Pharm. Exam 4
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What drugs should not be taken with caffeine, citrus juices, cola or tomato juice?
Penicillins are ______ spectrum.
Penicillins bacteriostatic or bactericidal ?
Mechanism of action for Penicillins?
Cell wall inhibitors
Patients that are allergic to penicillin may also have a reaction to _____.
- Steven Johnson's syndrome
- Diarrhea - C Diff
- Photo sensitivity
Lower doses of penicillin may be indicated in patients with what issues?
Renal disease - because excretion is reduced
Drug-Drug interactions may occur with Penicillin?
Effects of the penicillin will be reduced if taken with Tetracycline
Aminoglycocides will become ineffecive if given concurrently with penicillin in a parenteral (IV) forms.
Amoxicillin is what type of drug?
Penicillins should be taken how?
empty stomach with 8 oz. of water - 1 hour before or 2-3 hours after meals.
How do Sulfonamides work?
inhibit folic acid synthesis. needed for RNA/DNA in bacteria.
What are sulfa drugs used to treat?
UTI's and trachoma
Contraindication/ Cross sensitvity for Sulfa drugs:
- Know allergy to thiazide diuretics
- Renal disease - or if patient on cyclosporin
- Kidney Stones
What should you avoid when taking cephalosporins? why?
alcohol - will cause an antabuse like reaction
Contraindications for Cephalosporins:
Allergies to penicillin
How would you give cephalosporins?
with food to avoid GI upset
What type of drugs may increase glucose levels?
Drug-drug interactions for Cephalosporins?
aminoglycosides, oral anticoagulants, and ETOH (alcohol abuse)
What types of drugs are used to fight specific bacteria?
Name the cell wall inhibitors of antibiotics?
Penicillin, Cephalosporins, Monobactums, Vencomycin
All cell wall inhibitors are bacter_______.
Cell wall inhibitors are also know as ____ _____ antibiotics.
Monobactums work by disrupting the cell wall and ...
promoting the leakage of cellular content and cell death
What are monobactums used to treat?
Intra-abdominal and Gynecological infections, UTI, skin infections
How is monobactum given?
- IV or IM only
- Will cross placenta
Contraindications for use of Monobactum?
- Known allergies to penicillins or cephalosporins
- Renal or Hepatic dysfunction
- Pregnant or lactating women
Side effects of Vancomycin
- Red Neck Syndrome (red face, arms, back)
- Renal Failure
Drug of choice to treat Clostridum difficile:
Name the Protein Synthesis inhibitors:
What to monitor with Vancomycin
- Peak and trough
- renal function
- blood culture
What are Aminoglycosides used to treat?
gram-negative aerobic bacilli
How do protein synthesis inhibitors work?
- they inhibit the 30S & 50S protein syntheses
- in bacteria.
Humans us 40s & 60s
What to monitor when giving Aminoglycosides:
- Peak & Trough
- Whisper test
- May be kidney toxic
- Creatinine & BUN
- Vestibular fxn
Can a pregnant mom take cephalosporin?
Aminoglycosides are bactero_____.
bacterosidal & Narrow spectrum
Adverse effects of Amnioglycodise:
- May also cause numbness (parastesias)
Can''t HEAR, can't SEE, can't FEEL:
Macrolides should not be given with:
Coumadin or anticoagulants
Mechanism of action for Macrolides:
interfere with protein synthesis in susceptible bacteria.
Erythromycin is the drug of choice to treat what? what type of drug is it?
- Strep throat - Macrolide
- This one specifically should be given on an empty stomach
Drug-drug interaction with Macrolides :
Digoxin & oral anti-coagulants
First step in use of systemic antifungals?
How do Azoles work?
bind to sterols and cause cell death or interfere with replication
What does ZOLE stand for?
- Z many interactions
- Observe hygiene
- Liver enzymes
- Educate, take with food
What does Diflucan inhibit (specifically)?
CYP450 enzyme - this may be associated with drug-drug interactions
Tetracyclines all end in what?
How do Tetracyclines work?
inhibit protein synthesis in susceptible bacteria, preventing cell replication
Contraindicatoins for Tetracyclines:
- Pregnant / lactation
Drug-Drug interactions Tetracyclines:
- oral contraceptives
- Penicillin G
How would you give Tetracyclines:
- AVOID milk products; iron preparations
- Give on a empty stomach with water
- may cause photosensitivity
Name the inhibitors of Bacterial Replication:
How do Fluoroquinolones work?
interferes with DNA replication , preventing cell replication
What do all Fluoroquinolones end in?
Who would be contraindicated in the use of Fluoroquinolones:
- Patients under 18 years of age
- Pregnant women
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