Intro to Antibiotics Flashcards by Jessica Hyde

Q

Penicillin G belongs to which drug class?

A

Penicillins

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Q

Ampicillin belongs to which drug class?

A

Aminopenicillins

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Q

Amoxicillin belongs to which drug class?

A

Aminopenicillin

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Q

Methicillin belongs to which drug class?

A

Penicillinase-Resistant Penicillins

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Q

Nafcillin belongs to which drug class?

A

Penicillinase-Resistant Penicillins

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Q

Oxacillin belongs to which drug class?

A

Penicillinase-Resistant Penicillins

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Q

Dicloxacillin belongs to which drug class?

A

Penicillinase-Resistant Penicillins

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Q

Piperacillin belongs to which drug class?

A

Anti-Pseudomonal Penicillins

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Q

Cefazolin belongs to which drug class?

A

First Generation Cephalosporins

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Q

Cephalexin belongs to which drug class?

A

First Generation Cephalosporins

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Q

Cefuroxime belongs to which drug class?

A

Second Generation Cephalosporins

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Q

Cefaclor belongs to which drug class?

A

Second Generation Cephalosporins

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Q

Cefprozil belongs to which drug class?

A

Second Generation Cephalosporins

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Q

Cefotetan belongs to which drug class?

A

Cephamycins

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Q

Cefoxitin belongs to which drug class?

A

Cephamycins

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Q

Cefotaxime belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Cefixime belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Cefdinir belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Ceftibuten belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Ceftazidime belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Ceftriaxone belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Cefpodoxime Proxetil belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Cefditoren Pivoxil belongs to which drug class?

A

Third Generation Cephalosporins

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Q

Cefepime belongs to which drug class?

A

Fourth Generation Cephalosporins

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Ceftaroline Fasamil belongs to which drug class?

Fifth Generation Cephalosporins

Ceftolozane belongs to which drug class?

Fifth Generation Cephalosporins

Imipenem belongs to which drug class?

Carbapenems

Meropenem belongs to which drug class?

Carbapenems

Doripenem belongs to which drug class?

Carbapenems

Ertapenem belongs to which drug class?

Carbapenems

Aztreonam belongs to which drug class?

Monobactams

Vancomycin belongs to which drug class?

Glycopeptides

Telavancin belongs to which drug class?

Lipoglycopeptides

Dalbavancin belongs to which drug class?

Lipoglycopeptides

Oritavancin belongs to which drug class?

Lipoglycopeptides

CLavulanic Acid belongs to which drug class?

Beta-Lactamase Inhibitors

Sulbactam belongs to which drug class?

Beta-Lactamase Inhibitors

Tazobactam belongs to which drug class?

Beta-Lactamase Inhibitors

Linezolid belongs to which drug class?

Oxazolidinones

Tedizolid belongs to which drug class?

Oxazolidinones

Erythromycin belongs to which drug class?

Macrolides

Clarithromycin belongs to which drug class?

Macrolides

Azithromycin belongs to which drug class?

Macrolides

Fidaxomicin belongs to which drug class?

Macrolides

Telithromycin belongs to which drug class?

Ketolides

Quinupristin belongs to which drug class?

Streptogramins

Dalfopristin belongs to which drug class?

Streptogramins

Doxycycline belongs to which drug class?

Tetracyclines

Tetracycline belongs to which drug class?

Tetracyclines

Minocycline belongs to which drug class?

Tetracyclines

Demeclocycline belongs to which drug class?

Tetracyclines

Tigecycline belongs to which drug class?

Glycylcyclines

Streptomycin belongs to which drug class?

Aminoglycosides

Gentamicin belongs to which drug class?

Aminoglycosides

Tobramycin belongs to which drug class?

Aminoglycosides

Amikacin belongs to which drug class?

Aminoglycosides

Neomycin belongs to which drug class?

Aminoglycosides

Paromomycin belongs to which drug class?

Aminoglycosides

Moxifloxacin belongs to which drug class?

Fluoroquinolones

Ciprofloxacin belongs to which drug class?

Fluoroquinolones

Ofloxacin belongs to which drug class?

Fluoroquinolones

Gatifloxacin belongs to which drug class?

Fluoroquinolones

Gemigloxacin belongs to which drug class?

Fluoroquinolones

Levofloxacin belongs to which drug class?

Fluoroquinolones

Sulfamethoxazole belongs to which drug class?

Sulfonamides

Trimethoprim belongs to which drug class?

Benzylpyrimidines

Polymixin B belongs to which drug class?

Polymixins

Colistin belongs to which drug class?

Polymixins

What is another name for penicillin class?

Beta Lactam

Penicillin MOA

Cell wall synthesis inhibitor --> interfers with the transpeptidase reaction Inhibiting the penicillin-binding protein/transpeptidase inhibits peptidoglycan cell wall cross linking

What are the forms of resistance to penicillins?

1. Beta lactamases break the beta lactam ring of penicillin 2. Alteration of the molecular structure of penicillin binding protein/transpeptidase 3. Upregulation of penicillin efflix pumps

Types of penicillins?

1. Penicillin G 2. Aminopenicillins 3. Penicillinase Resistant Penicillins 4. Antipseudomonal penicillins

Penicillin G kills which bacteria?

``` S. pneumoniae S. pyogenes S. viridans N. meningitidis T. pallidum C. perfringens ```

Major reaction to penicillin-class drugs?

Hypersensitivity

What are aminopenicillins commonly combined with?

Beta-lactamase inhibitors | (increases spectrum to include beta-lactamase producing bacteria

Aminopenicillins kills which bacteria?

``` E. coli Proteus Salmonoella Shigella H. influenzae Klebsiella B. fragilis ```

What is special about penicillinase-resistant penicillins?

They were developed as a modified penicillin G to decrease its susceptibility to beta-lactamase

Which class of bacteria is penicillinase-resistant penicillins effective against?

Staphylococcal (aureus and epidermidis)

How do bacteria develop resistance to penicillinase-resistant penicillins?

Reduced affinity for the P-R-P in the binding pocket of transpeptidase

Antipseudomonal penicillins were developed to treat which bacteria?

Pseudomonas aeruginosa | Also treats Klebsiella pneumoniase, E. coli, H. influenzae, and B. fragilis

What kind of drug is antipseudomonal penicillin commonly combined with, and what classes of bacteria does this combination treat?

Combined with a beta-lactamase inhibitor (piperacillin + tazobactam) Treats s. aureus and Enterococcus faecalis

MOA of Cephalosporin family

Inhibits the formation of the cell wall by binding to and inhibiting transpeptidase

What is the primary mechanism that renders Cephalosporin drugs inactive?

Beta-lactamases They break the beta-lactam ring, rendering the cephalosporin inactive. HOWEVER, cephalosporins are most stable than penicillins

Which two bacteria are resistant to cephalosporins?

Klebsiella and E. Coli

Other mechanisms of bacterial resistance to cephalosporins?

1. Altering porins 2. Altering the molecular structure of transpeptidase 3. Upregulation of cephalosporin efflux pumps

General trends of cephalosporin coverage

First generation has better gram (+) coverage | Third generation has better gram (-) coverage

Main side effect of cephalosporins?

Hypersensitivity - maculopapular rash develops several days post-therapy Sometimes accompanied with eosinophilia or fever

First generation cephalosporins available in the US

Cefazolin | Cephalexin

Main bacteria treated by first-generation cephalosporins?

Gram (+) cocci such as staph aureus | EXCEPTIONS: MRSA, enterococci, and staph epidermidis

Other bacteria covered by first-generation cephalosporins?

``` Moderate gram (-) Anaerobic cocci (NOT b. fragilis) ```

Second generation cephalosporins available in the US

Cefaclor Cefprozil Cefuroxime Also: cefotetan and cefoxitin, but these are cephamycins that are structurally similar

Coverage of second-generation cephalosporins?

Same as the first generation, with expanded gram (-) to include Klebsiella

Cefaclor, Cefprozil, and Cefuroxime have activity against which bacteria?

H. influenzae, N. meningitidis, S. pneumoniae Moderate coverage of E. coli and Klebsiella

Cefoxitin and Cefotetan have activity against which bacteria?

B. fragilia and Serratia | **these are cephamycins**

What bacteria is NOT covered by second generation cephalosporins?

P. aeruginosa | DO NOT TREAT ENTEROBACTER WITH 2ND GEN

Adverse reactions to second generation cephalosporins?

Hypersensitivity | Cefotetan - hypothrombinemia and bleeding, can cause a disulfiram-like reaction (do not drink alcohol while using)

Which third generation cephalosporins are available in the US?

Cefotaxime, cedixime, cefdinir, ceftibuten, ceftazidime, ceftriaxone, cefpodoxime proxetil (--> cefpodoxime), cefditoren pivoxil (--> cefditoren)

Spectrum of coverage by third generation cephalosporins?

Compared to first generation: more gram (-) bacteria, less gram (+) (especially strep and staph)

Specific classes of bacteria covered by third generation cephalosporins?

Neisseria and Haemophilus

Which third generation cephalosporin is active against P. aeruginosa?

Ceftazidime

Cefotaxime and ceftriaxone have poor activity against _____?

B. fragilis

Are cefpodoxime and cefditoren more or less potent than cefotaxime?

Less

Third generation cyclosporin active against e. coli, h. influenzae, p. mirabilis, and s. pyogenes

Cefixime, Cefpodoxime, Cefdinir, and Ceftibuten

Adverse effects of third generation cyclosporins?

Hypersensitivity | Ceftriaxone: neonatal jaundice, biliary pseudolithiasis

Name the single fourth generation cyclosporin

Cefepime

Which species of bacteria are covered by fourth generation cyclosporins?

Enterobacter and Pseudomonas

Name the fifth generation cyclosporins

Ceftaroline fosamil (-->ceftaroline) and ceftolozane

What other drug is ceftolozane co-formulated with?

Tazobactam (beta-lactamase inhibitor)

What kind of bacteria is ceftaroline effective against? How?

MRSA, penicillin-resistant S. pneumoniae | Has increased binding to transpeptidase

What kind of bacteria is ceftolozane effective against?

Pseudomonas | Co-formulated with beta-lactamase inhibitor tazobactam to increase activity against Enterobacteriaceae