Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

First Aid Step 1 material > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Penicillin G, V Mechanism

A 
β-lactam antibiotics
Bind PBP (transpeptidases).
Block transpeptidase cross-linking of peptidoglycan in cell wall. 
Activate autolytic enzymes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Penicillin G, V clinical use

A

Strep and gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Penicillin G, V Toxicity

A

Hypersensitivity reactions, hemolytic anemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Amoxicillin, ampicillin (aminopenicillins) clinical use HHELPSS

A

H. influenzae, H. pylori, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Amoxicillin, ampicillin (aminopenicillins) toxicity

A

Hypersensitivity reactions; diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dicloxacillin, nafcillin, oxacillin (penicillinase-resistant) clinical use

A

Strep and Staph (except MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dicloxacillin, nafcillin, oxacillin (penicillinase-resistant) toxicity

A

Hypersensitivity reactions, interstitial nephritis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Piperacillin, ticarcillin clinical use

A

only PCN for PSEUDOMONAS
Strep
SPACE
PEcK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Piperacillin, ticarcillin toxicity

A

Hypersensitivity reactions.
Ticarcillin Na+ overload
dose dependent platelet dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

β-lactamase inhibitors CAST mnemonic

A

Clavulanic Acid, Sulbactam, Tazobactam.

Often added to penicillin antibiotics to protect the antibiotic from destruction by β-lactamase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cephalosporins (generations I–V) Mechanism

A

β-lactam drugs that inhibit peptidoglycan cross-linking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Organisms typically not covered by cephalosporins are LAME and the exception

A

Listeria, Atypicals (Chlamydia, Mycoplasma, Legionella), MRSA, and Enterococci.

Exception: ceftaroline covers MRSA and enterocci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

1st generation Cephalosporin (cefazolin, cephalexin) clinical use (PEcK mnemonic)

A

staph, strep

Proteus mirabilis, E. coli, Klebsiella pneumoniae.

Cefazolin used prior to surgery to prevent S. aureus wound infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2nd generation Cephalosporin (cefoxitin, cefotetan, cefuroxime) (HEN PEcKS mnemonic)

A

staph, strep

H. influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Kleb. pneumoniae, Serratia marcescens.

TANFOX - anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3rd generation Cephalosporin (ceftriaxone, ceftazidime) clinical use

A

serious gram-negative infections, S(P)ACE

community acquired and nosocomial pneumonia

Meningitis

Ceftriaxone—meningitis, gonorrhea
Ceftazidime—Pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

4th generation Cephalosporin (cefepime)

A

staph, strep
SPACE
fever in neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

5th generation Cephalosporin (ceftaroline)

A

staph, strep,
MRSA
enterococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cephalosporin toxicity

A

Hypersensitivity reactions, autoimmune hemolytic anemia, disulfiram-like reaction, vitamin K deficiency. Exhibit cross-reactivity with penicillins.􏰃nephrotoxicity of aminoglycosides.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Carbapenems (Imipenem, meropenem, ertapenem, doripenem) mechanism

A

Binds to PBP-1 and PBP-2, B-Lactamase resistant

Always administered with cilastatin (inhibitor of renal dehydropeptidase I) to􏰄 decrease inactivation of drug in renal tubules.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Imipenem mnemonic

A

With imipenem, “the kill is lastin’ with cilastatin.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Carbapenem (Imipenem, meropenem, ertapenem, doripenem) clinical use

A

Gram-positive cocci, gram-negative rods, and anaerobes.

significant side effects limit use to life-threatening infections or after other drugs have failed.

Meropenem has a decreased 􏰄risk of seizures and is stable to dehydropeptidase I.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Carbapenem (Imipenem, meropenem, ertapenem, doripenem) toxicity

A

GI distress, skin rash, and CNS toxicity (SEIZURES)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vancomycin Mechanism

A

Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors.

Bactericidal.

Not susceptible to β-lactamases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Vancomycin clinical use

A

Gram-positive bugs only—serious, multidrug-resistant organisms.

Clostridium difficile (oral dose for pseudomembranous colitis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Vancomycin Toxicity (NOT mnemonic)

A

Nephrotoxicity, Ototoxicity, Thrombophlebitis

Red Man Syndrome (can largely prevent by pretreatment with antihistamines and slow infusion rate).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Aminoglycosides (Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin) mechanism

A

Bactericidal; irreversible inhibition of initiation complex through binding of the 30S subunit.

Messes with LPS

Require O2 for uptake; therefore ineffective against anaerobes.

27
Q

Aminoglycosides (Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin) clinical use

A

Severe gram-negative infections.

Neomycin for bowel surgery.

28
Q

Aminoglycosides (Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin) toxicity

A

Nephrotoxicity, Neuromuscular blockade, Ototoxicity, Teratogen.

29
Q

Aminoglycosides mnemonic

A

GNATS caNNOT kill anaerobes.

30
Q

Tetracyclines (Tetracycline, doxycycline, minocycline) Mechanism

A

Bacteriostatic; bind to 30S, limited CNS penetration.

Doxycycline is fecally eliminated and can be used in patients with renal failure.

Do not take tetracyclines with milk, antacids or iron-containing preparations because divalent cations inhibit drugs’ absorption in the gut.

31
Q

Tetracyclines (Tetracycline, doxycycline, minocycline) Clinical Use

A

Lyme Disease, M. pneumoniae, Rickettsia, Chlamydia, acne, vibrio cholera, brucellosis (unpasteurized cheese and milk)

demeclocycline used to treat SIADH

32
Q

Tetracyclines (Tetracycline, doxycycline, minocycline) Toxicity

A

GI distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity.

Fanconi-like syndrome - urine problems

Contraindicated in pregnancy.

33
Q

Chloramphenicol mechanism

A

Blocks peptidyltransferase at 50S ribosomal subunit. Bacteriostatic.

34
Q

Chloramphenicol clinical use

A

Meningitis and Rocky Mountain spotted fever (Rickettsia rickettsii)

35
Q

Chloramphenicol toxicity

A

Anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome (in premature infants because they lack liver UDP-glucuronyl transferase).

36
Q

Clindamycin mechanism

A

Blocks peptide transfer (translocation) at 50S ribosomal subunit. Bacteriostatic.

37
Q

Clindamycin clinical use

A

Anaerobic infections in aspiration pneumonia, lung abscesses, and oral infections.

Also effective against invasive group A strep

38
Q

Clindamycin use vs Metronidazole use

A

Treats anaerobic infections above the diaphragm vs. metronidazole (anaerobic infections below diaphragm).

39
Q

Clindamycin toxicity

A

Pseudomembranous colitis (C. difficile overgrowth), fever, diarrhea.

40
Q

Oxazolidinones (Linezolid) mechanism

A

Inhibit protein synthesis by binding to 50S subunit and preventing formation of the initiation complex.

41
Q

Oxazolidinones (Linezolid) clinical use

A

Gram-positive species including MRSA and VRE

42
Q

Oxazolidinones (Linezolid) toxicity

A

Bone marrow suppression (especially thrombocytopenia), peripheral neuropathy, serotonin syndrome.

43
Q

Monobactams (Aztreonam) mechanism

A

Less susceptible to β-lactamases.
Prevents peptidoglycan cross-linking by binding to PBP-3.
Synergistic with aminoglycosides.
No cross-allergenicity with penicillins.

44
Q

Monobactams (Aztreonam) clinical use

A

Gram-negative rods only

For penicillin-allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides.

45
Q

Monobactams (Aztreonam) toxicity

A

Usually nontoxic; occasional GI upset.

46
Q

Macrolides (Azithromycin, clarithromycin, erythromycin) mechanism

A

Inhibit protein synthesis by blocking translocation (“macroslides”); bind to the 23S rRNA of the 50S ribosomal subunit.
Bacteriostatic.

47
Q

Macrolides (Azithromycin, clarithromycin, erythromycin) clinical use

A

Atypicals

Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STIs (Chlamydia), gram-positive cocci (streptococcal infections in patients allergic to penicillin), and B. pertussis.

48
Q

Macrolides (Azithromycin, clarithromycin, erythromycin) toxicity (MACRO mnemonic)

A

MACRO: Gastrointestinal Motility issues, Arrhythmia caused by prolonged QT interval, acute Cholestatic hepatitis, Rash, eOsinophilia.
Increases serum concentration of theophyllines, oral anticoagulants.
Clarithromycin and erythromycin inhibit cytochrome P-450.

49
Q

Trimethoprim mechanism

A

Inhibits bacterial dihydrofolate reductase. block of folate synthesis.

Bacteriostatic.

50
Q

Trimethoprim clinical use

A

Used in combination with sulfonamides (TMP- SMX)

Combination used for UTIs, Shigella, Salmonella, Pneumocystis jirovecii pneumonia treatment and prophylaxis, toxoplasmosis prophylaxis.

51
Q

Trimethoprim toxicity (TMP mnemonic)

A

Megaloblastic anemia, leukopenia, granulocytopenia. (May alleviate with supplemental folinic acid).
TMP Treats Marrow Poorly.

52
Q

Sulfonamides (Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine) mechanism

A

Inhibit folate synthesis. Para-aminobenzoic acid (PABA) antimetabolites inhibit dihydropteroate synthase. Bacteriostatic (bactericidal when combined with trimethoprim).
Dapsone, used to treat lepromatous leprosy, is a closely related drug that also inhibits folate synthesis.

53
Q

Sulfonamides (Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine) clinical use

A

Gram-positives, gram-negatives, Nocardia, Chlamydia.

Triple sulfas or SMX for simple UTI.

54
Q

Sulfonamides (Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine) toxicity

A

Hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity (tubulointerstitial nephritis), photosensitivity, kernicterus in infants
displace other drugs from albumin (e.g., warfarin).

55
Q

Fluoroquinolones (Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin) mechanism

A

Inhibit prokaryotic enzymes topoisomerase
II (DNA gyrase) and topoisomerase IV. Bactericidal.
Must not be taken with antacids.

56
Q

Fluoroquinolones (Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin) clinical use

A

Gram-negative rods of urinary and GI tracts (including Pseudomonas), Neisseria, some gram-positive organisms.

57
Q

Fluoroquinolones (Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin) toxicity

A

GI upset, superinfections, skin rashes, headache, dizziness. Less commonly, can cause leg cramps and myalgias.

Contraindicated in pregnant women, nursing mothers, and children 60 years old and in patients taking prednisone.

58
Q

Fluroquinolones toxicity mnemonic

A

Fluoroquinolones hurt attachments to your bones.

59
Q

Daptomycin mechanism

A

Lipopeptide that disrupts cell membrane of gram-positive cocci.

60
Q

Daptomycin clinical use

A

S. aureus skin infections (especially MRSA), bacteremia, endocarditis, VRE.

Not used for pneumonia (avidly binds to and is inactivated by surfactant).

61
Q

Daptomycin toxicity

A

Myopathy, rhabdomyolysis.

62
Q

Metronidazole mechanism

A

Forms toxic free radical metabolites in the bacterial cell that damage DNA. Bactericidal, antiprotozoal.

63
Q

Metronidazole clinical use (GET GAP on the Metro with metronidazole!)

A

Treats Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteroides, C. difficile).

Used with a proton pump inhibitor and clarithromycin for “triple therapy” against H. Pylori.

64
Q

Metronidazole toxicity

A

Disulfiram-like reaction with alcohol; headache, metallic taste.

First Aid Step 1 material (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions