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Block 5 Material > Pharmacology > Flashcards

Flashcards in Pharmacology Deck (61):
1

Cell wall synthesis inhibitors

Beta lactams
Glycopeptides
Daptomycin

2

Modifiers of DNA / nucleic acid synthesis

Fluoroquinolones
Metronidazole

3

Modifiers of protein synthesis
8

Tetracycline
Macrolides/Ketolides
Aminoglycosides
Chloramphenicol
Quinupristin/Dalfopristin
Clindamycin
Linezolid
Glycylcycline

4

Modifiers of energy metabolism

Sulfamethoxazole/Trimethoprim
SMX/TMP

5

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

Continuous IV
Needs the most time above the MIC

6

What is the best route for concentration dependent killers?

Largest dose without toxicity
Given once

7

Beta lactams

Penicillins
Cephalosporins
Carbapenems
Monobactams

8

This class of drugs binds to the PBP

Beta lactams

9

What are beta lactamases?
What produces them?

Enzymes secreted by bacteria
Gram -
Staph

10

Beta lactamase inhibitors

Clavulanate
Sulbactam
Tazobactam

11

Natural penicillins are used for__

Group A strep

12

Aminopenicillins are used for__

Enterococcus faecalis
Strep pneumoniae (high dose!!)

13

Penicillinase resistant penicillins include:

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

14

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

Penicillin

15

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

Piperacillin / Tazobactam

Used when pseudomonas is suspected
Broad spectrum

16

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

Higher generations have better ___ coverage.

Gram +
Gram -

17

First generation cephalosporins are active against __

Gram + aerobes
MSSA
E. coli

18

Second generation cephalosporins Example?

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

This is the only one that is below the diaphragm

19

Third generation cephalosporins
Example?

Mostly gram -
Don't usually use for gram +

Ceftazidime is the ONLY third gen that can cover pseudomonas

20

Fourth generation cephalosporins
Example?

Gram -
Stability against beta lactamases
Cefepime

21

Fifth generation cephalosporins
Example?

Ceftaroline is the only beta lactam that covers MRSA

it can attach to the altered PBP

22

What gen of cephalosporins is Cefepime?

4th

23

What gen of cephalosporins is Ceftazidime?

3rd

24

What gen of cephalosporins is Ceftaroline?

5th

25

What gen of cephalosporins is Cefoxitin?

2nd

26

What are the broadest spectrum antibiotics we have?

Carbapenems

27

What is NOT covered by carbapenems?

MRSA
C. diff

Ertapenem does not cover pseudomonas but the other 3 do

28

List of carbapenems

Ertapenem

Meropenem
Imipenem-cilastatin
Doripenem

29

Aztreonam is a __
4 key points

Monobactam

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

30

Glycopeptides:

Vancomycin and its copy cats:
Televancin
Oritavancin
Dalbavancin

31

Coverage of vancomycin

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

C. diff (ORAL ONLY)

32

Dosage for vancomycin is based on ___

Kidney function

33

ADE for vancomycin

Red man syndrome
IV related

34

ADE for televancin

Foamy urine
Metallic taste

35

Daptomycin only covers ___ bacteria.
You cannot use it for ___ because ___

Gram +
Pneumonia
It is inactivated by lung surfactant

36

Tetracyclines

Doxycycline
Minocycline (acne)
Tetracycline (not really used)

37

Doxycycline covers ___

Gram + aerobes
-staph aureus (MSSA/MRSA)

Gram - aerobes but resistance is common

Atypical bacteria

38

Doxycycline can interact with ___

ADE?

Divalent and trivalent cations

GI symptoms
Nausea
Vomiting
Diarrhea

39

Glycylcycline example?

Tigecycline

Limited to severe infections

40

Macrolides/Ketolides

Erythromycin
Calrithromycin
Azithromycin *

41

Macrolides/Ketolides spectrum

S. pneumoniae
H. influenzae
M. catarrhalis
Atypicals
Mycobacterium

42

ADE for macrolides/ketolides

QTc prolongation
Nausea
Vomiting
Diarrhea

*Black Box Warning

43

Aminoglycosides key points
4

Usually only gram -
Only IV
only hospital settings
Severe infections

44

Aminoglycosides are ___ and ___

Bactericidal and concentration dependent

45

Aminoglycosides spectrum

Enterococcus - synergy
Gram - aerobes

*rarely monotherapy

46

Aminoglycosides absorption

Poor GI absorption
No oral options
Dosage based on kidney function

47

ADE of aminoglycosides

Nephrotoxicity
Ototoxicity

48

Clindamycin spectrum

Gram + and - aerobes
Staph aureus including MRSA
Anerobes

49

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

Clindamycin

50

Linezolid spectrum

Useful for MRSA
Gram + only

51

ADE of linezolid

Myelosuppression with >2 weeks use

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

52

What are the 3 Fluoroquinolones?

Ciprofloxacin
Moxifloxacin
Levofloxacin

53

Fluoroquinolones spectrum

Gram + and -
Enterobacteriaceae
Atypicals
MSSA
AVOID IN MRSA (resistance induced)

Strep pneumoniae (except ciprofloxacin)
Pseudomonas (except moxifloxacin)

54

ADE of fluoroquinolones

QTc prolongation

Can interact with divalent and trivalent cations

55

QTc prolongation is an ADE for ___ and ___

Macrolides/Ketolides

Fluoroquinolones

56

Metronidazole spectrum

Anaerobic
Bacteroides
C. diff

57

Metronidazole can interact with __

Ethanol

58

Sulfamethoxazole/Trimethoprim inhibits___

Folate synthesis

59

SMX/TMP covers ___

MRSA

60

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

SMX/TMP

61

ADE of SMX/TMP

Leukopenia
Thrombocytopenia
Eosinophilia

Epidermal necrolysis
Steven's-Johnson

Crystalluria