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Antibacterials Flashcards

1
Q

What organisms are resistant to beta-lactams?

A
  1. Mycoplasma Pneumoniae
    • No cell wall
  2. Chlamydia
    • Intracellular
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2
Q

What is the MOA of beta-lactams?

A

(-) transpeptidases

(-) cross-linking of cell wall

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3
Q

What characterizes broad spectrum beta-lactamases?

A

hydrophilic

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4
Q

What are the first gen penicillins?

A
  1. Penicillin G
  2. Penicillin V
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5
Q

What types of organisms do first gen penicillins treat?

A
  • G+: Strep
    • (Do NOT treat staph)
  • Anaerobes
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6
Q

Penicillin G

  • IND
  • SE
A
  • First gen penicillin
  • IND
    • G+: Strep
    • Anaerobes
  • SE
    • CNS tox
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7
Q

Penicillin V

  • IND
  • SE
A
  • First gen penicillin
  • IND
    • G+: Strep
    • Anaerobes
  • SE
    • Decreased estrogen
    • Decreased effect of OCs
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8
Q

What are the Antistaphylococcal penicillin drugs?

A
  • Dicloxacillin
  • Nafcillin
  • Oxacillin
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9
Q

What types of organisms do Antistaphylococcal penicillins treat?

A
  • G+
    • MSSA
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10
Q

Dicloxacillin

  • Class
  • IND
A
  • Antistaphylococcal penicillin
  • IND
    • G+
      • MSSA
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11
Q

Nafcillin

  • IND
  • SE
A
  • Antistaphylococcal penicillin
  • IND
    • G+
      • MSSA
  • SE
    • Phlebitis
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12
Q

Oxacillin

  • Class
  • IND
A
  • Antistaphylococcal penicillins
  • IND
    • G+
      • MSSA
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13
Q

What are the Amino Penicillin drugs?

A
  • Amoxicillin
  • Ampicillin

Amino penicillins start with an “A”

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14
Q

What types of organisms do Amino Penicillins treat?

A
  • G+
  • G-

Not resistant to beta-lactamases

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15
Q

Amoxicillin

  • IND
  • SE
A
  • Amino Penicillin
  • IND
    • DOC: Otitis media
    • G+
    • G-
  • SE:
    • Decrease estrogens
    • decrease effectiveness of OCs
    • Colitis
      • leads to infx by C. dif
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16
Q

Ampicillin

  • IND
  • SE
A
  • Amino Penicillin
  • IND
    • G+
    • G-
  • SE:
    • Decrease estrogens
    • Decrease effectiveness of OCs
    • Colitis
      • leads to infx by C. dif
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17
Q

Ticarcillin

  • IND
  • SE
A
  • Carboxypenicillins
  • IND
    • G+
    • G-
    • New: Enterobacter
    • Pseudomonas
  • SE:
    • (-) platelet aggregation
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18
Q

Piperacillin

  • IND
  • SE
A
  • Ureido penicillin
  • IND
    • G+
    • G-
    • Pseudomonas (FA)
    • New: Enterococci, Klebsiella
  • SE
    • (-) platelet aggregation
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19
Q

What drug is combined with amoxicillin to counter resistance to beta-lactams?

A

Clavulanic acid

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20
Q

What drug is combined with Ampicillin to counter resistance to beta-lactams?

A

Sulbactam

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21
Q

What are the beta-lactamase inhibitors added to penicillins to counter resistance?

A

“CAST”

  • Clavulanic Acid
    • w/ Amoxicillin or Ticarcillin
  • Sulbactam
    • Ampicillin
  • Tazobactam
    • Piperacillin
      • Piper drinks Tazo tea
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22
Q

Which Penicillins are used for Pseudomonas?

A

Ticarcillin

Piperacillin

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23
Q

What types of organisms to Carbapenems treat?

A
  • G+
  • G-
  • Anaerobes
  • Used for complicated infx of
    • Abdomen
    • UTI
    • Skin
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24
Q

What must be given with Imipenem to decrease inactivation in renal tubules?

A

Cilastin

“the kill is lastin’ with cilastin”

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25
Q

When are carbapenems contraindicated?

A

Patients w/ anaphylaxis to beta-lactams

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26
Q

What are the specific clinical uses of Imipenem?

A
  • Endocarditis
  • Sepsis
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27
Q

What is the specific clinical use of Meropenem?

A

Meningitis

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28
Q

What type of organisms do Monobactams (Aztreonam) treat?

A
  • G- aerobes only
    • _​_Pseudomonas!
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29
Q

Aztreonam

  • Class
  • IND
A
  • Monobactam
  • MOA
    • (-) crosslinking of cell wall by transpeptidases
  • IND
    • G- aerobes only
      • Pseudomonas
    • Use in Penicillin allergies
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30
Q

What is the MOA of Cephalosporins?

A
  • Beta-lactam drugs
  • inhibit cell wall synthesis
    • (-) cross linking
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31
Q

What types of organisms do 1st Gen cephalosporins treat?

A
  • G+
    • Strep
  • Some G-
    • E. coli
    • Klebsiella
  • Anaerobes
    • except Bacteroides fragilis
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32
Q

What are the 1st Gen cephalosporin drugs?

A
  • Cefazolin
  • Cephalexin
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33
Q

What are the 2nd Gen Cephalosporin drugs?

A
  • Cefuroxime
  • Special: Cefotetan (cephamycin group)
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34
Q

Cefuroxime

  • Class
  • IND
A
  • 2nd Gen Cephalosporin
  • IND
    • G-:
      • H. influenza
      • N. meningitidis
      • Enterobacteriaceae
    • Some G+
      • Strep
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35
Q

Cefotetan

  • Class
  • IND
  • SE
A
  • 2nd Gen Special Cephalosporin (cephamycin)
  • IND
    • G- anaerobes
      • Bacteroides
  • SE
    • disulfiram rxn w/ alcohol
    • bleeding disorder
      • give w/ Vit K
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36
Q

What are the 3rd Gen Cephalosporin drugs?

A
  • Cefdinir
  • Cefpodoxime
  • Ceftazidime
  • Ceftriaxone
37
Q

What type of organisms do 3rd Gen Cephalosporins treat?

38
Q

Ceftazidime

  • Class
  • IND
A
  • 3rd gen Cefalosporin
  • IND
    • G-
      • Pseudomonas
39
Q

Ceftriaxone

  • Class
  • IND
  • SE
A
  • 3rd Gen Cephalosporin
  • IND
    • G-
      • Neisseria gonorrhea
  • SE
    • Biliary sludging
40
Q

Cefepime

  • Class
  • IND
A
  • 4th Gen Cephalosporin
  • IND
    • G+
      • Pseudomonas
    • Meningitis
      • can cross BBB
41
Q

Ceftaroline

  • Class
  • IND
A
  • 5th Gen Cephalosporin
  • IND
    • G+
    • G-
    • MRSA

Ceftaroline => Caroline => Madoline => MRSA

42
Q

Bacitracin

  • MOA
  • IND
A
  • MOA
    • (-) lipid bactoprenol pyrophosphate
      • can’t carry murein
      • (-) murein monomer synthesis
      • only one w/ lipid target
  • IND
    • C. difficile
    • Enterococci
43
Q

Vancomycin

  • MOA
  • IND
  • SE
A
  • MOA
    • (-) transglycosidase
    • Blocks addition of murein units to polymer chain
    • (-) cell wall synthesis
  • IND
    • G+ rods and cocci
      • MRSA
      • MRSE
      • C. diff
  • SE:
    • Ototoxicity
44
Q

What type of organisms do Quinolones treat? What is the MOA associated with each type?

A
  • G+
    • Target Topoisomerase IV
    • cause unlinking of daughter chromosomes (decantanation)
  • G-
    • Target Topoisomerase II
    • (-) supercoiling
    • (-) DNA replication
45
Q

What are the SEs of the Quinolones?

A
  • Long QT
  • Tendon rupture (tendonitis)
    • Black Box warning
    • Quinolones hurt attachments to your bones
46
Q

Ciprofloxacin

  • Class
  • IND
  • SE
A
  • Quinolone
  • IND
    • Bacillus anthracis
    • Atypicals:
      • Legionella pneumoniae
      • Mycoplasma pneumoniae
    • UTI
  • SE (same as group)
    • Long QT
    • Tendon rupture
47
Q

Levofloxacin

  • Class
  • IND
  • SE
A
  • Quinolone
  • IND
    • UTI
    • RTI
  • SE (Same as group)
    • Long QT
    • Tendon rupture
48
Q

Moxifloxacin

  • Class
  • IND
  • SE
A
  • Quinilone
  • IND
    • RTI
  • SE (same as group)
    • Long QT
    • Tendon rupture
49
Q

Sulfamethoxazole

  • Class
  • MOA
  • IND
  • SE
A
  • Sulfonamide
  • MOA
    • (-) dihydropteroate
    • (-) folate synthesis
      • (-) nucleotide and protein synthesis
  • IND
    • UTIs
  • SE
    • Kernicterus in infants
    • Stevens Johnson Syndrome
    • Hemolytic anemia
50
Q

Trimethoprim

  • MOA
  • IND
A
  • MOA
    • (-) DHFR
    • (-) folate synthesis
      • (-) nucleotide and protein synthesis
    • Bacteriostatic
  • IND
    • UTI
51
Q

TMP-SMX

  • MOA
  • IND
  • SE
A
  • Sulfamethoxazole + Trimethoprim
  • MOA
    • combination folate inhibitor
  • IND
    • UTI
  • ​SE
    • Stevens Johnson Syndrome
    • Hemolytic anemia
52
Q

What are the aminoglycoside drugs?

A
  • Amikacin
  • Gentamicin
  • Tobramycin
53
Q

What organisms do aminoglycosides treat?

A
  • Aerobic only!
    • Need O2 to pass thru porins
  • G-: Serious infxn
    • Pseudomonas
    • Klebsiella
54
Q

What is the MOA of aminoglycosides?

A
  • Inhibit formation of initiation complex, causing misreading of mRNA
    • binds 16S rRNA
    • Targets 30s ribosomal subunit
55
Q

What side effects are associated with aminoglycosides?

A
  • ***Ototoxicity
    • Vestibular
    • Hearing
  • Neuromuscular blockade
    • pts w/ myesthenia gravis
56
Q

Amikacin

  • Class
  • MOA
  • IND
  • SE
A
  • Aminoglycoside
  • MOA
    • targets 30s ribosomal subunit
      • Inhibits formation of initiation complex
  • IND
    • aerobes
    • G-: serious infxn
      • Pseudomonas
      • Klebsiella
  • SE
    • Ototoxicity
57
Q

Gentamicin

  • Class
  • MOA
  • IND
  • SE
A
  • Aminoglycoside
  • MOA
    • targets 30S ribosomal subunit
    • Inhibits formation of initiation complex
  • IND
    • Aerobes only
    • G-: serious infxn
  • SE
    • Ototoxicity
58
Q

Tobramycin

  • Class
  • MOA
  • IND
  • SE
A
  • Aminoglycoside
  • MOA
    • Targets 30s ribosomal subunit
    • Inhibits formation of initiation complex
  • IND
    • aerobes only
    • G-: serious infxns
      • Pseudomonas
      • Klebsiella
  • SE
    • Ototoxicity
59
Q

Spectinomycin

  • Class
  • MOA
  • IND
A
  • Aminocylitol
  • MOA
    • Targets 30s ribosomal subunit
    • Bacteriostatic
  • IND
    • N. gonorrhea
60
Q

What are the tetracycline drugs?

A
  • Doxycycline
  • Tetracycline
61
Q

What is the MOA of Tetracyclines?

A

Target 30S ribosomal subunit

Prevents attachment of aminoacyl-tRNA to acceptor site

62
Q

What organisms do tetracyclines treat?

A
  • DOC: tick-borne diseases
    • Rickettsia
    • Lyme disease
  • G+
  • G-
63
Q

What are the side effects of Tetracyclines?

A
  • Teeth become discolored
  • (-) bone growth
  • Superinfection w/ C. diff (colitis)
    • alteration in normal flora
64
Q

What side effect is specific to doxycycline and not tetracycline?

A

Photosensitivity

65
Q

Tigecycline

  • Class
  • MOA
  • IND
A
  • Glycylcycline
  • MOA
    • targets 30S ribosomal subunit
    • Bacteriostatic
  • IND
    • MRSA
    • G+
    • G-
    • Anaerobes
66
Q

What are the macrolide drugs?

A
  • Azithromycin
  • Clarithromycin
  • Erythromycin

the “-thromycin”s

67
Q

What organisms do the macrolides treat?

A
  • G+
    • Strep
  • G-
    • Treponema pallidum
    • Mycoplasma
    • Borrelia
68
Q

What is the MOA of Macrolides?

A

Target 50S ribosomal subunit

Block aminoacyl tRNA complex translocation step

69
Q

Azithromycin

  • Class
  • MOA
  • IND
A
  • Macrolide
  • MOA
    • Target 50S ribosomal subunit
    • Blocks aminoacyl tRNA complex translocation step
  • IND
    • Bronchitis
    • (list of bacteria)
70
Q

Clarithromycin

  • Class
  • MOA
  • IND
  • SE
A
  • Macrolide
  • MOA
    • targets 50S ribosomal subunit
    • Blocks aminoacyl tRNA complex translocation step
  • IND
    • Bronchitis
    • Mycobacterium avium
  • SE:
    • (-) P450

Clarithromycin => clear air -thromycin => clear air for the birds to fly => mycobacterium avium

71
Q

Erythromycin

  • Class
  • MOA
  • IND
  • SE
A
  • Macrolide
  • MOA
    • targets 50S ribosomal subunit
    • Blocks aminoacyl tRNA to acceptor site
  • IND
    • Otitis media
  • SE
    • Arrythmia
72
Q

Telithromycin

  • Class
  • MOA
  • IND
  • SE
A
  • Ketolide
  • MOA
    • Targets 50S ribosomal subunit
  • IND
    • Pneumonia
  • SE:
    • Visual toxicity
73
Q

Chloramphenicol

  • Class
  • MOA
  • IND
  • SE
A
  • Amphenicol
  • MOA
    • Targets 50S ribosomal subunit
  • IND: treats all types
    • Brain abcess
    • Meningitis
    • Rickettsia
    • Chlamydia
  • SE:
    • Gray Baby Syndrome
    • Optic neuritis
    • Myelosuppression
74
Q

Clindamycin

  • Class
  • MOA
  • IND
  • SE
A
  • Streptogramin
  • MOA
    • Targets the 50S ribosomal subunit
    • Blocks initiation complex formation and aminoacyl tRNA complex translocation step
  • IND
    • All types
    • C. diff is resistant
  • SE:
    • C diff invxn
      • pseudomembranous colitis
75
Q

Dalfoprisitin / Quinupristin

  • Class
  • MOA
  • IND
  • CON
A
  • Streptogramins
  • MOA
    • Target 50S ribosomal RNA
  • IND
    • some G+
      • -cidal
    • Strep faecium
      • -static
  • CON
    • pt w/ liver failure
76
Q

Linezolid

  • Class
  • MOA
  • IND
  • SE
A
  • Oxazolinidone
  • MOA
    • Targets 50S ribosomal subunit
  • IND
    • Resitant, G+ bacteria
      • MRSA
      • VRE
      • VRSA
    • Enterococci and Staph
      • -static
    • Strep
      • -cidal
  • SE:
    • Myelosuppression
    • Neurotoxicity
77
Q

Daptomycin

  • MOA
  • IND
  • SE
A
  • MOA
    • inserts in membrane
      • disrupts potential
    • (-) DNA / RNA / peptide synthesis
  • IND
    • multi-drug resistant G+
    • R-side endocarditis
    • NOT pneumonia
  • SE
    • Rhabdomyolitis
78
Q

Nitrofurantoin

  • MOA
  • IND
  • SE
A
  • MOA
    • Produces ROS
  • IND
    • uncomplicated UTIs
  • SE
    • Pulmonary fibrosis
    • Peripheral neuropathy
    • Hep tox
79
Q

Metronidazole

  • MOA
  • IND
  • SE
A
  • MOA
    • Produces ROS
  • IND
    • anaerobes:
      • Bacteria:
        • Bacteroides
        • Clostridium
      • Protozoa
        • Entamoeba
        • Giardia
        • Trichomonas
  • SE
    • Optic neuropathy
    • Aseptic meningitis
    • Disulfiram effects w/ alcohol
80
Q

Muprirocin

  • MOA
  • IND
A
  • MOA
    • Binds isoleucyl-tRNA synthase
      • (-) protein synthesis
  • IND
    • G+ resistant bacteria
    • MRSA
81
Q

Polymixin B and E

  • MOA
  • IND
  • SE
A
  • MOA
    • long, hydrophobic tail disrupts plasma membrane
  • IND
    • G-
      • Pseudomonas
      • Acinetobacter
  • SE
    • Neuro tox
    • Nephro tox
82
Q

What drugs are used to treat M. tuberculosis?

A

TB is “RRIPE” for treatment

  • Rifampin
  • Rifapentine
  • Isoniazid
  • Pyrazinamide
  • Ethambutol
83
Q

Isoniazid

  • MOA
  • IND
  • SE
A
  • MOA
    • (-) mycolic acid synthesis
      • part of cell wall
  • Use
    • Active or latent TB
  • SE
    • SLE
    • Hepatotox
84
Q

Pyrazinamide

  • MOA
  • IND
  • SE
  • CON
A
  • MOA
    • (-) FA synthase
      • disrupts cell membrane
  • IND
    • Active TB
  • SE
    • Porphyria
    • Photosensitivity
    • Hepato tox
  • CON
    • Acute gout
85
Q

Rifampin

  • MOA
  • IND
  • SE
A
  • MOA
    • (-) DNA dependent RNA polymerase
  • IND
    • Latent or active TB
    • Meningitis
  • SE
    • Red tears, sweat, urine
86
Q

Rifapentine

  • MOA
  • IND
  • SE
A
  • MOA
    • (-) DNA dependent RNA polymerase
  • IND
    • latent TB
  • SE
    • red-brown color to body fluids
87
Q

Ethambutol

  • MOA
  • IND
  • SE
A
  • MOA
    • (-) metabolite synthesis
  • IND
    • Active TB
  • SE
    • Optic neuritis
    • Blindness
88
Q

Bedaquiline

  • MOA
  • IND
  • SE
A
  • MOA
    • (-) mycobacterial ATP synthase
  • IND
    • last resort for MDR-TB
  • SE
    • Black box: Arrhythmia
      • Long QT
    • Death with no known cause
    • Hemoptysis
89
Q

Dapsone

  • MOA
  • IND
A
  • MOA
    • (-) folate production
  • IND
    • Leprosy
    • Pneumocystis pneumonia

Pharmacology (12 decks)

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