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Chapter 11a (antibacterials) Flashcards

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1
Q

most common cause of death in world

A

infectious disease

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2
Q

many antibiotics originally came from…

A

natural sources

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3
Q

Louis Pasteur discovered…

A

anthrax and rabies vaccines; that microorganisms inhibit replication of other microorganisms

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4
Q

Dr. Ehrlich

A

discovered “magic bullet”; an organic arsenic compound (Salvarsan) used to treat syphilis and trypanosomiasis

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5
Q

Salvarsan

A

organic arsenic compound used to treat syphilis and trypanosomiasis; discovered at turn of 20th century

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6
Q

Gerhard Domagk

A

discovered first sulfa drug from injecting dye into daughter with sepsis; Prontosil (sulfanilamide)

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7
Q

Prontosil

A

sulfanilamide; pro-drug sulfa antibiotic. First named sulfa drug. Gets converted into sulfanilamide in body.

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8
Q

sulfa drugs

A

sulfonamide based drugs; some have antimicrobial properties while others are antiinflammatory or anticonvulsant
Rarely used now as antibiotics b/c of resistance, but many diabetic and diuretic medications use sulfa compounds

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9
Q

sulfa drugs or penicillin on skin

A

never used b/c they are too sensitizing

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10
Q

sulfonamide antibacterials

A

stop folic acid synthesis so bacteria cannot synthesize DNA

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11
Q

sulfonamide antibacterials often mixed with…

A

trimethoprim, because both stop folic acid synthesis so synergism occurs.
trimethoprim stops dihydrofolatase and sulfa drugs inhibit tetrahydrofolatereductase

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12
Q

qualities of a good antibiotic

A
  1. reaches site of infection
  2. penetrates cell
  3. reaches target and kills it
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13
Q

mercury compounds

A

used to be injected intraurethrally to treat syphilis

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14
Q

mechanisms of resistance

A
  1. decreased permeability (eg pseudomonas)
  2. antibiotic efflux pump (S. pneumonia vs. quinolones and macrolides)
  3. drug inactivation (eg B-lactamase from H. influenzae, staph, E.coli, and Klebsiella)
  4. altered target site (eg S. pneumonia with altered PBPs, S. pneu against macrolides with ribosomal methylase, S pneu against quinolones with GyrA and Topo4)
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15
Q

porin channels found in what bacteria?

A

gram negative

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16
Q

B lactamase…

A

breaks open B-lactam ring which renders penicillins, cephalosporins, monobactams, and carbepenems useless

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17
Q

PBPs

A

penicillin binding proteins; penicillin binds to these and then prevents cell wall synthesis

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18
Q

sulfadiazine

A

modern sulfa antibiotic; one of main ingredients in silver sulfadiazine cream which is used extensively for burns

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19
Q

sulfamethoxazole

A

one of time ingredients in Septra and Bactrim combination antibacterials

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20
Q

Alexander Flemming

A

recognized the importance of the antibiotic action of penicillin

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21
Q

Penicillins

A

kill bacteria by interfering with cell wall synthesis and by destabalizing transmembrane potential to cause cell lysis; all have common beta-lactam ring structure

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22
Q

first penicillins

A

could not be given orally b/c they were inactivated by gastric acids

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23
Q

penicillin V

A

stable in acid so can be given orally;

“pen-vee”

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24
Q

aminopenicillins

A

penicillin base with amino group added; like amoxicillin or ampicillin

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25
broad-spectrum penicillins
from resistance, now only some of the newer, more expensive penicillins are broad-spectrum; those in the 3rd and 4th generation
26
Bicillin
penicillin G; not acid stable so can't be given orally; given by IM or IV, first mass-produced antibiotic in US (in 1940s)
27
ampicillin is very similar to
amoxicillin; both are aminopenicillins
28
ticarcillin
has extended spectrum of action against gram negative bacteria beyond that of earlier penicillins 4th gen; antipseudomonal penicillin; given by IM or IV
29
Augmentin
amoxicillin/clavulanate combination used against penicillinase producing bacteria; oral
30
increased antibiotic resistance comes from...
overuse of antibiotics; inappropriate antibiotic given; low dose given (subinhibitory exposure or not long enough time taking antibiotic)
31
Quinolones
interfere with genetic duplication of bacteria by interfering with DNA gyrase and topoisomerase IV (the enzymes that untwist DNA so it can be read and then fold it back up)
32
penicillin hives
true drug allergy to penicillin (raised welt-like bumps), just a rash w/o raised bumps is not an actual allergy and it is okay to take penicillin again, unlike if person actually has allergy then 2nd exposure could cause bronchoconstriction and serious allergy response
33
aminoglycosides
inhibit bacterial protein synthesis; most have to be administered parenterally or topically, usually in the hospital with blood level monitoring b/c of kindey and hearing toxicities
34
streptomycin
first aminoglycoside discovered
35
gentamicin
modern prototype aminoglycoside; used systemically by parenteral admin for gram negative sepsis
36
cephalosporins
have B-lactam ring that interferes with bacterial cell wall synthesis
37
Keflex
cephalexin; first generation cephalosporin
38
Ceclor
cefaclor; second generation cephalosporin
39
first and second gen penicillins and cephalosporins
good at treating staphylococcus and strep infections
40
Rocephin
ceftriaxone; 3rd gen cephalosporin that is good at treating STIs like chlamydia and gonorrhea; however the admin is painful so it is mixed with lidocaine
41
carbapenems and monobactams
B lactam antibacterials, and are therefore bacterial cell wall inhibitors; used for complicated infections caused by organisms that are resistant to other agents None exist in oral form; only parenteral
42
B-lactam antibiotic classes
penicillins, cephalosporins, carbepenems, and monobactams
43
Azactam
aztreonam; best known monobactam, works great against gram negative, but not positive
44
penicillin allergy and cephalosporins
b/c they are so similar in structure, someone who has allergy to one may be allergic to both
45
tetracyclines
inhibit protein synthesis (the original broad-spectrum antibiotics)
46
tetracycline
one specific drug in the tetracycline family; sometimes used to treat acne but it causes GI upset often so not well tolerated usually. Has a strong affinity for Ca2+ and can cause teeth staining in young children
47
Minocin
minocycline; tetracycline antibiotic that causes less side effects than tetracycline and used much more often
48
Vibramycin
doxycycline; tetracycline antibiotic that causes less side effects than tetracycline and used much more often
49
fluorouinolones
broad spectrum antibiotics that inhibit DNA synthesis directly (not through folic acid inhibition); some of best outpatient antibiotics for infections that are not "run of the mill". Used for severe eye infections, kidney, sinus, or anthrax infections Can be given orally and well tolerated, but expensive *but are conclusively linked to tendinitis and tendon rupture
50
Cipro
ciproflaxacin; fluoroquinolone antibiotic
51
Levaquin
levofloxacin; fluoroquinolone antibiotic
52
Macrolides
erythromycin-like drugs; broad-spectrum antibiotics that interfere with bacterial protein synthesis (have large ring structures) Used when people are allergic to penicillins Used mostly in oral form for treatment of common infections of skin and upper respiratory tract
53
erythromycin
macrolide antibiotic; not used much anymore
54
Ketolide antibacterials
work by inhibiting bacterial protein synthesis
55
spinoff macrolides
synthetically produced and are much better drugs than macrolides
56
Zithromax
azithromycin; a synthetic macrolide
57
Biaxin
clarithromycin; a synthetic macrolide
58
vancomycin
used to treat MRSA (methicillin resistant S. aureus); oral or IV, kind of toxic to use otherwise
59
Flagyl
metronidazole; for anaerobic infections (such as those that cause some type of vaginitis or skin infections). Will also treat protozoa infecting the GI tract (like Giardia lamblia, “Beaver Fever”); but it is an awful drug to take because it causes so much GI upset
60
Cleocin
clindamycin; bacterial protein synthesis inhibitor common component of topical acne drugs; another alternative for penicillin allergic people (have very large ring structures) Treat anaerobic infections (such as those that cause some type of vaginitis or skin infections)
61
alternatives to penicillin for allergic people
clindamycin and macrolides
62
clavulanic acid
structurally looks just like penicillin (B-lactam); a suicide substrate for penicillinase and has even greater binding affinity than penicillin so can block B-lactamase so B lactams can still work w/o being destroyed
63
Septra DS
trimethoprim and sulfamethoxazole (a sulfa drug); combination antibiotic used for uncomplicated UTIs
64
Bactrim
trimethoprim and sulfamethoxazole (a sulfa drug); combination antibiotic used for uncomplicated UTIs
65
spectrum of action
refers to the different kinds of bugs that can be killed by the antibiotic
66
locality to resistance
a drug that might be effective in geographic area may be overused in another so it is ineffective there
67
broad spectrum
means that the drug works well against a variety of gram negative and gram positive bacteria
68
broad spectrum antibiotics
tetracyclines, 2+3+4th gen cephasporins, fluoroquinolones, cabepenems, and monobactams
69
narrow spectrum antibiotics
sulfa drugs (like sulfonilamide), penicillins, aminoglycosides (like streptomycin), and glycopeptides (like vancomycin)
70
imipenem-cilastatin
carbapenem antibiotic; given by IM or IV
71
timentin
combination antibiotic; ticarcillin/clavulanic acid mix
72
trimethoprim
stops dihydrofolatase
73
sulfisoxazole
sulfonamide antibiotic
74
chloramphenicol
bacterial protein synthesis inhibitor
75
antibiotic families and mechanisms
fluoroquinolones; direct inhibition of DNA/RNA synthesis sulfonamide; folate synthesis inhibition to stop DNA synthesis Tetracycline, macrolides, aminoglycosides; inhibition of protein synthesis Penicillins, cephalosporins, carbapenems, monobactams; cell wall synthesis inhibitors
76
methicillin
synthetic drug resistant to penicillinase
77
neomycin
aminoglycoside antibiotic; used in many antibiotic ointments (too toxic for internal use)
78
bacitracin
topical antibiotic in ointments
79
polymyxin B
topical antibiotic in ointments
80
Claforan
cefotaxime; third gen cephalosporin used in ED a lot for treating STIs
81
piperacillin
4th gen penicillin
82
tazobactam
B-lactamase inhibitor like clavulanate
83
TB cause
tuberculosis is caused by Mycobacterium tuberculosis
84
4th generation penicillins
ticarcillin and piperacillin; semi-synthetic modifications of natural penicillin that have more effect on gram negative bacteria than before, especially pseudomonas, enterbacter, proteus, and klebsiella species

Pre-pharmacology (27 decks)

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