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Flashcards in Antibiotics Deck (79):
1

How is penicillin bactericidal?

Binds to PBPs...can't form wall
Inhibit cross-linkages b/w peptidoglycan chains
Increases autolysis

2

When is penicillin used?

Gram+
T. pallidum (syphilis)
N. meningitidis

3

What are the potential side effects to penicillin?

Hypersensitivity
Hemolytic anemia
Thrombocytopenia

4

What are the Penicillinase-Resistant Penicillins?

Methicillin (Not used clinically)
Nafcillin
Oxacillin
Dicloxacillin

5

What is the difference between the Penicillinase-Resistant Penicillins and Penicillin?

The addition of large R groups prevents beta-lactamase actions

6

What are the aminopenicillins?

Ampicillin
Amoxicillin (more orally available)

7

What can aminopenicillins be used to treat?

Gram+
Some Gram-

8

What Gram-'s do aminopenicillins treat?

"Aminopenicillins HELPSES with many Gram-"

9

What is the 'H' in "HELPSES" for aminopenicillin treatment of Gram-'s?

H. influ

10

What are the 'E's in "HELPSES" for aminopenicillin treatment of Gram-'s?

Enterococci
E. coli

11

What is the 'P' in "HELPSES" for aminopenicillin treatment of Gram-'s?

Proteus mirabilis

12

What are the 'S's in "HELPSES" for aminopenicillin treatment of Gram-'s?

Salmonella
Shigella

13

What can happen if a person with mono is given an aminopenicillin?

A full-body rash

14

What are the carboxy penicillins?

Ticarcillin
Pipercillin
Carbenicillin

15

What are carboxy penicillins used for?

Pseudomonas
Gram+

16

What are cephalosporins?

Basically, penicillin...only less susceptible to penicillinases

17

What are the first generation cephalosporins?

Cefazolin
Cephalexin

18

What do cefazolin and cephalexin treat?

Gram+ cocci
Some Gram-'s ("PEcK")

19

What does the 'P' in "PEcK"...for 1st generation cephalosporins...stand for?

Proteus mirabilis

20

What does the 'Ec' in "PEcK"...for 1st generation cephalosporins...stand for?

E. coli

21

What does the 'K' in "PEcK"...for 1st generation cephalosporins...stand for?

Klebsiella pneumo

22

What are the second generation cephalosporins?

There are like 4 of 'em...just know the 2 first gen, 1 4th gen, and that the third gen have a 't' or 'd' shortly after the 'cef'

23

What do the 2nd generation cephalosporins treat?

Gram+ cocci
More Gram-'s

24

What gram-'s do 2nd generation cephalosporins treat?

HENS PEcK

25

What does the "PEcK" in "HENS PEcK"...for 2nd generation cephalosporins...stand for?

Same as 1st gen

Proteus mirabilis
E. coli
Klebsiella

26

What does the 'H' in "HENS"...for 2nd generation cephalosporins...stand for?

H. influ

27

What does the 'E' in "HENS"...for 2nd generation cephalosporins...stand for?

Enterobacter

28

What does the 'N' in "HENS"...for 2nd generation cephalosporins...stand for?

N. meningitidis

29

What does the 'S' in "HENS"...for 2nd generation cephalosporins...stand for?

Serratia marcescens

30

What are the third generation cephalosporins?

Ceftriaxone
Cefotaxime
Ceftazidime
Cefdinir (Otitis Media)

(t or d shortly after def)

31

When are 3rd generation cephalosporins used?

Serious gram-'s resistant to other beta-lactams

32

When is ceftriaxone used?

Meningitis
Gonorrhea

33

When is ceftazidime used?

Pseudomonas

34

What is the 4th generation cephalosporin?

Cefepime

35

When can cefepime be used?

Pseudomonas (and other gram-s)
Gram+ organisms

36

What toxicities are seen with cephalosporins?

Hypersensitivity
Vitamin K deficiency
Nephrotoxicity with aminoglycosides
Disulfiram reaction

37

Does penicillin sensitivity cross react with cephalosporins?

No...these patients may be given cephalosporins

38

What can't cephalosporins treat?

"Cephalosporins are LAME against some bugs"

Listeria
Atypicals (Mycoplasma, chlamydia)
MRSA (except 5th gen)
Enterococci

39

What is the MoA of aztreonam?

Inhibits cell wall synthesis by binding to PBP3

40

When is aztreonam used?

Gram- rods only...and if aminoglycosides aren't tolerated

41

Does penicillin sensitivity cross-react with aztreonam?

No...penicillin sensitive patients can be given aztreonam

42

What are the carbapenems?

Imipenem/cilastatin
Meropenem
Ertapenem
Doripenem

43

When are carbapenems used?

Gram+ cocci
Gram- rods
Anaerobes
Pseudomonas

Empiric treatment of life-threatening infections

44

When aren't carbapenems used?

MRSA

45

What are some potential side effects of carbapenems?

GI distress
Skin rash
Seizures (imipenem/cilastatin)

46

Why is cilastatin always coupled to imipenem?

Cilastatin inhibits imipenem deactivation in the renal tubules

47

What is the MoA of vancomycin?

Binds to D-ala D-ala...inhibits glycopeptide polymerization

48

When is vancomycin used?

MRSA
C. diff (oral...usually metronidazole)
Staph e endocarditis

49

What are the side effects of vancomycin?

"NOT"
Nephrotoxicity
Ototoxicity
Thrombophlebitis

Red Man Syndrome

50

"Mean GNATS caNNOT kill anaerobes"...what class of drugs is this for?

A"mean"oglycosides

51

What are the aminoglycosides?

"GNATS"
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin

52

What are the side effects of aminoglycosides?

"caNNOT"
Nephrotoxicity
Neuromuscular blockade
Ototoxicity (with loop diuretics)
Teratogen (ototoxicity)

53

When aren't aminoglycosides useful?

Anaerobes...obviously

54

When are aminoglycosides used?

Severe gram- rod infections

Synergistic to beta-lactams

55

What is the MoA of aminoglycosides?

Prevents ribosomal initiation complex formation by binding to 30S

Causes misreading of mRNA and blocks translocation

56

What is the MoA of tetracyclines?

Inhibit A site by binding to 30S

57

What are the tetracyclines?

Tetracycline
Doxycycline
Minocycline
Demeocycline

58

When is the mnemonic for when tetracyclines are used?

"VACUUM THe BedRoom"

59

What does the 'V' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

Vibrio cholerae

60

What does the 'A' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

Acne

61

What does the 'UU' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

Ureaplasma Urealytica

62

What does the 'M' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

Mycoplasma pneumo

63

What does the 'T' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

Tularemia

64

What does the 'H' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

H. pylori

65

What does the 'B' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

Borrelia burgdorferi

66

What does the 'R' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?

Rickettsia rickettsii

67

What are the toxicities associated with tetracyclines?

GI distress
Discoloration of teeth and inhibition of bone growth in kids
Photosensitivity

NOT FOR PREGGERS

68

What are the macrolides?

Azithromycin
Clarithromycin
Erythromycin

69

What is the MoA of macrolides?

"Macrolides...more like macroslides"

Inhibit translocation by binding to the 23S of the 50S

70

What other drugs also inhibit translocation by binding to the 50S?

Clindamycin
Linezolid
Streptogramins

71

When is clindamycin used?

Anaerobes above the diaphragm

(Metronidazole is used for anaerobes below the diaphragm)

72

What is the risk with clindamycin?

Pseudomembranous colitis (C. diff)

73

When is linezolid used?

Outpatient MRSA or VRE

74

What is the streptogramin?

Quinupristin/Dalfopristin

75

When is Q-pristin/D-pristin used?

MRSA
VRE
Staph and strep skin infections

76

What are some side effects of Q-pristin/D-pristin?

Hepatotoxicity
Pseudomembranous colitis

Inhibits p450

77

What is the MoA of chloramphenicol?

Inhibits peptidyltransferase by binding to the 50S

78

When is chloramphenicol used?

Meningitis (H. influ, N. meningitidis, Strep pneumo)

79

What are some possible side effects of chloramphenicol?

Anemia (dose dependent)
Gray Baby Syndrome (in premies)