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Bacteriology -NM > Antibacterial Drugs > Flashcards

Antibacterial Drugs Flashcards

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1
Q

cephalosporin resistances in general

A

intrinsic: pseudomonas. enterococci; membrane permeability; altered PBPs; B-lactamases

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2
Q

cefoxitin activity

A

excellent anaerobic activity 2nd generation

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2
Q

ceftriaxone clinical use

A

community acquired pneumonia meningitis(penetrates CSF) UTI

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2
Q

Penicillin G. administration

A

IV

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2
Q

Nafcillin. administration

A

IV

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2
Q

piperacillin. administration

A

IV

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2
Q

piperacillin-tazobactam. administration

A

IV

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3
Q

Bacitracin. activity

A

GP only, topical

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3
Q

cephalexin. administration

A

PO

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3
Q

metronidazole adverse effects

A

metallic taste;

HA, vertigo, confusion, psychosis,

disulfram-like effect w/alcohol(vomit, flush)

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4
Q

Penicillin G. adverse effects

A

hypersensitivity reactions(rash. hives/anaphylaxis. serum sickness. immune mediated cytopenias. acute interstitial nephritis); seizures at high doses

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4
Q

clindamycin, mechanism, activity, adverse reaction

A

binds 50S subunit GP only! “above the diaphragm” classically some CA-MRSA adverse reaction is c. diff infection

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5
Q

Vancomycin resistance?

A

alteration of vancomycin binding site (vanA.B.C.D.E),VRE; thickened cell wall(VISA)

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5
Q

rifaximin use

A

traveler’s diarrhea enteric drug; does not absorb across gut

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5
Q

isoniazid mechanism, clinical use

A

inhibits mycolic acid cell-wall syntehsis via O2 dependent pathways used for mycobacterial infections

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6
Q

aztreonam activity, clinical use

A

GN only, used w/b-lactam allergy occasionally; limited immunogenic potential

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7
Q

amoxicillin. administration

A

PO

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10
Q

Polymyxin B. Colistin activity

A

GN bactilli only

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11
Q

Daptomycin. adverse effects

A

GI distress. HA. elevated CPK(creatine phosphokinase)/rhabdomyolysis(avoid statins)

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12
Q

ampicillin, amoxicillin activity

A

widens spectrum to some GN(H. flu. E. coli; NOT pseudomonas)

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13
Q

Daptomycin. activity

A

GP ONLY! MRSA activity; enterococci(including VRE). anaerobes

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13
Q

ceftazidime clinical use

A

pseudomonas activity; very broad GN

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14
Q

ceftriaxone penetration, half life

A

high degree of CSF penetration; EXTREMELY long t1/2. can q24h dose for outpatient IV

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16
Q

name the tetracyclines, mechanism and activity

A

doxycycline tetracycline minocycline reversibly bind 30S subunit blocking tRNA access to mRNA broad GN(no pseudo) staph, strep(some CA-MRSA) some anaerobic atyps: chlamydia, mycoplasma 4(tetra) minos by the dox

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18
Nafcillin. Dicloxacillin clinical use
primarily used for methicillin-susceptible S. aureus
20
ceftaroline. administration
IV
20
Vancomycin oral
does not cross GI tract given orally; used for c. diff
22
Fosfomycin. clinical use
UTI only
23
Vancomycin. activity
GP ONLY! MRSA activity; enterococci if susceptible; anaerobes
25
Nafcillin. resistance?
altered PBP encoded by mecA--\>PBP2a(MRSA); cant bind it anymore
25
adverse effects of **TMP-SMX**
**common** - HANV, rash **less** - hyperkalemia, hepatitis, pancreatits **rare** - SCAR, anemias, thrombocytopenias, separates drugs from albumin, kernicterus
26
ethambutol use
inhibits arabinogalactan, lipoarabinomannan synthesis used for mycobacterial infections
27
carbopenam. adverse effects
hypersensitivity(cross-reaction w/penicillin)
28
Nafcillin, dicloxacillin activity
GP ONLY; narrow specturm; think penicillin G with overcoming certain b-lactamases
28
Vancomycin. clinical use
only use instead of b-lactam if: empiric therapy for severe infection. resistant GP infection. allergy to b-lactam; used for C. diff via oral dose
29
cefepime activity
EXTREMELY GN active including pseudomonas; one of broadest spectrum agents available; still has GP activity; resistant to almost all b-lactamases 4th gen
30
anti-tubercular drugs
isoniazid, rifampin, streptomycin, ethambutol, pyrazinamide
31
name all the drugs with GP only activity
nafcillin dicloxacillin vancomycin daptomycin bacitracin mupirocin clindamycin linezolid tedezolid
32
aztreonam. administration
IV
34
Penicillin G. activity
GN: cocci only; GP: cocci and anaerobes; spirochetes. enterococci
34
name all the cephalosporins in order by generation
1st gen: cefazolin cephalexin(PO) 2nd gen cefoxitin 3rd gen ceftriaxone ceftazidime 4th gen cefepime 5th gen ceftaroline
35
name the macrolides, mechanism, and activity
azithromycin clarithromycin erythromycin binds 50S subunit, blocks translocation broad GN(no pseudo) GP: staph,strep, pneumo(if susc.) atyp: myco, legionella, chlamydia
36
carbapenem administration
IV
37
fidoxamicin mechanism, use
blocks RNA polymerase by not letting DNA open PO drug approved for c.diff infections does not cross GI; very narrow spectrum(only effects some GP in gut); preserves flora better than others
38
name all the drugs with pseudomonas activity
piperacillin/pip-tazo ceftazidime cefapime meropenem imipenem fosfomycin - UTI only aminoglycosides(gentamicin, amikacin, tobramycin, streptomycin)
39
**metronidazole** mechanims, activity
diffuses into bacteria and produces free radicals activity: **ANAEROBES**"below diaphragm" includes b. fragilis; protozoa
41
Polymyxin B and colistin adverse effects
nephrotoxicity. neurotoxicity
42
cefazolin. administration
IV
42
tigecycline, mechanism, activity, problems
semi-synthetic tetracycline very broad spectrum GN(no pseudo) GP(MRSA and VRE) most anerobes resistance develops rapidly...limits use; also increased mortality w/pneumonia pts....
43
name the carbapenems
meropenem imipenem ertapenem doripenem(black boxed)
45
Vancomycin. administration
IV/PO PO for c.diff; not absorbed
46
cefepime. administration
IV
48
Penicillin G. clinical use
Grp A and B strep. and Streptococcus pneumoniae; anaerobic infections(dental abscess. human bites); syphilis
49
Daptomycin. administration
IV
51
cefoxitin clinical use
prophylaxis for intra-abdominal surgery 2nd gen
53
ampicilin. amoxicilin adverse effects
in addition to hypersensitivity�.GI distress is common; maculopapular rash if treating mono(100% of pts)
54
ceftazidime. administration
IV
55
cephalosporins activity
GN increases w/generations(except 5); most have som GP ; no good against enterococci; only 1 good against MRSA. not much anaerobe activity
56
Colistin(polymyxin E). administration
IV
57
ceftaroline activity
MRSA activity; broad GP activity. no enterococci; only some gram-neg activity. no pseudomonas�similar activity to that of gen3
58
cefoxitin. administration
IV
59
adverse effects of rifampin
orange secretions, hepatitis, GI and heme issues
60
Carbapenems resistance?
any weird acquired metallo-beta-lactamases. KPCs can still be resistant to carbapenems
61
Polymyxin B. Colistin clinical use
Serious resistant GN infections; inhaled resistant GN pneumonia
62
piperacillin-tazobactam. activity
adds S.aureus (not MRSA). B-lactamase producing GN and anaerobes; AND PSEUDOMONAS
63
Daptomycin. clinical use
complex GP infections(soft tissue; bacteremia/endocardidits)
64
ampicillin. administration
IV
65
Vancomycin. adverse effects
Red Man Syndrome; dose-related ototoxicity; nephrotoxicity(avoid co-administration with other agents)
68
cefazolin, cephalexin(1st gen) clinical use
surgical prophylaxis. soft skin/tissue infections(resistance limiting)
69
Polymyxin B. administration
IV
70
name the B-lactamase drug combos
ampicillin-sulbactam amoxicillin-clavanic acid piperacillin-tazobactam
71
Dicloxacillin. administration
PO
73
Fosfomycin. administration
PO/Powder
74
ceftriaxone, ceftazidime activity
excellent GN activity 3rd gen
75
Penicillin G. resistance?
B-lacatamases hydrolyze b-lactam ring; PBPs can be modified on transpeptidase; decreased perm.; efflux pumps
76
rifampin clinical use
prophylaxis for n. meningitidis, s. aureus mycobacterial infections
77
ceftriaxone. administration
IV
77
unique PK/PD of rifampin
p450 inducer; can decrease concentrations of other drugs in body
79
carbapenem activity
VERY BROAD SPECTRUM; GN w/pseudomonas; GP;Anaerobes ertapenem = no pseudo/acinetobacter spp.
80
name the aminoglycosides and their mechanism and activity
gentamicin amikacin tobramycin streptomycin binds 30S ribosome; stops protein synthesis only GN(w/pseudo) activity; cant' penetrate GP wall w/out synergy
81
Fosfomycin resistance?
can develop rapidly on the transporter that brings the drug into the bacteria
82
Daptomycin cannot be used where?
inhibited by pulmonary surfactant. DON�T USE FOR PNEUMONIA; bactericidal
83
Carbapenems. clinical use
empiric treatment for serious infections and resistant infections
84
Penicillin V. administration
PO
85
ampicillin. amoxicilin clinical use
community acquired HEENT/upper resp infectsion; community acquired UTI
86
adverse effects of **fluoroquinolones**
**Common** - HANV(HA,nausea, vomiting) ab pain, dizzy **less common** - long QT, tendon rupture, cartilage problems in kids, pregos can cause c.diff

Bacteriology -NM (12 decks)

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