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HY REVIEW > ANTIBACTERIAL DRUGS HY > Flashcards

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
Q

Cross allergencity with penecillns or cephalosporin or naah

A

no, no allergencity

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26
Q

RED MAN syndrome is an AA of which drug

A

VANCOMYCIN occurs due to inc histamine relase

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27
Q

MOA of vancomycin

A

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

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28
Q

MOR vancomycin

A

(VRSA) (VRE) change in the muramyl pentapeptide

“target,”I.e terminal D-ala is replaced by D-lactate

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29
Q

vancomycin eliminated via

A

kidney , dose modification required

NO CNS passage
used IV and orally for collitis

30
Q

AA of vancomycin

A

REDMAN SYNDROME(histamine release)
Ototoxicity
Nephrotoxicity

31
Q

Organisms not covered by

cephalosporins are “LAME”:

A 
Listeria monocytogenes
Atypicals (e.g., Chlamydia,
Mycoplasma)
MRSA
Enterococci
32
Q

VANCOMYCIN CLINICAL SPECTRUM

A

Spectrum:
– MRSA
– Enterococci
– Clostridium difficile (backup drug)

33
Q

Bacterial protein synthesis inhibitor

A 
MASTCCL
macrolides
Aminoglycosides
streptogramins
Tetracycline
Clindamycin
chlorophenicol
Linezolid
34
Q

Which ribosomal subunit do they act on

A

MC-SC50 , TA30
macrolides ,Clindamycin,
strptogramns and chlorophenicol on 50S

and Tetracycline ,, Aminoglycosides act on
30S

35
Q 
whose AA these
Nephrotoxicity
Ototoxicity
NM blockade
Hypersensitvity(type IV)
contact dermatitis
A

AMINOGLYCOSIDES

36
Q 
Gentamicin
Tobramycin
Amikacin
Streptomycin
Neomycin
Spectinomycin
are drugs of which protein synthesis inhbitor
A

AMINOGLYCOSIDES

37
Q

USES OF AMINOGLYCOSIDES

A

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
Q

DOC for buboniq plaque and tularemia

A

streptomycin

39
Q

which drugs MOA is this

A

Bactericidal, accumulated intracellularly via an
O2-dependent uptake

binds to 30S ribosomal
subunit

40
Q

dose modification required in renal or hepatic dys in aminoglycosides

A

renal

41
Q

TETRACYCLINE DRUG names

A

Doxycycline
Minocycline
Tigecycline

42
Q

SPECTRUM OF TETRACYCLINES

A

Broad spectrum

vs Atypical bacteria(claymadia , H pylori , mycoplasma , ricketssia

43
Q

doxycylin given in

A

prostatitis has inc activity comp to other tetracycline .

44
Q

Minocycline and tigecycline

A

complicated skin infections

45
Q

Tooth enamel dysplasia is an AA of

chelator i.e binds to divalent cation = dec absorbtion

A

Tetracyclines

46
Q

Tetracycline AA

A

Tooth enamel dysplasia and dec bone growth
phototoxicity
Gi distress, superinfection

47
Q

superinfection is an AA of

A

Tetracycline

48
Q 
Erythromycin
Azithromycin
Clarithromycin
Telithromycin
Fidaxomicin
are drugs of...
A

Macrolides

49
Q

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

A

Macrolide

50
Q

which macrolide drug is safest in pregnancy

A

Azithromycin (safest in pregnancy)

51
Q

i have a QT elongation on my ecg and overdosed hence im no deaf , have severe
gastric distress, i wonddr which drug i took

A

Macrolide

inhibits CYp450

52
Q

GRAY BABY SYNDROME is an AA of

A

Chloramphenicol

used in neonates

53
Q

MOA of chloromphenicol

A

bacteriostatic
Binds to 50S ribosomal
subunit

54
Q

dose modification incase of renal or liver dys … huh…

A

Hepatic elimination

55
Q

AA of chloramphenicol

A

dose dependent bone marrow suppression
A plastic anemia
GRAY BABY SYNDROME

56
Q

Streptogramin drugs

A

Quinupristin

Dalfopristin

57
Q

spectrum.. of streptogramins

A

Spectrum VRSA and vRE

58
Q

Infusion-related
arthralgia
and myalgia
which drug..

A

Streptogramin

59
Q

INHBITORS OF NUCLEIC ACID SYNTHESIS

A

Fluoroquinolones, rifampin
and Follic acid inhibitors pyrimethamine
Sulfonamides, trimethoprim,
Trimethoprim sulfamethaxole

60
Q

MOA of antifollate drugs

A

Sulfonamides inhibit dihydropteroate synthase

Trimethoprim and pyrimethamine inhibit dihydrofolate reductase

61
Q

MOA of Flouroquinalones

A

bactericidal
interfere with DNA synthesis − Inhibit topoisomerase II (DNA gyrase) and topoisomerase IV
(responsible for separation of replicated DNA during cell division)

62
Q

drugs of FLOUROQUNIALONES

A

ciprofloxacin

levofloxacin

63
Q

INDICATIONS AND SPECTRUM OF FLOUROQUINALONES

A

Effective in urogenital, GI tract, and some
respiratory infections
• activity versus gonococci •
limited use in tuberculosis

64
Q

PHARMAKOKINETICS of flouroquinalones

A

Renal elimination , dose mod req in renal dys

Iron, calcium limit their absorption

65
Q

Side effect of Flouroquinalones

A

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
Q

Sulfonamide AA

A

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
Q

KERNICTERUS in neonate and STEVE JOHNSONS SYNDROME IS AA of

A

Sulfonamide

68
Q

why are flouroquinalones contrainicated in children

A

bcz (inhibition of chondrogenesis)

69
Q

trimehtoprim and pyrimethamine AA

A

Bone marrow suppression (leukopenia

70
Q

indication and clinical spectrum of TRIMETHOPRIM SULPHAMETHAXOLE

A

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
Q

DOC NOCARDIA

A

Trimethoprim sulfamehtaxole

72
Q

prophylaxis and treatment of HIV Oppurtunistic infections

A

Trimethoprim sulfamehtaxole

HY REVIEW (4 decks)

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