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Antimicrobial Flashcards

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1
Q

Drugs the block viral penetration

A
  1. Enfuvirtide
  2. Maravoric
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2
Q

Macrolides adverse affect

A
  1. Stimulate motilin receptors causing GI distress (Clarithromycin is the least)
  2. Reversible deafness at high doses
  3. Increase QT interval
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3
Q

Most likely cause of pseudomembranous colitis

A

Clindamycin

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4
Q

First generation cephalosporins cover

A
  1. Gram + cocci
  2. E. coli
  3. Klebsiella
  4. Proteus
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5
Q

Pyrantel pamoate mechanism of action

A

NM agonist leading to spastic paralysis

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6
Q

DOC for Trichomoniasis

A

Metronidazole

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7
Q

Penicillins and cephalosporins mechanism of resistance

A

Beta-lactamases that cleave the beta-lactam ring strucutre changing penicillin-binding proteins

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8
Q

Which Azole enters CSF

A

Fluconazole

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9
Q

DOC for Trypanosomiasis (African)

A

Arsenicals

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10
Q

Acyclovir adverse affects

A
  1. Crystalluria (maintain hydration)
  2. Neurotoxicity
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11
Q

Linezolid mechanism of action

A
  • Binds to 50S and inhibits formation of initiation complex
  • Prevents formation of N-formylmethionyl-tRNA-robosome-mRNA ternary complex
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12
Q

Ganciclovir adverse affects

A
  1. Hematotoxicity (leukopenia, thrombocytopenia)
  2. Mucositis, fever, rash
  3. Crystalluria
  4. Seizures in OD
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13
Q

Drugs the inhibit viral DNA polymerases

A
  1. Acyclovir
  2. Foscarnet
  3. Ganciclovir
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14
Q

Affect of food on Itraconazole

A

Increase absorption

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15
Q

Griseofulvin adverse affects

A

Disulfiram

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16
Q

Fluctosine Mechanism of action

A
  • Activated by fungal cytosine deaminase to 5-FU then after triphosphorylation is incorportaed into fungal RNA
  • also inhibits thymidylate sythase decreasing thymine when it is in 5-fluorodeoxyurine monophosphate (5-Fd-UMP) form
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17
Q

AG spectrum

A
  1. Gram - rods
  2. TB
  3. Bubonic plague
  4. Tularemia
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18
Q

Cefaclor is

A

Second generation cephalosporin

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19
Q

Streptomycin used for

A

AG

  1. TB
  2. DOC for Bubonic plague and tularemia
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20
Q

Drugs that inhibit viral aspartate protease

A

-Navir

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21
Q

Drugs that inhibit nucleic synthesis

A
  1. Fluoroquinolones
  2. Rifampin
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22
Q

DOC for Toxoplasmosis

A

Pyrimethamine and sulfadiazine

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23
Q

Very narrow Spectrum penicillins are

A

Beta-lactamase resistant

  1. Nafcillin
  2. Methicillin
  3. Oxacillin
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24
Q

INH mechanism of action

A
  1. Inhibits mycolic acid synthesis
  2. Requires converstion by catalase
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25
Macrolide drugs:
**-THROMYCIN** 1. Erythromycin 2. Azithromycin 3. Clarithromycin
26
Vancomycin covers
1. MRSA 2. Enterococci 3. C. Diff
27
Drugs that inhibit viral reverse transcriptase
1. **Zalcitabine** 2. **Nevirapine** 3. **Efavirenz** 4. **-Dine** (Pyrimidine) 5. **-Sine** (Purine)
28
Ceftriaxone is
Third generation cephalosporin given IM
29
Cefotetan is
Second generation Cephalosporin
30
Foscarnet adverse affects
1. Nephrotoxicity with ATN 2. Avoid **Pentamidine IV** (increases Nephrotoxicity and HypoCa)
31
DOC for Trypanosomiasis (Chagas disease)
Nifurtimox
32
Ampicillin covers
1. G + cocci but not staph 2. E. coli 3. H. Influenzae 4. Listeria
33
Fluoroquinolone adverse affects
1. Tendonitis, tendon rupture 2. Phototoxicity, rash 3. CNS (insomnia, dizziness, headache)
34
Aminoglycoside CHX:
Bactericidal Needs O2 Dependent uptake (Anaerobes are resistant)
35
What penicillins are excreated in bile:
1. Nafcillin 2. Oxacillin
36
Second generation cephalosporin CNS entry
None other **Cefuroxime**
37
Extended spectrum Penicillins are
**Antipseudomonal** **Beta lactamase sensitive** 1. Ticarcillin 2. Piperacillin
38
Terbinafine used for
Dermatophytes
39
Sulfonamides mechanism of resistance
* Change in sensitivity to inhibition of target enzyme. * Increase formation of PABA * Use os exogenous Folic Acid
40
DOC for Amebiasis infection
Metronidazole
41
Cefazolin is
First generation Cephalosporin
42
Doxycycline used for
**Tetracycline** Prostitis because it collects in prostatic fluid
43
Ketoconazole Co-DOC for
**Paracoccidiodes** and back up for **Blastomyces** and **Histoplasma**
44
Polyenes are
1. Amphotericin B 2. Nystatin
45
Drugs that inhibit viral RNA polymerase
1. Foscarnet 2. Ribavirin
46
Demeclocycline used for
**Tetracycline** Used in SIADH because it blocks ADH receptors
47
Macrolides and clindamycin mechanism of action
Bind to 50S and inhibit translocation
48
INH mechanis of resistance
Deletion of **katG** gene
49
INH adverse affects
1. Hepatitis (age dependent) 2. Peripheral neuritis (give **B6**) 3. Sideroblastic anemia (give **B6**) 4. SLE in slow acetylators
50
Cefotaxime is
Third generation cephalosporin given parenteral
51
Carbepenems are
1. Imi**penem** 2. Mero**penem**
52
Sulfonamides inhibits
Dihydropteroate synthetase preventing converstion of Dihydropteroid acid
53
Fluroquinolones inhibit
Topoisomerase 2 (DNA gyrase) and topoisomerase 4 (seperates replicated DNA during cell division)
54
Drugs that inhibit viral neuraminidase
1. Zanamivir 2. Oseltamivier
55
Narrow spectrum Penicillins are:
Pen G and Pen V
56
Ethambutol mechanism of action
Inhibits synthesis of **arabinogalactan** (part of cell wall)
57
Fluoroquinolones spectrum
1. UTI 2. STD: **Chlamydia**, **gonorrhea** 3. Gram - skin, soft tissue and bone infections 4. Diarrhea due to **Shigella**, **Salmonella**, **E. coli**, **Campylobacter**
58
Extended spectrum Penicillins cover
1. Gram - rods 2. Psedomonas
59
Lamivudine adverse affects
Least toxic of the NRTIs but some GI and Neutropenia
60
Cephalexin is
First generation cephalosporin
61
Carbepenem mechanism of action
Same as penicillin and cephalosporin but are **Beta-Lactamase resistant**
62
Trimethoprim-sulfamethoxazole spectrum
1. **DOC** in Nocardia 2. Listeria (backup) 3. Gram - (E. coli, Salmonella, Shigella, H. influenzae) 4. Gram + (Staph, MRSA, Strep) 5. Pneumocystis jiroveci 6. Toxoplasma gondii
63
Rifampin adverse affects
1. Hepatitis 2. Induction of P450 (give **Rifabutin** instead) 3. Red-Orange metabolites
64
Didanosine Adverse affects
1. Pancreatitis 2. Peripheral neuopathy, hyperuricemia, liver dysfunction
65
Tetracycline adverse affects
1. Tooth enam dysplasia and decreas bone growth in children 2. Photoxicity (**Demeclocycline**, **doxycycline**) 3. GI distress 4. Vestibular dysfunction (**Minocycline**) 5. Liver dysfunction during pregnancy
66
Vancomycin mechanism of action
Binging to **D-ala-D-ala** to sterically hinder the **tranglycosylation** reaction and preventing elongation of peptidoglycan chains
67
FAST drugs not used in pregnancy
* F: Fluoroquinolones * A: AG * S: Sulfonamides * T: Tetracycline
68
Which cephalosporin is eliminated in the bile?
Ceftriaxone
69
Praziquantel used for
1. Cestodes (tapeworms) 2. Trematodes (flukes)
70
Macrolides DOC for
Community acquired pneumonia
71
Tetracycline mechanism of action
Binds to 30S and inhibites AA incorportation by blocking the attachment of **aminoacyl tRNA** to acceptor site
72
Acyclovir used for
non-resistant HSV and VZV
73
Aminoglycosides mechanism of action
* Binds to 30S and inhibits formation of initiation complex * Interfere with initiation codon function by blocking association of 50S ribosomal subunit with mRNA-30S causing misreading of code * Incorporates wrong AA
74
Amoxicillin covers
1. G + cocci but not staph 2. E. coli 3. H. Influenzae 4. **Borreilia** 5. **H. Pylori**
75
AG mechanism of resistance
Formation of enzymes that inactivate drugs via conjugation reactions that transfer acetyl, phosphoryl or adenylyl groups
76
Fluconazole DOC for
Esophageal and invasive **Candidiasis** and **Coccidioidomycoses**
77
Ribavirin adverse affects
1. Hematotoxic 2. Upper airway irritation 3. Teratogenic
78
Chloramphenical mechanism of action
Bind to 50S to inhibit formation of peptide bond by inhibiting activity of **peptidyl-transferase**
79
Drugs that block viral uncoating
1. Amantadine 2. Ramaltidine
80
Itraconazole and Voriconazole DOC for
**Blastomycoses**, **Sporotrichoses**, **aspergillosis** Back up for mycoses and **candidiasis**
81
Clinical value of Clindamycin
Accumulates in bone so good for Gram + osteomyelitis
82
Fluoroquinolones mechanism of resistance
* Change in sensitivity to inhibition of target enzymes * Increase activity of transport system that promotes drug efflux
83
Macrolides and Clindamycin mechanism of resistance
* Formation of methytransferases that alter drug binding site on the 50S ribosomal subunit * Active transport out of cells
84
First generation cephalosporins CNS entry
None
85
Drugs the inhibit bacterial cell wall
1. Penicillin 2. Cephalosporin 3. Imipenem/Meropenem 4. Aztreonam 5. Vancomycin
86
Ribavirin mechanism of action
* **Monophosphorylated** form inhibits **IMP dehydrogenase** * Triphosphate inhibits viral **RNA polymerase** and **end-capping** of viral RNA
87
First generation cephalosporins are commonly used for
Surgical prophylaxis
88
Cefixime is
third generation cephalosporin given Orally
89
Which tetracycline is excreted via liver?
Doxycycline
90
Dalfopristin/quinupristin (**streptogramins**) mechanism of action
Binds to 50S and inhibites AA incorportation by blocking the attachment of **aminoacyl tRNA**​ to acceptor site
91
Second generation cephalosporin cover
1. Increase Gram - coverage 2. some anaerobes
92
Terbinafine adverse affects
1. GI distress 2. Rash 3. Headache 4. Increase liver function test
93
Drugs that inhibit bacterial proten synthesis
1. AG 2. Chloramphenicol 3. Macrolides 4. Tetracyclines 5. Streptogramins 6. Linezolid
94
Acyclovir mechanism of action
* Phosphorylated by viral **thymidine** **kindase** * Phosphorylated Acyclovir inhibits viral **DNA polymerase** * Incorporated into DNA and acts as a **chain terminator**
95
Polyenes mechanism of action
Interact with **ergosterol** in funal membrane to form artificial pores which disrupt membrane permeability
96
Affect of antacid on Ketoconazole
Decrease absorption
97
Linezolid adverse affects
Bone marrow suppression (platelets) causes bleeding
98
Imipenem is given with what to decrease metabolim to a nephrotoxic metabolite
Cilastatin
99
DOC for Leishmaniasis
Stibogluconate
100
Tetracycline spectrum
1. Chlamydia 2. Mycoplasma 3. H. Pylori 4. Rickettsia 5. Borrelia 6. Brucella 7. Vibrio 8. Treponema (backup drug)
101
Drugs for intestinal nematodes (worms)
1. Mebendazole 2. Pyrantel pamoate
102
Tigercycline used for
**Tetracycline** complicated skin, soft tissue, and intestinal infections due to resistant gram +, gram -, and anarobes
103
Praziquantel mechanism of action
Increase Ca influx leading to increase vacuolization
104
Clindamycin spectrum
1. Very narrow 2. Gram + Cocci 3. Anaerobes
105
Griseofulvin mechanism of action
deposits in newly formed keratin and disrupts microtubule structure
106
Vancomycin elimination:
Via renal filtration Conteract dose with renal impairment
107
Trimethoprim or pyrimethamine adverse affects
Bone marrow suppression (leukopenia)
108
Amp B DOC for
1. Aspergillus 2. Candida 3. Cryptococcus 4. Histoplasma 5. Mucor 6. Sporothrix
109
Griseofluvin used for
Dermatophytes orally
110
AG drugs:
1. Gentamicin 2. Tobramcyin 3. Amikacin 4. Streptomycin 5. **-MYCIN**
111
Third generation cephalosporins CNS entry
Yes and are important in empiric managment of meningitis and sepsis
112
Aztreonam mechanism of action
Same as penicillin and cephalosporins but **Resistant to Beta-Lactamases**
113
Aztreonam is used for
IV for Gram - rods
114
Ethambutol adverse affects
Retrobular neuritis causing decrease vision and red-green discrimination
115
Drugs that inhibit Folic Acid Synthesis
1. Sulfonamides 2. Trimethoprim 3. Pyrimethamine
116
Terbinafine mechanism of action
Inhibits squaliene epoxidase decreasing ergosterol
117
Macrolides spectrum
1. Gram + cocci 2. Atypical organisms 3. Legionella 4. Campylobacter jejuni 5. MAC 6. H. pylori
118
Raltegravir mechanism of action
Integrase inhibitor
119
Third generation cephalosporins cover
1. Gram + and Gram - cocci 2. N. gonorrhea 3. Gram - rods
120
AZOLES mechanism of action
Fungicidal that interfere with the synthesis of ergosterol by inhibiting **14-alpha-demethylase** (funal P450) that converts **lanosterol to ergosterol**
121
Zidovudine adverse affects
1. Hematotoxicity 2. Myalgia, myopathy and peripheral neuropathy
122
Tetracyclines Mechanism of resistance
Pumps out the drug
123
Cefepime is
Fourth generation cephalosporin give in IV
124
Mebendazole mechanism of action
Decrease glucose uptake and decrease microtubular structure
125
Ribavirin Clinical uses
1. Hep C and RSV 2. Lassa fever 3. Hantavirus
126
DOC for Giardiasis
Metronidazole
127
Carbepenem adverse affects
* GI distress * Drug fever (partial cross- allergenicity with Pen) * CNS effects: seizures * Renal dysfunction with Imipenem
128
Rifampin mechanism of action
inhibits **DNA-dependent RNA polymerase** NA synthesis inhibitor
129
Caspo**fungin** (Echinocandins) mechanism of action
Inhibit synthesis of Beta-1,2 glucan
130
Azoles adverse affect
Decreas synthesis of steriods including cortisol and testosterone leading to: 1. Decreased Libido 2. Gynecomastia 3. Menstrual irregularities
131
Penicillin mechanism of action
Interact with cytoplasmic membrane-binding proteins (**PBP**) to inhibit **transpeptidation** **reaction** involved in **cross-liking** the final steps in cell-wall synthesis
132
Drugs that cause phototoxicity
* Tetracycline * Sulfonamides * Quinolones
133
Carbepenem cover
1. Gram + cocci 2. Gram - rods 3. Anaerobes
134
Vancomycin adverse affects
1. Red-man syndrome (histamine release. Give corticosteroids or antihistamine) 2. Ototoxicity 3. Nephrotoxicity
135
Fluconazole prophylaxis for
Cryptococcal meningitis
136
What is Jarisch-Herxheimer reaction
Adverse affect of penicillin use with Syphilis when the toxins are released into circulation
137
Chloramphenicol mechanism of resistance
Formation of **inactivation** **acetyltransferases**
138
Narrow spectrum Penicillins cover
1. Streptococci 2. Pneumococci 3. Meningococci 4. Treponema pallidum
139
Fluoroquinolone drugs
**-floxacins**
140
Cefuroxime is
Second generation cephalosporin
141
Trimethoprim and pyrimethamine inhibits
Dihydrofolate reductase inhibiting conversion of DHF to THF
142
Minocycline used for
**Tetracycline** Meningococcal carrier state because of high conc in saliva and tears
143
Very narrow Spectrum Penicillins cover
Known or suspected Staphlococci
144
Extended spectrem Penicillins (aminopenicillins) are
**Beta-lactamase sensitive** 1. Ampicillin 2. Amoxicillin
145
AG adverse affects
1. Nephrotoxicity (enhanced with Vanco, Amph B, Cisplatin, Cyclosporine) 2. Ototoxicity (enhanced with Loop Diuretics) 3. NMJ block with decreased release of ACh
146
What penicillin undergoes enterohepatic cycling but excreted via kidneys
Ampicillin
147
Cephalosporns are LAME
* L: Listeria * A: Atypical * M: MRSA * E: Enterococci
148
Sulfasalazine used in
UC and RA

Pharmacology (12 decks)

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