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Z pharm > Antimicrobes > Flashcards

Antimicrobes Flashcards

1
Q

cefazolin

A 
1st gen: 
gram ⊕ cocci, 
Proteus mirabilis, 
E coli, 
Klebsiella pneumoniae. 
Cefazolin used prior to surgery to prevent S aureus wound infections.

β-lactam drugs that inhibit cell wall synthesis
but are less susceptible to penicillinases.
Bactericidal

Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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2
Q

cephalexin

A 
1st gen: 
gram ⊕ cocci, 
Proteus mirabilis, 
E coli, 
Klebsiella pneumoniae.

β-lactam drugs that inhibit cell wall synthesis
but are less susceptible to penicillinases.
Bactericidal

Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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3
Q

cefaclor

A

2nd gen β-lactam drugs that inhibit cell wall synthesis
but are less susceptible to penicillinases.
Bactericidal

—gram ⊕ cocci, 
H influenzae,
Enterobacter aerogenes, 
Neisseria spp., 
Serratia marcescens, 
Proteus mirabilis, 
E coli, 
Klebsiella pneumoniae.
2nd graders wear fake fox fur to tea parties.
2nd generation—HENS PEcK.
Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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4
Q

cefoxitin

A

2nd gen β-lactam drugs that inhibit cell wall synthesis
but are less susceptible to penicillinases.
Bactericidal

gram ⊕ cocci, 
H influenzae,
Enterobacter aerogenes, 
Neisseria spp., 
Serratia marcescens, 
Proteus mirabilis, 
E coli, 
Klebsiella pneumoniae.
2nd graders wear fake fox fur to tea parties.
2nd generation—HENS PEcK.
Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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5
Q

cefuroxime

A

2nd gen β-lactam drugs that inhibit cell wall synthesis
but are less susceptible to penicillinases.
Bactericidal

gram ⊕ cocci, 
H influenzae,
Enterobacter aerogenes, 
Neisseria spp., 
Serratia marcescens, 
Proteus mirabilis, 
E coli, 
Klebsiella pneumoniae.
2nd graders wear fake fox fur to tea parties.
2nd generation—HENS PEcK.
Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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6
Q

cefotetan

A

2nd gen β-lactam drugs that inhibit cell wall synthesis
but are less susceptible to penicillinases.
Bactericidal

gram ⊕ cocci, 
H influenzae,
Enterobacter aerogenes, 
Neisseria spp., 
Serratia marcescens, 
Proteus mirabilis, 
E coli, 
Klebsiella pneumoniae.
2nd graders wear fake fox fur to tea parties.
2nd generation—HENS PEcK.
Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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7
Q

Ceftriaxone

A

3rd gen: serious gram ⊝ infections resistant to other β-lactams.

Can cross blood-brain barrier.
Ceftriaxone—meningitis, gonorrhea,
disseminated Lyme disease.

Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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8
Q

cefpodoxime

A

3rd gen: serious gram ⊝ infections resistant to other β-lactams.

Can cross blood-brain barrier.

Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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9
Q

ceftazidime

A

3rd gen: serious gram ⊝ infections resistant to other β-lactams.
Pseudomonas
Can cross blood-brain barrier.

Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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10
Q

cefotaxime

A

3rd gen: serious gram ⊝ infections resistant to other β-lactams.

Can cross blood-brain barrier.

Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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11
Q

cefepime

A 
4th generation (cefepime)—gram ⊝ organisms,
with increased activity against Pseudomonas and gram
⊕ organisms.
Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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12
Q

ceftaroline

A

5th generation (ceftaroline)—broad gram ⊕ and
gram ⊝ organism coverage; unlike 1st–4th
generation cephalosporins, ceftaroline covers
Listeria,
MRSA,
and Enterococcus faecalis—
does not cover Pseudomonas.

Adverse effects: 
*Hypersensitivity reactions, 
*autoimmune hemolytic anemia, 
disulfiram-like reaction,
vitamin K deficiency. 
Low rate of crossreactivity
even in penicillin-allergic patients.
increase nephrotoxicity of aminoglycosides.
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13
Q

Colistin (polymyxin E), polymyxin B.

A

Cation polypeptides that bind to phospholipids on cell membrane of gram ⊝ bacteria. Disrupt cell
membrane integrity > leakage of cellular components > cell death.

Salvage therapy for multidrug-resistant gram ⊝ bacteria (eg, P aeruginosa, E coli, K pneumoniae).
Polymyxin B is a component of a triple antibiotic ointment used for superficial skin infections.

Nephrotoxicity, neurotoxicity (eg, slurred speech, weakness, paresthesias), respiratory failure.

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14
Q

Dapsone

A

Similar to sulfonamides, but structurally distinct
agent.

CLI NICAL USE: Leprosy (lepromatous and tuberculoid),
Pneumocystis jirovecii prophylaxis.

ADVERSE EFFECTS Hemolysis if G6PD deficient,
methemoglobinemia.

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15
Q

Prophylaxis and Tx for M avium–intracellulare

A

Prophylaxis: Azithromycin, rifabutin

Tx: More drug resistant than M tuberculosis.
Azithromycin or clarithromycin + ethambutol.
Can add rifabutin or ciprofloxacin.

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16
Q

Prophylaxis and Tx M leprae

A

no prevention
Long-term treatment with dapsone and rifampin
for tuberculoid form. Add clofazimine for
lepromatous form.

17
Q

Pyrimethamine

A

treats toxoplasmosis

18
Q

suramin

A

Trypanosoma brucei

19
Q

melarsoprol

A

Trypanosoma brucei

20
Q

nifurtimox

A

T cruzi

21
Q

sodium stibogluconate

A

leishmaniasis

22
Q

Permethin

Lindane

A

(inhibits Na+ channel deactivation
> neuronal membrane depolarization),
malathion (acetylcholinesterase inhibitor),

Lindane (blocks GABA channels
> neurotoxicity).
Used to treat scabies
(Sarcoptes scabiei) and lice (Pediculus and
Pthirus).
Treat PML (Pesty Mites and Lice) with PML
(Permethrin, Malathion, Lindane), because
they NAG you (Na, AChE, GABA blockade).

23
Q

Chloroquine

A

Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia.

CLI NICAL USE
Treatment of plasmodial species other than P falciparum (frequency of resistance in P falciparum is too high). Resistance due to membrane pump that decreases intracellular concentration of drug. Treat
P falciparum with artemether/lumefantrine or atovaquone/proguanil. For life-threatening malaria,
use quinidine in US (quinine elsewhere) or artesunate.
ADVERSE EFFECTS
Retinopathy; pruritus (especially in dark-skinned individuals).

24
Q

Pyrantel pamoate, Ivermectin, Mebendazole Praziquantel,

Diethylcarbamazine.

A

Helminths get PIMP’D
Antihelminthic
therapy

25
Q

Oseltamivir

A

Inhibit influenza neuraminidase > decreases release of progeny virus.

CLI NICAL USE
Treatment and prevention of both influenza A and B. Beginning therapy within 48 hours of
symptom onset may shorten duration of illness.

26
Q

Zanamivir

A

Inhibit influenza neuraminidase > decreases release of progeny virus.

CLI NICAL USE
Treatment and prevention of both influenza A and B. Beginning therapy within 48 hours of
symptom onset may shorten duration of illness.

27
Q

Emtricitabine (FTC)

A

Competitively inhibit nucleotide binding to
reverse transcriptase and terminate the DNA
chain (lack a 3′ OH group). Tenofovir is a
nucleoTide; the others are nucleosides. All
need to be phosphorylated to be active.
ZDV can be used for general prophylaxis
and during pregnancy to decrease risk of fetal
transmission.
Have you dined (vudine) with my nuclear
(nucleosides) family?

Bone marrow suppression (can be reversed with
granulocyte colony-stimulating factor [G-CSF]
and erythropoietin), peripheral neuropathy,
lactic acidosis (nucleosides), anemia (ZDV),
pancreatitis (didanosine).
Abacavir contraindicated if patient has
HLA-B*5701 mutation due to increased risk of
hypersensitivity.

28
Q

Enfuvirtide

A

Binds gp41, inhibiting viral entry. Skin reaction at injection sites.

Enfuvirtide inhibits fusion.

29
Q

Maraviroc

A

Maraviroc Binds CCR-5 on surface of T cells/monocytes,
inhibiting interaction with gp120.
Maraviroc inhibits docking

Z pharm (4 decks)

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