Anti-Bac

Question 1

erythromycin

Answer 1

Class: macrolide
Gen: 1
MOA: 50s ribosomal INH, blocks translocation
Resistance: ribosomal methylation or mutation of 23S rRNA (part of 50s ribo) = active efflux (pumps drug out of cell, allowing protein synthesis)
AE: CYP INH, jaundice, QT prolongation
Organisms: Legionella*

Question 2

azithromycin

Answer 2

Class: macrolide
Gen: 3
MOA: 50s ribo INH, blocks translocation
Resistance: ribosomal methylation or mutation of 23S rRNA (part of 50s ribo) = active efflux (pumps drug out of cell, allowing protein synthesis)
AE: jaundice, QT prolongation

Question 3

doxycycline

Answer 3

Class: tetracycline
MOA: 30s ribo INH, blocking protein synthesis
Resistance: decreased entry in cell & increased efflux from target insensitivity
AE: discolored teeth, photosensitivity, decrease bone growth
Pregnancy: detrimental on fetal skeleton dev. & bone growth

Question 4

levofloxacin

Answer 4

Class: flurooquinolone
MOA: DNA topoisomerase II INH, prevent DNA replication
Resistance: mutation of DNA topo II, active efflux
AE: children: cartilage damage, adults: tendon rupture
Renal Impairment: ADJUST
Pregnancy: decrease fetal wt & increased fetal mortality

Question 5

amoxicllin + clavulanic acid

Answer 5

Class: penicillin
MOA: blocks cell wall cross-linking
Resistance: beta-lactamase inactivate drugs, altered PBPs (penicillin binding proteins) = target insensitivity
AE: penicillin cross-reactivity of allergy, maculopapular rash
Renal Impairment: ADJUST

Question 6

piperacillin + tazobactam

Answer 6

Class: penicillin
MOA: blocks cell wall cross-linking
Resistance: altered PBPs (penicillin binding proteins) = target insensitivity, beta-lactamase inactivates drug
AE: decrease coagulation
Renal Impairment: ADJUST
Breastfeeding: diarrhea, skin rash, candidiasis

Question 7

meropenem

Answer 7

Class: carbopenem
MOA: blocks cell wall cross-linking
AE: seizures
Renal/Biliary Impairment: ADJUST

Question 8

cefazolin

Answer 8

Class: cephalosporin
Gen: 1
MOA: inhibit cell wall cross-linking
Resistance: decreased permeability of gram - outer membrane, active efflux
AE: cross-reactivity within cephalosporin
Renal Impairment: ADJUST

Question 9

cefuroxime

Answer 9

Class: cephalosporin
Gen: 2
MOA: inhibit cell wall cross-linking
Resistance: decreased permeability of gram - outer membrane, active efflux
AE: cross-reactivity within cephalosporin

Question 10

ceftriaxone

Answer 10

Class: cephalosporin
Gen: 3
MOA: inhibit cell wall cross-linking
Resistance: decreased permeability of gram - outer membrane, active efflux
AE: cross-reactivity within cephalosporin

Question 11

ceftazidime

Answer 11

Class: cephalosporin
Gen: 3
MOA: inhibit cell wall cross-linking
Resistance: decreased permeability of gram - outer membrane, active efflux
AE: cross-reactivity within cephalosporin
Renal Impairment: ADJUST

Question 12

cefepime

Answer 12

Class: cephalosporin
Gen: 4 (used with gram+ and -)
MOA: inhibit cell wall cross-linking
Resistance: active efflux
AE: cross-reactivity within cephalosporin
Renal Impairment: ADJUST

Question 13

gentamicin

Answer 13

Class: aminoglycoside
MOA: 30s ribo INH
Resistance: drug inactivation by amino glycoside modifying enzyme, decreased permeability of gram - outer membrane, active efflux, ribo methylation
AE: nephrotoxicity, ototoxicity, neuromuscular paralysis
Renal Impairment: ADJUST
Pregnancy: bilateral deafness
Organisms: gram - rod

Question 14

clindamycin

Answer 14

Class: lincosamide
MOA: 50s ribo INH, blocks translocation
Resistance: methylation of binding site, enzymatic inactivation
AE: hepatotoxicity, renal toxicity, cardiac arrest
Organisms: anaerobe (H. influenza)

Question 15

vancomycin

Answer 15

Class: glycopeptide
MOA: inhibit cell wall syn
Resistance: rare (used as empirical tx until cause can be found)
AE: nephrotoxicity, ototoxicity, Red Man’s Syndrome
Organisms: gram +