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Kaplan Pharm > Antimicrobial > Flashcards

Antimicrobial Flashcards

(96 cards)

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1
Q

inhibit bacterial cell-wall synthesis

A 
penicillin
cephalosporins
imipenem/meropenem
aztreonam
vancomycin
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2
Q

inhibit bac protein synthesis

A 
aminoglycosides
chloramphenicol
macrolides
tetracyclines
streptogramins
linezolid
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3
Q

inhibit nucleic synthesis

A

fluoroquinilones

rifampin

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4
Q

inhibit folic acid synthesis

A

sulfonamides
trimethoprim
pyrimethamine

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5
Q

penicillin MoR

A
  1. B-lactamases – drugs are either resistant or sensitive
  2. change target (PBP)
  3. prevent entry (porin structure)
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6
Q

narrow spectrum, B-lactamase sensitive, penicillin

A

pen G and pen V

for: strep, pneumo, meningococci, Treponema pallidum

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7
Q

very narrow spectrum, B-lactamase resistant, penicillin

A

naficillin, methicillin, oxacillin

for: staphylococci

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8
Q

only B-lactamase resistant penicillins

A

naficillin, methicillin, oxacillin

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9
Q

broad spectrum, B-lactamase sensitive, penicillin

A

ampicillin, amoxicillin

for: gram (+) cocci, E coli, H influenzae, Listeria, Borrelia burgdorferi, H pylori

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10
Q

treat listeria with

A

ampicillin

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11
Q

treat Borrelia burgdorferi and H pylori with

A

amoxicillin

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12
Q

extended spectrum, B-lactamase sensitive, penicillin

A

ticarcillin, pipercillin

for: gram (-), Pseudomonas

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13
Q

clavulanic acid and sulbactam are

A

B-lactamase inhibitors

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14
Q

nafcillin and oxacillin are eliminated

A

in bile

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15
Q

active tubular secretion of penicillins in blocked by

A

probenecid

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16
Q

ampicillin is metabolized by

A

enterohepatic cycling

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17
Q

1st gen cephalosporin

A

cefazolin, cephalexin

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18
Q

2nd gen cephalosporin

A

cefotetan, cefaclor, cefuroxime

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19
Q

3rd gen cephalosporin

A

ceftriaxone (IM), cefotaxime (parenteral), cefdinir, cefixime (oral)

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20
Q

4th gen cephalosporin

A

cefepime

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21
Q

ceftriaxone is eleminated

A

in the bile – don’t give to neonates

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22
Q

cefazolin, cephalexin used for

A

gram (+) cocci, E coli, Klebsiella, pneumoniae, Proteus, surgical prophylaxis

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23
Q

cefotetan, cefaclor, cefuroxime used for

A

increased gram (-) coverage, some anaerobes

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24
Q

cephalosporins that enter CNS

A

cefuroxime (2nd gen), most 3rd gens, cefepime (4th gen)

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25
ceftriaxone, cefotaxime, cefdinir, cefixime used for
gram (+) and gram (-) cocci, Neisseria gonorrhea, gram (-) rods, meningitis, sepsis
26
cefepime
widest spectrum
27
which cephalosporins are resistant to B-lactamase?
3rd and 4th gen
28
penems are resistant/sensitive to B-lactamases?
resistant
29
penems are used for
gram (+) cocci, gram (-) rods (enterobacter and pseudomonas) and anaerobes
30
What is cilastatin do?
inhibits imipenem from being metabolized to a nephrotoxic metabolite
31
SE of penems
seizures in patients with renal dysfunction
32
aztreonam
for gram (-) rods **has no cross-allergenicity
33
vancomycin binds
D-ala-D-ala muramyl pentapeptide
34
vancomycin spectrum
MRSA, enterococci, C diff
35
MoR to vancomycin
D-ala --> D-lactate
36
vancomycin side effects
"red man syndrome" from histamine release when given too rapidly, ototoxicity, nephrotoxicity
37
interfere with initiation codon function
aminoglycosides (30S) and linezolid (50S)
38
block docking of tRNA (amino acid incorporation)
tetracyclines (30S) and dalfopristin/quinupristin (50S)
39
blocks peptidyl transferase movement from P site to A site (formation of a peptide bond)
chloramphenicol (50S)
40
blocks translocation of peptidyl-tRNA from A to P
macrolifes and clindamycin (50S)
41
30S inhibitors
aminoglycosides and tetracyclines
42
aminoglycoside spectrum
gram (-) rods
43
aminoclycoside bactericidal/bacteristatic
bactericidal
44
aminoglycoside uptake involves
O2-dependent, therefore anaerobes are innately resistant
45
aminoglycoside side effects
nephrotoxic (enhanced by vancomycin, amphotericin B, cisplatin, and cyclosporine), ototoxic (enhanced by loop diuretics), NM blockade with decreased release of ACh (enhances effects of muscle relaxants)
46
specific aminoglycosides
gentamicin, tobramycin, amikacin --> gram (-) rods | streptomycin --> TB, bubonic plague, tularemia
47
tetracycline spectrum
chlamydial and mycoplasmal species, H. pylori, Rickettsia, Borrelia burgdorferi, Brucella, Vibrio, and Treponema
48
tetracucline uptake is decreased by
dairy products
49
tetracycline side effects
tooth enamel dysplasia, decreased bone growth in children, phototox, GI distress
50
doxycycline
prostatitis
51
minocycline
high concentrations in tears and saliva, used in meningococcal carrier state
52
demclocycline
SIADH
53
tigecycline
resistant gram (+) MRSA and VREF, gram (-), anaerobes
54
rash on neck and forearms indicates
phototoxicity by tetracyclines, sulfonamides, or quinolones
55
contraindicated in pregnancy
aminoglycosides, fluoroquinolones, sulfonamides, tetracyclines
56
chloramphenicol spectrum
backup drug for Salmonelle typhi, B fregilis, Rickettsia, bac meningitis
57
chloramphenicol inhibits
cytochrome p450
58
chloramphenicol side effects
bone marrow suppression | "gray baby" because no glucuronosyl transferase
59
macrolides (50S)
erythromycin, azithromycin, clarithromycin,
60
macrolide spectrum
gram (+) cocci, atypical organisms, Legionella, Campylobacter, Mycobacterium avium-intracellulare, H pylori
61
macrolides inhibit
p450
62
macrolide side effects
stimulate motilin receptors, reversible deafness, increased QT interval
63
clindamycin
gram (+) cocci, anaerobes SE pseudomembranous colitis
64
linezolid mechanism
prevents the formation of N-formylmethionyl-tRNA-ribosome-mRNA ternary complex
65
linezolid spectrum and side effects
VRSA, VRE, drug-resistant pneumococci causes bone marrow suppression
66
quinupristin/dalfopristin
block tRNA docking used for VRSA, VRE
67
4 organisms not covered by cephalosporins
Listeria Atypicals MRSA Enterococci
68
inhibitors of folic acid synthesis
sulfonamides, trimethoprim, pyrimethamine
69
sulfonamides inhibit
dihydropteroate synthetase (enzyme only in bacteria)
70
trimethoprim and pyrimethamine inhibit
dihydrofolate reductase
71
sulfasalazine is a prodrug for
ulcerative colitis and RA
72
trimethoprim-sulfamethoxazole uses
bacteria, fungi - Pneumocystis jiroveci, protozoa - toxoplasma gondii
73
bacteria covered by trimethoprim-sulfamethoxazole
Nocardia, listeria, gram (-) infections -- UTIs, gram (+) infections
74
sulfonamides, trimethoprim, pyrimethamine have high/low protein binding
high protein binding --> drug interactions!!
75
sulfonamides side effects
Steven-Johnson syndrome, hemolysis in G6PD deficiency, phototoxicity
76
trimethoprim or pyrimethamine side effects
bone marrow suppression
77
inhibitors of nucleic acid synthesis
quinolones, "floxacins"
78
quinolones inhibit
topoisomerase II and topoisomerase IV
79
quinolones are used for
UTIs, STDs, diarrhea due to CHielle, Salmonella, E coli, Campylobacter, drug-resistant pneumonia
80
quinolone absorption is inhibited by
iron and Ca
81
side effects of quinolones
tendonitis. phototox, CNS, contraindicated in pregnancy and kids
82
metronidazole mechanism
converted to free radicals by ferredoxin
83
use for metronidazole
antiprotozoal, anaerobic gram (-)
84
metronidazole side effects
metallic taste, disulfiram-like effect (patients shouldn't drink alcohol)
85
antibiotics for H pylori
MCAT (metronidazole, clarithromycin, amoxillin, tetracycline)
86
isoniazid inhibits
mycolic acid synthesis
87
isoniazid is converted by
catalase
88
which vitamin should be given with isoniazid
vit B6 - to prevent peripheral neuritis and sideroblastic anemia
89
isoniazid can cause
hepatitis, SLE
90
rifampin inhibits
DNA-dependent RNA polymerase
91
rifampin side effects
p450 inducer, red-orange metabolites, hepatitis
92
ethambutol inhibits
synthesis of arabinogalactan in the cell wall
93
ethambutol side effects are
dose dependent retrobulbar neuritis aka red-green color blindness and decreased visual acuity
94
pyrazinamide can cause
hyperuricemia, hepatitis
95
streptomycin, a protein synthesis inhibitor, can be used to treat
TB
96
streptomycin can cause
deafness, vestibular dysfunction, nephrotoxicity, muscle weakness

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