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Block 1: Pharmacology > Antibiotics Overview > Flashcards

Antibiotics Overview Flashcards

1
Q

What are Antibiotics?

A

Chemicals that inhibit or kill Microorganisms (Bacteria ONLY)
(WILL NOT WORK ON VIRUSES)

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2
Q

Selective Toxicity?

A

Harm Bacteria without harming our cells

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3
Q

Ideal Antibiotic?

A

Kill Bacteria with no side effect (Penicillin G)

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4
Q

Types of Antibiotics?

A

-Bacteriostatic
-Bactericidal
-Sulfonamides

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5
Q

(Types of Antibiotics)
Bacteriostatic?

A

(Inhibit bacterial cell replication)
STATEC:
-Tetracyclines
-Erythromycin
-Chloramphenicol

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6
Q

(Types of Antibiotics)
Bactericidal?

A

(Causes microbial cell death and lysis)
PACS A PUNCH:
-Penicillins
-Aminoglycosides (Gentamycin, Tobramycin)
-Cephalosporins

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7
Q

Sulfonamides?

A

(Either -cidal or -static according to environment)
“Surfs Between -cidal and -static”

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8
Q

Targets for Drug?

A

-Cell Wall Synthesis
-DNA –> RNA
-Protein Synthesis
-Cell Membrane
-Folic Acid

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9
Q

(Targets for Drug)
Cell Wall Synthesis?

A

(PCCMV)
“I hit a wall, Please Come C My Vehicle”
-Penicillin (G, Ampicillin)
-Cephalosporin (Ceftriaxone, Ceftaroline)
-Carbapenems (Imipenam)
-Monobactams (Aztreonam)
-Vancomycin (Tricyclic Glycopeptide)

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10
Q

(Targets for Drug)
DNA –> RNA?

A

(MR. Q)
-Quinolones DNA gyrase, Replication (Ciprofloxacin, Levofloxacin)
-Rifampin (RNA Polymerase)
-Metronidazole (Damage DNA)

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11
Q

(Targets for Drug)
Protein Synthesis?

A

(MAT C)
-Tetracyclines (Doxycycline)
-Aminoglycosides (Gentamycin, Tobramycin)
-Chloramphenicol
-Macrolides: Azithromycin, Erythromycin

(Both make 70s)
(50s: Macrolides, Chloramphenicol, Lincosamides, Streptogramins, Oxazolidines)
(30s: Tetracycline, Glycylcyclines, Aminoglycosides)

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12
Q

(Targets for Drug)
Cell Membrane?

A

(PD)
“Daps the Membrane, punch a hole in the Membrane”
-Polymyxins
-Daptomycin

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13
Q

(Targets for Drug)
Folic Acid?

A

-Trimethoprim
-Sulfonamides (Sulfamethoxazole)

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14
Q

Treatment for C. Diff?

A

Vancomycin

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15
Q

Resistant Bacteria in GI system?

A

-C. Diff
-C. Albicin

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16
Q

Empiric Therapy?

A

When there is not enough time to wait for lab test, so you make an Educated guess based on guidelines

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17
Q

Ideal situation for when a patient presents with symptoms of possible bacterial infection is to?

A

Identify via Lab Tests

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18
Q

Drugs of Choice for Empiric Therapy “First Choice”?

A
  • Treponema pallidum, Syphillis (Penicillin G)

-Mycobacterium tuberculosis (RIPE) (Rifampin + Isoniazid + Pyrazinamide + Ethambutol)

-Psuedomonas aeruginosa, Pneumonia
(PTT) (Piperacillin/Tazobactam + Tobramycin)
(B. Lactam/B. Lactamase Inhibitor + Aminoglycoside)

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19
Q

(Drugs of Choice for Empiric Therapy “First Choice”)
Treponema pallidum, Syphilis?

A

Penicillin G

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20
Q

(Drugs of Choice for Empiric Therapy “First Choice”)
Mycobacterium tuberculosis?

A

(RIPE)
-Rifampin
-Isoniazid
-Pyrazinamide
-Ethambutol

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21
Q

(Drugs of Choice for Empiric Therapy “First Choice”)
Pseudomonas aeruginosa, Pneumonia?

A

(PTT)
-Piperacillin/Tazobactam
-Tobramycin

-B. Lactam/B. Lactamase Inhibitor + Amigoglycoside

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22
Q

AGE?

A

-Neonates
-Children
-CHF
(Increase Gentamicin (NOT a Contraindication))

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23
Q

(AGE)
Neonates?

A

-Chloramphenicol –> Gray Baby Syndrome (lower dose)
-Sulfonamides –> Kernicterus or Toxic Encephalopathy (Contraindication)

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24
Q

(AGE)
Children?

A

Tetracycline –> Bone growth/Teeth discoloration

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25
Q

(AGE)
CHF?

A

Ticarcillin disodium/Clavulanate potassium –> Edema/Arrythmia

26
Q

Pregnancy Contradications?

A

(MFSAT)
“MF SAT”
-Metronidazole
-Fluoroquinolones
-Sulfonamides
-Antifolate drugs (Try)
-Tetracyclines

27
Q

Synergy?

A

-Cell Wall Synthesis Inhibitor (Penicillin) + Protein Synthesis Inhibitor (Aminoglycoside)

-Sequential Pathway, beta-Lactamase Inhibitor: TazoBactam

28
Q

(Synergy)
Penicillins + Aminoglycosides?

A

Penicillins:
-Penicillin G
-Ampicillin
-Piperacillin

Aminoglycosides:
-Gentamicin
-Tobramycin
-Amikacin

29
Q

Penicillins?

A

(All B-Lactams)
-Mechanisms of Action
-Pharmacokinetics
-Side Effects
-Mechanisms of Resistance

30
Q

(Penicillins)
Mechanisms of Action?

A

-Inhibit peptidoglycan transpeptidase (Cross-Linking)
-Penicillin Binding Protein (PBP)
-Trigger autolysins

31
Q

(Penicillins)
Pharmacokinetics?

A

Majority undergo renal clearance (ALL ANTIBIOTICS)

32
Q

(Penicillins)
Side Effects?

A

-NVD
-Superinfection of GI Tract: C. Diff
-Allergy

33
Q

(Penicillins)
Mechanisms of Resistance?

A

-Changes in PBP
-Tolerance: deficiency in autolytic enzymes
-Changes in porins (Gram -) beta-Lactamase

34
Q

NVD?

A

-Nausea
-Vomiting
-Diarrhea

35
Q

Cephalosporins (B-Lactam)?

A

-Cefazolin 1st (PEKS)
-Cefoxitin 2nd (HEN PEK)
-Ceftriaxone 3rd (ACES)
-Cefepime 4th (Gram +)
-Ceftaroline 5th

36
Q

If allergic to Penicillin, probably allergic to?

A

Cephalosporins

37
Q

Monobactam (B-Lactam)?

A

Aztreonam
(Give if Allergic to Penicillin)
(mostly G-rods)
-Side effects: 1% of B-Lactam allergic patients

38
Q

What Drug to use if Patient is allergic to Penicillin?

A

Aztreonam (Monobactam (B-Lactam))

39
Q

(Cephalosporins (B-Lactam))
Cefazolin?

A

1st (PEKS)
-Proteus mirabilis
-Escherichia coli
-Klebsiella pneumonia

40
Q

(Cephalosporins (B-Lactam))
Cefoxitin?

A

2nd (HEN PEK)
-Haemophilus influenzae
-Enterobacter aerogenes
-Neisseria gonorrhoeae

41
Q

(Cephalosporins (B-Lactam))
Ceftriaxone?

A

3rd (ACES)
-Acinetobacter calcoaceticus
-Citrobacter diversus
-Enterobacter cloacae
-Serratia marcescens

42
Q

(Cephalosporins (B-Lactam))
Cefepime?

A

4th (Gram +)

43
Q

Cephalosporins (B-Lactam) has same Mechanism of Action/Resistance?

A

Same as Penicillin

44
Q

Do not give to patients with a history of severe penicillin reaction?

A

Cephalosporins (B-Lactams)

45
Q

Tricyclic Glycopeptide (Cell Wall Synthesis)?

A

(Vancomycin)
Mechanisms of Action:
-Inhibitor of peptidoglycan synthase (attaches to NAG and NAM), binds to D-Ala-D-Ala

Therapeutic Uses:
-Primarily G+: MRSA, MRSE, Serious multi-drug resistance infections (Clostridioides difficile (PO))

Mechanisms of Resistance:
-D-Ala-D-Ala –> D-Ala-D-Lactate
-VRE (Vancomycin resistant enterococci) = overproduce D-ALA

46
Q

Tricyclic Glycopeptide (Cell Wall Synthesis)
Mechanisms of Action?

A

-Inhibitor of peptidoglycan synthase (attaches to NAG and NAM)
-Binds to D-Ala-D-Ala

47
Q

Tricyclic Glycopeptide (Cell Wall Synthesis)
Therapeutic Uses?

A

Primarily G+: MRSA, MRSE, Serious multi-drug resistance infections (Clostridioides difficile (PO))

48
Q

Tricyclic Glycopeptide (Cell Wall Synthesis)
Mechanisms of Resistance?

A

-D-Ala-D-Ala –> D-Ala-D-Lactate
-VRE (Vancomycin resistant enterococci) = overproduce D-ALA

49
Q

Cyclic Lipopeptide (Cell Wall Synthesis)?

A

-Daptomycin (DAPS HOLES)
-Mechanism of Action:
Binds to cell membrane, forms pores
-Therapeutic use:
Primarily G+: MRSA, VRE

50
Q

Tetracyclines (Protein Synthesis Inhibitor, 30s A site)?

A

-Bacteriostatic (TEC)
-Doxycycline primarily fecally eliminated –> OK with renal failure
-Contraindicated during pregnancy

51
Q

Doxycycline primarily fecal eliminated but ok with?

A

Renal Failure

52
Q

Glycylcyclines?

A

Tigecycline (Reserved for: Difficult to treat infection)
-MOA: 30s Protein Synth Inhibitor
-Increase risk of mortality, contradiction in pregnancy
-Tiger = Mortality

53
Q

Tiger = ?

A

Mortality

54
Q

Macrolides?

A

Erythromycin, Azithromycin
-MOA: 50s, Protein Synth Inhibitor
-USE: Chlamydia, URTI
-Side Effects: Prolong QTc interval
-MOR: Methylation of 23 rRNA-binding site, prevents binding

55
Q

Macrolides used for?

A

-Upper Respiratory Tract Infections
-Chlamydia

56
Q

Lincosamides?

A

“CCC”
(Clindamycin, Ca-mrsa, CDAD)
-MOA: Protein Synth Inhibitors, 50s Ribosomal Unit
-USE: CA-MRSA
-Side Effects: CDAD

57
Q

Streptogramins?

A

Quinopristin/Dalfopristin (In Same Dose) Synergy
-MOA: Binds to 50s ribosome subunit, Bactericidal

58
Q

Aminoglycosides?

A

Gentamicin, Tobramycin
-MOA: 30s ribosomal
-Bactericidal
-Synergistic with B-Lactams (PCCM)

59
Q

Sulfonamides?

A

Sulfamethoxazole, Trimethoprim (-DFHR)
-S= Inhibition of Dihydropteroate synthase
-T= Inhibition of Dihydrofolate reductase
(Both Inhibit Folic Acid Synth)
-Side Effects: Rash: Sulfa allergy, SJS, TEN

60
Q

SJS do not take?

A

Sulfonamides

Block 1: Pharmacology (9 decks)

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