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Evan's Step 1 Prep Material > Anti-Bacterials EC > Flashcards

Anti-Bacterials EC Flashcards

1
Q

Penicilin (MOA, Use, Tox, Resistance)

A

Bind transpeptidases and inhibit cross-linking of peptidoglycan (pen.G=IV/IM, pen.V=oral)

Gram +’s (S. pneumo, S. pyogenes, Neisseria meningitidis, Treponema pallidum)

Hypersensitivity, Hemolytic anemia

Beta-lactamases cleave

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2
Q

Oxacillin, Nafcillin, Dicloxacillin (MOA, Use, Tox, Resistance)

A

Same as penicillin.
Narrow spectrum; penicillinase resistant because bulky R group blocks

S. aureus (except MRSA;altered PBP)
“USE NAF FOR STAPH”

Hypersensitivity reactions, Interstitial nephritis

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3
Q

Ampicillin, Amoxicillin (MOA, Use, Tox, Resistance)

A

Same as penicillin
Wider spectrum: also combine with clavulanic acid to protect against beta lactamase

“amOxicillin has greater Oral bioavailability”

“ampicillin/amoxicillin HELPSS kill enterococci”
Penicillin +: H. influenzae, E. coli, Listeria, Proteus, Salmonella, Shigella

Hypersensitivity, Ampicillin rash, Pseudomembranous colitis

Beta lactamase + are resistant

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4
Q

Ticarcillin, Pipercillin

A

Same as penicillin
Extended spectrum

PSEUDOMONAS

Hypersensitivity reactions

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5
Q

Beta-lactamase inhibitors

A

“CAST”
Clavulanic Acid
Sulbactam
Tazobactam

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6
Q

Cephalosporins

A

Beta-lactam
Less susceptible to penicillinases

Toxicity:
Hypersensitivity, vit K deficiency, low cross-reactivity w/ pen., increased nephrotoxicity of aminoglycosides

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7
Q

1st generation cephalosporins

A

PH in name (except ceFAZolin “don’t let that FAZe you”)
Cephalothin, Cephapirin, Cephradine, Cefazolin, Cephalexin

Great gram + coverage and Strep pneumo. Bad gram -
Proteus, E.coli, Klebsiella

Cefazolin prior to surgery to prevent S. aureus infections

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8
Q

2nd generation cephalosporins

A

Fam, Fa, Fur, Fox, Tea,
ceFAMandole, ceFaclor, ceFURoxime, ceFOXitin, cefoTEAtan

Good gram -, strep. pneumo, gram +
H. influenzae, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia

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9
Q

3rd generation cephalosporins

A

Great for gram -

Ceftriaxone-meningitis and gonorrhea
Ceftazidime-pseudomonas

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10
Q

4th generation cephalosporins

A

Cefepime- Pseudomonas

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11
Q

Aztreonam

A

MAGIC BULLET FOR GRAM NEGATIVE AEROBES

Monobactam resistant beta lactamase
Synergistic with aminoglycosides
No cross-allergy w/ penicillins

Penicillin allergic patients

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12
Q

Imipenem/Cilastatin, Meropenem

A

Imipenem- BROADEST SPECTRUM OF ANY

Always given with CILASTATIN (inhibits renal dehydropeptidase I- decreased inactivation of drug)

Wide spectrum

GI distress, skin rash, CNS toxicity (seizures)

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13
Q

Vancomycin

A

Inhibits cell wall peptidoglycan formation (binds D-ala-D-ala)

Gram + only: MRSA, enterococci, C. dif

Nephrotoxicity, Ototoxicity, Thrombophlebitis, Red-man syndrome

Change in D-ala-D-ala gives resistance

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14
Q

Chloramphenicol

A

Binds 50S ribosomal subunit and inhibits protein synthesis

Very wide spectrum (limited by tox.)
Bacterial meningitis
Rickettsial infection in children and preg. women (tetracycline usually first choice)

Bone marrow suppression (aplastic anemia)
Grey baby syndrome

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15
Q

Clindamycin

A

Binds 50S ribosomal subunit and inhibits protein synthesis

Wounds penetrating abdomen
Female genital tract
Toxo gondii
Toxic shock syndrome

Can cause pseudomenbranous colitis

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16
Q

Linezolid

A

Bind 50S ribosomal subunit and inhibit protein synthesis

Nocosomial pneumonia
Complicated skin/soft tissue infections
S. aureus pneumonia
MRSA and VRE

Bone marrow suppression

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17
Q

Macrolides (Erythromycin, Azithromycin, Clarithromycin)

A

Bind 50S ribosomal subunit and inhibit protein synthesis

Outpatient upper and lower respiratory tract infections
Atypicals (Legionella, Mycoplasma, Chlamydia)

Can prolong QT

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18
Q

Tetracycline, Doxycycline, Minocycline

A

Binds 30S subunits and inhibit protein synthesis

ODD BUGS
Rickettsia
Chlamydia 
Mycoplasma pneumoniae
E. histolytica
Spirochetes 
(Ance) 
Phototoxic dermatitis 
Renal/Hepatotoxicity 
FANCONI SYNDROME: ingestion of outdated drugs leads to renal tubule dysfunction
TERATOGENIC
Discolors teeth
19
Q

Aminoglycosides (Streptomycin, Gentamycin, Tobramycin, Amikacin, Neomycin)

A

Bind 30S subunits and inhibit protein synthesis

(Often given w/ penicillin b/c must pass through membrane)
Gram negative enterics
Yersinia pestis, Brucellosis, Mycobacterium tuberculosis

Ototoxicity
Renal toxicity
Neuromuscular blockade

20
Q

Spectinomycin

A

Binds 30S subunit and inhibit protein synthesis

Gonorrhea

21
Q

What is the treatment regimen forTB?

A 
Active infection:
Isoniazid
Rifampin
Pyrazinamide 
Ethambutol

Prophylaxis:
Isoniazid

” I Saw a Red Pyre burning the liver”

22
Q

Isoniazid (INH) (MOA, Use, Toxicity)

A

Decreases MYCOLIC ACID synthesis

TB solo prophylaxis
Part of TB treatment regimen

Hepatotoxicity
Neurotoxicity (can be avoided with vit. B6-pyridoxine)
Lupus

23
Q

Rifampin (MOA, Use, Toxicity)

A

Inhibits DNA-dependent RNA-polymerase

Part of TB treatment
Leprosy treatment (delays Dapsone resistance)
Meningococcal prophylaxis
Prophylaxis for contacts around H. influenzae B

Minor hepatotoxicity
Orange body secretions
Revs up P450 (OCPs, warfarin, hypoglycemics, corticosteroids, phenytoin less effective)

"4R's:
RNA polymerase inhibitor
Revs up P450s
Red/orange body fluids
Rapid resistance if used alone"
24
Q

Pyrazinamide (MOA, Use, Tox)

A

Unknown MOA

TB (rapidly bactericidal)

Hepatotoxicity (limits duration of use)
Hyperuricemia

25
Q

Ethambutol (MOA, Use, Tox)

A

Bind ARABINOSYLTRANSFERASE and decrease carb polymerization of cell wall

TB

Optic neuropathy (red-green color blindness) - reversible

26
Q

Mycobacterium avium treatment

A 
Treatment:
Azithromycin
Rifampin
Ethambutol 
Streptomycin

Prophylaxis:
Azithromycin

27
Q

Mycobacterium leprae treatment

A

Tuberculoid:
Dapsone
Rifampin

Lepromatous:
Dapsone
Rifampin
Clofazimine

28
Q

Fluoroquinolones (MOA, Use, Tox)

A

-FLOXACIN

Inhibit DNA GYRASE (bactericidal)

Gram - rods of urinary and GI tract (including pseudomonas)
Neisseria
Some gram +

Tendonitis, tendon rupture, myalgias.
Superinfections, rash, headache, dizziness.
QT prolongation

29
Q

Metronidazole (MOA, Use, Tox)

A

Form free radicals in bacterial cell and damages DNA

"GET GAP on the Metro"
Giardia
Entamoeba
Trichomonas
Gardnerella vaginalis
Anaerobes (Bacteriodes, C. dif)
h. Pylori (part of triple therapy)

Disulfiram-like reaction with alcohol

30
Q

Sulfamethoxazole (MOA, Use Tox)

A

PABA antimetabolite: inhibit DIHYDROPTEROATE SYNTHASE (bacteria must synthesize own folate)

Gram +
Gram - 
Nocardia
Chlamydia
UTI (w/ TMP)

Hemolysis in G6PD
Nephrotoxic
Displacement of drugs from albumin (warfarin!)

31
Q

Trimethoprim (MOA, Use, Tox)

A

Inhibits bacterial DIHYDROFOLATE REDUCTASE

UTIs (w/ SMX)
Shigella (w/ SMX)
Pneumocystis jirovecii (w/ SMX)

Megaloblastic anemia

32
Q

Meningococcal infection prophylaxis

A

Ciprofloxacin

Rifampin for kids

33
Q

Gonorrhea prophylaxis

A

Ceftriaxone

34
Q

Syphilis prophylaxis

A

Penicillin G

35
Q

Recurrent UTI prophylaxis

A

TMP-SMX

36
Q

Prophylaxis for endocarditis with surgical or dental procedure

A

Penicillins

37
Q

Prophylaxis for pregnant woman carrying group B strep

A

Ampicillin

38
Q

Prophylaxis of strep pharyngitis in child with prior rheumatic fever

A

Oral penicillin

39
Q

Prevention of postsurgical infection due to S. aureus

A

Cefazolin

40
Q

Prevention of gonococcal or chlamydial conjunctivitis in newborn

A

Erythromycin ointment

41
Q

Treatment of MRSA

A

Vancomycin

42
Q

Treatment of VRE

A

Linezolid and Streptogramins

43
Q

Antibiotics to avoid in pregnancy

A

SAFe Children Take Really Good Care

Sulfonamides (kernicterus)
Aminoglycosides (ototoxicity)
Fluoroquinolones (cartilage damage)
Clarithromycin (embryotoxic)
Tetracyclines (inhibited bone growth, discolored teeth)
Ribavirin (teratogenic)
Griseofulvin (teratogenic)
Chloramphenicol ("grey baby")

Evan's Step 1 Prep Material (72 decks)

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