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Flashcards in Antibiotics Deck (73):
1

penicillin mechanism

inactivates transpeptidase from cross-linking peptidoglycan

2

penicillin clinical use

gram positive (Strep pneumo, Staph pyogenes, Actinomyces)
Gram negative (Neisseria meningitis, treponema palladium)

3

penicillin reistance mechs

altered penicillin binding proteins (MRSA) and beta-lacatamases

4

oxacillin, nafcillin, dicloxacillin: what are they, uses?

beta-lactamase resistant cause R group. use for Staph aureus except for MRSA (use naf for staph"

5

Ampicillin, amoxicillin are what?

extended spectrum penicillin (still penicillinase sensitive)

6

beta-lactamase inhibitors

Clavulanic Acid, Sulbactam, Tazobactam (CAST)

7

ampicillin amoxicilin uses

same as penicillin but also HELPSS: H flu, E. coli, Listeria, Proteus mirabilis, Salmonella, Shigella

8

ampicillin and amoxicillin toxicity

ampicillin rash, pseudomembranous colitis (C diff)

9

Ticarcillin, piperaciliin

anti-pseudomonals (lactamse sensitive)

10

Cephalosporin mechanism

they are beta lactams that are penicillinase resistant

11

1st gen cephalosporins

cefazolin, cephalexin

12

1st gen cephalosporin uses

PEcK: proteusmirabilis, E. coli, Klebsiella

13

2nd gen cephalosporin names

cefoxitin, cefaclor, cefuroxime

14

2nd gen cephalosporin uses

gram + cocci, HEN PEcKS: H flu, Enterbacter aerogenes, Neisseria, Proteus, E. coli, Klebsiella, Serratia

15

3rd gen Cephalosporins

ceftriaxone, cefotaxime, ceftazidime

16

3rd gen cephalosporin uses

serious gram negative infxns. ceftriaxone: neisseria. ceftazidime: pseudomonas

17

4th gen cephalosporin name and use

cefepime, pseudomonas and gram positives

18

toxicity of cephalosporins

vitamin k def, nephrotox when used with aminoglycosides

19

what can be used synergistically with beta-lactams?

aminoglycosides

20

aztreonam mech and use

monobactam (a beta lactam resistant to degradation). only Gram negative rods and used in patients who can tolerate other stuff cause this has low toxicity

21

Imipenem/cilastatin, meropenem mech

broad spectrum beta lactam that is resistant to degrad. give with cilastatin to prevent inactivation in kidneys

22

imipenem/cilastatin, meropenem use

kills almost everything: gram + cocci, gram - rods, and anaerobes. but lots of sides so only use in life-threatening

23

imipenem/cilastatin, meropenem tox

Gi distress, skin rash, CNS tox

24

vancomycin mechanism

inhibits cell wall synthesis by binding to D-ala D-ala portion of precursor

25

vancomycin uses

gram + only for serious drug-reistant bugs including MRSA, Enterococci, and C diff

26

vancomycin toxicity

NOT: nephrotox, ototox, thrombophlebitis
and Redman!!! causes diffuse flushing which can be treated with antihistamine

27

vancomycin resistance

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

28

which drugs hit 30S vs 50S

buy AT 30, CCEL at 50
30: Aminoglycosides, tetracyclines
50: Chloramphenicol, Clindamycin, Erythromycin, Linezolid

29

Aminoglycosides (names)

GNATS: gentamicin, neomycin, amikacin, tobramycin, streptomycin

30

drug given with bowel surgery

neomycin (aminoglycoside)

31

aminoglycoside mechanism

bind 30S and inhibits formation of initiation complex and misreading of mRNA/translocation

32

aminoglycoside uptake

requires ATP and oxygen. does not kill anaerobes

33

aminoglycoside use

synergistic with beta lactams, used for severe gram - rods

34

aminoglycoside toxicity

NNOT: nephrotoxicity (worse with cephalosporine), neuromuscular blockade, otoxicity (worse with furosimide), teratogen

35

aminoglycoside resistance

transferase enzymes inactivate it by PTMs

36

aminoglycoside mneumonic

Mean (aminoglyco) GNATS (names) caNNOT (tox) kill anaerobes

37

tetracyclin names

tetracycline, doxycyclin, demeclocycline, minocycline

38

tetracycline mechanism

bind 30S to prevent attachment of aminoacyl-tRNA.

39

tetracycline clinical notes (not targets but indications)

fecally eliminated (so for renal failure), no CNS penetrance, don't take with milk/antacids/iron or it won't be absorbed.

40

tetracycline uses (bugs)

borrelia burgdorferi, Mycobacterium pneumoniae, and it accumulates intracellularly so very effective against rickettsia and chlfamydia

41

tetracycline toxicity

GI distress, discoloration of teeth and retardation of bone growht in children, photosensitivity

42

tetracycline resistance mech

decrease uptake or increase efflux

43

Macrolides (names)

Azithromycin, clarithromycin, erythromycin (-thromycin)

44

macrolide mechanism

blocks ribosome slide (macroslide) by bindings 23S of 50S

45

macrolide uses

atypical pneumonias (mycoplasma, legionella), Chlamydia, and gram + cocci (for penicillin allergy)

46

macrolide toxicities

MACRO: motility issues, arrhthymia, cholestatic hepatitis, rash, eOsinophilia. also increases theophylline/anticoag serum concentration

47

macrolide resistance mech

methylation of 23S rRNA binding site

48

Chloramphenicol mech

blocks peptidyltransferase at 50S

49

chloramphenicol use

Meningiits (H flu, N meningitidis, S pneumo).
it sucks cause of tox but is cheap as fuck

50

chloramphenicol tox

anemia (dose dependent), aplastic anemia (dose dependent), gray baby syndrome

51

Clindamycin mech

blocks peptide transfer at 50S

52

clindamycin use

anaerobic infections, aspiration pneumonia. however may cause C diff

53

treating anaerobes

above diaphram: clindamycin
below diaphram: metronidazole

54

TMP-SMX name and mech

Sulfamethoxazole-Trimethoprim. they block different steps in bacterial folate (THF to DNA) synthesis

55

sulfonamides tox

like SMX. hypersen, hemolysis in G6PD, nephrotox, phototox, kernicterus in infant, displaces other drugs from albumin

56

TMP-SMX use

UTIs, Shigella, Salmonella, Pneumocystis jiroveciii

57

Fluoroquinolones and quinolone (names)

Ciprofloxacin (all -floxacin) and the one quinolone (nalidixic acid)

58

Flouroquinolone mechanism

inhibits dna gyrase (topoisomerase II) and topoisomerase IV

59

Fluoroquinolone use

gram - rods of urinary and GI tract, pseudo, neisseria

60

Fluoroquinolone tox

tendon rupture, tendonitis, superinfxn, skin rash, gi upset

61

fluoroquinolone resistance

chromosome via DNA gyras muts, or plasmid via efflux pumps

62

metronidazole mech

forms free radicals that damage DNA

63

metronidazole uses

kills bacteria and protozoa! GET GAP: giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes, h Pylori

64

Penicillin G vs V

G is IV/IM, V is oral

65

treatment for mycobacterium tuberculosis

prophylaxis: isoniazid
treatment: RIPE: Rifampin, Isoniazid, Pyrazinamide, Ethambutol

66

Isoniazid mech

decreases mycolic acid synth. bacterial catalase-peroxidase (KatG) needed to covert to active form.

67

Isoniazid side efects

INH Injures Neurons and Hepatocytes. B6 (pyridoxine) to prevent.

68

Rifampin mechanism

inhibits DNA-dependent RNA pol

69

Rifampin uses

TB, leprosy, meningococcal/h flu prophylaxis

70

Rifampin tox

activates P-450, Orange body fluids

71

RRRRifampin

RNA pol inhib, Revs up P-450, Red/orange body fluids, Rapid resistance if used alone

72

Pyrazinamide

mech unclear, helps acidicify phagolysosome (which MB sulfatides block)

73

Ethambutol

decreasese carbohydrate polymerization in mycobacterium cell wall (arabinosyltransferase). may cause optic neuropathy/color blindness