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Comprehensive Prep > Chapter 6: Antibiotics > Flashcards

Chapter 6: Antibiotics Flashcards

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1
Q

Iodophors (Betadine)

A

Antiseptic: good for GPCs and GNRs; poor for fungi

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2
Q

Chlorhexidine gluconate (Hibiclens)

A

Antiseptic: good for GPCs, GNRs, and fungi

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3
Q

Inhibitors of cell wall synthesis

A

Penicillins, cephalosporins, carbapenems, monobactams, vancomycin

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4
Q

Inhibitors of the 30S ribosome and protein synthesis

A

Tetracycline, aminoglycosides (tobramycin, gentamicin), linezolid

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5
Q

Inhibitors of the 50s ribosome and protein synthesis

A

Erythromycin, clindamycin, Synercid

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6
Q

Inhibitor of DNA helicase (DNA gyros)

A

Quinolones

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7
Q

Inhibitor of RNA polymerase

A

Rifampin

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8
Q

Produces oxygen radicals that breakup DNA

A

Metronidazole (Flagyl)

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9
Q

PABA analogue - Inhibits purine synthesis

A

Sulfonamides

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10
Q

Inhibits dihydrofolate reductase which inhibits purine synthesis

A

Trimethoprim

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11
Q

Bacteriostatic antibiotics

A

Tetracycline, clindamycin, erythromycin (all have reversible ribosomal binding), Bactrim

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12
Q

Have irreversible binding to ribosome and are considered bactericidal

A

Aminoglycosides

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13
Q

Mechanism: penicillin resistance

A

Due to plasmids for beta-lactamase

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14
Q

Resistance caused by a mutation of cell wall-binding protein

A

Methicillin-resistant S. aureus (MRSA)

Vancomycin-resistant enterococcus (VRE)

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15
Q

Resistance due to modifying enzymes leading to a decrease in active transport of this antibiotic into the bacteria

A

Gentamicin resistance

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16
Q

Vancomycin

  • Peak
  • Trough
A

Vancomycin

  • Peak: 20-40 ug/mL
  • Trough: 5-10 ug/mL
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17
Q

Gentamicin

  • Peak
  • Trough
A

Gentamicin

  • Peak: 6-10 ug/mL
  • Trough:
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18
Q

What if the peak is too high?

A

Decrease amount of each dose

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19
Q

What if the trough is too high?

A

Decrease frequency of doses (increase time interval between doses)

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20
Q

Penicillin

A

GPCs: streptococci, syphilis, Neisseria meningitides (GPR), Clostridium perfringens (GPR), beta-hemolytic Streptococcus, anthrax
- Not effective against Staphylococcus or Enterococcus

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21
Q

Antibiotics: anti-staph penicillins (staph only)

A

Oxacillin and nafcillin

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22
Q

Antibiotics: same as penicillin but also picks up enterococci

A

Ampicillin and amoxicillin

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23
Q

Unasyn (ampicillin/sulbactam)

Augmentin (amoxicillin/clavulanic acid): bugs

A
  • Broad spectrum: pick up GPCs (staph/strep), GNRs +/- anaerobic coverage.
  • Effective for enterococci; not effective for Pseudomonas, Acinetobacter, or Serratia
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24
Q

Timentin (ticarcillin/clavulanic acid)

Zosyn (piperacillin/sulbactam): bugs, side effects

A

(antipseudomonal penicillins)

  • Broad spectrum: pick up GPCs (staph/strep), GNRs, anaerobes
  • Effective for enterococci; effective for pseudomonas, acinetobacter, serratia
  • SE: inhibits platelets, high salt load
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25
1st - generation cephalosporins (cefazolin, cephalexin): bugs
- GPCs: staph and strep | - Not effective for Enterococcus; does not penetrate CNS
26
Why is ancef (cefazolin) good for prophylaxis?
It has a long half life.
27
2nd - generation cephalosporin (cefoxitin, cefotetan, cefuroxime): bugs
- GPCs, GNRs, +/- anaerobic coverage; lose some staph activity. - Not effective for enterococcus, pseudomonas, acinetobacter, serratia - Effective only for community-acquired GNRs
28
Why is cefotetan good for prophylaxis?
It has a long half life.
29
3rd - generation cephalosporin (ceftriaxone, ceftazidime, cefepime, cefotaxime): bugs, side effects
- GNRs mostly, +/- anaerobic coverage. - Not effective for enterococcus; effective for pseudomonas, acinetobacter, and serratia - Side effects: cholestatic jaundice, sludging in gallbladder (ceftriaxone)
30
Monobactam (aztreonam): bugs
GNRs, picks up pseudomonas, acinetobacter, serratia
31
Carbapenems (meropenem): bugs, side effects
- Given with cilastin - Broad spectrum: GPCs, GNRs, and anaerobes - Not effective for MEP: MRSA, Enterococcus, Proteus - Side effects: seizures.
32
Why are carbapenems given with cilastin?
Prevents renal hydrolysis of the drug and increase half-life
33
What are carbapenems not effective for?
MEP | - MRSA, Enterococcus, and Proteus
34
Bactrim (TMP/SMX): bugs, side effects
GNRs, +/-GPCs - Not effective for enterococcus, pseudomonas, acinetobacter, serratia - Side effects: teratogenic, allergic reactions, renal damage, SJS, hemolyis in G6PD
35
Quinolones (Ciprofloxacin, levofloxacin, norfloxacin): bugs
- Some GPCs, mostly GNRs - Not effective for enterococcus, picks up Pseudomonas, acinetobacter, serratia - 40% of MRSA sensitive; some efficacy PO and IV.
36
Aminoglycosides (gentamicin, tobramycin): bugs, side effects
GNRs - Good for pseudomonas, acinetobacter, and serratia; not effective for anaerobes (need O2) - Synergistic with ampicillin for Enterococcus - Beta-lactams (ampicilin, amoxicililn) facilitate penetration - Side effects: reversible nephrotoxicity, irreversible ototoxicity
37
What is aminoglycoside resistance secondary to?
Resistance due to modifying enzymes leading to decreased active transport
38
Erythromycin (macrolides): bugs, side effects
- GPCs, best for community-acquired pneumonia and atypical pneumonias - Side effects: nausea (PO), cholestasis (IV) - Also binds motilin receptor and is pro kinetic for bowel
39
Vancomycin (glycopeptides): bugs, side effects
- GPCs, Enterococcus, Clostridium difficile (with PO intake), MRSA) - Binds cell wall proteins - Side effects: HTN, Redman syndrome (histamine release), nephrotoxicity, ototoxicity
40
What is resistance to vancomycin (glycopeptides) due to?
Resistance develops from a change in cell wall-binding protein
41
Synercid (streptogramin - quinupristin-dalfopristin) | Linezolid (oxazolidinones): bugs
GPCs, includes MRSA, VRE
42
Tetracycline: bugs, side effects
- GPCs, GNRs, syphilis | - Side effects: tooth discoloration in children
43
Clindamycin: bugs, side effects
- Anaerobes, some GPCs - Good for aspiration pneumonia - Can be used to treat C. perfringens - Side effects: pseudomembraneous colitis
44
Metronidazole (Flagyl): bugs, side effects
- Anaerobes | - Side effects: disulfiram-like reaction, peripheral neuropathy (long-term use)
45
Amphotericin
Antifungal: binds sterols in wall and alters membrane permeability - Side effects: nephrotoxic, fever, hypokalemia, hypotension, anemia - Liposomal type has fewer side effects
46
Voriconazole | Itraconazole
Antifungal: inhibit ergosterol synthesis (needed for cell membrane)
47
Anidulafungin (Eraxis)
Antifungal: inhibits synthesis of cell wall glucan
48
Prolonged broad-spectrum antibiotics +/- fever
Itraconazole
49
Tx: invasive aspergillosis
Voriconazole
50
Tx: candidemia
Anidulafungin
51
Tx: fungal sepsis other than cadida and aspergillus
Liposomal amphotericin
52
Tuberculosis drugs
RIPE: rifampin, isoniazid, pyrazinamide, ethambutol
53
Isoniazid
TB: inhibits mycolic acids (give with pyridoxine | -Side effects: hepatotoxicity, B6 deficiency
54
Rifampin
TB: inhibits RNA polymerase | -Side effects: hepatotoxicity, GI symptoms, high rate of resistance
55
Pyrazinamide
TB: | -Side effect: hepatotoxcity
56
Ethambutol
TB: | - Side effect: retrobulbar neuritis
57
Acyclovir
Inhibits viral DNA polymerase | Used for HSV infections, EBV
58
Ganciclovir
Inhibits viral DNA polymerase Used for CMV infections - Side effects: decreased bone marrow, CNS toxicity
59
Antibiotics effective for enterococcus
Vancomycin Timentin / Zosyn Ampicillin / amoxicillin Gentamicin w/ ampicillin
60
Effective for Pseudomonas, Acinetobacter, Serratia
``` Ticarcillin / piperacillin Timentin / Zosyn Third generation cephalosporins Aminoglycosides (gentamicin and tobramycin) Meropenem / imipenem Fluoroquinolones ```

Comprehensive Prep (45 decks)

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