Antimicrobials

Question 1

Sulfonamides MOA
ADRs
Examples

Answer 1

• inhibit one of the sequential steps in the production of folic acid, often combined with trimethoprim
• skin rash, GI, headache, renal damage, liver damage, kernicterus in newborns, STEVEN JOHNSON SYNDROME, BONE MARROW SUPPRESSION
• sulfamethoxazole (bactrim)
• community acquired MRSA

Question 2

Penicillins MOA

ADRs

Answer 2

• inhibit bacterial cell wall synthesis
• fairly non toxic, GI (NVD), rash
• can be used in pregnancy

Question 3

examples of narrow spectrum PCNs

Answer 3

PCN G (injection/IV)
PCN V (oral)

Question 4

examples of extended spectrum PCN

Answer 4

ampicillin
amoxicillin
piperacillin and ticarcillin combined w/beta lactamase inhibitor for nosocomial pneumonias

Question 5

PCNase resistant PCN examples

Answer 5

methicillin
nafcillin/oxacillin
dicloxacillin
used for serious staph infections

Question 6

Beta-lactamase inhibitors MOA and examples

Answer 6

inhibits beta-lactamase enzyme, no antimicrobial activity alone, must be combined w/ beta-lactam antibiotic

• amox + clavulanate=augmentin
• ticaricillin
• ampicillin
• piperacillin

Question 7

misc beta lactams aztreonam IV

Answer 7

• good for gram - (p. aeruinosa)

- can be used in PCN allergy pts

Question 8

misc beta lactam carbapenems examples

Answer 8

-PENEMs
-wide range of gram +/-. aerobic and anaerobic
-can’t be used in PCN allergy
impinem/cilistatin IV
meropenem IV
Ertapenem IV/IM
Doripenem

Question 9

Cephalosporins MOA and ADRs

Answer 9

-inhibit bacterial wall synthesis, but beta-lactamase resistant
-similar to PCN
can be used in pregnancy

Question 10

1st gen ceph

Answer 10

good for gram +, limited gram -
-cefadroxil (PO)
-cefazolin (IV)
cephalexin (PO)

Question 11

2nd gen ceph

Answer 11

similar gram +. some gram -

• cefaclor
• cefprozil
• ceftetan
• cefoxitin
• cefuroxime axetil

Question 12

3rd gen ceph

Answer 12

less gram +, more gram -

• cefixime
• cefdinir
• cefpodoxime
• cefditoren
• ceftibuten
• ceftriaxone
• ceftazidime

Question 13

4th gen ceph

Answer 13

best for gram -

cefipime IV

Question 14

5th gen ceph

Answer 14

new drug for MRSA
ceftaroline
ceftolozane

Question 15

fluoroquinolones name endings, MOA, ADR and CI

Answer 15

• OXACIN
• inhibit DNA topoisomerase which is involved in repair, transcription, recombination and replication of DNA
• photosensitivity, GI, tendinopathy
• children <18 and pregnant
• do not give with cations

Question 16

macrolides name endings, MOA, ADR, and example

Answer 16

• THROMYCIN
• inhibit bacterial protein synthesis on the 50s ribosomal subunit
• GI, cholestatic hepatitis
• good alternative for PCN allergy, can be used in pregnancy
• erythromycin

Question 17

advanced macrolide examples

Answer 17

azithromycin and clarithromycin

Question 18

tetracycline MOA, ADRs

Answer 18

• inhibit bacterial protein synthesis at 30s ribosomal subunit, reversible
• yellow/gray teeth, photosensitivity, don’t give w/cations

Question 19

aminoglycosides MOA, ADRS, examples

Answer 19

• inhibit bacterial protein synthesis at 30s ribosomal subunit, irreversible
• oto and nephrotoxic, monitor blood levels
• gentamycin, tobramycin, kanamycin

Question 20

chloramphenicol (IV) MOA, ADR

Answer 20

• blocks peptide bond formation at 50s subunit

- aplastic anemia, gray-baby syndrome

Question 21

vancomycin MOA, ADR

Answer 21

• inhibit bacterial wall synthesis
• restrict use to serious gram + infections like MRSA or C. Dif
• red man syndrome

Question 22

daptomycin MOA, ADR

Answer 22

• depolarization of bacterial cytoplasmic membrane

- nausea, constipation, increased LFTs and CPK level

Question 23

telavancin MOA, ADR

Answer 23

• inhibit bacterial wall synthesis w/additional MOA disrupting bacterial cell membrane
• used for resistant gram + such as MRSA
• taste disturbances, foamy urine

Question 24

Dalbavancin MOA ADR

Answer 24

• interfere w/cell wall synthesis
• nausea, headache, diarrhea
• possible anaphylactic rxn

Question 25

oritavancin MOA ADR

Answer 25

- inhibits transglycosylation step of cell wall biosyn by binding to the stem pepide of peptidoglycan precursor - inhibits transpeptidation step of cell wall bio - disruption of bacterial membrane integrity leading to depolarization

Question 26

linezolid MOA ADR

Answer 26

- binds to site on the bacterial 23S ribosomal RNA of the 50S subunit and prevents formation of a functional 70S initiation complex - used to treat VRSA, MRSA, VRE-faecalis and faecium - bone marrow suppression, tongue discoloration

Question 27

tedizolid MOA

Answer 27

-binding to the 50S subunit of the bacterial ribosome

Question 28

metronidazole

Answer 28

- used for first line C. Diff and trichomoniasis | - NO ETOH

Question 29

Bezlotoxumab

Answer 29

-human monoclonal antibody that binds to C. Diff toxin B

Question 30

Clindamycin

Answer 30

- used to treat strep and staph - anaerobic infections - do not use more than 10 days

Question 31

quinupristin/dalfopristin

Answer 31

- streptogramin class | - painful IV injection, ,arthralgia

Question 32

rifampin

Answer 32

- primary use for TB | - red-orange urine/sweat/tears

Question 33

nitrofurantoin

Answer 33

prevention and tx of UTIs

Question 34

fidaxomicin MOA

Answer 34

- macrolide | - used for C diff after metronidazole

Question 35

benznidazole

Answer 35

-tx off Chagas disease

Question 36

raxibacumab

Answer 36

binds free protective antigen of anthrax blocking the combo of secreted enzymes with PA which makes them toxic

Question 37

obiltoxaximab

Answer 37

BBW for hypersensitivity and anaphylaxis

Question 38

inhibit cell wall synthesis

Answer 38

beta lactams (PCN, cephalosporins, carbapenems) vancomycin daptomycin

Question 39

inhibit nucleic acid synthesis

Answer 39

quinolones-DNA topoisomerase sulfamethoxazole-folic acid metronidiazole/nitrofurantoin-free radicles

Question 40

inhibit 50S subunit

Answer 40

``` macrolides clindamycin linezolid streptogramin chloramphenicol ```

Question 41

inhibit 30S subunit

Answer 41

amingoglycosides | tetracyclines