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Pharmacology > (2) Antibiotics > Flashcards

(2) Antibiotics Flashcards

1
Q

What are the two main classes of bacteria

A 
Gram positive (simple cell wall)
Gram negative (more advanced cell wall)
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2
Q

are gram negative or gram positive typically more resistant to antibiotics

A

gram negative are typically more resistant to some antibiotics

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3
Q

List the 6 clinically significant gram negative pathogens

A 
Bordetella pertussis
Helicobacter pylori
Klebsiella pneumonia
Yersinia pestis
shigella dysenteriae
Vibrio Cholerae
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4
Q

Bordetella pertusis
Gram + or - ?
Morphology?
Disease caused?

A

Gram negative
cocci
whooping cough

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5
Q

Helicobacter pylori
Gram + or - ?
Morphology?
Disease caused?

A

Gram negative
spirochete
peptic ulcers

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6
Q

Klebsiella pneumoniae
Gram + or - ?
Morphology?
Disease caused?

A

Gram negative
rods
pneumonia

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7
Q

Yersina pestis
Gram + or - ?
Morphology?
Disease caused?

A

Gram negative
Rods
bubonic plague

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8
Q

Shigella dysenteriae
Gram + or - ?
Morphology?
Disease caused?

A

Gram Negative
Rods
Dysentery

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9
Q

Vibrio Cholerae
Gram + or - ?
Morphology?
Disease caused?

A

Gram Negative
Flagellated Rods
Cholera

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10
Q

Bacillus Anthrax
Gram + or - ?
Morphology?
Disease caused?

A

Gram Positive
Rods, Chains
Anthrax

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11
Q

Clostridium Tetani
Gram + or - ?
Morphology?
Disease caused?

A

Gram positive
Rods
Tetanus

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12
Q

Mycobacterium Tuberculosis
Gram + or - ?
Morphology?
Disease caused?

A

Gram positive
Rods
Tuberculosis

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13
Q

Staphylococcus Aureus
Gram + or - ?
Morphology?
Disease caused?

A

Gram positive
Cocci
Wound Infections

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14
Q

What is MIC when referring to antibiotics

A

Minimum inhibitory Concentration

the minimal concentration of an antimicrobial that inhibits visible growth of a microorganism after overnight incubation

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15
Q

What is MIC (minimum inhibitory concentration) used for

A

to determine antibiotic resistance of an organism and determine the potency of new antibiotics

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16
Q

What is a superinfection

A

a secondary infection that occurs following a primary infection.

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17
Q

what is often a significant factor in superinfections

A

the use of broad spectrum antibiotics

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18
Q

What are the 3 common gram positive bacteria in the powerpoint

A

Bacillus Anthrax
Clostridium Tetani
Mycobacterium Tuberculosis
Staphylococcus aureus

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19
Q

What are the 6 main characteristics used to select the correct antibiotic

A
  1. reaches the target
  2. binds to the target
  3. interferes with functional capacity of the target
  4. reaches target in the appropriate concentration
  5. maintains adequate contact time
  6. avoids toxicity to the host
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20
Q

What are the 6 different mechanisms of action for antibiotics

A 
folic acid metabolism inhibitors
DNA gyrase inhibitors
RNA polymerase inhibitors
Cell wall synthesis inhibitors
Protein synthesis inhibitors (30s)
Protein synthesis inhibitors (50s)
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21
Q

What are the two types of folic acid metabolism inhibitors

A

sulfanomides

Trimethoprim

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22
Q

What type of antibiotics is a DNA gyrase inhibitor

A

Fluoroquinolones

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23
Q

What type of antibiotic is a RNA polymerase inhibitor

A

Rifamycins

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24
Q

What 4 antibiotics are cell wall synthesis inhibitors

A

B-lactams
Glycopeptides
Bacitracin
cyclic lipopeptides

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25
Q

what 3 antibiotics are protein synthesis inhibitors (30s)

A

Aminoglycosides
Tetracyclines
Glycylcyclines

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26
Q

What 5 antibiotics are protein synthesis inhibitors (50s)

A 
macrolides/lincomycins
Streptogramins
Chloraphemicol
Ketolides
Oxazolidinones
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27
Q

Are Sulfonamides bacteriostatic or bactericidal

A

bacteriostatic

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28
Q

What does it mean to be bacteriostatic and bacteriocidal

A 
bacteriostatic = stops the bacteria from reproducing but doesn't kill the bacteria
Bactericidal = kills the bacteria
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29
Q

what is the mechanism of action for sulfonamides

A

prevent the bacteria from using PABA for folic acid synthesis

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30
Q

What are the commonly used sulfonamides

A

sulfamethoxazole (UTI)
Sulfasalazine (RA and Ulcerative colitis)
Sulfacetamide (acne and conjunctivitis)

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31
Q

Why are sulfonamides used less now than previously

A

increasing bacterial resistance

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32
Q

what are the adverse affects of sulfonamides

A

Crystalluria
Rashes
psychosis

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33
Q

What type of antibiotic is Trimethoprim

A

Folate inhibitor

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34
Q

is Trimethoprim bacteriostatic or bactericidal

A

bacteriostatic

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35
Q

what is trimethoprim primarily used to treat

A

UTI

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36
Q

what are the adverse affects of Trimethoprim

A

rashes
Megaloblastic anemia
leukopenia

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37
Q

Trimethoprim is sometimes used in conjunction with which antibiotic to be more broad spectrum

A

Sulfamethoxazole

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38
Q

What are the different types of cell wall inhibitors

A

Beta-lactams
glycopeptides
Cyclic lipopeptides

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39
Q

What is specific to bacterial cell walls that allows antibiotics to destroy bacterial cells without harming human cells

A

peptidoglycan, repeating NAM and NAG units joined by glycosidic bonds and peptide cross bridges

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40
Q

What is the comparison of peptidoglycan between Gram - and Gram + cells

A

Gram + has a thicker layer of peptidoglycan over the cell membrane
Gram - has a thin layer between inner and outer cell membranes

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41
Q

What are the different types of Beta Lactams

A

Penicillins
Carbapenems
Monobactams
Cephalosporin

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42
Q

What is the method of action for the beta lactams

A

they inhibit transpeptidase (enzyme that forms the peptide crosslinks in the peptidoglycan) which causes a break in the cell wall and eventually cellular lysis

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43
Q

Beta lactams have ______ selectivity and _____ toxicity

A

high selectivity and low toxicity

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44
Q

What was the first Beta lactam antibiotic

A

penicilin

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45
Q

are beta lactams bacteriostatic or bactericidal

A

bactericidal

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46
Q

What causes resistance to the beta lactams drugs

A

beta lactamases

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47
Q

how is penicillin exctreted

A

renally

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48
Q

How is penicillin G and its derivatives administered and why

A

IV or IM because it is unstable in gastric acid

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49
Q

how is penicillin V administered

A

PO

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50
Q

what is the difference when you give penicillin G IV and IM

A 
IV = very short half life
IM = more sustained levels due to slower absorption
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51
Q

Which has a longer half life Penicillin G or V

A

both about the same, only 30 minutes

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52
Q

what is the difference in method of excretion between penicillin G and V

A

no difference, both renally excreted

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53
Q

what is a more broad spectrum antibiotic penicillin G or V?

A

both are narrow spectrum antibiotics

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54
Q

are penicillin G and V both effective in treating many oral infections

A

yes

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55
Q

What bacteria are most sensitive to the penicillins

A

Gram negative cocci (viridans streptococci)

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56
Q

When are nafcillin and Oxacillin used

A

to treat methicillin sensitive Staph Aureus infections

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57
Q

how are nafcillin and oxacillin administered

A

IV

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58
Q

Is Amoxicillin broad spectrum or narrow

A

broad spectrum

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59
Q

how is amoxicillin administered

A

PO

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60
Q

Aminopenicillins is a group made up of which penicillins

A

amoxicillin, ampicillin, bacampicillin

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61
Q

What is clavulanic acid

A

a beta lactamase inhibitor

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62
Q

Clavulanic acid is a beta lactamase inhibitor, what are two others

A

sulbactam

tazobactam

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63
Q

what is often given in conjuction with amoxicillin and why

A

calvulanic acid (to prevent beta lactamases from metabolisng the amoxicillin

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64
Q

what antibioitic is often used for dental prophylaxis

A

amoxicillin

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65
Q

what is the unique adverse effects associated with amoxicilin

A

a rash in people who have mono or take allopurinol

66
Q

What is augmentin

A

amoxicillin and clavulanic acid combined in one drug

67
Q

Ampicilin and sulbactam are often taken together, how are they administered and what are they used for

A

they are administered parenterally

they are given for intra-abdominal infections and severe UTIs

68
Q

What is carbenicillin used for

A

systemic infections of pseudomonas aeruginosa

69
Q

What antibiotic is known as “antipseudomonal penicillin”

A

carbenicillin

70
Q

how is carbenicillin administered

A

enterally or parenterally

71
Q

why is aminoglycoside often administered with carbenicilin

A

to prevent bacterial resistance from forming

72
Q

Carbenicillin is the antipseudomonal penicillin, but what are other antipseudomonal drugs

A

Ticarcillin (often taken with clavulanic acid)(Timentin)

Piperacillin

73
Q

of the three antipseudomonal drugs, which is the most active

A

piperacillin

74
Q

how is piperacillin administered

A

parenterally

75
Q

is piperacillin used with aminoglycosides like carbenicilin is

A

yes (to prevent bacterial resistance)

76
Q

What are the penicillinase resistant penicillins

A 
Methicillin
Oxacillin
Dicloxacillin
Cloxacillin
Nafcillin
77
Q

When is Nafcillin used

A

for mixed staph/strep infections that are penicillin resistant

78
Q

when are methicillin, oxacillin, dicloxacillin, cloxacillin used

A

for infections with penicillin resistant staph aureus

79
Q

How are the penicillinase resistant penicillins administered (methicillin, oxacillin, cloxacillin, dicloxacillin, nafcillin)

A

parenterally because of poor absorption and breakdown by gastric acid

80
Q

how does the method of action of cephalosporins differ from the method of action of the penicillins

A

they don’t the method of action of both the cephalosporins and penicillins are the same

81
Q

are cephalosporins broad or narrow spectrum

A

broad

82
Q

how are cephalosporins administed

A

PO

83
Q

What are the 1 generation cephalosporins and what do they treat

A

cefazolin, cephalexin, cefadroxil

E. Coli and MSSA

84
Q

What are the 2nd generation cephalosporins and what do they treat

A

cefoxitin, cefaclor

oral bacteroides

85
Q

what are the 3rd generation cephalosporins ans what do they treat

A

cefotaxime, ceftriaxone, ceftazidime

N gonorrhea, N meningitides, E. Coli, H. Influenzae

86
Q

What is the 4th generation cephalosporin and what does it treat

A

cefipime

P. aeruginosa

87
Q

What is the 5th generation cephalosporin and what does it treat

A

ceftaroline

Multidrug resistant S. Aureus, S pneumoniae, H influenza

88
Q

What is the chance of cross allergies for those who are allergic to penicillin and are taking cephalosporins

A

10%

89
Q

Which patients, according to the American Heart Association, should take prophylactic antibiotics prior to dental appointments

A

patients with

  1. history of heart valve surgery
  2. history of endocarditis
  3. heart transplant with abnormal valve function
  4. cyanotic congenital heart disease that hasn’t been fully repaired
  5. congenital heart defects that have been fully repaired but the repair was in the last 6 months
  6. residual heart defects
90
Q

what common heart conditions don’t require premedication?

A 
history of MI?
Innocent Heart Mumur
Cardiac pacemakers
Mitral valve prolapse
coronary artery bipass surgery
91
Q

What is the standard drug given to pt’s as prophylactic antibiotic against Infective Endocarditis (pt has no allergies and can take oral medication)

A

Amoxicillin

92
Q

What is the standard drug given to pt’s as prophylactic antibiotic against Infective Endocarditis (pt has penicillin allergies and can take oral medication)

A

Clindamycin
Cephalexin (cephalosporin 10% allergy)
Clarithromycin
azithromycin

93
Q

What is the standard drug given to pt’s as prophylactic antibiotic against Infective Endocarditis (pt has no allergies but can’t take oral medication)

A

Ampicillin
Cefazolin
Ceftriaxone

94
Q

What is the standard drug given to pt’s as prophylactic antibiotic against Infective Endocarditis (pt has penicillin allergies and can’t take oral medication)

A

Clindamycin
cefazolin
ceftraixone

95
Q

What is Imipenem

A

an atypical beta lactam

96
Q

what are the drugs with the suffix Penem

A

atypical beta lactams (Aztreonam is also one:)

97
Q

what is taken with imipenem

A

cilastatin (inhibits imipenem metabolism)

98
Q

What is imipenem taken for

A

P. aeruginosa, gram negative rods, streptococci

99
Q

What is bacitracin

A

a peptide antibiotic via cell wall inhibition

100
Q

how is bacitracin administered

A

topically

101
Q

what is vancomycin

A

the last resort antibiotic against MRSA and C dificile

102
Q

how is vancomycin adminstered

A

IV

103
Q

why is vancomycin last resort for MRSA and C dificile

A

can cause ototoxicity and nephrotoxicity

104
Q

What class of antibiotic are macrolides

A

Protein synthesis inhibitors

105
Q

are macrolides bacteriostatic or bactericidal

A

bacteriostatic

106
Q

What is the mechanism of action for macrolides

A

they bind the 50s subunit of the ribosome and inhibit translocation

107
Q

What are examples of macrolides

A

erythromycin
Clarithromycin
Azithromycin

108
Q

When are macrolides commonly used

A

in patients with penicillin allergies

109
Q

Which of the macrolides is the most potent

A

azithromycin

110
Q

what are the side effects of macrolides

A

GI upset
Inhibition of drug metabolism
QT prolongation

111
Q

are macrolides narrow or broad spectrum antibiotics

A

broad spectrum

112
Q

What organisms are sensitive to macrolides

A

Legionella pneumophila
mycoplasma pnumoniae
Chlamydia pneumoniae

113
Q

Tetracyclines
Broad or narrow spectrum?
Bacteriostatic or bactericidal

A

broad spectrum

bacteriostatic

114
Q

What is the antibiotic class that tetracyclines belong to

A

protein synthesis inhibitors

115
Q

What bacteria are susceptible to tetracyclines

A 
M. pneumoniae
C. pneumonia
H pylori
Borreliia burgdorfi
Bacteria associated with refractory and local aggressive periodontitis
Bacteria associated with acne
116
Q

What are the common tetracycline drugs

A

tetracycline
doxycycline
minocycline

117
Q

What are tetracycline drugs often used for

A
  1. acute phases of adult periodontitis
  2. chronic severe acne
  3. chlamydia infections
118
Q

What are the side effects of tetracycline

A
  1. staining of teeth when used during tooth formation

2. photosensitivity

119
Q

What class of antibiotic are amphenicols?

A

protein synthesis inhibitors

120
Q

are amphenicols bacteriostatic or bactericidal

A

bacteriostatic

121
Q

When are amphenicols used

A

they are reserved for serious, resistant infections

122
Q

What is the side effect of amphenicols

A

severe bone marrow depression “Gray baby syndrome:

123
Q

What class of antibiotics are aminoglycosides

A

protein synthesis inhibitors

124
Q

What are some examples of aminoglycosides

A

Gentamycin
Amikacin
Neomycin
Streptomycin

125
Q

What is streptomycin typically used for

A

TB

126
Q

What are the side effects of aminoglycosides

A

ototoxicity

nephrotoxicity

127
Q

Is Clindamycin broad or narrow specturm

A

narrow

128
Q

what is the method of action of clindamycin

A

inhibits protein synthesis by binding to the 50s subunit

129
Q

what organisms are affected by clindamycin

A 
S pneumonia
S pyogenes
S aureus
viridans
bacteroids
130
Q

is cilndamycin useful for oral infections

A

yes

131
Q

is clindamycin ever used as propylaxis for dental treatment

A

yes

132
Q

What antibiotic is a DNA synthesis inhibitor

A

metronidazole

133
Q

is metronidazole narrow or broad spectrum

A

narrow

134
Q

what antibiotic is also useful for parasitic infectinos

A

metronidazole

135
Q

What are contraindications for the DNA synthesis inhibitor metronidazole

A

pregnancy
alcohol use
disulfram use

136
Q

what are examples of fluoroquinolones

A 
levofloxacin
cirpofloxacin
moxifloxacin
norfloxacin
sparfloxacin
137
Q

What are the most common antibiotics used for oral infections

A

penicillins

138
Q

other than penicillins what types of antibiotics are used for oral infections

A

macrolides
clindamycin
tetracycline
metronidazole (oral anaerobes)

139
Q

What bacteria causes TB

A

mycobacterium tuberculosis

140
Q

What makes mycobacterium so hard to treat

A

it can survive inside of the macrophages

141
Q

What drugs are used to treat TB

A 
Isoniazid
Prazinamide
Ethambutol
Rifampin
Rifabutin
142
Q

what bacteria causes leprosy

A

mycobacterium leprae

143
Q

What drugs are used to treat

A

dapsone
rifampicin
clofazimine

144
Q

What type of drug is amphotercin B

A

antifungal

145
Q

what type of fungal infections is amphotercin B used for

A

systemic

146
Q

what is a complication with amphotercin B

A

it is lipophilic so it can be very toxic

147
Q

What type of drug is nystatin

A

antifungal

148
Q

how is nystatin administered

A

topically

149
Q

What is oral candidiasis treated with

A

nystatin

150
Q

What are the suffixes of antifungals

A

azole
fungin
ifine

151
Q

What drugs are used to treat herpesvirus

A

Acyclovir

Vidarabine (when resistant to acyclovir)

152
Q

What type of herpes virus isn’t treated with acyclovir

A

CMV

153
Q

Acyclovir is a prodrug

A

yep

154
Q

What are the side effects of acyclovir

A

nephrotoxicity
encephalopathy
bone marrow depression
abnormal hepatic function

155
Q

What drugs are used to treat CMV

A

Ganciclovir

Foscarnet

156
Q

What drugs are used to treat influenza

A

amantidine
rimantadine
oseltamivir
ribavirin

157
Q

What is a problem with treating influenza with amantadine and rimantadine

A

resistance has become very common

158
Q

what is the trade name of oseltamivir

A

tamiflu

159
Q

what is the method of action of oseltamivir

A

blocks neuraminidase required for viral budding

160
Q

what is ribavarin

A

a synthetic purine analog used to treat influenza and RSV

161
Q

What drugs are used in the treatment of HIV

A 
Zidovudine
Dideoxycytidine
Dideoxyinosine
3 thiacytidine
Efavirenz
nevirapine
ritonavir
saquinovir
idinavir

Pharmacology (8 decks)

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