAP

pharyngitis 

17

Are Cefpodoxime and Cefditoren orally active?

 

What is the 1/2 life?

 

Are there any drug-drug interactions?

Yes

 

2-3 hours and 1.6hrs, increased with worsening renal function 

 

Yes

18

What are some concerning adverse effects of Cefpodoxime and Cefditoren?

B-lactam allergies

Superinfection (C.diff) 

19

Which drug class is bacteriostatic at the 30S subunit ?

Tetracyclines 

 

Kills bacteria that lack cell walls (Mycoplasma pneumonia) 

20

Which tetracycline is the drug of choice for CAP?

Doxycycline

21

Who should not receive Tetracyclines and why?

Don't use in children due to risk of teeth staining

22

What things interfere with tetracycline absorption?

 

What is recommended to avoid GI upset?

 

Should it be combined with bactericidal drugs (PNC)?

Antacids (Aluminum, Ca, Mg, Fe) and dairy products 

 

Take with water 

 

No, generally not recommended 

23

Which drug class binds to the 50S subunit and blocks elongation and is BacterioStatic ?

Macrolides (Erythromycin) 

24

What are the macrolide drug of choice for CAP?

Azithromycin

Clarithromycin 

25

Macrolides are effective against which bugs?

Most Aerobic and anaerobic gram + bugs 

Not Gram negatives except: Pasturella, Haemophilus, Neisseria 

Legionella, Mycoplasma, mycobacteria, rickettsia, chlamydia

No fungi 

26

Which drug is a well knwon inhibitor of cytochrome P450?

 Erythromycin

increases concentration of other drugs 

27

Which drug causes less GI upset, erythromycin or clarithromycin?

Clarithromycin causes LESS GI upset

28

Unlike Erythromycin, which macrolide does NOT disrupt CP450?

Azithromycin

concentrates in cells and slowly releases bacteriostatic levels over 2-4 days (1/2 life) 

29

Which drug class is broad-spectrum, administered orally, and is more effective than tetracyclines or macrolides for PNA? 

Fluoroquinolones (-Oxacins)

Use as LAST RESORT to minimize tolerance 

30

What is the main adverse effect of Fluoroquinolones?

Tendon rupture, especially Achille's Tendon in elderly, children, and those at risk