Anti-Bacterials EC Flashcards Preview

Evan's Step 1 Prep Material > Anti-Bacterials EC > Flashcards

Flashcards in Anti-Bacterials EC Deck (43):
1

Penicilin (MOA, Use, Tox, Resistance)

Bind transpeptidases and inhibit cross-linking of peptidoglycan (pen.G=IV/IM, pen.V=oral)

Gram +'s (S. pneumo, S. pyogenes, Neisseria meningitidis, Treponema pallidum)

Hypersensitivity, Hemolytic anemia

Beta-lactamases cleave

2

Oxacillin, Nafcillin, Dicloxacillin (MOA, Use, Tox, Resistance)

Same as penicillin.
Narrow spectrum; penicillinase resistant because bulky R group blocks

S. aureus (except MRSA;altered PBP)
"USE NAF FOR STAPH"

Hypersensitivity reactions, Interstitial nephritis

3

Ampicillin, Amoxicillin (MOA, Use, Tox, Resistance)

Same as penicillin
Wider spectrum: also combine with clavulanic acid to protect against beta lactamase

"amOxicillin has greater Oral bioavailability"

"ampicillin/amoxicillin HELPSS kill enterococci"
Penicillin +: H. influenzae, E. coli, Listeria, Proteus, Salmonella, Shigella

Hypersensitivity, Ampicillin rash, Pseudomembranous colitis

Beta lactamase + are resistant

4

Ticarcillin, Pipercillin

Same as penicillin
Extended spectrum

PSEUDOMONAS

Hypersensitivity reactions

5

Beta-lactamase inhibitors

"CAST"
Clavulanic Acid
Sulbactam
Tazobactam

6

Cephalosporins

Beta-lactam
Less susceptible to penicillinases

Toxicity:
Hypersensitivity, vit K deficiency, low cross-reactivity w/ pen., increased nephrotoxicity of aminoglycosides

7

1st generation cephalosporins

PH in name (except ceFAZolin "don't let that FAZe you")
Cephalothin, Cephapirin, Cephradine, Cefazolin, Cephalexin

Great gram + coverage and Strep pneumo. Bad gram -
Proteus, E.coli, Klebsiella

Cefazolin prior to surgery to prevent S. aureus infections

8

2nd generation cephalosporins

Fam, Fa, Fur, Fox, Tea,
ceFAMandole, ceFaclor, ceFURoxime, ceFOXitin, cefoTEAtan

Good gram -, strep. pneumo, gram +
H. influenzae, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia

9

3rd generation cephalosporins

Great for gram -

Ceftriaxone-meningitis and gonorrhea
Ceftazidime-pseudomonas

10

4th generation cephalosporins

Cefepime- Pseudomonas

11

Aztreonam

MAGIC BULLET FOR GRAM NEGATIVE AEROBES

Monobactam resistant beta lactamase
Synergistic with aminoglycosides
No cross-allergy w/ penicillins

Penicillin allergic patients

12

Imipenem/Cilastatin, Meropenem

Imipenem- BROADEST SPECTRUM OF ANY

Always given with CILASTATIN (inhibits renal dehydropeptidase I- decreased inactivation of drug)

Wide spectrum

GI distress, skin rash, CNS toxicity (seizures)

13

Vancomycin

Inhibits cell wall peptidoglycan formation (binds D-ala-D-ala)

Gram + only: MRSA, enterococci, C. dif

Nephrotoxicity, Ototoxicity, Thrombophlebitis, Red-man syndrome

Change in D-ala-D-ala gives resistance

14

Chloramphenicol

Binds 50S ribosomal subunit and inhibits protein synthesis

Very wide spectrum (limited by tox.)
Bacterial meningitis
Rickettsial infection in children and preg. women (tetracycline usually first choice)

Bone marrow suppression (aplastic anemia)
Grey baby syndrome

15

Clindamycin

Binds 50S ribosomal subunit and inhibits protein synthesis

Wounds penetrating abdomen
Female genital tract
Toxo gondii
Toxic shock syndrome

Can cause pseudomenbranous colitis

16

Linezolid

Bind 50S ribosomal subunit and inhibit protein synthesis

Nocosomial pneumonia
Complicated skin/soft tissue infections
S. aureus pneumonia
MRSA and VRE

Bone marrow suppression

17

Macrolides (Erythromycin, Azithromycin, Clarithromycin)

Bind 50S ribosomal subunit and inhibit protein synthesis

Outpatient upper and lower respiratory tract infections
Atypicals (Legionella, Mycoplasma, Chlamydia)

Can prolong QT

18

Tetracycline, Doxycycline, Minocycline

Binds 30S subunits and inhibit protein synthesis

ODD BUGS
Rickettsia
Chlamydia
Mycoplasma pneumoniae
E. histolytica
Spirochetes
(Ance)

Phototoxic dermatitis
Renal/Hepatotoxicity
FANCONI SYNDROME: ingestion of outdated drugs leads to renal tubule dysfunction
TERATOGENIC
Discolors teeth

19

Aminoglycosides (Streptomycin, Gentamycin, Tobramycin, Amikacin, Neomycin)

Bind 30S subunits and inhibit protein synthesis

(Often given w/ penicillin b/c must pass through membrane)
Gram negative enterics
Yersinia pestis, Brucellosis, Mycobacterium tuberculosis

Ototoxicity
Renal toxicity
Neuromuscular blockade

20

Spectinomycin

Binds 30S subunit and inhibit protein synthesis

Gonorrhea

21

What is the treatment regimen forTB?

Active infection:
Isoniazid
Rifampin
Pyrazinamide
Ethambutol

Prophylaxis:
Isoniazid

" I Saw a Red Pyre burning the liver"

22

Isoniazid (INH) (MOA, Use, Toxicity)

Decreases MYCOLIC ACID synthesis

TB solo prophylaxis
Part of TB treatment regimen

Hepatotoxicity
Neurotoxicity (can be avoided with vit. B6-pyridoxine)
Lupus

23

Rifampin (MOA, Use, Toxicity)

Inhibits DNA-dependent RNA-polymerase

Part of TB treatment
Leprosy treatment (delays Dapsone resistance)
Meningococcal prophylaxis
Prophylaxis for contacts around H. influenzae B

Minor hepatotoxicity
Orange body secretions
Revs up P450 (OCPs, warfarin, hypoglycemics, corticosteroids, phenytoin less effective)

"4R's:
RNA polymerase inhibitor
Revs up P450s
Red/orange body fluids
Rapid resistance if used alone"

24

Pyrazinamide (MOA, Use, Tox)

Unknown MOA

TB (rapidly bactericidal)

Hepatotoxicity (limits duration of use)
Hyperuricemia

25

Ethambutol (MOA, Use, Tox)

Bind ARABINOSYLTRANSFERASE and decrease carb polymerization of cell wall

TB

Optic neuropathy (red-green color blindness) - reversible

26

Mycobacterium avium treatment

Treatment:
Azithromycin
Rifampin
Ethambutol
Streptomycin

Prophylaxis:
Azithromycin

27

Mycobacterium leprae treatment

Tuberculoid:
Dapsone
Rifampin

Lepromatous:
Dapsone
Rifampin
Clofazimine

28

Fluoroquinolones (MOA, Use, Tox)

-FLOXACIN

Inhibit DNA GYRASE (bactericidal)

Gram - rods of urinary and GI tract (including pseudomonas)
Neisseria
Some gram +

Tendonitis, tendon rupture, myalgias.
Superinfections, rash, headache, dizziness.
QT prolongation

29

Metronidazole (MOA, Use, Tox)

Form free radicals in bacterial cell and damages DNA

"GET GAP on the Metro"
Giardia
Entamoeba
Trichomonas
Gardnerella vaginalis
Anaerobes (Bacteriodes, C. dif)
h. Pylori (part of triple therapy)

Disulfiram-like reaction with alcohol

30

Sulfamethoxazole (MOA, Use Tox)

PABA antimetabolite: inhibit DIHYDROPTEROATE SYNTHASE (bacteria must synthesize own folate)

Gram +
Gram -
Nocardia
Chlamydia
UTI (w/ TMP)

Hemolysis in G6PD
Nephrotoxic
Displacement of drugs from albumin (warfarin!)

31

Trimethoprim (MOA, Use, Tox)

Inhibits bacterial DIHYDROFOLATE REDUCTASE

UTIs (w/ SMX)
Shigella (w/ SMX)
Pneumocystis jirovecii (w/ SMX)

Megaloblastic anemia

32

Meningococcal infection prophylaxis

Ciprofloxacin
Rifampin for kids

33

Gonorrhea prophylaxis

Ceftriaxone

34

Syphilis prophylaxis

Penicillin G

35

Recurrent UTI prophylaxis

TMP-SMX

36

Prophylaxis for endocarditis with surgical or dental procedure

Penicillins

37

Prophylaxis for pregnant woman carrying group B strep

Ampicillin

38

Prophylaxis of strep pharyngitis in child with prior rheumatic fever

Oral penicillin

39

Prevention of postsurgical infection due to S. aureus

Cefazolin

40

Prevention of gonococcal or chlamydial conjunctivitis in newborn

Erythromycin ointment

41

Treatment of MRSA

Vancomycin

42

Treatment of VRE

Linezolid and Streptogramins

43

Antibiotics to avoid in pregnancy

SAFe Children Take Really Good Care

Sulfonamides (kernicterus)
Aminoglycosides (ototoxicity)
Fluoroquinolones (cartilage damage)
Clarithromycin (embryotoxic)
Tetracyclines (inhibited bone growth, discolored teeth)
Ribavirin (teratogenic)
Griseofulvin (teratogenic)
Chloramphenicol ("grey baby")

Decks in Evan's Step 1 Prep Material Class (72):