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Flashcards in antimicrobials Deck (91):
1

folic acid synthesis inhibitors

sulfonamides (blocks PABA ->DHF)
trimethoprim (blocks DHF -> THF)

2

peptidoglycan synthesis inhibitors

glycopeptides: Bactracin, Vanco

3

Peptidoglucan cross linking inhibitors

penicillins
antipsuedomonals
cephalopsprins
carbapenems
monobactams

4

penicillinase-sensitive penicillins

amoxicillin
ampicillin
penicillin G, V

5

penicillinase-resistant

dicloaxcillin
nafcillin
oxacillin

6

antipseudomonals

piperacillin
ticarcillin

7

carbapenems

-penem

8

monobactams

aztreonam

9

30s inhibitors

aminoglycosides
tetracycline

10

aminoglycosides

GNATS
genatmicin
neomycin
amikacin
tobramycin
streptomycin

11

tetracyclines

doxycyclin
minocyclin
tetracyclin

12

50s inhibitors

chloramphenicol
clindamycin
linezolid
macrolides
streptogramins

13

macrolides

azithromycin
clarithromycin
erythromycin

14

streptogramins

dalfoprisitn
quinupristin

15

mRNA synthesis inhibitors

rifampin

16

Damages DNA

metronidazole

17

DNA topisomerase inhibitors

florquinolones

18

penicillin G,V mode of admin

penicillin G- IV/IM
penicillin V- PO

19

penicillin G, V uses

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

20

ADR of penicillin G,V

hypersensitivity rxn
hemolytic anemia

21

amoxicillin, ampicillin mode of admin

amOxicillin higher oral bioavailability then ampicillin

22

amoxicillin, ampicillin uses

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

23

amoxicillin, ampicillin ADRs

hypersensitivity rxn
rash
pseudomembranous colitis

24

Dicloxacillin, nafcilllin, oxacillin MOA

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

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