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Pharmacology > Abx overview > Flashcards

Abx overview Flashcards

1
Q

Which of the four MOAs of antibacterials do we use the most?

A

inhibition of DNA synthesis and integrity

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2
Q

List the 3 inhibitors of cell wall synthesis

A
  1. Beta-Lactams: PCN
  2. Cephalosphorins
  3. Glycopeptides: Vancomycin
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3
Q

List the 4 inhibitors of translation of transcription

A
  1. Tetracyclines: Doxycycline
  2. Macrolides: Z-pack
  3. Clindamycin
  4. Oxazolidinones: Linezolid
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4
Q

List the 3 inhibition of DNA synthesis and integrity/inhibitors of folate synthesis and function

A
  1. Sulfonamides
  2. Trimethoprim
  3. Quinolones
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5
Q

Mechanism of bactericidal

A

Ability to kill

-Inhibition of cell wall synthesis

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6
Q

List the time-dependent abx

A
  1. Beta-Lactams: PCN

2. Vancomycin

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7
Q

List the concentration-dependent abx

A
  1. Aminoglycosides

2. Quinolones

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8
Q

Bacteriostatic mechanism

A

Inhibition of protein synthesis

-Slow the microorganism down

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9
Q

List the bacteriostatic abx

A
  1. Tetracyclines: Doxycycline
  2. Macrolides
  3. Sulfonamides
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10
Q

What do we have to use in immunocompromised pt’s?

A

Bactericidal

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11
Q

What would be a appropriate combination for empiric therapy?

A

two bactericidals

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12
Q

Postantibiotic effect

A

Persistent suppression of bacterial growth after limited exposure (1-2 hrs) to an antimicrobial agent

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13
Q

Abx contraindicated in renal impairment

A
  1. Sulfonamide (long-acting)
  2. Tetracyclines
  3. Nitrofurantoin
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14
Q

Dosage adjustment needed in hepatic impairment

A
  1. Z-Pack

2. Clindamycin

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15
Q

List penicillinase-susceptible abx (narrow spectrum)

A

Penicillin VK

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16
Q

List penicillinase-resistant abx

A

Nafcillin: S. aureus

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17
Q

List a wider spectrum abx that is +/- penicillinase

A

Amoxicillin

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18
Q

What additional microorganisms are covered by Amoxicillin, but not by PCN?

A

Gram negatives: H.influenza

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19
Q

How is PCN cleared?

A

Renally

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20
Q

What PCN are biliary cleared?

A

Ampicillin

Nafcillin

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21
Q

PCN adverse side effects

A
  1. Hypersensitivity rxs: angioedema

2. Maculopapular rash: Ampicllin

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22
Q

What organisms do narrow spectrum PCN cover?

A
  1. Streptococcal infections

2. Staphyloccocal infections

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23
Q

What organisms do wider spectrum PCN cover?

A

Greater activity vs. gram (-) bacteria

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24
Q

What cephalosporin crosses the blood brain barrier and are used for CNS infections?

A

3rd generation: Ceftriaxone

-Treat meningitis

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25
Q

What generation has partial cross-reactivity with PCN?

A

First generation: Cephalexin

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26
Q

What cephalosporin is not given to newborns and why?

A

Ceftriaxone (Rocephen)

-Cleared by biliary tract, newborns don’t have this ability yet

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27
Q

First generation cephalosporin name and clinical use

A

Cephalexin:

  1. Skin
  2. Soft tissue
  3. UTI
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28
Q

Second generation cephalosporin name and clinical use

A

Cefuroxime:
More active against:
1. S. pneumoniae
2. H. Influenza

29
Q

What cephalosporin has remained susceptible to Gonorrhea since the Vietnam War?

A

Ceftriaxone

30
Q

Fourth generation clinical use

A

Pseudomonas coverage

31
Q

Fifth generation clinical use

A
  1. Community acquired pneumonia

2. MRSA

32
Q

What monobactam has no cross-allerginicity with beta-lactams?

A

Aztreonam

33
Q

What is the go to drug for MRSA and PRSP strains?

A

Vancomycin

34
Q

How would you administer Vancomycin for systemic infections?

A

Parenteral

35
Q

What is effective against C. diff and how is it administered?

A

Vancomycin

ORALLY!!!!!

36
Q

Red neck or red man syndrome

A

erythematous rash on face and upper body from giving the vancomycin infusion too quickly

37
Q

Daptomycin gram positive activity

A
  1. Endocarditis
  2. Sepsis
  3. MSSA and MRSA coverage
38
Q

Daptomycin off-tabled use?

A
  1. Osteomyelitis

2. Prosthetic joint infections

39
Q

Daptomycin unique toxicity?

A

Myopathy

-Monitor creatinine pho shop-kinase (CPK) weekly

40
Q

Tetracycline (Doxycycline) MOA

A
  • Inhibits bacterial protein synthesis
  • Binds 30s subunits of transcription/translation
  • Bacteriostatic
41
Q

Tetracycline (Doxycycline) activity spectrum

A
  1. Chlamydial
  2. Mycoplasma: “walking pneumonia”
  3. Rickettsiae
  4. Spirochetes (Lyme disease)
42
Q

Why don’t we want to give Tetracycline (Doxycycline) to a child under 8 y.o. or a child developing in pregnancy?

A

Deposits in developing bones and teeth

43
Q

What does Brubaker recommend you take with Tetracycline (Doxycycline)? Why?

A

Cola: Natural anti-emetic effect

44
Q

A unique adverse side effect of Tetracycline (Doxycycline)?

A

Photosensitivity- Wear sunblock

45
Q

Macrolides MOA

A
  1. Inhibit bacterial protein synthesis

2. Bacteriostatic

46
Q

Why do Macrolides cause diarrhea?

A

Prokinetic effect= Increases GI motility

47
Q

Erythroymycin (Z-pack) side effects

A
  1. QT prolongation
  2. CYP450 inhibition (not azithromycin)
  3. Resistance gaining
48
Q

Macrolides activity spectrum

A
  1. Community acquired pneumonia
  2. Pertussis
  3. Diptheria
  4. Chlamydial
49
Q

What abx has the highest INCIDENCE of C.diff?

A

Clindamycin (lincosamides)

50
Q

What has the highest PREVALENCE of C. diff?

A

Amoxicillin

Cephalosporins

51
Q

What is unique about Clindamycin (lincosamides)

A

Anaerobic infections=diaphragm up

52
Q

What can cause dose-related anemia (aplastic anemia) requiring a bone transplant?

A

Chloramphenicol

53
Q

Chloramphenicol activity spectrum

A
  1. Tx of serious infections due to organisms resistant to less toxic abx
  2. Active against Vancomycin-resistant enterococci (VRE) **
54
Q

Gray baby syndrome

A

Adverse rxn of Chloramphenicol

  • Circulatory collapse
  • Cyanosis
  • Acidosis
55
Q

What abx causes Serotonin Syndrome with SSRIs?

A

Oxazolidinone (Linezolid)

Often with dosage adjustment

56
Q

Oxazolidinone (Linezolid) activity spectrum

A
  1. MRSA
  2. PRSP
  3. VRE strains
57
Q

What is a great example of empirical abx therapy drug combo?

A

Aminoglycosides + Beta-Lactams

58
Q

List the aminoglycosides

A
  1. Gentamycin

2. Tobamyccin

59
Q

aminoglycosides ADE’s

A
  1. Ototoxicity (irreversible)
  2. Neuromuscular blockade**
  3. Nephrotoxicity (reversible)
60
Q

Who do we give high dose folic acid to?

A

Spinal tubal defects

61
Q

“Sequential blockade” in Sulfonamides with Trimethoprim

A

Combination is bactericidal

-Synergistic inhibition of folic acid synthesis

62
Q

What is the dosing based on in TMP-SMZ?

A

trimethoprim component

63
Q

TMP-SMZ (Bactrim) Acitivity spectrum

A
  1. UTI

2. MSSA or MRSA (skin/soft tissue infections)

64
Q

What stage of pregnancy should TMP/SMX be avoided?

A

Frist trimester

-This is when the spinal tube is forming

65
Q

List the Quinolones and uses of each

A
  1. Ciprofloxacin- UTIs

2. Levofloxacin- “respiratory”

66
Q

In what neuromuscular disease should quinolones be avoided?

A

MYASTHENIA GRAVIS and Neuromuscular blockers before surgery

67
Q

Other ADE’s of Quinolones (many, she hates this drug)

A
  1. CNS effects**
  2. Achilles tendinitis**
  3. Neuromuscular-blocking activity
68
Q

What does an antibiogram provide?

A
  1. Info about local resistance patterns

2. Can be used to determine empiric tx options

Pharmacology (9 decks)

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