Antibiotics Flashcards
(44 cards)
1
Q
Penicillin
A
- GPCs, GPRs, GNc, spirochetes
- Bind PBP (transpeptidase) and inhibits PG cross-linking
- Also activates autolytic enzymes
2
Q
Nafcillin, Oxacillin, Dicloxacillin
A
- MSSA
* Penicillinase-resistant (bulky R group)
3
Q
Ampicillin, Amoxicillin
A
- UTI, neonatal, prophylaxis for bacterial endocarditis
* HELPSS kill Enterococci (H. flu, E. coli, Listeria, Proteus, Salmonella, Shigella)
4
Q
Ticarcillin, Piperacillin
A
*Pseudomas, GNR
5
Q
Clavulonic acid, Sulbactam, Tazobactam
A
Beta-lactamase inhibitors
6
Q
Cefazolin, Cephalexin
A
- 1st gen cephalosporins
- UTI, dental procedures
- GPCs + PEcK (Proteus, E. coli, Klebsiella)
- Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
7
Q
Cefoxitin, Cefaclor, Cefuroxime
A
- 2nd gen cephalosporins
- GPCs + HEN PEcKS (H. flu, Enterobactor aerogenes, Neisseria spp., Serratia)
- Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
8
Q
Ceftriaxime, Cefotaxime, Ceftazidime
A
- 3rd gen cephalosporins
- Serious resistant GNs, S. pneumo, GBS (break rule of less GP coverage as go down generations)
- Ceftriaxone for meningitis, gonorrhea
- Ceftazidime for psuedomonas
- Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
9
Q
Cefipime
A
- 4th gen cephalosporin
- Pseudomonas, GPs
- Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
10
Q
Aztreonam
A
- Binds PBP3, beta-lactamase resistant
* GNR only! for patient with penicillin allergy or renal toxicity
11
Q
Imipenem/Cilastatin, Meropenem
A
- Big guns for life-threatening infections with GPC, GNR, anaerobes, covers eneterococci
- No MRSA coverage
- Tox: seizures!
12
Q
Vancomycin
A
- Binds D-ala-D-ala
- For MRSA, enterococci
- Tox: NOT (nephro, oto, thrombophlebitis), Red Man syndrome (give histamine and slow infusion)
13
Q
Streptomycin, Tobramycin, Amikacin, Neomycin, Gentamicin
A
- Aminoglycosides (STAND) caNNOT kill anaerobes
- Inhibit 30S (initiation)
- For severe GNRs
- NNOT tox: nephro, oto, teratogenic (avoid in preg d/t oto), neurotoxic
- Resistance via acetylation, phosphorylation, adenylation by transferases
14
Q
Tetracycline, Doxycycline, Demeclocycline, Minocycline
A
- Inhibit 30S (aa-tRNA attachment)
- For VACUUM THe BedRoom (vibrio cholera, acne, chlamydia, ureaplasma urealyticum, mycoplasma, tularemia, h.pylori, burellia, ricketssia)
- Milk, antacids, iron tablets inhibit aborption
- Resistance via efflux
- Tox to teeth, long bone growth (avoid in preg)
15
Q
Azithromycin, Erythromycin, Clarithromycin
A
- Macrolides inhibit 50S (23S) (translocation)
- For PUS (atypical PNA, URI, STDs)
- Tox: MACRO (motility, arrhythmia long QT, cholestatic hepatitis, rash, eOsinophilia)
- Resistance via 23S methylation
- Clarithro is embryotoxic (avoid in preg)
16
Q
Chloramphenicol
A
- Inhibits 50S peptidyltransferase
- For SHiN
- Tox gray baby (no UDP glucuronyl transferase) (avoid in preg), aplastic anemia
- Resistance via plasmid acyltransferase
17
Q
Clindamycin
A
- Inhibits 50S (transpeptidation)
* For anaerobes above diaphragm (aspiration PNA)
18
Q
Sulfamethoxazole (SMX), Sulfisoxazole, Sulfadiazine
A
- Metabolized to PABA, which inhibits dihydropepteroate synthase
- Avoid in pregnancy d/t kernicterus
19
Q
Trimethoprim
A
- Inhibits DHF reductase
* For UTI, PNA (shigella, salmonella, PCP)
20
Q
Ciprofloxacin, other floxacins
A
- Fluoroquinolones inhibit topoisomerase II (gyrase) and IV
- Antacids inhibit absorption
- Teratogenic - damage tendons, cartilage (avoid in pregnancy)
- Nalidixic acid is a quinolone
21
Q
Metronidazole
A
- Free radical damage
* For anaerobes below diaphragm, GET GAP (giardia, enteroeba, trichomonas, gardnerella, anaerobes, h. pylori)
22
Q
TB therapy
A
- Rifampin inh RNA pol, Revs up P450, Red/orange fluids, Rapid resistance if alone
- INH: decreases mycolic acid synthesis, give with B6 to prevent neuro and hepatotox; R via KatG
- Pyrazinamide: works in low pH of phagolysosomes
- Ethamutol inhibits arabinosyltransferase, decreasing carbohydrate polymerase; tox red-green blind and decreased vision
23
Q
MAC therapy
A
RASE: Rifampin, Azithromycin (CD<50), Streptomycin, Ethambutol
24
Q
Leprosy therapy
A
Dapsone, Rifampin (to delay dapsone resistance), Clofazimine (for lepromatous form)
25
Ampho B
* Binds ergosterol and tears holes in membrane
* For serious systemic mycoses, intrathecally for meningitis
* Nephrotoxic (supplement K+, Mg2+), IV phlebitis, etc.
26
Nystatin
* Same as Ampho B but topical
| * Swish and swallow for oral candidiasis, topical for diaper rash and vaginal candidiasis
27
Azoles
* Inhibit P450 that turns lanosterol into ergosterol
* For local and less serious mycoses (fluconazole for crypto meningitis suppression)
* Inhibits hormone synthesis (gynecomastia), liver dysfunction
28
Flucytosine
* Met. to 5-FU, inhibits DNA and RNA synthesis
| * For systemic infections (combines with Ampho B for Crypto meningitis)
29
Caspofungin, Micafungin
* Inhibits B-glucan synthesis, inhibiting cell wall
* For invasive aspergillosis, candida
* Histamine release causes GI, flushing
30
Terbinafine
* Inhibits squalene epoxidase
* For dermatophytoses, esp. onychomycosis bc deposits in nails
* Live and visual tox
31
Griseofulvin
* Interferes with microtubule function, disrupting mitosis
* Deposits in keratin tissues (nails), for dermatophytes (tinea, ringwormm)
* Teratogenic (avoid in preg), carcinogenic, increases P450 (Warfarin)
32
Toxoplasmosis
Pyrimethamine, Sulfamethamine
33
Trypanosoma brucei
Suramin and Melarsoprol
34
T. cruzi
Nifurtimox
35
Leishmaniasis
Sodium Stibogluconate
36
Malaria
* Chloroquine blocks heme detox to hemozoin -> heme accumulates and damages plasmodia (falciparum are resistant with pump); retinopathy tox
* Tx falciparum with artemether/lumifantrine or atovaquone/proguanil
* Life-threatening malaria use quinidine (elsewhere quinine) or artisunate
37
Helminths
Mebendazole, Pyrantel Pamoate, Ivermectin, Diethylcarbamazine, Praziquantel
*Praziquantel for flukes (trematodes e.g. Schistosoma)
38
Amantadine
* Blocks viral penetration and uncoating, causes release of DA from nerve terminals (PD tx)
* Resistance via M3 protein
* SE anticholinergic
* Ravantamine is modified form that does not cross BBB
39
Zanamivir, Oseltamivir
* Inhibit neuraminidase, decreasing progeny release
* For influenza A, B, H1N1, H5N1
* Lots of resistance
40
Ribavirin
* Inhibits guanine synthesis by competitively inhibiting IMP dehydrogenase
* For RSV (adults), HCV
* Tox hemolytic anemia, teratogen (avoid in preg)
41
Acyclovir
* Phosphorylated by thymidine kinase -> guanosine analog -> triphosphate by cellular enzymes -> inhibits viral DNA polymerase by chain term.
* For active HSV, VZV (weak EBV, no CMV)
* Valacyclovir better oral availability
* Famciclovir for herpes zoster
42
Ganciclovir
* 5' phosphorylated by CMV viral kinase -> guanosine analog -> inhibits viral DNA polymerase
* For CMV, esp. immunocompromised
* Valganciclovir better oral availability
* More toxicity that acyclovir (BM suppression, renal)
* R via mutated DNA pol or absent kinase
43
Foscarnet
* Pyrophosphate analog that inhibits DNA pol. without activation
* For CMV retinitis when ganciclovir fails, HSV when acyclovir fails
* Nephrotox
44
Cidofovir
* Inhibits DNA pol. without activation
* For CMV retinitis, acyclovir-resistant HSV
* Nephrotox (prevent with probenecid and IV saline)
