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Antimicrobials Flashcards

Learn the major classes of antimicrobials, the drugs in each, what class a drug belongs to, and the mechanism of action of each class. Specific resistance mechanisms and pharmacokinetics/ROA indications are not covered. MOA = mechanism of action (107 cards)

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1
Q

4 ways bacteria resist antimicrobials

A

Alter receptor target; decrease entry in or out of; alter metabolic pathway; inactivate drug directly

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2
Q

Mechanisms of antimicrobial action

A

Inhibit: cell wall synthesis, protein synthesis, folic acid synthesis, or DNA/RNA synthesis

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3
Q

Penicillins mechanism of action

A

Inhibit cell wall synthesis by binding to transpeptidase, a PBP, preventing cell wall peptidoglycan layer synthesis

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4
Q

Natural penicillins

A

Penicillin G and V

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5
Q

Penicillin G ROE

A

IM or IV

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6
Q

Natural penicillins microbe targets

A

G+

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7
Q

Penicillin V ROE

A

oral on empty stomach

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8
Q

Ampopenicillins

A

Ampicillin and amoxicillin

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9
Q

Ampopenicillins ROE

A

Enteral or parenteral

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10
Q

Penicillinase-resistant penicillins

A

dicloxacillin, methicillin, oxacillin, nafcillin

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11
Q

Penicillinase-resistant penicillins are named because

A

Side groups prevent B-lactmases from degrading them

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12
Q

Irreversible B-lactamase inhibitors

A

Clavulanic acid, sulbactam, tazobactam

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13
Q

People allergic to penicillins shouldn’t take this class of antibiotics

A

Cephalosporins

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14
Q

B-lactams MOA

A

cell wall synthesis

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15
Q

Vancomycin MOA

A

cell wall synthesis

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16
Q

Trimethoprim MOA

A

Folic acid synthesis (dihydrofolate reductase inhibition)

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17
Q

Sulfonamides MOA

A

Inhibits folic acid production (dihydropteroate synthetase inhibition - upstream from Trimethoprim)

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18
Q

Quinolones MOA

A

DNA synthesis

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19
Q

Rifampin MOA

A

Inhibits bacterial RNA polymerase; used for mycobacterial infections

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20
Q

Chloramphenicol MOA

A

Protein synthesis - 50S

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21
Q

Macrolides MOA

A

Protein synthesis - 50S

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22
Q

Clindamycin MOA

A

Protein synthesis - 50S

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23
Q

Tetracyclines MOA

A

Protein synthesis - 30S

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24
Q

Aminoglycosides MOA

A

Protein synthesis - 30S

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25
Monobactams MOA
Cell wall synthesis
26
Carbapenems MOA
Cell wall synthesis
27
These penicillin classes are used to treat G+
Natural penicillins and penicillinase-resistant penicillins
28
These penicillin classes are used to treat G-
Aminopenicillins and antipseudomonal penicillins
29
Antipseudomonal penicillins
Carbenicillin, ticarcillin, mezlocillin, piperacillin
30
This drug when administered orally is limited in use to treating UTIs
carbenicillin
31
B-lactamase inhibitors
Clavulanic acid, sulbactam, tazobactam
32
Combine this class of drug with penicillins to broaden spectrum
Irreversible B-lactamase inhibitors
33
Carbapenems
imipenem/cilastatin, doripenem, ertapenem, meropenem
34
Carbapenems - bactericidal or bacteriostatic?
Bactericidal
35
Carbapenems have this advantage over penicillins and cephalosporins
B-lactamase resistant
36
Other cell wall disrupters
telavancin, vancomycin
37
Vancomycin MOA
Blocks polymerization and cross-linking of peptidoglycan by binding to Ala-Ala pair
38
Cycloserine MOA
Blocks cell wall synthesis in G+ and G-
39
Cycloserine is usually reserved for this disease
TB
40
Polymyxin B MOA
Disrupts PM in all G- except Proteus
41
Aminoglycosides
Amikacin, gentamicin, kanamycin, netilmicin, streptomycin, tobramycin, neomycin
42
Aminoglycosides are limited to treating this type of bacterial infection
G-
43
Major side effects of aminoglycosides
Ototoxicity and nephrotoxicity via accumulation due to high water solubility
44
Antimicrobial effect observed even as aminoglycoside [plasma] decreases
Postantibiotic effect - translation still inhibited
45
Tetracyclines
tetracycline, minocycline, doxycycline, demeclocycline, oxytetracycline, tigecycline
46
Absorption of tetracyclines may be inhibited by these
Divalent cations (Ca2+, Mg2+) = don't take with milk or antacids!
47
This tetracycline is safest for patients with renal dysfunction and say why
Doxycycline because it is excreted in feces
48
Lincosamides
clindamycin
49
Clindamycin MOA
Binds 50S subunit and prevent translation
50
Macrolides
erythromycin + anything = macrolide; clarithromycin, azithromycin
51
Erythromycins have this significant cardiovascular side effect - except one member of the class
Prolong TQ interval which can lead to fatal arrythmia - azithromycin doesn't do this
52
Ketolides
Telithromycin
53
Ketolides MOA
Bind 50S in two different domains, requiring 2 mutations to develop resistance
54
Retapamulin MOA
A "pleuromutlin" antibiotic that blocks protein synthesis by interfering with peptidyl transferase, preventing 50S formation
55
Penicillin G
Natural penicillin (readily destroyed in acidic environments so only IV or IM)
56
Penicillin V
Natural penicillin (oral administration on empty stomach)
57
Ampicillin
Aminopenicillin (enteral or parenteral)
58
Amoxicillin
Aminopenicillin (enteral or parenteral)
59
Dicloxacillin
Penicillinase-resistant penicillins
60
Dicloxacillin
Penicillinase-resistant penicillins
61
Methicillin
Penicillinase-resistant penicillins
62
Oxacillin
Penicillinase-resistant penicillins
63
Nafcillin
Penicillinase-resistant penicillins
64
Carbenicillin
Antipseudomonal penicillin
65
Ticarcillin
Antipseudomonal penicillin
66
Mezlocillin
Antipseudomonal penicillin
67
Piperacillin
Antipseudomonal penicillin
68
Clavulanic acid
B-lactamase inhibitor
69
Sulbactam
B-lactamase inhibitor
70
Tazobactam
B-lactamase inhibitor
71
Iminipenem/clastatin
Carbapenems
72
Doripenem
Carbapenems
73
Ertapenem
Carbapenems
74
Meropenem
Carbapenems
75
Telavancin
Other cell wall inhibitors
76
Vancomycin
Other cell wall inhibitors
77
Cycloserine
Other cell wall inhibitors
78
Polymyxin B
Other cell wall inhibitors
79
Amikacin
Aminoglycosides (protein synthesis inhibitors)
80
Gentamicin
Aminoglycosides
81
Kanamycin
Aminoglycosides
82
Netilmicin
Aminoglycosides
83
Streptomycin
Aminoglycosides
84
Tobramycin
Aminoglycosides
85
Neomycin
Aminoglycosides
86
Tetracyclines are easy to name because
they all have -cycline
87
Clindamycin
Lincosamide
88
Erythromycin and its derivatives
Macrolides
89
Clarithromycin
Macrolides
90
Azithromycin
Macrolides
91
Telithromycin
Ketolides
92
Streptogramins are a combination of these
Quinupristin and dalfopristin
93
Sulfa-anything
Sulfonamides
94
Any-floxacin
Fluoroquinolones
95
Fluoroquinolones MOA
Inhibit DNA synthesis (DNA gyrase or topoisomerase IV)
96
Daptomycin
Lipopeptides
97
Linezolid MOA
Binds 50S subunit preventing 70S formation
98
Mupirocin has a unique MOA and usability because...
No cross-resistance risk; inhibits tRNA that transports isoleucine
99
Metronidazole MOA
Absorbed only be anaerobes and some protozoans; its metabolism generates toxic metabolites that inhibit DNA synthesis (mutagenic and possibly carcinogenic so contraindicated during 1st trimester)
100
Nitazoxanide MOA
Interferes with pyruvate electron transfer, necessary for anaerobic matabolism
101
Tinidazole MOA
Damages DNA and inhibits further synthesis (thus is mutagenic and possibly carcinogenic and contraindicated during 1st trimester)
102
Daptomycin MOA
Binds to bacterial PM and disrupts membrane potential, causing rapid depolarization and inhibition of DNA/RNA/protein synthesis (so unique that no cross-resistance known)
103
Rifaximin MOA
Binds bacterial RNA polymerase
104
Isoniazid MOA
Inhibits mycolic acid synthesis, which is required by mycobacteria
105
Pyrazinamide MOA
Unclear (but we have to know it?) but may lower pH in tubercle cavity
106
Ethambutol MOA
Inhibits RNA synthesis (mycobacteria)
107
Clofazimine MOA
Inhibits mycobacterial RNA polymerase

Pharmacology (3 decks)

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