Anitimicrobials Flashcards
BacteriCIDAL Antibiotics
Very Finely Proficient At Murder
Vancomycin Fluoroquinolones Penicillins Aminoglycosides Metronidazole
BacterioSTATIC Antibiotics
we’re ECSTaTiC about bacteriostatics!
Erythromycin Clindamycin Sulfamethoxazole Trimethoprim Tetracycline Chloramphenicol
Narrow spectrum penicillins
SE: hypersensitivity, GI upset
Penicillin V
Penicillin G
Penicillinase-resistant penicillins
SE: interstitial nephritis, neutropeniA
Methicillin
Extended spectrum penicillins
SE: pseudomembranous colitis
Ampicillin
Anti-pseudomonal penicillins
SE: hypertension, hypervolemia, and bleeding
Piperacillin
1st Generation cephalosporin
High bone penetration
surgical prophylaxis
greatest gram-positive coverage
SE: Hypersensitivity Reaction
Cefazolin
Cefadroxil Cefazolin Cephalotin Cephapirin Cephradine Cephalexin
2nd generation cephalosporin
added gram negative coverage
SE: Disulfiram reaction
Cefamandol Cefoxitin Cefuroxime Cefaclor Cefofetan
3rd generation ceohalosporin
Pseudomonas coverage
Commonly used as empiric therapy
SE: Disulfiram reaction
Cefoperazone (“ine” / “one”)
Ceftriaxone
Ceftazidime
Cefotaxime
Most efficacious cephalosporin for Pseudomonas aeruginosa
Ceftazidime
3rd gen ceph
4th generation cephalosporin
broad spectrum activity
(gram positive & gram negative)
Ceftaroline
Cefepime
cephalosporin has the best penetrance to the BBB?
Ceftriaxone
Microbes covered by 1st Gen cephalosporins
Proteus mirabilis
Escherichia coli
Klebsiella pneumoniae
First Generation Cephalosporins
Cefadroxil Cefazolin Cephalotin Cephapirin Cephradine Cephalexin
Microbes covered by 2nd Gen ceohalosporins
Haemophilus influenzae Enterobacter aerogenes Neisseria spp. Klebsiella pneumoniae Escherichia coli Proteus mirabilis Serratia marcescens
2nd Generation Ceohalosporins
Cefamandole Cefuroxime Cefoxitin Cefotetan Cefaclor Loracarbef Cefprozil Cefmetazole Cefonicid
Cephalosporins causing Disulfiram reaction
Cefamandole
Cefmetazole
Cefotetan
Cefoperazone
3rd Generation Cephalosporins
Cefetamet Cefpodoxin Cefoperazone Cefixime Ceftriaxone Ceftazidime Cefotaxime Ceftizoxime Ceftibuten
Anti-pseudomonal Cephalosporins
Ceftazidime
Cefepime
Cefoperazone
SILVER BULLET against gram negative bacteria
with anti-pseudomonal coverage
NO gram (+) coverage
Aztreonam
Beta lactamase inhibitor.
SE: Cholestatic jaundice
CAST
Clavulanic Acid
Avibactam
Sulbactam
Tazobactam
Drug of last resort, broad spectrum of activity
SE: CNS toxicity (confusion, encephalopathy, seizures)
Imipinem-Cilastatin
Treatment for MRSA
SE: Red man syndrome
Vancomycin
Which antibiotics are considered drug of last resort?
I AM Last Shot Victory
Imipinem Amikacin Meropenem Linezolid Streptogramins Vancomycin
Protein synthesis:
Binds to 50s Subunit
SE: Aplastic anemia, gray baby syndrome
Chloramphenicol (static)
Protein synthesis:
Binds to 30s subunit
SE: tooth enamel discoloration, photosensitivity
Tetracycline (static)
MOA: blocks the attachment of T-RNA to acceptor site
Protein synthesis:
Binds to 50s subunit
DOC for Penicillin-allergic patients
SE: diarrhea, cholestatic jaundice
Erythromycin (static)
Macrolides
Protein synthesis:
Binds to 50s subunit
highest volume of distribution — single dose administration
Azithromycin
Protein synthesis:
Binds to 50s subunit
anaerobic coverage
SE: pseudomembranous colitis
Clindamycin
Protein synthesis:
Binds to 50s subunit, Vancomycin-resistance
Linezolid (static)
Streptogramin— no effect on CY P450
For anaerobic infections ABOVE the diaphragm
Clindamycin
For anaerobic infections BELOW the diaphragm
Metronidazole
Aminoglycosides:
Bactericidal
binds to 30s subunit
treatment of endocarditis
SE: nephrotoxicity, ototoxicity
Gentamicin
Aminoglycosides:
Treatment of ocular infections
Tobramycin
Aminoglycoside used for Tuberculosis
Streptomycin
Aminoglycosides:
For drug-resistant gonorrhea
Spectinomycin
Aminoglycosides:
widest spectrum of activity
pseudomonas coverage
narrow therapeutic window
Amikacin
Aminoglycoside used for the treatment of hepatic encephalopathy.
Neomycin
SULFONAMIDES:
Blocks dihydroPTEROATE SYNTHASE
Sulfamethoxazole (static)
SULFONAMIDES:
Blocks dihydroFOLATE reductase
Trimethophrim
SULFONAMIDES:
Sequential blockade in folate synthesis
urinary tract infections
SE: hypersensitivity (SJS,TEN), kernicterus, hemolysis in patients with G6PD
TMP-SMX
Sulfonamide used in treatment of burn infections
SE: neutropenia
Sulfadiazine
2nd generation quinolone
treatment of urinary tract infections and GIT infections.
SE: tendinitis, tendon rupture
Ciprofloxacin
3rd generation quinolone
treatment of pulmonary infections
Levofloxacin
3rd generation quinolone
broad spectrum of activity
anaerobic coverage
treatment of ocular infections.
Moxifloxacin
3rd generation quinolone
SE: Diabetes mellitus
Gatifloxacin
3rd generation quinolone
SE: Cardiotoxicity
Grepafloxacin
4th generation quinolone
SE: hepatotoxicity
Trovafloxacin
Anaerobic and antiprotozoal coverage
treatment of urinary tract infections.
SE: Disulfiram reaction, metallic taste, neurotoxicity
Metronidazole
Treatment of UTI
SE: pulmonary fibrosis
Nitrofurantoin
ANTI-TB:
Cidal, inhibits mycolic acid synthesis
SE: neurotoxicity, hepatotoxicity, sideroblastic anemia, drug-induced lupus, potent CYP450 inhibitor
Isoniazid
ANTI-TB:
Cidal
inhibits DNA-dependent RNA Polymerase
SE: red orange urine, hepatotoxicity, CYP450 inducer
Rifampicin
ANTI-TB:
Static
inhibits arabinoglactan synthesis
SE: visual dysfunction
(retrobulbar neuritis, color blindness)
Ethambutol
ANTI-TB:
Static but cidal on actively dividing MTB
SE: hyperuricemia, hepatotoxicity (most)
Pyrazinamide
ANTI-TB:
Cidal, binds to 30s, IM
SE: neurotoxicity, ototoxicity
Streptomycin
Most active drug against M. Leprae, inhibits folate synthesis
SE: Methemoglobinemia, hemolysis in G6PD deficient patients
Dapsone
ANTI-LEPROSY:
Inhibits DNA-Dependent RNA Polymerase
SE: red-orange urine
delays onset of dapsone resistance
Rifampicin
ANTI-LEPROSY:
Phenazine dye
binds to guanine bases
SE: skin discoloration (red-orange)
Clofazimine ; cidal
ANTI-FUNGAL:
Most efficacious anti-fungal drug
forms artificial pores
Binds to ergosterol to produce pores
SE: nephrotoxicity (RTA), infusion related reactions
Amphotericin B
ANTI-FUNGAL:
Topical treatment of dermatophytosis and candidiasis
SE: gynecomastia, CYP450 inhibitor
Ketoconazole
ANTI-FUNGAL:
DOC for treatment and secondary prophylaxis of Cryptococcal meningitis
Fluconazole
ANTI-FUNGAL:
Interferes with fungal microtubules
SE: potent CYP450 inducer
Griseofulvin
ANTI-FUNGAL:
Treatment of candidiasis (oropharyngeal, esophageal, vaginal)
swish and swallow or suppository preparations.
SE: Nephrotox hence topical only
Nystatin
ANTI-VIRALS:
Treatment of HSV and VZV.
Requires activation by viral thymidine kinase
SE: Crystalluria
Acyclovir
ANTI-VIRALS:
Treatment of CMV.
Requires activation by viral thymidine kinase
Ganciclovir
ANTI-VIRALS:
Treatment of HSV, VZV, and CMV
DOES NOT require viral thymidine kinase activation
Foscarnet
Cidofivir
Foscarnet: SE: HYPOcalcemia
ANTI-VIRALS:
Prevents viral UNCOATING
influenza A coverage
SE: cerebellar dysfunction, livedo reticularis
Amantadine
ANTI-VIRALS:
Neuramnidase inhibitor
DOC for influenza
Oseltamivir
ANTI-VIRALS:
Treatment of Hepatitis B infection
Lamivudine
Entecavir
ANTI-VIRALS:
Treatment of Hepatitis C and RSV infection
Ribavirin
ANTI-RETROVIRAL:
Nucleoside reverse transcriptase inhibitor (NRTI)
(+) requires phosphorylation
PRIMARY drug for HIV
prevents vertical transmission of HIV
SE: lactic Acidosis
Zidovudine
ANTI-RETROVIRAL:
Non-nucleoside reverse transcriptase inhibitor (NNRTI)
NO phosphorylation required
SE: Hepatotoxicity
Delavirdine
ANTI-RETROVIRAL:
Protease inhibitor
SE: Fat redistribution Syndrome, hyperlipidemia, insulin resistance
Ritonavir
NAVIR (never) tease a protease
ANTI-RETROVIRAL:
Fusion inhibitor
Binds gp41 subunit
Enfuvirtide
ANTI-RETROVIRAL:
Binding inhibitor
CCR5 antagonist
Maraviroc
ANTI-RETROVIRAL:
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Never Ever Deliver nucleoside
Nevirapine
Efavirenz
Etravirine
Delavirdine
ANTI-MALARIAL:
Primary drug for malaria
prevents heme polymerization into hemozoin
SE: retinal damage (BOV) and hearing loss
Chloroquine
ANTI-MALARIAL:
Chloroquine-resistance
severe malaria
DOC for pregnant patients with malaria
SE: hypoglycemia, Blackwater fever, cinchonism (headache, tinnitus, vertigo)
Quinine
ANTI-MALARIAL:
Eradication of hypnozoites of P. Vivax and ovale
Produces free radicals
Primaquine
ANTI-MALARIAL:
Chemoprophylaxis (chloroquine-resistant areas)
Mefloquine
Malarone
ANTI-MALARIAL:
Chemoprophylaxis
For multi drug resistant areas
Doxycycline
ANTI-MALARIAL:
DOC in the Philippines (P. falciparum)
Co-Artem
ARTEMER
ANTI-PROTOZOAL:
Asymptomatic cyst carriers of E. Hystolitica
Diloxanide furoate
ANTI-PROTOZOAL:
DOC for Amebic dysentery, trichomoniasis, bacterial vaginosis.
SE: Disulfiram reaction
Metronidazole
ANTI-PROTOZOAL:
DOC for Cryptosporidium parvum infection
Nitazoxanide
Alternative: Paromomycin
ANTI-PROTOZOAL:
DOC for Pneumocystis jiroveci pneumonia
TMP-SMX
ANTI-PROTOZOAL:
DOC for Toxoplasmosis
Pyrimethamine - Sulfadiazine
ANTI-PROTOZOAL:
DOC for African sleeping sickness
Melarsoprol + Suramin
ANTI-PROTOZOAL:
DOC for Chagas disease
Nifurtimox
ANTI-PROTOZOAL:
DOC for Leishmaniasis
Sodium stibogluconate
ANTI-HELMINTHS:
Inhibits helminthic microtubules, ovicidal
DOC for Whipworm (Trichuris tri)
Mebendazole
ANTI-HELMINTHS:
Inhibits helminthic microtubules
BOTH ovicidal and larvicidal
DOC for hydatid disease (echinococcosis)
Albendazole
ANTI-HELMINTHS:
DOC for Filaria and Loa loa
SE: filarial fever
DEC
ANTI-HELMINTHS:
DOC for Strongyloides and onchocerca
SE: Mazzotti reaction
Ivermectin
ANTI-HELMINTHS:
DOC for Enterobius
Pyrantel Pamoate
ANTI-HELMINTHS:
DOC for trichinosis
Thiabendazole
ANTI-HELMINTHS:
DOC for trematodes and cestodes EXCEPT echinococcosis (Albendazole)
Praziquantel
ANTI-HELMINTHS:
Back-up drug to Praziquantel
Niclosamide