Antibiotics: Part 1 (Revised) Flashcards by Dylan Null

Only effective against a few classes of bacteria.

Narrow Spectrum

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Effective against a broad range of bacteria.

Broad Spectrum

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A chemically modified narrow-spectrum agent used to increase effectiveness against more bacteria.

Extended Spectrum

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Drug that inhibits growth and replication of bacteria.

Bacteriostatic

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Drug that actually kills bacteria.

Bactericidal

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Total amount of drug that is exposed to the body over time.

Area Under the Curve (AUC)

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Lowest concentration of a drug that can prevent growth of the organism.

Minimum Inhibitory Concentration

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Antibiotics that eradicate microbes based on the time for which bacteria are exposed to the antibiotics at a concentration higher than the minimum inhibitory concentration.

Time-dependent Antibiotics

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What class of antibiotics are all “Time-dependent”

Carbapenems

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Antibiotics where the rate and extent of killing increases as peak drug concentration increases.

Concentration Dependent Antibiotics

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An affect that causes suppression of bacterial growth after a limited exposure to an antibiotic

Post-Antibiotic Effect

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What classes of antibiotics work via Cell Wall Inhibition?

Beta Lactams
Aztreonam
Gylcopeptides
Lipopeptides

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What families of antibiotics consist of Beta Lactams (which are also Cell Wall Inhibitors)

Penicillins
Cephalosporins
Carbapenems

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What antibiotics work via Protein Synthesis Inhibition?

Clindamycin
Chloramphenicol
Linezolid
Erythromycin
Azithromycin
Tetracyclines
Aminoglycosides

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What antibiotic works via Folate Antagonism?

Sulfonamides and Trimethoprim
(Bactrim)

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What class of antibiotics work via the Inhibition of DNA Topoisomerases?

Fluoroquinalones

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Bacteriostatic Antibiotics:
ECSTaTiC

Erythromycin
Clindamycin
Sulfamethoxazole
Trimethoprim
Tetracycline
Chloramphenicol

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Bactericidal Antibiotics:
Very Finely Proficient At Cell Murder

Vancomycin
Fluoroquinalones
Penicillins
Aminoglycosides
Cephalosporins
Metronidazole

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Beta-lactams and Monobactams consist of 4 different subcategories.

Penicillins
Cephalosporins
Carbapenems
Monobactam

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The final step in synthesis of a bacterial cell wall is the cross-linking of adjacent peptidoglycan stands. What is this process called?

Transpeptidation

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Beta-lactams and Monobactams work via competing for and binding to enzymes that catalyze transpeptidation and cross linking. What are the enzymes in this process known as?

Penicillin-Binding Proteins (PBPs)

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All beta-lactams are bactericidal or bacteriostatic?

Bactericidal

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What is the name of the bacterial enzymes that breaks the beta-lactam ring of antibiotics, making them ineffective.

Beta Lactamase

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A high dose of Beta-Lacatams or Monobactams can cause what medical emergency?

Seizures

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Accumulation of Beta-Lactams and Monobactams might occur if the dose of the antibiotics doesn't adjust or account for what function in the body?

Renal Function

What are the two natural penicillins that we learned about in this lecture?

Penicillin G Penicillin VK

Penicillin G and Penicillin VK are reliable against what two organisms?

Streptococci Treponema pallidum

Penicillin G and Penicillin VK are the drugs of choice against what two diseases?

Syphilis (G) Streptococcal Pharyngitis (VK)

What are the two Aminopenicillins that we learned about in this lecture?

Ampicillin Amoxicillin

Ampicillin and Amoxicillin are reliable against what two organisms?

Enterococci Streptococci

Amoxicillin is the drug of choice for what infection?

Otitis Media

Ampicillin is the drug of choice for what two infections?

Enterococci Listeria monocytogenes

Ampicillin by itself is only bacteriostatic against enterococci, what must be added as a synergist to allow it to become bactericidal?

Aminoglycoside

What are three anti-staphylococcal penicillins that we learned about in this lecture? (AKA - Penicillinase-Resistant Penicillins)

Nafcillin Oxacillin Methicillin

Nafcillin, Oxacillin, and Methicillin are reliable against what two organisms?

MSSA Streptococci

Nafcillin, Oxacillin, and Methicillin are the drugs of choice for what infections?

SSTIs Endocarditis (MSSA)

Why are Nafcillin, Oxacillin, and Methicillin preferred of Vancomycin for MSSA infections?

They are more rapidly bactericidal

What are the three pairs of Beta-Lactams + Beta-Lactamase Inhibitors that we learned about in this lecture?

Ampicillin + Sulbactam (Unasyn) Amoxicillin + Clavulanate (Augmentin) Piperacillin + Tazobactam (Zosyn)

Piperacillin + Tazobactam (Zosyn) is reliable against what organism?

Pseudomonas aeruginosa

Piperacillin + Tazobactam (Zosyn) and Ticarcillin + Clavulanate can be used to treat what type of nosocomial infection?

Hospital Acquired Pneumonia (HAP)

B-Lactams + B-Lactamase Inhibitors restore of the activity of antibiotics against B-Lactamase producing bacteria. This means they have no effect on resistance that is acquired through other means. Name two examples of organisms where this synergism would have no effect?

MRSA PCN-resistant pneumococci

What is the most common drug allergy that is reported by patients?

Penicillin Allergy

What is the most common presentation of a penicillin allergy?

Rash

What percent of the population reports having a penicillin allergy?

10%

What percent of the population that reports have a penicillin allergy, actually has one?

10%

How do cephalosporins work? What is their mechanism of action?

Inhibition of Cell Wall Synthesis (via binding to Penicillin Binding Proteins)

What generation of cephalosporins are able to penetrate the central nervous system?

3rd Gen.

What disease do 3rd Gen. Cephalosporins allows us to treat?

Meningits

What are the two 1st Gen. Cephalosporins that we learned about in this lecture?

Cefazolin Cephalexin

Cefazolin and Cephalexin are reliable against what two organisms?

MSSA Streptococci

Cefazolin and Cephalexin may be used to treat or prevent what diseases?

SSTIs and Endocarditis (MSSA) Surgical Prophylaxis

What is the 2nd Gen. Cephalosporin that we learned about in this lecture that is considered to be for "Respiratory" treatments?

Cefuroxime

What organism is Cefuroxime reliable against?

H. influenzae

2nd Gen. Cephalosporins activity against H. influenzae differentiates it from what generation of cephalosporins?

1st Gen.

What are the two 2nd Gen. Cephalosporins that we learned about in this lecture that are considered to be for "Enteric" treatments?

Cefoxitin Cefotetan

What organism is Cefoxitin and Cefotetan reliable against?

H. influenzae

Cefoxitin and Cefotetan may be used to treat what two types of infection and a prophylaxis for what type of surgery?

Abdominal and Gynecologic Infections Abdominal Surgery Prophylaxis

Cefoxitin and Cefotetan are differentiated from other cephalosporins due to their activity against what organism?

Bacteroides fragilis

What two 3rd Gen. Cephalosporins did we focus on in this lecture?

Ceftriaxone Ceftazidime

What organism is Ceftazidime reliable against?

Pseudomonas aeruginosa

Ceftriaxone + a macrolide or doxycycline can be used to treat what three diseases?

Community Acquired Pneumonia (CAP) UTIs Lyme Disease

Ceftriaxone is the drug of choice for what two infections?

Gonorrhea Meningitis

What is the 4th Gen. Cephalosporin that we learned about in this lecture?

Cefepime

What organism is Cefepime reliable against?

Pseudomonas aeruginosa

What is the additive bonus of a 4th Gen. Cephalosporin over a 3rd Gen. Cephalosporin?

better Staph + Strep activity

What is the 5th Gen. Cephalosporin that we learned about in this lecture?

Ceftaroline

Ceftaroline has a high affinity for penicillin-binding protein 2a which allows it to be effective against what organism?

MRSA

Ceftaroline is similar to Ceftriaxone with the additional activity against what two organisms?

MRSA E. faecalis

What are the two carbapenems that we learned about in this lecture?

Imipenem Meropenem

Carbapenems are the drug of choice for what type of organism?

Extended-Spectrum Beta Lactamase producing GNRs (ESBL)

What is the name of the Monobactam that we learned about during this lecture?

Aztreonam

What does Aztreonam have no activity against?

Gram (+) bacteria

Aztreonam is reliable against what two organisms?

Most GNRs Pseudomonas

Aztreonam is often used in patients with what type of severe allergy?

B-lactam allergy

What class of oral antibiotics are a good option for treating Pseudomonas?

Fluoroquinalones

What class of IV antibiotics are a good option for treating Pseudomonas?

Carbapenems

What are the only two antibiotics discussed in this lecture that did not require renal dose adjustments?

Ceftriaxone Nafcillin

What is the name of the Gylcopeptide antibiotic that was discussed in this lecture?

Vancomycin

How does Vancomycin work? What is the mechanism of action?

Inhibits cross-linking of linear peptidoglycans

What must be monitored when administering Vancomycin to a patient?

Drug Levels

What are three adverse drug reactions that Vancomycin might cause?

Nephrotoxicity Ototoxicity Red-Man Syndrome

What organism is Vancomycin reliable against and the drug of choice for?

MRSA

Why might you give Vancomycin orally to a patient?

Severe C. difficile infection

Why is Vancomycin not systemically distributed when taken orally?

Not absorbed by the GI tract

What is the name of the Lipopeptide that we learned about in this lecture?

Daptomycin

How does Daptomycin work? What is the mechanism of action?

Binds to the membrane of the bacteria and causes a depolarization of the bacteria. This results in the loss of membrane potential and results in death.

Daptomycin should be avoided in cases of what disease?

Pneumonia

What are two adverse drug reactions that when taking Daptomycin may occur?

Rhabdomyolysis (avoid with statins if possible) Hepatic Effects

What are three aminoglycosides that we learned about in this lecture?

Gentamicin Tobramycin Amikacin

Are aminoglycosides bactericidal or bacteriostatic?

Bactericidal

How do aminoglycosides work? What is the mechanism of action?

Protein Synthesis Inhibition (30s Subunit)

What must you monitor when administering a patient aminoglycosides?

Drug Levels

Are aminoglycosides given as a monotherapy or in a combination therapy?

Combination Therapy

What are the two adverse drug reactions we learned about that can occur due to Aminoglycosides?

Nephrotoxicity Ototoxicity

What are some infections where aminoglycosides would be used as part of a combination therapy?

Sepsis Cystic Fibrosis Ventilator Associated Pneumonia Febrile Neutropenia

Aminoglycosides have no coverage against Gram (+) bacteria. What antibiotics might you pair this with to gain that coverage?

Beta Lactams Vancomycin