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Block 5 Material > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Cell wall synthesis inhibitors

A

Beta lactams
Glycopeptides
Daptomycin

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2
Q

Modifiers of DNA / nucleic acid synthesis

A

Fluoroquinolones

Metronidazole

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3
Q

Modifiers of protein synthesis

8

A 
Tetracycline
Macrolides/Ketolides
Aminoglycosides 
Chloramphenicol 
Quinupristin/Dalfopristin
Clindamycin
Linezolid
Glycylcycline
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4
Q

Modifiers of energy metabolism

A

Sulfamethoxazole/Trimethoprim

SMX/TMP

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5
Q

What is the best route for concentration independent killers? Why?

A

Continuous IV

Needs the most time above the MIC

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6
Q

What is the best route for concentration dependent killers?

A

Largest dose without toxicity

Given once

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7
Q

Beta lactams

A

Penicillins
Cephalosporins
Carbapenems
Monobactams

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8
Q

This class of drugs binds to the PBP

A

Beta lactams

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9
Q

What are beta lactamases?

What produces them?

A

Enzymes secreted by bacteria
Gram -
Staph

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10
Q

Beta lactamase inhibitors

A

Clavulanate
Sulbactam
Tazobactam

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11
Q

Natural penicillins are used for__

A

Group A strep

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12
Q

Aminopenicillins are used for__

A 
Enterococcus faecalis
Strep pneumoniae (high dose!!)
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13
Q

Penicillinase resistant penicillins include:

A

Dicloxacillin (oral)
Oxacillin (IV)
Nafcillin (IV)
Methicillin (IV)

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14
Q

What is the drug of choice for non-MRSA staph aureus infections?

A

Penicillin

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15
Q

What beta lactams/beta lactamase inhibitor combo is mostly used?
When is it used?

A

Piperacillin / Tazobactam

Used when pseudomonas is suspected
Broad spectrum

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16
Q

In general, lower generations of cephalosporins have better ___ coverage.

Higher generations have better ___ coverage.

A

Gram +

Gram -

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17
Q

First generation cephalosporins are active against __

A

Gram + aerobes
MSSA
E. coli

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18
Q

Second generation cephalosporins Example?

A

Cefoxitin is active against Bacteroides and Clostridium
BUT NOT C. diff

This is the only one that is below the diaphragm

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19
Q

Third generation cephalosporins

Example?

A

Mostly gram -
Don’t usually use for gram +

Ceftazidime is the ONLY third gen that can cover pseudomonas

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20
Q

Fourth generation cephalosporins

Example?

A

Gram -
Stability against beta lactamases
Cefepime

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21
Q

Fifth generation cephalosporins

Example?

A

Ceftaroline is the only beta lactam that covers MRSA

it can attach to the altered PBP

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22
Q

What gen of cephalosporins is Cefepime?

A

4th

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23
Q

What gen of cephalosporins is Ceftazidime?

A

3rd

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24
Q

What gen of cephalosporins is Ceftaroline?

A

5th

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25
Q

What gen of cephalosporins is Cefoxitin?

A

2nd

26
Q

What are the broadest spectrum antibiotics we have?

A

Carbapenems

27
Q

What is NOT covered by carbapenems?

A

MRSA
C. diff

Ertapenem does not cover pseudomonas but the other 3 do

28
Q

List of carbapenems

A

Ertapenem

Meropenem
Imipenem-cilastatin
Doripenem

29
Q

Aztreonam is a __

4 key points

A

Monobactam

IV only
Covers pseudomonas
Can be safely used in people w/penicillin allergies
Gram - only

30
Q

Glycopeptides:

A

Vancomycin and its copy cats:
Televancin
Oritavancin
Dalbavancin

31
Q

Coverage of vancomycin

A

Gram + only
Staph aureus
-MRSA
-MSSA but use beta lactam first!

C. diff (ORAL ONLY)

32
Q

Dosage for vancomycin is based on ___

A

Kidney function

33
Q

ADE for vancomycin

A

Red man syndrome

IV related

34
Q

ADE for televancin

A

Foamy urine

Metallic taste

35
Q

Daptomycin only covers ___ bacteria.

You cannot use it for ___ because ___

A

Gram +
Pneumonia
It is inactivated by lung surfactant

36
Q

Tetracyclines

A

Doxycycline
Minocycline (acne)
Tetracycline (not really used)

37
Q

Doxycycline covers ___

A

Gram + aerobes
-staph aureus (MSSA/MRSA)

Gram - aerobes but resistance is common

Atypical bacteria

38
Q

Doxycycline can interact with ___

ADE?

A

Divalent and trivalent cations

GI symptoms
Nausea
Vomiting
Diarrhea

39
Q

Glycylcycline example?

A

Tigecycline

Limited to severe infections

40
Q

Macrolides/Ketolides

A

Erythromycin
Calrithromycin
Azithromycin *

41
Q

Macrolides/Ketolides spectrum

A 
S. pneumoniae
H. influenzae
M. catarrhalis
Atypicals
Mycobacterium
42
Q

ADE for macrolides/ketolides

A

QTc prolongation
Nausea
Vomiting
Diarrhea

*Black Box Warning

43
Q

Aminoglycosides key points

4

A

Usually only gram -
Only IV
only hospital settings
Severe infections

44
Q

Aminoglycosides are ___ and ___

A

Bactericidal and concentration dependent

45
Q

Aminoglycosides spectrum

A

Enterococcus - synergy
Gram - aerobes

*rarely monotherapy

46
Q

Aminoglycosides absorption

A

Poor GI absorption
No oral options
Dosage based on kidney function

47
Q

ADE of aminoglycosides

A

Nephrotoxicity

Ototoxicity

48
Q

Clindamycin spectrum

A

Gram + and - aerobes
Staph aureus including MRSA
Anerobes

49
Q

What is the most common cause of antibiotic associated C. diff?

A

Clindamycin

50
Q

Linezolid spectrum

A

Useful for MRSA

Gram + only

51
Q

ADE of linezolid

A

Myelosuppression with >2 weeks use

Monoamine oxidase inhibition
-should not be used with MAOIs and SSRIs

52
Q

What are the 3 Fluoroquinolones?

A

Ciprofloxacin
Moxifloxacin
Levofloxacin

53
Q

Fluoroquinolones spectrum

A 
Gram + and -
Enterobacteriaceae
Atypicals
MSSA
AVOID IN MRSA (resistance induced)
Strep pneumoniae (except ciprofloxacin)
Pseudomonas (except moxifloxacin)
54
Q

ADE of fluoroquinolones

A

QTc prolongation

Can interact with divalent and trivalent cations

55
Q

QTc prolongation is an ADE for ___ and ___

A

Macrolides/Ketolides

Fluoroquinolones

56
Q

Metronidazole spectrum

A

Anaerobic
Bacteroides
C. diff

57
Q

Metronidazole can interact with __

A

Ethanol

58
Q

Sulfamethoxazole/Trimethoprim inhibits___

A

Folate synthesis

59
Q

SMX/TMP covers ___

A

MRSA

60
Q

What drug requires dosage adjustment when CrCl <30ml/min?

A

SMX/TMP

61
Q

ADE of SMX/TMP

A

Leukopenia
Thrombocytopenia
Eosinophilia

Epidermal necrolysis
Steven’s-Johnson

Crystalluria

Block 5 Material (17 decks)

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