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FA-Microbiology > Anti-microbial drugs special considerations*** > Flashcards

Anti-microbial drugs special considerations*** Flashcards

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1
Q

Which antimicrobial drug is assoc with hypersensitivity adn hemolytic anemia

A

Penicillin G, V

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2
Q

What is the primary cause of resistance of penicllin?

A

penicillinase in bacteria ( a type of beta-lactamase) cleaves beta-lactam ring

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3
Q

Which anti-microbial drug has its toxicity:

Hypersensitivity, rash, pseudomembranous colitis

A

Ampicillin, amoxicillin, (aminopenicllins, penicillinase-sensitive penicillins)

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4
Q

Which anti-microbial drug has its toxicity:

hypersensitivity rxn, and interstital nephritis

A

Dicloxacillin, Oxacillin, Nafcillin

penicillinase resistant-penicllinase)

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5
Q

Which anti-microbial has its toxicity:

hypersensitiivty rxn

A

Ticarcillin, piperacillin

(anti-pseudomonals)

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6
Q

Which anti-microbial drug has a toxicity:

  • inc nephrotoxicity of aminoglycosides
  • low cross reactivity with penicillins
  • vit K def
  • Hypersensitivity
A

cephalosporins (gen I, II, III, IV, V)

  • 1st gen: cefazolin, cephalexin
  • 2nd gen: cefoxitin, cefaclor, cefuroxime
  • 3rd gen: ceftriaxone, cefotaxime, ceftazidime
  • 4th gen: cefepime
  • 5th gen: ceftaroline
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7
Q

What is aztreonam used for?

What is the toxicity of aztreonam?

A
  • a monobactam, G- rods only (resistant to beta-lactamase)
  • usually nontoxic, GI
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8
Q

which anti-microbial has toxicity:

GI distress, skin rash, CNS toxicity (seizures), at high plasma levels.

A

Carabpenems

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9
Q

What are carbapenems used for?

A

Wide spectrum, G+ cocci, G- rods and anaerobes

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10
Q

Imipenenem (class: carbapenems)

  • What is its MOA
  • What is it always admin w/_ _ (define moa) and why?
A
  • broad spectrum beta-lactamase (resistant carbapenem)
  • Cilastatin
    • MOA: inhibitor of renal dehydropeptidase I
    • dec inactivation of drug in renal tubules

‘With imipenem, the killin’ is lastin’ with cilastatin’

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11
Q

Which anti-microbial drug is assoc w/ the following toxicity:

Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing

how do you deal with diffuse flushing (aka red man syndrome)

A
  • Vancomycin
  • pretreatment w/antihistamines adn slow infusion rate
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12
Q

What is the mechanism of resistance:

Vancomycin

A
  • Occurs in bacteria via amino acid modification of D-ala D-ala to D-ala D-lac.

Pay back 2 D-alas (dollars) for vandalizing (vancomycin)

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13
Q

Whichi antimicrobial is assoc w/the following toxicity:

(Name class and give ex)

  • Nephrotoxicity (especially when used with cephalosporins)
  • Neuromuscular blockade
  • Ototoxicity (especially when used with loop diuretics
  • Teratogen
A

aminoglycosides

  • Tobramycin
  • Amikacin
  • Neomycin
  • Gentamycin
  • Streptomycin
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14
Q

Which antimicrobial is assoc w/the following toxicity:

  • Discoloration of teeth
  • Contraindicated in pregnancy
  • Photosensitivity
  • Inhibition of bone growth in children
  • GI distress
A

Tetracycline

DC PIG

  • Tetracycline
  • Doxycycline
  • minocycline
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15
Q

Tetracyclines

mechanism of resistance is what?

A
  • Dec uptake of inc efflux of bacterial cells by plasmid encoded transport pumps!!!
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16
Q

Which antimicrobial is assoc w/the following toxicity:

  • Motility issues
  • Arrhythmia caused by prolonged QT
  • acute Cholestatic hepatitis
  • Rash
  • eOsinophilia
A

Macrolides

  • Azithromycin
  • Clarithromycin
  • Erythromycin
17
Q

Macrolides

  • define the MOA
  • define the MOR
A
  • MOA
    • inhibits protein synthesis
      • by blocking translocation (macroslides)
    • bind to the 23S rRNA of the 50S ribosomal subunit.
    • Bacterostatic
  • MOR
    • methylation of 23S rRNA-binding site prevents binding of drug
18
Q

Which antimicrobial is assoc w/ the following toxicity:

  • Anemia (dose-dependent)
  • aplastic anemia (dose-dependent)
  • gray baby syndrome (define what it is)
A
  • Chloramphenicol
  • Gray baby syndrome: in premature infants b/c they lack liver UDP-glucoronyl transferase.
19
Q

Which antimicrobial is assoc w/ the following toxicity:

  • pseudomembrane colitis (C. difficle overgrowth)
  • fever
  • diarrhea
A

Clindamycin

20
Q

Chloramphenicol

  • define the MOA
  • define the MOR
A
  • MOA: blocks peptidyltransferase at 50 S ribosomal subunit
  • MOR: plasmid encoded acetyltransferase inactivates the drug.
21
Q

Which antimicrobial is assoc w/ the following toxicity:

  • Hypersensitivity rxns
  • Hemolysis of G6PD def
  • Nephrotoxicity (tubulointerstitial nephritis)
  • Photosensitivity
  • Kernicterus in infants
  • Displace other drugs from albumin (e.g. warfarin)
A

Sulfonamides

  • SMX (sulfamethoxazole)
  • Sulfisoxazole
  • Sulfadiazine
22
Q

Sulfonamides

  • define the MOA
  • define the MOR
A
  • MOA: inhibit folate syntehsts
    • neg on Dihydropteroate synthase
    • no PABA–> Dihydropteroic acid
  • MOR: Altered enzyme (bacterial dihydropteroate synthase) dec uptake, or inc PABA synthesis.
23
Q

Which antimicrobial is assoc w/ the following toxicity:

  • Megalobasltic anemia
  • leukopenia
  • granulocytopenia (how may it be aleviated?)
A
  • Trimethoprim
  • supplemental folinic acid
24
Q

Which antimicrobial is assoc w/ the following toxicity:

  • GI stress, superinfections, skin rashes, headache, dizziness
  • Less commonly, can cause tendonitis, tendon rupture, leg cramps, and myalgias
  • Contraindicated in preganat women, nursing mothres, and children under 18 yo due to possible damage to cartilage.
  • Some may cause prolonged QT interval
  • May cause tendone rupture in people >60 yo and in patients taking prednisone.
A

Flurorquinolones

  • oxacin and nalidixic acid (quinolone)
  • Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, sparfloxacin, moxifloxacin, gemifloxacin, enoxacine
25
Q

Fluoroquinolones

  • Define the MOA
  • Define the MOR
A
  • MOA: Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV.
    • Bactericidal
    • must not be taken with antiacids
  • MOR: Chromosome-encoded mutation in DNA gyrase, plasmid mediated resistance, efflux pumps
26
Q

Which antimicrobial is assoc w/ the following toxicity:

  • Disulfiram-like rx (**define it) **w/alcohol
  • headache
  • metallic taste
A
  • Metronidazole
  • Disulfiram-like rx (severe flushing, tachycardia, hypotension)
27
Q

Which antimicrobial is assoc w/ the following toxicity:

Neurotoxicity, hepatotoxicity

what can be given to prevent neurotoxicity and other diseases?

A
  • Isoniazid (INH)
  • Pyridoxine (vit B6) can prevent neurotoxicity
    • can prevent other diseases assoc with drug such as lupus.
28
Q

Which antimicrobial is assoc w/ the following toxicity:

  • Minor hepatotoxicity and drug interactions (p450)
  • Orange body fluids (nonhazardous se)

Which drug is favored over with in pts w/HIV infection due to less cytochrome P-450 stimulation?

A

Rifamycins (Rifampin, Rifabutin)

  • Rifabutin is favored over rifampin
29
Q

Which antimicrobial is assoc w/ the following toxicity:

Hyperuricemia, hepatotoxicity

A

Pyrazinamide

30
Q

Which antimicrobial is assoc w/ the following toxicity:

optic neuropathy (red-green color blindness)

A

Ethambutol

FA-Microbiology (38 decks)

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