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Antimicrobials Flashcards

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1
Q

Which drugs have DNA replication as their site of antimicrobial action?

A

Quinolones

Metronidazole

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2
Q

Which drugs have cell wall synthesis as their site of antimicrobial action?

A 
Beta lactams
Vancomycin
Daptomycin
Isoniazid
Ethambutol
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3
Q

Which drugs have protein synthesis (ribosome S30) as their site of antimicrobial action?

A

Aminoglycosides
Tetracyclines
Tigecycline

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4
Q

Which drugs have protein synthesis (ribosome S50) as their site of antimicrobial action?

A 
Chloramphenicol
Macrolides
Clindamycin
Linezolid
Streptogramins
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5
Q

Which drugs have antimetabolites as their site of antimicrobial action?

A

Sulfonamides

Trimethoprim

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6
Q

Which drugs have RNA synthesis as their site of antimicrobial action?

A

Rifampicin

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7
Q

Which drugs have membrane permeability as their site of antimicrobial action?

A

Polymixen

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8
Q

What is the site of antimicrobial action of beta lactams?

A

Cell wall synthesis

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9
Q

What is the site of antimicrobial action of vancomycin?

A

Cell wall synthesis

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10
Q

What is the site of antimicrobial action of isoniazid?

A

Cell wall synthesis

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11
Q

What is the site of antimicrobial action of ethambutol?

A

Cell wall synthesis

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12
Q

What is the site of antimicrobial action of aminoglycosides?

A 
Protein synthesis (ribosome S30) 
Reversible
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13
Q

What is the site of antimicrobial action of tetracyclines?

A 
Protein synthesis (ribosome S30)
Reversible
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14
Q

What is the site of antimicrobial action of chloramphenicol?

A 
Protein synthesis (ribosome S50)
Irreversible
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15
Q

What is the site of antimicrobial action of macrolides?

A 
Protein synthesis (ribosome S50)
Irreversible
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16
Q

What is the site of antimicrobial action of clindamycin?

A 
Protein synthesis (ribosome S50)
Irreversible
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17
Q

What is the site of antimicrobial action of sulfonamides?

A

Antimetabolites

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18
Q

What is the site of antimicrobial action of trimethoprim?

A

Antimetabolites

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19
Q

What is the site of antimicrobial action of polymixen?

A

Membrane permeability

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20
Q

What is the site of antimicrobial action of rifampicin?

A

RNA synthesis

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21
Q

What are the four kinds of beta lactams?

A

Penicillin
Cephalosporins
Carbapenems
Monobactams

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22
Q

Name the kinds of penicillins

A

Natural
Beta-lactamase resistant
Broad-spectrum
Extended-spectrum (antipseudomonal)

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23
Q

Name natural penicillins

A

Benzylpenicillin (pen G)

Phenoxymethylpenicillin (pen V)

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24
Q

Name beta-lactamase resistant penicillins

A 
Oxacillin
Cloxacillin
Flucloxacillin
Dicloxacillin
Methicillin
Nafcillin
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25
Name broad-spectrum penicillins
Amoxicillin | Ampicillin
26
Name extended-spectrum (antipseudomonal) penicillins
Piperacillin Ticarcillin Indanyl carbenicillin
27
Name thee kinds of cephalosporins
1st generation 2nd generation 3rd generation 4th generation
28
Name 1st generation cephalosporins
Cefadroxil Cefazolin Cephalexin Cephalothin
29
Name 2nd generation cephalosporins
``` Cefaclor Cefamandole Cefprozil Cefuroxime Cefotetan Cefoxitin ```
30
Name 3rd generation cephalosporins
``` Cefdinir Cefixime Cefoperazone Cefotaxime Ceftazidime Ceftibuten Ceftizoxime Ceftriazone ```
31
Name 4th generation cephalosporins
Cefepime
32
Name carbapenems
Imipenem Meropenem Ertapenem
33
Why is imipenem combined with cilastatin?
Cilastatin inhibits dehydropeptidase, the enzyme which renally degrades imipenem. It is combined intravenously with imipenem in order to protect it from dehydropeptidase and prolong its antibacterial effect.
34
Name monobactams
Aztreonam
35
What is the spectrum of monobactams?
Aerobic gram -
36
Name beta lactamase inhibitors
Clavulanic acid Sulbactam Tazobactam
37
What is the spectrum of natural penicillins?
``` Gram + cocci Gram + bacilli Gram - cocci Anaerobes Spirochetes ```
38
What is the spectrum of beta lactamase resistant penicillins?
Strep Step NOT enterococci, anaerobes, gram- cocci, gram - bacilli
39
What is the spectrum of broad-spectrum penicillins
``` Gram + cocci Gram + bacilli Gram - cocci Anaerobes Spirochetes AND Gram - bacilli - salmonella, shigella (2GIT) - e coli, proteus mirabilis (2UTI) - H influenza, pertussis (2 resp) ```
40
What is the spectrum of extended-spectrum penicillins?
``` Gram + cocci Gram + bacilli Gram - cocci Anaerobes Spirochetes AND Pseudomonas AND Gram - bacilli (KEEPS) - klebsiella - ecoli - enterobacter - proteus - serratia ```
41
What coverage extends with increasing cephalosporin generation?
Gram -
42
What is the spectrum of 1st generation cephalosporins?
``` Gram(+) cocci: • Staph. aureus* (* Except MRSA) • Staph. epidermidis • Strep. pneumoniae • Strep. pyogenes • Anaerobic streptococci ``` Gram(-) bacilli: • E. coli • Klebsiella pneumoniae • Proteus mirabilis
43
What is the spectrum of 2nd generation cephalosporins?
``` Gram(+) cocci: • Strep. pneumoniae • Strep. pyogenes • Anaerobic streptococci Gram(-) cocci: • N. gonorrhoeae ``` ``` Gram(-) bacilli: • Enterobacter aerogenes • E. coli • H. influenza • Klebsiella pneumoniae • Proteus mirabilis ```
44
What is the spectrum of 3rd generation cephalosporins?
``` Gram(-) cocci: • N. gonorrhoeae Gram(-) bacilli: • Enterobacter aerogenes • E. coli • H. influenza • Klebsiella pneumoniae • Proteus mirabilis • Pseudomonas aeruginosaGram(-) cocci: • N. gonorrhoeae ``` ``` Gram(-) bacilli: • Enterobacter aerogenes • E. coli • H. influenza • Klebsiella pneumoniae • Proteus mirabilis • Pseudomonas aeruginosa ```
45
What is the spectrum of 4th generation cephalosporins?
Wide antibacterial spectrum and excellent coverage of gram(+) and gram(-) organisms
46
What are cephamycins active against and which is the most potent?
Anaerobes eg bacteroides fragilis | Cefoxitin
47
What is the spectrum of carbapenems?
Broadest of all beta lactams Gram + Gram - Anaerobes
48
Which beta lactams have the broadest bacterial coverage and why?
Carbapenems [ ] dependent killing and postantibiotic effect vs Other beta lactams Time dependent killing and no antibiotic effect
49
What is the spectrum of imipenem?
``` GRAM(-) BACILLI: • Acinetobacter species • Citrobacter species • Enterobacter species • E. coli • Gardnerella vaginalis • H. influenza • Klebsiella species • Proteus species • Providencia species • Salmonella species • Serratia species • Pseudomonas aeruginosa*** (*** Resistant strains reported) ``` GRAM(-) COCCI: • Neisseria meningitidis** (** Including penicillinase producing strains.) • Neisseria gonorrhoeae ``` GRAM(+) COCCI: • Staph. aureus* (*MRSA are resistant) • Staph. epidermidis • Enterococcus faecalis • Streptococcus Group A, B & C • Strep. pneumoniae ``` ``` ANAEROBIC ORGANISMS: • Clostridium species • Peptococcus species • Peptostreptococcus species • Propionibacterium species • Bacteroides species (e.g. B. fragilis) • Fusobacterium species ``` OTHER: • Actinomyces • Nocardia species
50
Name macrolides
Erythromycin Clarithryomycin Azithromycin Telithromycin
51
How is erythromycin excreted?
Bile -> enterohepatic -> urine
52
How is azithromycin excreted?
Bile -> enterohepatic -> urine
53
How is clarithromycin excreted?
Renal + hepatic -> urine
54
Name side effects of macrolides
GIT disturbances Cholestatic jaundice Ototoxicity
55
Name contraindications for macrolides
Liver dysfunction | Renal dysfunction
56
What is important about 30S vs 50S
``` 30S = reversible 50S = irreversible ```
57
Name tetracyclines
Tetracycline Doxycyline Minocycline Demeclocycline
58
Which tetracycline provides therapeutic levels in CSF?
Minocycine
59
Name side effects of tetracyclines
GIT discomforty Bone deposition Phototoxicity Vestibular problems
60
Name contraindications for tetracyclines
Pregnancy Breastfeeding Children <8yo
61
Name side effects of cotrimoxazole
``` Skin rash NV Haematological disturbances - megaloblastic anemia - leukopenia - thrombocytopenia ```
62
What does trimethroprim inhibit?
Dihydrofolate reductase
63
Which drug is linked to Gray baby syndrome?
Chloramphenicol
64
Name the side effects of chloramphenicol
Anemias Gray baby syndrome Drug interactions (CYP450)
65
What is important concerning lipophilic drugs and the brain?
They cross the BBB
66
What is clostridium difficile always resistant to?
Clindamycin
67
Name side effects of clindamycin
Skin rashes | Pseudomembranous colitis
68
Name aminoglycosides
``` Amikacin Gentamicin Tobramycin Streptomycin Neomycin ```
69
Name side effects of aminoglycosides
Ototoxicity Nephrotoxicity Neuromuscular paralysis Skin rash w/ neomycin
70
Name 1st generation fluoroquinolones
Nalidixic acid
71
Name 2nd generation fluoroquinolones
Ciprofloxacin Norfloxacin Ofloxacin
72
Name 3rd generation fluoroquinolones
Gatifloxacin Levofloxacin Moxifloxacin Sparfloxacin
73
Name 4th generation fluoroquinolones
Trovafloxaci
74
Name side effects of fluoroquinolones
GIT disturbances Headaches and dizziness Phototoxicity Drug interaction (CYP450)
75
Name contraindications for fluoroquinolones
Pregnancy Breast feeding <18 yo Arrythmias
76
Which drugs inhibit DNA gyrase?
Quinolones
77
Which drugs inhibit folate synthesis?
Trimethoprim | Sulfamethoxazole
78
Which drugs create free radicals?
Metronidazole | Nitrofurantoin

Pharmacology (32 decks)

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