Anti-bacterial Drugs Flashcards by Janine Bilono

MOA of beta lactam antibacterial agents

inhibits transpeptidation reaction that cross-links the linear peptidoglycan chain of the cell all

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DOC for syphilis, streptococcal, pneumococcal, meningococcal, , G+ bacilli, sipirochete infection

Penicillins

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antistaphylococcal or known as

Isoxazolyl Penicillin (Methicillin, Oxacillin, Nafcillin)

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Antimicrobial coverage of extended spectrum Penicillin (Ampicillin and Amoxicillin

HELPSE

H. Influenzae
E. coli
L. monocytogenes
Proteus mirabilis
Salmonella sp
Enterococci

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First Gen has coverage for Gram + and little Gram -. what are these gram negative organism that is covered

P.Ec.K
Psedumonas
Enterobacter
Klebsiella

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Diseases associated with Pseudomonas:

PSEUDOMONAS

Pneumonia
Sepsis
Ecthyma gangrenosum
UTI
DM
Mucopolysaccharidoses - Cystic and fibrosis
Osteomyelitis
Nosocomial infection - HAP and VAP
Skin Infection - burns and hot tub folliculitis

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Cephalosporin: Bactericidal or Bacteriostatic?

Bactericidal

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All Cephalosporin have renal excretion, except:

Cefoperazone and Ceftriaxone (3G)

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microbes covered by 2G cephalosporin?

HEN PEcK

H. influenzae
Enterobacter aerogenes
Neisseria spp

P. mirabilis
Ec. coli
K. pneumoniae

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DOC for gonorrhea?

Ceftriaxone and Cefixime

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3G cephalosporin with anti-pseudomonal property:

Cefoperazone - Ceftazidime

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Carbapenem active against Pseudomonas and Acinetobacter, except:

Ertapenem

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A drug describe as the silver bullet –> design for gram negative rods?

Aztreonam

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MOA of Clavulanic Acid?

Inhibits inactivation of Penicillins by bacterial beta lactamase

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Use of Vancomycin?

Serious infection: MRSA, sepsis, endocarditis, meningitis, Pseudomembranous colitis

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Common side effect of Vancomycin?

Red man syndrome

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Bacterial protein synthesis inhibitors:

AT CELLS

Aminoglycosides
Tetracyclines

Chloramphenicol
Erythromycin
Lincosamides
Linezolid
Streptogramins

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All bacterial protein synthesis inhibitors are Bacteriostatic, except:

Aminoglycosides - Streptogramins

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Common side effect of Chloramphenicol?

Gray baby syndrome

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MOA of Tetracycline?

Binds to 30s ribosomal subunit

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Drugs under class Macrolide?

Azithromycin
Erythromycin
Clarithromycin
Telithromycin
Roxithromycin

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All macrolide inhibit CYP450, except

Azithromycin

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Class of Clindamycin?

Lincosamides

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Drug that is against anaerobic infection ABOVE the diaphragm:

Clindamycin

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Drug that is against anaerobic infection BELOW the diaphragm:

Metronidazole

Most vestibulotoxic and nephrotoxic aminoglycosides?

Gentamicin and Tobramycin

Most Ototoxic Aminoglycoside

Kanamycin - Amikacin

DOC for Toxoplasmosis

Sulfadiazine-Pyrimethamine

MOA of Quinolones

Interferes in the bacterial DNA synthesis by inhibiting Topoisomerase II (DNA gyrase) in gram - and Topoisomerase IV in gram \+

1G of Quinolones and its coverage

Nalidixic acid - Cinoxacin - Rosoxacin - Oxolinic acid UTI

2G of Quinolones and its coverage

Ciprofloxacin - Ofloxacin - Norfloxacin - Lomefloxacin - Enoxacin Gram -, gram + cocci, Mycoplasma, Gonococci

3G Quinolones and its coverage

Levofloxacin, Gemi, Moxi, Spar, Grepa, Gati, Pazu, Tosu, Balo Streptococci and Enterococci

4G of Quinolones and its coverage

Trovafloxacin, Alatro, Pruli, Clina Anaerobes

Generation of Quinolones that are known as Respiratory Quinolones

Elimination of Quinolones is via kidney by tubular secretion, except

Moxifloxacin

Effect of 3G Quinolones in Cardio

prolongs QT (3G and 4G)

DOC for Amoebiasis, Giardiasis, Pseudomembranous colitis

Metronidazole

Which among the first line drugs of anti-mycobateria has a sterilizing agent?

Pyrazinamide

which among anti-TB drugs has the most hepatotoxic effect?

Pyrazinamide > Rifampin > Isoniazid

Drug that is most active against M. leprae

Dapsone

A Drug that prevents the neurotoxicity of Isoniazid?

Co-administering Pyridoxine (VIt B6)

Antifungal drugs that can be used in Fungal Meningitis?

Flucytosine. Amphotericin B cannot cross BBB.

Only Generation with ANAEROBE coverage

2 GEn

what are 2G cephalosporins that covers Anaerobes

CEFAMYCIN - Teta-Meta-Fox CefoTETAn CefoMETAzole CeFOXitine

Organisms that is covered by 3G cephalosporin

HENPEcK + SSS Serratia Salmonella Shigella

Penicillin rash is mediated by what hypersensitivity?

Delayed type Hypersensitivity (T cell mediated) occurs 72hrs

Best substitute for Allergic to Penicillin

Macrolide

Cephalosporin Beta lactam is attached to Dihydrothiazine ring =

7-aminocephalosporanic acid (7-ACA)

What is the Cyclic ring in beta lactam antibotics

Amide Cyclic Ring

Penicillin is attached to THIAZOLIDINE ring =

6-aminopenicillanic acid (6-APA)

most potent Ureidopenicillin

Piperacillin

Management for HA-MRSA

Vancomycin IV

Management for CA-MRSA

Clindamycin

type of drug interaction of beta lactam + beta lactam inhibitor

Potentiation

Carbapenem with Best coverage for Pseudomonas

Doripenem

DOC for ESBL infection

Carbapenem

Most epileptogenic Carbapenem

Imipenem

Ampicillin + Sulbactam

Sultamicillin

Amoxicillin + Clavulunic Acid

Co-amoxiclav

All beta lactamase inhibitor are parenteral,except:

Co-amoxiclav (oral)

2G with good activity against B. fragilis

Cefotetan Cefoxitin

Drug interaction of Ampicillin and Aminoglycoside

Synergistic

ALL 3G have penetrate BBB except

Cefoperazone Cefixime

3G with VERYGOOD CNS penetration

Ceftriaxone

3G with most active against Penicillin resistant S. pneumoniae

Ceftriaxone Cefotaxime

Drug that inhibits Dihydrofolate reductase in forming Tetrahydrofolic acid in Nucleic acid synthesis

Trimethoprim MTX

Target site of Vancomycin:

D-Ala-D-Ala terminus

DOC of Pseudomembranous colitis in Local setting

Metronidazole

Antibiotic with Cationic dtergent

Polymyxin B and Polymyxin E - reserved for MDR organism

All protein synthesis inhibitor are BACTERIOSTATIC, except:

Aminoglycoside (cidal)

ALL Aminoglycoside is given parenterally, except:

Neomycin - topical, oral

Drug for the management of Sternothrophomas maltophilia, Burkdolderia cepacia, P. jirovecii, T. gondi

Co-trimoxazole/ TMP-SMX

Quinolones that cover Anaerobic

Moxifloxacin (3G)

Quinolones that cover Pseudomonas

Ciprofloxacin (2G) Levofloxacin (3G)

All Quinolones can cause Hyperglycemia, except

Gatifloxacin -- hypoglycemia

Long acting Tetracycline

DoMino Doxycycline Minocycline

All Macrolide exhibit Time-dependent, except

Azithromycin

metabolic pathway in detoxifying Chloramphenicol

Glucoronidation reaction (phase II) enzyme: UDP-glucoronyl transferase

Drugs for MRSA and VRSA

LInezolid

-Mycin is derived from

Streptomyces

- micin is derived from

Micromniospora

All tetracycline is excreted in the bile and urine, except

Doxycycline -- biliary only

tetracycline + dairy products, divalent cations, Fe Ca, Mg, Al =

CHELATION/ Complex Formation

Drug that inhibits Dihydropteroate synthase in Nucleic acid synthesis

Sulfonamide

Sulfa drugs are C/I in patients with what biochemical disorder

G6PD deficiency --- hemolytic anemia

Commonly seen S/E in Metronidazole

Furry tongue Dry mouth Metallic taste GI irritation

Resistance of Rifampicin is cause by the mutation

mutation rpoB gene MC type of resistance in TB

ALL 1st line drug of TB are BACTERICIDAL, except

Ethambutol

TB Drugs with Sterilizing activity

Rifampicin Pyrazinamide

Antifungal with WIDEST antifungal spectrum

Polyene Amphoterecin B

ALL NRTIs needs phosphorylation prior to action, except

Tenofovir

Mode of release of Enveloped virueses

Exocytosis

Mode of release of Naked virueses

Cell lysis

DOC for malaria in pregnant patients

Quinidine

it causes Blackwater fever, Cinchonism

Quinine [C], Quinidine Gluconate

DOC for uncomplicated falciparum malaria in the Philippines

Artemether-Lumefantrine (Co-Artem)

DOC for asymptomatic cyst carriers of E.histolytica

Diloxanide, Furoate

DOC for Cryptosporidiosis

Nitazoxanide