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NURP 424 - Pharm Exam 3 Study Guide.
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NURP 424 - Pharm Exam 3 Study Guide.
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Exam 3Week 10: Bacterial, Viral, Fungal, and Protozoal Infections (19)
Antibiotics (13)
48-72 hours until start feeling better
Empiric- evidence based guidelines
Prophylactic- prevent infection
Definitive- culture
Penicillin, cephalosporins, vancomycin
MOA: prevent cell wall synthesis
Penicillin V, Penicillin G Benzathine
Aerobic, gram positive organisms, S. pneumoniae, group A beta-hemolytic
streptococci
Syphilis Penicillin G
Amoxicillin, Amoxicillin/Clavulanic Acid
Gram positive organisms, S. pneumoniae, group A beta-hemolytic streptococci,
greater activity against gram negative bacteria
Endocarditis, H. pylori, Lyme disease treatment
Contraindications- hx hypersensitivity reaction (Stevens Johnsons syndrome), caution in
renal impairment
ADR: N/V/D, candidiasis, C. difficile, maculopapular rash
Cefazolin, Cephalexin (Keflex)
Gram positive cocci, S. aureus, S. epidermis, most streptococci
2nd generation cephalosporins
Cefuroxime, Cefprozil, Cefaclor
Gram positive cocci, methicillin sensitive S. aureus, S. epidermis, E. Coli, H. influenzae
3rd generation
Ceftriaxone, Cefdinir, Cefpodoxime
Gram positive cocci, N. gonorrhoeae, H. flu, complicated UTI (pregnancy, male UTI,
kidney involvement)
Cross-sensitivity/ cross-resistance If patient has anaphylaxis reaction to penicillins,
avoid cephalosporins (very similar chemical structure- contain structurally similar side
chains and beta lactam ring)
Glycopeptides (Vancomycin)
Gram positive (Cdiff)
, Oral very little systemic involvement. Peak/trough not necessary to monitor
Lincosamides (Clindamycin)
Bind to 50S subunit of bacterial ribosome, suppresses protein synthesis
Gram +
Methicillin resistant S. aureus (MRSA)
Strep pharyngitis, PID
Take with full glass of water, Sit/stand for 30 min after
Call clinic if diarrhea develops
Macrolides (Azithromycin, Erythromycin, Clarithromycin)
Bind to 50S subunit of bacterial ribosome, suppresses protein synthesis
Broad spectrum gram + and gram –
S. pneumoniae, MSSA, H. flu, pertussis, Chlamydia (treatment of choice)
Topically for acne
Risk of QT prolongation (Torsades de pointes)
Erythromycin and Azithromycin first choice in pregnancy
Doxycycline, Tetracycline
Inhibit protein synthesis by reversibly binding to 30S subunit of bacterial
ribosome
Broad spectrum for gram + and – bacteria
SUNSCREEN
Avoid in pregnancy discoloration of teeth in neonates
Caution in renal and hepatic impairment
Avoid in children younger than 8 bone health
Take with food, but NOT dairy
Take with full glass of water, Sit/stand for 30 min after
Fluoroquinolones (Levofloxacin, Ciprofloxacin)
Affects DNA Gyrase
Cipro- complicated UTI, travelers diarrhea, anthrax
Levofloxacin- complicated infections COPD exacerbation, prostatitis,
complicated UTI
BBW- Tendon rupture, tendonitis (rare) report new onset of pain
Avoid in myasthenia gravis, renal and hepatic impairment
Sulfonamides, Trimethoprim
Prevents folic acid synthesis, which is important for some bacteria to survive
Gram + and gram –
Avoid in sulfa allergy, G6PD, caution in folate deficiency
Nitrofurantoin
Gram + cocci, gram – bacilli
Really only used for uncomplicated UTI
Concentrates in kidneys and urine
Avoid if CrCl less than 30 mL/min, caution if less than 60***
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