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Flashcards in Antibiotics Deck (86):
1

penicillin G used where?

IM, IV

2

penicillin V used where?

oral

3

mechanism of penicillin G/V

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

4

penicillin G used for:

T. pallidum (syphilis)

5

SEs of penicillins

hypersensitivity rxns

6

resistance to penicillins mediated by

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

7

amoxicillin and ampicillin are _____ to B-lactamase

sensitive

8

amoxicillin uses ____ route, ampicillin uses ____ route

oral, IV

9

use of amoxicillin/ampicillin

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

10

SEs of amoxicillin/ampicillin

hypersensitivity rxns

11

resistance to amoxicillin/ampicillin mediated by

B-lactamase production

12

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

- amoxicillin, ampicillin, piperacillin, ticarcillin
- clavulanic acid, sulbactam, tazobactam

13

B-lactamase resistant penicillins include:

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

14

clinical use of nafcillin, dicloxacillin, oxacillin

MSSA

15

SEs of nafcillin, dicloxacillin, oxacillin

hypersensitivity rxns

16

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

piperacillin, ticarcillin + B-lactamase inhibitor

17

mechanism of cephalosporins

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)

18

cefazolin and cephalexin are:

1st gen cephalosporins

19

cefazolin and cephalexin are used for:

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

20

cefaclor, cefoxitin, cefuroxime are:

2nd gen cephalosporins (Fake Fox Fur)

21

cefaclor, cefoxitin, cefuroxime are used for:

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

22

ceftriaxone, cefotaxime, cefpodoxime, ceftazidime are:

3rd generation cephalosporins

23

Which third generation cephalosporin covers Pseudomonas?

ceftazidime

24

Cefepime is a ___ gen cephalosporin

4th

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