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antimicrobials > PRO > Flashcards

PRO Flashcards

1
Q

MOA of Macrolides

A

Binds to 50S sub unit and prevents TRANSLOCATION

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2
Q

One of the best treatment for community acquired Pneumonia

A

Macrolides

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3
Q

Best treatment for Hospital acquired pneumonia

A

3rd generation cephalosporins because most likely cause - Pseudomonas (gram negative)

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4
Q

Most common clinical uses of Macrolides

A

1) Str.pyogenes Str.pnemoniae
2) N.gonorrhoea
3) C.diptheria
4) Gardenella vaginalis
5) Legionella
6) Mycoplasma (atypical)

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5
Q

Common side effects of macrolides

A
  • —> Stomach upset
  • —> Deafness at high doses
  • —> Increased QT interval (inhibition of CYP450)
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6
Q

How do organisms acquire resistance to macrolides?

A

Methylation of the drug binding sites on the 50S subunit

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7
Q

Mmm.. mm (Pnemonic for Macrolides)

A 
Macrolides
MAC
Mycoplasma
Motility receptors (activate)
Methylation(resistance)
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8
Q

Advantages of Clarithro over Erythro?

A

Covers MAC, and mycoplasma better

1st line drug for H.Pylori MAC infection

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9
Q

Azithromycin clinical uses

A

1st line drug for

1) Legionarres pneumonia
2) chlamydia Trachomatis
3) Donovanosis
4) chancroid

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10
Q

Distinctive feature of Clindamycin

A

Covers anaerobes especially Bact.Fragilis

Not sensitive against Chlamydia, Mycoplasma, Rickettsiae

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11
Q

Most striking side effect of Clindamycin

A

Psedomembranous enterocolitis (superinfection by clostridium difficlie)

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12
Q

MOA of Vancomycin

A

Binding to D ala D ala sites to hinder the transglycosylation that hinders peptidoglycan chain elongation.

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13
Q

Vancomycin clinical uses

A

Serious gram positive infections e.g Hospital acquired MRSA, enterococci

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14
Q

Drug of choice for C.diff

A

Metronidazole

Vancomycin (back up drug)

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15
Q

How does VRSA develop resistance ?

A

D ala replaced by D lactate

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16
Q

MOR of penicillins and cephalosporins

A

Production of beta-lactamases
Alteration of penicillin binding sites
Change in porin structure (gram negative)

17
Q

Difference between action of Penicillin and Vancomycin

A

Penicillin- inhibits transpeptidase( cross linking enzyme)

Vancomycin- inhibits transglycolase enzyme (elongation of peptidoglycan chain stopped)

18
Q

Drug of choice for Treponema

A

Pencillin G

19
Q

Antibacterial spectrum of Penicillin

A

Most Gram positive cocci and bacilli
Gram negative cocci
But no Gram negative Bacilli

20
Q

Name the B lactam antibiotics which are beta lactamase resistant

A

Very narrow spectrum anti Staphylococci penicllins.(methicillin nafcillin oxacillins)

21
Q

How do MRSA develop resistance to methicillin

A

Altering PBP

22
Q

Drug of choice for Listeria

A

Ampicillin

23
Q

Clinical uses of Ampicillin

A

Respiratory tract inf (sinusitis, otitis media, bronchitis)

Meningitis (in combo with 3rd gen cephalo/chloramphenicol)

24
Q

What are the penicillins that are antipsedomonal in nature?

A

Very broad spectrum penicillins ( piperacillin carbenicillin)

25
Q

Piperacillin uses

A

Pseudomonas
Klebsiella
immunocompromised patients with serious gram negative infections

26
Q

1st Generation cephalosporin spectrum

A

Only gram positive cocci
E.coli, Klebsiella
Some proteus
surgical prophylaxis

27
Q

Its a FACt that im a FOXy and FURry man

A

Cefaclor
Cefoxitine
Cefuroxime

28
Q

3rd gen cephalosporins uses

A

Empirical treatment for meningitis

29
Q

One ceph to avoid in neonates

A

Ceftriaxone (mostly excreted in bile which is underdeveloped in neonates)

30
Q

what are the organisms not covered by cephalosporins

A

L- listeria
A- atypicals (chlamydia and mycoplasma)
M- MRSA
E- enterococci

31
Q

What is a drawback of Iminepem

A

inhibited by dehydropeptidase in renal tubules

so always given Cilastatin

32
Q

1st choice drug for Lyme disease (Borella)

A

Tetracyclines

antimicrobials (2 decks)

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