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Pharmacology > Antibacterials > Flashcards

Antibacterials Flashcards

1
Q

Gram- Antibacterials

A

B-Lactams:
*Aztreonam

Other Cell Wall inhibitors:
*Isoniazid (Cell Wall Synthesis Inhibitor)

Protein Synthesis Inhibitors:

  • Aminoglycosides (Streptomycin, Amikacin)
  • Rifampin

Other: *Methenamine (Urinary Tract Antiseptic)

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2
Q

Gram+ Antibacterials

A

*Linezolid (Protein Synthesis Inhibitor)
*Vancomycin (Cell Wall Formation inhibitor D-ala D-ala)
Some Gram-:
*Extended Penicillins (some Gram-)

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3
Q

Positives and ANaerobic bacteria Antibacterials

A

B-Lactams:
*Penicillin G (G-rated, so doesn’t get too deep…)

Protein Synthesis Inhibitors:

  • Macrolides (Erythromycin)
  • Clindamycin

DNA Synthesis Inhibition:
*Metronidazole (Flagyl)

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4
Q

Name the B-Lactams

A
  • Penicillin G
  • Extended Penicillin

Monobactams:
*Aztreonam

Carbapenems:

  • Ertapenem
  • Iminpenem (with Cilastatin)
  • Meropenem

Cephalosporins:

  • 1st gen: Cefazolin, Cephalexin
  • 2nd gen: Cefoxitin, Cefuroxime, CEfaclor
  • 3rd gen: Ceftriaxone, Cefixime, Ceftazidime, Cefoperzone
  • 4th gen:__
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5
Q

Name the Cephalosporins

A

1st gen: Cefazolin, Cephalexin
2nd gen: Cefoxitin, Cefuroxime, Cefaclor
3rd gen: CefTRIaxone, Cefixime, Ceftazidime, Cefoperazone
4th gen: ___

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6
Q

Name all the Broad-Spectrum Antibacterial drugs

A

B-lacs:

  • Cephalosporin 3rd gen (Ceftriaxone, Ceixime, Ceftadizime, Cefoperazone)
  • Iminpenem (with Cilastatin)

Protein Synthesis Inhibitors:

  • Chloramphenicol
  • Fluoroquinolones and Quinolones 2nd gen (Norflaxin, Ciproflaxin)
  • Tetracyclines (Tetra~, Doxy~, Tige~)

Folic Acid Synthesis Inhibitors:

  • Dapsone
  • Sulfonamides (Sulfisoxale, Sulfamethoxazole)
  • Trimethoprim
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7
Q

Name the Cell Wall Inhibitor Classes and Drugs

A

B-Lacs:

  • Penicillin G and Extended
  • Monobactams - Axtreonam
  • Carbapenem - Ertepenem, Meropenem, Iminpenem WITH Cilastatin
  • Cephalosporins -
  • *1st Gen: Cefazolin, Cefalexin
  • *2nd Gen: Cefoxitin, Cefuroxime, Cefaclor
  • *3rd Gen: CefTRIaxone, Cefixime, Ceftazidime, Cefoperazone
  • Other: Ethambutol, Isoniazid, Pyrazinamide, Vancomycin
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8
Q

Name the DNA Synthesis Inhibitors

A
  • Quinolones
  • Fluoroquinones
  • Metronizadole
  • Folic Acid Synthesis inhibitors:
  • *Dapsone
  • *Sulfanamides
  • *Trimethroprim
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9
Q

Name Protein Synthesis Inhibitors

A

30S Inhibitors:

  • Tetracycline (Tetra, Doxy, Tige) (Reversible)
  • Aminoglycosides (Streptomycin and Amikacin) (Irreverisible)

50S:

  • Macrolides (Azithro, Erythro, and Clarithro)
  • Chloramphenicol
  • Linezolid
  • Daptomycin (Dapsone)
  • Clindamycin
  • Metronizadole

RNApoly:

  • Rifampin
  • Rifabutin
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10
Q

Metronizadole

A

** “NO ETOH WHILE ON METRO OR DURING FIRST TRIMESTER OF PREGNANCY.” **
*DNA and Protein Synth Inh by forming covalent bonds
Metabolized in liver that then has further activity that limits aldehyde dehydrogenase, which metabolizes ETOH.
Metallic taste, reddish-brown urine
SUPERINFECTION possible

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11
Q

Erythromycin

A
  • Macrolide (50S inh)
  • Gram+ Rods and Cocci (v. few Gram-)
  • Alternate to penicillin allergy
  • *INHIBITS p450
  • GI intolerance, Liver toxicity at high doses, HEARING LOSS (reversible), Ventricular Tachy with QT lengthening
  • Per the gut, stimulates Gut motility and makes things go Ery-THROUGH-YOU
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12
Q

Clarithromycin

A
  • Macrolide (50S inh)
  • Similar to Erythro
  • MORE HEARING LOSS than erythro
  • TERATOGENIC - NOT during PREGNANCY
  • INHIBITS p450
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13
Q

Azithro

A
  • Macrolide (50S inh)
  • Similar to Clarithro
  • Oral, excellent tissue penetration and CNS and long half life, easy to take home!
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14
Q

Clindamycin

A
  • SIMILAR TO MACROLIDE, but NOT A MACROLIDE
  • Treat MRSA!!
  • Oral, SUPERINFECTION side effect
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15
Q

Linezolid

A
  • For Vanc-resistant
  • MOSTLY Gram+
  • 23S RNA moiety of 50S subunit to prevent 70S formation
  • MYELOSUPPRESSION and Peripheral and Optic Neuropathy from long use
  • Mild Inh of Monoamine Oxidase, which makes hard for body to metabolize some nutrients like tyramine (BP rises)
  • *DOES NOT INHIBIT p450
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16
Q

Daptomycin

A
  • ONLY FOR VANC-RESISTANT STAPH INFECTIONS
  • Forms a pore allowing ions in and cell burst
  • IV only
  • Muscle weakness
  • STOP STATINS and agents with rhabdomyolysis because can be significant muscle breakdown
17
Q

Tetracyclines

A
  • Tetra, Doxy, Mino, Tige
  • Gram+ and Gram-
  • usually not first choice, except MINOCYCLINE for acne and Lyme and DOXY for STDs and tick-related vectors
  • REVERSIBLE bind to 30S and cannot accept new AAs
  • ORAL except Tige
  • CHELATES with METALS, so don’t take with food, also like to settle in bones and teeth because of the calcium there
  • BILE and URINE excre.
  • Mech of resistance: influx/efflux, ribosome change, enzyme metabolism
  • SUPERINFECTION is possible bc affects gut 1st, Some heart (vestibular) dysfunction, can cause aciduria
  • NOT FOR KIDS or MOMS
18
Q

Aminoglycosides

A
  • 30S binding IRREVERSIBLE so will KILL, RNApoly cannot start translation, will end early, or will incorporate incorrect AAs
  • Streptomycin and Amikacin
  • IV, does not penetrate
  • Concentration-dependent, will build up
  • Gram-, Plague, TB
  • *NOT ANAEROBES bc **OXYGEN-DEPENDENT TRANSPORT across inner cell membrane means will only act on bacteria that like O2
  • OTOTOXICITY and RENAL impairment (because concentration builds), also vestibular and auditory
  • Works with b-lacs
19
Q

What type of bacteria do Aminoglycosides NOT work well against, and why?

A
  • Anaerobes

* OXYGEN-DEPENDENT TRANSPORT across inner cell membrane means will only act on bacteria that like O2

20
Q

Chloramphenicol

A

Gram+/- Aerobic and Anaerobic

  • 50S binding to inhibit peptidyltransferase between A and P sites
  • Can interfere with mitochondrial Ribosomes
  • INHIBITS p450!!!
  • MYELOSUPPRESSION - anemia, GREY BABY SYNDROME
21
Q

Drugs that cause Myelosuppression

A

Chloramphenicol
Linezolid
Benzimidazoles

22
Q

Dapsone

A
  • Folic Acid Metabolism Inh
  • PABA analog
  • Inhibits Dihydropteroate Synthase, like the Sulfonamides
  • BROAD spectrum, including Anaerobes
23
Q

Sulfonamides

A
  • Folic Acid Metabolism Inh
  • PABA analog
  • Inhibits Dihydropteroate Synthase
  • UROCRYSTAL FORMATION
24
Q

Rifampin

A
  • Gram+/-, MYCOBACTERIA, CHLAMYDIA
  • Protein Synthesis inhibition
  • Beta subunit of RNApoly to inhibit RNA synth
  • ACTIVATES p450
25
Q

Rifambutin

A

Similar to Rifampin but LESS ACTIVATION OF p450

26
Q

Isoniazid

A
  • Cell Wall Inhibitor
  • MYCOBACTERIA treatment first choice
  • Inhibits Mycolic acid synthesis, hence the treatment of mycobacteria
  • Oral
  • Kidney excre.
  • Some immun reactions, liver loxicities with clinical hepatitis
27
Q

50S DNA Synthesis Inhibitors

A
  • Macrolides (Azithro, Erythro, and Clarithro)
  • Chloramphenicol
  • Metronizadole
  • Linezolid
  • Clindamycin
28
Q

30S DNA Synthesis Inhibitors

A
  • Tetracycline (Tetra, Doxy, Tige) (Reversible)

* Aminoglycosides (Streptomycin and Amikacin) (Irreverisible)

29
Q

VRE Trio

A
  • Linezolid
  • Clindamycin
  • Daptomycin (forms pore)
30
Q

Drugs that act on RNApolymerase

A
  • Rifampin

* Rifabutin

31
Q

Drugs that act on TB and Mycobacteria

A

REPuBLIC

  • Rifampin
  • Ethambutol
  • Pyrazinamide
  • Bedaquiline
  • Levofloxacin
  • Isoniazid
  • Cycloserine
32
Q

p450 INDUCERS

A

p450 must think that something is RIGged against it:

  • Rifampin
  • Isoniazid (only one CYP that importantly metabolizes Aceteminophen, otherwise inhibits many other CYPs)
  • Griseofulvin (antifungal)
33
Q

p450 INHIBITORS

A 
These put p450 on ICCE-T:
*Isoniazid
*Ciproflaxin 
*Clarithromycin
*Erythromycin
*Trimethoprim+Sulfonamide
*Fluconazole
*Itraconazole
*Metronidazole
(*Ritonavir and Cobisistant BOOSTERS for other drugs, and they inhibit p450)
34
Q

TB drug Cell Wall Formation Inhibitors

A

EPIC:

  • Ethambutol
  • Pyrazanimide
  • Isoniazid
  • Cycloserine
35
Q

Abx that are dangerous during Pregnancy

A

Tetra, Amino, Metro, and Chlor: Mamas-to-be like CLARIce can’t have them no more!
The 30S inhibitors, Chloramphenicol, Clarithromycin, and Metronidazole

36
Q

Special use for Erythromycin

A

Stimulate gut motility post-surgery

Pharmacology (7 decks)

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