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Abcs Flashcards

1
Q

Mechanism of action fluoroquinolones and quinolones?

A

inhibition of DNA gyrase

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2
Q

Name a quinolone

A

Nalidixic acid

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3
Q

Mechanism of Rifampin

A

RNA polymerase inhibitor

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4
Q

Chloramphenicol, Clindamycin, Linezolid mechanism of action

A

Inhibition of protein synthesis through 50S

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5
Q

Inhibitors of 50 S subunit

A

Chloramphenicol, clindamycin, linezolid Macrolides: Azitro, Claritro, Erithromycin Streptogramins: quinupristin, dalfopristin

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6
Q

Mechanism of action of Aminoglycosides and name them

A

Inhibition of 30 S, misreading/translation. Gentamicin, Neomycin, Amikacin, Tobramycin

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7
Q

Mechanism of action of tetracyclines and names

A

Inhibition of 30S- inhibit binding of aminoacyl-tRNA to mRNA complex. Tetracycline Doxycycline Minocycline

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8
Q

Inhibitors of peptidoglycan synthesis

A

Glycopeptides Vancomycin Bacitracin

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9
Q

Penicillinase sensitive penicillins

A

Penicillin G (iv, im), V (oral) Ampicilin Amoxicillin

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10
Q

Penicillinase resistan penicillins

A

Oxacillin Nafcillin DiclOxacillin (oral) methicillin

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11
Q

Antipseudomonals

A

Piperacillin, ticarcilin

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12
Q

Piperacillin, ticarcilin are what type of ABCs

A

antipseudomonals

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13
Q

Monobactams

A

Aztreonam

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14
Q

Folic acid synthesis and reduction ( DNA methylation

A

Sulfonamides ( block PABA TO DHF) Trimpetrophin ( DHF to THF)

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15
Q

Types of penicillins

A

Penicillin G (IV, IM), Penicillin V (oral)

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16
Q

Mechanism of action of penicillins

A

D-ala D-ala structural analog, so binds to penicillin binding protein Avoids crosslinking–> leaky wall Activate autolytic enzymes

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17
Q

Use of penicillins

A

Gram +: S pneumoniae, S, pyogenes, Actinomyces Gram - cocci: N. meningitidis, spirochetes ( T pallidum

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18
Q

EA penicillins

A

Hypersensitivity reactions, direct Coombs + hemolytic anemia, Thrombocytopenia

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19
Q

Penicillinase sensitive penicillins mechanism

A

Same as penicillin,Wider spectrum. Combine with clavulonate.

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20
Q

Which penicillinase sensitive penicillin has excellent oral bioavailability?

A

Amoxicillin better than ampicillin

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21
Q

Clinical use of AMPI, AMOXI, AMINOPENICILLIN?

A

HHELPSS-E H. influenza, H. pylori, E.coli , listeria, proteus, Salmonella, Shigella, enterococci

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22
Q

AE penicillinase sensitive penicillins?

A

Hypersensitivity reaction, rash (when given for mononucleosis) Pseudomembranous colitis

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23
Q

Penicillinase-Resistant penicillins mechanism

A

same as penicillin Narrow spectrum bulky R group blocks access of B lactamase to B lactam ring

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24
Q

Why methicillin is no longer used clinically?

A

interstitial nephritis It is used to determine resistant strain of staph

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25
Clinical use of penicillinase resistance penicillin
S aureus ( except MRSA, resistant because of altered penicillin-binding protein target site)
26
AE penicillinase resistance penicillin
Hypersensitivity reaction interstitial nephritis
27
Which are the b-lactamase inhibitors?
CAST Clavulanic Acid Sulbactam Tazobactam
28
Syphilis treatment
Penicillin G
29
UTI treatment
Aminopenicillin( amoxi)
30
2 mechanism of resistance for penicillin
1. B lactamase 2. Alteration of penicilllin binding protein
31
How is the bacterial coverage with cephalosporins?
The gram negative coverage increases as we increase the generation
32
Organisms not covered by 1st-4th generation cephalosporins?
LAME: Listeria Atypicals( Chlamydia, Mycoplasma) MRSA Enterococci
33
1st generation cephalosporins
Cefazolin, cephalexin
34
1st generation cephalosporins coverage
PEcK Proteus E.coli Klebsiella
35
1st generation cephalosporins use
UTI, URIS, Prophylaxis for viridians strep endocarditis
36
A specific use of cefazolin
surgery prophylaxis - prevent S aureus infection
37
2nd generation cephalosporins
Fake Fox Fur Cefaclor, cefoxitin, cefuroxime
38
2nd generation cephalosporins
HENS PEcK H. influenza, Enterobacter aerogenes, Neisseria, Serratia, Proteus, E.Coli, klebsiella
39
3rd generation cephalosporins
Ceftriaxone Cefotaxime Cefdimir Ceftazidime
40
Clinical use of Ceftriaxone
Meningitis, gonorrhea, disseminated lyme
41
Clinical use of ceftazidime
antipseudomona
42
4th generation cephalosporin
Cefepime - pseudmonas and gram +
43
5th generation cephalosporin
Ceftaroline- broad gram + and gram -, including MRSA, DOESNT COVER PSEUDOMONA
44
AE of cephalosporins
Hypersensitivity reactions Autoimmune hemolytic anemia **Disulfiram like reaction** **Vitamin K deficiency** **Exhibit cross reactivity with penicillins** **Increased nephrotox of aminoglycosides**
45
metabolism of Ceftriaxone
Bile, so perfect in pts with renal failure.
46
Imipenem should always be given with ____ : an inhibitor of renal dehydropeptidase
cilastatin- decreases inactivation of the drug in the renal tubules
47
What is the advantage of meropenem ?
decreases risk of seizures and is stable to dehydropeptidase
48
AE Carbapenems
GI distress Skin rash CNS toxictiy ( seizures)
49
Ertapenem covers pseudomona T/F
F, limited coverage
50
Monobactam
Aztreonam
51
Mechanism of action of Aztreonam( monobactam)
Prevents peptidoglycan cross-linking binds to penicillin binding protein 3
52
Interaction between aminoglycosides and monobactams
synergistic
53
Monobactam use
" aminoglycoside pretender" Gram negative only For penicillin-allergic patients and those with renal insuff who do not tolerate aminoglycoside
54
Vancomycin mechanism
Inhibit peptidoglycan synthesis - binds to D-ala D ala Bacteriostatis again dificile
55
Vancomycin use
Gram + only C.difficile oral dose -
56
AE Vancomycin
R-NOT Red man syndrome( pretreat with antihist and slow infusion rate to prevent it) Nephrotox Otototox Thrombophlebitis
57
Aminoglycosides inefective againsT anaerobes T/F
True require O2 for uptake so ineffective against anaerobes.
58
When is Neomycin used?
Bowel surgery
59
AE Aminoglycosides
**Nephrotoxicity** **Neuromuscular blockade** Ototoxicity(especially when used with loop diuretics) Teratogen
60
Tetracyclines enter CNS?
LIMITED CNS PENETRATION
61
Elimination of Doxycyclin
fecally, safe in renal failure
62
Recommendation for pts taking tetracyclines
Don't take with milk( Ca2+), antacids ( Ca or Mg) , or iron containing preparations because they divalent cations inhibit drug absorption in the gut.
63
Tetracyclines use- mention organisms
VACCUUM THe BedRoom- Vibrio cholera, Acne, Chlamydia Ureaplasma ureolyticum Mycoplasma pneumoniae Tularemia H.pylori Borrelia Rickettsia
64
AE Tetracyclines
GI distress Discoloration of teeth Inhibition of bone growth in children Photosensitivity (SAT for Photo: sulfonamides, amiodarone, tetracyclines) Minocycline: bluish coloration of skin
65
Chloramphenicol use
Meningitits and Rocky mountain spotted fever(Rickettsia)
66
AE Chlormaphenicol
Anemia ( dose dependent) Aplastic anemia Gray Baby syndrome( in premature infants because they lack liver UDP - glucuronyl transferase)
67
Gray baby syndrome:
In newborns or prematures. they lack liver UDP- glucuronyl transferase -- so chloramphenicol accumulates) cyanosis, abdominal distention, vasomotor collapse (often with irregular respiration), and death. R**eaction appears to be associated with serum levels ≥50 mcg/mL** (Powell 1982). Occurs 2-10 days TTO:STOP Exchange transfusion Phenobarb- induce UDP glucuronyl transferase
68
Clindamycin use
ANAEROBIC INFECTIONS ( bacteroides spp, clostridium perfringens) Aspiration pneumonia Lung abscess Oral infections Effective against Strep A infection
69
AE Clindamycin
Pseudomembranous colitis Fever diarrhea
70
Linezolid mechanism
binds 23 S RNA and interacts with bacterial initiation complex
71
Linezolid use
MRSA, VRSA
72
AE linezolid
BM suppression, thrombocytopenia peripheral neuropathy serotonin syndrome
73
Gray MAN syndrome
Amiodarone Blue color ( ceruloderma) due to deposit of melanin and lopofuscin
74
Macrolides use
"PUS" Pneumonia ( atypical- mycoplasma, Chlamydia, legionella) URI ( S. penumonia, S. pyogenes) STDS ( Chlamydia, Gonorrhea)
75
AE Macrolides
MACROslides GI Motility issues Arrythmia due to prolonged QT Acute Cholestatic hepatitis-- erythro Rash Eosinophilia
76
Macrolides med interactions
Increases serum concentration of theophylline, oral anticoagulants
77
EA Sulfonamides
Hypersensitivity reactions hemolysis if G6PD def Nephrotoxicity ( tubulointerstitial nephritis) Photosensitivity Kernicterus in infants Displaces other drugs from albumin( eg. warfarin)
78
Dapsone mechanism
same as sulfonamides inhibit PABA TO dhf
79
Dapsone use
Leprosy( lepromatous and TB) Pneumocystis jirovecii prophylaxis
80
AE Dapsone
Hemolysis if G6PD def
81
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AV_Step 3 UWORLD (8 decks)

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