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Antibiotics > ABX Overview > Flashcards

ABX Overview Flashcards

1
Q

Gram Positives

A

Staphylococcus
Streptococcus
Enterococcus

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2
Q

Piddly Category – Gram Negative

A

Haemophilus (H.flu)
Morexella (M.cat)
Morganella/Salmonella/Shigella
Neisseria/Provedentia

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3
Q

Fence Category (PEK)– Gram Negative

A

Proteus
E.coli
Klebsiella

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4
Q

SPACE BUGS – Gram Negative

A 
Serratia
Pseudomonas
Acinetobacter
Citrobacter
Enterobacter
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5
Q

Atypicals

A

Chlamydia
Mycoplasma
Legionella

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6
Q

Anaerobes

A

Peptostreptococcus
Bacteroides
Clostridium

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7
Q

What kind of antibiotics are Lethal to susceptible microorganisms?

A

Bactericidal Agent

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8
Q

What kind of antibiotics are Inhibitory to growth of susceptible microorganisms?

A

Bacteriostatic Agent

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9
Q

Trimethoprim/Sulfamethoxazole combo is an example of what?

How?

A

Synergism

Sequential inhibition of folic acid synthesis

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10
Q

Penicillin/Aminoglycoside combo is an example of what?

How?

A

Synergism

Increased penetration of aminoglycoside as penicillin breaks down cell wall.

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11
Q

Why don’t you ususally use Bacteriostatic/Bactericidal combos?

A

Antagonism
Most cidal agents require active cell division or protein synthesis for expression of their bactericidal activity, and many of the static agents inhibit these processes.

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12
Q

What is Postantibiotic Effect (PAE)?

Which classes of ABX exhibit it?

A
  • Persistent effect of an antimicrobial on bacterial growth following brief exposure of organisms to a drug.
  • Aminoglycosides and fluoroquinolones have been shown to have a high degree of postantibiotic effect.
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13
Q

What type of bacterial killing:
Bacterial killing is dependent on peak concentration
- Postantibiotic effect assists in this concept.
- Aminoglycosides and fluoroquinolones

A

Concentration Dependent Killing

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14
Q

What type of bacterial killing:
Bacterial killing is dependent on the amount of time the concentrations stay above the MIC during the dosing interval.
- B-lactam antibiotics (Penicillins, cephalosporins)

A

Time Dependent Killing

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15
Q

What route of administration of ABX do you use for:

Mild to moderate infections?

A

ORAL

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16
Q

What route of administration of ABX do you use for:
Moderate to severe infections
Patient unable to take oral agents?

A

INTRAVENOUS

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17
Q

What route of administration of ABX do you use for:

IV access is not obtainable?

A

INTRAMUSCULAR

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18
Q

How long should a patient be afebrile before considering changing them to oral ABX?

A

2 days

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19
Q

What’s the catch22 with taking oral erythromycin or ampicillin?

A

stomach upset if don’t take with food but decreased absorption if you take with food

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20
Q

Which ABX have Urine concentrations GOOD but systemic concentrations NOT good?

A

Nitrofurantoin

Carbenicillin

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21
Q

What are some examples of when Renal excretion is desired as opposed to hepatic?

A

Urinary Tract Infection

Hepatitis

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22
Q

What is the Cockroft-Gault Equation?

What does it measure?

A

[(140-Age) X Weight (kg)]
[(SrCr X 72)]
*Multiply by 0.85 if female

Measures Creatinine Clearance (mL/min)

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23
Q

How would you treat a “SPACE bug” (what is the name of the method and how does it work)?

A

Box and One Coverage (B-lactam with AG or FQN)

  • Cell Wall Inhib = PCN, Ceph, Carbapenem, Monobactam
  • DNA gyrase = Fluoroquinolones
  • 30 S = Aminoglycosides
  • Ace in the Hole = Aztreonam (Anaphylaxis)
  • Last Resort = Colistin (last resort)
24
Q

What penicillins would you consider for use in “Box and One Coverage” method?

A

PCNS

Piperacillin Pip/Tazobactam
Ticarcillin Ticar/Clauvulanate

25
Q

What Cephalosporins would you consider for use in “Box and One Coverage” method?

A

Cephalosporins

Ceftazidime
Cefepime

26
Q

What Carbapenems would you consider for use in “Box and One Coverage” method?

A

Carbapenems

Imipenem
Meropenem
Doripenem

27
Q

What Monobactam would you consider for use in “Box and One Coverage” method?

A

Monobactam

Aztreonam (when PCN allergy)

28
Q

What Aminoglycosides would you consider for use in “Box and One Coverage” method?

A

AminoGlycosides

Gentamycin
Tobramycin
Amikacin

29
Q

What Fluoroquinolones would you consider for use in “Box and One Coverage” method?

A

FluoroQuinoloNe

Ciprofloxacin
Levofloxacin

30
Q

Which ABX:
Prevents cross-linking of peptidoglycan strands by
inhibiting transpeptidases

A

Penicillins
Cephalosporins
Carbapenems
Aztreonam

31
Q

Which ABX:

Inhibits peptidoglycan synthetase and polymerization of linear peptide

A

Vancomycin

32
Q

Which ABX:

Inhibits 30 S ribosome; Causes misreading of mRNA

A

Aminoglycosides

33
Q

Which ABX:

Inhibits peptidyl transferase and peptide band formation

A

Chloramphenicol

34
Q

Which ABX:

Inhibits 50 S ribosome

A

Erythromycin, clindamycin, lincomycin

35
Q

Which ABX:
Inhibits binding of aminoacyl tRNA to ribosome
•30S ribosome

A

Tetracyclines

36
Q

Which ABX:

23 S ribosome

A

Streptogramins/Linezolid

37
Q

Which ABX:

Cationic detergent

A

Polymixin B, Colistin

38
Q

Which ABX:

Inhibits DNA-dependent RNA polymerase

A

Rifampin

39
Q

Which ABX:

Interferes with supercoiling of DNA by action on DNA gyrase (topoisomerase II)

A

Fluoroquinolones

40
Q

Which ABX:

Inhibits lipid synthesis

A

Isoniazid, ethambutol

41
Q

Which ABX:

Prevents synthesis of folic acid

A

Sulfonamides, trimethoprim

42
Q

What ABX are interfered with by Antacids?

A

Quinolones

Tetracycline

43
Q

What ABX should you NOT take with Warfarin?

A

Bactrim

Erythromycin

44
Q

What ABX should you NOT take with Theophylline?

A

Ciprofloxacin

45
Q

What is “Serotonin Storm” what causes it?

A

Way too much serotonin

drug interaction between Linezolid and SSRIs

46
Q

What Mechanisms of Resistance are there for Penicillins/Cephalosporins?

A

B-lactamases
PBP changes
Porin channel changes

47
Q

What Mechanisms of Resistance are there for Aminoglycosides?

A

Enzyme inactivating

48
Q

What Mechanisms of Resistance are there for Macrolides?

A

Methyltransferases that alter drug binding sites on 50S ribosomal subunit

49
Q

What Mechanisms of Resistance are there for Tetracyclines?

A

Transport systems that pump drugs out of the cell

50
Q

What Mechanisms of Resistance are there for Sulfonamides?

A

Increased PABA formation &

Target enzyme sensitivity

51
Q

What Mechanisms of Resistance are there for Fluoroquinolones?

A

Target enzyme changes &

Drug efflux

52
Q

Dose related toxicity with Imipenem is…

A

seizures

53
Q

Dose related toxicity with Amphotericin is…

A

nephrotoxicity

54
Q

Dose related toxicity with Cefazolin is…

A

Neutropenia

55
Q

Idiosyncratic reaction with Chloramphenicol is…

A

Aplastic Anemia

56
Q

Why should you never prescribe or allow a patient to take something like immodium when they have C. Difficile?

A

diarrhea stops but is still being produced by toxin; results in pseudomembranous colitis and toxic megacolon
patient ends up needing colectomy

Antibiotics (25 decks)

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