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Flashcards in Spectrums Deck (51):
1

Imipenem

Carbapenem (P) (Needs to be paired with Cilastatin to inhibit dehydropeptidase)

G+:

  • Staph (not MRSA)
  • Strep (including PRSP)
  • Listeria
  • Enterococcus

G-:

  • H. Influ
  • Neisseria
  • Enterobacteriaceae
  • Pseudomonas 
  • Acinetobacter

Anaerobes:

  • Most (except C diff)

SMAC are RESISTANT

Spirochete, MRSA, Atypicals, C diff

2

Meropenem

Carbapenem (P)

G+:

  • Staph (not MRSA)
  • Strep (including PRSP)
  • Listeria
  • Enterococcus

G-:

  • H. Influ
  • Neisseria
  • Enterobacteriaceae
  • Pseudomonas 
  • Acinetobacter

Anaerobes:

  • Most (except C diff)

SMAC are RESISTANT

Spirochete, MRSA, Atypicals, C diff

3

Ertapenem

Carbapenem (P)

G+:

  • Staph (not MRSA)
  • Strep (including PRSP)
  • Listeria

G-:

  • H. Influ
  • Neisseria
  • Enterobacteriaceae

Anaerobes:

  • Most (except C diff)

SMAC APE are RESISTANT

Spirochete, MRSA, Atypicals, C diff, Acinetobacter, Pseudomonas, Enterococcus

4

Aztreonam

Monobactam (P)

G- (ONLY):

  • Pseudomonas
  • Serratia
  • Enterobacteriaceae

Alternative for AG's in G- infections

NO GRAM POS OR ANAEROBE ACTIVITY

5

Vancomycin

Vancomycin (P) (ORAL FORMULATION FOR C DIFF)

Bacteriocidal: Prevent Transglycosylation and subsequent transpeptidation reaction

G+:

  • MRSA
  • VRSA (w/ an aminoglycoside)
  • PRSP (w/ a G3 Cephalosporin)
  • Enterococci (NOT VRE)

Anaerobes:

  • C diff (GIVEN ORALLY FOR THIS)

 

6

Televancin

Televancin (P) (reserve for resistant gram positives)

Bacteriocidal: Like vancomycin (prevents transglycosylation) but also disrupts bacterial membane

G+:

  • MRSA
  • VRSA
  • VRE
  • PRSP

Anaerobes:

  • C Diff
  •  

7

Bacitracin

Bacitracin (T) (often combined with Neomycin or Polymixin topically)

Topically for Skin and Occular (Oral for C Diff Colitis RARELY)

Block step 2 of CWS with Blocking Bactoprenol Phosphate

G+:

  • Streptococcus
  • Staphylococcus
  • Enterococcus (INCLUDING VRE)

G-:

  • Some

Anaerobes:

  • ALL (INCLUDING C DIFF)

 

8

Fosfomycin

Fosfomycin (O)

Similar to Phosphoenolpyruvate structurally; ireversibly inhibits Enolpyruvate transferase- blocks synthesis of UDP MurNAc (step 1)

Used Primarily for UTIs (good distribution to bladder, kidneys, prostate and seminal vess)

  • Enterobacteriaceae
  • Serratia
  • Proteus
  • Ecoli
  • Citrobacter
  • Klebsiella

9

Tobramycin

Aminoglycoside (poorly absorbed in stomach and intestines) (more expensive then Genta)

Bactericidal: Irreversible binding to the 30S subunit to inhibit INITIATION

Reserved for serious G- infections resistant to less toxic drugs (Aminoglycosides have best action against aerobic gram - but are also often more toxic)

G+:

  • MRSA (w/ Vancomycin)
  • Listeria (w/ Ampicillin)
  • Streptococcus

G-:

  • Pseudomonas (w/ piperacillin)
  • Enterobacteriaceae
  • H Influenza
  • Mycobacteria

INEFECTIVE AGAINST ANAEROBES and ENTEROCOCCI

10

Amikicin

Aminoglycoside

Reserved for organisms resistant to other AGs (more resistant to drug modifying enz)

G+:

  • MRSA
  • Listeria (w/ Ampicillin)
  • Streptococcus

G-:

  • Pseudomonas (w/ piperacillin)
  • Enterobacteriaceae
  • H Influenza
  • Mycobacteria (MDR- TB) (better than Genta or Tobra)

INEFECTIVE AGAINST ANAEROBES and ENTEROCOCCI

11

Neomycin

Aminoglycoside (T) (Most Nephrotoxic so limited to Topical use w/ bacitracin and polymixin)

Used as PROPHYLAXIS FOR COLORECTAL SURGERY (HSR with long term use)

Gram + and Gram -

BUT NO ANAEROBES

12

Gentamicin

Aminoglycoside

G+:

  • Enterococci (w/B-Lac or Vanc)
  • MRSA (w/ Vancomycin)
  • Listeria (w/ Ampicillin)
  • Streptococcus

G-:

  • Pseudomonas (+ piperacillin)
  • Enterovacteriaceae
  • H Influenza
  • Mycobacteria:various 

INEFFECTIVE AGAINST ANAEROBES

13

Streptomycin

Aminoglycoside

Least toxiv but also least active against G- and resistance is developed quickly

G+:

  • Enterococci 

G-:

  • Francisella Tularensis
  • Yersinia Pestis
  • Brucellosis
  • Mycobacterial TB

INEFFECTIVE AGAINST ANAEROBES AND PSEUDOMONAS

14

Tetracycline

Tetracyclines (O) (food decreases absorption)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION

Absorption is decreased by Polyvalent cations

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

15

Doxycycline

 

Tetracyclines (O,P) (Hepatic) (Food does NOT decrease absorption)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION

Absorption is decreased by Polyvalent cations

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

16

Minocycline

Tetracyclines (O,P) (food does NOT decrease absorption)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION

Absorption is decreased by Polyvalent cations

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

17

Tigecycline

Tetracyclines (P) (Biliary)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION BUT IT BINDS WITH 5X THE AFFINITY OF TETS

Additional coverage to tetracyclines

  • PRSP
  • MRSA (CA+HA)
  • VRSA
  • VRE

SAME AS TETRACYCLINES BELOW

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

18

Erythromycin

Macrolides (absorption dec by food) (all macrolides billiary)

Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)

G+:

  • Staphylococcus (NOT MRSA)
  • Streptococcus (NOT PRSP)
  • C diptheria

G-:

  • Neisseria Meningitidis
  • Bordetella Pertussis
  • Campylobacter
  • H. INfluenza

Atypicals:

  • Chlamydia
  • Mycoplasma Pneumonia
  • Legionella Pneumophillia 

Rickettsieae

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Anaerobes:

  • PROPRIONIBACTERIUM
  • All (EXCEPT C DIFF)

19

Azitromycin

Macrolides (absorption dec by food) (all macrolides billiary)

Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)

ERythro  (seen below) Plus

  • Moraxella 
  • MAC

G+:

  • Staphylococcus (NOT MRSA)
  • Streptococcus (NOT PRSP)
  • C diptheria

G-:

  • Neisseria Meningitidis
  • Bordetella Pertussis
  • Campylobacter
  • H. INfluenza

Atypicals:

  • Chlamydia
  • Mycoplasma Pneumonia
  • Legionella Pneumophillia 

Rickettsieae

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Anaerobes:

  • PROPRIONIBACTERIUM
  • All (EXCEPT C DIFF)

20

Clarithromycin

Macrolides (absorption IS DELAYED BY FOOD NOT DEC) (all macrolides billiary)

Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)

ERythro  (seen below) Plus

  • Moraxella 
  • MAC
  • H Pylori (w/ amoxicillin and omeprazole)

G+:

  • Staphylococcus (NOT MRSA)
  • Streptococcus (NOT PRSP)
  • C diptheria

G-:

  • Neisseria Meningitidis
  • Bordetella Pertussis
  • Campylobacter
  • H. INfluenza

Atypicals:

  • Chlamydia
  • Mycoplasma Pneumonia
  • Legionella Pneumophillia 

Rickettsieae

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Anaerobes:

  • PROPRIONIBACTERIUM
  • All (EXCEPT C DIFF)

21

Clindamycin

Lincosamide (absorption not affected by food) (Unchanged when renally excreted)

Bacteriostatic: binds 50S to block Initiation complex AND block translocation step

G+:

  • Streptococcus (PRSP)
  • Staphylococcus (CA-MRSA)

Anaerobes:

  • MOST (EXCEPT C DIFF)

NO GRAM NEGATIVE EFFECT DUE TO  INEFFICIET PORIN PENETRATION

22

Chloramphenicol

Chloramphenicol (P) (inactivated by glucuronosyl transferase host enzyme) abosrbed well in gut (last resort drug rarely used in US)

Bacteriostatic: binds to 50S to block Petidyl transferase and prevent peptide bond formation

chloRAMPHEnicol

  • Ricettsiae
  • Anaerobes and Atypicals
  • Meningococci
  • Pneumococci
  • H Influenza
  • Enterobacteriaceae

23

Sulfamethoxazole

Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (low solubitiy=Crystalluria)

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii

 

24

Sulfisoxazole

Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (Highly soluble little renal toxicity)

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

(COMBO WITH ERYTHROMYCIN FOR OTITIS MEDIA IN KIDS)

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii

25

Sulfasalazine

Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (Poorly absorbable=good for gi and IBD) 

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

Metabolites have further antibiotic and antiinflammatory 5ASA activity

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii

26

Silver Sulfadiazine

Sulfonamide (TOPICAL) (broad spectrum) (almost always combo therapy with DHFI) (low solubitiy=Crystalluria)

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

Inhibits NEARLY ALL BACTERIA AND FUNGI USED IN BURN/SKIN INFECTIONS 
BUT CAN LEAD TO SUPERINFECTIONS

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii

27

Trimethoprim

Dihydrofolate Reductase Inhibitor

Competitive inhibitor of dihydrofolate reductase much stronger for bacterial than human

Concentrates in acidic fluid  like the prostate and vagina 

CAN BE USED ALONE IN UTI AND PROSTATE INFECTIONS BUT USUALLY PAIRED WITH SULFONAMIDES

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii

28

Nalidixic Acid

Quinolone

Urinary accumulation only: so only used for UTI

29

Norfloxicin

G1 Fluoroquinolone (Broad Spectrum) (absorption decreases with multivalent cations)

Bactericidal: inhibits DNA topoisomerase II (DNA Gyrase) and Topo IV (seperates circular chromosomes after DNA replication decatenation-fluoros block the religation) , thus damaging DNA

Urinary accumulation only so only used for UTI

G+:

  •  

G-:

  •  

Atypicals:

  •  

Mycobacteria:

  •  

30

Ciprofloxacin

G2 Fluoroquinolone

31

Ofloxacin

G2 Fluoroquinolone

32

Levofloxacin

G3 Fluoroquinolone

33

Moxifloxacin

G3 Fluoroquinolone (Biliary)

34

Gemifloxacin

G3 Fluoroquinolone

35

Quinupristin-Dalfopristin

Protein Synthesis inhibitor 50S Binding (P) (Biliary)

36

Linezolid

23S Binding Protein Synthesis inhibitor (O,P)

37

Daptomycin

Lipo-Peptide (P)

38

Mupirocin

Mupirocin (T)

39

Isoniazid

TB Drug First Line CWSI (O)

40

Ethambutol

TB Drug First Line CWSI (O)

41

Rifampin

Rifamycin TB First Line Drug (O)

42

Rifabutin

Rifamycin TB First Line Drug (O)

43

Rifapentine

Rifamycin TB First Line Drug (O)

44

Pyrazinamide

TB First Line Drug (O)

45

TB Second Line Drugs

Aminoglycosides: Streptomycin, Amikacin, Kanamycin, capreomycin Fluoroquinolines: Moxi, Levo, Cipro, Gatifloxacin CWSI: Ethionamide, cycloserine Sulfonamide: PAS

46

Capreomycin

Aminoglycoside TB 2nd line (IM)

47

Ethionamide

CWSI TB 2nd line (O)

48

PAS

inhibits acetylation of INH

49

Leprosy Drugs

Sulfonamide: Dapsone (O) Clofazimine (O) Thalidomide (O)

50

Thalidomide

(O)

51

First Line TB Drugs

(O) CWSI: isoniazid, ethambutol Rifamycins: Rifampin, Rifabutin, Rifapentine Pyrazinamide