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Flashcards in Intro to Antibiotics II Deck (47):
1

carbapenems

same MOA as PCNs

resistant to hydrolysis until emergence of KPC carbepenemase

2

carbapenem coverage

aerobic and anaerobic, gram positive, excellent against enterobacter, pseudomonas, acinetobacter

3

stenotrophomonas maltophilia

resistant to carbapenams

4

carbapenems

ertapenem
imipenem
meropenem
ertapenem

5

lower resp tract infection tx

carbapenems

6

monobactam mechanism

same as PCNs

7

monobactam spectrum

gram negative

NO activity against gram positive cocci or anaerobes

8

glycopeptide mechanism

inhibit cell wall synthesis
-binds high afinity D-ala-Dala terminal of cell wall precursor units

-unable to penetrate outer membrane of gram negatives

9

glycopeptide coverage

gram positive
-staph aureus (MRSA), staph epidermidis (MRSE), streptococci, bacillus, corynbacterium, actinomyces, clostridium

10

all gram negative and mycobacterium

resistant to glycopeotides

11

vancomycin

glycopeptide

give IV**

12

MRSA tx

vancomycin

13

clostridium dificile tx

vancomycin (orally)

14

important for vancomycin

monitor serum drug concentrations

15

red-man syndrome

side effect of rapid vancomycin infusion
-flushing, tachycardia, hypotension

mast cells - histamine release

16

fluoroquinolones mechanism

concentration dependent killing

target bacterial DNA gyrase and topoisomerase

DNA gyrase - introduces negative supercoils

17

fluoroquinolone spectrum

E. coli, salmonella, shigella, enterobacter, campylobacter, neisseria, pseudomonas, s. aureus

18

respiratory fluoroquniolones

levofloxacin
gatifloxacin
moxifloxacin

cover streptococcus species

19

ciprofloxacin

fluoroquinolone

-covers pseudomonas

20

adverse with FQs

GI sx, CNS, rash, photosensitive, achilles rupture

21

aminoglycoside mechanism

concentration dependent killing

bind 30S ribosome - interfere with protein synthesis

alters permeability

diffusion through outer pore proteins in gram negatives

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aminoglycoside spectrum

aerobic gram negatives, limited gram positive

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synergistic bactericidal activity against gram positive

aminoglycoside PLUS

beta-lactam or vancomycin

24

gentamicin

aminoglycoside

active against serratia

25

hospital acquired pneumonia tx

gentamicin

26

tetracycline and glycylcyclines mechanism

bacteriostatic
-inhibits protein synthesis by binding 30S ribosome

prevents receptor of aminoacyl tRNA acceptor site

27

spectrum for tetracyclines and glycylcyclines

aerobic and anaerobic gram positive and gram negative

also - rickettsia, coxiella burnetii, mycoplasma pneumonia, chlamydia species, legionella, burrelia burdorferi, treponema pallidum

28

all strains of pseudomonas

resistant to tetracyclines and glycylcyclines

29

community acquire pneumonia

doxycycline

30

rock mountain spotted fever tx

rickettsial infection

tetracyclines and glycylcyclines

31

anthrax tx

tetracyclines and glycylcyclines

32

Q fever tx

tetracyclines and glycylcyclines

33

macrolides mechanism

bacteriostatic
-reversibly binds 50S subunit

34

macrolides

clarithromycin
azithromycin

35

macrolide spectrum

aerobic gram positive cocci and bacilli

inactive against most gram negatives

36

azithromycin tx

respiratory tract infetion
-coverage of strep pneumonia, h. influenza and atypicals - mycoplasma, chlamydophilia, legionella

37

macrolide drug interaction

CYP3A4 inhibition

38

lincosamide mechanism

bind to 50S suppress protein synthesis

39

spectrum of lincosamides

pneumococci, s. pyogenes, viridans streptococci, MSSA, b. fragilis

40

lung abscess tx

clindamycin

lincosamide

41

clindamycin

lincosamide

42

anaerobic lung and pleural space infetcion

clindamycin

43

oxazolidinones mechanism

inhibit protein synthesis binding 50S subunit

prevent larger fmet-tRNA complex formation

44

oxazolidinones specdtrum

gram positive staph (MSSA, MRSA, VRSA), streptococcus, enterococci, gram positive anaerobic cocci, gram positive rods

45

linezolid

oxazolidinone

absorbed well orally

reserve for multi-drug resistant organisms**

46

hospital acquired pneumonia by MSSA and MRSA

linezolid

47

adverse of oxazolidones

myelosuppression
-anemia, leukopenia, thrombocytopeina

GI sx, HA, rash