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ANTIBACTERIAL DRUGS HY Flashcards

1
Q

MECH OF ACTION OF ANTIBACTERIAL DRUGS

A

1)Inhibition of bacterial cell-wall
synthesis

2)Inhibition of bacterial protein
synthesis

3) Inhibition of nucleic synthesis
4) Inhibition of folic acid synthesis

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2
Q

bacterial cell wall synthesis inhibitor include

mnemonic = AIM

A 
Penicillin
cephalosporin
Imipenem, Meropenem
Aztreonam 
Vancomycin
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3
Q

Beta lactam drugs inc

A

Penicillins, cephalosporins,
imipenem/meropenem, aztreonam
except vancomycin

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4
Q

MOA of B Lactam drugs

A

Bacterial cell wall is cross-linked polymer of polysaccharides and pentapeptides

Penicillins interact with cytoplasmic membrane-binding proteins
(PBPs)
to ……inhibit transpeptidation reactions involved in cross-linking,
the final steps in cell-wall synthesis

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5
Q

Mechanisms of resistance

A

1)Penicillinases (beta-lactamases) break lactam ring structure (e.g.,staphylococci)

2)Structural change in PBPs (e.g., methicillin-resistantStaphylococcus
aureus [MRSA], penicillin-resistant pneumococci)

3)Change in porin structure (e.g., Pseudomonas)

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6
Q

Generations of Penecillin

A

1)Narrow spectrum s
Penicillin G
Penicillin V

2)very Narrow spectrum R
Nafcillin
Oxacillin

3)Broad spectrums
Ampicillin
Amoxicillin

4)Extended spectrums
Piperacillin
Ticarcillin

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7
Q

SPECTRUM OF 1ST GEN

A

Streptococcal and
meningococcal infections
• syphilis

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8
Q

SPECTRUM OF 2nd gen

A

Staph infections not MRSA

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9
Q 
Broad spectrums
Ampicillin
Amoxicillin
Extended spectrums
Piperacillin
Ticarcillin
spectrum
A

greater activity vs gram negative bacteria

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10
Q

pharmacokinetics of Penicllin

A

Renal elemination , hence dose modification required in renal dys
biliary elimination of nafcillin and oxacillin

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11
Q

Adverse effects of

A

have S hence Hypersensitivity (1-4) 7perc ,
utricial rash or anaphylaxis

Complete cross allergenecity between indivisual penecillin
Gi distress ,
Jarisch-Herxheimer reaction in treatment of syphilis

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12
Q

Q)Give cephalosporin classfication with examples of each group

A

Cephalosporins
First generation
Cephalexin
Cefazolin

2nd generation
Cefuroxime

Third generation
Ceftriaxone
Cefixime

Forth generation
Cefepime

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13
Q

which second generation cephalosporin enter CNS

A

cefurixime

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14
Q

pharmacokinetics

A

Renal elimination
hence dose modification is required in patients with renal dys
CEFTRIAXONE eliminated via liver

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15
Q

1st generation cephalosporin uses and spectrum

A

strong gram possitve coverage and some gram negative(kleibsela , proteus)

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16
Q

third generation cepohalosporin uses

A

Emperic management of sepsis and meningitis

pneumonia and gonorrhea

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17
Q

ADVERSE EFFECT OF CEPHALOSPORINS

A

Side effects:
Hypersensitivity:Incidence: 2%
Wide range, but rashes and drug fever most common

Positive Coombs test, but rarely hemolysis

Assume complete cross-allergenicity between cephalosporins

partial cross-allergenicity with penicillins (about 5%

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18
Q

COOMBES TEST IS POSSTIVE in….

A

Cephalosporin

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19
Q

carbapenem names …

A

Imipenem with cilastatin ,meropene m

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20
Q

why is imipenem given with cilastatin

A

cilastatin is a renal DEHYDROPEPTIDASE INHIBITOR

hence it inhibits renal metabolism of imipenem to a nephrotoxic metabolite

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21
Q

give spectrum ofcarbapenems and pharmakokinetic

A

Broad spectrum includes Gram-positive cocci
PRSP strains (not MRSA),
gram-negative rods

are B lactamase resistant

Both drugs undergo renal elimination— ↓ dose in renal dysfunction

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22
Q

Adverse Effect of carbapenem

A

l Side effects:
− GI distress
− Drug fever (partial cross-allergenicity with penicillins)
− CNS effects, including seizures with imipenem in overdose or renal
dysfunction

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23
Q

Partial Cross allergenicity with …

A

penecillin

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24
Q

Aztreonam are b lactamse resistant or sensitive

A

resistant

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25
Cross allergencity with penecillns or cephalosporin or naah
no, no allergencity
26
RED MAN syndrome is an AA of which drug
VANCOMYCIN occurs due to inc histamine relase
27
MOA of vancomycin
MOA Binding at the D-ala-D-ala muramyl pentapeptide to sterically hinder the transglycosylation reactions (and indirectly preventing transpeptidation) involved in elongation of peptidoglycan chains − Does not interfere with PBPs
28
MOR vancomycin
(VRSA) (VRE) change in the muramyl pentapeptide | “target,”I.e  terminal D-ala is replaced by D-lactate
29
vancomycin eliminated via
kidney , dose modification required NO CNS passage used IV and orally for collitis
30
AA of vancomycin
REDMAN SYNDROME(histamine release) Ototoxicity Nephrotoxicity
31
Organisms not covered by | cephalosporins are “LAME”:
``` Listeria monocytogenes Atypicals (e.g., Chlamydia, Mycoplasma) MRSA Enterococci ```
32
VANCOMYCIN CLINICAL SPECTRUM
Spectrum: – MRSA – Enterococci – Clostridium difficile (backup drug)
33
Bacterial protein synthesis inhibitor
``` MASTCCL macrolides Aminoglycosides streptogramins Tetracycline Clindamycin chlorophenicol Linezolid ```
34
Which ribosomal subunit do they act on
MC-SC50 , TA30 macrolides ,Clindamycin, strptogramns and chlorophenicol on 50S and Tetracycline ,, Aminoglycosides act on 30S
35
``` whose AA these Nephrotoxicity Ototoxicity NM blockade Hypersensitvity(type IV) contact dermatitis ```
AMINOGLYCOSIDES
36
``` Gentamicin Tobramycin Amikacin Streptomycin Neomycin Spectinomycin are drugs of which protein synthesis inhbitor ```
AMINOGLYCOSIDES
37
USES OF AMINOGLYCOSIDES
Aerobic gram-negative bacteria gentamcin ,tobramycin and amikacin used in combination streptomycin used in tuberclosis DOC for buboniq plaque and tularemia synergistic action with oencillin (G or ampicillin)
38
DOC for buboniq plaque and tularemia
streptomycin
39
which drugs MOA is this
Bactericidal, accumulated intracellularly  via an O2-dependent uptake binds to 30S ribosomal subunit
40
dose modification required in renal or hepatic dys in aminoglycosides
renal
41
TETRACYCLINE DRUG names
Doxycycline Minocycline Tigecycline
42
SPECTRUM OF TETRACYCLINES
Broad spectrum | vs Atypical bacteria(claymadia , H pylori , mycoplasma , ricketssia
43
doxycylin given in
prostatitis has inc activity comp to other tetracycline .
44
Minocycline and tigecycline
complicated skin infections
45
Tooth enamel dysplasia is an AA of | chelator i.e binds to divalent cation = dec absorbtion
Tetracyclines
46
Tetracycline AA
Tooth enamel dysplasia and dec bone growth phototoxicity Gi distress, superinfection
47
superinfection is an AA of
Tetracycline
48
``` Erythromycin Azithromycin Clarithromycin Telithromycin Fidaxomicin are drugs of... ```
Macrolides
49
Gram-positive cocci (not MRSA) Atypical organisms (Chlamydia, Mycoplasma, and Ureaplasma species) Legionella pneumophila Campylobacter jejuni Mycobacterium avium-intracellulare (MAC) in HIV patients H. pylori is the spectrum of which drug
Macrolide
50
which macrolide drug is safest in pregnancy
Azithromycin (safest in pregnancy)
51
i have a QT elongation on my ecg and overdosed hence im no deaf , have severe gastric distress, i wonddr which drug i took
Macrolide | inhibits CYp450
52
GRAY BABY SYNDROME is an AA of
Chloramphenicol | used in neonates
53
MOA of chloromphenicol
bacteriostatic Binds to 50S ribosomal subunit
54
dose modification incase of renal or liver dys ... huh...
Hepatic elimination
55
AA of chloramphenicol
dose dependent bone marrow suppression A plastic anemia GRAY BABY SYNDROME
56
Streptogramin drugs
Quinupristin | Dalfopristin
57
spectrum.. of streptogramins
Spectrum VRSA and vRE 
58
Infusion-related arthralgia and myalgia which drug..
Streptogramin
59
INHBITORS OF NUCLEIC ACID SYNTHESIS
Fluoroquinolones, rifampin and Follic acid inhibitors pyrimethamine Sulfonamides, trimethoprim, Trimethoprim sulfamethaxole
60
MOA of antifollate drugs
Sulfonamides inhibit dihydropteroate synthase Trimethoprim and pyrimethamine inhibit dihydrofolate reductase
61
MOA of Flouroquinalones
bactericidal interfere with DNA synthesis − Inhibit topoisomerase II (DNA gyrase) and topoisomerase IV (responsible for separation of replicated DNA during cell division)
62
drugs of FLOUROQUNIALONES
ciprofloxacin | levofloxacin
63
INDICATIONS AND SPECTRUM OF FLOUROQUINALONES
Effective in urogenital, GI tract, and some respiratory infections • activity versus gonococci • limited use in tuberculosis
64
PHARMAKOKINETICS of flouroquinalones
Renal elimination , dose mod req in renal dys | Iron, calcium limit their absorption
65
Side effect of Flouroquinalones
Side effects: Side effects: – Tendonitis, tendon rupture , Phototoxicity, rashes, tendonitis − CNS effects (insomnia, dizziness, headache) − Contraindicated in pregnancy and in children (inhibition of chondrogenesis) inc QT interval
66
Sulfonamide AA
Kernicterus in neonates (avoid in third trimester) Hypersensitivity (rashes, exfolliative dermatitis/Stevens-Johnson syndrome) have sulphur and analogs of paba Hemolysis in G6PD deficiency Phototoxicity
67
KERNICTERUS in neonate and STEVE JOHNSONS SYNDROME IS AA of
Sulfonamide
68
why are flouroquinalones contrainicated in children
bcz (inhibition of chondrogenesis)
69
trimehtoprim and pyrimethamine  AA
Bone marrow suppression (leukopenia
70
indication and clinical spectrum of TRIMETHOPRIM SULPHAMETHAXOLE
DOC in Nocardia Listeria (backup) Gram-negative infections (E. coli, Salmonella, Shigella, H. influenzae) Gram-positive infections (Staph., including communityacquired MRSA, Strep.) PROPHYLAXIS AND TREATMENT OF HIV opputnistic infection Fungus: Pneumocystis jiroveci (back-up drugs are pentamidine and atovaquone)
71
DOC NOCARDIA
Trimethoprim sulfamehtaxole
72
prophylaxis and treatment of HIV Oppurtunistic infections
Trimethoprim sulfamehtaxole

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