Antibacterials Flashcards
A natural beta-lactam antibiotic that is poorly absorbed from the intestinal tract and instead is given parenterally
IV form of this antibiotic that is aqueous
IM form of this antibiotic that has a depot effect
Penicillin G (Benzyl Penicillin)
Crystalline Pen G
Benzathine Pen V
A natural beta-lactam antibiotic that is oral due to it being acid stable
Penicillin V (Phenoxymethyl penicillin)
A class of antibiotic that interferes with the transpeptidation or cross-linking of peptidoglycan chain. It is from Penicillium notatum, with a nucleus known as the 6-aminopenicillanic acid. The beta-lactam ring of this antibiotic is a thiazolidine ring. This class has gram positive coverage, with no atypical, anaerobic, and Pseudomonas coverage. It also has no gram negative coverage except for N. meningitidis, T. pallidum, and Leptospira spp.
Penicillin
Also called as anti-staphylococcal penicillin that aims to attack the penicillinase, which is a virulence factor of the bacteria
Penicillinase resistant penicillin
Cloxacillin, Oxacillin, Nafcillin, Dicloxacillin, and Methicillin
The first penicillinase-resistant penicillin that is now removed from the market due to its high incidence of interstitial nephritis and due to a class of S. aureus developing a resistance against it
Drug used for community acquired resistance of this antibiotic
Drug used for hospital acquired resistance of this antibiotic, which is more common
Methicillin
Clindamycin
Vancomycin
A penicillinase-resistant penicillin antibiotic that can be given to patients with renal problems
ADR: Agranulocytosis
Nafcillin
They are penicillinase-resistant penicillins under another name. They are best absorbed and are used for the treatment of impetigo.
ADR: Drug-induced hepatitis
Isoxazoyl penicillins
Oxacillin, Cloxacillin, Dicloxacillin
They are a class of antibiotics with an antibacterial spectrum that is similar with Pen G but are more effective against Gram + bacilli. They are the most active oral beta lactam antibiotics for susceptible Streptococcus pneumonia
Aminopenicillins (Ampicillin, Amoxicillin)
This is an aminopenicillin that has poor GI absorption, thus is more frequently administered parenterally
ADR: Pseudomembranous colitis, maculopapular rash, diarrhea
Ampicillin
This is an aminopenicillin that has better GI absorption, thus is more frequently administered orally
ADR: Diarrhea
Amoxicillin
They are a class of antibiotics that have a Gram + and a little bit of Gram - coverage. They also have anaerobic coverage including Bacteroides fragilis
Anti-pseudomonal penicillins
These anti-pseudomonal penicillins are under carboxypenicillins
One of the drugs have an ADR that is disturbances in hematology
Carbenicillin
Ticarcillin
Ticarcillin
These anti-pseudomonal penicillins are under ureidopenicillins
It is the most potent ureidopenicillin against pseudomonas
Piperacillin, Azlocillin, Mezlocillin
Piperacillin
They are structurally related to the beta-lactam ring of penicillin but do not have antibacterial activity. Instead, they bind to and inactivate beta lactamases
Beta-lactamase inhibitors
Clavulanic acid, Sulbactam, Tazobactam
This is a class of antibiotics that have a dihydrothiazine ring that is attached to its beta-lactam. Its nucleus is known as 7-aminocephalosporanic acid. It is classified into 5 generations
Cephalosporins
This generation of cephalosporins is active against Proteus, E. coli, and Klebsiella
1st generation cephalosporins
CEPH
Cefazolin, Cefalexin, Cefadroxil
This generation of cephalosporins is active against Proteus, E. coli, and Klebsiella, as well as against H. influenzae, Enterobacter and Neisseria. It is also known to be the only generation that has an activity against anaerobes
2nd generation cephalosporins
Cef + vowel, except
Cefprozil, Cefmetazole, and Loracarbef
This generation of cephalosporins is active against Proteus, E. coli, Klebsiella, H. influenzae, Enterobacter and Neisseria, as well as Shigella, Salmonella, and Serratia.
These 2 drugs under this generation are the only ones with activity against Pseudomonas
3rd generation cephalosporins
Cef + consonant, except
Cefotaxime, Cefoperazone, Cefixime, Moxalactam
Ceftazidime and Cefoperazone
This generation of cephalosporins is active against Proteus, E. coli, Klebsiella, H. influenzae, Enterobacter, Neisseria, Shigella, Salmonella, and Serratia. It also has greater Gram + cocci activity and has activity against Pseudomonas
Group 4 cephalosporins
Cefepime, Cefpirome
This generation of cephalosporins is active against Proteus, E. coli, Klebsiella, H. influenzae, Enterobacter, Neisseria, Shigella, Salmonella, and Serratia. It also has greater Gram + cocci activity and has activity against Pseudomonas. Lastly, it has activity against MRSA
5th generation cephalosporins
Ceftaroline, Ceftobiprole
These antibiotics differ with penicillin in that the sulfur atom of the thiazolidine ring has been replaced by a carbon atom. It has coverage against Gram +, Gram -, and anaerobes. They are known to be the DOC for infections caused by ESBLs and are considered to be the most epileptogenic class
Carbapenem
Ertapenem, Doripenem, Imipenem, Meropenem
A carbapenem that is best for Pseudomonas
A carbapenem that has no coverage for Pseudomonas
A carbapenem that is the most epileptogenic, and is often combined with Cilastatin, a dehydropeptidase enzyme, to prolong its half-life
Doripenem
Ertapenem
Imipenem
This drug has coverage against Gram - and Pseudomonas and is administered IV. It can be given to patients with meningitis.
ADR: Transaminitis or elevation of liver enzymes
Monobactam
This class of antibiotics inhibits cell wall synthesis by binding to the D-Ala D-Ala terminus through inhibition of transglycosylase. Usually administered topically
ADR: Renal toxicity
This drug is different from other drugs in this glass since it is given parenterally. It is also the DOC for MRSA
Polypeptides
Vancomycin
This class of drug is used for infections caused by multi-drug resistant organism and is not recommended as monotherapy
Polymyxins
This is a class of antibiotics that inhibit protein synthesis at the 30s ribosomal subunit and is synergistic with beta-lactam antibiotics. They are usually given parenterally. They have coverage against Gram +, Gram -, and pseudomonas. It is bactericidal
Aminoglycosides
Aminoglycoside that ends with -mycin is derived from?
Aminoglycoside that ends with -micin is derived from?
Streptomyces
Microminospora
An aminoglycoside that is given orally and is relatively new
Neomycin
Aminoglycosides that are given against M. tuberculosis
Streptomycin (most active)
Amikacin
Aminoglycosides that are ototoxic
Aminoglycosides that are vestibulotoxic
Aminoglycosides that are nephrotoxic
Neomycin, Amikacin, Kanamycin
Streptomycin, Gentamycin
Neomycin, Gentamycin, Tobramycin
Aminoglycoside that is considered to be the most toxic
Tobramycin
This class of drug inhibits protein synthesis at the 30s subunit and is bacteriostatic. It has a naphtacene core. Usually, its absorption is impaired by food, antacids, dairy products, divalent cations (Mg, Fe, Ca) and Al. It is also excreted in bile, urine, and milk. It is considered as the broadest spectrum antibiotic, having coverage against gram +, gram -, atypical, and anaerobic bacteria. It is the DOC for Ricketssiae.
ADR: Permanent teeth discoloration, enamel hypoplasia, bone deformity, growth retardation, Fanconi syndrome (glycosuria, amino aciduria, phosphaturia)
Is Category D in pregnancy risk
Tetracyclines
Short acting: Tetracycline, chlortetracycline, oxytetracycline
Intermediate acting: Demeclocycline, metacycline
Long acting: Doxycycline, Minocycline
It is a tetracycline that can be used for the prophylaxis of malaria and Leptospira spp
Doxycyline
It is characterized by having a large lactone ring with a ketone and it inhibits protein synthesis at the 50s subunit. It has coverage against gram +, gram -, and atypical organisms. It is used for community-acquired pneumonia and is the alternative agent for those with beta lactam allergy
Macrolides
Clarithromycin, Azithromycin, Roxithromycin, Erythromycin
A macrolide that comes from Streptomyces erythreus. It is formerly known as Ilotycin (Ilosone). This is known to be the alternative to penicillin but is inactivated by gastric acid
Erythromycin
A macrolide more potent than erythromycin due to its methyl group. It is used as treatment of disseminated MAC in AIDS
Clarithromycin
A macrolide that has the longest half-life and thus, requires once a day dosing only. It is used for the prophylaxis against disseminated MAC in AIDS and is the drug for chlamydial STD. It is also the only macrolide that has concentration-dependent killing.
S/E: Arrythmia
Azithromycin
A lincosamide that has sulfur in it isolated from Streptomyces lincolnensis
Lincomycin
A lincosamide that has coverage against gram + and anaerobes. It is useful for community acquired MRSA. It is given for anaerobic infections above the diaphragm (except the brain)
ADR: Pseudomembranous colitis (DOC: Vancomycin, in Phil: Metronidazole)
Clindamycin
It is a drug that inhibits protein synthesis through the 50S subunit. It is used before for enteric fever and now for meningitis (2nd line to 3rd generation cephalosporins). It is also used for anaerobic infections and intraocular infections.
ADR: Gray baby/ Blue baby syndrome
Pregnancy risk category C
Chloramphenicol
This drug inhibits the nucleic acid synthesis, with one competing with PABA/ inhibiting dihydropteroate synthase and the other one inhibiting the dihydrofolate reductase. It has activity against gram +, more gram -, and atypical bacteria. It is also considered as the last line antibacterial agent. It is the DOC against Stenotrophomonas maltophilia and Burkholderia cepacia, as well as Pneumocystic jiroveci pneumonia (Pneumocystic carinii pneumonia) It may be used for prostatitis. It is an alternative drug for Toxoplasma gondii (DOC: pyrimethamine-sulfadiazine)
ADR: Crystalluria, hemolytic anemia, rashes, agranulocytosis, nausea and vomiting, kernicterus (SJS)
Trimethoprim-Sulfamethoxazole
Co-trimoxazole
This class of drugs interfere with DNA gyrase and topoisomerase
ADR: Hyperglycemia, hypoglycemia (with oral hypoglycemic agents), arthropathy, pregnancy category risk C
Quinolones
Nalidixic acid and fluroquinolones (Ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin
A first generation quinolone that has moderate gram -ve activity
Nalidixic acid
A second generation quinolone that has expanded gram -ve activity, some activity against gram +ve and atypical organisms. They are synergistic with beta lactams
ADR: prolonged QT interval
Ciprofloxacin
A third generation quinolone with expanded gram - activity, improved gram + activity and atypical organisms. It is excellent against S. pneumoniae
Levofloxacin
Fourth generation quinolones with improved activity against gram + and anaerobic activity
Moxifloxacin
Gemifloxacin
Fluoroquinolones that cover pseudomonas
Ciprofloxacin and levofloxacin
Fluroquinolones that cover anaerobes
Moxifloxacin
Fluoroquinolones that are respiratory quinolones
Moxifloxacin
Gemifloxacin
Levofloxacin
A prodrug that is converted by pyruvate-ferredoxin oxidoreductase. It has coverage against anaerobes below the diaphragm (including the brain). It can also target Giardia (giardiasis or beaver fever), Entamoeba (amoebiasis), and Trichomonas (Trichominiasi). It is also the DOC for Pseudomembranous colitis
Metronidazole
