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AV_Step 3 UWORLD > Abcs > Flashcards

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
Q

Clinical use of penicillinase resistance penicillin

A

S aureus ( except MRSA, resistant because of altered penicillin-binding protein target site)

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26
Q

AE penicillinase resistance penicillin

A

Hypersensitivity reaction interstitial nephritis

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27
Q

Which are the b-lactamase inhibitors?

A

CAST Clavulanic Acid Sulbactam Tazobactam

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28
Q

Syphilis treatment

A

Penicillin G

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29
Q

UTI treatment

A

Aminopenicillin( amoxi)

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30
Q

2 mechanism of resistance for penicillin

A
  1. B lactamase 2. Alteration of penicilllin binding protein
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31
Q

How is the bacterial coverage with cephalosporins?

A

The gram negative coverage increases as we increase the generation

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32
Q

Organisms not covered by 1st-4th generation cephalosporins?

A

LAME: Listeria Atypicals( Chlamydia, Mycoplasma) MRSA Enterococci

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33
Q

1st generation cephalosporins

A

Cefazolin, cephalexin

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34
Q

1st generation cephalosporins coverage

A

PEcK Proteus E.coli Klebsiella

35
Q

1st generation cephalosporins use

A

UTI, URIS, Prophylaxis for viridians strep endocarditis

36
Q

A specific use of cefazolin

A

surgery prophylaxis - prevent S aureus infection

37
Q

2nd generation cephalosporins

A

Fake Fox Fur Cefaclor, cefoxitin, cefuroxime

38
Q

2nd generation cephalosporins

A

HENS PEcK H. influenza, Enterobacter aerogenes, Neisseria, Serratia, Proteus, E.Coli, klebsiella

39
Q

3rd generation cephalosporins

A

Ceftriaxone

Cefotaxime

Cefdimir

Ceftazidime

40
Q

Clinical use of Ceftriaxone

A

Meningitis, gonorrhea, disseminated lyme

41
Q

Clinical use of ceftazidime

A

antipseudomona

42
Q

4th generation cephalosporin

A

Cefepime - pseudmonas and gram +

43
Q

5th generation cephalosporin

A

Ceftaroline- broad gram + and gram -, including MRSA,

DOESNT COVER PSEUDOMONA

44
Q

AE of cephalosporins

A

Hypersensitivity reactions

Autoimmune hemolytic anemia

Disulfiram like reaction

Vitamin K deficiency

Exhibit cross reactivity with penicillins

Increased nephrotox of aminoglycosides

45
Q

metabolism of Ceftriaxone

A

Bile, so perfect in pts with renal failure.

46
Q

Imipenem should always be given with ____ : an inhibitor of renal dehydropeptidase

A

cilastatin- decreases inactivation of the drug in the renal tubules

47
Q

What is the advantage of meropenem ?

A

decreases risk of seizures and is stable to dehydropeptidase

48
Q

AE Carbapenems

A

GI distress

Skin rash

CNS toxictiy ( seizures)

49
Q

Ertapenem covers pseudomona T/F

A

F, limited coverage

50
Q

Monobactam

A

Aztreonam

51
Q

Mechanism of action of Aztreonam( monobactam)

A

Prevents peptidoglycan cross-linking

binds to penicillin binding protein 3

52
Q

Interaction between aminoglycosides and monobactams

A

synergistic

53
Q

Monobactam use

A

” aminoglycoside pretender”

Gram negative only

For penicillin-allergic patients and those with renal insuff who do not tolerate aminoglycoside

54
Q

Vancomycin mechanism

A

Inhibit peptidoglycan synthesis - binds to D-ala D ala

Bacteriostatis again dificile

55
Q

Vancomycin use

A

Gram + only

C.difficile oral dose -

56
Q

AE Vancomycin

A

R-NOT

Red man syndrome( pretreat with antihist and slow infusion rate to prevent it)

Nephrotox

Otototox

Thrombophlebitis

57
Q

Aminoglycosides inefective againsT anaerobes T/F

A

True

require O2 for uptake so ineffective against anaerobes.

58
Q

When is Neomycin used?

A

Bowel surgery

59
Q

AE Aminoglycosides

A

Nephrotoxicity

Neuromuscular blockade

Ototoxicity(especially when used with loop diuretics)

Teratogen

60
Q

Tetracyclines enter CNS?

A

LIMITED CNS PENETRATION

61
Q

Elimination of Doxycyclin

A

fecally,

safe in renal failure

62
Q

Recommendation for pts taking tetracyclines

A

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
Q

Tetracyclines use- mention organisms

A

VACCUUM THe BedRoom-

Vibrio cholera,

Acne,

Chlamydia

Ureaplasma ureolyticum

Mycoplasma pneumoniae

Tularemia

H.pylori

Borrelia

Rickettsia

64
Q

AE Tetracyclines

A

GI distress

Discoloration of teeth

Inhibition of bone growth in children

Photosensitivity (SAT for Photo: sulfonamides, amiodarone, tetracyclines)

Minocycline: bluish coloration of skin

65
Q

Chloramphenicol use

A

Meningitits and Rocky mountain spotted fever(Rickettsia)

66
Q

AE Chlormaphenicol

A

Anemia ( dose dependent)

Aplastic anemia

Gray Baby syndrome( in premature infants because they lack liver UDP - glucuronyl transferase)

67
Q

Gray baby syndrome:

A

In newborns or prematures. they lack liver UDP- glucuronyl transferase – so chloramphenicol accumulates)

cyanosis, abdominal distention, vasomotor collapse (often with irregular respiration), and death. Reaction 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
Q

Clindamycin use

A

ANAEROBIC INFECTIONS ( bacteroides spp, clostridium perfringens)

Aspiration pneumonia

Lung abscess

Oral infections

Effective against Strep A infection

69
Q

AE Clindamycin

A

Pseudomembranous colitis

Fever

diarrhea

70
Q

Linezolid mechanism

A

binds 23 S RNA and interacts with bacterial initiation complex

71
Q

Linezolid use

A

MRSA, VRSA

72
Q

AE linezolid

A

BM suppression,

thrombocytopenia

peripheral neuropathy

serotonin syndrome

73
Q

Gray MAN syndrome

A

Amiodarone

Blue color ( ceruloderma) due to deposit of melanin and lopofuscin

74
Q

Macrolides use

A

“PUS”

Pneumonia ( atypical- mycoplasma, Chlamydia, legionella)

URI ( S. penumonia, S. pyogenes)

STDS ( Chlamydia, Gonorrhea)

75
Q

AE Macrolides

A

MACROslides

GI Motility issues

Arrythmia due to prolonged QT

Acute Cholestatic hepatitis– erythro

Rash

Eosinophilia

76
Q

Macrolides med interactions

A

Increases serum concentration of theophylline, oral anticoagulants

77
Q

EA Sulfonamides

A

Hypersensitivity reactions

hemolysis if G6PD def

Nephrotoxicity ( tubulointerstitial nephritis)

Photosensitivity

Kernicterus in infants

Displaces other drugs from albumin( eg. warfarin)

78
Q

Dapsone mechanism

A

same as sulfonamides inhibit PABA TO dhf

79
Q

Dapsone use

A

Leprosy( lepromatous and TB)

Pneumocystis jirovecii prophylaxis

80
Q

AE Dapsone

A

Hemolysis if G6PD def

81
Q
A
82
Q
A
83
Q
A

AV_Step 3 UWORLD (8 decks)

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