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PCOL Cumulative Final > Exam II Antimicrobials General > Flashcards

Exam II Antimicrobials General Flashcards

1
Q

What are the types of Beta-Lactams?

A

Penicillins

Cephalosporins

Monobactams

Carbapenems

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2
Q

What are the types of penicillins ranked from least to most coverage?

A

Naturally occurring Penicillins

Aminopenicillins

Penicilinase Sensitive Penicillins

Antipseudomonal Penicillins

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3
Q

How do Bacteria resist Penicillin?

A

Bacteria change the confirmation sites at the penicillin-binding protein.

Bacteria create enzyme (penicillinase, or beta-lactamase) to destroy beta-lactam antibiotics.

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4
Q

Do Carbapenems have any significant ADRs and DDIs?

A

Imipenem is coformulated with cilastatin to protect the kidneys from it’s nephrotoxic metabolite (inhibits dehydropeptidase)

Meropenem causes a fast and rapid decrease in Valproic acid

Doripenem is least susceptible for MDR, GNR and Pseudomonas beta-lactamase

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5
Q

What drugs to use with Penicillin allergy?

Allergies caused by sidechains

A

Cephalosporin 3rd Gen < 0.5% chance of cross reacting

Cephalosporin 1st or 2nd Gen 2% chance of cross reacting

Carbapenem < 1% chance of cross reacting

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6
Q

How do you test Dose Antibiotics?

A

Test Dose = 1/10th of the target dose

Ex. Test Dose 100 mg of Cefepime

Target Dose 1000 mg Cefepime

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7
Q

How do Glycopeptides work?

A

Inhibit Penicillin binding protein from cross linking peptidoglycan.

Effective to overcome beta-lactamase or penicillinase mutations.

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8
Q

When would you administer PO Vancomycin?

A

For CDiff

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9
Q

How do Tetracyclines work?

A

Inhibit protein synthesis by preventing tRNA binding to the 30s ribosomal subunit.

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10
Q

How do Fluoroquinolones work?

A

Inhibit both DNA gyrase and Topoisomerase IV.

Prevent bacterial from replicating DNA

Renal Concerns

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11
Q

Fluoroquinolone ADRs

A
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12
Q

How do Macrolides work?

A

Inhibit Protein synthesis by preventing tRNA binding at the 50s ribosomal subunit.

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13
Q

What DDIs are you concerned about with non Z-pack macrolides?

A

CYP interactions

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14
Q

How does Clindamycin work?

A

Inhibit protein synthesis by preventing tRNA binding to 50s ribosomal subunit.

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15
Q

What are the ADEs associated with Clindamycin?

A

Nausea, GI upset, multiple dosing a day.

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16
Q

How does Metronidazole work?

A

Inhibits DNA synthesis by causing strand breakage.

17
Q

What ADEs does Metronidazole

A

Peripheral Neuropathy, GI intolerance, metallic taste

18
Q

How does SMX / TMP (Bactrim) work?

A

Inhibits formation of nucleic acids needed for DNA synthesis/replication.

SMX inhibits dihydropteroate

Trimethoprim inhibits dihydrofolate reductase

19
Q

How do Aminoglycosides work?

A

Irreversibly bind with 30s subunit, causing the mRNA to be misread.

20
Q

What are the two methods of dosing Aminoglycosides?

A

Once Daily (preferred)

Peak dose extended interval

Conventional

Small doses more frequently allowing for Renal monitor etc.

21
Q

How do you determine the Extended dosing interval of AMinoglycosides?

A

Use the Hartford Nomogram. Frequency-based off drug level at certain time points posts dosage.

22
Q

What needs to be monitored in conventional dosing of Aminoglycosides?

A

Peaks and Troughs

This is the dosing used for Synergy.

23
Q

How does Nitrofurantoin Work?

A

Metabolized within the Bacterial Cell to reactive intermediates that destroy DNA and ribosomal Proteins.

24
Q

How do Oxazolidinones work?

A

Bind the 50s ribosome inhibits the ability for 30s ribosome to bind. Does not allow protein synthesis to occur.

25
Q

What Oxazolidinone can cause Serotonin Excess?

A

Linezolid can cause SS when used with other drugs.

26
Q

How does Daptomycin work?

A

Binds calcium and inserts into the phospholipid cytoplasmic membrane. Other Daptomycin molecules aggregate and create holes in membrane.

27
Q

Where should you never use Daptomycin?

A

Pneumonia, it will bind with surfactant and be ineffective.

28
Q

How do streptogramins work?

A

Inhibit 50s ribosomal subunit, inhibiting tRNA from binding.

29
Q

How does Rifampin work?

A

Inhibits RNA polyermase

30
Q

How does Fosfomycin work?

A

Inhibits enzyme MurA, causing cell death by inhibiting cell wall synthesis.

31
Q

How does Fidaxomicin work?

A

Binds to RNA Polymerase preventing transcription.

32
Q

Which Antibiotic can decrease Oral Contraceptive effectiveness?

A

Rifampin

33
Q

What are the universal concerns of an antibiotic?

A

Yeast Infection

Diarrhea

Predisposition to C Diff

34
Q

Dose-Adjusted Liver

A

Dicloxacillin

Nafcillin

Oxacillin

Doxycycline

Minocycline

Tetracycline

Tigercycline

Omadacycline

Eravacycline

Azithromycin

Clindamycin

Metronidazole

Linezolid

Tedizolid

Quinupristin/Dalfopristin

Rifampin

35
Q

Dose-Adjusted Renal

A

Penicillin VK

Penicillin G

Amoxicillin

Ampicillin

Piperacillin

Piperacillin/Tazobactam

Ticarcillin/Clavulanate

Ampicillin/Sulbactam

Amoxicillin/Clavulanic acid

Cefazolin

Cephalexin

Cefadroxil

Cefaclor

Cefprozil

Cefuroxime

Lorbacef

Cefotetan

Cefoxitin

Cefepime

Ceftaroline

Ceftazidime/Avibactam

Ceftolozane/Tazobactam

Ertapenem

Imipenem/Cilastatin

Meropenem

Doripenem

Meropenem/Varobactam

Aztrenam

Vancomycin

Dalbavancin

Telavancin

Oritavancin

Ciprofloxacin

Levofloxacin

Delafloxacin

Sulfamethoxazole/Trimethoprim

Amikacin

Gentamicin

Tobramycin

Plazomicin

Nitrofurantoin

Daptomycin

PCOL Cumulative Final (14 decks)

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