1st Semester Final Drug Cards Flashcards
Drugs are bad, mmmk?
CLASS: B-lactam antibiotics mechanism of action and subclasses (4 of em)
- Disrupt cell wall to allow for water to flood in and cause the cell to burst
- PCNs, cephalosporins, carbapenums, and monobactam
SUBCLASS: PCN mech of action and what is it most active against?
Bind to penicillin binding proteins and cause inhibition of transpeptidases and activation of autolysins, primarily active against gram +
Most common ADR to PCN
Allergic rxn anaphylaxis, 7% approx
DRUG: PenG activity
- Gram + bacteria except for highly resistant ones
- Some gram neg including niesseria, also DOC for syphilis
- relatively narrow spectrum
DRUG: PenG administration
4 diff salts, none activated PO
DRUG: PenV how is it different from PenG?
Only diff is that it is immune to gastric acid so the go to standard for oral therapy
DRUGS: Nafcillin, oxacillin, dicloxacillin are most active against what?
Very narrow, only penicillinase producing strains of S. aureus and S. epidermidis
Name the 2 aminopenicillins
Ampicillin and amoxicillin
SUBCLASS: PCN, list the drugs (8 of em)
- PenG
- PenV
- Nafcillin
- oxacillin
- dicloxacillin
- ampicillin
- amoxicillin
- Piperacillin
DRUGS: ampicillin and amoxicillin are most active against what?
Most gram pos and some gram neg including enteric bacilli
Amoxicilin rash
Nonallergic maculopapular rash that appears with use and isn’t serious
Name the 3 methicilins (how do you remember them?)
Nafcilin
oxacilin
dicloxacilin
(NOD)
DRUG: Piperacillin is most active against what? How do you remember it?
Pseudomonas (think P), most gram + and some other gram -
SUBCLASS: cephalosporins mech of action and what is their spectrum?
Same as PCN, bind PBP’s and disrupt cell wall synthesis and activate autolysins, their spectrum is variant upon the generation
SUBCLASS: Name the 5 cephalosporin generations and their activity levels, what are the 2 trends important to knowing?
1) Cephalexin - highly active on gram + not so much -, rarely DOC its expensive and other things are more effective (Keflex - can be used for UTI)
2) Cefoxitin - highly active on gram + and more gram -
3) Cefazidime OR ceftriaxone - highly active on gram + and - and psuedomonas, can penetrate CSF
4) Cefipime - broad spectrum, highly resistant to B lactamase
5) Ceftaroline - can treat MRSA
Activity on gram - increases further down generations but gram + activity decreases as you go down
Common ADR’s for cephalosporins
- Maculopapular rash
- cross reactivity with penicillin
- alcohol intolerance (disulfam like reaction)
- Ca2+ precipitate formation
SUBCLASS: carbapenams mech of action and what is it active against?
-Bind PBP 1 and 2 cause weakening of bacterial cell wall with lysis and death, broad spectrum many gram + and -
SUBCLASS: carbapenams, list the drugs (4 of em) how do you remember them?
- Imipenam
- Meropenam
- Ertapenam
- Dorpipenam
(IMED)
DRUGS: Imipenam/Meropenam/ertapenam/dorpipenam spectrum, 1 significant ADR
Very broad (in fact most broad of any antimicrobial) mixed infections gram + and - most reactive against anaerobes, seizures in elderly
SUBCLASS/DRUG: Monobactam (Aztreonam) mech of action and what is it most active against?
Interferes with PBP3 to prevent synthesis of bacterial cell wall highly resistant to B lactamases, Narrow, only aerobic gram neg including
- H. influenzae
- P. aeruginosa
- Enterbacteriacieae
SUBCLASS/DRUG; aztreonam ADR
psueudomembranous colitis suprainfection
CLASS: Vanco and friends mech of action and what is it most active against? What are the drugs (4)
- Inhibit cell wall syntehsis WITHOUT using the PBP interaction, not a B lactam
- Mostly gram + highly resistant in serious infections such as MRSA, Cdiff and strep
- Vancomycin, teicoplanin, fofsomycin, televancin
DRUG: Vancomycin 3 big ADRs
- ototoxicity
- renal failure
- red man syndrome (potentially itchy, red rash not super dangerous but uncomfortable should stop treatment and take some antihistamines)
DRUG: Teicoplanin differences from Vanco
Similar action and structure to vanco but devoid of any ADR’s, used in vanco resistant cases
DRUG: Fofsomycin differences from vanco
Used to treat uncomplicated UTI’s specifically, used in vanco resistant cases
DRUG: televancin differences from vanco
Used to treat complex skin disturbances, has side effect of taste disturbance and foamy urine, used in vanco resistant cases
CLASS: Aminoglycoside mech of action and what is it most active against? List them (4)
Dirsupt bacterial protein synthesis by binding 30 s ribosomal unit after active transport across cell membrane via Oxygen dependent process, spectrum is narrowed to only gram negative aerobic bacilli, includes gentamycin, tobramycin, amikacin, and neomycin
CLASS: Aminoglycosides common 3 ADRS
- kidney damage
- inner ear damage
- neuromuscular blockage (flaccid paralysis)
DRUG: gentamycin is commonly used for what purpose?
Alongside vanco or B lactam to treat severe infections
DRUG: tobramycin is commonly used as what?
A topical eye treatment
DRUG: amikacin has 2 outstanding features. What are they?
- broadest spectrum of the aminoglycosides
- best resistance to inactivation by bacterial enzymes
DRUG: Neomycin is used for what purpose?
Pre-surgical suppression of bowel flora
CLASS: Bacteriostatic inhibitors of protein synthesis mech of action and list the 8 subclasses/drugs included (remember: Tony Tiger must chuck cocks down quivering ladies rectal masses)
Inhibit growth and replication, do not kill bacteria, include
- tetracyclines
- Tigecycline
- macrolides
- clindamycin
- chloramphenicol
- dalfopristin/quinipristin
- Linezolid
- Retamulin/mupirocin
SUBCLASS: Tetracyclines mech of action and what are they most active against?
Bind 30s ribosome preventing protein synthesis, actively transported into cell via energy dependent process only present in bacterial cells Broad spectrum including a lot of key ones -Rickettsial diseases -Chlamydia trachomatis -Brucella -Cholera -Mycoplasma pneumoniae -borelia burgdorferi -H pylori -antrahx
SUBCLASS: Tetracyclines, 3 common uses of them and 4 common ADR’s
1) acne
2) peptic ulcers
3) peridontal disease
Photosensitivty, bone and teeth discoloration, suprainfection, fanconi syndrome (if expired, fanconi syndrome where excess excretion by kidney and eventually renal failure
SUBCLASS: Tetracycline absorption considerations (2 ways to administer and one has some problems)? List the 4 tetracyclines
- Form chelates in gut with metal ions, often used topically
- tetracycline
- doxycycline
- minocycline
DRUG: Tetracycline key fact
-short acting, cannot take with food (chelates)
DRUG: doxycycline key fact
-long acting, cannot take with food (chelates)
DRUG: minocycline key fact
-Long acting, can take with food
SUBCLASS: Macrolides mech of action, what are they active against? Name the 3 of them (how do you remember it?)
Bind 50S ribosome subunit to prevent protein synthesis, broad spectrum antibiotic on gram + and - to extent
- Azithromycin
- Clarithromycin
- Erythromycin ((ACE!))
DRUG: erythromycin 3 ADRs
- Ototoxicity
- Suprainfection
- prolonged QT syndrome
- nausea and diahrrhea
DRUG: Clarythromycin 3 ADR, what is the significant difference between that and erythromycin
- ototoxicity
- suprainfection
- prolonged QT syndrome
it is 2-4x more active than erythromycin
SUBCLASS/DRUG: Clindamycin mech of action, what is it most active against? What is a big ADR with this?
Binds the 50S subunit to prevent protein synthesis, anaerobic GI gram -, pseudomembranous colitis suprainfection is the big one ADR
SUBCLASS/DRUG: chloramphenicol mech of action, what is it most active against (also note a specific disease)? What are 2 big ADRs with this?
Inhibition of the 50S ribosome to prevent protein synthesis, broad spectrum last resort often for bacterial meningitis and typhoid, 2 big ADR’s are pancytopenia and grey baby syndrome (builds up toxic metabolites causing generalized malaise and death)
SUBCLASS/DRUGS: (synercid) Dalflopristin/Quinipristin mech of action, what is it active against? What are 2 ADR’s associated with this?
Streptogamins that together become bactericidal, specific spectrum for VRE and MRSA, 2 ADR’s are hepatotoxicity and thrombophlebitis
SUBCLASS/DRUG: Linezolid mech of action, what is it active against? What is the big ADR associated with this?
Binds 23s portion of 50s subuinit of ribosome, cross resistance therefore unlikely, specific for VRE and MRSA, myelosuppression is the big ADR
SUBCLASS/DRUG: Tigecycline is identical to ____, just _____
Tetracyclines, just newer
SUBCLASS/DRUGS: Retapamulin/mupirocin use (2 things)
Topical antibiotics against impetigo and for recurrent MRSA skin infections
CLASS: Fluorquinolones mech of action, what is it active against? List all of them (2)
Enter bacterium by passive diffusion and inhibit replication of baterial DNA by inhibiting bacterial DNA gyrase and toposiomerase IV, active against complex most gram -, some gram + including MRSA but poor activity against anaerobes
1) ciprofloxacin
2) Moxifloxacin
DRUG: Augmentin is composed of what two components? What function does this serve?
- Amoxacillin and clavulanic acid
- it gives the goods of penicillin and overcomes resistance from B lactamases
Probenicid function
Supplement prolongation of PCN’s and cephalosporins in the body so they aren’t excreted so quickly
Keflex can be given this way to prevent UTI’s in women who are prone to them….
Prophylactically
Often lyme disease is treated with what?
Doxycycline