Antibacterials

Question 1

For gram positive organisms - S. Pneumoniae, S. Pyogenes, Actinomyces

For N. Meningitides, T. Pallidum

Answer 1

Pen G, V

Question 2

ADR of Penicillins G, V

Answer 2

Hypersensitivity, hemolytic anemia

Question 3

Wide spectrum beta lactamase antibiotic

Answer 3

Ampicillin, amoxicillin

Question 4

Combines with clavulanic acid

Answer 4

Ampicillin, amoxicillin

Question 5

Treatment for HELPSS

H. Influenza
E. Coli
L. Monocytogenes
P. Mirabilis
Salmonella
Shigella

Answer 5

Ampicillin, amoxicillin

Question 6

ADR of ampicillin, amoxicillin

Answer 6

Hypersensitivity

Pseudomembranous colitis

Question 7

Narrow spectrum penicillin

Penicillinase resistant due to bulky R group

Answer 7

Oxacillin, nafcillin, dicloxacillin

Question 8

Tx for S. Aureus and ADR

Answer 8

Oxacillin, nafcillin, dicloxacillin

Hypersensitivity, interstitial nephritis

Question 9

Antipseudomonals

Answer 9

Ticarcillin, piperacillin

Question 10

B lactamase inhibitors

Answer 10

CAST

Clavulanic Acid
Sulbactam
Tazobactam

Question 11

Organisms not covered by Cephalosporins

Answer 11

LAME

Listeria
Atypicals
MRSA
Enterococci

Question 12

1st generation Cephalosporins

Answer 12

PEcKs first

Proteus
E. Coli
Klebsiella
S. Aureus

Start with Ceph EXCEPT Cefadroxil and Cefazolin

Question 13

2ng generation Cephalosporins

Answer 13

HEN PEcKS

H. Influenza
Enterobacter aerogenes
Neisseria
Proteus mirabilis
E. Coli
Klebsiella
Serratia marcescens

Start with Cef, don’t end with -ime/one EXCEPT Cefuroxime

Question 14

3rd generation Cephalosporins

Answer 14

Ceftriaxone - meningitis and gonorrhea
Ceftazidime - pseudomonas

Start with Cef, ends with -ime/one EXCEPT Cefazolin

Question 15

4th generation cephalosporins

Answer 15

Increased activity against Pseudomonas and gram positive

Question 16

5th generation cephalosporin

Answer 16

Ceftaroline

Broad spectrum, does not cover pseudomonas

Question 17

Cephalosporin toxicity

Answer 17

Vitamin K deficiency, nephrotoxicity with aminoglycosides

Question 18

Aztreonam

MOA
Uses
ADRs

Answer 18

Binds to PBPs
Gram negative rods
Usually non toxic

Question 19

Carbpenems

MOA
Uses
ADRs

Answer 19

B lactamase resistant

Wide spectrum, for life threatening infections
Used with Cilastatin (decreases inactivation in kidneys)
CNS toxicity (decreased with Meropenem)

Question 20

Vancomycin

MOA
Uses
ADRs

Answer 20

Binding D-ala D-ala, inhibitis peptidoglycan
Gram positive, MRSA
NOT trouble free - Nephrotoxicity, Ototoxicity, Thrombophlebitis
Red man syndrome

Question 21

Aminoglycoside

Examples
MOA
Uses
ADRs

Answer 21

GNATS - gentamicin, neomycin (bowel sx), amikacin, tobramycin, streptomycin
Inhibits initiation complex causing misreading of mRNA, Require O2
For severe gram negative rod infections
Nephrotoxicity, Neuromuscular blockade, Ototoxicty, Teratogen

Question 22

Tetracylcins

Examples
MOA
Uses
ADR

Answer 22

Tetracycline, doxyxycline, minocycline
Binds 30s and prevents attachment of aminoacyl-tRNA
Borrelia, M. Pneumonia, Rickettsia, Chlamydia
Teeth discoloration, inhibition of bone growth, photosensitive, Contraindicated in pregnancy

Question 23

Macrolides

MOA
Uses
ADRs

Answer 23

Azithromycin, clarithromycin, erythromycin

Binds to 50s, blocks translation
Atypical pneumonia, Chlamydia, gram positive cocci
MACRO: Motility issues, arrhythmia, cholestatic hepatitis, rash, eosinophilia

Question 24

Used for meningitis, Rocky Mountains potted fever
Blocks 50s
Causes anemia and gray baby syndrome

Answer 24

Chloramphenicol

Question 25

Blocks 50s
For anaerobic infections above the diaphragm
Causes pseudo membranous colitis

Answer 25

Clindamycin

Question 26

Sulfonamide a

Examples
MOA
Uses
ADRs

Answer 26

Sulfamethoxazole, sulfisoxazole, sulfadiazine
Inhibits folate synthesis (inhibit dihydropteroate synthase)
Gram posive/negative, Nocardia, Chlamydia, UTI
Hemolysis is G6PD deficient, Nephrotoxicity, kernicterus, displaces warfarin from albumin

Question 27

Trimethoprim

MOA
Uses
ADRs

Answer 27

Inhibits dihydrofolate reductase
UTI, salmonella, shigella, pneumocystis jirovecii and toxoplasmosis prophylaxis
Megaloblastic anemia, leukopenia, granulocytopenia

Question 28

Fluroquinolones

Examples
MOA
Uses
ADR

Answer 28

Floxacins and nalidixic acid
Inhibits DNA gyrase (topoisomerase II) and topoisomerase IV
Gram negative rods for urinary and GIT, neisseria
Tendinitis

Question 29

Metronidazole

MOA
Uses
ADRs

Answer 29

Forms free radicals that damage DNA
GET GAP: giardia, entamoeba, trichomonas, gardnerella, anaerobes, h. Pylori (anaerobic infections below the diaphragm)
Disulfiram-like reaction, metallic taste

Question 30

Isoniazid

MOA
ADR

Answer 30

Decreased mycolic acid synthesis

INH Injures Neurons and Hepatocytes: Nuerotoxicity, hepatotoxicity

Question 31

Rifamycin

MOA
ADR

Answer 31

4Rs
RNA polymerase inhibitor
Ramps up microsomes cytochrome P450
Red orange body fluids
Rapid resistance
Ramps up cytochrome P450 BUT rifaBUTin does not

Question 32

Pyrazinamide

MOA
ADR

Answer 32

Unknown. Acidified intra cellular environment

Hyperuricemia, hepatotoxicity

Question 33

Ethambutol

MOA
ADR

Answer 33

Blocks arabinosyltransferase
Optic neuropathy (red green color blindness)

Question 34

Binds PBPs, blocks transpeptidase

Answer 34

Pen G, V

Question 35

Penicillinase sensitive penicillins

Answer 35

Pen G, V
Ampicillin
Amoxicillin

Question 36

Penicillinase resistant penicillins

Answer 36

Oxacillin, nafcicillin, dicloxacillin

Question 37

Antipseudomonals

Answer 37

Ticarcillin

Piperacillin