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Infectious Disease and Medical Microbiology > Antibacterial Therapy II > Flashcards

Antibacterial Therapy II Flashcards

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USMLE® Step 1 flashcards Biology 101 flashcards
1
Q

Glycopeptides MOA

A
  • Vancomycin
  • inhibit bacterial CW synthesis
  • earlier point than beta lactams
  • prevent incorporation of subunits into peptidoglycan
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2
Q

Lipopeptides MOA

A
  • Daptomycin
  • disrupt bacterial cell membrane
  • cause depolarization of cell membrane
  • calcium dependent
  • bactericidal
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3
Q

Glycopeptides/Lipopeptides Special Considerations

A
  • bactericidal
  • vancomycin is slowly tidal
  • vancomycin not well absorbed orally
  • daptomycin inactivated by lung surfactant - not effective vs. pneumonia
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4
Q

Vancyomycin

A

Glycopeptide
S: Enterococci, Penicillin R Streptococci, MRSA, CNS, C. diff
CI: Bacteremia, pneumonia, endocarditis, bone & joint ix’s, SSTI’s, C. diff ix’s (orally)

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5
Q

Daptomycin

A

Lipopeptide
S: Enterococci, Penicillin R. Streptococci, MRSA, CNS, vancomycin R organisms
CI: Bacteremia, endocarditis, SSTI, bone and joint ix’s

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6
Q

Aminoglycosides MOA

A
  • inhibit protein synthesis

- bind 30S subunit

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7
Q

Aminoglycosides Special Considerations

A
  • bactericidal
  • renally eliminated
  • nephrotoxicity
  • ototoxicity
  • Gentamicin synergy w/ beta lactams vs. Enterococci
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8
Q

Gentamicin

A

Aminoglycoside
S: G-, Pseudo, Enterococci and Streptococci (w/ beta lactams)
CI: bacteremia, G- sepsis, drug resistant UTI

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9
Q

Tobramycin

A

Aminoglycoside
S: G-, Pseudo (better than gentamicin)
CI: combo therapy vs. Pseudo, drug R UTI

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10
Q

Macrolides MOA

A
  • inhibit protein synthesis

- bind 23S subunit

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11
Q

Macrolides Special Consideration

A
  • bacteriostatic
  • active vs IC organisms
  • azithromycin has long half life
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12
Q

Azithromycin

A

Macrolide
S: Mycoplasma, Chlamydophila, Moraxella catarrhalis, Legionella, Neisseria gonorrhea, MAC, Chlamydia trachomatis
CI: combo tx for MAC, MAC prophylaxis in HIV pt’s, second line for STI’s, combo w/ beta lactams vs. CAP

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13
Q

Azithromycin preferred over erythromycin and clarithromycin. Why?

A
  • fewer drug interactions
  • once daily oral dosing
  • broader spectrum
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14
Q

Lincosamide MOA

A
  • inhibit protein synthesis

- binds 50S subunit

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15
Q

Lincosamide Special Considerations

A
  • bacteriostatic
  • high bioavailability
  • high risk of C. diff
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16
Q

Clindamycin

A

Lincosamide
S: Streptococci, MRSA, S. aureus, anaerobes
CI: abscesses, SSTI, bone and joint ix’s, polymicrobial ix’s, combo w/ penicillin for NF

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17
Q

Tetracyclines and Glycylcyclines MOA

A
  • inhibit protein synthesis

- bind 30S and 50S subunits

18
Q

Tetracyclines and Glycylcyclines Special Considerations

A
  • active vs. IC organisms

- bacteriostatic

19
Q

Doxycycline

A

Tetracycline
S: Legionella, M. catarrhalis, Chlamydophila, C. trachomatis, Mycoplasma, S. pneumo, H. influenzae
CI: CAP, COPD, chlamydial STI’s

20
Q

Tigecycline

A

Glycylcycline
S: Broad spectrum, G+, G-, anaerobes
CI: last line of polymicrobial, MDR ix’s if susceptible

21
Q

Tetracycline

A
  • requires QID dosing on empty stomach
  • poorly tolerated
  • narrower spectrum than doxycycline
22
Q

Fluoroquinolones MOA

A

-inhibit DNA gyrase and topoisomerase

23
Q

Fluoroquinolones Special Considerations

A
  • high bioavailability
  • bactericidal
  • increasing levels of resistance
  • levo and moxi active vs. IC organisms
  • high risk of C. diff
24
Q

Ciprofloxacin

A

Fluoroquinolone
S: G-, Pseudo
CI: not first line (increasing resistance), UTI’s, combo w/metronidazole or clindamycin vs. polymicrobial ix’s

25
Q

Levofloxacin

A

Fluoroquinolone
S: Streptococci, Mycoplasma, Chlamydophila, Legionella, G-
CI: suspected drug resistant respiratory ix’s

26
Q

Moxifloxacin

A
  • respiratory quinolone
  • others preferred
  • high risk of C. diff
  • active vs. MDR tuberculosis
27
Q

Trimethoprim-Sulfamethoxazole MOA

A
  • inhibits folate production, purine synthesis

- inhibits dihydropteroate synthase and dihydrofolate reductase

28
Q

Nitrofurantoin

A
  • reduced IC’ly into reactive intermediates that damage proteins, RNA
  • complex mechanism, minimal resistance
29
Q

TMP-SMX Special Considerations

A
  • bacteriostatic
  • high oral bioavailability
  • increasing S. pneumo and E. coli resistance
30
Q

Nitrofurantoin resistance

A
  • only reaches therapeutic levels in urine
  • bactericidal
  • effective for cystitis, not pyelonephritis
31
Q

TMP-SMX

A

Anti-folate
S: S. pneumo, S. aureus (MRSA), PJP, G-
CI: PJP prophylaxis, UTI, purulent cellulitis

32
Q

Nitrofurantoin

A

Anti-folate
S: E. coli, E. faecalis, Klebsiella
CI: 1st line for cystitis

33
Q

Nitroimidazole MOA

A

-inhibit DNA synthesis

34
Q

Nitroimidazole Special Considerations

A
  • high bioavailability
  • high CNS penetration
  • disulfram reaction with alcohol
35
Q

Metronidazole

A

Nitroimidazole
S: anaerobes, including C. diff, protozoa (eg. Giardia)
CI: C. diff ix’s, polymicrobial ix’s, trichomoniasis

36
Q

Oxazolidinone MOA

A
  • inhibit protein synthesis

- binds 30S subunit

37
Q

Oxazolidinone Special Considerations

A
  • activity vs. beta lactam and vancomycin resistant organisms
  • high bioavailability
  • bacteriostatic
  • cytopenias with prolonged therapy
38
Q

Linezolid

A

Oxazolidinone
S: Streptococci, Enterococci, Staphylococci, anaerobes
CI: failure w/ vancomycin therapy

39
Q

Anti-tuberculous drugs Special Considerations

A
  • four drug combo therapy due to increasing resistance
  • bactericidal
  • well absorbed
  • rifampin induces CYP 3A4
  • monitor for hepatotoxicity
40
Q

Four Anti-tuberculous drugs

A

Rifampin*
Ethambutol*
Pyrazinamide
Isoniazed

*active vs. MAC as well

Infectious Disease and Medical Microbiology (11 decks)

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