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Bacteriology -NM > Antibacterial Drugs > Flashcards

Antibacterial Drugs Flashcards

1
Q

cephalosporin resistances in general

A

intrinsic: pseudomonas. enterococci; membrane permeability; altered PBPs; B-lactamases

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2
Q

cefoxitin activity

A

excellent anaerobic activity 2nd generation

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2
Q

ceftriaxone clinical use

A

community acquired pneumonia meningitis(penetrates CSF) UTI

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2
Q

Penicillin G. administration

A

IV

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2
Q

Nafcillin. administration

A

IV

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2
Q

piperacillin. administration

A

IV

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2
Q

piperacillin-tazobactam. administration

A

IV

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3
Q

Bacitracin. activity

A

GP only, topical

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3
Q

cephalexin. administration

A

PO

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3
Q

metronidazole adverse effects

A

metallic taste;

HA, vertigo, confusion, psychosis,

disulfram-like effect w/alcohol(vomit, flush)

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4
Q

Penicillin G. adverse effects

A

hypersensitivity reactions(rash. hives/anaphylaxis. serum sickness. immune mediated cytopenias. acute interstitial nephritis); seizures at high doses

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4
Q

clindamycin, mechanism, activity, adverse reaction

A

binds 50S subunit GP only! “above the diaphragm” classically some CA-MRSA adverse reaction is c. diff infection

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5
Q

Vancomycin resistance?

A

alteration of vancomycin binding site (vanA.B.C.D.E),VRE; thickened cell wall(VISA)

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5
Q

rifaximin use

A

traveler’s diarrhea enteric drug; does not absorb across gut

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5
Q

isoniazid mechanism, clinical use

A

inhibits mycolic acid cell-wall syntehsis via O2 dependent pathways used for mycobacterial infections

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6
Q

aztreonam activity, clinical use

A

GN only, used w/b-lactam allergy occasionally; limited immunogenic potential

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7
Q

amoxicillin. administration

A

PO

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10
Q

Polymyxin B. Colistin activity

A

GN bactilli only

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11
Q

Daptomycin. adverse effects

A

GI distress. HA. elevated CPK(creatine phosphokinase)/rhabdomyolysis(avoid statins)

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12
Q

ampicillin, amoxicillin activity

A

widens spectrum to some GN(H. flu. E. coli; NOT pseudomonas)

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13
Q

Daptomycin. activity

A

GP ONLY! MRSA activity; enterococci(including VRE). anaerobes

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13
Q

ceftazidime clinical use

A

pseudomonas activity; very broad GN

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14
Q

ceftriaxone penetration, half life

A

high degree of CSF penetration; EXTREMELY long t1/2. can q24h dose for outpatient IV

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16
Q

name the tetracyclines, mechanism and activity

A

doxycycline tetracycline minocycline reversibly bind 30S subunit blocking tRNA access to mRNA broad GN(no pseudo) staph, strep(some CA-MRSA) some anaerobic atyps: chlamydia, mycoplasma 4(tetra) minos by the dox

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18
Q

Nafcillin. Dicloxacillin clinical use

A

primarily used for methicillin-susceptible S. aureus

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20
Q

ceftaroline. administration

A

IV

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20
Q

Vancomycin oral

A

does not cross GI tract given orally; used for c. diff

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22
Q

Fosfomycin. clinical use

A

UTI only

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23
Q

Vancomycin. activity

A

GP ONLY! MRSA activity; enterococci if susceptible; anaerobes

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25
Q

Nafcillin. resistance?

A

altered PBP encoded by mecA–>PBP2a(MRSA); cant bind it anymore

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25
Q

adverse effects of TMP-SMX

A

common - HANV, rash

less - hyperkalemia, hepatitis, pancreatits

rare - SCAR, anemias, thrombocytopenias, separates drugs from albumin, kernicterus

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26
Q

ethambutol use

A

inhibits arabinogalactan, lipoarabinomannan synthesis used for mycobacterial infections

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27
Q

carbopenam. adverse effects

A

hypersensitivity(cross-reaction w/penicillin)

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28
Q

Nafcillin, dicloxacillin activity

A

GP ONLY; narrow specturm; think penicillin G with overcoming certain b-lactamases

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28
Q

Vancomycin. clinical use

A

only use instead of b-lactam if: empiric therapy for severe infection. resistant GP infection. allergy to b-lactam; used for C. diff via oral dose

29
Q

cefepime activity

A

EXTREMELY GN active including pseudomonas; one of broadest spectrum agents available; still has GP activity; resistant to almost all b-lactamases 4th gen

30
Q

anti-tubercular drugs

A

isoniazid, rifampin, streptomycin, ethambutol, pyrazinamide

31
Q

name all the drugs with GP only activity

A

nafcillin dicloxacillin vancomycin daptomycin bacitracin mupirocin clindamycin linezolid tedezolid

32
Q

aztreonam. administration

34
Q

Penicillin G. activity

A

GN: cocci only; GP: cocci and anaerobes; spirochetes. enterococci

34
Q

name all the cephalosporins in order by generation

A

1st gen: cefazolin cephalexin(PO) 2nd gen cefoxitin 3rd gen ceftriaxone ceftazidime 4th gen cefepime 5th gen ceftaroline

35
Q

name the macrolides, mechanism, and activity

A

azithromycin clarithromycin erythromycin binds 50S subunit, blocks translocation broad GN(no pseudo) GP: staph,strep, pneumo(if susc.) atyp: myco, legionella, chlamydia

36
Q

carbapenem administration

37
Q

fidoxamicin mechanism, use

A

blocks RNA polymerase by not letting DNA open PO drug approved for c.diff infections does not cross GI; very narrow spectrum(only effects some GP in gut); preserves flora better than others

38
Q

name all the drugs with pseudomonas activity

A

piperacillin/pip-tazo ceftazidime cefapime meropenem imipenem fosfomycin - UTI only aminoglycosides(gentamicin, amikacin, tobramycin, streptomycin)

39
Q

metronidazole

mechanims, activity

A

diffuses into bacteria and produces free radicals

activity: ANAEROBES“below diaphragm”
includes b. fragilis; protozoa

41
Q

Polymyxin B and colistin adverse effects

A

nephrotoxicity. neurotoxicity

42
Q

cefazolin. administration

42
Q

tigecycline, mechanism, activity, problems

A

semi-synthetic tetracycline very broad spectrum GN(no pseudo) GP(MRSA and VRE) most anerobes resistance develops rapidly…limits use; also increased mortality w/pneumonia pts….

43
Q

name the carbapenems

A

meropenem imipenem ertapenem doripenem(black boxed)

45
Q

Vancomycin. administration

A

IV/PO PO for c.diff; not absorbed

46
Q

cefepime. administration

48
Q

Penicillin G. clinical use

A

Grp A and B strep. and Streptococcus pneumoniae; anaerobic infections(dental abscess. human bites); syphilis

49
Q

Daptomycin. administration

51
Q

cefoxitin clinical use

A

prophylaxis for intra-abdominal surgery 2nd gen

53
Q

ampicilin. amoxicilin adverse effects

A

in addition to hypersensitivity�.GI distress is common; maculopapular rash if treating mono(100% of pts)

54
Q

ceftazidime. administration

55
Q

cephalosporins activity

A

GN increases w/generations(except 5); most have som GP ; no good against enterococci; only 1 good against MRSA. not much anaerobe activity

56
Q

Colistin(polymyxin E). administration

57
Q

ceftaroline activity

A

MRSA activity; broad GP activity. no enterococci; only some gram-neg activity. no pseudomonas�similar activity to that of gen3

58
Q

cefoxitin. administration

59
Q

adverse effects of rifampin

A

orange secretions, hepatitis, GI and heme issues

60
Q

Carbapenems resistance?

A

any weird acquired metallo-beta-lactamases. KPCs can still be resistant to carbapenems

61
Q

Polymyxin B. Colistin clinical use

A

Serious resistant GN infections; inhaled resistant GN pneumonia

62
Q

piperacillin-tazobactam. activity

A

adds S.aureus (not MRSA). B-lactamase producing GN and anaerobes; AND PSEUDOMONAS

63
Q

Daptomycin. clinical use

A

complex GP infections(soft tissue; bacteremia/endocardidits)

64
Q

ampicillin. administration

65
Q

Vancomycin. adverse effects

A

Red Man Syndrome; dose-related ototoxicity; nephrotoxicity(avoid co-administration with other agents)

68
Q

cefazolin, cephalexin(1st gen) clinical use

A

surgical prophylaxis. soft skin/tissue infections(resistance limiting)

69
Q

Polymyxin B. administration

70
Q

name the B-lactamase drug combos

A

ampicillin-sulbactam amoxicillin-clavanic acid piperacillin-tazobactam

71
Q

Dicloxacillin. administration

73
Q

Fosfomycin. administration

74
Q

ceftriaxone, ceftazidime activity

A

excellent GN activity 3rd gen

75
Q

Penicillin G. resistance?

A

B-lacatamases hydrolyze b-lactam ring; PBPs can be modified on transpeptidase; decreased perm.; efflux pumps

76
Q

rifampin clinical use

A

prophylaxis for n. meningitidis, s. aureus mycobacterial infections

77
Q

ceftriaxone. administration

77
Q

unique PK/PD of rifampin

A

p450 inducer; can decrease concentrations of other drugs in body

79
Q

carbapenem activity

A

VERY BROAD SPECTRUM; GN w/pseudomonas; GP;Anaerobes ertapenem = no pseudo/acinetobacter spp.

80
Q

name the aminoglycosides and their mechanism and activity

A

gentamicin amikacin tobramycin streptomycin binds 30S ribosome; stops protein synthesis only GN(w/pseudo) activity; cant’ penetrate GP wall w/out synergy

81
Q

Fosfomycin resistance?

A

can develop rapidly on the transporter that brings the drug into the bacteria

82
Q

Daptomycin cannot be used where?

A

inhibited by pulmonary surfactant. DON�T USE FOR PNEUMONIA; bactericidal

83
Q

Carbapenems. clinical use

A

empiric treatment for serious infections and resistant infections

84
Q

Penicillin V. administration

85
Q

ampicillin. amoxicilin clinical use

A

community acquired HEENT/upper resp infectsion; community acquired UTI

86
Q

adverse effects of fluoroquinolones

A

Common - HANV(HA,nausea, vomiting) ab pain, dizzy

less common - long QT, tendon rupture, cartilage problems in kids, pregos can cause c.diff

Bacteriology -NM (12 decks)

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