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MD2 ID > Antibiotics for interns > Flashcards

Antibiotics for interns Flashcards

(61 cards)

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1
Q

Narrow spectrum penicillins

A

Penicillin

Fluclox

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2
Q

Moderate spectrum penicillins

A

Amoxi

Amp

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3
Q

Broad spectrum penicillins

A

Ticarcillin

Piperacillin

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4
Q

1st gen cephalosporins

A

Cephazolin

Cephalexin

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5
Q

2nd gen cephalosporins

A

Cefaclor

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6
Q

3rd gen cephalosporins

A

Ceftriaxone

Cefotaxime

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7
Q

4th gen cephalosporins

A

Ceftazidime

Cefepime

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8
Q

5th gen cephalosporins

A

Ceftaroline

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9
Q

Carbapenems

A

Meropenem
Imipenem
Ertapenem

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10
Q

Mechanism of action of B-lactams

A

Bind to PBPs in bacterial cell walls to inhibit peptidoglycan (and therefore cell wall) synthesis)

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11
Q

B-lactams: bacteriostatic or bactericidal?

A

Bactericidal (except for Enterococcus)

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12
Q

Is bacterial killing by B-lactams concentration-dependent or -independent? Relevance to management?

A

Concentration-independent (TIME above MIC is what dictates efficacy)
Give frequent low doses

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13
Q

Absorption of B-lactams

A

Variable oral absorption (gastric acid degrades many penicillins, food delays rate and extent of absorption)

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14
Q

3 mechanisms of resistance to B-lactams (including examples of bacteria which utilise these)

A

Production of B-lactamase (MSSA, E. coli)
Alteration in PBPs to decrease binding affinity (MRSA, Strep pneumo)
Alteration of outer membrane to decrease penetration

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15
Q

Benzylpenicillin (pen B), amoxi, amp spectrum of activity

A

Strep/enterococci
E.coli/Klebs/Haem (amp)
Anaerobes (gram+ oral)

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16
Q

B-lactams

A

Pencillins
Cephalosporins
Carbapenems

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17
Q

Typical administration of amp vs amoxi

A

Amp: IV
Amoxi: oral

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18
Q

MSCNS

A

Methicillin-susc coag-negative Staph

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19
Q

Amoxiclav spectrum of activity

A

MSSA, MSCNS
Strep/enterococci
E.coli/Klebs/Haem
Some bowel anaerobes

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20
Q

Fluclox/diclox

A

MSSA, MSCNS

Some activity against Strep pyogenes

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21
Q

Ticarc/clav, piper/tazobactam spectrum of activity

A 
MSSA, MSCNS
Strep/enterococci
E.coli/Klebs/Haem
Pseudomonas
Anaerobes
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22
Q

Cephalosporins CANNOT be used for?

A

Enterococci

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23
Q

1st gen ceph spectrum of activity

A

MSSA, MSCNS
Strep
E.coli/Klebs/Haem (generally not)

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24
Q

3rd gen ceph spectrum of activity

A

MSSA, MSCNS
Strep
E. coli/Klebs/Haem
Some anaerobes

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25
4th gen ceph spectrum of activity
Same as 3rd gen + pseudomonas
26
Carbapenems spectrum of activity
``` MSSA, MSCNS Strep/enterococci E.coli/Klebs/Haem Enterobacter etc Pseudomonas Anaerobes ```
27
Mechanism of B-lactam anaphylaxis
Immune response directed to B-lactam ring (don't use ANY B-lactams)
28
Mechanism of non-anaphylactic B-lactam allergies
Immune response directed to side-chain (may be able to give OTHER B-lactams)
29
B-lactam adverse effects
``` GI: increased LFTs, N+V, diarrhoea, pseudomembranous colitis Interstitial nephritis (type IV HS) Phlebitis, seizures, cytopenias ```
30
Glycopeptides
Vancomycin | Teicoplanin
31
Mechanism of action of glycopeptides
Inhibits synthesis and assembly of 2nd stage of peptidoglycan polymers by binding D-alanyl-D-alanine portion of cell wall precursors
32
Glycopeptides: bacteriostatic or bactericidal?
Bactericidal (except for Enterococcus)
33
Glycopeptide dosing
Based on weight and renal function
34
Glycopeptide spectrum of activity
MSSA, MSCNS MRSA Strep/enterococci
35
Metronidazole adverse effects
``` GI: N+V, stomatitis, metallic taste, intolerance with alcohol Peripheral neuropathy (seizures) ```
36
Metronidazole spectrum of activity
Anaerobes (esp bowel)
37
Clindamycin mechanism of action
Inhibits protein synthesis
38
Clindamycin: bacteriostatic or bactericidal?
Bacteriostatic
39
Clindamycin spectrum of activity
Staph Strep Gram+ oral anaerobes
40
ESCAPPM
Organisms with chromosomally-mediated inducible B-lactamase activity (Enterobacter, Serratia, Citrobacter freundi, Aeromonas, Proteus, Providencia, Morganella morganii)
41
Clindamycin adverse effects
C. difficile colitis
42
Fluoroquinones mechanism of action
Inhibit bacterial topoisomerases (necessary for DNA synthesis)
43
Is bacterial killing by FQs concentration-dependent or -independent? Relevance to management?
Concentration-dependent | Give infrequent high doses
44
FQs: bacteriostatic or bactericidal?
Bactericidal
45
FQs spectrum of activity
E.coli/Klebs/Haem ESCAPPM (beware resistance) Pseudomonas (beware resistance)
46
Ciprofloxacin
FQ
47
FQ adverse effects
``` Hepatitis Tendonopathy Damage to developing cartilage Long QT Resistance develops easily ```
48
Absorption of FQs
Good oral | Good penetration to many tissues (e.g. prostate, bone)
49
Macrolides
Erythromycin (not really used) Clarithromycin Roxithromycin Azithromycin
50
Macrolides mechanism of action
Inhibits protein synthesis by reversibly binding the 50S ribosomal subunit to suppress RNA-dependent protein synthesis
51
Macrolides: bacteriostatic or bactericidal?
Typically bacteriostatic
52
Is bacterial killing by macrolides concentration-dependent or -independent? Relevance to management?
Concentration-independent | Give frequent low doses
53
Macrolides adverse effects
Long QT | Interactions
54
Aminoglycosides mechanism of action
Inhibition of protein synthesis by irreversibly binding the 30S ribosomal subunit
55
Aminoglycosides
Gentamicin
56
Aminoglycosides: bacteriostatic or bactericidal?
Bactericidal
57
Aminoglycoside route of administration
IV with monitoring of levels
58
Aminoglycoside spectrum of activity
Gram- (including Pseudomonas) | Some Gram+
59
Aminoglycosides adverse effects
Nephrotoxicity (reversible) | Ototoxicity (irreversible, can occur at any dose/duration; for this reason rarely used at TNH)
60
Lincosamide
Clindamycin
61
"Red-man" syndrome
Administration of glycopeptides too fast; erythema and hypotension due to widespread histamine release

MD2 ID (8 decks)

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