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Antibiotics Flashcards

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1
Q

penicillin G used where?

A

IM, IV

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2
Q

penicillin V used where?

A

oral

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3
Q

mechanism of penicillin G/V

A

structure mimics D-ala-D-ala, bound by transpeptidases prevents cross-linking of peptidoglycan cell wall

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4
Q

penicillin G used for:

A

T. pallidum (syphilis)

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5
Q

SEs of penicillins

A

hypersensitivity rxns

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6
Q

resistance to penicillins mediated by

A

production of B-lactamase which cleaves the B-lactam ring in the chemical structure, rendering it non-functional

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7
Q

amoxicillin and ampicillin are _____ to B-lactamase

A

sensitive

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8
Q

amoxicillin uses ____ route, ampicillin uses ____ route

A

oral, IV

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9
Q

use of amoxicillin/ampicillin

A

H. infuenzae, H. pyloria, E. coli, Enterococcus, Listeria, Proteus, Salmonella, Shigella (HHEELPSS)

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10
Q

SEs of amoxicillin/ampicillin

A

hypersensitivity rxns

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11
Q

resistance to amoxicillin/ampicillin mediated by

A

B-lactamase production

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12
Q

B-lactamase inhibitors are added to _____ and include _____.

A
  • amoxicillin, ampicillin, piperacillin, ticarcillin

- clavulanic acid, sulbactam, tazobactam

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13
Q

B-lactamase resistant penicillins include:

A

nafcillin, dicloxacillin, oxacillin (due to bulky R group which blocks enzyme)

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14
Q

clinical use of nafcillin, dicloxacillin, oxacillin

A

MSSA

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15
Q

SEs of nafcillin, dicloxacillin, oxacillin

A

hypersensitivity rxns

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16
Q

Which penicillins can be used to treat Pseudomonas and gram negatives as well?

A

piperacillin, ticarcillin + B-lactamase inhibitor

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17
Q

mechanism of cephalosporins

A

same as penicillin, except less susceptible to B-lactamases (D-ala-D-ala analogue which is bound by transpeptidase and prevents cross-linking of peptidoglycan cell walls)

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18
Q

cefazolin and cephalexin are:

A

1st gen cephalosporins

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19
Q

cefazolin and cephalexin are used for:

A

Gram positive cocci, Proteus, E. coli, Klebsiella (PEcK)

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20
Q

cefaclor, cefoxitin, cefuroxime are:

A

2nd gen cephalosporins (Fake Fox Fur)

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21
Q

cefaclor, cefoxitin, cefuroxime are used for:

A

Gram positive cocci, H. influenza, Enterobacter, Neisseria, Serratia, Proteus, E. Coli, Klebsella (HENS PEcK)

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22
Q

ceftriaxone, cefotaxime, cefpodoxime, ceftazidime are:

A

3rd generation cephalosporins

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23
Q

Which third generation cephalosporin covers Pseudomonas?

A

ceftazidime

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24
Q

Cefepime is a ___ gen cephalosporin

A

4th

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25
coverage by cefepime includes
Gram positives, Gram negatives, Pseudomonas
26
Ceftaroline is a ___ gen cephalosporin
5th
27
coverage by ceftaroline includes
Gram positives, Gram negatives, MRSA, Listeria, Enterococcus
28
SEs of cephalosporins
hypersensitivity rxns independent of penicillin allergies
29
mechanism of resistance to cephalosporins
structural change in transpeptidases such that they no longer bind the drug
30
carbapenems are B-lactamase ____
resistant
31
coverage of carbapenems includes
Gram positive cocci, Gram negative rods, anaerobes
32
SEs of carbapenems include:
GI distress, skin rash, seizures
33
mechanism of aztreonam
like penicillin, but works specifically at transpeptidase PBP3
34
coverage of aztreonam includes
gram negative rods, used instead of aminoglycosides in pts with renal dysfunction
35
mechanism of vancomycin
bind to D-ala-D-ala portions of cell wall precursors and prevent peptidoglycan formation
36
SEs of vancomycin include
nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome (prevent with antihistamines and slow infusion rate)
37
mechanism of resistance to vancomycin
D-ala-D-ala --> D-ala-D-lac (develops via transposition VRE --> S. aureus)
38
aminoglycosides include:
gentamicin, neomycin, amikacin, tobramycin, streptomycin (GNATS)
39
mechanism of aminoglycosides
30S - inhibition of initiation complex, cause mRNA misreading, block translocation
40
aminoglycosides require ____ to function so are unable to kill ____
oxygen, anaerobes
41
aminoglycosides display ____ with B-lactam abx
synergy
42
SEs of aminoglycosides
nephrotoxicity, neuromuscular blockage, ototoxicity, teratogen
43
mechanism of tetracyclines
30S - prevent attachment of aminoacyl-tRNA
44
Do not take tetracyclines with:
Ca 2+, Mg 2+, Fe 2+
45
clinical use of tetracyclines
Lyme dz, M. pneumoniae, Rickettsia, Chlamydia, acne (they accumulate intracellularly)
46
SEs of tetracyclines
GI distress
47
teratogenicity of tetracyclines
discoloration of teeth, inhibition of bone growth, photosensitivity
48
coverage of tigecycline includes
anaeoribic, Gram +, Gram -, MRSA, VRE, deep tissue infections
49
mechanism of chloramphenicol
50S - blocks peptidyltransferase
50
clinical use of chloramphenicol
meningitis (S. pneumo, H. influenzae, N. meningitidis) and Rickettsia in developing countries
51
SEs of chloramphenicol
aplastic anemia, gray baby syndrome in premies
52
mechanism of clindamycin
50S - blocks translocation of peptide chain
53
clinical use of clidamycin
aerobic infections above the diaphragm, GAS
54
SEs of clindamycin
diarrhea
55
mechanism of linezolid
50S - prevents formation of initiation complex
56
clinical use of linezolid
Gram + species, MRSA, VRE
57
SEs of linezolid
BM suppression, peripheral neuropathy, serotonin syndrome (has MAOI activity)
58
mechanism of macrolides
50S - block translocation by binding 23S rRNA
59
clinical use of macrolides includes
- atypical PNA - Chlamydia STD - B. pertussis - gram + cocci
60
SEs of macrolides
GI dysmotility, QT prolongation, cholestatic hepatitis, rash, eosinophilia (MACRO)
61
mechanism of sulfonamides
PABA analoge, inhibition of dihydropteroate synthase
62
SEs of sulfonamides
hypersensitivity rxns, hemolysis with G6PD, interstitial nephritis, SJS
63
sulfonamides cause _____ in infants
kernicterus
64
dapsone is similar to ____
sulfonamides
65
dapsone used for:
- leprosy with rifamoin +/- clofazimine | - PCP ppx in sulfa allergic cats
66
Can dapsone be used in G6PD def?
hell nah
67
mechanism of TMP, pyrimethamine
inhibits dihydrofolate reductase
68
SEs of TMP, pyrimethamine
BM suppression
69
mechanism of fluoroquinolones
inhibit prokaryotic DNA gyrase (topoisomerase II)
70
clinical use of fluoroquinolones
GI/GU Gram negatives, otitis externa
71
SEs of fluoroquinolones
- cartilage damage - pregnant women (teratogen), nursing mothers, < 18 yo - spontaneous tendon rupture (> 60 yo)
72
mechanism of daptomycin
lipopeptide that creates transmembrane channels membranes of gram positive cocci
73
clinical use of daptomycin
MRSA, VRE - cannot be used for pneumonia since it is inactivated by surfactant
74
SEs of daptomycin
myopathy, rhabdomyolysis
75
mechanism of action of metronidazole
formation of toxic free radical metabolites inside bacterial cells that damage DNA
76
clinical use of metronidazole
giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes below the diaphragm, H. pylori
77
SEs of metronidazole
metallic taste, disulfiram-like rxn with EtOH
78
Prophylaxis for those who are high risk for endocarditis prior to undergoing surgical/dental procedures
amoxicillin
79
Prophylaxis for gonorrhea exposure
ceftriaxone
80
Prophylaxis for recurrent UTIs
TMP-SMX
81
Prophylaxis for meningococcus exposure
ceftriaxone, cipro, rifampin
82
Prophylaxis for GBS
intrapartum penicillin G or ampicillin
83
Prophylaxis for gonococcal conjunctivitis in neonates
erythromycin eye ointment
84
Prophylaxis for post-op S. aureus skin infxns
cefazolin
85
Prophylaxis for GAS dz in child with prior ARF
penicillin G or V
86
Prophylaxis for syphilis exposure
penicillin G

Pharmacology (22 decks)

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