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Review / Wrong Answers > DIT review - Micro 5 > Flashcards

DIT review - Micro 5 Flashcards

1
Q

MOA of Monobactams + Drug name

A

Aztreonam

Binds to penicillin-binding protein 3

Less susceptible to beta-lactamases

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2
Q

Uses of Aztreonam

A

Think of monobactams as aminoglycoside wannabees

Treat only gram negative aerobes (including pseudomonas)

Uses for penicillin-allergic patients with renal insufficiency who cannot tolerate aminoglycosides

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3
Q

What are the Carbapenem drugs

A
  • Imipenem, Ertapenem, Meropenem, Doripenem
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4
Q

Uses of Carbapenems

A

Are broad-spectrum and beta-lactamase resistant

Treat gram-negatives, gram-positives, anaerobes (including psuedomonas)

Used only when bugs are resistant to other drugs because of side effects

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5
Q

What drug must be co-administered with Carbapenems and why?

A

Cilastatin

Carbapenems are inactivated by dihydropeptidases in the renal tubules; Cilastin inhibits dihydropeptidase

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6
Q

Adverse effects of Carbapenems

A

Skin rash

GI distress

Lowered seizure threshold

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7
Q

MOA of Vancomycin

A

Inhibits cell wall formation by binding to D-ala D-ala peptidoglycan

Vs. Pencillins which binds to PBPs

Not susceptible to beta-lactamases

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8
Q

Describe Vancomycin resistance

A

Modificiation of D-ala D-ala to D-ala D-lac

So now Vancomycin cannot bind

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9
Q

Uses of Vancomycin

A

Gram + bugs only

Including MRSA, S. epidermidis, Vancomycin-sensitive enterococcus, Clostridium difficile

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10
Q

Adverse effects of Vancomycin

A

THINK: NOT

Nephrotoxicity, Ototoxicity, Thrombophlebitis

Red man syndrome

DRESS syndrome

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11
Q

How do you prevent red man syndrome?

A

Pre-treat with antihistamines

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12
Q

MOA of Daptomycin

A

Inserts its lipid tail into the cell membrane, leading to depolarization and cell death

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13
Q

Uses of Daptomycin

A

Vancomycin resistant bugs (VRE)

Staph: MRSA (especially MRSA bacteremia), VRSA, Endocarditis

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14
Q

What can Daptomycin NOT be used to treat and why?

A

Pneumonia

Daptomycin is inactivated by surfactant

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15
Q

Adverse effects of Daptomycin

A

Myopathy

Rhabdomyolysis

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16
Q

What drugs cause phototoxicity

A
  • THINK: I SAT for a photo
    • S – Sulfonamides
    • A – Amiodorone
    • T – Tetracyclines
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17
Q

What and at what CD4 count do you use prophylaxis for Pneumocytis jirovecii

A

TMP-SMX

CD4 < 200

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18
Q

What and at what CD4 count do you use prophylaxis for Toxoplasmosis

A

TMP-SMX

CD4 < 100

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19
Q

What and at what CD4 count do you use prophylaxis for Mycobacterium Avium

A

Azithromycin or Clarithromycin

CD4 < 50

20
Q

What drug is used for prophylaxis of endocarditis and undergoing surgical/dental procedure

A

Amoxicillin

21
Q

What drug is used for prophylaxis against pregnant women who is Group B strep +

A

Ampicillin or Penicillin G during deliver

22
Q

What are the protein synthesis inhibitors, and which work on 30S vs. 50S subunit

A
  • THINK: buy AT 30, CCEL at 50
    • 30S inhibitors = Aminoglycosides, Tetracyclines
    • 50S inhibitors = Chloramphenicol, Clindamycin, Erythromycin (macrolides), Linezolid
23
Q

Uses of Tetracycline

A
  • Broad spectrum
  • THINK: VACUUM THe BedRoom
    • Vibrio cholera, Acne, Chlamydia, Ureaplasma, Mycoplasma, Tularemia, H. Pylori, Borrelia, Rickettsia
  • Zoonotics: Yersinia, Ehrlichia, Francisella, Brucella, Coxiella
24
Q

Method of resistance to tetracyclines

A

Increased efflux out of cells via plasmid-encoded transport pumps

25
Q

MOA of tetracycline

A
  • Bind 30S and prevent attachment of aminoacyl-tRNA
26
Q

What is triple therapy for H. Pylori

A

PPI + Amoxicillin + Clarithromycin

27
Q

Macrolide drug names

A
  • Azithromycin, Clarithromycin, Erythromycin
28
Q

MOA of macrolides

A
  • Binds to 50S. blocking translocation (THINK: macroSLIDES)
  • Bacteriostatic
29
Q

Uses of macrolides

A
  • THINK: PUS
    • Pneumonia (atypical – Mycoplasma, Chlamydia, Legionella)
    • URI (Strep pneumo, Strep pyogenes)
    • STD (Chlamydia, gonorrhea)
      • Erythromycin drops treat neonatal conjunctivitis
  • Bordatella pertussis
  • Gram + cocci in penicillin allergic patients
  • Prophylaxis for mycobacterium avium CD4 < 50 (Azithromycin)
  • H. Pylori triple therapy (PPI + Amoxicillin + Clarithromycin)
30
Q

Adverse effects of macrolide

A
  • GI motility, prolonged QT interval, CYP450 inhibitor, acute cholestatic hepatitis
31
Q

MOA of Clindamycin

A
  • Binds 50S and blocks peptide transfer (translocation)
  • Bacteriostatic
32
Q

Uses of clindamycin

A
  • Anaerobic infections above the diaphragm (Clostridium, Bacteroides)
    • Lung abscesses (aspiration pneumonia) – Bacteroides = back of the mouth
    • Clostridium perfringens
    • Polymicrobial female genital tract infections (e.g. IUD, retained abortion)
      • Used Clindamycin + Gentamicin
    • Bacterial vaginalis
  • Gram (+) – Staph and strep
    • Strep pyogenes soft tissue infections
    • MRSA
33
Q

Adverse effects of clindamycin

A
  • Diarrhea, C. Diff, fever
34
Q

Uses of Chloramphenicol

A
  • Not really used in US anymore but still used in developing countries due to low cost
  • Meningitis (Neisseria, H. Flu, Strep pneumo)
  • Rocky mountain spotted fever
35
Q

Adverse effects of Chloramphenicol

A
  • Anemia (dose-dependent)
  • Aplastic anemia (dose independent)
  • Gray baby syndrome (infants lack UDP-glucuronyl transferase, which metabolizes Chloramphenicol)
36
Q

MOA of Linezolid

A
  • Binds 23S portion of 50S, preventing formation of complex
37
Q

Uses of Linezolid

A
  • Gram + species, including MRSA and VRE
38
Q

Adverse effects of Linezolid

A
  • Bone marrow suppression (especially thrombocytopenia)
  • Peripheral neuropathy + optic neuropathy
  • Serotonin syndrome (Linezolid is a weak inhibitor of MAO)
39
Q

MOA of aminoglycosides

A
  • Irreversible binding of 30S; can cause misreading of mRNA
  • Bactericidal (only one)
  • Coupled with beta-lactams to help get through the cell wall
40
Q

Use of Neomycin

A
  • Neomycin à ninja master near tunnel
    • When taken orally, remains active in GI tract until excreted in feces– useful in bowel prep before colorectal surgery
      • à colon tunnel
      • à scalpel weapon (surgery prep)
41
Q

Use of Paramycin

A
  • Paramycin à pair of mice
    • Luminal agent against intestinal parasites such as Entomoeba histolytica
42
Q

Use of Streptomycin

A
  • Streptomycin à sai master
    • Treat Tularemia caused by Francisella
      • à rabbit ears
    • Treats plague caused by Yersinia pestis
      • à squirrels with fleas
43
Q

Use of Gentamicin

A
  • Gentamicin à judo master
    • Treats resistant gram negative infections (e.g. Enterobacter, Serratia, Klebsiella)
      • à red shogun representing systemic gram negative infections (e.g. septicemia, nosocomial RTI, complicated UTI, intra-abdominal infection)
    • Pseudomonas
      • à Mona Lisa (treated with Gentamicin, Tobramycin, and Amikacin)
44
Q

Use of Tobramycin

A
  • Tobramycin à cobra ninja
    • Similar spectrum to Gentamicin
      • Both treat pseudomonas
        • à mona lisa
45
Q

Use of Amikacin

A
  • Amikacin à Katana master
    • Resistant to many of the enzymes that inactivate other aminoglycosides in resistant bacteria
    • Treatment against pseudomonas
      • à mona lisa
46
Q

Adverse effects of aminoglycosides

A
  • Adverse effects:
    • Nephrotoxicity, Neuromuscular blockade, Ototoxicity, Teratogen
      • Contraindicated in myasthenia gravis

Review / Wrong Answers (140 decks)

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