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Pharm > Antibacterial New Deck > Flashcards

Antibacterial New Deck Flashcards

1
Q

Natural Penicillins

A

Penicillin G and Penicillin V

MOA: PBPs

T: Mainly gram positive

AS: includes N. Meningitidis, T. Palladium

R: Mycoplasma and any B-lactamase producer (Staph aureus)

ROA: IV (G), oral (V)

CA: (G) syphilis, strep infections, susceptible pneumococci; (V) strep throat, mild/moderate infection upper respiratory/skin

AE: hypersensitivity, GI, seconday infections

C: B-lactam allergies

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2
Q

Repository Penicillins

A

Penicillin G Procaine, Penicillin G Benzathine

MOA: PBPs

T: mainly gram positive

AS: includes N. meningitidis, T. Pallidum

R: myoplasma & any that produce B-lactamase (staph aureus)

ROA: IM

CA: Penicillin G Benzathine: syphilis, rheumatic fever prophylaxis

AE: hypersensitivity, GI, secondary infections

C: B-lactam allergies

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3
Q

Extended-Spectrum Penicillins

A

Amoxicillin and Ampicillin

MOA: PBPs

T: gram positive and some gram negatives

AS: H. influenzae, H. pylori, E. coli, Listeria, P. Mirabilis, Samonella, Shigella

R: mycoplasma, any that produce B-lactamase (staph aureus)

ROA: Amoxicillin mainly oral; Ampicillin oral/IV/IM

CA: mild/moderate infections (URI, UTI, skin)

AE: hypersensitivity, GI, maculopapular rash, secondary infections

C: B-lactam allergies

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4
Q

Antistaphylococal Penicillins

A

Dicloxacillin, Oxacillin, Methicillin, Nafcillin

MOA: PBPs

T: gram positive

AS: B-lactamase resistant

R: Mycoplasma, MRSA/VRSA

ROA: Dicloxacillin oral; Oxacillin IV; Methicillin not FDA approved, Nafcillin IV

CA: B-lactamase producing staphylococci

AE: hypersensitivity, GI, secondary infections; Oxacillin hepatitis; Methicillin interstital Nephritis; Nafcillin neutropenia

C: B-lactam allergies

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5
Q

Antipseudomonal Penicillins

A

Carbenicillin, Piperacillin, Ticarcillin

MOA: PBPs

T: Gram positive and Gram negative

AS: includes P. aeruginosa

R: Mycoplasma and any B-lactamase producer (staph aureus)

ROA: IV; Carbenicillin IV/oral

CA: P. aeruginosa, moderate-severe GN infections (febrile neutropenia)

AE: hypersensitivity, GI, secondary infections

C: B-lactam allergies

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6
Q

Cephalosporins 1st Generation

A

Cefazolin and Cephalexin

MOA: PBPs

T: mainly Gram positive

AS: P. mirabilis, E. coli, K. pneumoniae

R: Listeria, Legionella, Chlamydia, Mycoplasma, Acinetobacter, MRSA

ROA: Cefazolin parenteral only, Cephalexin oral

CA: penicillin G substitute; Cefazolin surgical prophylaxis

AE: hypersensitivity, superinfections

C: B-lactam allergies (partial cross-reactivity)

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7
Q

Cephalosporins 2nd Generation

A

Cefaclor, Cefoxitin, Cefotetan, Cefamandole

MOA: PRPs

T: Gram positive and some Gram negatives

AS: H. influenzae, Enterobacter, Neisseria, P. mirabilis, E. coli, Klebsiella pneumoniae, Serratia maracens

R: Listeria, Legionella, Chlamydia, Mycoplasma Acinetobacter, MRSA

ROA: Paraenteral only except Cefaclor is oral

CA: mild-moderate infections, sinusitis, otits media, and lower respiratory infections

AE: hypersensitivity, superinfections; Cefotetan/Cefamandole hypoprothrombinemia and disulfram-like reactions

C: B-lactam allergies (parital cross-reactivity)

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8
Q

Cephalosporins 3rd Generation

A

Ceftriaxone, Cefaperazone, Cefotaxine, Ceftazidime, Cefixime

MOA: PRPs

T: extended Gram negative coverage

AS: highly active against Enterobacteriacae, Neissera, H. influenzae, and possible pneumococci

R: Listeria, Legionella, Chlamydia, Mycoplasma, Acinetobacter, MRSA

ROA: Parenteral only except Cefixime is oral

CA: mild-severe gram negative infections (otitis, meningitis, and pseudomonas)

AE: hypersensitivity, superinfections; Cefaperazone hypoprothombinemia, Disulfiram-like reactions

C: B-lactam allergies (partial cross-reactivity)

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9
Q

Cephalosporin 4th Generation

A

Cefipime

MOA: PBPs

T: broad specturm

AS: increased activity against Pseudomonas aeruginosa

R: Listeria, Leigonella, Chlamydia, Mycoplasma, Acinetobacter, MRSA

ROA: parenteral only

CA: complicated susceptible infections (UTI, febrile neutropenia, intra-abdominal)

AE: hypersensitivity, superinfections

C: B-lactam allergies (parital cross-reactivity)

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10
Q

Cephalosporin 5th Generation

A

Ceftaroline

MOA: PBPs

T: Gram negative & some gram positives

AS: MRSA

R: Pseudomonas

ROA: Parenteral only

CA: complicated skin/soft tissue infections due to MRSA especially if GN also present

AE: hypersensitivity, superinfection

C: B-lactam allergies (partial cross-reactivity)

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11
Q

Carbapenems

A

Imipenem and Meropenem

MOA: PRPs

T: broad spectrum

AS: Gram positive, Gram negative, Aerobes, Anaerobes including P. aeruginosa

R: carbapenemase producing organisms (Enterobacteriaceae & carbepenem resistant Klebsiella & MRSA)

ROA: parenteral only

CA: restricted to emperic therapy of serious infections

AE: GI, rash; Imipenem nephrotoxic (combined with cilastatin), CNS toxicity (seizures)

C: B-lactam allergies (partial cross-reactivity)

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12
Q

Monobactams

A

Aztreonam

MOA: PRPs

T: aerobic Gram negative rods only

AS: P. aeruginosa resistant to B-lactamase

R: mycoplasma & gram positive

ROA: parenteral

CA: UTI, lower respiratory infections, other GN infections

AE: relatively nontoxic

C: little cross-reactivity with other B-lactams

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13
Q

Vancomycin

A

Vancomycin (glycopeptide)

MOA: D-Ala-D-Ala terminus

T: Gram positive only

AS: multidrug resistant organisms (MRSA, Enterococci, PRSP, C. difficile)

R: VRSA, VRSP, and virtually all GN

ROA: Parenteral (or oral for C. difficile)

CA: serious infections caused by resistant GP organisms and for pts severely allergic to penicillin

AE: nephrotoxicity, ototoxicity, Red man syndrome

C:

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14
Q

Daptomycin

A

Daptomycin (glycopeptide)

MOA: cell membrane insertion of lipid tail

T: Gram positive only

AS: MRSA/VRSA, Enterococci, VRE

R: pneumonia (inactivated by surfactant)

ROA: parenteral

CA: serious infections caused by resistant GP, complicated skin/structure infections

AE: myopathy/rhabodomyolysis

C:

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15
Q

Bacitracin

A

Bacitracin (Miscellaneous)

MOA: PRPs

T: Gram positive

AS:

R:

ROA: mainly topical

CA: skin infections and burns

AE: topical irritation (nephrotoxicity when given systemically)

C:

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16
Q

Fosfomycin

A

Fosfomycin (Miscellaneous)

MOA: inhibits enolpyruvate transferase

T: broad spectrum

AS:

R:

ROA: oral

CA: uncomplicated lower UTI’s

AE:

C:

17
Q

Beta-Lactamase Inhibitors

A

Clavulanic Acid/Clavulanate, Sulbactam, Tazobactam

MOA: PRPs inhibition

T:

AS: combined with B-lactam antibiotics to enhance antimicrobial spectrum

R:

ROA: oral; Sulbactam/Tazobactam also parenteral

CA:

AE:

C:

18
Q

Tetracyclines

A

Doxycycline, Minocycline, Tetracycline

MOA: 30S ribosomal subunit

T: broad spectrum

AS: intracellular organisms (Rickettsia & Chlamydia)

R: most exhibit some sort of resistance

ROA: oral, parenteral

CA: Empiric treatment of PNA, Lyme disease, Acne, Roseaca, Chlamydia, Syphilis

AE: GI distress, discoloration of teeth, inhibition of bone growth in children, photosensitivity, superinfections

C: pregnancy and children under 8

19
Q

Glycylcyclines

A

Tigecycline (Tetracycline)

MOA: 30S ribosomal subunit

T: broad spectrum

AS: multi-drug resistant organisms (MRSA/VRSA/VRE)

R:

ROA: parenteral

CA: complicated skin, soft tissue, and intestinal infections due to resistant bacteria

AE: GI distress, discoloration of teeth, inhibition of bone growth in children, phosensitivty, superinfection

C: pregnancy, children under 8

20
Q

Aminoglycosides

A

Amikacin, Gentamicin, Neomycin, Streptomycin

MOA: 30S ribosomal subunit

T: aerobic gram negative rods

AS: aerobes only

R: anaerobes

ROA: Parenteral except Neomycin is topical and oral

CA: Amikacin/Streptomycin combination for empiric therapy of serious infections; Gentamicin combination with Vancomycin for emperic therapy of serious infection (septicemia, endocarditis); Neomycin component of triple antibiotic ointment or orally for hepatic encephalopathy

AE: nephrotoxicity, ototoxicity; Neomycin only nephrotoxicity when given orally

C: pregnancy (Neomycin only when given systemically)

21
Q

Macrolides

A

Azithromycin, Clarithromycin, Erythromycin, Telithromycin

MOA: 50S ribosomal subunit

T: Gram positive and some gram negative

AS:

R:

ROA: oral; Azithromycin/Erythromycin also given by IV

CA: atypical PNAs, GP cocci, URI, soft tissue infections, STD’s for penicillin allergic pts; Telithromycin not used in minor illnesses

AE: GI motility issues, QT prolongation, rash eosinophilia; Clarithromycin/Erythromycin inhibit CYP; Telithromycin fatal hepatotoxicity, myasthenia gravis exacerbation, visual disturbances

C: statins for Clarithromycin/Erythromycin/Telithromycin

22
Q

Streptogramins

A

Dalfoprisitin + Quinupristin

MOA: 50S ribosomal subunit (seperate sites)

T: Gram positive only

AS: includes VRSA and VRE

R: E. faecalis is intrinsically resistant

ROA: parenteral

CA: severe infections caused by multi-drug resistant Staphylococci or VRE

AE: infusion-related irrita tion/arthralgias/myalgias, hyperbilireubinemia, inhibits CYP

C:

23
Q

Clindamycin

A

Clindamycin (Lincosamide)

MOA: 23S of 50S ribosomal subunit

T: primarily gram positive anaerobes

AS: anaerobes (Bacteriodes, Clostridium perfringens)

R:

ROA: oral, parenteral

CA: anaerobic infections (especially above diaphragm, aspiration PNA), skin/soft tissue infections

AE: Pseudomembranous colitis​

C:

24
Q

Linezolid

A

Linezolid (Lincosamide)

MOA: 23S portion of 50S ribosomal subunit

T: Gram positive only

AS: MRSA, VRSA, VRE, and bacteria resistant to other drugs

R:

ROA: oral, parenteral

CA: severe infetions caused by multi-drug resistant GP

AE: bone marrow suppresion, peripheral neuropathy, Serotonin syndrome (inhibitor of MAO)

C: adrenergic and serotonergic drugs

25
Q

Chlorampenicol

A

Chlorampenicol (miscellaneous)

MOA: 23S portion of 50S ribosomal subunit

T: broad spectrum

AS: aerobic/anaerobic GP/GN (VRE, Bacteroides fragilis)

R:

ROA: oral, parenteral, topical drops

CA: topical treatment of ear and eye infections (not un U.S.), systemically reserved to serious infections

AE: anemia, aplastic anemia, Gray Baby Syndrome, inhibits CYP

C: pregnancy

26
Q

Mupirocin

A

Mupirocin (miscellaneous)

MOA: bacterial isoleucyl transfer-RNA synthetase

T: gram positive cocci

AS: MRSA and most Strepticocci

R: Enterococci

ROA: topical, intranasal

CA: eradication of MRSA in healthcare workers, topical Tx of impetigo, skin lesions

AE: dermatological effects

C:

27
Q

Fidaxomicin

A

Fidaxomicin (miscellaneous)

MOA: gram positive aerobes and anaerobes

T: RNA polymerase

AS: C. difficile

R:

ROA: oral

CA: treatment of C. difficile in adults (especially if recurrent)

AE: GI distress

C: children (not tested)

28
Q

Rifampin

A

Rifampin (miscellaneous)

MOA: RNA polymerase

T: broad spectrum

AS: includes MRSA and TB

R:

ROA: oral, parenteral

CA: TB, Leprosy, MRSA, prophylaxis against meningitis

AE: orange/red bodily fluids, strong inducer of CYP

C:

29
Q

Fluoroquinolones 1st Generaction

A

Nalidixic Acid

MOA: DNA topoisomerase (Gyrase)

T: Gram negatives

AS:

R:

ROA: oral, parenteral

CA: uncomplicated UTI’s

AE: connective tissue problems, GI distress, photosensitivity, rash, superinfection

C: pregnancy, children uner 18

30
Q

Fluoroquinolones 2nd Generation

A

Ciprofloxacin

MOA: DNA topoisomerase (gyrase)

T: Gram negative and some gram positive

AS: includes P. aeruginosa

R:

ROA: oral, parenteral

CA: traveler’s diarrhea, P. aeruginosa, prophylaxis against meningitis/UTI’s resistant to cotrimoxazole

AE: connective tissue problems, GI distress, photosensitivity, rash, superinfections

C: pregnancy, children under 18

31
Q

Fluoroquinolones 3rd Generation

A

Levofloxacin

MOA: DNA topoisomerase (gyrase)

T: broad spectrum

AS: S. pneumoniae, H. influenzae, and M. catarrhalis

R:

ROA: oral, parenteral

CA: prostatitis, STD’s, skin infections, acute sinusitis, acute bronchitis/TB

AE: connective tissue problems, QT prolongation, GI distress, photosensitivity, rash, superinfections

C: pregnancy, children under 18

32
Q

Fluoroquinolones 4th Generation

A

Gemifloxacin, Moxifloxacin

MOA: DNA topoisomerase (gyrase)

T: broad spectrum

AS: S. pneumoniae, H. influenzae, M. catarrhalis

R:

ROA: oral, parenteral

CA: prostatitis, STD’s, skin infections, acute sinusitis, acutre bronchitis, TB

AE: Connective tissue problems, QT prolongation, GI distress, photosensitivity, rash, superinfections

C: pregnancy, children under 18

33
Q

Sulfonamides

A

Sulfadiazine, Sulfamethoxazole, Sulfasalazine

MOA: dihydropteroate synthase inhibitor (analog of PABA)

T: broad spectrum

AS:

R: very common

ROA: oral, topical

CA: Sulfadiazine/Sulfamethoxazole used in combination with other drugs for ocular/burn infections; Sulfasalazine orally for ulcerative colitis, enteritis, IBD

AE: hypersensitivity, crystalluria, hemolysis if G6PD deficient, photosensitivity, Kernicterus

C: Newborns and infants less than 2 months old

34
Q

DHFR Inhibitor

A

Trimethoprim

MOA: dihydrofolate reductase inhibitor

T: broad specturm

AS:

R:

ROA: oral

CA: uncomplicated UTI’s, prostatitis, vaginitis

AE: antifolate effects (megoblastic anemia, leukopenia, granulocytopenia)

C: pregnancy

35
Q

Sulfonamide + DHFR Inhibitor

A

Cotrimoxazole

MOA: dihydropteroate synthase & dihydrofaolate reductase inhibitor

T: broad spectrum

AS:

R:

ROA: oral, IV

CA: uncomplicated UTI’s, mild-moderate infections (respiratory, ear, sinus, PCP, Nocardiosis, Toxoplasmosis)

AE: dermatological, hemolytic, anemia, GI

C: pregnancy

36
Q

Metronidazole

A

Metronidazole (miscellaneous)

MOA: forms cytotoxic compounds

T: broad specturm

AS: Giardia, Entamoeba, Trichomonas, G. vaginalis, H. pylori, C. difficile, Bacteriodes

R: aerobic bacteria

ROA: oral, IV, rectal, topical

CA: anaerobic infections below diaphragm

AE: disulfiram-like reactions, headache, metallic taste

C: pregnancy

37
Q

Urinary Antiseptic

A

Nitrofurantoin

MOA: forms cytotoxic compounds

T: broad spectrum

AS: highly active against E. coli

R:

ROA: oral

CA: uncomplicated UTI’s

AE: GI distress, hemolytic anemia (G6PD deficient pts)

C: pregnancy (post 38 wks), infants less than 1 month, renal insuficiency

Pharm (14 decks)

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