AB review Flashcards
(143 cards)
1
Q
How many “R” groups do Penicillins have?
A
1
2
Q
What is the main AE of Linezolid?
A
Monoamine Oxidase Inhibitor (increased risk of serotonin syndrome)
3
Q
How many “R” groups do Cephalosporins have?
A
2
4
Q
Which TCN is used against MRSA? Enterococcus? Pseudomonas?
A
Doxy + Minocycline for MRSA only
5
Q
Which GEN of cephalosporins covers most strep and MSSA?
A
1st
6
Q
Which AB is associated w/ Gray baby syndrome?
A
Chloramphenicol
7
Q
Aminoglycosides are used against MRSA? Enterococcus? Pseudomonas?
A
Only Gentamycin, Amikacin, and Tobramycin are used for Pseudomonas
8
Q
What is the MOA of macrolides?
A
Inhibit protein synthesis by binding reversibly to the 50S ribosomal subunits
9
Q
Is it okay to take cephalosporins if you have an allergy to penicillin?
A
Yes, just not with anaphylaxis or hives
10
Q
Which AB has been associated with Red-Man Syndrome? How do you get rid of this?
A
Vanco
D/C or slow the rate
11
Q
Which cephalosporin can be used against typhoid fever or non-typhi species of Salmonella?
A
Ceftriaxone
12
Q
Which AB have alcohol intolerance?
A
Cephalosporins + Flagyl
13
Q
Which quinolones cover Pseudomonas?
A
Levofloxacin
Ciprofloxacin
Delafloxacin
14
Q
What are the two main glycopeptides?
A
- Vanco
2. Telavancin
15
Q
What is the most active carbapenem against Pseudomonas?
A
Doripenem
16
Q
G+ or G-
Which one does TCN cover?
A
Both
17
Q
Which AB covers MRSA, VRSA, and VRE?
A
Zyvox (Linezolid)
18
Q
Which of the following works via inhibition of DNA gyrase?
Sulfonamides
Fluroquinolones
Aminoglycosides
Penicillins
A
Fluroquinolones
19
Q
Which AB competitively inhibit Linezolid?
A
Chloramphenicol and Lincomycin
20
Q
What are the two inhaled AB?
A
Tobramycin + Aztreonam
21
Q
Which AB can cover atypical organisms?
A
Macrolides/Ketolides
Quinolones
22
Q
Which AB can target the bone?
A
Lincosamides, Chloramphenicol, and Quinolones
23
Q
G+ vs G-
Erythromycin
A
Good = G+ Little = G-
24
Q
Which macrolide has no interactions with CYP3A4?
A
Azithromycin
25
Which AB can be used if you have a rash/hypersensitivity to penicillins or another B-lactam?
Aztreonam
26
Which cephalosporin covers N. gonorrhea?
Ceftizoxime + Ceftriaxone
27
Which aminoglycoside is the broadest of the group?
Amikacin
28
G+ or G-, Aerobe or Anaerobe
Which one does Tigecycline target?
All
Anaerobes = Clostridium perfinges, Bacteroides spp
29
What is the only natural penicillin used clinically?
Pen. G
30
Which carbapenem is used to treat bacterial meningitis?
Meropenem
31
G+ or G-, Aerobic or Anaerobic
Which one does Amox (w/ Clav), Ampicillin (w/ sulbactam), Zosyn, and Ticarcillin (w/ Clav) cover?
G+, little G-, Anaerobic
32
Which AB could cause vestibular toxicity?
Minocycline
33
Which AB has been associated w/ metallic or soapy taste?
Telavancin for both. Metronidazole can cause just the metallic taste
34
G- or G+, aerobe vs anaerobe
Which one does Aztreonam (Monobactam) work against?
G- aerobe
35
Which GEN of cephalosporins have great G- coverage?
5th
36
Of the cell wall synthesis inhibitors, which one inhibits recycling of carrier which transports cell wall precursors across the plasma membrane?
Bacitracin
37
Of all the macrolides and ketolide, what is something in common?
Have good coverage on atypical organisms such as:
Legionella pneumophilia
Chlamydia sp.
Mycoplasma sp.
38
Of the cell wall synthesis inhibitors, which one inhibits cross-linking of cell wall components?
B-lactams
39
Which Lincosamide is available via PO? IV?
```
PO = Clindamycin only
IV = Both Clinda + Lincomycin
```
40
Which drug has an AE of Cholestatic hepatitis?
Erythromycin estolate
41
PO or IV, which form does Linezolid come in?
Both
42
Can Lincosamides go against MRSA, Pseudomonas, and Enterococcus?
Only Clindamycin is somewhat useful against MRSA (60% effectiveness)
43
G+ vs G-
Quinupristin/Dalfopristin
Mostly G+, limited G-
44
What do all quinolones have in common in terms of coverage?
All hit atypical bugs
45
How does Aztreonam work?
Interacts w/ penicillin-binding proteins of susceptible microorganisms and induces formation of long filamentous bacterial structures
46
What are some AE of Dapto?
1. Myopathy
2. Creatine phosphokinase elevation
**consider suspending statins
47
Which AB causes C. difficile colitis?
Lincosamides (Clindamycin + Lincomycin)
48
Which AB has a black box warning reported that all-cause mortality with this drug was higher than any other versus its own class?
Cefepime
49
Compared to Erythromycin, how does Telithromycin compare?
Better coverage, such as S. pneumoniae and aureus
50
Is Vanco against MRSA, Pseudomonas, and Enterococcus?
Not all
Good for MRSA
Good for Methicillin resistant but Vanco susceptible Enterococcus
51
Which carbapenem is against MRSA?
None
52
Is Aztreonam against MRSA, Pseudomonas, and Enterococcus?
Nope, only against Pseudomonas
53
Which AB's AE is Myopathy and creatine phosphokinase elevation?
Dapto
54
Which of the following is not a beta-lactam?
Aminoglycoside
Cephalexin
Doripenem
Amoxicillin
Aminoglycoside
55
What is the MOA of Dapto?
Binds to bacterial MEMBRANE which causes rapid depolarization of membrane potential
Cell lysis does not occur
56
G+ vs G-
Clarithromycin
Just like Azithromycin, it has better coverage than Erythromycin by covering Mycobacterium avium-intracellulare
57
What are some AE of Telavancin?
1. Metallic/soapy taste
| 2. Black box = abnormal fetal development
58
Is Telavancin against MRSA, Pseudomonas, and Enterococcus?
Not all
Good for MRSA
59
Of all antimicrobials, which have the most broad spectrum of activity?
Carbapenems
60
G- or G+
Which one does Telavancin work on?
G+
61
Which AB cause Stevens-Johnson syndrome
Trimethoprim/Sulfamethoxazole; pretty much anything w/ sulfur in it
62
Which of the following does NOT work on bacterial ribosomal subunits?
Aminoglycosides
Macrolides
Clindamycin
Fluoroquinolones
Fluoroquinolones
63
What is the only cephalosporin that is good against MRSA?
Cefataroline
64
Which AB causes gradual rise in BUN and serum creatinine?
Aminoglycosides
65
Which GEN of cephalosporins have great G+ coverage?
1st
66
G+ or G-, Aerobic or Anaerobic
Which one does Aminoglycosides cover?
G+ and Aerobic
67
G+ vs G-, aerobe vs anaerobe
Trimethoprim/Sulfamethoxazole
No anaerobe, covers PCP as well
68
What is the drug of choice for Pseudomembranous colitis due to C. difficile?
Metronidazole
69
G+ vs G-, aerobe vs anaerobe
Chloramphenicol
Both G+ and G-, Anaerobe
70
Which GEN of quinolones just has good G- coverage?
All 4 GEN have good G- coverage
71
MOA of Linezolid?
Inhibits protein synthesis by binding to the P site of the 50S ribosomal subunit and preventing formation of the larger ribosomal-fMet-tRNA complex that initiates protein synthesis
72
Which AB is contraindicated w/ someone who has end stage renal disease?
IV Delafloxacin; it contains cyclodextrin
73
What are the cephamycins noted for in terms of their activity?
Covers B. fragilis
74
Of the cell wall synthesis inhibitors, which one depolarizes membranes?
Daptomycin
75
Which AB can cause possible peripheral neuropathy and/or myasthenia gravis?
Quinolones
76
Which AB could cause Fanconi syndrome due to use of outdated meds?
TCN
77
Which quinolone covers MRSA?
Delafloxacin
78
Which Penicillins are agents used for Pseudomonas?
Piper. w/ Tazo
| Ticaricillin w/ clav.
79
G+ or G-
Which one does Pen. G/V cover?
G+
80
Which of the following is NOT active against MRSA?
Vancomycin
Trimethoprim/sulfamethoxazole
Daptomycin
Piperacillin/tazobactam
Piper. w/ Tazo
81
Glycylcyclines aka Tigecycline is used against MRSA? Enterococcus? Pseudomonas?
MRSA and VRE
82
How do glycopeptides work?
Binds firmly to D-ala-D-ala portion of cell wall precursors to inhibit peptidoglycan units to grow polymer chain of cell wall.
83
Which GEN of quinolones has both G+ and G- coverage?
3rd and 4th
84
Which AB group is typically used to provide synergistic bacterial killing?
Aminoglycosides
85
What do the 2nd GEN cephalosporins cover that 1st GEN doesn't?
More G- coverage notably H. influenzae
86
Where do most of the macrolides/ketolides distribute to?
Pulmonary areas
87
Can Quinupristin/Dalfopristin go against MRSA, Pseudomonas, and Enterococcus?
Just MRSA. One ppt says against VRE, another doesnt mention it...?
88
What is the bioavailability of Linezolid via PO and IV?
Both are 100% :O
89
What are some drug interactions w/ Quinupristin/Dalfopristin?
Inhibits CYP450-3A4
90
Which AB causes bone marrow suppression?
Chloramphenicol
91
Besides alcohol intolerance, what is another AE that cephalosporins have?
Reduction in Vit. K producing bacteria
92
Quinolone AB target what specifically?
```
G+ = topoisomerase IV
G- = DNA gyrase
```
93
What is the ideal drug choice for MRSA?
Vanco
94
Aerobic vs anaerobic
Metronidazole
Anaerobic (plus against Protozoa)
95
Which AB have been associated w/ QTc prolongation?
Macrolides + Ketolides + Quinolones
96
What is the MOA of Bacitracin?
Inhibits incorporation of AA into cell wall by inhibiting dephosphorylation of phospholipid carrier cycle (inhibits NAM and NAG)
97
G+ vs G-, aerobe vs anaerobe
Lincosamides
G+ and anaerobes
98
What is an AE of all carbapenems?
Seizures, especially imipenem
Doripenem has the lowest chance.
99
What are some AE of Vanco?
1. Red-man syndrome
| 2. Ototoxicity
100
Which AB would you used for suspected/proven Rocky Mountain spotted fever?
Doxycycline
101
What is the most serious AE of Chloramphenicol?
Aplastic (more serious and not dose related) and Hemolytic anemia
102
Which AB causes Neuromuscular blockade? How could you reverse it?
Aminoglycosides.
Calcium Gluconate
103
G- or G+
Which one does Vanco work on?
G+
104
Which macrolide is NOT tolerated well?
Erythromycin
105
Which AB in contraindicated w/ myasthenia gravis
Ketolides
106
Which AB has a black box warning of tendonitis?
Quinolones
107
Which AB interacts w/ Divalent/Trivalent Cations?
TCN and Quinolones
108
G+ vs G-
Azithromycin
Just like Clarithromycin, it has better coverage than Erythromycin by covering Mycobacterium avium-intracellulare
109
What is the only for treatment of Clostridium difficile-associated diarrhea?
Fidaxomicin
110
What is the drug of choice for Pneumocystis jirovecii pneumonia?
Trimethoprim/Sulfamethoxazole
111
Is Dapto against MRSA, Pseudomonas, and Enterococcus?
Not all
Good for MRSA
Good for Methicillin-R and Vanco-R Enterococcus
112
MOA of Chloramphenicol?
Binding reversibly to the 50S ribosomal subunit
113
Which cephalosporin can be used for early Lyme disease or third-degree AV heart block?
Ceftriaxone and cefotaxime
114
What are some AE of Quinupristin/Dalfopristin
Venous irritation when administered in the peripheral vein
Myalgia, arthralgia
115
Which cephalosporins covers Pseudomonas?
Ceftazidime
Cefepime
Ceftolozane/tazobactam
Ceftazidime/avibactam
116
What group of AB are susceptible to bacterial metabolism and inactivation by amidases and lactamases?
Penicillins
117
Which AB needs to be taken on an empty stomach?
Azithromycin
118
Which AB has been associated w/ a black box warning of abnormal fetal development?
Telavancin
119
Of the cell wall synthesis inhibitors, which one prevents transfer of cell wall precursor from plasma membrane into cell wall?
Glycopeptides
120
What is the ratio of Trimethoprim:Sulfamethoxazole?
1:5
121
Which AB can cause ototoxicity?
Aminoglycosides
Macrolides
Vancomycin
122
What class of drugs is associate with the pathophysiology of ototoxicy caused by destruction of hair cells in the cochlear and/or vestibular apparatus?
Aminoglycosdes
123
Of the two ototoxicity toxicities resulting from use of aminoglycoside, which is reversible?
Auditory/cochlear or hearing
124
Of the two ototoxicity toxicities resulting from use of aminoglycoside, which is irreversible?
Vestibular
125
What 50s ribosomal subunit inhibitor demonstrates activity vs. VRE (faecium and not faecalis) & MRSA and is associated with myalgias and arthralgias?
Quinupristin/Dalfopristin
126
What 50s ribosomal subunit inhibitor should be administered through a central line as administration through peripheral lines results in venous irritation?
Quinupristin/Dalfopristin
127
What 50s ribosomal subunit inhibitor comes as a 30:70 racemic mixture of streptogamin B:A?
Quinupristin/Dalfopristin
128
The isoxazolyl R-group added to a thiazoline ring that is attached to a beta-lactam characterizes what group of antibiotics?
Penicillinase-resistant PCN
129
What advantage over the natural penicillins does the isoxazolyl side chain afford?
Resistance to penicillinase bacterial enzymes (adds MSSA to spectrum)
130
In the bacterial differentiation tree, what is the test that distinguishes between Staph & Strep
Catalase negative (Strep) or positive (Staph)
131
In the bacterial differentiation tree, what is the test to distinguish between S. aureus from S. epidermis?
Coagulase positive (aureus) or negative (epidermis)
132
Beta-lactams are susceptible to inactivation by two bacterial enzymes called __?
Amidases and lactamases
133
Which cephalosporins are noted for their activity vs. Bacteroides fragilis?
Cefotetan and cefoxitin
134
Cefotetan and cefoxitin are noted for their activity against what?
B. fragilis
135
Cefepime is noted for its use against what?
P. aeruginosa, Citrobacter as well as Enterobacter
136
Unlike other beta-lactam agents, vancomycin works on what bacterial enzyme?
Transglycoslase
137
Which AB works on transglycolase?
Vanco
138
What isoxazolyl side chain penicillin derivative is only available IV?
Naficillin
139
What isoxazolyl side chain penicillin derivative induces CYP450-3A4 pathway and is administered orally?
Dicloxacillin
140
Of the penicillin based agents, which is associated with the highest rates of diarrhea?
Augmentin
141
Drug of choice for treatment of Treponema pallidum is?
Penicillin G
142
Penicillin G is the drug of choice for treating what?
T. pallidum
143
Which AB readily cross the CNS w/o any meningeal inflammation?
1. Chloramphenicol
2. TCN
3. TMP-SMX
4. Zyvox
