Antibiotics 2 Flashcards by G V

New Beta-Lactams: 1. Monobactam - Buzzword, MOA, Use, Resistance (6)

Buzzword: Aztreonam

MOA: Binds to PBP’s 1a and 3 and inhibits transpeptidation

Use: Given IV against G-ve

No cross sensitivity to penicillins

Resistant to Beta-lactamse

Syngergistic to aminoglycosides

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New Beta-Lactams: 2. Carbapenem - Buzzword and MOA

Buzzwords: Imipenem/Cilastatin/Meropenem

MOA:

Imipenem is rapidly metabolized by renal dipeptidase

Cilastatin is a specific inhibitor of dipeptidase

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New Beta-Lactams: 2. Carbapenem - Indications and Resistant to?

Rx of serious infections

Resistant to Beta-lactamase

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New Beta-Lactams: 2. Carbapenem - Given Against and Side Effects

Given IV against G+ve, G-ve, and ANAEROBES

Side effects: Seizure with renal dysfunction (Imipenem)

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Vancomycin: Defined, Against and MOA

Is a bactericidal that is NOT a pencillin or cephalosporin

Against: G+ve ONLY

MOA: Inhibits bacterial cell wall, elongation of peptidoglycan chains

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Vancomycin: Buzzword and What it’s not effective against

Buzzwords: IV effective against MRSA

Oral effective against Clostridium difficile (pseudomembranous colitis)

Not effective against G-ve

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Vancomycin: Adverse Effects (4) and Resistance (2)

Redman/redneck Syndrome
Chills, fever, rash, red face and neck
Why? Histamine release
Ototoxcity
Hypersensitivty
Nephrotoxcity

Resistance: VRSA and VRE

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Macrolides: Buzzwords (3)

Erythromycin
Azithromycin
Clarithromycin

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Macrolides: Drug of choice for? (2)

Community acquired pneumonia

2. Mycoplasma pneumoniae

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Macrolides: Not effective against?

MRSA

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Macrolides: Side Effects (3)

Erythromycin estolate causes cholestatic jaundice

*Binds to motilin receptors –> diarrhea

Reversible ototoxicity

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Macrolides: Erythromycin Use and Side Effects

Good against Staph, Strep, Mycoplasma, and Legionella

Side effects: GI problems (diarrhea and vomiting), High dose (prolonged QT interval)

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Macrolides: Azithromycin

As good as erythromycin

Chlamydial urethritis

Lesser side effects than erythromycin

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Macrolides: Clarithromycin - Use, and Buzzword

As good as erythromycin

H. Influenza and H. Pylor

Buzzword: Good against MAC
Mycobacterium avium complex in AIDS patient
**Inhibits CYP450

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What’s an alternative to pencillin for H. Pylori?

Metronidazole

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New Class Related to Macrolides: Ketolides - Buzzword and Side Effects

Buzzword: Telithromycin (similar to azithromycin)

Side effects:
Prolonged QT interval
Inhibits CYP450

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Anaerobic Infections - Bacteroids: Clindamycin - Use and Buzzword

Use: Oral infections

Buzzword: Risk for Antibiotic-Associated Pseudomembranous Colitis (AAPMC)

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Anaerobic Infections - Bacteroids: Metronidazole - Use and Buzzword

Use: Intraabdominal

Buzzword: RX of AAPMC

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Metronidazole: Bactericidal mechanism is?

Unknown

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Metronidazole: Protozoal Drug of Choice (3)

Giardia Lamblia
Trichomonas vaginalis
Entamoeba histolytica

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Metronidazole: Bacterial Drug of Choice (3)

AAPMC
Bacteroids Fragilis
G. Vaginalis

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Metronidazole: Adverse Effects (3)

Furry tongue, glossitis
Peripheral neuropathy
Disulfiram-like Action

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Disulfiram-like action Drugs (5)

Metronidazole
Cefamandole
Cefoperazone
Cefotetan
Griseofulvin

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Tetracyclines: Drugs (4)

Tetracycline
Doxycycline
Minocycline
Demeclocycline

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Tetracyclines: Good for (6)

1. Chlamydia 2. Rickettsia 3. Mycoplasma 4. Brucella 5. Yersinia 6. Vibrio cholera

Tetracyclines: Used in?

Patients allergic to penicillin

Tetracyclines: What should be avoided with tetracyclines?

Dairy product EXCEPT Doxycycline and Minocycline Because it reduces absorption (chelators)

Tetracyclines: Demeclocycline inhibits and is the rx for?

Inhibits ADH Rx for SIADH

Tetracyclines: Doxycycline penetrates and is used in?

The prostate and used in prostatitis and Lyme disease

Tetracyclines: Adverse Reaction 1

1. Contraindicated in children younger than 8 years old Why? Causes permanent discoloration of teeth

Tetracyclines: Adverse Reaction 2

Use sunscreen and protective clothing when outdoors Why? Phototoxcity

Tetracyclines: Adverse Reaction 3

Outdated tetracycline: Fanconi like Syndrome (Kidneys)

Tetracyclines: Adverse Reaction 4

Hepatotoxicity seen more in pregnant women

Tetracyclines: Adverse Reaction 5

Nephrogenic Diabetes Insipidus (Demeclocycline)

Tetracyclines: Adverse Reaction 6

Vestibular ototoxcity (Minocycline)

Tetracyclines: All tetracyclines, EXCEPT DOXYCYCLINE require?

Dose adjustment in renal impairment

Tetracycline: Tigecycline - Defined (2)

Semisynthetic derivative fo minocycline Increased affinity to the 30S and decreased susceptibility to resistance

Tetracycline: Tigecycline - Buzzword (2)

Rx of skin and soft tissue infection caused by MRSA Rx of intra-abdominal infections caused by G+ve and G-ve organisms

Fluoroquinolones: Drugs (6)

1. Ciprofloxacin 2. Norfloxacin 3. Ofloxacin 4. Enoxacin 5. Sparfloxacin 6. Trovafloxacin

Fluoroquinolones: Buzzword

Analogues of Nalidixic acid

Fluoroquinolones: Drug of choise for?

Anthrax

Second choice for Anthrax?

Penicillins or tetracyclines

Fluoroquinolones: Good against

Gram -ve sepsis (PO) E.g. Cipro for E. Coli and UTIs

Fluoroquinolones: Cipro and Olfo for?

Single dose for gonorrhea

Fluoroquinolones: Spar and Olfo

Spar - resistant pneumococcus Oflo - Chlamydia

Fluoroquinolones: Contraindication (2)

1. Pregnancy | 2. Careful if <18 years old --> inhibits chondrocytes

What's best for gonorrohea?

Single shot of ceftriaxone

Fluoroquinolones: Black Box Warnings for?

Tendinitis risk (as well as for steroid infection)

Aminoglycosides: Use and Drugs (7)

Use: LIFE-THREATENING gram negative 1. Gentamycin 2. Tobramycin 3. Paromomycin 4. Amikacin 5. Neomycn 6. Kanamycin 7. Streptomycin

Aminoglycosides: Buzzword and Type of Transport

Gram -ve infections Active transport by O2 dependant system

Aminoglycosides: Used In Combo 1

1. Endometritis: Triple Antibiotcs Gentamycin + Ampicillin + Metronidazole

Aminoglycosides: Used in Combo 2

2. Enterococcus infection: Synergistic with ampicillin

Aminoglycosides: Used in Combo 3

2. Pseudomonal infection Synergistic with extended spectrum pencillin

Aminoglycosides: Adverse Effect 1 - Ototoxicity (2%)

Auditory: Irreversible (cochlear), high pitch 1st Vestibular: Reversible

Aminoglycosides: Adverse Effect 2 - Nephrotoxicty (7%)

Proteinuria, hypokalemia, and acute tubular necrosis

Aminoglycosides: Adverse Effect 3 - Neuromuscular Blockage

Decrease pre-junctional release of Ach

Aminoglycosides: All aminoglycosides require?

Dose adjustment in renal failure

Aminoglycosides: Drug Interactions 1 - Enhanced Ototoxicity (2)

Furosemide, Ethacrynic Acid

Aminoglycosides: Drug Interactions 2 - Enhanced Neprotoxicty (4)

1. Amphotericin B 2. Vancomycin 3. Cisplatin 4. Cyclosporin

Aminoglycosides: Spectinomycin is, use, and MOA ?

NOT AN AMINOGLYCOSIDE Rx of gonorrhea (After 1st choice of ceftriaxone shot) MOA: Inhibitis protein syntheisis by binding to 30S Doesn't cause misreading of the genetic code

Linezolid: Defined (2)

Synthetic oxazolidinedione Binds to the 23S RNA component of the 50S ribosomal subunit

Linezolid: Buzzword

Good against MRSA and VRE

Linezolid: Adverse Effects (2)

Thrombocytpenia Serotonin Toxicity by weakly inhibiting MAO

Mupiricin: Buzzword and Use

Topically for impetigo caused by streptococci and staphylococci To eradicate nasal carriers of MRSA in health care workers

Sulfonamides: Sulfisoxazole

Rx of UTI and Nocardial infection

Sulfonamides: Sulfasalazine

Rx of Ulcerative Colitis

Sulfonamides: Sulfacetamide

Rx of Trachoma (Topical)

Sulfonamides: Silver sulfadiazine

Rx of burns (Topical)

Sulfonamides: Sulfadiazine and Pyrimethamine

Rx of Toxoplasmosis

Sulfonamides: Trimethoprim/Sulfamethoxazole

Rx of Pneumocystis Jirovecii Pneumonia (PCP)

Sulfonamides: Side Effects (4)

1. Hypersensitivity (erythemia multiforme) ----> rash to Steven Johnson Syndrome (toxic endodermal necrolysis) 2. Hemolysis in GP6D deficiency 3. Photosensitivty 4. Crystalluria

Sulfonamides: Contraindication

3rd trimester of pregnancy Cross BBB --> Kernicterus

Sulfonamides: Drug Interactions (2)

1. Increase warfarin activity | 2. Increase phenytoin activity

Trimethoprin/Sulfamethoxazole (TMX-SMX)/Co-Timoxazle: Buzzword

Drug of choice for prophylaxis and rx of PCP Second choice: Rx of salmonella, chancroid, MRSA

Trimethoprin/Sulfamethoxazole (TMX-SMX)/Co-Timoxazle: Adverse Effects (4)

1. Thrombocytopenia 2. Leukopenia 3. GI Distress in AIDS patients 4. Hemolysis

Urinary Tract Anti-septics (2)

Methenamine mandelate Nitrofurantoin (when UTI is resistant to Cipro or Sulfas)

Urinary Tract Analgesic and Buzzword

Phenazopyridine Produce orange to red urine that may stain clothing

Broad Spectrum Antibacterial (not prescribed anymore) and Buzzword

Chloramphenicol Side effect: Apalastic anemia and gray baby syndrome

MRSA means Staph Aureus is resistant to?

Methicillins: Ox/Clox/Diclox/Naf

First choice to treat MRSA?

Vancomycin

If you have Vancomycin Restiant E and Staph Aureus (VRE and VRSA) then?

First choice: Linezolid Quinipristin/Dalfopristin

Other Drugs for MRSA

5th gen cephalosporin TMX/SMX?

Antibiotics 2 Flashcards

(82 cards)