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Flashcards in micro drugs Deck (25):
1

Penicillin

bind penicillin binding proteins and block transpeptidase cross liking
used for gram +
-N meningitid
-treponma
bactericidal
resistance via penicillinase in bacteria cleaves Beta lactam ring

2

amox/ampicillin

bind penicillin binding proteins and block transpeptidase cross linking
used for gram +
-n meningit
-treponema
-h influenza
-h pylori
-e coli
-listeria
-proteus
-salmonella
-shigella
-enterococci
toxicity: hypersensitivity rash, c diff
resistance via penicillinase in bacteria that cleaves beta lactam ring

3

dicloxacillin/nafcillin/oxacillin

penicillinase resistant penicliins
-bind penicillin binding proteins and preent transpeptidase cross linking
-bulky R group blocks penicillinase
S aureus (except MRSA)
tox: hypersensitivity, interstitial nephritis

4

piperacillin/ticarcillin

antipseudomonals
bind penicillin bidnign proteins and prevents transpeptidyase cross linking
used for pseudomonas, gram - rods
***sensitive to penicillinase so use with b lactamase inhibitor
-tazobactam, clavulanic acid, sulbactam

5

cephalosporins

inhibit cell wall synthesis but less sensitive to pencicillinases
-bactericidal
not convered by cephalosporins LAME
-listeria, atypicals (chlamydia mycoplasma), MRSA, enterococci
resistance via structural changes of penicillin binding proteins

6

cefazolin cephalexin

first generation cephalosporins
used for gram + cocci
-proteus ecoli klebsiella

7

cefoxitin cefuroxime cefaclor

2nd generation cephalosporins
gram +
h flu, enterobacter, neisseria, proteus, e coli, klebsiella, serratia

8

ceftriaxone cefotaxime ceftazidime

3rd generation cephalosporins for serious gram - infections
ceftriax: meningitis, gonorrhea, disseminated Lyme
ceftazidime: psuedomonas

9

cefepime

4th generation cephalosproin
gram -
pseudomonas

10

ceftaroline

5th generation cephalosporin
-broad gram + and gram - organism coverage including MRSA
NO pseudomonal

11

cephalosporin side effecets

hypersensitivity
autoimmune hemotylic anemia
vit k def
increase nephrotoxcity of aminoglycosids

12

imipenem meropenem ertapenem doripenam

betalactamase resistsant, prevents cell wall synthesis
always given with cilastatin to decrease inactivation of drug in the renal tubules
-used for gram + cocci
gram - rods
anaerobes
side effects limit use: Gi distress, skin rash, seizures at high plasma levels

13

aztreonam

monobactam
less susceptible to beta lacaases
binds to penicillin binding proteins and prevents peptidoglycan cross linking
-used for gram - rods only
-esp for patietns with penicillin allergy and renal disease who cannot handle aminoglycosides

14

vancomycin

binds D-ala D ala portion of cell wall precurosors and inhibits cell wall peptidoglycan formation
-Gram +
serious multidrug resistant bacteria: MRSA, S epi, enterococcus, c diff (oral)
toxicity: nephrotoxic, ototoxic, thrombophlebitis
red man syndrome: diffuse flusing-slow infusion and pre-treatment with antihistamines can prevent this from occuring
resistance via: D ala D ala to D ala D lac

15

gentamicin neomycin amikacin tobramycin streptomycin

aminoglycosides
inhibit 30s ribosomal subunit, irreversible inhibt protein synthesis, bacteriocidal
ineffective against anaerobes-require O2 (fusobacterium clostridium actinomyces bacteroides)
used for severe gram - rod infections
synergistic with beta lactam antibiotics
tox: nephro, oto, neuromusclar blockade, teratogen
resistance: bacterial transferase enzymes inactivate via acetylation/phosphorylation/adenylation

16

tetracycline, doxycycline, minocycline

bind 30s and prevent attachment of aminoacyn tRNA
-bacteriostatic
-minimal CNS penetration
used for borrelia, m pneumonia, rickettsia, chlamydia acne
toxicity: GI distress, teeth discoloration, inhibit bone growth in kids, photosensitivity
contraindicated in pregnancy
resistance: decreased bacterial intake or increased efflux by plasmid encoded transport pumps

17

chloramphenical

blocks peptidyl transferase at 50s ribosomal subunit, bacteriostatic
used for: meningitis-h influ, neissueria, strep pneu and RMSF
toxicity (high but used in developing countries bc cheap)
-anemai, aplastic anemia, grey baby syndrome
resistance via plasmid encoded acetyltransferase that inactivates the drug

18

clindamycin

blocks peptidyl transfer at 50S ribosomal subunit
-bacteriostatic
-used for anaerobic infections (bacteroides, clostridium, actinomyces, fusobactreium)
also GAS
toxicity: pseudomembranous colitis, fever, diarrhea

19

linezolid

inhibits protein synthesis by binding to 50s ribosomal subunit
-used for gram + MRSA, VRE
-tox-bone marrow suppreession (thrombocytopenia), peripheral neuropathy, serotonin syndrome
resistance: point mutation of ribosomal RNA

20

azithromycin, clarithromycin, arythromycin

macrolides
-bind 23s rRNA of 50s ribosomal subunit
used for aypical pneumonias: mycoplasma, legionella, chlamydia, STI-chlamydia, gram + cocci, b pertussis
toxicity: MACRO
-gi Motility, Arrythmia prolonged QT, Cholestatic hepatitis, Rash, eOsinophilia
increase serum concentration of theophyllines and oral anticoagulants-inhibit cyp p450
resistance via methylation of 23srRNA subunit

21

trimethoprim

inhibits dihydrofolate reductase
bacteriostatic
-used in combination with sulfamides
UTIs, shigella, salmonella, pneumocystis jirovecii tx and ppx , toxo ppx
toxicity: megaloblastic anemia, leukopenia, granulocytopenia

22

sulfonamides

sulfamethozazole, sulfaisoxazole, sulfadiazine
-inhibit folate syntheis
bacteriostatic-cidal when combined with trimethoprim
gram +. - nocardia/chlamydia
hypersensitivyt, hemolysis if G6PD def, nephrotoxic, photosensitivity, kernictuers in baby, displace other drugs from albumin (ie warfarin)
resistance: altered enzyme or decrease uptake/increased effluz, increase PABA synthesis

23

ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxiflocain, gemifloxacin, enoxacin

inhibit prokaryotic enzymes: topoisomerase (DNA gyrase)
-bactericidal, cannot be taken with antacids
gram - rods in urinary and Gi tract including pseudomonas, neisseria, and some gram +
toxicity: GI upset, superinfection, skin rash, headache, dizziness, leg cramps, myalgias, contraindicated in pregnant women, nursing mothers, and children <18
QT prolongation
resistance: chromosome encoded mutation in DNA gyrase
plasmid mediated resistance, efflux pumps

24

daptomycin

lipopeptide that disrupts cell membrane of gram positive cocci
-used for s auerus skin infections (esp MRSA), bacteremia, endocarditis, VRE *not pneumonia, binds to and is inactivated by surfactant
toxicity: myopathy, rhabdomyolysis

25

metronidazole

forms toxic free radical metabolites in the bactrerial cell taht damage DNA
-bactericidal, antiprotozoal
used for: giardia, entamoeba, trichomonas, gardernella, anaerobes, with PPI for triple therapy
toxicityL disulfiram like reation (tachy, flusing, hypotension) wtih alcohol, headache, metallic taste