Antimicrobrials Flashcards
(216 cards)
1
Q
What are the two toxicities of penicillins?
A
hypersensitivity and hemolytic anemia
2
Q
Which has a greater oral bioavailability, ampicillin or amoxicillin?
A
amoxicillin
3
Q
What six bugs can be treated with ampicillin/amoxicillin?
A
H. flu
E. coli
Listeria
Proteus
Salmonella
Shigella
4
Q
What would be the most severe reaction of ampicillin/amoxicillin?
A
pseudomembrane colitis
5
Q
What are the three penicillinase-resistant lactams?
A
Naficillin
Dicloxacillin
Oxacillin
6
Q
Are the penicillinase-resistant lactams used to treat MRSA?
A
no
7
Q
What are the two beta-lactim anti-pseudomonals?
A
Piperacillin and Ticeracillin
8
Q
What other drug are Piperacillin and Ticeracillin administered with?
A
beta-lactamase inhibitors
9
Q
What are the three β-lactamase inhibitors?
A
Sulbactam
Tazobactam
Clavulanic acid
10
Q
Which cephalosporin can cover MRSA?
A
Ceftaroline
11
Q
Which four bacteria are not covered by cephalosporins?
A
Listeria
Atypicals
MRSA
Enterococci
12
Q
What are the two first generation cephalosporins?
A
Cefalexin and Cefazolin
13
Q
What three bugs are the first generation cephalosporins effective against?
A
Proteus
E. coli
Klebsiella
14
Q
What are the three 2nd generation cephalosporins?
A
Cefaclor
Cefoxitin
cefuroxime
15
Q
What are the bugs treated by 2nd generation cephalosporins?
A
H. flu
Enterobacter
Klebsiella
Proteus
E. coli
Klebsiella
Serratia
16
Q
What two bugs does Ceftriaxone treat?
A
meningitis and gonorrhea
17
Q
What are the two cephalosporins for Pseudomonas?
A
Ceftazidime
Cefepime
18
Q
What is the fourth generatuon cephalosporin?
A
Cefepime
19
Q
What is cefepime active against?
A
Pseudomonas
20
Q
What is the 5th generation cephalosporin?
A
Ceftoraline
21
Q
What is ceftoraline not active against?
A
Pseudomonas
22
Q
Which class of drugs would display nephrotoxicity upon co-administration with cephalosporins?
A
Aminoglycosides
23
Q
Which β-lactam class of drugs can cause a Vitamin K deficiency?
A
Cephalosporins
24
Q
What is the MOA of Aztreonam?
A
penicillin binding protein
25
What class of drugs is Aztreonam synergistic with?
Aminoglycoside
26
What type of bacteria does aztreonam display activity against?
gram-negative rods ONLY
27
What other drug are piperacillin and tazobactam used with?
β-lactam inhibitors
28
What is the most important side effect of Carbapenems?
seizure
29
What is the MOA of carbapenems?
β-lactam
30
What enzyme can inactivate carbapenems?
Dehydropeptidase
31
Does vancomycin work only on gram-positives or gram-negatives?
positives
32
What are the three toxicities of vancomycin?
Nephro
Oto
Thrombophlebitis
33
What are two techniques to decrease Red Man Syndrome?
coadministration with anti-histamines
slow infusion
34
What would a bug resistant to vancomycin have in its cell wall?
D-ala-D-lac
35
Are aminoglycosides static or cidal?
cidal
36
Are tetracyclines static or cidal?
static
37
Is chloramphenicol static or cidal?
static
38
Is clindamycin static or cidal?
static
39
Is erythromycin static or cidal?
static
40
What ribosomal subunit does linezolid target?
50S
41
What ribosomal subunit does chloramphenicol target?
50S
42
What ribosomal subunit does clindamycin target?
50S
43
What are the three MOAs of aminoglycosides?
inhibit formation of initiation complex
cause misreading of mRNA
block translocation
44
What do aminoglycosides require for activity?
oxygen
45
Which aminoglycoside is used for surgery?
Neomycin
46
What is the use of aminoglycosides?
severe gram-negative infections
47
Which class of antimicrobials can cause neuromuscular blockage?
Aminoglycosides
48
Which antibiotic can be a teratogen?
aminoglycoside
49
What is the MOA of tetracyclines?
prevent attachment of aminoacyl-tRNA
50
Which tetracycline is fecally eliminated and can be used in patients with renal failure?
doxycycline
51
Which class of antibiotics absorption can be limited with divalent cations?
tetracyclines
52
Which class of antibiotics tends to accumulate intra-cellularly?
tetracycline
53
Are tetracyclines contraindicated in pregnancy?
yes
54
What can tetracyclines inhibit in adolescents?
inhibit long-bone growth
55
How is resistance against tetracyclines created?
efflux pumps
56
What is the MOA of macrolides?
inhibit peptide translocation
57
What specific ribosomal subunit is targeted by macrolides?
23 rRNA
58
What STD is treated with a macrolide?
Chlamydia
59
What class of drug is used for strep throat in a patient with a penicillin allergy?
Macrolide
60
What is the M of MACRO?
gut motility issues
61
What is the A of MACRO? By what mechanism?
arrhythmia
QT prolongation
62
What is the C of MACRO?
Cholestatic hepatitis
63
What is the R of MACRO?
rash
64
What is the O of MACRO?
Eosinophilia
65
What does chloramphenicol block?
peptidyltransferase
66
What two conditions is chloramphenicol used?
Meningitis and RMSF
67
How is resistance to chloramphenicol generated?
plasmid acetyltransferase
68
What does clindamycin block?
peptide transfer (translocation)
69
Is clindamycin used for anaerobes above or below the diaphragm?
above
70
Which single aerobe is clindamycin effective against?
Group A Strep
71
What do sulfonamides inhibit the synthesis of?
folate
72
What STD can sulfonamides be effective against?
Chlamydia
73
What antimicrobial can displace albumin from bound substances?
Sulfonamides
74
What are sulfa drugs an analogue of?
PABA
75
What enzyme do sulfa drugs inhibit?
Dihydropteroate synthase
76
Which two antimicrobials inhibit Dihydrofolate Reductase?
Trimethoprim
Pyrimethamine
77
What two enzymes do fluoroquinolones inhibit?
DNA topoisomerase two and four
78
What is another name for DNA Topoisomerase Two?
DNA gyrase
79
What must fluoroquinolones not be taken with?
antacids
80
What is the broad target of fluroquinolones?
Gram-negative rods of GI and urinary system
81
In what three groups of people are fluorquinolones contraindicated?
pregnant women
nursing mothers
children under 18
82
Presnidone can cause tendon rupture if taken with what antimicrobial?
fluoroquinolones
83
What are the three drugs for tuberculoid and lepromatous leprosy?
Rifampin
Dapsone
Clofazime
84
What enzyme is needed for INH to be effective?
catalase-peroxidase
85
What drug is used as prophylaxis for TB?
INH
86
What two drugs are used for meningococcal prophyaxis?
Rifampin and ciprofloxacin
87
What enzymedoes rifampin inhibit?
DNA dependent RNA polymerase
88
What drug does rifampin delay resistance to? What disease
Dapsone
Leprosy
89
Why is rifabutin preferred over rifampin in HIV patients?
less inhibition of p450
90
What TB drug is effective in the acidic phagosome?
Pyrazinamide
91
What are the two main toxicities of Pyrazinamide?
gout and liver
92
What drug blocks Arabinosyltransferase?
Ethambutol
93
What is the function of Arabinosyltransferase?
carbohydrate incorporation into cell wall
94
What is the toxicity of Ethambutol?
red-green color blind
95
What drug is used to treat endocarditis during dental procedures?
Penicillin
96
What drug is used for prophylaxis for Gonorrhea?
Ceftriaxone
97
What drug is used for GBS in pregnant women?
Penicillin
98
What drug is used for conjunctivitis for neonates born to a mother with Chlamydia or Neisseria?
Erythromycin
99
Which drug is used for S. aureus post-surgical infection?
Cefazolin
100
What drug is used for strep throat?
Penicillin
101
What drug is used for syphillis?
Penicillin G
102
What single drug is used for MAC prophylaxis?
Azithromycin
103
What drug is used as prophylaxis for Toxo?
TMP/SMX
104
Which drug is used for VRE?
Linezolid
105
Which antimicrobial can cause serotonin syndrome?
Linezolid
106
Which anti-fungal requires supplementation with electrolytes?
Amphotericin B
107
Which two electrolytes need to be supplemented during Amphotericin use?
potassium and magnesium
108
Which anti-fungal can cause fever and chills?
amphotericin
109
Which anti-fungal can cause hypotension?
amphotericin
110
What reaction is inihibited by Azoles? Catalyzed by what enzyme?
lanosterol to ergosterol
14-α-Demethylase
111
What drug for cryptococcal meningitis prophyaxis?
Fluconazole
112
Which azole for dimorphic fungi?
Itraconazole
113
What is flucytosine an analogue of?
5-flurouracil
114
What is the toxicity of flucytosine?
bone marrow suppression
115
What do echinocandins inhibit the synthesis of?
β-glucan
116
What is the main bug Echinocandins are used to treat?
invasive Aspergillis
117
What family of anti-fungals can cause flushing? Mediatated by what?
Echinocandins
histamine
118
What enzyme is inhibited by terbinafine?
squalene epoxidase
119
What anti-fungal deposits in keratin containing tissue?
Griseofulvin
120
What is the drug for Toxo?
Pyrimethamine
121
What anti-fungal can act as a teratogen?
Griseofulvin
122
What are the two drugs for Trypanosoma Brucei?
Suramin and Melarsoprol
123
What is the drug for T. cruzi?
Nifurtimox
124
What is the drug for Leishmania?
Sodium stibogluconate
125
What is the MOA of chloroquine?
blocks detoxification of heme into hemozoin
126
What is the only plasmodium species not treated by Chloroquine?
Falciparum
127
What two drugs is P. falciparum treated with?
Atovaquone and proquanil
128
What is the mechanism of resistance to Chloroquine?
pump
129
What are the two toxicities of Chloroquine?
Retinopathy and pruritus
130
What drug for flukes?
praziquantel
131
What is the CCR5 antagonist?
Maraviroc
132
What is the HIV fusion inhibitor?
Enfuvirtide
133
What is the integrase inhibitor?
Raltegravir
134
Which two viruses is interferon-α used to treat?
HBV and HCV
135
Which two viruses is RIbavirin used to treat?
HCV and RSV
136
What is Ribavirin an analogue of?
Guanine
137
What is acyclovir an analogue of?
Guanosine
138
What is gangciclovir an analogue of?
Guanosine
139
What drug is used for acyclovir resistant HSV?
Cidofovir
140
What are the MOAs of cidofovir and foscarnet?
viral DNA polymerase inhibitors
141
What enzyme does Ribavirin inhibit?
Inosine Monophosphate
142
What are the two toxicities of Ribavirin?
hemolytic anemia
teratogen
143
Drugs that end in -lovir are effective against which two viruses?
HSV and VZV
144
Which -lovir is used specifically for HSV?
Famciclovir
145
What is the toxicity of drugs that end in -lovir?
crystalline nephropathy
146
What is the toxicity of gangciclovir?
panytopenia
147
What is foscarnet an analogue of?
Pyrophosphate
148
What is the toxicity of foscarnet?
nephro
149
What enzyme does cidofovir inhibit?
viral DNA polymerase
150
What is the toxicity of cidofovor?
nephro
151
Which anti-viral is coadministered with Probenecid?
Cidofovir
152
Which protease inhibitor can cause hematuria?
Indinavir
153
What is a common toxicity for Protease inhibitors?
Nephrotoxicity
154
What is the common toxicity for all NRTIs?
bone marrow suppression
155
What are the two common toxicities for NNRTIs?
rash and hepatotoxicity
156
What is the integrase inhibitor?
Raltegravir
157
What is the toxicity of Raltegravir?
Hypercholesterolemia
158
What inhibits gp41?
Enfuvirtide
159
What inhibits CCR5? Prevents is from binding?
Maraviroc
gp120
160
What are the two toxicities of interferons?
Neutropenia and myopathy
161
Which macrolide is embryotoxic?
Clathiromycin
162
Which carbapenem has a decreased risk of seizures?
Meropenem
163
What drug is used to treat Strep in patients allergic to penicillin?
Macrolide
164
What effect of chloramphenicol is dose-independent?
aplastic anemia
165
What effect of chloramphenicol is dose-dependent?
anemia
166
Which two specific bacteria is Clindamycin used treat?
Clostridium and Bacteroides
167
What three classes of antibiotics are known to cause Pseudomembrane Colitis?
Clindamycin
Ampicillin
Cephalosporins
168
What are the two atypically named fluoroquinolones?
Enoxacin
Nalidixic acid
169
What is the most common side effects of fluoroquinolones?
GI Upset
170
Tendonitis caused by fluoroquinolones is dramictally increased with consumption with what other drug?
Glucocorticoids
171
What drug is used as prophylaxis for meningococcal?
Rifampin
172
What drug for dimorphic fungi?
Itraconazole
173
Which antifungal can decrease the synthesis of testosterone?
Ketoconazole
174
What is the toxicity of azoles?
liver
175
What is the function of β-glucan?
cross-links chitin
176
Which class of anti-fungals is particularly good at treating fungal infections of the toenails and fingernails?
Terbinafine
177
What is the drug for flukes?
Praziquantel
178
Which antiviral can cause Ataxia?
Amantadine
179
What drug is used for CMV retinitis?
Cidofovir
180
Which HAART is known to cause megaloblastic anemia?
Zidovudine
181
What are the three NNRTIs?
Nevirapine
Efavienz
Delavirdine
182
What are the two toxicities for NNRTIs?
rash and hepatotoxicity
183
What type of drug is Nalidixic Acid?
quinolone
184
Are cephalosporins cidal or static?
cidal
185
Which class of antibiotics can cause Vitamin K deficiency?
Cephalosporins
186
Which three drugs are used for treatment resistant MRSA?
Daptomycin
Linezolid
Vancomycin
187
Which antibiotic can cause an increase in CK and myopathy?
Daptomycin
188
Which specific ribosomal subunit does Linezolid cause?
23s
189
Name three toxicities of Linezoliod
thrombocytopenia
serotonin syndrome
optic neuritis
190
Are carbapenems beta-lactamase resistant or sensitive?
resistant
191
Which carbapenem is has a decreased risk of seizures?
Meropenem
192
Which carbapenem is resistant to Dehydropeptidase?
Meropenem
193
Which transmitters does permethrin block?
sodium
194
Which transmitters does malathion block?
Ach
195
Which transmitters does Lindane block?
GABA
196
Which anti-fungal is synergistic with Amphotericin B?
Flucytosine
197
What is the MOA of Bacitracin?
inhibits peptide transfer into bacterial cell wall
198
Which class of antibiotic causes ototoxicity with loop diuretics?
aminoglycoside
199
Which class of antibiotic is inactivated by modification? Which three modifications?
aminoglycosides
acetyl/phosphor/adenylation
200
What is the mechanism of resistance to macolides?
methylation of 23s ribosome
201
Are fluoroquinolones static or cidal?
cidal
202
Fluoroquinolones can cause tendon rupture especially with administration of what other drug?
Prednisone
203
Can linezolid cause pancytopenia?
yes
204
Which antimicrobial can have a metallic taste?
metronidazole
205
Which antigen does plasmodium bind?
duffy
206
What two drugs for life threatening malaria in US? Elsewhere?
US = quinidine or artesunate
Elsewhere = quinine
207
Which three "-lovir's" are in the same class?
Acyclovir
Famciclovir
Valacyclovir
208
What is gangciclovir an analogue of?
Guanosine
209
Which anti-viral can cause major electrolyte disturbances?
Foscarnet
210
What functional group do NRTIs lack?
3' OH
211
Which NRTI is a nucleotide?
Tenofivir
212
Which NNRTI produces vivid dreams and CNS symptoms?
Efavirenz
213
Which metabolic problem can nucleosides NRTIs causes?
lactic acidosis
214
What three drugs are used for HCV therapy?
ribavirin
simeprevir
sofosbuvir
215
What is the MOA of Simeprevir?
protease inhibitor
216
What is the MOA of Sofosbuvir?
RNA dependent RNA polymerase inhibitor
