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Abx > Spectrum/MOA > Flashcards

Spectrum/MOA Flashcards

(41 cards)

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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

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A

Anaerobes (C. diff)
Giardia, Entamoeba

Toxic to nucleic acids in anerobic environment

18
Q

Gentamycin/Tobramycin

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A

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

30S codon misreading and initiation

19
Q

Doxycycline

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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

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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

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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

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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

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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

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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
Amoxicillin Ampicillin (aminopenicillins) Equivalent to 2nd gen cephalosporins Cefuroxime (CNS entry)
Strep Non-penicillinase H. flu Binds to PBP and inhibits transpeptidase and cell wall cross linking
26
Amoxicillin + clavulanate (Augmentin) Equivalent to 2nd gen cephalosporins Cefuroxime
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
Piperacillin (extended spectrum penicillins) Equivalent to 3rd gen cephalosporins Ceftriaxone Ceftazidime Cefpodoxime
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
Piperacillin + tazobactam (IV Zosyn) Equivalent to 4th generation cephalosporins Cefepime
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
Carbapenem | Imipenem
``` Gram positive (except MRSA) Gram negative ``` Binds to PBP and inhibits transpeptidase and cell wall cross linking They are resistant to b-lactamases
30
Monobactam | Aztreonam
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
Vancomycin | Glycopeptide
``` 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
Daptomycin | Cyclic lipopeptide
Gram positives only that are resistant to vancomycin & lactams or allergies (VRE, VRSA) Inserts tail thru techie acid backbone, forming channel for leakage
33
Colistin | Polymixins
Gram negatives Esp resistant Pseudomonas (CF) Binds to LPS, disrupting membrane and causing leakage
34
Clotrimazole | Imidazoles
Broad spectrum: Candida and Dermatophytes Topical Inhibit ergosterol synthesis by blocking lanosterol demethylase
35
Tolnaftate | Allylamines
Dermatophytes Topical Inhibit ergosterol synthesis by blocking lanosterol demethylase
36
Fluconazole | Triazoles
Broad spectrum: deep mycoses and dermatophytes Systemic Inhibit ergosterol synthesis by blocking lanosterol demethylase
37
Terbinafine | Allylamines
Narrow spectrum: nail infections/onychomycoses Systemic Inhibit ergosterol synthesis by blocking lanosterol demethylase
38
Caspofungin
Life threatening fungal infections that are non-responsive (-azole resistant) Esp candida and aspergillus Systemic Inhibits glucan synthesis
39
Nystatin
Superficial fungal infections Candida Topical Forms pores in cell membranes where K and Mg leak out of cell
40
Amphotericin B
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
Flucytosine
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

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