Antibiotic discussion

Question 1

What is consistent of all penicillins structures?

Answer 1

1. Thiazolidine ring
   Beta-lactam ring
   Variable side chain

Question 2

What produces penicillin?

Answer 2

Microbial byproduct of fungus

Question 3

How are penicillins secreted?

Answer 3

Renal clearance

- Nafcillin and Oxacillin are excreted through the bile

Question 4

What are some side effects of penicillins?

Answer 4

1. Rash
2. Type 1 HSR
3. Pseudomembrane colitis (C. difficle)

Question 5

What penicillins usually cause C. Difficle?

Answer 5

Amox

Ampicillin

Question 6

What does penicillin cover?

Answer 6

1. Gram + organisms
2. N. meningiditis
3. Spirochetes

Question 7

What are the antipseudomonal penicillins and what do they cover?

Answer 7

Piperacillin and Ticarcillin

- covers pseudomonas as well as other gram - rods

Question 8

What do amox and amp cover?

Answer 8

HHELPSS
H influenzae
H pylori
E coli
Listeria monocytogenes
Proteus mirabilis
Salmonella
Shingella

Question 9

Pros and cons of Cephalosporins?

Answer 9

• Less susceptible to penicillinases
• Fever allergic rxns
• however need IV admid because not absorbed well in gut

Question 10

How are cephalosporins secreted?

Answer 10

Renal clearance

- Ceftiraxone is NOT–> bile rather

Question 11

Why are cephasporins LAME?

Answer 11

Dont cover:

• Listeria
• Atypicals like myocoplasma and chlamydia
• MRSA
• Enterococci

Question 12

What are the 1st gen cephalopsporins?

Answer 12

Cefazolin

Cephalexin

Question 13

What are the 2nd gen cephalopsporins?

Answer 13

FAke FOX FUR
Cefaclor
Cefoxitin
Cefuoxime

Question 14

What are the 3rd gen cephalopsporins?

Answer 14

Ceftriaxone
Cefotaxime
Ceftazidime

Question 15

What are the 4th gen cephalopsporins?

Answer 15

Cefepime

Question 16

What are the 5th gen cephalopsporins?

Answer 16

Cefaroline

Question 17

When would one use a direct coombs test?

Answer 17

Rh+ infant of a Rh- mother

- also checks for immune medial hemolytic anemia

Question 18

When would one use a indirect Coomb’s test?

Answer 18

To check an Rh - mother after first child who was RH+ to make sure she didn’t develop ab’s against Rh

Question 19

What is coombs reagent?

Answer 19

An antibody that binds to auto antibodies

Question 20

What are the carbapenems?

Answer 20

Imipenem
Meropenem
Ertapenum
Doripenem

Question 21

What must be administered with imipenem and why?

Answer 21

Cislastin because it inhibits dehydropeptidase 1 which inactivates drug in renal tubles

Question 22

What are some common AE with carbapenems?

Answer 22

Gi distress
Skin rash
CNS toxicity–> seizures
Eosinophilia

Question 23

What type of HSR is autoimmune hemolytic anemia?

Answer 23

Type 2

Question 24

What is vanco most often used for?

Answer 24

MRSA

Gram positive bacteria

Question 25

What are the AE of vanco?

Answer 25

NOT Nephrotoxic Ototoxic Thrombophlebitis

Question 26

What is red man syndrome?

Answer 26

``` Diffuse flushing that is NOT a true allergy - most often infusion rate dependent - puritis - HoTN Flushing of face and chest ```

Question 27

What are the drugs that cover MRSA?

Answer 27

``` Vanco Ceftaroline Linezolid Daptomycin Tigercycline ```

Question 28

What are the drugs that cover VRE?

Answer 28

Linezolid | Dalfopristin/quinupristin

Question 29

What is linezolid used for? cidal or static?

Answer 29

MRSA VRE Gram + - variable

Question 30

What are the AE of linezolid?

Answer 30

- Bone marrow suppression (thrombo and anemia) - Peripheral neuropathy - Serotonin syndrome - GI distress - HA

Question 31

What are the tetracyclines? Cidal or static?

Answer 31

Doxycycline Minocycline Tetracycline Tigecycline - static

Question 32

what is the MOA linezolid?

Answer 32

prevents formation of initiation complex by binding 50s subunit

Question 33

What is the MOA of tetracyclines?

Answer 33

Binds 30s subunit to prevent attachment of aminoacyl-tRNA

Question 34

What are tetracyclines used for?

Answer 34

Acne Borrelia burgodorferi M pneumoniae - accumulate intracellularly and thus fight against obligate intracellular organisms like rickettsia and chlamydia

Question 35

What is contraindicated to ingest while on tetracyclines ?

Answer 35

Milk, Antacids | - divalent cations inhibits drugs absorption

Question 36

What are some side effects of tetracyclines?

Answer 36

GI distress Discoloration of teeth and inhibits bone growth in children - photosensitivity - Class D drug

Question 37

What ist he mechanisms of resistance of tetracyclines?

Answer 37

Decreased uptake of increase efflux

Question 38

What are the macrolides ? cidal or static?

Answer 38

Azithromycin Erythromycin Clarithromycin - Static

Question 39

What is the MOA of macrolides?

Answer 39

Bind to 23s rRNA of 50s subunit and thus blocks translocation

Question 40

What are macrolides used for?

Answer 40

``` Mycoplasma Chlamydia Legionella Gram + cocci Bordetella pertussis ```

Question 41

WHat are some side effects of macrolides?

Answer 41

``` MACRO Gi Motility issues Arrhythmias Cholestatis hepatitis Rash Eosinophila ``` P450 metabolizer

Question 42

What is the mechanisms of resistance of macrolidse?

Answer 42

Via methylation of 23s rRNA binding site

Question 43

What are the quinolones? Static or cidal?

Answer 43

``` Ciprofloxacin Enoxacin Gemifloxacin Levofloxacin Moxifloxacin Nalidixic acid Norfloxacin Ofloxacin ``` - cidal

Question 44

What is the MOA of quinolones?

Answer 44

inhibit Topo 2 (DNA gyrase) | - inhibit Topo 4

Question 45

What must not be taken with quinolones?

Answer 45

antacids -Chelate cations so don’t take with calcium, iron, aluminum, and zinc - avoid dairy products or calcium-fortified juice Adjust for renal dysfunction

Question 46

What are some side effects of quinolones?

Answer 46

``` GI Rash HA Confusion Cartilage damage Tendon rupture or tendonitis ```

Question 47

What gets tendon rupture of tendonitis from quinolones?

Answer 47

>60 and also taking prednisone

Question 48

Why are quinolones contraindicated in mothers and children under 18?

Answer 48

Damage to cartilage

Question 49

What are quinolones used for?

Answer 49

Gram - rods | Gram +