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Abx > Spectrum/MOA > Flashcards

Spectrum/MOA Flashcards

1
Q

TMP-SMX

A 
Staph aureus 
E. coli      UTIs
Klebsiella 
H. flu 
Pneumocystis 
Toxoplasmosis

Inhibit dihydropteroate synthetase (sulfa) and dihydrofolate (tri)

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2
Q

Acylcovir

A

HSV
VZV

Nucleic acid analog one activated by viral TK

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3
Q

Ganciclovir

A

CMV (retinitis)

Guanine analog

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4
Q

Foscarnet

A

HSV (acyclovir-resistant)
VZV
CMV

Pyrophosphate congener

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5
Q

Oseltamivir

A

Influenza A/B

Neuroaminidase inhibitor

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6
Q

Zidovudine

A

HIV

NRTI

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7
Q

Lamivudine

A

HIV

NRTI

HAART=2NRTIs, NNRTI, and protease inhibitor

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8
Q

Efavirenz

A

HIV

NNRTI

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9
Q

Amprenavir

Ritonavir

A

HIV

Protease Inhibitor

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10
Q

Bocepravir

Telepravir

A

HCV

Protease Inhibitor

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11
Q

Enfurvitide

A

HIV

Fusion inhibitor

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12
Q

Raltegravir

A

HIV

Integrase inhibitor

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13
Q

Maraviroc

A

HIV

CCR5 receptor antagonist

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14
Q

Ciprofloxacin

A

Gram negatives
P. aeruginosa, E. cloacae has some FQ resistance via alteration of binding site

Inhibits DNA gyrase

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15
Q

Levofloxacin

A 
Gram negatives 
Strep pnemo (less than 1% are resistant)

Inhibits DNA gyrase and topoisomerase IV

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16
Q

Rifampin

A 
TB
Staph aureus (osteomyelitis)

Inhibit DNA-dependent RNA polymerase

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17
Q

Metronidazole

A

Anaerobes (C. diff)
Giardia, Entamoeba

Toxic to nucleic acids in anerobic environment

18
Q

Gentamycin/Tobramycin

A

Aerobic/ fac. aerobic Gram negative rods (enterobacteracaie)
Give quickly for sepsis, works fast

30S codon misreading and initiation

19
Q

Doxycycline

A 
Intracellular pathogens (mycoplasma, chlamydia, legionella, rikettsia)
Gram positives (MRSA, S. pnemo) if resistant to lactams

30S, blocks tRNA access to codon (elongation)
Resistance by pumping drug out of cell

20
Q

Azithromycin

A 
Intracellular pathogens (mycoplasma, chlamydia, LEGIONELLA)
H. flu 
Gram positives (MRSA, S. pnemo) if resistant to lactams

50S, inhibits translocase enzyme (translocation)
Methylation of 50S at P site- resistant S. aureus and S. pneumo

21
Q

Linezolid

A

Gram positives (especially MRSA and VRSA)

50 S, inhibits peptidyl transferase
Methylation of 50S at P site- resistant S. aureus and S. pneumo

22
Q

Clindamycin

A

Anaerobes (except C. diff)
Lactam resistant S. pnemo and MRSA

50S, inhibits elongation
Methylation of 50S at P site- resistant S. aureus and S. pneumo

23
Q

Penicillin

A

Strep
Oral anerobes

Binds to PBP and inhibits transpeptidase and cell wall cross linking
Penicillinase=resistance: all s. aureaus, b. fragilis, some H. flu
Strep pneumo: resistance thru PBP2b mutation

24
Q

Dicloxacillin
Oxacillin
(penicillinase-resistant)

Equivalent to 1st gen cephalosporins (according to Lehmann’s chart)
Cefazolin, cephalexin

A

Strep
MSSA

Binds to PBP and inhibits transpeptidase and cell wall cross linking
Strep pneumo: resistance thru PBP2b mutation
MRSA: resistance thru PBP 2b & 2x mutation

25
Q

Amoxicillin
Ampicillin
(aminopenicillins)

Equivalent to 2nd gen cephalosporins
Cefuroxime (CNS entry)

A

Strep
Non-penicillinase H. flu

Binds to PBP and inhibits transpeptidase and cell wall cross linking

26
Q

Amoxicillin + clavulanate (Augmentin)

Equivalent to 2nd gen cephalosporins
Cefuroxime

A

Strep
All anerobes
H. flu
MSSA

Binds to PBP and inhibits transpeptidase and cell wall cross linking
Adds back spectrum of penicillinase resistant
Strep pneumo, MRSA still resistant

27
Q

Piperacillin
(extended spectrum penicillins)

Equivalent to 3rd gen cephalosporins
Ceftriaxone
Ceftazidime
Cefpodoxime

A

Strep
Gram negative rods (Proteus)

Binds to PBP and inhibits transpeptidase and cell wall cross linking
Some P. aeruginosa and Enterobacter produce ESBLs and are resistant
ESBLs are resistant to ALL LACTAMS

28
Q

Piperacillin + tazobactam (IV Zosyn)

Equivalent to 4th generation cephalosporins
Cefepime

A

Strep
Gram - rods
all anerobes
MSSA

Binds to PBP and inhibits transpeptidase and cell wall cross linking
Adds back spectrum of penicillinase resistant
Strep pneumo, MRSA still resistant

29
Q

Carbapenem

Imipenem

A 
Gram positive (except MRSA) 
Gram negative

Binds to PBP and inhibits transpeptidase and cell wall cross linking
They are resistant to b-lactamases

30
Q

Monobactam

Aztreonam

A

Gram negative rods

Use for patients with penicillin/cephalosporin allergies

Binds to PBP and inhibits transpeptidase and cell wall cross linking
They are resistant to b-lactamases (good for pseudomonas)

31
Q

Vancomycin

Glycopeptide

A 
MRSA
S. epi 
Ampicillin-resistant Enterococcus 
Strep pnemo meningitis 
Metronidazole resistant clostridrium

Binds to D-ala-D-ala to inhibit transglycosylation by competing with L-alanine for access to racemase to convert to D-isomer (slower onset, so only use if you’re sure its MRSA)
Resistance with change to D-ala-D-lac

32
Q

Daptomycin

Cyclic lipopeptide

A

Gram positives only that are resistant to vancomycin & lactams or allergies (VRE, VRSA)

Inserts tail thru techie acid backbone, forming channel for leakage

33
Q

Colistin

Polymixins

A

Gram negatives
Esp resistant Pseudomonas (CF)

Binds to LPS, disrupting membrane and causing leakage

34
Q

Clotrimazole

Imidazoles

A

Broad spectrum: Candida and Dermatophytes

Topical

Inhibit ergosterol synthesis by blocking lanosterol demethylase

35
Q

Tolnaftate

Allylamines

A

Dermatophytes

Topical

Inhibit ergosterol synthesis by blocking lanosterol demethylase

36
Q

Fluconazole

Triazoles

A

Broad spectrum: deep mycoses and dermatophytes

Systemic

Inhibit ergosterol synthesis by blocking lanosterol demethylase

37
Q

Terbinafine

Allylamines

A

Narrow spectrum: nail infections/onychomycoses

Systemic

Inhibit ergosterol synthesis by blocking lanosterol demethylase

38
Q

Caspofungin

A

Life threatening fungal infections that are non-responsive (-azole resistant)
Esp candida and aspergillus

Systemic

Inhibits glucan synthesis

39
Q

Nystatin

A

Superficial fungal infections
Candida

Topical

Forms pores in cell membranes where K and Mg leak out of cell

40
Q

Amphotericin B

A

Life threatening deep mycoses
(sometimes in combo with flucytosine if immunocompromised)

Systemic

Forms pores in cell membranes where K and Mg leak out of cell

41
Q

Flucytosine

A

Used in combo with amphotericin B for life threatening systemic infections

Forms 5-FU, converted to nucleoside analog and incorporated into RNA, or inhibits thymidylate synthase

Abx (2 decks)

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