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Pharmacology > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Penicillin G, V (MOA)

A

G = IV and IM. V = oral. Beta-lactam antibiotic. Bind penicillin-binding proteins (transpeptidases). Block transpeptidase cross-linking of peptidoglycan on cell wall. Activate autolytic enzymes.

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2
Q

Penicillin G, V (T)

A

Hypersensitivity reactions, hemolytic anemia.

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3
Q

Penicillin resistance

A

Penicillinase in bacteria cleaves beta-lactam ring

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4
Q

Ampicillin, amoxicillin

A

Extended spectrum penicillin. penicillinase sensitive.

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5
Q

Oxacilin, nafcillin, dicloxacillin

A

penicillinase-resistant penicillins. narrower spectrum. Nafcillin for S. aureus (except MRSA).

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6
Q

Cephalosporins (MOA)

A

Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal.

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7
Q

Cephalosporins (T)

A

Hypersensitivity reactions, vitamin K deficiency. Low cross-reactivity with penicillins. Increases nephrotoxicity of aminoglycosides.

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8
Q

Aztreonam (MOA)

A

A monobactam; resistant to B-lactamases. prevents peptidoglycan cross-linking by binding to penicillin-binding protein 3. Synergistic with aminoglycosides. No cross-allergenicity with penicillins.

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9
Q

Aztreonam (CU)

A

Gram - only. For penicillin allergic pts and those with renal insufficiency who cannot tolerate aminoglycosides

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10
Q

Carbapenems (MOA)

A

Imipenem is broad-spectrum, B-lactamase-resistant. Always administered with cilistatin to decrease inactivation of drug in renal tubules.

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11
Q

Carbapenems (T)

A

GI distress, skin rash, and CNS toxicity (seizures) at high plasma levels

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12
Q

Vancomycin (MOA)

A

Inhibits cell wall peptidoglycan formation by inhibiting D-ala D-ala portion of cell wall precursors. Bactericidal.

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13
Q

Vancomycin (T)

A

Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing -red man syndrome

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14
Q

Vancomycine resistance

A

Occurs in bacteria via amino acid modification of D-ala D-ala to D-ala D-lac

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15
Q

Aminiglycosides (-mycine) (MOA)

A

Bactericidal; 30S inhibitors. Inhibit formation of initiation complex and cause misreading of mRNA. Also block translocation. Require O2 for uptake; therefore ineffective against anaerobes.

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16
Q

Aminoglycosides (T)

A

Nephrotoxic (especially when used with cephalosporins) Neuromuscular blockade, Ototoxicity (especially when used with loop diuretics). Teratogen

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17
Q

Tetracyclines (MOA)

A

Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration. Do not take with milk, antacid or iron-contaiting preparations cuz divalent cations inhibit its absorption in the gut.

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18
Q

Tetracyclines (T)

A

GI distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity. Contraindicated in pregnancy.

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19
Q

Macrolides (-thromycin) (MOA)

A

Inhibit protein synthesis by blocking translocation; bind to the 23s rRNA of the 50S ribosomal subunit. Bacteriostatic.

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20
Q

Macrolides (-thromycin) (T)

A

MACRO: GI Motility issues, Arrhythmias caused by prolonged QT, acute Cholestatic hepatitis, Rash, eOsinophilia

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21
Q

Chloramphenicol (MOA)

A

Blocks petidyltransferase at 50S ribosomal subunit. Bacteriostatic.

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22
Q

Chloramphenicol (T)

A

Anemia, aplastic anemia, gray baby syndrome

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23
Q

Clindamycin (MOA)

A

Blocks peptide transfer (translocation) at 50S ribosomal subunit. Bacteriostatic.

24
Q

Clindamycin (T)

A

Pseudomembranous colitis (C. diff overgrowth), fever, diarrhea

25
Q

Sulfonamides (MOA)

A

Inhibit folate synthesis. Bacteriostatic.

26
Q

Sulfonamides (T)

A

Hypersensitivity reaction, hemolysis if G6PD deficient, nephrotoxicity (tubulointerstitial nephritis), photosensitivity, kernicterus in infants, displace other drugs from albumin (warfarin)

27
Q

Trimethoprim (MOA)

A

Inhibits bacterial dihydrofolate reductase. Bacteriostatic. Used in combo with sulfonamides.

28
Q

Trimethoprim (T)

A

Megaloblastic anemia, leukopenia, granulocytopenia

29
Q

Fluoroquinolones (-floxacin) (MOA)

A

Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV. bacteriacidal. Must not be taken with antacids.

30
Q

Fluoroquinolones (-floxacin) (T)

A

Tendonitis, tendon rupture, leg cramps, myalgia

31
Q

Metronidazole (MOA)

A

Forms free radical toxic metabolites in the bacterial cell that damage DNA. Bactericidal, antiprotozoal

32
Q

Metronidazole (T)

A

Disulfiram-like reaction (severe flushing, tachycardia, hypotension) with alcohol; headache, metallic taste

33
Q

Isoniazid (MOA)

A

decreases synthesis of mycolic acids. Bacterial catalase-peroxidase needed to convert INH to active metabolite. Only agent used as solo prophylaxis against TB

34
Q

Isoniazid (T)

A

Nephrotoxicity, hepatoxicity, lupus. INH Injures Neurons and Hepatocytes.

35
Q

Rifamycins (MOA)

A

Inhibits DNA-dependant RNA polymerase. TB drug.

36
Q

Rifamycins (T)

A

P-450 inducer. (Rifampin not rifabutin). orange body fluids.

37
Q

Pyrazinamide (T)

A

TB drug. Hyperuricemia

38
Q

Ethambutol (MOA)

A

TB drug. Decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase.

39
Q

Ethambutol (T)

A

Red-green color blindness, optic neuropathy.

40
Q

Amphotericin B (MOA)

A

Binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes (amphoTERicin TEARs holes in fungal membrane by forming pores)

41
Q

Amphotericin B (T)

A

Fever, chills, hypotension, nephrotoxicity, arrhythmias, anemias, IV phlebitis. Hydration decreases nephrotoxicity

42
Q

Nystatin (MOA)

A

Same as Amphotericin B. Topical form because systemic is too toxic.

43
Q

Nystatin (CU)

A

Swish and swallow for oral candidiasis; topical for diaper rash or vaginal.

44
Q

Azoles (MOA)

A

Inhibit fungal sterol (ergosterol) synthesis, by inhibiting the cyt P450 enzyme that converts lanosterol to ergosterol

45
Q

Azoles (T)

A

Testosterone synthesis inhibition (gynecomastia esp with ketoconazole), liver dysfunction (inhibits P-450)

46
Q

Flucytosine (MOA)

A

Inhibits DNA and RNA biosynthesis by conversion to 5-flurouracil by cytosine deaminase

47
Q

Flucytosine (T)

A

Bone marrow suppression

48
Q

Chloroquine (MOA)

A

Blocks detox of heme into hemozoin. Heme accumulates and is toxic to plasmodia.

49
Q

Chloroquine (T)

A

Retinopathy, pruritus (especially in dark skinned individuals)

50
Q

Zanamivir

A

Inhibit influenza neuraminidase-> decreased release of progeny virus. Treatment and prevention of both Influenza A and B.

51
Q

Oseltamivir

A

Inhibit influenza neuraminidase-> decreased release of progeny virus. Treatment and prevention of both Influenza A and B.

52
Q

Ribavirin (MOA/CU)

A

Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase.
RSV, chronic hepatits C

53
Q

Ribavirin (T)

A

Hemolytic anemia. Severe teratogen.

54
Q

Acyclovir, famciclovir, valacyclovir (MOA)

A

Monophosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells -> few adverse effects. Guanosine analog. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNA polymerase by chain termination. No activity against CMV.

55
Q

Acyclovir, famciclovir, valacyclovir (T)

A

Obstructive crystalline nephropathy and acute renal failure if not adequately hydrated

56
Q

Ganciclovir (MOA)

A

5’ - Monophosphorylated by CMV viral kinase. Guanosine analog. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNA polymerase.
Used to treat CMV.

57
Q

Ganciclovir (T)

A

Leukopenia, neutropenia, thrombocytopenia, renal toxicity. More toxic to host enzymes than acyclovir.

Pharmacology (10 decks)

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