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Anti microbial Flashcards

1
Q

Penicillin

A

tx: GRam + bacteria
neisseria meningitis
affects cell wall by inhibiting Dala-Dala
sensitive to beta lactamases

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2
Q

What are the side effects of penicillin

A

Type 1 hypersensitivity
autoimmune hemolytic anemia
interstitial nephritis

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3
Q

Nafcillin, Oxacillin,Methicillin, Dicloxacillin

A

tx. resistant strains of gram + bacteria

bind to PBP and decrease cell wall synthesis

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4
Q

Cephalxin, cefazolin

A

1st generation
tx: gram +
pharyngitis
surgical prophylaxis

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5
Q

Cefuroxitime, cefoxetan, cefoxitin

A

2nd generation
extended gram - coverage
tx: HEN h.flue, neisseria, serratia

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6
Q

Ceftriaxone, cefuxtaxime, cefaxidime

A

3rd generation
gram + and -
given IV crosses BBB
tx; meningitis, h.flu, pneumonia, pseudomonas ,strep viridian’s, lyme disease, gonorrhea

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7
Q

Cefaprime

A

4th generation
broad spectrum
tx: pseudomonas , meningitis

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8
Q

Ceftarline

A

5th generation
broad spectrum
tx: MRSA

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9
Q

What are the side effects of cephalosporins

A

interstitial nephritis
hemolytic anemia
hypersensitivity

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10
Q

Monoobactem, aztreonam

A 
tx: pseudomona
anaerobic bacteria 
meningits
sepsis 
 best for penicillin allergies 
are beta lactase resistant
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11
Q

Carbapenem

A 
"penem" 
 broad spectrum 
tx: pseudomona
pneumonia 
\+ & - bacteria
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12
Q

What is imepenem given with ?

A

cilastin

decreases the degradation by dehydropeptidase by the renal tubule

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13
Q

What are the side effects of carbapenem?

A

skin rash
GI upset
decrease seizure threshold

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14
Q

What drug class is resistant to extended spectrum betalactamases?

A

monobactam

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15
Q

Vancomycin

A

bind directly to DALA D-ALA to decrease cell wall synthesis
Given IV

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16
Q

What does vancomycin treat?

A 
meningitis 
hospital pneumonia 
MRSA
staph epidermis 
endocarditis 
enterococcus 
c. difficile
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17
Q

What are the side effects of vancomycin ?

A 
Red man syndrome (flushing based on histamine release)
thrombophlebitis 
otoxicity 
renal insufficiency 
DRESS syndrome 
Renal toxicity
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18
Q

Daptomycin

A

tx: gram +
staph: endocarditis
enterococcus
MRSA
depolarizes the cells–> decrease cell wall

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19
Q

What are the side effects of daptomycin ?

A

ineffective in pneumonia

myopathy

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20
Q

Tetracyclines

A

bind 30 s inhibiting translation
bacteriostatic
decrease Ca, Mg, Fe absorption
removed fecally

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21
Q

What are the side effects of tetracyclines ?

A 
tooth discolouration in young children 
teratogenic : deposits in teeth and bones 
Nausea , vomiting 
photosensitivity 
fanconi syndrome--> RTA type 2
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22
Q

What cause resistance to tetracyclines?

A

efflux pumps

altered ribosomes

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23
Q

Macrolides

A

“Mycin”
bind the 50s subunit decreasing translocation
bacteriostatic

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24
Q

What are the side effects of macrolide?

A

hepatitis
prolong QT–> torsade de point
P450 inhibitor

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25
Clindamycin
binds the 50s ribosome--> decreases translation tx: gram + and anaerobic oral infections endometriosis
26
What is the best drug for female genital tract illnesses ?
Gentamycin + clindamycin
27
What are the effects of clindamycin?
c. difficile . diarrhea
28
Chloramphenicol
binds to 50 s --> decrease translocation tx: meningitis, rickettesia mostly in 3rd world countries
29
What are the adverse effects of chloraphenicol ?
repressed production of RBC aplastic anemia grey baby syndrome
30
Linezolid
``` bind to 50 s subunit tx: MRSA VRSA resistant enterococcus hospital acquired pneumonia ```
31
What are the side effects of linezolid?
thrombocytopenia optic neuropathy peripheral neuropathy (stock & glove) serotonin syndrome
32
Aminoglycosides
bind to 30s ribosome unit bactericidal --> decrease ignition complex coupled with cell wall penetrating drug IV administration
33
Neomycin
remains active in GI 'used before surgery
34
Paromycin
used for parasitic GI infections
35
Streptomycin
gram - bacteria | especially pseudomonas
36
Amikacin
resistant free | best for pseudomonas
37
What are the side effects of aminoglycocides
ototoxicity teratogenic: deafness of the newborn acute tubular necrosis neuromuscular blockade
38
SXM - sulfamethoxazole
is a PABA analog that block dihydropteroate synthesis
39
TMP- trimethoprim
blocks dihydrofolate reductase
40
What does TMP- SMX treat?
``` UTIs acute prostatitis GI bacteria MRSA nocardia prophylaxis in pneumocystis jirevecii prophylaxis in CD <200 CD< 100 against toxoplasmosis ```
41
What are the side effects of TMP-SMX?
``` pancytopenia megoblastic anemia teratogenic in 1st trimerst--> neural tube defects sulpha allergy hemolytic anemia in G6PD renal tubular acidosis -type 4 interstitial nephritis photosensitivty kernicterus in last month of pregnancy Diplaces drug like warfarin --> increased bleeding inhibits P450 ```
42
Fluroquinolones
decrease topoisomerase - DNA gyrase --> decreased replication
43
Levofloxacin, Ciprofloxacin
``` tx; pseudomonas pyelonephritis UTI- complicated gastroenteritis salmonella osteomyelitis bacillis anthrasis walking pneumonia legionella ```
44
What are the side effects of fluoquinolones?
decrease absorption of Fe, Mg, Ca risk of prolonged QT nausea, vomiting, diarrhea Tendon and cartilage damage in elderly & those on steroids Teratogenic not recommended for children <10 yrs --> cartilage damage
45
Metronidazole
free radical metabolites that disrupt bacterial DNA
46
Metronidazole treats?
``` polymicrobial infections entamoeba histolytica Giardia Trichomonas - vaginits & cervivitis (given to pt & partner) C. difficile Anearobic bacteria Gardenella H.pylori ```
47
What is the side effect of metronidazole ?
Disulfram reaction with alcohol - metallic taste, flushing, nausea ,tachycardia)
48
Amphotericin
bind ergosterol that then cause holes and leakage of the cell given IV liposomal drug formation decreases toxicity intrathecal for CNS infections
49
Side effects of amphotericin
``` bind human cholesterol - headache & hypotension fever & chills CNS effects thrombophlebitis Renal tubule acidosis -type 1 hypokalcemia magnesium wasting volume expansion w IV normal saline before drug is given decreased EPO --> anemia ```
50
Flucytosine
cytosine deaminase converts flu cytosine into 5-fluoruacil --> halts DNA & RNA tx: cryptococcus
51
Nystatin
bind to ergosterol to form holes in cell membrane | tx; vaginal and oral candidiasis
52
Azoles
inhibit the conversion of lanosterol to ergosterol --> decrease ergosterol synthesis inhibitor of p450
53
Voriconazole
inhibit p450 tx; aspergillosis candida
54
Side effects of voriconazole
blurry vision - flashes of light | changes in colour vision
55
Fluconazole
tx; mucutaneous candida vaginal candid oral , stomatitis, esophagitis - candida cryptococcal meningitis
56
Itraconazole
dimorphic infections | tine infections
57
ketoconazole
tx: dermatophytosis inhibit cushings decrease androgenic effects
58
Side effects of ketoconazole
inhibit human cholesterol | inhibit 17, 20 desmolase--> decrease androgen & estrogens
59
Griseofulvin
bind fungal microtubules--> halting mitosis Cyp450 inducer tx: dermatophytic - especially keratin area
60
Terbinafine
tx: dermatophytis onychomycosis destroys the ergosterol increases squalene --> liver toxicity , diarrhea
61
Echinocandins
Capsofungin, micafungin, anidula fungin inhibit beta 1,3 glucan in the cell wall--> decreased polysaccharide synthesis tx: candida, invasive aspergillosis
62
NRTIs
competitive inhibit of reverse transcriptase-->missing 3' OH --> premature chain --> termination
63
What is required for nucleosides to be active ?
phosphorylation
64
What are the side effects of NRTIs ?
mitochondrial toxicity | lactic acidosis
65
Lamivudine
tx: hepatitis B SE: peripheral neuropathy
66
Tenofovir
nucleotide- does not need phosphorylation to be active | tx: hepatitis
67
Zidovudine
used in pregnancy & breast feeding to decrease vertical transmission
68
What are the side effects of zidovudine?
myelosuppression--> anemia , granulocytopenia | lipodystrophy
69
Stavudine
se: lipodystrophy | peripheral neuropathy
70
Didanosine
pancreatitis | increased peripheral neuropathy with other drugs
71
Abacavir
se: hypersensitivity associated with HLA B 57:01 allele --> type 4 rash
72
Emticitabine
SE: hyper pigmentation of palms and soles
73
Elfavirenz , Efavirenz, Delavirdine
"VIR" do not need phosphorylation bind allostericlly to reverse transcription --> chain termination
74
What are the side effect os NNRTIs
hepatotoxicity & jaundice after 6 weeks with drug CNS - dizziness, drowsiness , headache, psychosis teratogenic activate p450 steven johnson syndrome
75
Protease inhibitors
"NAVIR" ending inhibit cleavage of poly proteins dont need phosphorylization stop POL gene --> decreases proteases
76
Side effects of protease inhibitors
hyperglycaemia due to insulin dyslipidemia lipodystrophy
77
Indinavir
SE: nephroliathiasis
78
Ritonavir
greatest CYP 450 inhibition | can be given to increase concentration of other drugs that are metabolized by CYP450
79
What is the reaction between protease inhibitors and Rifampin
rifampin activates p450--> decrease concentration of protease inhibitors
80
Maraviroc
binds to CCR5
81
Enfuvirtide
bind gp41
82
Raltegravir
bind intergrase | SE: rhabdomyolysis
83
GAG structural gene code for ?
p24, p7
84
ENV structural gene codes for
proteins for inflation gp41, gp 120
85
POL gene encodes for
reverse transcriptase protease integrase

Pharmacology (15 decks)

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