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Block 1: Pharmacology > Exam 1 (Part 2) > Flashcards

Exam 1 (Part 2) Flashcards

1
Q

(Antibiotic)
Bacteriostatic?

A

(Inhibit bacterial cell replication)
(STATEC)
-Tetracyclines
-Erythromycin
-Chloramphenicol

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2
Q

(Antibiotic)
Bactericidal?

A

(Causes microbial cell death and lysis at clinically achieved concentrations)
(PACS A PUNCH)
-Penicillins
-Aminoglycosides (Gentamycin, Tobramycin)
-Cephalosporins

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3
Q

(Antibiotic)
Sulfonamides?

A

Either -cidal or -static

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4
Q

Cell Wall Synthesis?

A

(“I hit a wall, Please Come C My Vehicle”)
-Penicillin (G, Ampicillin)
-Cephalosporin
-Monobactams
-Carbapenems
-Vancomycin

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5
Q

DNA –> RNA?

A

(MR. Q)
-Metronidazole-DNA
-Rifampin-RNA Polymerase
-Quinolones-DNA Gyrase

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6
Q

Protein Synthesis?

A

(MAT C)
-Macrolides
-Aminoglycosides
-Tetracyclines
-Chloraphenicol

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7
Q

Cell Membrane?

A

-Polymyxins
-Daptomycin

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8
Q

Folic Acid?

A

-Trimethoprim
-Sulfonamides

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9
Q

Skin and Subcutaneous Tissues?

A

-Burns (SSP)
-Skin Infections (SSH)
-Decubitus Wound Infections (SEB)
-Traumatic and Surgical Wounds (SSP)

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10
Q

(Skin and Subcutaneous Tissues)
Burns/Traumatic and Surgical Wounds?

A

(SSP)
-Staph aureus
-Strep
-Pseudo aeru

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11
Q

(Skin and Subcutaneous Tissues)
Skin Infections?

A

(SSH)
-Staph aureus
-Strep
-Herpes

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12
Q

(Skin and Subcutaneous Tissues)
Decubitus Wound Infections?

A

(SEB)
-Staph
-E. coli
-Bact fragilis

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13
Q

(“First Choice”)
Treponema pallidum, Syphilis?

A

Benzathine (salt) + Penicillin G

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14
Q

(“First Choice”)
Mycobacterium tuberculosis?

A

(RIPE)
Rifampin + Isoniazid + Pyrazinamide + Ethambutol

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15
Q

(“First Choice”)
Pseudomonas aeru, Pneumonia?

A

(PTT)
Piperacillin/Tazobactam + Tobramycin)
(B Lactam/ B Lactam Inhibitor)

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16
Q

(Hepatic Function)
Chloramphenicol, IV?

A

-Hepatic function impairment (use with caution)
-Reduced dosage

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17
Q

(Hepatic Function)
Clindamycin, IV?

A

-Hepatic function impairment, No dosage adjustment
-Use with caution with severe liver disease

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18
Q

(AGE)
(Neonates)
Chloramphenicol?

A

-Low concentrations of UGT, cleared by kidneys
-Gray Baby Syndrome
-Give low dose

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19
Q

(AGE)
(Neonates)
Sulfonamides?

A

-Displace bilirubin from albumin in blood which can deposit in brain, Kernicterus or toxic encephalopathy
-Contraindicated in neonates

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20
Q

Increase Gentamicin dose for?

A

Infants/Young Children

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21
Q

(AGE)
(Children)
Tetracycline?

A

-Teeth Discoloration
-Intracranial Hypertension

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22
Q

(AGE)
Isoniazid?

A

-Increased hepatitis risk with increased age

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23
Q

(AGE)
CHF Patients?

A

Ticarcillin disodium/ Clavulanate potassium –> Na+ and K (can cause edema and arrhythmia)

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24
Q

(Pregnancy and Nursing Contradictions)
Metronidazole?

A

Mutagenic

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25
(Pregnancy and Nursing Contradictions) Sulfonamides?
-Breast milk -Kernicterus: increased bilirubin, displaced from albumin
26
(Pregnancy and Nursing Contradictions) Antifolate drugs?
-Decreased concentrations of folic acid in pregnant women -Can lead to spina bifida
27
(Pregnancy and Nursing Contradictions) Fluoroquinolones?
Affect cartilage growth
28
(Pregnancy and Nursing Contradictions) Tetracyclines?
-Inhibit bone growth -Tooth enamel dysplasia
29
Do NOT use 2 drugs of?
Same class or same mechanism of action
30
(Bacteria) Gram +?
(Lactamase outside, thicker peptidoglycan wall) (Vancomycin) -Staph -Strep -E. Faccalis -Mono
31
(Bacteria) Gram -?
(Outer membrane with porin channel, thin peptido., lactamase inside) (Aminoglycosides) -E. Coli -Kleb -Pseudo -H. Influenzae
32
(Bacteria) Anaerobes?
-C. Diff -Bacterio Fragile
33
(Bacteria) Miscellaneous?
-Trep -Myco -Rickett
34
Penicillin targets?
Transpeptidase (Penicillin Binding Protein)
35
Penicillins?
-Pencillin G (Natural) -Amoxicillin, Ampicillin (Amino group added) -Dicloxacilin (Narrow, staph) -Ticarcillin + Piperacillin (Pseudo)
36
(Penicillins) Penicillin G?
-Narrow -Penicillinase-sensitive (Strep, Pepto, Trep, Necrotize)
37
(Penicillins) Dicloxacilin?
-Narrow -Penicillinase-resistant -MSSA -MSSE (Staph + Run of the mill)
38
(Penicillins) Amoxicillin?
-Broad Spectrum -Penicillinase-sensitive -Ear/URTI
39
(Penicillins) Ticarcillin?
-Broad -Penicillinase-sensitive (Pseudo Aeru + G- Nocosomial (hospital acquired))
40
(Penicillins) Piperacillin?
-Extended -Penicillinase-senstive (Klebsiella pneumoniae)
41
(Penicillins) Mechanisms of Action?
-Inhibit peptidoglycan transpeptidase -Prevents cross-linking of glycopeptide polymers -PBP -Trigger autolysis
42
(Penicillins) Pharmacokinetics?
-Renal clearance -Distributed widely -Poor in absence of inflammation -Conc. of drug achieved to treat meningitis, arthritis, endophthalmitis
43
(Penicillins) Side Effects?
-NVD -Superinfection of GI Tract: C. Diff -IV/IM: phlebitis, pain -Neurotoxicity -Penicillin allergy
44
(Pencillins) Mechanisms of Resistance?
-Changes in PBP -Tolerance -Changes in porins (Gram -) -B-lactamase
45
Cephalosporins?
-Cefazolin (1st) -Cefoxitin (2nd) -Ceftriaxone (3rd) -Cefepime (4th) -Ceftaroline (5th)
46
(Cephalosporins) Mechanisms of Action?
(Same as Penicillin) -Inhibit peptidoglycan transpeptidase -Prevents cross-linking of glycopeptide polymers -PBP -Trigger autolysins
47
(Cephalosporins) Cefazolin?
(1st) (PEKS) -Proteus, E. coli, Kleb, Staph/Strep -Prevention of surgical prophylaxis
48
(Cephalosporins) Cefoxitin?
(2nd) (HEN PEK) -Haemo, E. aero, Neiss (PEK)
49
(Cephalosporins) Ceftriaxone?
(3rd) (ACES) -2nd + Acine, Citro, Entero, Serr -Gram - -Meningitis
50
(Cephalosporins) Cefepime?
(4th) (Gram +) -3rd + MSSA, Strep, Pseudo, Citro -B-lactmase resistance -Serious G- nosocomial infections
51
(Cephalosporins) Ceftaroline?
(5th) -4th + MRSA -Acute bacterial skin and skin structure infections -Community acquired pneumonia
51
(Cephalosporins) Pharmacokinetics?
-Renal elimination (COME BACK TO SLIDE 42)
52
(Cephalosporins) Side Effects?
-Local reactions -Hypersensitivity reactions -Usually less immunogenic than penicillins (do NOT give to patients with Penicillin allergies)
53
(Cephalosporins) Mechanisms of Resistance?
(Similar to Cillins) -Changes in PBP -Tolerance -Changes in porins -B-lactamase
54
Carbapenems?
Imipenem
55
(Carbapenems) Mechanisms of Action?
(Same as Penicillin) -Inhibit peptidoglycan transpeptidase -Prevents cross-linking of glycopeptide polymers -PBP -Trigger autolysis
56
(Carbapenems) Therapeutic Uses?
-Mostly G-rods (pseudo, mono) -Empiric treatment of serious nosocomial infections
57
(Carbapenems) Pharmacokinetics?
-Renally cleared -Imipenem hydrolyzed in kidney
58
(Carbapenems) Side Effects?
-Seizures -Hypersensitivity reactions
59
(Carbapenems) Mechanisms of Resistance?
(Similar to Penicillins) -B-lactamase -PBP -Porins -Autolysis
60
Monobactam?
Aztreonam (give if allergic to Penicillin)
61
(Monobactam) Mechanisms of Action?
(Same as Penicillin) -Inhibit peptidoglycan transpeptidase -Prevents cross-linking of glycopeptide polymers -PBP -Trigger autolysins
62
(Monobactam) Therapeutic Uses?
Mostly G-rods (Pseudomonas aeruginosa)
63
(Monobactam) Pharmacokinetics?
Renally cleared
64
(Monobactam) Side Effects?
-GI upset -Phlebitis (IV), pain at injection (IM) -Hypersensitivity reaction (1% B-lactam allergic patients)
65
(Monobactam) Mechanisms of Resistance?
(Similar to cillins) -B-lactamase -PBP -Porins -Autolysins
66
Tricyclic Glycopeptide?
Vancomycin
67
(Tricyclic Glycopeptide) Mechanisms of Action?
-Inhibitor of peptidoglycan synthase (attaches to NAG and NAM) -Binds to D-Ala-D-Ala -Inhibitor of pentapeptide precursor and membrane carrier
68
(Tricyclic Glycopeptide) Therapeutic Uses?
-Primarily G+:MRSA, MRSE -Serious multi-drug resistant infections -Clostridioides difficile (PO)
69
(Tricyclic Glycopeptide) Pharmacokinetics?
-Renally cleared -Penetrates into pleural, pericardial, synovial and ascetic fluids -Can enter CSF with inflamed meninges
70
(Tricyclic Glycopeptide) Side Effects?
-Ototoxicity: rare -Nephrotoxicity: uncommon -Red man syndrome
71
(Tricyclic Glycopeptide) Mechanisms of Resistance?
-D-Ala-D-Lactase -VRE -VISA
72
Cyclic Lipopeptide?
Daptomycin
73
(Cyclic Lipopeptide) Mechanisms of Action?
-Binds to cell membrane, forms pores -Depolarization -Rapid Cell Death
74
(Cyclic Lipopeptide) Therapeutic Use?
-Primarily G+: MRSA, VRE -Treatment of skin/soft tissue infections -Endocarditis
75
(Cyclic Lipopeptide) Pharmacokinetics?
-Renally cleared -Pulmonary surfactant inactivates it (CANNOT use for lung infections like Pneumonia)
76
(Cyclic Lipopeptide) Side Effects?
-Myopathy, Rhabdomyolysis -Allergic pneumonitis, if used >2 weeks
77
(Cyclic Lipopeptide) Mechanisms of Resistance?
Treatment failure (increase MIC)
78
70s?
Bacterial Ribosomes
79
80s?
Eukaryotic
80
Tetracyclines?
-Minocycline -Tetracycline -Doxycycline
81
(Tetracyclines) Mechanisms of Action?
-Inhibit protein synthesis -Bind to bacterial 30s ribosomal subunit -Prevent attachment of aminoacyl-tRNA -Bacteriostatic (TEC)
82
(Tetracyclines) Therapeutic Uses?
-Mycoplasma pneumoniae -Cutibacterium acnes
83
(Tetracyclines) Pharmacokinetics?
-Limited CNS penetration -PO -Doxycyline primarily fecally eliminated --> OK with renal failure
84
(Tetracyclines) Side Effects?
-Contraindicated during pregnancy -N/V -Discoloration of teeth and inhibit bone growth -Photosensitivity -Superinfection (C. diff, C. albicans)
85
(Tetracyclines) Mechanisms of Resistance?
-Plasmid-determined resistance: decreased influx and increased efflux -Ribosomal change
85
Glycylcyclines?
Tigecycline (reserved for: difficult to treat infections)
86
(Glycylcyclines) Mechanisms of Action?
-Bind to bacterial 30s ribosomal subunit -Bacteriostatic
87
(Glycylcyclines) Therapeutic Use?
-Broad spectrum, many G+, G-, Anaerobes, MRSA, VRE, PRSP -Complicated skin and skin structure infections -Complicated intra-abdominal infections
88
(Glycylcyclines) Side Effects?
-Mortality risk (limit use for multi-resistance) -Contraindicated in pregnancy, superinfection
89
Macrolides?
-Erythromycin -Azithromycin -Clarithromycin
90
(Macrolides) Mechanisms of Action?
-Inhibit protein synthesis -Binds to peptidyl-tRNA binding region (P site) on 50s ribosome subunit -Bacteriostatic
91
(Macrolides) Therapeutic Use?
-Broad Spectrum (Chlamydia pneumoniae, H. influenzae, M. catarrhalis -Communit acquired: URTI, Pneumonia, Otitis media
92
(Macrolides) Side Effects?
-Prolong QTc interval -NVD Rash -Chloestatic hepatitis -Embryotoxic (C, animals)
93
(Macrolides) Mechanisms of Resistance?
-Methylation of 23 rRNA-binding site -Prevents binding
94
(Macrolides) Drug Interactions?
-Erythromycin >> clarithromycin -Inhibit CYP3A4
95
Chloramphenicol?
Chloramphenicol
96
(Chloramphenicol) Mechanisms of Action?
-Binds to 50s subunit -Inhibits peptide bond formation -Bacteriostatic -Bactericidal for meningitis treatment
97
(Chloramphenicol) Therapeutic Uses?
-Haemophilius influenzae -Neisseria -Strep -Rickett
98
(Chloramphenicol) Side Effects?
-Anemia (dose-related) -Aplastic anemia (dose-independent) -GRAY BABY SYNDROME (decreased UGT)
99
Lincosamides?
("CCC") -Clinamycin -Ca-mrsa -CDAD
100
(Lincosamides) Mechanisms of Action?
-Binds to 50s ribosome subunit -Bacteriostatic
101
(Lincosamides) Therapeutic Uses?
-CA-MRSA -BLA (B-lactam allergy)
102
(Lincosamides) Side Effects?
-CDAD -Diarrhea -Rash -Fever -Neutropenia (rare)
103
(Lincosamides) Mechanisms of Resistance?
-Methylation of 23 rRNA-binding site -Prevents binding
104
Streptogramins?
-Quinopristin/ Dalfopristin (in same dose) (synergistically)
105
(Streptogramins) Mechanisms of Action?
-Binds to 50s ribosome subunit -Bactericidal
106
(Streptogramins) Therapeutic Uses?
Primary G+ -Enterococcus faecium (VRE) -MRSA -PRSP -Osteomyelitis -Endocarditis
107
(Streptogramins) Side Effects?
-Pain -Phlebitis at infusion site -Arthralgia -Myalgias
108
(Streptogramins) Mechanisms of Resistance?
-Ribosomal methylate (Q) -Acetyltransferase (D)
109
Oxazolidinones?
-Linezolid -Tedizolid
110
(Oxazolidinones) Mechanisms of Action?
-Binds to 50s ribosome subunit -Bacteriostatic
111
(Oxazolidinones) Therapeutic Uses?
-Primary G+ -L -VRE -MRSA -MRSE -PRSP -Skin infections -Pneumonia -Bacteremia
112
(Oxazolidinones) Side Effects?
-Myelosuppression -MAOI -Rash -Peripheral neuropathy
113
(Oxazolidinones) Mechanisms of Resistance?
Ribosomal binding site mutation
114
Aminoglycosides?
-Gentamicin -Amikacin -Tobramycin
115
(Aminoglycosides) Mechanisms of Action?
-Inhibit protein synthesis -Binds to 30s ribosomal subunit -Bactericidal -Concentration-dependent killing -Synergistic with B-lactams (PCCVM)
116
(Aminoglycosides) Therapeutic Uses?
-Often combined with B-lactam -Bowel surgery (N)
117
(Aminoglycosides) Pharmacokinetics?
-Primary renally cleared -Polar --> decreases distribution (CNS, lungs)
118
(Aminoglycosides) Side Effects?
-Nephrotoxicity -Ototoxicity -Neuromuscular blockade -Teratogen (8th CN) -Myelosuppression (rare)
119
(Aminoglycosides) Mechanism of Resistance?
-Decreased porin permeation -Decreased ribosomal binding -Enzymatic inactivation: acetyltransferase -Phosphotransferase
120
Macrocyclic Antibiotic?
Fidaxomicin
121
(Macrocyclic Antibiotic) Mechanisms of Action?
-Binds to sigma unit of RNA polymerase -Inhibits protein synthesis
122
(Macrocyclic Antibiotic) Therapeutic Use?
-Clostridioides diffcile -CDAD (Vancomycin, Fidaxomicin)
123
(Macrocyclic Antibiotic) Side Effects?
-N/V -Abdominal pain -GI Hemorrhage -BMS (2%)
124
(Macrocyclic Antibiotic) Pharmacokinetics?
-PO: very little systemic absorption -High fecal concentration
125
Sulfonamides?
Sulfamethoxazole
126
(Sulfonamides) Mechanisms of Action?
-Inhibition of dihydropteroate synthase which inhibits synthesis of folic acid -Decreased biosynthesis of DNA, RNA, AA, Bacteriostatic
127
(Sulfonamides) Therapeutic Use?
-Broad Spectrum -UTI -Treatment of conjunctivitis -Burns, Ag Sulfadiazine
128
(Sulfonamides) Side Effects?
-Rash -Sulfa allergy -SJS -TEN -Kernicterus: Newborn Encephalopathy, Bilirubin deposits in brain, Sulfa displacement on albumin
129
(Sulfonamides) Pharmacokinetics?
-Renally cleared -NAT (primary) and UGT substrate -Inhibit CYP2C9 --> increased Warfarin AUC
130
(Sulfonamides) Mechanisms of Resistance?
-Do not biosynthesize folic acid -Increase PABA production -Dihydropteroate synthase -Decreased sulfa permeability
130
Trimethoprim/ Sulfamethoxazole?
-DFHR -DFHS
131
(Trimethoprim/ Sulfamethoxazole) Mechanisms of Action?
-DHFRI, DHPSI, Synergism -Bacteriostatic
132
(Trimethoprim/ Sulfamethoxazole) Therapeutic Uses?
-MRSA -E. coli -UTI -Prostatitis
133
(Trimethoprim/ Sulfamethoxazole) Side Effects?
-Hemolytic anemia
134
(Trimethoprim/ Sulfamethoxazole) Mechanisms of Resistance?
Trimethoprim
135
Quinolones (Floxacin)?
-Ciprofloxacin -Levofloxacin -Moxifloxacin
136
(Quinolones (Floxacin)) Mechanisms of Action?
-Inhibit Topoisomerase II (bacterial DNA gyrase) -Inhibit DNA replication
137
(Quinolones (Floxacin)) Side Effects?
-Tendonitis -Maysthenia graves
138
(Quinolones (Floxacin)) Drug Interactions?
-Chelation, Al, Mg, Fe, Ca -Inhibit CYP1A2, increased caffeine
139
(Quinolones (Floxacin)) Mechanisms of Resistance?
-Mutations in Topoisomerase II or IV, decreased binding -Increased efflux -Decreased influx

Block 1: Pharmacology (9 decks)

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