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Step 1 Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

(71 cards)

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1
Q

Class and MOA of penicillin?

A

Beta-lactam which blocks transpeptidase cross-linking of peptidoglycan in cell wall.

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2
Q

Penicillin is used for which organisms?

A

Gram + (S. pneumoniae, S. pyogenes, Actinomyces)
Gram - cocci (N. meningitidis)
Spriochetes (T. pallidum)

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3
Q

Class and MOA of amoxicillin/ampicillin?

A

Beta-lactam which blocks transpeptidase cross-linking of peptidoglycan in cell wall

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4
Q

Amoxicillin is used against which organisms?

A

H. influenzae, H. pylori, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, Enterococci

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5
Q

Which penicillinase-resistant penicillins are effective against S. aureus (MSSA)?

A

Dicloxacillin, nafcillin, oxacillin

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6
Q

What organism is piperacillin/ticarcillin effective against?

A

Pseudomonas spp. and gram - rods

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7
Q

Name three beta-lactamase inhibitors.

A

Clavulanic acid, sulbactam, tazobactam

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8
Q

MOA of cephalosporins?

A

Beta-lactams which inhibit cell wall synthesis

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9
Q

Organisms covered by 1st generation cephalosporins?

A

Cefazolin and cephalexin

Gram + cocci, proteus mirabilis, E. coli, Klebsiella pneumonia

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10
Q

Organisms covered by 2nd generation cephalosporins?

A

Cefoxitin, cefaclor, cefuroxime

Anaerobes, Gram + cocci, H. influenzae, Enterobacter aerogenes, Neisseria spp., Proteus, E. coli, Klebsiella, Serratia

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11
Q

Organisms covered by 3rd generation cephalosporins?

A

Ceftriaxone, cefotaxime, ceftazidime
Resistant gram - organisms, borrelia burgdorferi
Ceftazidime covers pseudomonas

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12
Q

Organisms covered by 4th generation cephalosporins?

A

Cefepime

Increased activity against gram + including pseudomonas

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13
Q

Organisms covered by 5th generation cephalosporins?

A

Ceftaroline
Broad gram + and gram - coverage including MRSA
Does not cover pseudomonas

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14
Q

MOA of carbapenems?

A

Inhibit peptidoglycan crosslinking

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15
Q

What should be administered with imipenem?

A

Cilastatin to decrease renal inactivation of the drug

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16
Q

Organisms covered by carbapenems?

A

Gram + cocci, gram - rods, anaerobes

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17
Q

Class and MOA of aztreonam?

A

Monobactam. Blocks peptidoglycan cross linking by linking by binding to penicillin binding protein 3. No cross allergy with penicillins.

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18
Q

MOA of vancomycin? Is it susceptible to beta-lactamases?

A

Inhibits peptidoglycan formation by binding D-ala D-ala portion of precursors. Not susceptible to beta-lactamases?

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19
Q

Organisms covered by vancomycin?

A

Gram + organisms including MRSA, S. epidermidis, some enterococcus, and C. difficile (oral administration)

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20
Q

Name six types of antibiotics that inhibit protein synthesis

A

30S inhibitors: aminoglycosides, tetracyclines

50S inhibitors: chloramphenicol, clindamycin, erythromycin, linezolid

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21
Q

Examples of aminoglycosides?

A

Gentamycin, neomycin, amikacin, tobramycin, streptomycin

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22
Q

MOA of aminoglycosides?

A

Inhibit initiation complex by binding 30S subunit

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23
Q

Organisms covered by aminoglycosides?

A

Gram - rods

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24
Q

MOA of tetracyclines?

A

Block attachment of ammoniacal-tRNA to 30S subunit

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25
Organisms covered by tetracyclines?
Borrelia burgdorferi, mycoplasma pneumoniae, rickettsia, chlamydia
26
MOA of chloramphenicol?
Blocks peptidyltransferase at 50S subunit
27
Organisms covered by chloramphenicol?
MENINGITIS: H. influenzae, N. meningitidis, S. pneumoniae | Rickettsia rickettsii
28
MOA of clindamycin?
Blocks translocation/peptide transfer at 50S subunit
29
Organisms covered by clindamycin?
Anaerobic infections above the diaphragm (Bacteroides spp., Clostridium perfringens) and group A strep
30
Class and MOA of linezolid?
Oxazolidinones | Blocks formation of initiation complex by binding 50S subunit
31
Organisms covered by linezolid?
Gram + species, notably MRSA and VRE
32
Examples of macrolides?
Azithromycin, clarithromycin, erythromycin
33
MOA of macrolides?
Block translocation by binding 50S subunit
34
Organisms covered by macrolides?
Atypical pneumonias (mycoplasma, chlamydia, legionella), STI's (chlamydia), gram + cocci, B. pertussis
35
Two antimetabolite antibiotics?
Trimethoprim and sulfonamides
36
MOA of trimethoprim?
Inhibits bacterial dihydrofolate reductase to inhibit nucleic acid synthesis
37
MOA of sulfonamides?
Para-aminobenzoic acid antimetabolites inhibit dihydropteroate synthase
38
Organisms covered by TMP-SMX?
S. pneumoniae, H. influenzae, UTIs (E. coli), shigella, salmonella, pneumocystis jirovecii, toxoplasmosis prophylaxis
39
Organisms covered by sulfonamides?
Sulfamethoxazole, sulfisoxazole, sulfadiazine | Gram +, gram -, Nocardia, Chlamydia
40
Examples of fluoroquinolones?
Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin
41
MOA of fluoroquinolones?
Inhibit prokaryotic enzymes topoisomerase II and IV
42
Organisms covered by fluoroquinolones?
Gram - rods of GU and GI tracts, Pseudomonas, Neisseria, some gram + organisms
43
MOA of daptomycin?
Lipopeptide that disrupts cell membrane of gram + cocci
44
What organisms does daptomycin cover? In what organ is it ineffective?
S. aureus skin infections (MRSA), bacteremia, endocarditis, VRE Inactivated by surfactant, ineffective against pneumonia
45
MOA of metronidazole?
Forms free radical metabolites that damage DNA
46
What organisms are covered by metronidazole?
Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, anaerobes (Bacteroides, C. difficile), H. pylori
47
Drugs used to treat TB?
Rifampin, Isoniazid, Pyrazinamide, Ethambutol | Prophylaxis: isoniazid
48
Drugs used to treat M. avium-intracellulare?
Azithromycin or clarithromycin + ethambutol
49
Treatment for lepromatous leprosy? Tuberculoid?
Lepromatous: dapsone, rifampin, clofazimine Tuberculoid: dapsone, rifampin
50
MOA of rifampin?
Inhibits DNA-dependent RNA polymerase
51
What is rifampin used as prophylaxis for?
Meningococcal prophylaxis and chemoprophylaxis in contacts of children with HIB
52
MOA of isoniazid?
Decrease synthesis of mycolic acids needed for cell wall.
53
What bacterial enzyme does isoniazid require?
Bacterial catalase peroxidase converts it to an active metabolite
54
MOA of ethambutol?
Blocks arabinosyltransferase which decreases carbohydrate polymerization in mycobacterium cell wall
55
Prophylaxis for endocarditis before procedures?
Amoxicillin
56
Prophylaxis for gonorrhea exposure?
Ceftriaxone
57
Prophylaxis for recurrent UTI?
TMP-SMX
58
Prophylaxis for pregnant women with GBS?
Penicillin G
59
Prophylaxis for gonococcal conjunctivitis in newborn?
Erythromycin ointment
60
Prevention of post surgical infection due to S. aureus?
Cefazolin
61
Prophylaxis of strep pharyngitis with hx of rheumatic fever?
Benzathine penicillin G, oral penicillin V
62
Prophylaxis for syphilis exposure?
Benzathine penicillin G
63
Antibiotics that cover pseudomonas?
Extended-spectrum beta-lactams, cefepime, ceftazidime, carbapenems, aztreonam, coprofloxacin, aminoglycosides, polymixins
64
Antibiotics that cover MDR pseudomonas and MDR acinetobacter?
Polymyxins B and E (colistin)
65
Antibiotics that cover MRSA?
Vancomycin, daptomycin, linezolid, tigecycline, ceftaroline
66
Antibiotics that cover VRE?
Linezolid, streptogramins (quinupristin, dalfopristin), daptomycin, tigecycline
67
Prophylaxis for HIV?
CD4 < 200: TMP-SMX for pneumocystis pneumonia CD4 < 100: TMP-SMX for toxoplasmosis CD4 < 50: azithromycin/clarithromycin for MAC
68
Antibiotics that cover anaerobes?
Penicillins with a beta-lactamase inhibitor (augmented, unasyn, zosyn), second-generation cephalosporins, carbapenems, chloramphenicol, clindamycin, metronidazole, moxifloxacin, tigecycline
69
Best antibiotic for broad spectrum gram negative coverage?
Aztreonam. Fluoroquinolones are also good for gram -
70
What major bugs does tigecycline cover?
MRSA and VRE
71
What does quinupristin/dalfopristin cover?
Vancomycin resistent enterococcus faecium (not faecalis), MRSA, group A strep infections

Step 1 Pharmacology (4 decks)

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