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Flashcards in Antibiotics Deck (90):
1

Bind PBPs to inhibit cross-linking of PG. Used for some gram +, N meningitis, T pallidum. Beta-lactamase sensitive

Penicillin G, V

2

PCN SE

HSR, hemolytic anemia

3

PCN MOR

Beta lactamase

4

Bind PBPs to inhibit cross-linking of PG. Used for H flu, E coli, Listeria, Proteus, Salmonella, Shigella, enterococci (HELPSS kille enterococci). Beta lactamase sensitive.

Ampicillin, Amoxicillin (better oral availability)

5

Ampicillin SE

HSR, rash, pseudomembraous colitis

6

Ampicillin MOR

Beta lactamase

7

Bind PBPs to inhibit cross-linking of PG. Resistant to beta-lactamase due to bulky R group

oxacillin, nafcillin, dicloxacillin

8

Oxacillin CU

MSSA (MRSA has an altered PBP target site)

9

Oxacillin SE

HSR, interstitial nephritis

10

Antipseudomonals

Ticarcillin, piperacillin

11

Piperacillin CU

Pseudomonas and gram negative rods, with beta-lactamase inhibitors

12

Beta lactamase inhibitors

Clavulanic acid, sulbactam, taxobactam

13

Pipercillin SE

HSR

14

Cefazolin, Cephalein

1G - Gram + and Proteus, E coli, Klebsiella (PEcK)

15

Cefoxitin, Cefaclor, Cefuroxime

2G - H flu, Enterobacter, Neisseria, Proteus, E coli, Klebsiella, Serratia (HEN PEcKS)

16

Ceftriaxone

3G - Serious gram negative infections, esp meningitis and gonorrhea

17

Ceftazidime

3G - Serious gram negative infections, esp Pseudomonas

18

Cefepime

4G - increased activity against Pseudomonas and gram +

19

Ceftaroline

5G - MRSA (broad gram + and - coverage, but not pseudomonas)

20

Cephalosporin SE

HSR, vitamin K deficiency, increase nephrotoxicity of aminoglycosides

21

Monobactam that binds PBP3 to inhibit cross-linking of PG. Beta-lactmase resistant. Synergistic with aminoglycosides

Aztreonam

22

Aztreonam CU

Gram neg rods only!

23

Carbapenem must be administered with this inhibitor of renal dehydropeptidase I to decrease inactivation of drug in renal tubuels

cilastin

24

Carbapenem SE

CNS toxicity (seizures) at high plasma levels.

25

Binds D-Ala-D-Ala to prevent PG synthesis

Vanco

26

Vanco CU

GRAM POS ONLY
-MRSA
-Enterococci
-C diff

27

Vanco SE

Nephrotoxicity, Ototoxicity, Thrombophlebitis, Red man syndrome (prevent with anti-histamine pretreatment)

28

Van MOR

D-ala-D-ala to D-ala-D-lac

29

30S inhibitors

Aminoglycosides and tetracyclines

30

50S inhibitors

Chloramphenicol, Clindamycin, Macrolides, Linezolid

31

Aminoglycosides (Mean GNATS cannot kill anaerobes)

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

32

Prevent formation of inhibition complex --> misreading of mRNA, block translation

Aminoglycosides

33

Aminoglycoside CU

Severe gram neg rod infxns. Ineffective against anaerobes

34

Aminoglycoside SE

Nephrotoxicity, NMB, Ototoxicity, Teratogen

35

Aminoglycoside MOR

Bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, or adenylation

36

Binds 30s and prevents attachment of aa-tRNA

Tetracycline

37

tetracycline CU

Borrelia, M pneumo, Rickettsia, Chlamydia (concentrates intracellularly)

38

tetracycline SE

Discoloration of teeth and inhibition of bone growth in kids and fetuses, GI distress, photosensitivity

39

tetracycline MOR

decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps

40

Macrolides

Azithromycin, Clarithromycin, Erythromycin

41

Bind 50S. Inhibit protein synthesis by blocking translocation

Macrolides (macroslides)

42

Macrolide CU

Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (Chlamydia), gram positive cocci (strep infection in pats allergic to PCN)

43

Macrolide SE

MACRO
Motility
Arrhythmia (prolonged QT)
Cholestatic hepatitis
Rash
eOsinophilia
P450 inhibitor

44

Macrolide MOR

Methylation of 23S binding site prevents bidng of drug

45

Blocks peptidyltransferase at 50s (blocks peptide bond formation)

Chloramphenicol

46

Chloramphenicol CU

Meningitis (H. flu, Neisseria, Strep pneumo) and Rickettsia rickettsii

47

Chloramphenicol SE

Anemia, aplastic anemia, gray baby (baby lacks liver UDP -glucuronyl transferase)

48

Chloramphenicol MOR

Plasmid encoded acetyltransferase inactivates the drug

49

Blocks peptide transfer (translocation) at 50S.

Clindamycin

50

Clindamycin CU

Anaerobes above the diaphragm (i.e. lung abscess, vs metronidazole for anaerobes below the diaphragm). Also invasive group A strep infection?

51

Clindamycin SE

Pseudomembranous colitis (C. diff),

52

Inhibit folate synthesis. PABA antimetabolites inhibits dihydropteroate synthase.

sulfonamides

53

Sulfonamide SE

HSR, hemolysis if G6PD deficient, nephrotoxicity, kernicterus in infants, photosensitivity, displace other drugs from albumin (warfarin)
p450 inhibitor

54

Sulfonamide MOR

Altered bacterial dihydropteroate synthase, decreased uptake, or increased PABA synthesis.

55

Inhibits bacterial DHFR

trimethoprim

56

TMP-SMX CU

UTIs, shigella, salmonella, PCP tx and prophylaxis, toxo prophylaxis

57

Trimethoprim SE

Megaloblastic anemia, leukopenia, granulocytopenia (may alleviate with supplemental folinic acid)

58

Inhibit DNA gyrase (topo II) and topo IV.

Fluoroquinolone

59

Fluoroquinolone CU

Gram neg robs of Urinary and GI tracts (incl Pseudomonas), Neisseria, some gram pos

60

Fluoroquinolone SE

tendon rupture, prolonged QT, teratogen
Cipro inhibits P450

61

Fluoroquinolone MOR

Chromosome encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pumps

62

Forms free radical toxic metabolites in the bacterial cell that damage DNA

Metronidazole

63

Metronidazole CU

GET GEP on the metro!
Giardia, Entamoeba, Trichomonas,
Gardnerella, Anaerobes, Pylori

64

Metronidazole SE

Disulfiram-like reaction (flushing, tachycardia, hypotension) with alcohol, headache, metallic tast

65

Decreased synthesis of mycolic acids. Bacterial catalase peroxidase (encoded by KatG) needed to convert this drug to active metabolite.

Isoniazid

66

INH SE

Neurotoxicity, hepatotoxicity, vitamin B6 deficiency, drug-induced lupus. Pyridoxine can prevent neurotoxicity, lupus

67

Inhibits DNA-dependent RNAP

Rifampin, rifabutin

68

Rifampin SE

P450 inducer; orange body fluids; rifabutin favored in HIV+ pts due to less p450 stimulation.

69

Mechanism uncertain. Though to acidify intracellular environment via conversion to pyrazinoic acid. Effective in acidic pH of phagolysosomes where TB engulfed by macrophages is found

Pyrazinamide

70

Pyrazinamide SE

Hyperuricemia, hepatotoxicity

71

Decreased carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

Ethambutol

72

Ethambutol SE

Optic neuropathy (red-green color blindness)

73

Prophylaxis against endocarditis with surgical or dental procedures

PCN

74

Prophylaxis against gonorrhea

Ceftriaxone

75

Prophylaxis against recurrent UTIs

TMP-SMX

76

Prophylaxis against meningococcal infxn

Cipro (DOC, adults); Rifampin (kids)

77

Prophylaxis against maternal-fetal transmission of group B strep

Ampicillin

78

Prophylaxis against gonococcal or chlamydial conjunctivitis in newborn

erythromycin eye drops

79

Prophylaxis against post surgical Staph aureus inxn

Cefazolin

80

Prophylaxis against strep pharyngitis in child with prior rheumatic fever

PCN

81

Prophylaxis against syphilus

Benzathine PCN G

82

Prophylaxis against PCP + Toxo in HIV+ pt

TMP-SMX

83

Prophylaxis against MAC

Azithromycin

84

MRSA tx

vanco, (daptomycin, linezolid (can cause serotonin syndrome), tigecyline, ceftaroline

85

VRE tx

linezolid, streptogramins (quinupriston/dalfopriston)

86

Daptomycin MOA

depolarizes cell membrane

87

Daptomycin SE

myopathy, inc CPK, inactivated by pulmonary surfactant

88

Linezolid MOA

inhibits protein systhesi sby bindg to 50 S

89

Linezolid SE

Thrombocytopenia, neuritis, serotonin syndrome

90

Ceftazidime

3G, serious gram negs, esp Pseudomonas