(2) Antibiotics Flashcards
(161 cards)
1
Q
What are the two main classes of bacteria
A
Gram positive (simple cell wall) Gram negative (more advanced cell wall)
2
Q
are gram negative or gram positive typically more resistant to antibiotics
A
gram negative are typically more resistant to some antibiotics
3
Q
List the 6 clinically significant gram negative pathogens
A
Bordetella pertussis Helicobacter pylori Klebsiella pneumonia Yersinia pestis shigella dysenteriae Vibrio Cholerae
4
Q
Bordetella pertusis
Gram + or - ?
Morphology?
Disease caused?
A
Gram negative
cocci
whooping cough
5
Q
Helicobacter pylori
Gram + or - ?
Morphology?
Disease caused?
A
Gram negative
spirochete
peptic ulcers
6
Q
Klebsiella pneumoniae
Gram + or - ?
Morphology?
Disease caused?
A
Gram negative
rods
pneumonia
7
Q
Yersina pestis
Gram + or - ?
Morphology?
Disease caused?
A
Gram negative
Rods
bubonic plague
8
Q
Shigella dysenteriae
Gram + or - ?
Morphology?
Disease caused?
A
Gram Negative
Rods
Dysentery
9
Q
Vibrio Cholerae
Gram + or - ?
Morphology?
Disease caused?
A
Gram Negative
Flagellated Rods
Cholera
10
Q
Bacillus Anthrax
Gram + or - ?
Morphology?
Disease caused?
A
Gram Positive
Rods, Chains
Anthrax
11
Q
Clostridium Tetani
Gram + or - ?
Morphology?
Disease caused?
A
Gram positive
Rods
Tetanus
12
Q
Mycobacterium Tuberculosis
Gram + or - ?
Morphology?
Disease caused?
A
Gram positive
Rods
Tuberculosis
13
Q
Staphylococcus Aureus
Gram + or - ?
Morphology?
Disease caused?
A
Gram positive
Cocci
Wound Infections
14
Q
What is MIC when referring to antibiotics
A
Minimum inhibitory Concentration
the minimal concentration of an antimicrobial that inhibits visible growth of a microorganism after overnight incubation
15
Q
What is MIC (minimum inhibitory concentration) used for
A
to determine antibiotic resistance of an organism and determine the potency of new antibiotics
16
Q
What is a superinfection
A
a secondary infection that occurs following a primary infection.
17
Q
what is often a significant factor in superinfections
A
the use of broad spectrum antibiotics
18
Q
What are the 3 common gram positive bacteria in the powerpoint
A
Bacillus Anthrax
Clostridium Tetani
Mycobacterium Tuberculosis
Staphylococcus aureus
19
Q
What are the 6 main characteristics used to select the correct antibiotic
A
- reaches the target
- binds to the target
- interferes with functional capacity of the target
- reaches target in the appropriate concentration
- maintains adequate contact time
- avoids toxicity to the host
20
Q
What are the 6 different mechanisms of action for antibiotics
A
folic acid metabolism inhibitors DNA gyrase inhibitors RNA polymerase inhibitors Cell wall synthesis inhibitors Protein synthesis inhibitors (30s) Protein synthesis inhibitors (50s)
21
Q
What are the two types of folic acid metabolism inhibitors
A
sulfanomides
Trimethoprim
22
Q
What type of antibiotics is a DNA gyrase inhibitor
A
Fluoroquinolones
23
Q
What type of antibiotic is a RNA polymerase inhibitor
A
Rifamycins
24
Q
What 4 antibiotics are cell wall synthesis inhibitors
A
B-lactams
Glycopeptides
Bacitracin
cyclic lipopeptides
25
what 3 antibiotics are protein synthesis inhibitors (30s)
Aminoglycosides
Tetracyclines
Glycylcyclines
26
What 5 antibiotics are protein synthesis inhibitors (50s)
```
macrolides/lincomycins
Streptogramins
Chloraphemicol
Ketolides
Oxazolidinones
```
27
Are Sulfonamides bacteriostatic or bactericidal
bacteriostatic
28
What does it mean to be bacteriostatic and bacteriocidal
```
bacteriostatic = stops the bacteria from reproducing but doesn't kill the bacteria
Bactericidal = kills the bacteria
```
29
what is the mechanism of action for sulfonamides
prevent the bacteria from using PABA for folic acid synthesis
30
What are the commonly used sulfonamides
sulfamethoxazole (UTI)
Sulfasalazine (RA and Ulcerative colitis)
Sulfacetamide (acne and conjunctivitis)
31
Why are sulfonamides used less now than previously
increasing bacterial resistance
32
what are the adverse affects of sulfonamides
Crystalluria
Rashes
psychosis
33
What type of antibiotic is Trimethoprim
Folate inhibitor
34
is Trimethoprim bacteriostatic or bactericidal
bacteriostatic
35
what is trimethoprim primarily used to treat
UTI
36
what are the adverse affects of Trimethoprim
rashes
Megaloblastic anemia
leukopenia
37
Trimethoprim is sometimes used in conjunction with which antibiotic to be more broad spectrum
Sulfamethoxazole
38
What are the different types of cell wall inhibitors
Beta-lactams
glycopeptides
Cyclic lipopeptides
39
What is specific to bacterial cell walls that allows antibiotics to destroy bacterial cells without harming human cells
peptidoglycan, repeating NAM and NAG units joined by glycosidic bonds and peptide cross bridges
40
What is the comparison of peptidoglycan between Gram - and Gram + cells
Gram + has a thicker layer of peptidoglycan over the cell membrane
Gram - has a thin layer between inner and outer cell membranes
41
What are the different types of Beta Lactams
Penicillins
Carbapenems
Monobactams
Cephalosporin
42
What is the method of action for the beta lactams
they inhibit transpeptidase (enzyme that forms the peptide crosslinks in the peptidoglycan) which causes a break in the cell wall and eventually cellular lysis
43
Beta lactams have ______ selectivity and _____ toxicity
high selectivity and low toxicity
44
What was the first Beta lactam antibiotic
penicilin
45
are beta lactams bacteriostatic or bactericidal
bactericidal
46
What causes resistance to the beta lactams drugs
beta lactamases
47
how is penicillin exctreted
renally
48
How is penicillin G and its derivatives administered and why
IV or IM because it is unstable in gastric acid
49
how is penicillin V administered
PO
50
what is the difference when you give penicillin G IV and IM
```
IV = very short half life
IM = more sustained levels due to slower absorption
```
51
Which has a longer half life Penicillin G or V
both about the same, only 30 minutes
52
what is the difference in method of excretion between penicillin G and V
no difference, both renally excreted
53
what is a more broad spectrum antibiotic penicillin G or V?
both are narrow spectrum antibiotics
54
are penicillin G and V both effective in treating many oral infections
yes
55
What bacteria are most sensitive to the penicillins
Gram negative cocci (viridans streptococci)
56
When are nafcillin and Oxacillin used
to treat methicillin sensitive Staph Aureus infections
57
how are nafcillin and oxacillin administered
IV
58
Is Amoxicillin broad spectrum or narrow
broad spectrum
59
how is amoxicillin administered
PO
60
Aminopenicillins is a group made up of which penicillins
amoxicillin, ampicillin, bacampicillin
61
What is clavulanic acid
a beta lactamase inhibitor
62
Clavulanic acid is a beta lactamase inhibitor, what are two others
sulbactam
| tazobactam
63
what is often given in conjuction with amoxicillin and why
calvulanic acid (to prevent beta lactamases from metabolisng the amoxicillin
64
what antibioitic is often used for dental prophylaxis
amoxicillin
65
what is the unique adverse effects associated with amoxicilin
a rash in people who have mono or take allopurinol
66
What is augmentin
amoxicillin and clavulanic acid combined in one drug
67
Ampicilin and sulbactam are often taken together, how are they administered and what are they used for
they are administered parenterally
| they are given for intra-abdominal infections and severe UTIs
68
What is carbenicillin used for
systemic infections of pseudomonas aeruginosa
69
What antibiotic is known as "antipseudomonal penicillin"
carbenicillin
70
how is carbenicillin administered
enterally or parenterally
71
why is aminoglycoside often administered with carbenicilin
to prevent bacterial resistance from forming
72
Carbenicillin is the antipseudomonal penicillin, but what are other antipseudomonal drugs
Ticarcillin (often taken with clavulanic acid)(Timentin)
| Piperacillin
73
of the three antipseudomonal drugs, which is the most active
piperacillin
74
how is piperacillin administered
parenterally
75
is piperacillin used with aminoglycosides like carbenicilin is
yes (to prevent bacterial resistance)
76
What are the penicillinase resistant penicillins
```
Methicillin
Oxacillin
Dicloxacillin
Cloxacillin
Nafcillin
```
77
When is Nafcillin used
for mixed staph/strep infections that are penicillin resistant
78
when are methicillin, oxacillin, dicloxacillin, cloxacillin used
for infections with penicillin resistant staph aureus
79
How are the penicillinase resistant penicillins administered (methicillin, oxacillin, cloxacillin, dicloxacillin, nafcillin)
parenterally because of poor absorption and breakdown by gastric acid
80
how does the method of action of cephalosporins differ from the method of action of the penicillins
they don't the method of action of both the cephalosporins and penicillins are the same
81
are cephalosporins broad or narrow spectrum
broad
82
how are cephalosporins administed
PO
83
What are the 1 generation cephalosporins and what do they treat
cefazolin, cephalexin, cefadroxil
| E. Coli and MSSA
84
What are the 2nd generation cephalosporins and what do they treat
cefoxitin, cefaclor
| oral bacteroides
85
what are the 3rd generation cephalosporins ans what do they treat
cefotaxime, ceftriaxone, ceftazidime
| N gonorrhea, N meningitides, E. Coli, H. Influenzae
86
What is the 4th generation cephalosporin and what does it treat
cefipime
| P. aeruginosa
87
What is the 5th generation cephalosporin and what does it treat
ceftaroline
| Multidrug resistant S. Aureus, S pneumoniae, H influenza
88
What is the chance of cross allergies for those who are allergic to penicillin and are taking cephalosporins
10%
89
Which patients, according to the American Heart Association, should take prophylactic antibiotics prior to dental appointments
patients with
1. history of heart valve surgery
2. history of endocarditis
3. heart transplant with abnormal valve function
4. cyanotic congenital heart disease that hasn't been fully repaired
5. congenital heart defects that have been fully repaired but the repair was in the last 6 months
6. residual heart defects
90
what common heart conditions don't require premedication?
```
history of MI?
Innocent Heart Mumur
Cardiac pacemakers
Mitral valve prolapse
coronary artery bipass surgery
```
91
What is the standard drug given to pt's as prophylactic antibiotic against Infective Endocarditis (pt has no allergies and can take oral medication)
Amoxicillin
92
What is the standard drug given to pt's as prophylactic antibiotic against Infective Endocarditis (pt has penicillin allergies and can take oral medication)
Clindamycin
Cephalexin (cephalosporin 10% allergy)
Clarithromycin
azithromycin
93
What is the standard drug given to pt's as prophylactic antibiotic against Infective Endocarditis (pt has no allergies but can't take oral medication)
Ampicillin
Cefazolin
Ceftriaxone
94
What is the standard drug given to pt's as prophylactic antibiotic against Infective Endocarditis (pt has penicillin allergies and can't take oral medication)
Clindamycin
cefazolin
ceftraixone
95
What is Imipenem
an atypical beta lactam
96
what are the drugs with the suffix Penem
atypical beta lactams (Aztreonam is also one:)
97
what is taken with imipenem
cilastatin (inhibits imipenem metabolism)
98
What is imipenem taken for
P. aeruginosa, gram negative rods, streptococci
99
What is bacitracin
a peptide antibiotic via cell wall inhibition
100
how is bacitracin administered
topically
101
what is vancomycin
the last resort antibiotic against MRSA and C dificile
102
how is vancomycin adminstered
IV
103
why is vancomycin last resort for MRSA and C dificile
can cause ototoxicity and nephrotoxicity
104
What class of antibiotic are macrolides
Protein synthesis inhibitors
105
are macrolides bacteriostatic or bactericidal
bacteriostatic
106
What is the mechanism of action for macrolides
they bind the 50s subunit of the ribosome and inhibit translocation
107
What are examples of macrolides
erythromycin
Clarithromycin
Azithromycin
108
When are macrolides commonly used
in patients with penicillin allergies
109
Which of the macrolides is the most potent
azithromycin
110
what are the side effects of macrolides
GI upset
Inhibition of drug metabolism
QT prolongation
111
are macrolides narrow or broad spectrum antibiotics
broad spectrum
112
What organisms are sensitive to macrolides
Legionella pneumophila
mycoplasma pnumoniae
Chlamydia pneumoniae
113
Tetracyclines
Broad or narrow spectrum?
Bacteriostatic or bactericidal
broad spectrum
| bacteriostatic
114
What is the antibiotic class that tetracyclines belong to
protein synthesis inhibitors
115
What bacteria are susceptible to tetracyclines
```
M. pneumoniae
C. pneumonia
H pylori
Borreliia burgdorfi
Bacteria associated with refractory and local aggressive periodontitis
Bacteria associated with acne
```
116
What are the common tetracycline drugs
tetracycline
doxycycline
minocycline
117
What are tetracycline drugs often used for
1. acute phases of adult periodontitis
2. chronic severe acne
3. chlamydia infections
118
What are the side effects of tetracycline
1. staining of teeth when used during tooth formation
| 2. photosensitivity
119
What class of antibiotic are amphenicols?
protein synthesis inhibitors
120
are amphenicols bacteriostatic or bactericidal
bacteriostatic
121
When are amphenicols used
they are reserved for serious, resistant infections
122
What is the side effect of amphenicols
severe bone marrow depression "Gray baby syndrome:
123
What class of antibiotics are aminoglycosides
protein synthesis inhibitors
124
What are some examples of aminoglycosides
Gentamycin
Amikacin
Neomycin
Streptomycin
125
What is streptomycin typically used for
TB
126
What are the side effects of aminoglycosides
ototoxicity
| nephrotoxicity
127
Is Clindamycin broad or narrow specturm
narrow
128
what is the method of action of clindamycin
inhibits protein synthesis by binding to the 50s subunit
129
what organisms are affected by clindamycin
```
S pneumonia
S pyogenes
S aureus
viridans
bacteroids
```
130
is cilndamycin useful for oral infections
yes
131
is clindamycin ever used as propylaxis for dental treatment
yes
132
What antibiotic is a DNA synthesis inhibitor
metronidazole
133
is metronidazole narrow or broad spectrum
narrow
134
what antibiotic is also useful for parasitic infectinos
metronidazole
135
What are contraindications for the DNA synthesis inhibitor metronidazole
pregnancy
alcohol use
disulfram use
136
what are examples of fluoroquinolones
```
levofloxacin
cirpofloxacin
moxifloxacin
norfloxacin
sparfloxacin
```
137
What are the most common antibiotics used for oral infections
penicillins
138
other than penicillins what types of antibiotics are used for oral infections
macrolides
clindamycin
tetracycline
metronidazole (oral anaerobes)
139
What bacteria causes TB
mycobacterium tuberculosis
140
What makes mycobacterium so hard to treat
it can survive inside of the macrophages
141
What drugs are used to treat TB
```
Isoniazid
Prazinamide
Ethambutol
Rifampin
Rifabutin
```
142
what bacteria causes leprosy
mycobacterium leprae
143
What drugs are used to treat
dapsone
rifampicin
clofazimine
144
What type of drug is amphotercin B
antifungal
145
what type of fungal infections is amphotercin B used for
systemic
146
what is a complication with amphotercin B
it is lipophilic so it can be very toxic
147
What type of drug is nystatin
antifungal
148
how is nystatin administered
topically
149
What is oral candidiasis treated with
nystatin
150
What are the suffixes of antifungals
azole
fungin
ifine
151
What drugs are used to treat herpesvirus
Acyclovir
| Vidarabine (when resistant to acyclovir)
152
What type of herpes virus isn't treated with acyclovir
CMV
153
Acyclovir is a prodrug
yep
154
What are the side effects of acyclovir
nephrotoxicity
encephalopathy
bone marrow depression
abnormal hepatic function
155
What drugs are used to treat CMV
Ganciclovir
| Foscarnet
156
What drugs are used to treat influenza
amantidine
rimantadine
oseltamivir
ribavirin
157
What is a problem with treating influenza with amantadine and rimantadine
resistance has become very common
158
what is the trade name of oseltamivir
tamiflu
159
what is the method of action of oseltamivir
blocks neuraminidase required for viral budding
160
what is ribavarin
a synthetic purine analog used to treat influenza and RSV
161
What drugs are used in the treatment of HIV
```
Zidovudine
Dideoxycytidine
Dideoxyinosine
3 thiacytidine
Efavirenz
nevirapine
ritonavir
saquinovir
idinavir
```
