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Infectious Disease > AB review > Flashcards

AB review Flashcards

1
Q

How many “R” groups do Penicillins have?

A

1

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2
Q

What is the main AE of Linezolid?

A

Monoamine Oxidase Inhibitor (increased risk of serotonin syndrome)

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3
Q

How many “R” groups do Cephalosporins have?

A

2

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4
Q

Which TCN is used against MRSA? Enterococcus? Pseudomonas?

A

Doxy + Minocycline for MRSA only

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5
Q

Which GEN of cephalosporins covers most strep and MSSA?

A

1st

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6
Q

Which AB is associated w/ Gray baby syndrome?

A

Chloramphenicol

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7
Q

Aminoglycosides are used against MRSA? Enterococcus? Pseudomonas?

A

Only Gentamycin, Amikacin, and Tobramycin are used for Pseudomonas

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8
Q

What is the MOA of macrolides?

A

Inhibit protein synthesis by binding reversibly to the 50S ribosomal subunits

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9
Q

Is it okay to take cephalosporins if you have an allergy to penicillin?

A

Yes, just not with anaphylaxis or hives

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10
Q

Which AB has been associated with Red-Man Syndrome? How do you get rid of this?

A

Vanco

D/C or slow the rate

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11
Q

Which cephalosporin can be used against typhoid fever or non-typhi species of Salmonella?

A

Ceftriaxone

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12
Q

Which AB have alcohol intolerance?

A

Cephalosporins + Flagyl

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13
Q

Which quinolones cover Pseudomonas?

A

Levofloxacin
Ciprofloxacin
Delafloxacin

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14
Q

What are the two main glycopeptides?

A
  1. Vanco

2. Telavancin

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15
Q

What is the most active carbapenem against Pseudomonas?

A

Doripenem

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16
Q

G+ or G-

Which one does TCN cover?

A

Both

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17
Q

Which AB covers MRSA, VRSA, and VRE?

A

Zyvox (Linezolid)

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18
Q

Which of the following works via inhibition of DNA gyrase?

Sulfonamides
Fluroquinolones
Aminoglycosides
Penicillins

A

Fluroquinolones

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19
Q

Which AB competitively inhibit Linezolid?

A

Chloramphenicol and Lincomycin

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20
Q

What are the two inhaled AB?

A

Tobramycin + Aztreonam

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21
Q

Which AB can cover atypical organisms?

A

Macrolides/Ketolides

Quinolones

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22
Q

Which AB can target the bone?

A

Lincosamides, Chloramphenicol, and Quinolones

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23
Q

G+ vs G-

Erythromycin

A 
Good = G+
Little = G-
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24
Q

Which macrolide has no interactions with CYP3A4?

A

Azithromycin

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25
Q

Which AB can be used if you have a rash/hypersensitivity to penicillins or another B-lactam?

A

Aztreonam

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26
Q

Which cephalosporin covers N. gonorrhea?

A

Ceftizoxime + Ceftriaxone

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27
Q

Which aminoglycoside is the broadest of the group?

A

Amikacin

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28
Q

G+ or G-, Aerobe or Anaerobe

Which one does Tigecycline target?

A

All

Anaerobes = Clostridium perfinges, Bacteroides spp

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29
Q

What is the only natural penicillin used clinically?

A

Pen. G

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30
Q

Which carbapenem is used to treat bacterial meningitis?

A

Meropenem

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31
Q

G+ or G-, Aerobic or Anaerobic

Which one does Amox (w/ Clav), Ampicillin (w/ sulbactam), Zosyn, and Ticarcillin (w/ Clav) cover?

A

G+, little G-, Anaerobic

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32
Q

Which AB could cause vestibular toxicity?

A

Minocycline

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33
Q

Which AB has been associated w/ metallic or soapy taste?

A

Telavancin for both. Metronidazole can cause just the metallic taste

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34
Q

G- or G+, aerobe vs anaerobe

Which one does Aztreonam (Monobactam) work against?

A

G- aerobe

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35
Q

Which GEN of cephalosporins have great G- coverage?

A

5th

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36
Q

Of the cell wall synthesis inhibitors, which one inhibits recycling of carrier which transports cell wall precursors across the plasma membrane?

A

Bacitracin

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37
Q

Of all the macrolides and ketolide, what is something in common?

A

Have good coverage on atypical organisms such as:

Legionella pneumophilia
Chlamydia sp.
Mycoplasma sp.

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38
Q

Of the cell wall synthesis inhibitors, which one inhibits cross-linking of cell wall components?

A

B-lactams

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39
Q

Which Lincosamide is available via PO? IV?

A 
PO = Clindamycin only
IV = Both Clinda + Lincomycin
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40
Q

Which drug has an AE of Cholestatic hepatitis?

A

Erythromycin estolate

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41
Q

PO or IV, which form does Linezolid come in?

A

Both

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42
Q

Can Lincosamides go against MRSA, Pseudomonas, and Enterococcus?

A

Only Clindamycin is somewhat useful against MRSA (60% effectiveness)

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43
Q

G+ vs G-

Quinupristin/Dalfopristin

A

Mostly G+, limited G-

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44
Q

What do all quinolones have in common in terms of coverage?

A

All hit atypical bugs

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45
Q

How does Aztreonam work?

A

Interacts w/ penicillin-binding proteins of susceptible microorganisms and induces formation of long filamentous bacterial structures

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46
Q

What are some AE of Dapto?

A
  1. Myopathy
  2. Creatine phosphokinase elevation

**consider suspending statins

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47
Q

Which AB causes C. difficile colitis?

A

Lincosamides (Clindamycin + Lincomycin)

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48
Q

Which AB has a black box warning reported that all-cause mortality with this drug was higher than any other versus its own class?

A

Cefepime

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49
Q

Compared to Erythromycin, how does Telithromycin compare?

A

Better coverage, such as S. pneumoniae and aureus

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50
Q

Is Vanco against MRSA, Pseudomonas, and Enterococcus?

A

Not all

Good for MRSA

Good for Methicillin resistant but Vanco susceptible Enterococcus

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51
Q

Which carbapenem is against MRSA?

A

None

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52
Q

Is Aztreonam against MRSA, Pseudomonas, and Enterococcus?

A

Nope, only against Pseudomonas

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53
Q

Which AB’s AE is Myopathy and creatine phosphokinase elevation?

A

Dapto

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54
Q

Which of the following is not a beta-lactam?

Aminoglycoside
Cephalexin
Doripenem
Amoxicillin

A

Aminoglycoside

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55
Q

What is the MOA of Dapto?

A

Binds to bacterial MEMBRANE which causes rapid depolarization of membrane potential

Cell lysis does not occur

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56
Q

G+ vs G-

Clarithromycin

A

Just like Azithromycin, it has better coverage than Erythromycin by covering Mycobacterium avium-intracellulare

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57
Q

What are some AE of Telavancin?

A
  1. Metallic/soapy taste

2. Black box = abnormal fetal development

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58
Q

Is Telavancin against MRSA, Pseudomonas, and Enterococcus?

A

Not all

Good for MRSA

59
Q

Of all antimicrobials, which have the most broad spectrum of activity?

A

Carbapenems

60
Q

G- or G+

Which one does Telavancin work on?

61
Q

Which AB cause Stevens-Johnson syndrome

A

Trimethoprim/Sulfamethoxazole; pretty much anything w/ sulfur in it

62
Q

Which of the following does NOT work on bacterial ribosomal subunits?

Aminoglycosides
Macrolides
Clindamycin
Fluoroquinolones

A

Fluoroquinolones

63
Q

What is the only cephalosporin that is good against MRSA?

A

Cefataroline

64
Q

Which AB causes gradual rise in BUN and serum creatinine?

A

Aminoglycosides

65
Q

Which GEN of cephalosporins have great G+ coverage?

66
Q

G+ or G-, Aerobic or Anaerobic

Which one does Aminoglycosides cover?

A

G+ and Aerobic

67
Q

G+ vs G-, aerobe vs anaerobe

Trimethoprim/Sulfamethoxazole

A

No anaerobe, covers PCP as well

68
Q

What is the drug of choice for Pseudomembranous colitis due to C. difficile?

A

Metronidazole

69
Q

G+ vs G-, aerobe vs anaerobe

Chloramphenicol

A

Both G+ and G-, Anaerobe

70
Q

Which GEN of quinolones just has good G- coverage?

A

All 4 GEN have good G- coverage

71
Q

MOA of Linezolid?

A

Inhibits protein synthesis by binding to the P site of the 50S ribosomal subunit and preventing formation of the larger ribosomal-fMet-tRNA complex that initiates protein synthesis

72
Q

Which AB is contraindicated w/ someone who has end stage renal disease?

A

IV Delafloxacin; it contains cyclodextrin

73
Q

What are the cephamycins noted for in terms of their activity?

A

Covers B. fragilis

74
Q

Of the cell wall synthesis inhibitors, which one depolarizes membranes?

A

Daptomycin

75
Q

Which AB can cause possible peripheral neuropathy and/or myasthenia gravis?

A

Quinolones

76
Q

Which AB could cause Fanconi syndrome due to use of outdated meds?

77
Q

Which quinolone covers MRSA?

A

Delafloxacin

78
Q

Which Penicillins are agents used for Pseudomonas?

A

Piper. w/ Tazo

Ticaricillin w/ clav.

79
Q

G+ or G-

Which one does Pen. G/V cover?

80
Q

Which of the following is NOT active against MRSA?

Vancomycin
Trimethoprim/sulfamethoxazole
Daptomycin
Piperacillin/tazobactam

A

Piper. w/ Tazo

81
Q

Glycylcyclines aka Tigecycline is used against MRSA? Enterococcus? Pseudomonas?

A

MRSA and VRE

82
Q

How do glycopeptides work?

A

Binds firmly to D-ala-D-ala portion of cell wall precursors to inhibit peptidoglycan units to grow polymer chain of cell wall.

83
Q

Which GEN of quinolones has both G+ and G- coverage?

A

3rd and 4th

84
Q

Which AB group is typically used to provide synergistic bacterial killing?

A

Aminoglycosides

85
Q

What do the 2nd GEN cephalosporins cover that 1st GEN doesn’t?

A

More G- coverage notably H. influenzae

86
Q

Where do most of the macrolides/ketolides distribute to?

A

Pulmonary areas

87
Q

Can Quinupristin/Dalfopristin go against MRSA, Pseudomonas, and Enterococcus?

A

Just MRSA. One ppt says against VRE, another doesnt mention it…?

88
Q

What is the bioavailability of Linezolid via PO and IV?

A

Both are 100% :O

89
Q

What are some drug interactions w/ Quinupristin/Dalfopristin?

A

Inhibits CYP450-3A4

90
Q

Which AB causes bone marrow suppression?

A

Chloramphenicol

91
Q

Besides alcohol intolerance, what is another AE that cephalosporins have?

A

Reduction in Vit. K producing bacteria

92
Q

Quinolone AB target what specifically?

A 
G+ = topoisomerase IV
G- = DNA gyrase
93
Q

What is the ideal drug choice for MRSA?

94
Q

Aerobic vs anaerobic

Metronidazole

A

Anaerobic (plus against Protozoa)

95
Q

Which AB have been associated w/ QTc prolongation?

A

Macrolides + Ketolides + Quinolones

96
Q

What is the MOA of Bacitracin?

A

Inhibits incorporation of AA into cell wall by inhibiting dephosphorylation of phospholipid carrier cycle (inhibits NAM and NAG)

97
Q

G+ vs G-, aerobe vs anaerobe

Lincosamides

A

G+ and anaerobes

98
Q

What is an AE of all carbapenems?

A

Seizures, especially imipenem

Doripenem has the lowest chance.

99
Q

What are some AE of Vanco?

A
  1. Red-man syndrome

2. Ototoxicity

100
Q

Which AB would you used for suspected/proven Rocky Mountain spotted fever?

A

Doxycycline

101
Q

What is the most serious AE of Chloramphenicol?

A

Aplastic (more serious and not dose related) and Hemolytic anemia

102
Q

Which AB causes Neuromuscular blockade? How could you reverse it?

A

Aminoglycosides.

Calcium Gluconate

103
Q

G- or G+

Which one does Vanco work on?

104
Q

Which macrolide is NOT tolerated well?

A

Erythromycin

105
Q

Which AB in contraindicated w/ myasthenia gravis

106
Q

Which AB has a black box warning of tendonitis?

A

Quinolones

107
Q

Which AB interacts w/ Divalent/Trivalent Cations?

A

TCN and Quinolones

108
Q

G+ vs G-

Azithromycin

A

Just like Clarithromycin, it has better coverage than Erythromycin by covering Mycobacterium avium-intracellulare

109
Q

What is the only for treatment of Clostridium difficile-associated diarrhea?

A

Fidaxomicin

110
Q

What is the drug of choice for Pneumocystis jirovecii pneumonia?

A

Trimethoprim/Sulfamethoxazole

111
Q

Is Dapto against MRSA, Pseudomonas, and Enterococcus?

A

Not all

Good for MRSA

Good for Methicillin-R and Vanco-R Enterococcus

112
Q

MOA of Chloramphenicol?

A

Binding reversibly to the 50S ribosomal subunit

113
Q

Which cephalosporin can be used for early Lyme disease or third-degree AV heart block?

A

Ceftriaxone and cefotaxime

114
Q

What are some AE of Quinupristin/Dalfopristin

A

Venous irritation when administered in the peripheral vein

Myalgia, arthralgia

115
Q

Which cephalosporins covers Pseudomonas?

A

Ceftazidime
Cefepime
Ceftolozane/tazobactam
Ceftazidime/avibactam

116
Q

What group of AB are susceptible to bacterial metabolism and inactivation by amidases and lactamases?

A

Penicillins

117
Q

Which AB needs to be taken on an empty stomach?

A

Azithromycin

118
Q

Which AB has been associated w/ a black box warning of abnormal fetal development?

A

Telavancin

119
Q

Of the cell wall synthesis inhibitors, which one prevents transfer of cell wall precursor from plasma membrane into cell wall?

A

Glycopeptides

120
Q

What is the ratio of Trimethoprim:Sulfamethoxazole?

121
Q

Which AB can cause ototoxicity?

A

Aminoglycosides
Macrolides
Vancomycin

122
Q

What class of drugs is associate with the pathophysiology of ototoxicy caused by destruction of hair cells in the cochlear and/or vestibular apparatus?

A

Aminoglycosdes

123
Q

Of the two ototoxicity toxicities resulting from use of aminoglycoside, which is reversible?

A

Auditory/cochlear or hearing

124
Q

Of the two ototoxicity toxicities resulting from use of aminoglycoside, which is irreversible?

A

Vestibular

125
Q

What 50s ribosomal subunit inhibitor demonstrates activity vs. VRE (faecium and not faecalis) & MRSA and is associated with myalgias and arthralgias?

A

Quinupristin/Dalfopristin

126
Q

What 50s ribosomal subunit inhibitor should be administered through a central line as administration through peripheral lines results in venous irritation?

A

Quinupristin/Dalfopristin

127
Q

What 50s ribosomal subunit inhibitor comes as a 30:70 racemic mixture of streptogamin B:A?

A

Quinupristin/Dalfopristin

128
Q

The isoxazolyl R-group added to a thiazoline ring that is attached to a beta-lactam characterizes what group of antibiotics?

A

Penicillinase-resistant PCN

129
Q

What advantage over the natural penicillins does the isoxazolyl side chain afford?

A

Resistance to penicillinase bacterial enzymes (adds MSSA to spectrum)

130
Q

In the bacterial differentiation tree, what is the test that distinguishes between Staph & Strep

A

Catalase negative (Strep) or positive (Staph)

131
Q

In the bacterial differentiation tree, what is the test to distinguish between S. aureus from S. epidermis?

A

Coagulase positive (aureus) or negative (epidermis)

132
Q

Beta-lactams are susceptible to inactivation by two bacterial enzymes called __?

A

Amidases and lactamases

133
Q

Which cephalosporins are noted for their activity vs. Bacteroides fragilis?

A

Cefotetan and cefoxitin

134
Q

Cefotetan and cefoxitin are noted for their activity against what?

A

B. fragilis

135
Q

Cefepime is noted for its use against what?

A

P. aeruginosa, Citrobacter as well as Enterobacter

136
Q

Unlike other beta-lactam agents, vancomycin works on what bacterial enzyme?

A

Transglycoslase

137
Q

Which AB works on transglycolase?

138
Q

What isoxazolyl side chain penicillin derivative is only available IV?

A

Naficillin

139
Q

What isoxazolyl side chain penicillin derivative induces CYP450-3A4 pathway and is administered orally?

A

Dicloxacillin

140
Q

Of the penicillin based agents, which is associated with the highest rates of diarrhea?

141
Q

Drug of choice for treatment of Treponema pallidum is?

A

Penicillin G

142
Q

Penicillin G is the drug of choice for treating what?

A

T. pallidum

143
Q

Which AB readily cross the CNS w/o any meningeal inflammation?

A
  1. Chloramphenicol
  2. TCN
  3. TMP-SMX
  4. Zyvox

Infectious Disease (32 decks)

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