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Antibacterials Flashcards

1
Q

What organisms are resistant to beta-lactams?

A
  1. Mycoplasma Pneumoniae
    • No cell wall
  2. Chlamydia
    • Intracellular
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2
Q

What is the MOA of beta-lactams?

A

(-) transpeptidases

(-) cross-linking of cell wall

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3
Q

What characterizes broad spectrum beta-lactamases?

A

hydrophilic

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4
Q

What are the first gen penicillins?

A
  1. Penicillin G
  2. Penicillin V
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5
Q

What types of organisms do first gen penicillins treat?

A
  • G+: Strep
    • (Do NOT treat staph)
  • Anaerobes
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6
Q

Penicillin G

  • IND
  • SE
A
  • First gen penicillin
  • IND
    • G+: Strep
    • Anaerobes
  • SE
    • CNS tox
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7
Q

Penicillin V

  • IND
  • SE
A
  • First gen penicillin
  • IND
    • G+: Strep
    • Anaerobes
  • SE
    • Decreased estrogen
    • Decreased effect of OCs
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8
Q

What are the Antistaphylococcal penicillin drugs?

A
  • Dicloxacillin
  • Nafcillin
  • Oxacillin
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9
Q

What types of organisms do Antistaphylococcal penicillins treat?

A
  • G+
    • MSSA
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10
Q

Dicloxacillin

  • Class
  • IND
A
  • Antistaphylococcal penicillin
  • IND
    • G+
      • MSSA
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11
Q

Nafcillin

  • IND
  • SE
A
  • Antistaphylococcal penicillin
  • IND
    • G+
      • MSSA
  • SE
    • Phlebitis
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12
Q

Oxacillin

  • Class
  • IND
A
  • Antistaphylococcal penicillins
  • IND
    • G+
      • MSSA
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13
Q

What are the Amino Penicillin drugs?

A
  • Amoxicillin
  • Ampicillin

Amino penicillins start with an “A”

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14
Q

What types of organisms do Amino Penicillins treat?

A
  • G+
  • G-

Not resistant to beta-lactamases

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15
Q

Amoxicillin

  • IND
  • SE
A
  • Amino Penicillin
  • IND
    • DOC: Otitis media
    • G+
    • G-
  • SE:
    • Decrease estrogens
    • decrease effectiveness of OCs
    • Colitis
      • leads to infx by C. dif
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16
Q

Ampicillin

  • IND
  • SE
A
  • Amino Penicillin
  • IND
    • G+
    • G-
  • SE:
    • Decrease estrogens
    • Decrease effectiveness of OCs
    • Colitis
      • leads to infx by C. dif
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17
Q

Ticarcillin

  • IND
  • SE
A
  • Carboxypenicillins
  • IND
    • G+
    • G-
    • New: Enterobacter
    • Pseudomonas
  • SE:
    • (-) platelet aggregation
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18
Q

Piperacillin

  • IND
  • SE
A
  • Ureido penicillin
  • IND
    • G+
    • G-
    • Pseudomonas (FA)
    • New: Enterococci, Klebsiella
  • SE
    • (-) platelet aggregation
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19
Q

What drug is combined with amoxicillin to counter resistance to beta-lactams?

A

Clavulanic acid

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20
Q

What drug is combined with Ampicillin to counter resistance to beta-lactams?

A

Sulbactam

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21
Q

What are the beta-lactamase inhibitors added to penicillins to counter resistance?

A

“CAST”

  • Clavulanic Acid
    • w/ Amoxicillin or Ticarcillin
  • Sulbactam
    • Ampicillin
  • Tazobactam
    • Piperacillin
      • Piper drinks Tazo tea
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22
Q

Which Penicillins are used for Pseudomonas?

A

Ticarcillin

Piperacillin

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23
Q

What types of organisms to Carbapenems treat?

A
  • G+
  • G-
  • Anaerobes
  • Used for complicated infx of
    • Abdomen
    • UTI
    • Skin
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24
Q

What must be given with Imipenem to decrease inactivation in renal tubules?

A

Cilastin

“the kill is lastin’ with cilastin”

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25
When are carbapenems contraindicated?
Patients w/ anaphylaxis to beta-lactams
26
What are the specific clinical uses of Imipenem?
* Endocarditis * Sepsis
27
What is the specific clinical use of Meropenem?
Meningitis
28
What type of organisms do Monobactams (Aztreonam) treat?
* G- aerobes _only_ * _​_Pseudomonas!
29
Aztreonam * Class * IND
* Monobactam * MOA * (-) crosslinking of cell wall by transpeptidases * IND * G- aerobes only * Pseudomonas * Use in Penicillin allergies
30
What is the MOA of Cephalosporins?
* Beta-lactam drugs * inhibit cell wall synthesis * (-) cross linking
31
What types of organisms do 1st Gen cephalosporins treat?
* **G+** * Strep * Some G- * E. coli * Klebsiella * Anaerobes * except Bacteroides fragilis
32
What are the 1st Gen cephalosporin drugs?
* Cefazolin * Cephalexin
33
What are the 2nd Gen Cephalosporin drugs?
* Cefuroxime * Special: Cefotetan (cephamycin group)
34
Cefuroxime * Class * IND
* 2nd Gen Cephalosporin * IND * **G-**: * H. influenza * N. meningitidis * Enterobacteriaceae * Some G+ * Strep
35
Cefotetan * Class * IND * SE
* 2nd Gen Special Cephalosporin (cephamycin) * IND * G- anaerobes * Bacteroides * SE * disulfiram rxn w/ alcohol * bleeding disorder * give w/ Vit K
36
What are the 3rd Gen Cephalosporin drugs?
* Cefdinir * Cefpodoxime * Ceftazidime * Ceftriaxone
37
What type of organisms do 3rd Gen Cephalosporins treat?
* G-
38
Ceftazidime * Class * IND
* 3rd gen Cefalosporin * IND * G- * Pseudomonas
39
Ceftriaxone * Class * IND * SE
* 3rd Gen Cephalosporin * IND * G- * Neisseria gonorrhea * SE * Biliary sludging
40
Cefepime * Class * IND
* 4th Gen Cephalosporin * IND * G+ * Pseudomonas * Meningitis * can cross BBB
41
Ceftaroline * Class * IND
* 5th Gen Cephalosporin * IND * G+ * G- * **MRSA** Ceftaroline =\> Caroline =\> **_M_**adoline =\> **_M_**RSA
42
Bacitracin * MOA * IND
* MOA * (-) lipid bactoprenol pyrophosphate * can't carry murein * (-) murein monomer synthesis * only one w/ lipid target * IND * C. difficile * Enterococci
43
Vancomycin * MOA * IND * SE
* MOA * (-) transglycosidase * Blocks addition of murein units to polymer chain * (-) cell wall synthesis * IND * G+ rods and cocci * **MRSA** * MRSE * C. diff * SE: * Ototoxicity
44
What type of organisms do Quinolones treat? What is the MOA associated with each type?
* G+ * Target Topoisomerase IV * cause unlinking of daughter chromosomes (decantanation) * G- * Target Topoisomerase II * (-) supercoiling * (-) DNA replication
45
What are the SEs of the Quinolones?
* Long QT * Tendon rupture (tendonitis) * Black Box warning * Quino**lones** hurt attachments to your **bones**
46
Ciprofloxacin * Class * IND * SE
* Quinolone * IND * **Bacillus anthracis** * Atypicals: * Legionella pneumoniae * Mycoplasma pneumoniae * UTI * SE (same as group) * Long QT * Tendon rupture
47
Levofloxacin * Class * IND * SE
* Quinolone * IND * UTI * RTI * SE (Same as group) * Long QT * Tendon rupture
48
Moxifloxacin * Class * IND * SE
* Quinilone * IND * RTI * SE (same as group) * Long QT * Tendon rupture
49
Sulfamethoxazole * Class * MOA * IND * SE
* Sulfonamide * MOA * (-) dihydropteroate * (-) folate synthesis * (-) nucleotide and protein synthesis * IND * UTIs * SE * **Kernicterus in infants** * Stevens Johnson Syndrome * Hemolytic anemia
50
Trimethoprim * MOA * IND
* MOA * (-) DHFR * (-) folate synthesis * (-) nucleotide and protein synthesis * Bacteriostatic * IND * UTI
51
TMP-SMX * MOA * IND * SE
* Sulfamethoxazole + Trimethoprim * MOA * combination folate inhibitor * IND * UTI * ​SE * Stevens Johnson Syndrome * Hemolytic anemia
52
What are the aminoglycoside drugs?
* Amikacin * Gentamicin * Tobramycin
53
What organisms do aminoglycosides treat?
* Aerobic only! * Need O2 to pass thru porins * G-: Serious infxn * Pseudomonas * Klebsiella
54
What is the MOA of aminoglycosides?
* Inhibit formation of initiation complex, causing misreading of mRNA * binds 16S rRNA * Targets 30s ribosomal subunit
55
What side effects are associated with aminoglycosides?
* \*\*\*Ototoxicity * Vestibular * Hearing * Neuromuscular blockade * pts w/ myesthenia gravis
56
Amikacin * Class * MOA * IND * SE
* Aminoglycoside * MOA * targets 30s ribosomal subunit * Inhibits formation of initiation complex * IND * aerobes * G-: serious infxn * Pseudomonas * Klebsiella * SE * Ototoxicity
57
Gentamicin * Class * MOA * IND * SE
* Aminoglycoside * MOA * targets 30S ribosomal subunit * Inhibits formation of initiation complex * IND * Aerobes only * G-: serious infxn * SE * Ototoxicity
58
Tobramycin * Class * MOA * IND * SE
* Aminoglycoside * MOA * Targets 30s ribosomal subunit * Inhibits formation of initiation complex * IND * aerobes only * G-: serious infxns * Pseudomonas * Klebsiella * SE * Ototoxicity
59
Spectinomycin * Class * MOA * IND
* Aminocylitol * MOA * Targets 30s ribosomal subunit * Bacteriostatic * IND * **N. gonorrhea**
60
What are the tetracycline drugs?
* Doxycycline * Tetracycline
61
What is the MOA of Tetracyclines?
Target 30S ribosomal subunit Prevents attachment of aminoacyl-tRNA to acceptor site
62
What organisms do tetracyclines treat?
* DOC: **tick-borne diseases** * Rickettsia * Lyme disease * G+ * G-
63
What are the side effects of Tetracyclines?
* **Teeth become discolored** * (-) bone growth * Superinfection w/ **C. diff** (colitis) * alteration in normal flora
64
What side effect is specific to doxycycline and not tetracycline?
Photosensitivity
65
Tigecycline * Class * MOA * IND
* Glycylcycline * MOA * targets 30S ribosomal subunit * Bacteriostatic * IND * **MRSA** * G+ * G- * Anaerobes
66
What are the macrolide drugs?
* Azithromycin * Clarithromycin * Erythromycin the "-thromycin"s
67
What organisms do the macrolides treat?
* G+ * Strep * G- * **Treponema pallidum** * Mycoplasma * Borrelia
68
What is the MOA of Macrolides?
Target 50S ribosomal subunit Block aminoacyl tRNA complex translocation step
69
Azithromycin * Class * MOA * IND
* Macrolide * MOA * Target 50S ribosomal subunit * Blocks aminoacyl tRNA complex translocation step * IND * Bronchitis * (list of bacteria)
70
Clarithromycin * Class * MOA * IND * SE
* Macrolide * MOA * targets 50S ribosomal subunit * Blocks aminoacyl tRNA complex translocation step * IND * Bronchitis * Mycobacterium avium * SE: * (-) P450 Clarithromycin =\> clear air -thromycin =\> clear air for the birds to fly =\> mycobacterium avium
71
Erythromycin * Class * MOA * IND * SE
* Macrolide * MOA * targets 50S ribosomal subunit * Blocks aminoacyl tRNA to acceptor site * IND * Otitis media * SE * Arrythmia
72
Telithromycin * Class * MOA * IND * SE
* Ketolide * MOA * Targets 50S ribosomal subunit * IND * Pneumonia * SE: * **Visual toxicity**
73
Chloramphenicol * Class * MOA * IND * SE
* Amphenicol * MOA * Targets 50S ribosomal subunit * IND: treats all types * Brain abcess * Meningitis * Rickettsia * Chlamydia * SE: * **Gray Baby Syndrome** * Optic neuritis * Myelosuppression
74
Clindamycin * Class * MOA * IND * SE
* Streptogramin * MOA * Targets the 50S ribosomal subunit * Blocks initiation complex formation and aminoacyl tRNA complex translocation step * IND * All types * C. diff is resistant * SE: * C diff invxn * **pseudomembranous colitis**
75
Dalfoprisitin / Quinupristin * Class * MOA * IND * CON
* Streptogramins * MOA * Target 50S ribosomal RNA * IND * some G+ * -cidal * Strep faecium * -static * CON * pt w/ liver failure
76
Linezolid * Class * MOA * IND * SE
* Oxazolinidone * MOA * Targets 50S ribosomal subunit * IND * Resitant, G+ bacteria * MRSA * VRE * VRSA * Enterococci and Staph * -static * Strep * -cidal * SE: * Myelosuppression * Neurotoxicity
77
Daptomycin * MOA * IND * SE
* MOA * inserts in membrane * disrupts potential * (-) DNA / RNA / peptide synthesis * IND * multi-drug resistant G+ * **R-side endocarditis** * NOT pneumonia * SE * **Rhabdomyolitis**
78
Nitrofurantoin * MOA * IND * SE
* MOA * Produces ROS * IND * uncomplicated UTIs * SE * **Pulmonary fibrosis** * **Peripheral neuropathy** * Hep tox
79
Metronidazole * MOA * IND * SE
* MOA * Produces ROS * IND * anaerobes: * Bacteria: * Bacteroides * Clostridium * Protozoa * Entamoeba * Giardia * Trichomonas * SE * **Optic neuropathy** * **Aseptic meningitis** * Disulfiram effects w/ alcohol
80
Muprirocin * MOA * IND
* MOA * **Binds isoleucyl-tRNA synthase** * (-) protein synthesis * IND * G+ resistant bacteria * MRSA
81
Polymixin B and E * MOA * IND * SE
* MOA * long, hydrophobic tail disrupts plasma membrane * IND * G- * Pseudomonas * Acinetobacter * SE * Neuro tox * Nephro tox
82
What drugs are used to treat M. tuberculosis?
TB is "RRIPE" for treatment * **_R_**ifampin * **_R_**ifapentine * **_I_**soniazid * **_P_**yrazinamide * **_E_**thambutol
83
Isoniazid * MOA * IND * SE
* MOA * (-) mycolic acid synthesis * part of cell wall * Use * Active or latent TB * SE * **SLE** * Hepatotox
84
Pyrazinamide * MOA * IND * SE * CON
* MOA * (-) FA synthase * disrupts cell membrane * IND * Active TB * SE * **Porphyria** * Photosensitivity * Hepato tox * CON * Acute gout
85
Rifampin * MOA * IND * SE
* MOA * (-) DNA dependent RNA polymerase * IND * Latent or active TB * Meningitis * SE * **Red tears, sweat, urine**
86
Rifapentine * MOA * IND * SE
* MOA * (-) DNA dependent RNA polymerase * IND * latent TB * SE * **red-brown color to body fluids**
87
Ethambutol * MOA * IND * SE
* MOA * (-) metabolite synthesis * IND * Active TB * SE * **Optic neuritis** * **Blindness**
88
Bedaquiline * MOA * IND * SE
* MOA * (-) mycobacterial ATP synthase * IND * last resort for **MDR-TB** * SE * Black box: **Arrhythmia** * Long QT * Death with no known cause * Hemoptysis
89
Dapsone * MOA * IND
* MOA * (-) folate production * IND * **Leprosy** * Pneumocystis pneumonia

Pharmacology (12 decks)

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