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Infectious Disease > Drugs one last time > Flashcards

Drugs one last time Flashcards

The Ultimate List

1
Q

B-lactam antibiotics function, categories, structure

A
  • Disrupt cell wall to allow for water to flood in and cause the cell to burst
  • PCNs, cephalosporins, carbapenums, and aztreonam
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2
Q

PCN mechanism of action

A

Bind to penicillin binding proteins and cause inhibition of transpeptidases and activation of autolysins

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3
Q

PCN is mostly affective against gram…

A

positive organisms

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4
Q

Most common ADR to PCN

A

Allergic rxn, approx 7%

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5
Q

How organisms have developed resistance to PCN

A
  • B-lactamase production
  • PCN can’t reach PBPs
  • PBP’s with low affinity
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6
Q

PenG is active against…

A
  • Gram + bacteria except for highly resistant ones

- Some gram neg including niesseria, also DOC for syphilis

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7
Q

PenG specrum

A

Narrow

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8
Q

PenG administration

A

4 diff salts, none activated PO

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9
Q

PenG elimination prolongation is caused by what?

A

Probencid

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10
Q

What 2 drug classes should never share IV?

A

PCN and aminoglycoside, inhibit each other when distributed together, synergistic when administered separately

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11
Q

PenV

A

-Identical version of PenG but has resistance to gastric acid so is the go to standard for oral therapy

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12
Q

Nafcillin, oxacillin, dicloxacillin spectrum

A

Very narrow, only penicillinase producing strains of S. aureus and S. epidermidis

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13
Q

Aminopenicillins include…

A

Ampicillin, amoxicillin

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14
Q

Ampicillin and amoxicillin antimicrobial spectrum

A

Most gram + organisms, some gram - including Haemophilus, Escherechia coli, Salmonella, Shigella, E. faecalis

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15
Q

Most commoon amoxicillin ADR

A

Amoxicillin rash, nonallrgic maculopapular rash not serious

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16
Q

Piperacillin spectrum

A

Pseudomonas aeruginosa, enterobacter, bacteroides fragilis, klebsiella, as well as most gram + and some other gram -

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17
Q

3 common B-lactamase inhibitors to be combined with penicillinase sensitive PCN

A

1) clavulanic acid
2) tazobactam
3) sulbactam

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18
Q

Cephalosporins mechanism of action

A

Same as PCN, bind PBP’s and disrupt cell wall synthesis and activate autolysins

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19
Q

How has resistance against cephilosporins developed?

A

B-lactamases, altered PBP production with lower affinity

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20
Q

Cephalexin spectrum

A

Highly active against gram + bacteria, not a lot against gram -

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21
Q

5 generations of cephalosportins

A

1) cephalexin
2) cefoxitin
3) ceftazidime
4) cefipime
5) ceftaroline

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22
Q

Cefoxitin spectrum

A

Highly active against gram +, more active against gram - as well such as klebsiella

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23
Q

Ceftazidime spectrum

A

Highly active against gram + and neg, and pseudomonas, can penetrate CSF (DOC for meningitis)

24
Q

Cefipime spectrum

A

Broad spectrum, high resistance to B-lactamases

25
Q

Ceftaroline spectrum

A

MRSA mother fucker

26
Q

Cephalosporin ADRs

A
  • Allergic reaction
  • cross reactivity with penicillin
  • Reduction of prothrombin levels
  • alcohol intolerance
  • Ca2+ precipitate formation
27
Q

Cephalosporins are ineffective against this type of bacteria

A

Enterococci

28
Q

Carbapenems mechanism of action

A

-Bind PBP 1 and 2 cause weakening of bacterial cell wall with lysis and death, resistant to most B lactamases and can penetrate gram neg envelope

29
Q

Imipenem spectrum

A

Very broad, many mixed infections with anaerobes, staph aureus, and gram neg bacilli, gram + and -, P. aeruginosa, B. fragilis

30
Q

Cilistatin interacts with what drug to inhibit destruction by renal enzymes?

A

Imipenem

31
Q

Imipenem ADR

A
  • Siezures in elderly

- Cross allergy with penicillin

32
Q

Meropenem spectrum

A

Active against most gram pos and gram neg, meningitis in children

33
Q

Ertapenem spectrum

A

Narrower than other carbapenems, no activity against P. aeruginosa

34
Q

Carbapenams absorption

A

Typically parenterally (IV)

35
Q

Dorpipenim spectrum

A

Broad range, including P. aeruginosa

36
Q

Aztreonam mechanism of action

A

Interferes with PBP3 to prevent synthesis of bacterial cell wall

37
Q

Aztreonam spectrum

A

Narrow, only aerobic gram neg including

  • H. influenzae
  • P. aeruginosa
  • Enterbacteriacieae
38
Q

Types of infeections aztreonam treats

A

As a sub for aminoglycosides in UTI, lower respiratory, and soft tissue infections

39
Q

Aztreonam ADR

A

Pseudomembranous colitis suprainfection

40
Q

Vancomycin mechanism of action

A

-Inhibiting cell wall synthesis without PBP interaction

41
Q

Vancomycin treats what organisms

A
  • DOC for Cdiff, MRSA
  • Serious infections in patients with PCN allergies
  • Mostly gram pos
42
Q

Vancomycin ADRs

A

Renal failure, ototoxicity, red man syndrome

43
Q

Vancomycin absorption

A

Parenterally, IV

44
Q

Teicoplanin

A

Similar action and structure to vancomycin, but largely devoid of any ADRs

45
Q

Fosfomycin

A

Similar action and structure to vancomyscin, often used in uncomplicated UTI

46
Q

Telavancin

A

Similar action and structure to vancomycin, treats complex skin infections and causes taste disturbance and foamy urine

47
Q

Aminoglycoside spectrum

A

Narrow, only gram - aerobic bacilli, such as the enterobacteriaciae class

48
Q

Aminoglycoside common ADR’s

A

Kidney and inner ear damage, neuromuscular blockage

49
Q

Aminoglycoside mechanism of action

A

Dirsupt bacterial protein synthesis by binding 30 s ribosomal unit after active transport across cell membrane via Oxygen dependant process

50
Q

Aminoglycosides, despite their status as a protein inhibitor, are fundamentally bacterio….

A

…cidal

51
Q

Aminoglycoside resistance

A

Transfer of enzymes that inactivate them via R factors

52
Q

Aminoglycoside absorption

A

Parenteral therapy or topical use

53
Q

Gentamicin indication

A

Often used in combination with vanco or cephalosporin for severe gram + infection

54
Q

Tobramycin indication

A

More active against P. aeruginosa, topical eye treatment

55
Q

Amikacin 2 outstanding features

A

1) Broadest spectrum of all aminoglycocides

2) Least vulnurable to inactivation by bacterial enzymes

56
Q

Neomycin 3 outstanding features

A

1) most toxic of all aminoglycosides
2) topical application
3) used to suppress bowel flora prior to surgery

Infectious Disease (24 decks)

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