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Pharmacology by THer > Antibiotic Agents > Flashcards

Antibiotic Agents Flashcards

1
Q

Bactericidal Antibiotics

A 
Very Finely Proficient At Cell Murder
Vancomycin
Fluoroquinolones
Penicillins
Aminoglycosides
Cephalosporins
Metronidazole
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2
Q

Bacteriostatic Antibiotics

A 
ECSTaTiC
Erythromycin
Clindamycin
Sulfamethoxazole
Trimetoprim
Tetracycline
Chloramphenicol
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3
Q

What Bacteriostatic antibiotics become bactericidal when combined?

A

TMP - SMX

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4
Q

Define: Lowest concentration capable of inhibiting growth of an organism

A

Minimum Inhibitory Concentration

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5
Q

MOA of Which Class of Drugs?
Binds to PBP
Inhibits Transpeptidation Reation
Activates Autolytic Enzymes

A

Beta Lactams

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6
Q

Mechanisms for Penicillin Resistance

A

Beta-lactamases
Structural changes in target PBPs
Changes in porin structures

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7
Q

Narrow spectrum Penicillin
Drug of Choice for Syphilis
SE: Hypersensitivity, cross-allergenicity with similar drugs, GI disturbances

A

Penicillin G

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8
Q

Renal Tubular Reabsorption of this drug is inhibited by Probenecid

A

Penicillin G

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9
Q

VERY NARROW spectrum Penicillin
DOC for Staphylococcal infections
SE: Hypersensitivity, cross allergenicity with similar drugs, GI disturbances, INTERSTITIAL NEPHRITIS, NEUTROPENIA
Resistant to beta-lactamase

A

Methicillin
(Naf/Oxa/Cloxacillin)

Use Naf for Staph.

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10
Q 
Extended spectrum Penicillin
Drug for Enterococci, Listeria, E. Coli, Proteus, H. Influenzae, MORAXELLA
SE: Pseudomembranous Colitis, Rash
Inactivated by beta-lactamase
Enhanced with beta-lactamase inhibitors
Synergistic effect with aminoglycosides
A

AMPicillin (AMPed up Penicillin)

AmOxicillin) (greater Oral bioavailability

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11
Q

Extended spectrum penicillins are effective for the following organisms

A 
Hemophilus influenza
E. Coli
Listeria
Proteus
Salmonella spp.
Enterococci

Amoxicillin HELPS kill Enterococci

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12
Q

Anti-pseudomonal Penicillin
Drug for Pseudomonas, Enterobacter, Klebsiella
SE: Hypersensitivity, Cross-allergenicity with similar drugs, GI disturbances
Inactivated by beta-lactamase
Enhanced with beta-lactamase inhibitors
Synergistic effect with aminoglycosides vs. Pseudomonas

A

Piperacillin

Ticarcillin, Carbenicillin

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13
Q

Anti-pseudomonal antibiotic with anti-platelet activity

A

Ticarcillin

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14
Q

Drugs for Pseudomonas

A

Takes Care of Pseudomonas
Ticarcillin
Carbenicillin
Piperacillin

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15
Q

First Generation Cephalosporin
Binds to PBP, inhibits transpeptidation
Drug for Surgical Prophylaxis, Bone Infection, E. Coli, Klebsiella, Proteus
SE: Hypersensitivity, partial cross-allergenicity with penicillins
Increases nephrotoxicity of aminoglycosides

A

CeFAZolin

FADer help me FAZ my PHarmacology boards

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16
Q

First Generation Cephalosporins

A 
FADer help me FAZ my PHarmacology boards
CeFADroxil
CeFAZolin
CePHalothin
CePHradine
CePHalexine
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17
Q

Second Generation Cephalosporin
Can cross BBB
Drug for Haemophilus, Enterobacter, and Neisseria
SE: Hypersensitivity, Disulfiram reaction with CefaMANdole and CefoTETan
Increases nephrogenicity of aminoglycosides

A

Cefamandole

FOXy FAMily in FUR, drinking TEa
CeFOXitin, CeFAMandole, CeFURoxime, CefoTEtan
FAC! LORA the PROfessional AZhOLE is on the FONe.
CeFAClor, LORAcarbef, CefPROzil, CefmetaZOLE, CeFONicid

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18
Q

Second Generation Cephalosporins

A

FOXy FAMily in FUR, drinking TEa
CeFOXitin, CeFAMandole, CeFURoxime, CefoTEtan
FAC! LORA the PROfessional AZhOLE is on the FONe.
CeFAClor, LORAcarbef, CefPROzil, CefmetaZOLE, CeFONicid

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19
Q

Third Generation Cephalosporin
Drugs for Pseudomonas and Bacteroides
SE: Hypersensitivity, Disulfiram reaction with Cefoperazone
Synergistic with AMINOGLYCOSIDES

A 
FEnge Po ng PERA to FIX my TTTTTv
CeFEtamet
CefPOdoxin
CefoPERAzone
CeFIXime
CefTriaxone
CefTazidime
CefoTaxime
CefTizoxime
CefTibuten
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20
Q

Third Generation Cephalosporin

A 
FEnge Po ng PERA to FIX my TTTTTv
CeFEtamet
CefPOdoxin
CefoPERAzone
CeFIXime
CefTriaxone
CefTazidime
CefoTaxime
CefTizoxime
CefTibuten
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21
Q

Wide coverage against gram positive and gram negative bacteria
SE: Hypersensitivity
Resistant to Beta-lactamase

A

CefePime

Porth (4th)

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22
Q

Anti-Pseudomonal Cephalosporins

A

CefTAZidime 3rd
CeFEPime 4th
CefoPERAzone 3rd

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23
Q

Carbapenem
Wide coverage against gram positive and gram negative bacteria
SE: Hypersensitivity, CNS Toxicity (Confusion, Enceph, Seizures)
Reserved for serious life threatening conditions

A

Imipenem-Cilastatin

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24
Q

This drug inhibits renal metabolism of Imipenem

A

Cilastatin

With Imipenem, Kill is LASTIN with CiLAStaTIN

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25
Q 
Monobactam
Drug for Gram (-) Rods, NO GRAM +/Anaerobe COVERAGE
SE: superinfection
Resistant to Beta-lactamase
No cross allergenicity with penicillins
A

Aztreonam

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26
Q

Beta-lactamase inhibitor
Inhibits inactivation of penicillins by bacterial penicillinase
SE: Hypersensitivity
Usually combined with Amoxicillin, Ampicillin, and Piperacillin

A

Clavulanic Acid

Sulbactam, Tazobactam

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27
Q

Glycopeptide
Inhibits D-Ala D-Ala terminus of nascent peptidoglycan
Drug for MRSA, Pseudomembranous colitis
SE: Redman Syndrome, Nephrotoxicity, Ototoxicity
Reserved for serious life threatening infections

A

Vancomycin

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28
Q

First line drug for Pseudomembranous Colitis

A

Metronidazole

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29
Q

Tx for Redman syndrome

A

Slow down infusion rate

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30
Q

Drugs of Last Resort

A 
I AM your Last Shot at Victory
Imipenem
Amikacin
Meropenem
Linezolid
Streptogrammins
Vancomycin
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31
Q

Peptide Antibiotic
Interferes with late-stage cel wall synthesis in Gram + bacteria
SE: Nephrotoxicity
Reserved for Topical Use only due to marked nephrotoxicity

A

Bacitracin

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32
Q

Antimetabolite
Blocks incorporation of D-Ala
2nd line drug for Drug-Resistant TB
SE: Neurotoxicity

A

Cycloserine

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33
Q

30s Inhibitors

A

Aminoglycosides
Tetracyclines

Buy AT 30

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34
Q

50s Inhibitors

A 
Chloramphenicol
Erythromycin (Macrolides)
Lincosamides (Clindamycin)
Linezolid
Streptogrammins

CELLS at 50

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35
Q

Bactericidal Protein Synthesis Inhibitors

A

Aminoglycosides

Streptogrammins

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36
Q 
Broad Spectrum Antibiotic
Bacteriostatic
Inhibits 50s
Drug for Meningitis (esp Neisseria), Backup for Salmonella Rickettsia, Bacteroides 
SE: Aplastic Anemia, Gray Baby Syndrome
A

Chloramphenicol

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37
Q

Decreased RBC, Cyanosis and Cardiovascular Collapse
Ashen Gray Skin
Premature neonates with deficient glucuronosyltransferase

A

Gray Baby Syndrome

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38
Q

Binds to 30s subunit, Bacteriostatic
Drug for M. Pneumoniae, Chlamydia, Rickettsiae, Vibrio, PUD, SIADH
SE: Tooth enamel dysplasia/dyscoloration, Photosensitivity
Tigecycline has broadest spectrum

A

Tetracycline
(Doxycycline, Minocycline, Tigecycline, Demeclocyline)

LAHAT NG MAY -CYCLINE

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39
Q

Tetracycline with broadest spectrum

A

Tigecycline

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40
Q

Antibiotic that should NOT be take with Milk

A

Tetracyclines

Decreased absorption

41
Q

Tetracycline for Acne

A

Doxycycline

42
Q

Drug of Choice for Cholera

Class?

A

Tetracycline

43
Q

Macrolide
Binds 50s, bacteriostatic
Prokinetic agent, stimulates GI motility
SE: Cholestatic hepatitis, QT prolongation, Drug interactions

A

Erythromycin
(Azithromycin, Clarithromycin, Telithromycin)

LAHAT NG MY -THROMYCIN

44
Q

All Macrolides inhibit CYP450 EXCEPT

A

Azithromycin

45
Q

Macrolide with highest Vd and slowest elimination

A

Azithromycin

46
Q

Macrolide used for macrolide resistance

A

Telithromycin

47
Q

Lincosamide
Binds 50s subunit, bacteriostatic
Drug for Anaerobic infections, PCP Pneumonia
SE: Pseudomembranous colitis (C. difficile overgrowth)
Cross resistance between macrolides is common

A

Clindamycin

Lincomycin

48
Q

DOC for Anaerobic infections ABOVE the diaphragm

A

Clindamycin

49
Q

DOC for Anaerobic infections BELOW the diaphragm

A

Metronidazole

50
Q 
Streptogramin
Binds 50s subunit, bactericidal
Drug for MRSA, VRSA, VRE
SE: Arthralgia-myalgia syndrome
Inhibits CYP450 enzymes, causing multiple drug interactions
A

Quinupristin-Dalfopristin

51
Q

Oxazolidinone
Binds 50s subunit, bacteriostatic
Drug for MRSA, VRSA, VRE, Listeria, Corynebacteria

A

Linezolid

52
Q

Identify Mode of Antibacterial Action:

As the plasma level is above the MIC, an increasing proportion of the bacteria are killed at a more rapid rate

A

Concentration-Dependent Killing Action

Seen in Aminoglycosides

53
Q

Identify Mode of Antibacterial Action:

Efficacy is directly related to time above the MIC

A

Time-Dependent Killing Action

54
Q

Greater efficacy when administered as a single large dose
Toxicity depends on a critical plasma concentration

Seen in which drug?

A

Postantibiotic effect

Seen in aminoglycosides and fluoroquinolones

55
Q

Identify class of Antibiotics:
Not absorbed after oral
Limited Tissue Penetration
Glomerular Filtration is mode of excretion

A

Aminoglycosides

56
Q

Aminoglycoside with narrowest therapeutic window

A

Amikacin

57
Q

Antibiotics with this MOA are synergistic with Aminoglycosides

A

Cell Wall Inhibitors

58
Q

Class of Antibiotics that require oxygen for reuptake

Binds to 30s

A

Aminoglycosides

Ineffective against anaerobes

59
Q

Drugs with Postantibiotic Effect

A

Amikacin
Levofloxacin
Aminoglycosides
Fluoroquinolones

60
Q

Resistance to this drug arises from
Group Transferases
Changes to ribosomal binding site

A

Aminoglycosides

61
Q

Aminoglycosides

A 
mean GNATS canNOT kill anaerobes
Gentamicin: Nephrotoxicity
Neomycin: Ototoxicity
Amikacin: Teratogen
Tobramycin
Streptomycin
62
Q

Aminoglycoside that binds to 30s subunit, bactericidal
Drug for aerobic gram - bacteria, endocarditis, ocular infections
SE: Nephrotoxicity, Ototoxicity

A

Gentamicin

Tobramycin

63
Q

Most vestibulotoxic and nephrotoxic aminoglycosides

A

Gentamicin

Tobramycin

64
Q

Aminoglycoside
Binds to 30s, bactericidal
Drug for Pseudomonas, Drug Resistant TB (2nd line)
SE: Nephrotoxicity, Ototoxicity

A

Amikacin

65
Q

Aminoglycoside with the least resistance and narrowest therapeutic window

A

Amikacin

66
Q

Aminoglycoside
Binds to 30s, bactericidal
Drug for TB, Tularemia, Bubonic Plague, Brucellosis
SE: Nephrotoxic (reversible), Ototoxic (vestibulotoxic, Irreversible) Teratogen (Congenital Deafness)
Administered IM

A

Streptomycin

67
Q 
Aminoglycoside
Binds to 30s, bactericidal
Drug for bowel preparation for elective surgery, hepatic encephalopathy, Visceral Leishmaniasis
SE: Neuromuscular blockade
Limited to topical and oral use
A

Neomycin

Kanamycin, Paromomycin

68
Q

Neuromuscular blockade from Neomycin may be reversed with _____________ and _________

A

Calcium Gluconate

Neostigmine

69
Q

Most Ototoxic Aminoglycosides

A

Kanamycin

Amikacin

70
Q

Aminoglycoside
Binds to 30s, bactericidal
Drug for gonorrhea in penicillin-allergic and drugresistant pxs
SE: Nephrotoxicity (reversible), Ototoxicity (irreversible), anemia

A

Spectinomycin

71
Q

Most Nephrotoxic Aminoglycosides

A

Tobramycin

Gentamicin

72
Q

Skin reactions are most common in which Aminoglycosides

A

Neomycin

Streptomycin

73
Q

Short acting Sulfonamide

A

Sulfisoxazole

74
Q

Intermediate acting Sulfonamide

A

Sulfamethoxazole

75
Q

Long acting Sulfonamide

A

Sulfadioxine

76
Q

Weakly acidic
Resembles PABA
Decreased solubility in Acidic Urine

Class?

A

Sulfonamides

77
Q

Similar to Folic acid
Weak base
High concentrations in prostatic and vaginal fluids

Class?

A

Trimethoprim

78
Q

Identify Drug Class:

MOA: competitive inhibitor of dihydropteroate synthesis

A

Sulfonamides

79
Q

Identify Drug:

MOA: selective inhibitor of dihydrofolate reductase

A

Trimethoprim

80
Q

Building block of DNA

A

Purines

81
Q

Resistance to Antifolate drugs

A

decreased drugs
increased substrate
increased tolerance

82
Q

Sulfonamide
Bacteriostatic
Drug for Burns
SE: Acute hemolysis in G6PD deficiency, hypersensitivity, kernicterus
Displaces protein binding of other drugs/bilirubin

A

Silver Sulfadiazine

83
Q

Sequential blockade of dihydropteroate synthase and dihydrofolate reductase, bactericidal
Drug for urinary tract, P. Jirovecci pneumonia
SE: Acute hemolysis in G6PD deficiency, hypersensitivity, kernicterus
Displaces protein binding of other drugs/bilirubin

A

Co-Trimoxazole

84
Q

Toxicity of Sulfonamides

A 
Hypersensitivity
GI Distress
Hematotoxicity
Nephrotoxicity
Drug Interactions
85
Q

Increased levels of unconjugated bilirubin
Due to immature BBB
Bilirubin deposits in basal ganglia and subcortical nuclei
Leading to hypo/hypertonia, lethargy, high-pitched cry, opisthotonos

Identify Disease

A

Kernicterus

86
Q

MOA of which class of antibiotics:
Inhibits Topoisomerase II (DNA Gyrase) in Gram (-) organisms, Topoisomerase IV in Gram (+) organism
Usually bactericidal
Exhibits postantibiotic effect

A

Fluoroquinolones

87
Q 
Resistance of which class of antibiotics
Efflux pumps
changes in porin structure
changes in the sensitivity
A

Fluoroquinolones

88
Q

Fluroroquinolones

A

Nalidixic Acid
Ciprofloxacin, Ofloxacin, Norfloxacin
Levofloxacin
Moxifloxacin, Gatifloxacin

89
Q

Trend of Fluoroquinolone coverage

_________ generation, ________ Gram + activity

A

Increasing generation, increasing gram positive activity

90
Q

Inhibits DNA gyrase and Topisomerase IV, bactericidal
Drug for UTI, Atypical Pneumonia, 2nd line for TB
SE: GI distress, Tendinitis and tendon rupture
Avoid use in children and pregnant
Enhances toxicity of methylxanthines (Theophylline)

A

Ciprofloxacin
(Ofloxacin, Norfloxacin)

FLUOROquinoBONES!

91
Q

3rd Generation
Inhibits DNA gyrase and topoisomerase IV, bactericidal
Drug for atypical pneumonia and lung infections
SE: GI distress, tendinitis, QTc prolongation (predispose to torsades)
Avoid use in children and pregnant
Enhances toxicity of methylxanthines (Theophylline)

A

Levofloxacin

Sparfloxacin, Grepafloxacin

92
Q

Aminoglycoside that was withdrawn due to severe cardiotoxicity (arrhythmia)

A

Grepafloxacin

93
Q

4th Generation
Inhibits DNA gyrase, Topoisomerase IV, Bactericidal
Drug with broad spectrum activity and enhanced activity versus ANAEROBES
SE: GI distress, tendinitis, QTc prolongation, diabetes, hepatotoxicity
Avoid use in children and pregnant
Enhances toxicity of methylxanthines (Theophylline)
Widest spectrum of activity

A

Moxifloxacin

94
Q

Disrupts ETC by forming free radicals, Bactericidal
Drug for Anaerobic or mixed intra abdominal infections, Vaginitis, Pseudomembranous colitis
SE: GI Irritation, Metallic taste, Disulfiram Reaction

A

Metronidazole

95
Q

Most common drug that causes Pseudomembranous colitis

A

Clindamycin

96
Q

2nd line drug for Pseudomembranous colitis

A

Vancomycin

97
Q

Dose of Metronidazole for Trichomonas infection

A

2grams

98
Q

Bactericidal
Drug used for UTI (except Proteus and Pseudomonas) only uncomplicated
SE: Skin rashes, Pulmonary infiltrates

A

Nitrofurantoin

99
Q

Pulmonary FIbrosis can be caused by the following drugs

A 
BBBAN Me
Bleomycin
Busulfan
Bromocriptine
Amiodarone
Nitrofurantoin
Methotrexate

Pharmacology by THer (31 decks)

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