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Infectious Disease (OSI type) > Antibacterial > Flashcards

Antibacterial Flashcards

1
Q

What is the mechanism of action of beta-lactam antibiotics?

A

Inhibits transpeptidation

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2
Q

What is the mechanism of action of action of penicillin resistance in beta-lactams?

A

hydrolyze beta lactam ring by lactamases

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3
Q

What is the mechanism of action of penicillin resistance of pseudomonas?

A

change in porin structure in outer cell wall

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4
Q

What drug inhibits renal tubular reabsorption of penicillin?

A

probenecid

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5
Q

What are examples of long acting intramuscular preparations of penicillin?

A

Benzathine Penicillin and Procained Penicillin

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6
Q

What drug is given together with penicillin to exhibit an increased activity agains enterococci?

A

Aminoglycoside

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7
Q

Drugs that are anti-staphylococcal?

A 
Cloxacillin
Oxacillin
Nafcillin
Dicloxacillin
Methicillin
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8
Q

Anti-staphylococcal drug that exhibits biliary clearance

A

Methicillin

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9
Q

Penicillin that are resistant to beta lactamase inhbitiion

A

Isoxazoyl penicillin

Cloxacillin
Oxacillin
Nafcillin
Dicloxacillin
Methicillin
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10
Q

An extended penicillin that can cause pseudomembranous colitis and rash

A

Ampicillin

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11
Q

Extended penicillins that undergoes enterohepatic recirculation

A

Ampicillin

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12
Q

Extended penicillin that is inactivated by beta-lactamase inhibitors

A

Ampicillin, Amoxicillin

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13
Q

Drugs that are susceptible to extended spectrum penicillin

A

HELPS

Haemophilus influenzae
Escherichia coli
Listeria monocytogenes
Proteus mirabilis
Salmonella sp
Enterococci
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14
Q

Examples of antipseudomonal penicillins

A
  1. Carbenicillin
  2. Piperacillin
  3. Ticarcillin
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15
Q

Penicillins with greater activity agains gram negative infections

A
  1. Carbenicillin
  2. Piperacillin
  3. Ticarcillin
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16
Q

Penicillins that has a greater activity to pseudomonas, enterobacter and Klebsiella

A
  1. Carbenicillin
  2. Piperacillin
  3. Ticarcillin
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17
Q

Examples of antipseudomonal penicillins that are inactivated by penicillinase

A
  1. Carbenicillin
  2. Piperacillin
  3. Ticarcillin
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18
Q

These antipseudomonal penicillins has synergistic effect when combined with?

A

aminoglycosides

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19
Q

Different diseases associated with pseudomonas?

A 
Pneumonia
Sepsis
Ecthyma gangrenosus
UTI
DM
Otitis externa
Mucopolysaccharidoses - cystic fibrosis
Osteomyelitis
Nosocomial infections
Skin Infection
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20
Q

What are your first generation cephalosporins?

A 
Cefadroxil
Cefazolin
Cephalothin
Cephapirin
Cepharadine
Cephalexin

FADer, help me FAZ my PHarmacology boards

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21
Q

Indications for 1st generation cephalosporin

A
  1. Surgical prophylaxis
  2. Bone infections
  3. Skin and soft tissue infections
  4. UTI
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22
Q

Combining 1st generation cephalosporin and aminoglycosides can increase?

A

Nephrotoxicity

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23
Q

First generation cephalosporins are effective against?

A

PEK

Proteus mirabilis
Escherichia coli
Klebsiella pneumoniae

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24
Q

What are your second generation cephalosporins?

A

Cefamandole
Cefoxitin
Cefuroxime
Cefotetan

Foxy cousin wearing a Fur coat and drinking TEA

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25
Q

Second generation cephalosporins are effective agains what microorganisms?

A

Haemophilus
Proteus mirabilis
Escherichia coli
Klebsiella pneumoniae

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26
Q

This second generation cephalosporin has an improved action agains pneumococcos and H. influenza

A

Cefuroxime

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27
Q

This second generation cephalosporin has a good activity agains B. fragilis (used for abdominal and pelvic infections

A

Cefotetan and Cefoxitin

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28
Q

[What generation is this]

Cefaclor
Loracarbef
Cefprozil
Cefmetazole
Cefonicid
A

2nd generation

FAC LORA the PROfessional AZhOLE is still on the FONe

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29
Q

What are your third generation cephalosporins?

A

CefoTAXime
CefoPERAzone
CeftaziDIME

CefTIZOxime
CeFIXime
CefTRIAxone

Cefpodoxime proxetil
Cefnidir
Cefditoren pivoxil
Ceftibuten
Moxalactam
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30
Q

This generation of cephalosporin has a decreased gram positive coverage, and increased gram negative activity

A

Third generation

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31
Q

What cephalosporins are used for gonorrhea?

A

Ceftriaxone

Cefixime

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32
Q

What generation of cephalosporins are useful for pseudomonas, bacteroides, providencia, serratia?

A

third generation

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33
Q

Which third generation cephalosporin have renal excretion?

A

Cefoperazone

Ceftriaxone

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34
Q

Which third generation cephalosporin CANNOT cross the BBB

A

Cefoperazone

Cefixime

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35
Q

Which third generation cephalosporin are the most active against penicillin-resistant S. pneumoniae

A

Ceftriaxine

Cefotaxime

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36
Q

Which third generation cephalosporin are commonly used agains bacteroides?

A

Ceftizoxime

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37
Q

Which third generation cephalosporin has a good CNS penetration?

A

Ceftriaxone

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38
Q

What are your fourth generation cephalosporins?

A

Ceftaroline
Cefpiro
Cefepime

Taro, Piro, Fepi

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39
Q

These cephalosporins have a wide coverage against gram positive and gram negative bacteria

A

Third generation

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40
Q

What fourth generation cephalosporin can be used for MRSA

A

Ceftaroline

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41
Q

What are you anti-pseudomonal cephalosporins?

A

Ceftazidime
Cefepime
Cefoperazone

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42
Q

A novel cephalosporin, combined with tazobactam, used for the treatment of complicated urinary tract infections and itraabdominal infections

A

Ceftolozone

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43
Q

a carbapenem inhibits the renal metabolism of imipinem

A

cislastated

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44
Q

Which carbapenem has no activity agains pseudomonas and acinetobacter

A

Ertapenem

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45
Q

What renal enzyme metabolize imipenem?

A

dihydropeptidase

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46
Q

A monobactam used to treat Klebsiella, Pseudomonas, Serratia

A

Aztreonam

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47
Q

Which beta-lactamase inhibitor is not a good inhibitor of inducible chromosomal B lactamase (enterobacter, Pseudomonas, Serratia)

A

Sulbactam

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48
Q

Glycopeptides inhibit cell wall synthesis by binding to___

A

D-Ala-D-Ala terminus; prevents elongation and cross-linking

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49
Q

Which drug class will you use for drug-resistant, gram positive organisms?

A

Glycopeptide

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50
Q

What are your glycopeptide?

A

Vancomycin
Teicoplanin
Dalbavancin
Telavancin

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51
Q

How will you manage red man syndrome?

A

Slow the rate of infusion

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52
Q

Glycopeptides that are used for bacterial enterocolitis

A

Teicoplanin
Televancin

since they are not absorbed in the GIT

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53
Q

Among the glycopeptides, which has the longest half life?

A

Dalbavancin

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54
Q

What drugs are considered to be drugs of last resort?

A 
Imipenem
Amikacin
Meropenem
Linezolid
Streptogramins
Vancomycin
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55
Q

___ is a peptide antibiotic that interferes with a late stage in cell wall synthesis in gram positive organism

A

bacitracin

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56
Q

___ blocks incorporation of D-ala into pentapeptide side chain of the peptidoglycan

A

cycloserine

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57
Q

An agent used as a second-line agent in TB

A

cycloserine

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58
Q

___ binds to the cell membrane causing depolarization and rapid cell death

A

daptomycin

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59
Q

Daptomycin cant be used against pneumonia since it is inactivated by ____

A

pulmonary surfactants

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60
Q

___ acts on the cell wall by inactivating UDP-N-acetyglucosamine-3-enol pyruvyltransferase thereby preventing formation of NAM

A

fosfomycin

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61
Q

A 50s protease inhibitor that is a backup drug for salmonella, Rickettsia and bacteroides

A

Chloramphenicol

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62
Q

a 50s protease inhibitor that can cause idiosyncratic aplastic anemia and gray baby syndrome

A

Chloramphenicol

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63
Q

Chloramphenicol is bactericidal to these microorganisms

A
  1. H. influenza
  2. Neisseria
  3. Bacteroides
  4. S. pneumoniae
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64
Q

Gray baby syndrome is due to a decrease in ____

A

hepatic glucoronyltransferase

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65
Q

What are the examaples of protein synthesis inhibitors?

A 
Aminoglycoside
Tetracycyclines
Chloramphenicol
Erythromycin
Lincozamide
Linezolid
Streptogramins
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66
Q

A 50S inhibitor that can cross the placenta and BBB

A

Chloramphenicol

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67
Q

A 30s protease inhibitor that can be used in peptic ulcer disease

A

tetracycline

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68
Q

A 30s protease inhibitor that can be used in SIADH

A

Demeclocycline

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69
Q

A 30s protease inhibitor that can be used in bronchitis, chlamydia, Rickettsia

A

Doxycycline

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70
Q

A 30s protease inhibitor that can cause tooth enamel dysplasia

A

Tetracycline

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71
Q

A 30s protease inhibitor that can cause reversible vestibulotoxicity

A

minocycline

72
Q

A 30s protease inhibitor that are considered divalent, concommitant milk intake is not advised

A

Tetracycline

73
Q

A 30s protease inhibitor that is excreted via the bile

A

Doxycyline

74
Q

What is the resistance mechanism of tetracycline?

A
  1. development of efflux pumps for active extrusion of tetracycline
  2. formation of ribosomal protection
75
Q

A 50s protease inhibitor (macrolide) causes what ECG changes

A

QT prolongation

76
Q

Which macrolide cannot inhibit CYP450

A

Azithromycin

77
Q

What macrolide is used in rare fulminant hepatic failure?

A

Telithromycin

78
Q

What macrolide has the highest Vd, slowest elimination

A

Azithomycin

79
Q

What is the resistance mechanism for macrolides?

A
  1. Efflux pumps

2. production of methylase enzyme

80
Q

What are examples of lincosamides?

A

Clindamycin

81
Q

A 50s binder used for endocarditis prophylaxis

A

Clindamycin

82
Q

A 50s binder that can lead to pseudomembranous colitis

A

clindamycin

83
Q

What is the mechanism of clindamycin resistance?

A
  1. Methylation of binding sites

2. Enzymatic inactivation

84
Q

Clindamycin is used for anaerobes ___ (above/below) the diaphragm

A

above

85
Q

Metronidazole is used for anaerobes ___ (above/below) the diaphragm

A

below

86
Q

What are examples of streptogramin?

A

Quinupristin-Dalfoprisin

87
Q

A 50s subunit binder used to treat drug-resistant staphylococcus and E. faecium

A

Quinupristin-Dalfopristin

88
Q

What are examples of your Oxazolidinone

A

Linezolid

Tedizolid

89
Q

What is the mechanism of action of you linezolid?

A

Binds to the 23S rRNA of 50s subunit

90
Q

What will you give to treat drug-resistant Listeria, Corynebacterium?

A

Linezolid

91
Q

Taking of linezolid and SSRIs can cause what syndrome

A

Serotonin Syndrome

92
Q

What is the resistance pattern of linezolid?

A

decreased affinity of drug to binding site

93
Q

Aminoglycosides exhibit these unique killing action

A
  1. Concentration-dependent killing action
  2. Time-dependent killing action
  3. Post-antibiotic effect
94
Q

What is the major mode of excretion of aminoglycosides?

A

renal excretion

95
Q

Among the aminoglycosides, this has the narrowest therapeutic window

A

Amikacin

96
Q

What ribosomal subunit dies aminoglycosides bind to?

A

30S

97
Q

What is the mechanism of resistance of aminoglycosides

A

plasmid-mediated

98
Q

Streptomycin resistance is due to?

A

changes in the ribosomal binding site

99
Q

What are examples of aminoglycosides?

A 
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin

GNATS

100
Q

What are the side effects of your aminoglycosides?

A

Nephrotoxicity
Ototoxicity
Teratogenicity

101
Q

Aminoglycosides used for ocular infections

A
  1. Tobramycin

2. Gentamicin

102
Q

Aminoglycosides can cause irreversible ___

A

ototoxicity

103
Q

Amikacin can be used for ____

A
  1. Proteus
  2. E. coli
  3. Klebsiella
    PEK
  4. Enterics (Providencia, Pseudomonas, Serratia)
104
Q

What aminoglycoside is used as second line drug for MDRTB

A

Amikacin

105
Q

Aminoglycoside effective for bubonic plague

A

Streptomycin

106
Q

Aminoglycoside effective for tularemia

A

Streptomycin

107
Q

What aminoglycoside can cause congenital deafness

A

Streptomycin

108
Q

Drug of choice used in elective bowel surgery

A
  1. Neomycin
  2. Kanamycin
  3. Paromomycin
109
Q

What is the drug of choice for Kala-azar?

A

Kala-azar = Visceral Leishmaniasis

Paromomycin

110
Q

Aminoglycosides that cause neuromuscular blockade

A
  1. Kanamycin
  2. Neomycin
  3. Paromomycin
111
Q

How will you reverse the neuromuscular blockade caused by kanamycin, neomysin and paromomycin?

A
  1. Calcium gluconate

2. Neostigmine

112
Q

What is the drug of choice for drug-resistant gonorrhea?

A

Spectinomycin

Harvey specter

113
Q

What is the drug of choice for patients with gonorrhea but are allergic to penicillin?

A

Spectinomycin

Can cause anemia

114
Q

This amonoglycoside has no cross resistance to other anti-gonorrheal drug

A

Spectinomycin

Can cause anemia

115
Q

This amonoglycoside has no cross resistance to other anti-gonorrheal drug

A

Spectinomycin

Can cause anemia

116
Q

Among the aminoglycosides, which is the most ototoxic?

A
  1. Kanamycin

2. Amikacin

117
Q

Among the aminoglycosides, which is the most vestibulotoxic?

A
  1. Tobramycin

2. Gentamicin

118
Q

Among the aminoglycosides, which is the most nephrotoxic?

A
  1. Tobramycin

2. Gentamicin

119
Q

Among the aminoglycosides, that can usually cause skin reactions?

A
  1. Neomycin

2. Streptomycin

120
Q

A protease inhibitor that inhibits the protein translocation used as topical agent against S. aureus

A

Fusidic acid

121
Q

____ are weakly acidic compounds that have a common chemical nucleus resembling PABA

A

sulfonamides

122
Q

What are your short acting sulfonamides

A
  1. Sulfacytine
  2. Sulfisoxazole
  3. Sulfamethizole

Site, Socks, Methi

123
Q

What are your intermediate acting sulfonamides

A
  1. Sulfadiazine
  2. Sulfamethoxazole
  3. Sulfapyridine

Azine, metho, fire

124
Q

What are you long acting sulfonamides?

A

Sulfadoxine

125
Q

Antifolate drug structurally similar to folic acid; weak base that is trapped in acidic environment

A

Trimethoprim

126
Q

Trimethoprim reaches high concentrations in these bodily fluids

A
  1. Prostatic fluids

2. Vaginal fluids

127
Q

Sulfonamides are bacteriostatic inhibitors of folic acid synthesis. It competitively inhibits what enzyme

A

dihydropteroate synthase

128
Q

___ are selective inhibitor of bacterial dihydrofolate reductase

A

Trimethoprim

129
Q

Combination of TMP-SMX is ___ bactericidal/bacteriostatic?

A

bactericidal

130
Q

___drug competes with PABA

A

sulfonamides

131
Q

Resistance to TMP-SMX is due to?

A

plasmid-mediated

132
Q

A sulfonamide used in burn infection that can cause metabolic acidosis and can penetrate eschar

A

Mefenide acetate

133
Q

A sulfonamide used to treat P. jirovecii

A

Co-trimoxazole

134
Q

What is the ration of TMP-SMX in co-trimoxazole?

A

1:5

135
Q

Sulfonamide used only for lower UTI

A

Sulfisoxazole

136
Q

What is the DOC for toxoplasmosis?

A

Sulfadiazine-Pyrimethamine

137
Q

What sulfonamide is the 2nd line for malaria?

A

Sulfadoxine-Pyrimethamine

138
Q

Sulfonamide that is co-administered with leucovorin to limit bone marrow toxicity

A

Pyrimethamine

139
Q

Sulfonamide can displace protein binding affecting levels of these drugs?

A
  1. Warfarin

2. Methotrexate

140
Q

DNA gyrase (Topoisomerase II) in gram negative organism prevents what in the DNA

A

prevents relaxation of supercoiled DNA

141
Q

Topoisomerase IV in gram positive bacteria interferese with

A

separation of replicated chromosomal DNA during cell division

142
Q

What are the resistance pattern of fluoroquinolones?

A
  1. Efflux pump
  2. Porin structure
  3. changes the sensitivity of the target enzyme via point mutation
143
Q

What are example of your first generation fluoroquinolones?

A
  1. Nalidixic acid
  2. Oxolinic acid
  3. Cinoxacin
  4. Rosoxacin
144
Q

What are example of your second generation fluoroquinolones?

A
  1. Ciprofloxacin
  2. Ofloxacin
  3. Norfloxacin
  4. Lomefloxacin
  5. Enoxacin
145
Q

What are example of your third generation fluoroquinolones?

A
  1. Levofloxacin
  2. Gemflixacin
  3. Moxifloxacin
  4. Sparfloxacon
  5. Grepafloxacin
  6. Gatifloxacin
  7. Pazufloxacin
  8. Tosufloxacon
  9. Balofloxacin
146
Q

What are example of your fourth generation fluoroquinolones?

A
  1. Trovafloxacin
  2. Alatrofloxacin
  3. Prulifloxacin
  4. Clinafloxacin
147
Q

[What generation of FQ]

Urinary tract infections

A

1st generation

148
Q

[What generation of FQ]

gram negative, gonococci, mycoplasma

A

2rd generation

149
Q

[What generation of FQ]

gram positives, stretococci, enterococci

A

3rd generation

150
Q

[What generation of FQ]

broad specturm, anaerobes

A

4th generation

151
Q

2nd generation FQ used as 2nd line drug for TB

A

Ciprofloxacin

152
Q

Intake of this anti-asthmatic drug enhances the toxicity of 2nd generation FQ

A

methylxanthinse (theophylline)

153
Q

FQ that does not compete with probenecid

A

Moxifloxacin

154
Q

3rd generation FQ used as 2nd line treatment for TB

A

Levofloxacin

155
Q

What is the mode of clearance for moxifloxacin>

A

hepatic

156
Q

3rd generation FQ used to treat C. trachomatis

A

Ofloxacin

157
Q

What generation of FQ is also called respiratory quinolones

A

third generation

158
Q

Levofloxacin can be used in CAP that is caused by

A
  1. Chlamydia
  2. Mycoplasma
  3. Legionella
159
Q

Third generation FQ that can cause QT prolongation

A
  1. Levofloxacin
  2. Gemfloxacon
  3. Moxifloxacin
160
Q

Third generation FQ that can cause hyperglycemia in DM patients

A

Gatifloxacon

161
Q

Metronidazole belongs to what class of drugs

A
  1. Nitroimidazole

2. Antiprotozoal

162
Q

What is the MOA of metronidazole?

A

Reactive reduction by ferredoxin forming free radicals that disrupt ETC

163
Q

What is the DOC for amebiasis and giardiasis?

A

metronidazole

164
Q

Used to treat Trichomonas and Garnerella

A

metronidazole

165
Q

This forms reactive intermediate when acted upon by bacterial nitrofuran reductase

A

Nitrofurantoin

166
Q

nitrofurantoin can be used in UTI except if it is caused by what organisms?

A
  1. Proteus

2. Pseudomonas

167
Q

___ inhibits staphylococcal isoleucyl tRNA synthetase

A

mupirocin

168
Q

topical DOC for impetigo

A

mupirocin

169
Q

__ are cationic detergents that disrupt bacterial cell membrane, bind and inactivate endotoxin

A

polymixin

170
Q

Polymixin is used are salvage therapy of these organisms

A
  1. Acinetobacter
  2. Enterobacteriacease
  3. Pseudomonas
171
Q

These organism are resistant to polymixin

A
  1. Proteus

2. Neisseria

172
Q

____ binds to the sigma subunit of RNA polymerase

A

Fidaxomycin

173
Q

DOC for C. difficile colitis in adults

A

Fidaxomicin

174
Q

What is the outpatient regimen of PID?

A
  1. Ceftriaxine 250mgIM
  2. Doxycyclin 100 mg BID PO x14
  3. Metronidazole 500mg PO BID for 14 days
175
Q

What is the regimen A for parenteral treatment of PID

A
  1. Cefotetan 2g IV q12h or Cefoxitin 2g IV q6h

PLUS

  1. Doxycycline 100mg IV PO q12h
176
Q

What is the regimen B for parenteral treatment of PID

A
  1. Clindamycin 900mg IV q8h

2. Gentamicin LD 2mg/kg then maintainance dose 1.5mg/kg q8h

Infectious Disease (OSI type) (24 decks)

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