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antibiotics Flashcards

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1
Q

penicillin moa

A

bind PBPs (transpeptidases) and block transpeptidase cross-linking for peptidoglycan; activate autolytic enzymes

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2
Q

penicillin clinical use

A

gram +, neisseria meningitidis, and syphilis

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3
Q

penicillin tox

A

hypersensitivity reactions, hemolytic anemia

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4
Q

penicillin resistance

A

penicillinase in bacteria (beta-lactamase) cleaves beta-lactam ring

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5
Q

aminopenicillins (drugs)

A

amoxicillin, ampicillin

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6
Q

aminopenicillin clinical use

A

extended-specturm penicillin - H. flu, e. coli, listeria, proteus, salmonella, shigella, enterococci

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7
Q

penicillinase resistant penicillins

A

oxacillin, nafcillin, dicloxacillin

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8
Q

penicillinase resistant penicillin clinical use

A

s. aureus

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9
Q

aminopenicillin resistance

A

penicillinase in bacteria (beta-lactamase) cleaves beta-lactam ring

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10
Q

penicillinase resistant penicillins mechanism

A

binds PBPs; bulky R group blocks access of beta latamase to the beta lactam ring

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11
Q

beta-lactamase inhibitors

A

clavulanic acid, sulbactam, tazobactam

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12
Q

first generation cephalosporins (drugs)

A

cefazolin and cephalexin

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13
Q

1st gen cephalosporins use

A

proteus, e.coli, klebsiella, gram + cocci

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14
Q

2nd gen cephalosporin drugs

A

cefoxitin, cefaclor, cefuroxime

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15
Q

2nd gen cephalosporin use

A

h. flu, enterobacter, neisseria, proteus, E.coli, klebsiella, serratia, Gram + cocci

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16
Q

3rd gen. cephalosporin drugs

A

ceftriaxone, cefotaxiime, ceftazidime

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17
Q

3rd gen cephalosporin use

A

serious gram negative infections resistant to other beta lactams

ceftriaxone: meningitis and gonorrhea
ceftazidime: pseudomonas

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18
Q

4th gen cephalosporin drug

A

cefepime

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19
Q

cefepime use

A

pseudomonas and gram +

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20
Q

5th generation cephalosporin drug

A

ceftaroline

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21
Q

ceftaroline use

A

broad gram + and gram - coverage, including MRSA; does not cover pseudomonas

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22
Q

cephalosporin toxicity

A

hypersensitivity, vit K deficiency, low cross-reactivity with PCN, increased nephrotoxicity of aminoglycosides

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23
Q

aztreonam moa

A

monobactam resistant to beta lactamases; prevents peptidoglycan crosslinking by binding PBP-3; synergistic with ahminoglycosides

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24
Q

aztreonam use

A

gram negative rods only; no activity against gram + or anaerobes; nontoxic

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25
carbapenems drugs
imipenem, meropenem, ertapenem, doripenem
26
carbapenem moa
broad-spectrum beta-lactamase resistant
27
imipenem administration
must be given with cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of the drug in renal tubules
28
carbapenem clinical use
gram + cocci, gram-neg. rods and anaerobes; wide spectrum;
29
carbapenem toxicity
GI, skin rash, CNS toxicity, seizures (esp. meropenem)
30
vancomycin moa
inhibits cell wall synthesis by binding D-ala D-ala portion of cell wall precursors
31
vancomycin clinical use
gram + only; MRSA, enterococci, and C. difficile
32
vancomycin toxicity
nephrotoxicity, ototoxicity, thrombophlebitis, diffuse flushing - red man syndrome
33
vancomycin resistance
modification of D-ala D-ala to D-ala D-lac
34
aminoglycosides drugs
gentamicin, neomycin, amikacin, tobramycin, streptomycin
35
aminoglycoside moa
inhibit formation of initiation complex and cause misreading of mRNA; also block translocation;
36
aminoglycoside use
severe gram neg. rod infection; require O2 for uptake so ineffective against anaerobes; neomycin for bowel surgery
37
aminoglycoside resistance
bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, or adenylation
38
tetracyclines drugs
tetracycline, doxycycline, minocycline
39
tetracycline moa
bind 30S and prevent attachment of ammoniacal-tRNA; limited CNS penetration;
40
doxycycline metab
fecally eliminated so it can be used in renal failure; do not take with milk or antacids (Ca or Mg) or iron preparation because divalent cations inhibits its absorption in the gut
41
tetracycline use
intracellular microbes: borrelia burgdorferi, m. pneumoniae, rickettsia, and chlamydia; can be used to treat acne
42
tetracycline toxicity
GI, discoloration of teeth and inhibition of bone growth in children, photosensitivity; contraindicated in pregnancy and children
43
tetracycline resistance
decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps
44
macrolides drugs
azithromycin, clarithromycin, erythromycin
45
macrolide moa
bind to the 23S of the 50S and block translocation
46
macrolide use
atypical pneumonias, STDs, and pram + cocci
47
macrolide toxicity
GI motility issues, arrhythmia due to QT prolongation, acute cholestatic hepatitis (erythromycin), rash, eosinophilia, cyp inhibition
48
macrolide resistance
methylation of the 23S rRNA-binding site
49
chloramphenicol moa
blocks peptidyltransferase at 50S
50
chloramphenicol use
limited due to toxicity; meningitis and RMSF
51
chloramphenicol toxicity
anemia, aplastic anemia, gray baby syndrome,
52
chloramphenicol resistance
plasmid-encoded acetyltransferase inactivates the drug
53
clindamycin moa
blocks peptide transfer at 50S
54
clindamycin use
anaerobic infections in aspiration pneumonia, lung abscesses, and oral infections; also invasive GAS infections
55
clindamycin toxicity
pseudomembranous colitis, fever, diarrhea
56
sulfonamides drugs
sulfamethoxazole, sulfisoxazole, sulfadiazine
57
sulfonamide moa
inhibit folate synthesis; para-aminobenzoic acid (PABA) antimetabolites inhibit dihydropteroate synthase
58
sulfonamides use
gram +, gram-, nocardia, chlymidai; simple UTI
59
sulfonamides toxicity
hypersensitivity reactions; hemolysis in G6PD deficient, nephrotoxic (tubulointerstitial nephritis), photosensitivity, kernicterus in infants, displaces other drugs from albumin (e.g. warfarin) causing increased drug levels
60
sulfonamide resistance
altered enzyme (bacterial dihydropteroate synthase), decreased uptake, or increased PABA synthesis
61
trimethoprim moa
inhibits DHFR
62
trimethoprim use
used with sulfonamides, never alone; UTIs, shigella, salmonella, pneumocystis jirovecii and toxoplasmosis prophylaxis in AIDS
63
trimethoprim toxicity
megaloblastic anemia, leukopenia, granulocytopenia
64
fluoroquinolones drugs
ciprofloxacin and other -floxacin drugs
65
fluoroquinolone moa
inhibts DNA gyrase (topo II) and topo IV; cannot be used with antacids
66
fluoroquinolone use
gram negative rods of urinary and GI tracts including pseudomonas, neisseria; some gram + organisms
67
fluoroquinolone toxicity
GI, superinfection, tendonitis, tendon rupture, leg cramps, myalgias contraindicated in pregnancy some cause QT prolongation
68
Fluoroquinolone resistance
chromosome-encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pumps
69
metronidazole moa
forms free radical toxic metabolites in the bacteria cell that damage DNA
70
metronidazole toxicity
disulfiram-like reaction with alcohol, metallic taste
71
metronidazole use
GET GAP on the metro: guard, entamoeba, trichomonad, gardeners vaginalis, anaerobes (bacteroides and c. diff) H. pylori
72
linezolid moa
binds 23S of 50S
73
linezolid use
VRE and MRSA
74
linezolid toxicity
serotonin syndrome

step 1 pharm (20 decks)

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