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