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antimicrobials Flashcards

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1
Q

folic acid synthesis inhibitors

A

sulfonamides (blocks PABA ->DHF)

trimethoprim (blocks DHF -> THF)

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2
Q

peptidoglycan synthesis inhibitors

A

glycopeptides: Bactracin, Vanco

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3
Q

Peptidoglucan cross linking inhibitors

A 
penicillins 
antipsuedomonals
cephalopsprins
carbapenems
monobactams
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4
Q

penicillinase-sensitive penicillins

A

amoxicillin
ampicillin
penicillin G, V

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5
Q

penicillinase-resistant

A

dicloaxcillin
nafcillin
oxacillin

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6
Q

antipseudomonals

A

piperacillin

ticarcillin

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7
Q

carbapenems

A

-penem

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8
Q

monobactams

A

aztreonam

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9
Q

30s inhibitors

A

aminoglycosides

tetracycline

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10
Q

aminoglycosides

A 
GNATS
genatmicin
neomycin
amikacin
tobramycin
streptomycin
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11
Q

tetracyclines

A

doxycyclin
minocyclin
tetracyclin

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12
Q

50s inhibitors

A 
chloramphenicol
clindamycin
linezolid
macrolides
streptogramins
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13
Q

macrolides

A

azithromycin
clarithromycin
erythromycin

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14
Q

streptogramins

A

dalfoprisitn

quinupristin

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15
Q

mRNA synthesis inhibitors

A

rifampin

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16
Q

Damages DNA

A

metronidazole

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17
Q

DNA topisomerase inhibitors

A

florquinolones

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18
Q

penicillin G,V mode of admin

A

penicillin G- IV/IM

penicillin V- PO

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19
Q

penicillin G, V uses

A

gram +
some gram - cocci (N. meningitidis) and spirochetes (T. pallidum)
bacteriacidal

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20
Q

ADR of penicillin G,V

A

hypersensitivity rxn

hemolytic anemia

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21
Q

amoxicillin, ampicillin mode of admin

A

amOxicillin higher oral bioavailability then ampicillin

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22
Q

amoxicillin, ampicillin uses

A 
bactericidal, still penicillinase sensitive 
wider spectrum then penicillin
HHELPSS
H. influenza
H. pylori
E. coli
Listeria
Proteus
Salmonella
Shigella
enterococci
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23
Q

amoxicillin, ampicillin ADRs

A

hypersensitivity rxn
rash
pseudomembranous colitis

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24
Q

Dicloxacillin, nafcilllin, oxacillin MOA

A

same as penicillin
but narrow spectrum
pencillinase resistance d/t bulky R group which blocks access

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25
dicloxacillin, nafcillin, oxacillin uses
S. aureus (not MRSA) | naf for staph
26
dicloxacillin, nafcillin, oxacillin ADRs
hypersensitivity rxn | interstitial nephritis
27
piperacillin, ticarcillin MOA
same as penicillin | extended spectrum
28
piperacillin, ticarcillin uses
pseudomonas gram neg rods susceptible to penicillinase so combo w/beta lactamase inhibitor
29
piperacillin, ticarcillin ADRs
hypersensitivity rxn
30
beta lactamase inhibitors
CAST Clavulanic Acid Sulbactam Tazobactam
31
cephalosporins MOA
beta-lactams that inhibit cell wall synthesis, but less susceptible to pencillinases bactericidal
32
what organisms are NOT covered by cephalosporins
``` LAME listeria atypical (Chlaymyida, mycoplasma) MRSA (exception, cefaroline 5th gen does cover MRSA) Enterocicci ```
33
1st generation cephalosporins
have pH cefazolin (exception) cephalexin
34
uses of 1st gen
``` +PEcK gram + cocci proteus E.coli Klebsiella used prior to surgery to prevent S. aureus ```
35
2nd gen
Family celebrating w/Foxy cousin drinking Tea, wearing Fur cefoxitin cefuroxime
36
2nd gen uses
``` HEN PEcKS H. influenza Enterobacter Neisseria Proteus E.coli Klebsiella Serratia ```
37
3rd gen
ceftriaxone cefotaxime ceftazidine
38
3rd gen uses
serious gram neg ceftriaxone- meningitis, gonorrhea, Lyme Ceftazidime- pseudo
39
4th gen
cefepime
40
4th gen uses
gram neg | increased activity against pseudo and gram +
41
5th gen
ceftaroline
42
5th gen uses
broad gram neg and pos includes MRSA does NOT cover pseudo
43
cephalospoin ADRs
``` hypersensitivity rxn autoimmune hemolytic anemia disulfram-like rxn vit K deficiency cross reactive w/penicillins increase nephrotoxicity of aminoglycosides ```
44
carbapenems MOA
broad spectrum, beta lactamase resistant | administer w/cilastatin to decrease inactivation of drug in renal tubules
45
carbapenems uses
gram + cocci, gram - rods, and anaerobes | significant side effects limit use
46
carbapenems ADRs
GI skin rash CNS toxicity -> seizures
47
monobactams general
synergistic w/aminoglycosides | no cross reactivity w/penicillin
48
monobactams uses
gram neg rods only | for penicillin allergic pts and those w/renal insufficiency who cannot tolerate aminoglycosides
49
monobactams ADRs
usually nontoxic, can cause GI upset
50
vanco MOA
D-ala D-ala binding blocks cell wall synthesis
51
vanco uses
``` gram + only MRSA S. epidermidis Enterococci C. difficile (PO) ```
52
ADRs vanco
Nephrotoxic Ototoxic Thrombophlebitis Red man flush
53
aminoglycosides MOA
bactericidal 30S require O2 for uptake, so no effect on anaerobes
54
aminoglycosides uses
severe gram - rods | synergisitc w/beta lactams
55
aminoglycoside ADRs
Nephrotoxic Neuromuscular blockade Ototoxic Teratogen
56
aminoglycoside mechanism of resistance
bacterial transferase enzymes inactivate drug via acetylation, phosphorylation, or adenylation
57
tetracyclines MOA
bacteriostatic bind 30s limited CNS penetration DO not take w/milk, antacids, or Fe b/c block absorption Doxy ok in renal failure b/c fecally eliminated
58
tetracyclines uses
Borrelia burgerdorferi M. pneumoniae accumulates intracellularly -> rickettsia and Chlaymida also for acne
59
tetracycline ADRs
GI discoloration of teeth and inhibition of growth in kids photosensitivity CI in prego
60
tetracycline resistance
decrease uptake and/or increase efflux
61
chloramphenicol MOA
blocks 50s | bacteriostatic
62
chloramphenicol uses
meningitis (H. influenza, N. meningitidis, S. penumoniae) RMSF limited use d/t toxcicities, but good in 3rd world cause cheap
63
chloramphenicol ADRs
anemia aplastic anemia gray baby syndrome (lack UDP-glucuronyl transferase)
64
chloramphenicol resistance
plasmid encoded acetyltransferase inactivates drug
65
clindamycin MOA
50s | bacteriostatic
66
clindamycin uses
anaerobic infections (bacteroides, C. perfringens) invasive grp A strep treats anaerobic infections above diaphragm (metronidazole below)
67
clindamycin ADRs
pseudomembranous colitis fever diarrhea
68
oxazolidinoles (linezolid) MOA
50s
69
oxazolidinoles uses
gram + including MRSA and VRE
70
oxazolidinoles ADRs
bone marrow suprresion peripheral neuropathy serotonin syndrome
71
oxazolidinoles resistance
point mutation in ribosomal RNA
72
Macrolides MOA
50s | bacteriostatic
73
macrolides uses
atyical penumonias (Chlamydia, legionella, mycoplasma) STIs (chlamydia) gram + cocci B. pertussis
74
macrolides ADRs
``` MACRO GI Motility issues Arrhythmia (prolonged QT) acute Cholestatic hepatitis Rash eOsinophilia clarithromycin and erythromycin inhibit cytochrome P-450 ```
75
macrolides resistance
methylation of 23S rRNA binding site
76
trimethoprim MOA
inhibits DHF reductase | bacteriostatic
77
trimethoprim uses
``` combo w/sulfa (TMP-SMX) UTIs Shigella Salmonella Pneumocystis jirovecii toxoplasmosis prophylaxis ```
78
trimethoprim ADRs
megaloblastic anemia leukopenia granulocytopenia TMP - treats marrow poorly
79
sulfonamides MOA
inhibit folate synthesis | bacteriostatic (bacteriocidal when combo with TMP)
80
sulfonamide uses
``` gram + gram - nocardia chlamydia triple sulfas or SMX for UTI ```
81
sulfonamide ADRs
``` hypersensitivity rxn hemolysis if G6PD deficient nephrotoxic photosensitivity kernicterus in infants displace other drugs from albumin (warfarin) ```
82
sulfonamides resistance
altered enzyme decrease uptake increase PABA synthesis
83
floroquinlones MOA
inhibit prokaryotic enzymes topoisomerase II (DNA gyrase) bacteriocidal cannot be taken w/antacids
84
floroquinolones uses
gram neg rodes of UTI and GI tract pseudo, Neisseria some gram +
85
floroquinolones ADRs
``` GI superinfections skin rashes HA dizziness leg commonly leg cramps and myalgias CI in prego, nursing, ```
86
floroquinolones resistance
efflux pumps
87
daptomycin MOA
lipopeptide disrupts cell membrane of gram + S. aureus skin infections (especially MRSA) bacterimia endocarditis VRE not used for pneumonia (inactivated by surfactant)
88
daptomycin ADRs
myopathy | rhabdomyolysis
89
metronidazole MOA
toxic free radical metabolites that damage DNA bactericidal antiprotozoal
90
metronidazole uses
``` GET GAP on Metro Giardia Entamoeba Trichomonas Garderelaa Anaerobes (bacteroides, C. diff) H. pylori Tx of anaerobic infection below diaphragm (clindamycin above) ```
91
metronidzole ADRs
disulfiram like rxn w/alcohol HA metallic taste

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