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1 STEP Microbiology > FA macrolides/monobactam/metronidazole > Flashcards

FA macrolides/monobactam/metronidazole Flashcards

1
Q

macrolides examples?

A

azithromycin, clarithromycin, erythromycin

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2
Q

administration of macrolides?

A

p/os or i/v

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3
Q

macrolides static or cidic?

A

static

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4
Q

mechanism of macrolides?

A

bind to 23S ribosomal RNA molecule of the 50S subunit → blockage of translocation → inhibition of bacterial protein synthesis

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5
Q

macrolides Route of elimination?

A

biliary

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6
Q

macrolides for what pneumonia?

A

Atypical pneumonia caused by:
Mycoplasma pneumonia
Legionella pneumophila
Chlamydophila pneumoniae

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7
Q

macrolides for what STI?

A

STIs caused by Chlamydia

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8
Q

macrolides are replacement for what?

A

Gram-positive cocci especially for the treatment of streptococcal infection in patients who are allergic to penicillin)

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9
Q

special indication for claritromycin?

A

H. pylori (clarithromycin is the part of triple therapy?

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10
Q

what other m/os treated with macrolides?

A

Ureaplasma urealyticum;
bordetela pertussis;

Neisseria spp.:
Second-line prophylaxis for N. meningitidis
Dual therapy with ceftriaxone for N. gonorrhoeae (azithromycin)

Mycobacterium avium
Prophylaxis: azithromycin
Treatment: azithromycin, clarithromycin

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11
Q

adverse of macrolides?

A 
Adverse effects
Increased intestinal motility → GI upset
QT-interval prolongation --> arrhythmia
Acute cholestatic hepatitis
Eosinophilia
Rash
Increased risk of hypertrophic pyloric stenosis (erythromycin and azithromycin) in infants up to 6 weeks of age.
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12
Q

macrolides actions on what enzyme?

A

INHIBIT P450

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13
Q

macrolides increase concentraton of what?

A

teophyline and oral anticoagulants (warfarin).

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14
Q

half life of macrolides?

A

All macrolides (except azithromycin) have a short half-life.

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15
Q

macrolides mechanism of resistance?

A

Methylation of the binding site of 23S rRNA prevents the macrolide from binding to rRNA.

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16
Q

macrolides in pregnant women?

A

contraindicated

17
Q

Nitroimidazoles agent?

A

metronidazole

18
Q

metronidazole administration?

A

p/os or i/v

19
Q

metronidazole static or cidal?

A

cidal

20
Q

metronidazole route of elimination?

A

renal

21
Q

metronidazole BBB penetration?

A

good

22
Q

metronidazole mechanism of action?

A

Creates free radicals within the bacterial cell → DNA-strand breaks → cell death (bactericidal and antiprotozoal effect)

23
Q

metronidazole covers what protozoa?

A

Certain protozoa: Entamoeba histolytica, Giardia, Trichomonas

24
Q

metronidazole what facultative anaerobes?

A

Gardnerella vaginalis

Helicobacter pylori in place of amoxicillin (e.g., in case of penicillin allergy) as part of a triple therapy regimen

25
Q

metronidazole anaerobes?

A

C. difficile, Bacteroides spp.

26
Q

metronidazole agains aerobes?

A

NOT EFFECTIVE

27
Q

metronidazole - most prominent adverse?

A

Disulfiram-like reaction: a systemic reaction occurs when metronidazole is consumed with alcohol
Nitroimidazoles inhibit acetaldehyde dehydrogenase → accumulation of acetaldehyde → immediate hangover-like symptoms after ethanol intake
Symptoms include flushing, tachycardia, and hypotension.

28
Q

what are adverse of metronidazole?

A

headache, disulfiram-like reaction, metatic taste, peripheral neuropathy, vestibular dysfunction

29
Q

metronidazoles for infections in relation to ,,diaphragma”?

A

metronidazole for anaerobic infections BELOW diaphragm (clindamycin - above)

30
Q

monobactams agent?

A

aztreonam

31
Q

aztreonam administration?

A

i/v

32
Q

aztreonam mechanism?

A

Specifically binds to PBP3: inhibits peptidoglycan cross-linkin

PBP3 - penicillin binding protein 3

33
Q

clinical use of aztreonam for gram?

A

gram - only including nosocomial Pseudomonas, H. influenzae, and N. meningitidis

not active agains gram + or anaerobes

34
Q

aztreonam in penicillin allergy?

A

Alternative for penicillin-allergic patients (no cross-sensitivity with penicillins)

35
Q

aztreonam as alternative for what?

A

Can be used as an alternative to aminoglycosides for patients with renal insufficiency because it is synergistic with aminoglycosides

36
Q

aztreonam broad spectrum in combination with what?

A

Broad-spectrum coverage in combination with vancomycin or clindamycin

37
Q

aztreonam adverse?

A

Adverse effects: rare, usually nontoxic
GI upset
Injection reactions
Rash

1 STEP Microbiology (20 decks)

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