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Flashcards in Antibiotics Deck (15):
1

Penicillin G, V: MOA, clinical use, toxicity, resistance

1. Binds PBP, blocks crosslinking, activates autolytic enzymes
2. Gram +ve, Syphillis, N meningitidis
3. Hypersensitivity, hemolytic anemia
4. Penicillinase

2

Amoxycillin, ampicillin: MOA, clinical use, toxicity, resistance

1. Same as penicillin, wider spectrum
2. Extended spectrum-> HHELPSS kill enterococci (h infl, H pylori, e coli, l monoC, salmonella, shigella
3. Hypersensitivity, rash, pseudoM colitis
4. Penicillinase

3

Dicloxacillin, flucloxacillin: MOA, clinical use, toxicity,

1. Same as penicillin, narrow
2. Staph aureus (not MRSA)
3. HypersenS, interstitial nephritis

4

Piperacillin, ticarcillin: MOA, clinical use, toxicity, resistance

1. Same as penicillin
2. Pseudomonas, gram -ve rods
3. Hyeprsensitivity

5

Cephalosporins generations 1-5

1. Inhibits cel wall synthesis
2. Organisms not covered->Listeria, Atypicals (Chlamydia, mycoplasma), MRSA, Entercocci (LAME)
3. Clinical use:
a. 1st: cephazolin, cephalexin-> Proteus mirabilis, E. coli, Klebsiella (PEcK)
b. 2nd-> cefoxitin-> H. Influenza, Enterobacter, Neisseria, Proteus, E coli, Klebsiella, Serratia (HEN PEcKS)
c. 3rd: ceftriaxone (meningitis, gonorrhea, Lyme), cefotaxime, ceftazidime-> serious gram negative organism
d. 4th: cefepime->gram negative
e. 5th: borad gram +ve and gram negative
4. HyperS, AI hemolytic, disulfuram, vit K deficiency, cross reactivity with penicillin, +nephrotoxicity

6

Imipenem, meropenem: MOA, clinical use, toxicity, resistance

1. Imipenem + cisplatin
2. Gram +ve cocci, gram -ve rod and anaerobes. Significant side effects limit use to life threatening
3. GI distress, skin rash, CNS toxicity

7

Vancomycin: MOA, clinical use, toxicity, resistance

1. Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion. Bacteriacidal
2. Gram positive->serious, multidrug resistant-> MRSA, S epidermidis, Enterococcus, C difficile
3. Nephrotoxic, ototoxic, thrombophlebitis, red man syndrome

8

Aminoglycosides->gentamicin: MOA, clinical use, toxicity, resistance

1. Irriversible inhibition of 30S->misreading mRNA. Blokcs translocation. Needs oxygen
2. Severe gram negative rods, synergistic w/ beta lactams
3. Nephrotoxcity, NM blockade, ototoxicity (w/ diuretics+_, teratogen

9

Tetracycline->doxycyclin: MOA, clinical use, toxicity, resistance

1. Binds 30S, inhibits tRNA binding. Limited CNS penetration. Do not use with milk, antacids or iron containing
2. M pneumonia, Rickettsia, Chlamydia, acne
3. GI distress, teeth discolouration, inhibits bone growth in children, photosensitivity, contraI in pregnancy

10

Chloramphenicol: MOA, clinical use, toxicity, resistance

1. Blocks translocation at 50S
2. H influenza, N menigitidis, S pneumonia, RMSF
3. Anemia, aplastic anemia, gray baby syndrome

11

Clindamicin: MOA, clinical use, toxicity, resistance

1. Blocks translocation 50S
2. Anaerobes->bacteroides, C perfringes, aspiration pneumonia, lung abscesses, oral infections, invasive GAS

12

Macrolides->azithromycin, clarithromycin, erythromycin: MOA, clinical use, toxicity, resistance

1. Blocks translocaation at 50S
2. Atypical pneumonias, STIs, gram +ve cocci, B pertussis
3. MACRO: motility issues (GI), Arrythmia prolonged QT, Cholestatic hepatitis, Rash, eosinophilia, inhibition of p450

13

Trimethoprim and sulfamethoxazole: MOA, clinical use, toxicity, resistance

1. Dihydrofolate inhibitor and dihydropteroate inhibitor via anti-metabolites
2. Combination with sulfamethoxazole: UTIs, Shigella, salmonella, PJP prophylaxis, toxoplasmosis prophylaxis
3. Megaloblastic anemia, leukopenia, granulocytopneia
TMP= treats marrow poorly

14

Fluroquinolones->ciprofloxacin: MOA, clinical use, toxicity, resistance

1. Inhibits DNA gyrase. Bacteriocidal, do not take with antacids.
2. Gram negative rods of UTI, GIT
3, GI upset, skin rash, HA. Not for pregnant, not for nursing, prolong QT

15

Metronidazole: MOA, clinical use, toxicity, resistance

1. Toxic free metabolite
2. GET GAP: Giardia, entameba, trichomonas, Gardnerella, anaerobes, H pylori
3. Disulfuram reaction with alcohol