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Micro > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Beta Lactam Goups

A

Penicillins, Cephalosporins, Monobactams, Carbapenems

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2
Q

General Beta Lactam MOA

A

Inhibits transpeptidation

activates autolysin in cell wall

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3
Q

Beta Lactam Resistance

A

Beta-lactamases

Lack PBP (transpeptidase)

Autolysin mutations

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4
Q

Beta-Lactam side effects

A
  • *Allergy** (pen>ceph>mono)
  • *Toxicity**
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5
Q

How to most effectively use beta lactams?

A

Use with beta lactamase inhibitors

Clavulanic acid

Sulbactam

Tazobactam

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6
Q

Penicillin method of delivery

A

Injection

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7
Q

Acid resistant penicillins best against ______

A

Gram +

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8
Q

Acid resistant penicillins

A

Amoxicillin

PenV

Oxacillin

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9
Q

Expanded spectrum penicillins

A

Ampicillin

Piperacillin

Mezlocillin

Ticarcillin

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10
Q

These penicillins are resistant to beta lactamase but have _____ activity

A

These have lower activity

Nafcillin

Oxacillin

Cloxacillin

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11
Q

Common pairs for penicillin

A

Augmentin (Amox + CA)

Ampicillin + Sulbactam

Zosyn, Tazomed (Piperacillin + tazobactam

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12
Q

1st gen Cephs (Properties and Rx)

A

G +, Prophylaxis only

Cephalexin, Cephalothin, Cefazolin

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13
Q

2nd gen cephs (use and Rx)

A

Gram + and -

Used for bacterioides and not pseudomonas

Cefalcor, cefuroxime, cefoxitin

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14
Q

3rd gen ceph (use and Rx)

A

Gram + and -

Use for pseudomonas – **Penetrates CNS (avoid overuse)

Ceftazidine, Cefotaxime, Ceftriaxone

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15
Q

4th gen ceph (use and Rx)

A

Expanded spectrum

Cefepime

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16
Q

5th gen ceph (use and Rx)

A

MRSA and drug-resistant Staph Pneumoniae

Cephtaroline

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17
Q

Monobactams are resistant to ______

A

beta lactamases

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18
Q

Monobactams used for _____

A

Gram (-) only

*no anaerobes

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19
Q

Monobactam Rx

A

Aztreonem

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20
Q

Carbapenems use and Rx

A

Broad spec for Gram + and -

Imipenem, Meropenem

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21
Q

Monobactam structure

A

monocyclic beta lactam ring

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22
Q

Bacitracin MOA and use

A

Blocks dephosphorylation of bactoprenol

Use synergistically for Gram +

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23
Q

Bacitracin side effects

A

Poor absorption

Renal toxicity

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24
Q

Glycopeptides MOA

A

Blocks transglycosylation and transpeptidation

*binds to terminal amino acid

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25
Q

Glycopeptides use

A

Used for Staphylococci and Enterococci

Not for Gram -

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26
Q

Glycopeptide resistance

A

Ala-Lactate at the end instead of Ala-Ala on pentapeptide

*Chromosomal genes for VanB, Plasmid genes for VanA

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27
Q

Glycopeptide Rx

A

Vancomycin, Telavancin

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28
Q

Cycloserine MOA

A

D-Ala analog

inhibits ALA Racemase

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29
Q

Cycloserine use

A

UTI

2nd line Tx for TB

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30
Q

Cycloserine side effects

A

Neurotoxic (seizures)

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31
Q

Isoniazid & Ethionamide use and MOA

A

Used for Mycobacterium

Inhibits pyridoxine step in myoclic acid synthesis

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32
Q

Isoniazid & Ethionamide taken with _______? Why?

A

Pyridoxine

Inhibits host B6

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33
Q

Ethambutol use and MOA

A

Used for Mycobacterium

Inhibits arabinosyl transferase (stops synth of arabinogalactan)

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34
Q

Ethambutol resistance

A

Rapid!

Use synergistically

35
Q

Pyrazinamide Use and MOA

A

Used for Mycobacterium

Activated by Pyrazinamase from MB, Inhibits trans-translation

36
Q

Drugs to use for confirmed Mycobacterium infection

A

Pyrazinamide, Ethambutol, Isoniazid & Ethionamide

+ Rifampin

37
Q

Polymyxins MOA

A

Dissolve phosphatidylethanolamine in Gram - membrane

**also in host!

38
Q

Polymyxins Sides

A

Renal toxicity

(use topically or as a last resort)

39
Q

Polymyxins are synergistic with ______ and _______?

A

Bacitracin + Neosporin

40
Q

Daptomycin structure and MOA

A

Cyclic lipopeptide

Dissolves in membrane to disrupt membrane potential

41
Q

Daptomycin use and Rx

A

USed for Gram + cocci, MRSA

Cubicin

42
Q

Daptomycin delivery

It’s synergistic with _____

A

Given intravenously

Synergistic with Beta Lactams

43
Q

Sulfonamides MOA and use

A

Inhibits PABA –> DHF -> THF -> Pyrimidines

Used for Nocardia (still susceptible)

44
Q

SxT synergistic for ______

A

UTI, Salmonella, Shigellla

45
Q

Sulfonamides Resistance

A

PABA overproduction

(altered enzymes)

46
Q

Fluoroquinolones MOA and Rx

A

Inhibit DNA gyrase

Ciprofloxacin, Moxifloxacin

47
Q

Fluoroquinolones Resistance

A

Mutated DNA gyrase

Drug exclusion

48
Q

Fluoroquinolones solublility? How do we deal with this?

A

It is NOT very soluble, so it is fluorinated for UTI treatment

49
Q

Fluoroquinolones use

A

Gram - or +

Mycobacterium (2nd line)

Pseudomonas

50
Q

Fidaxomycin MOA and properties

A

Targets “switch region” of RNA Polymerase (no DNA)

Minimally absorbed, Narrow Spectrum

51
Q

Fidaxomycins Rx

A

Dificid

52
Q

Fidaxomycins use

A

Alternative to Vancomycin for VanR C.diff

53
Q

Rifamycin MOA

A

Blocks RNA polymerase elongation subunit

54
Q

Rifamycin use and Rx

A

Blocks Poxvirus assembly

Used for Meningitis b/c it enters CNS

Used for Mycobacterium

Rifampin

55
Q

Rifamycin resistance

A

Mutation in Beta subunit of RNApol

56
Q

Rifamycin sides

A

Excreted in sweat and urine (orange)

57
Q

Rifamycin used with _____ to do what?

A

Isoniazid

to delay resistance in mycobacterium

58
Q

Metronidazole structure and MOA

A

Partially reduced complex with ferredoxin

breaks DNA (free radical)

59
Q

Metronidazole use

A

Used against anaerobic bacteria (bacterioides, clostridium)

Antiprotozoal (Giardia)

60
Q

Aminoglycosides MOA and Rx

A

Binds 30S subunit (blocks initiation– no tRNA-fMet)

streptomycin, neomycin, gentamycin,
tobramycin, amikacin

61
Q

Aminoglycosides resistance

A

Altered P12 ribosomal protein

Aminoglycosidases

Altered permeability of drug

62
Q

Aminoglycosides uses

Synergistic with _______

A

Used for G- enterics

Synergistic with Cephalosporins or Penicillins

63
Q

Tetracycline MOA and Rx

A

Inhibits binding of aa-tRNA to A-site of ribosome (30S subunit)

Doxycycline, Tigecycline

64
Q

Tetracycline resistance

A

Efflux pumps

65
Q

Tetracycline sides

A

Toxicity

Dizziness

Tinnitus

Fluorescent teeth

Newborn bone damage

replace flora

66
Q

Tetracycline uses

A

Rickettsia

Chlamydia

Mycoplasmas

67
Q

Chloramphenicol MOA

A

Inhibits peptidyl-transferase reaction

(50S)

68
Q

Chloramphenicol resistance

A

Chloramphenicol Acetyl-Transferase

(CAT)

69
Q

Chloramphenicol uses

A

No longer a drug of choice because of resistance and toxicity

70
Q

Macrolides MOA and Rx

A

Binds to rRNA and inhibits translocation (50S)

Clarithromyicn, Erythromycin, Azythromycin

71
Q

Macrolide resistance

A

Methylation of rRNA

72
Q

Macrolide use

A

Used for Gram + and some Gram -

73
Q

Lincosamides MOA and Rx

A

Binds to rRNA and inhibits translocation

Clindomycin

74
Q

Lincosamides resistance

A

Long term use carries risk for C. diff colonization

75
Q

Lincosamides use

A

Used for anaerobes (bacterioides)

Anti-malarial

NOT to CNS

76
Q

Nitrofurantoin MOA and use

A

Inhibits 30S

Use for UTI (concentrates in urine)

77
Q

Mupirosin MOA

A

**Inhibits ISOLEUCINE-tRNA synthase

(important?)

78
Q

Mupirosin use

A

Topical use for Gram+

MRSA

79
Q

Streptogramins MOA and use

A

Inhibits 50S

Use for VRE and VRSA

80
Q

Streptogramin combo

A

quinupristin + dalfopristin

81
Q

Oxazolidinones MOA, use and Rx

A

Inhibit 50S

Use for VRE and VRSA

Linezolid

82
Q

Methenamine MOA and use

A

Releases formaldehyde in acidified urine for UTI

–> cross links proteins

83
Q
A

Micro (3 decks)

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