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Kaplan Pharm > Antimicrobial > Flashcards

Antimicrobial Flashcards

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
Q

ceftriaxone, cefotaxime, cefdinir, cefixime used for

A

gram (+) and gram (-) cocci, Neisseria gonorrhea, gram (-) rods, meningitis, sepsis

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26
Q

cefepime

A

widest spectrum

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27
Q

which cephalosporins are resistant to B-lactamase?

A

3rd and 4th gen

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28
Q

penems are resistant/sensitive to B-lactamases?

A

resistant

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29
Q

penems are used for

A

gram (+) cocci, gram (-) rods (enterobacter and pseudomonas) and anaerobes

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30
Q

What is cilastatin do?

A

inhibits imipenem from being metabolized to a nephrotoxic metabolite

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31
Q

SE of penems

A

seizures in patients with renal dysfunction

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32
Q

aztreonam

A

for gram (-) rods

**has no cross-allergenicity

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33
Q

vancomycin binds

A

D-ala-D-ala muramyl pentapeptide

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34
Q

vancomycin spectrum

A

MRSA, enterococci, C diff

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35
Q

MoR to vancomycin

A

D-ala –> D-lactate

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36
Q

vancomycin side effects

A

“red man syndrome” from histamine release when given too rapidly, ototoxicity, nephrotoxicity

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37
Q

interfere with initiation codon function

A

aminoglycosides (30S) and linezolid (50S)

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38
Q

block docking of tRNA (amino acid incorporation)

A

tetracyclines (30S) and dalfopristin/quinupristin (50S)

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39
Q

blocks peptidyl transferase movement from P site to A site (formation of a peptide bond)

A

chloramphenicol (50S)

40
Q

blocks translocation of peptidyl-tRNA from A to P

A

macrolifes and clindamycin (50S)

41
Q

30S inhibitors

A

aminoglycosides and tetracyclines

42
Q

aminoglycoside spectrum

A

gram (-) rods

43
Q

aminoclycoside bactericidal/bacteristatic

A

bactericidal

44
Q

aminoglycoside uptake involves

A

O2-dependent, therefore anaerobes are innately resistant

45
Q

aminoglycoside side effects

A

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
Q

specific aminoglycosides

A

gentamicin, tobramycin, amikacin –> gram (-) rods

streptomycin –> TB, bubonic plague, tularemia

47
Q

tetracycline spectrum

A

chlamydial and mycoplasmal species, H. pylori, Rickettsia, Borrelia burgdorferi, Brucella, Vibrio, and Treponema

48
Q

tetracucline uptake is decreased by

A

dairy products

49
Q

tetracycline side effects

A

tooth enamel dysplasia, decreased bone growth in children, phototox, GI distress

50
Q

doxycycline

A

prostatitis

51
Q

minocycline

A

high concentrations in tears and saliva, used in meningococcal carrier state

52
Q

demclocycline

A

SIADH

53
Q

tigecycline

A

resistant gram (+) MRSA and VREF, gram (-), anaerobes

54
Q

rash on neck and forearms indicates

A

phototoxicity by tetracyclines, sulfonamides, or quinolones

55
Q

contraindicated in pregnancy

A

aminoglycosides, fluoroquinolones, sulfonamides, tetracyclines

56
Q

chloramphenicol spectrum

A

backup drug for Salmonelle typhi, B fregilis, Rickettsia, bac meningitis

57
Q

chloramphenicol inhibits

A

cytochrome p450

58
Q

chloramphenicol side effects

A

bone marrow suppression

“gray baby” because no glucuronosyl transferase

59
Q

macrolides (50S)

A

erythromycin, azithromycin, clarithromycin,

60
Q

macrolide spectrum

A

gram (+) cocci, atypical organisms, Legionella, Campylobacter, Mycobacterium avium-intracellulare, H pylori

61
Q

macrolides inhibit

A

p450

62
Q

macrolide side effects

A

stimulate motilin receptors, reversible deafness, increased QT interval

63
Q

clindamycin

A

gram (+) cocci, anaerobes

SE pseudomembranous colitis

64
Q

linezolid mechanism

A

prevents the formation of N-formylmethionyl-tRNA-ribosome-mRNA ternary complex

65
Q

linezolid spectrum and side effects

A

VRSA, VRE, drug-resistant pneumococci

causes bone marrow suppression

66
Q

quinupristin/dalfopristin

A

block tRNA docking

used for VRSA, VRE

67
Q

4 organisms not covered by cephalosporins

A

Listeria
Atypicals
MRSA
Enterococci

68
Q

inhibitors of folic acid synthesis

A

sulfonamides, trimethoprim, pyrimethamine

69
Q

sulfonamides inhibit

A

dihydropteroate synthetase (enzyme only in bacteria)

70
Q

trimethoprim and pyrimethamine inhibit

A

dihydrofolate reductase

71
Q

sulfasalazine is a prodrug for

A

ulcerative colitis and RA

72
Q

trimethoprim-sulfamethoxazole uses

A

bacteria, fungi - Pneumocystis jiroveci, protozoa - toxoplasma gondii

73
Q

bacteria covered by trimethoprim-sulfamethoxazole

A

Nocardia, listeria, gram (-) infections – UTIs, gram (+) infections

74
Q

sulfonamides, trimethoprim, pyrimethamine have high/low protein binding

A

high protein binding –> drug interactions!!

75
Q

sulfonamides side effects

A

Steven-Johnson syndrome, hemolysis in G6PD deficiency, phototoxicity

76
Q

trimethoprim or pyrimethamine side effects

A

bone marrow suppression

77
Q

inhibitors of nucleic acid synthesis

A

quinolones, “floxacins”

78
Q

quinolones inhibit

A

topoisomerase II and topoisomerase IV

79
Q

quinolones are used for

A

UTIs, STDs, diarrhea due to CHielle, Salmonella, E coli, Campylobacter, drug-resistant pneumonia

80
Q

quinolone absorption is inhibited by

A

iron and Ca

81
Q

side effects of quinolones

A

tendonitis. phototox, CNS, contraindicated in pregnancy and kids

82
Q

metronidazole mechanism

A

converted to free radicals by ferredoxin

83
Q

use for metronidazole

A

antiprotozoal, anaerobic gram (-)

84
Q

metronidazole side effects

A

metallic taste, disulfiram-like effect (patients shouldn’t drink alcohol)

85
Q

antibiotics for H pylori

A

MCAT (metronidazole, clarithromycin, amoxillin, tetracycline)

86
Q

isoniazid inhibits

A

mycolic acid synthesis

87
Q

isoniazid is converted by

A

catalase

88
Q

which vitamin should be given with isoniazid

A

vit B6 - to prevent peripheral neuritis and sideroblastic anemia

89
Q

isoniazid can cause

A

hepatitis, SLE

90
Q

rifampin inhibits

A

DNA-dependent RNA polymerase

91
Q

rifampin side effects

A

p450 inducer, red-orange metabolites, hepatitis

92
Q

ethambutol inhibits

A

synthesis of arabinogalactan in the cell wall

93
Q

ethambutol side effects are

A

dose dependent retrobulbar neuritis aka red-green color blindness and decreased visual acuity

94
Q

pyrazinamide can cause

A

hyperuricemia, hepatitis

95
Q

streptomycin, a protein synthesis inhibitor, can be used to treat

A

TB

96
Q

streptomycin can cause

A

deafness, vestibular dysfunction, nephrotoxicity, muscle weakness

Kaplan Pharm (1 decks)

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