Antibacterials

Question 1

Classes that affect folate synthesis

Answer 1

Sulfonamides, trimethoprim

Question 2

Drug classes that target DNA integrity

Answer 2

Metronidazole (causes ds breaks)

Question 3

Drug classes that target DNA gyrase

Answer 3

Fluorquinolones, Quinolone

Question 4

Drugs that target cell wall synthesis

Answer 4

Beta lactams (-cillins), vancomycin, bacitracin, carbapenams, cephalosporins, monobactams

Question 5

Drug classes that target microbial protein synthesis

Answer 5

Aminoglycosides, Tetracyclines, Chloramphenicol, Clindamycin, Linezolid, Macrolides, Streptogramins

Question 6

MOA: Penicillin

Answer 6

D-ala-D-ala analog, binds to PBPs, blocking cross-linking of peptioglycans
*As a result - used for Gram + mostly

Question 7

AE of Penicillins

Answer 7

Major AE is hypersensitivity reactions, which tend to be cross-reactive across penicillins, as well as cephalosporins

Question 8

Exception: Name the Anti-Pseudomonal penicillins

Answer 8

Piperacillin and ticarcillin

Question 9

B Lactamase Inhibitors - name the 4

Answer 9

CAST:
Clavulonic acid
Avibactam
Sulbactam
Tazobactam

Question 10

Cephalosporins - MOA

Answer 10

Inhibit cell wall synthesis, beta-lactam drugs

Question 11

Cephalosporins - AEs

Answer 11

Hypersensitivity (check for penicillin allergies), AIHA, disulfiram-life rxn, vitamin K deficiency

Question 12

Cephalosporins - MOR

Answer 12

Structural changes to the PBPs

Question 13

Vancomycin - MOA + MOR

Answer 13

Binds D-ala-D-ala portion of cell wall, inhibiting synthesis

MOR: Bacteria changes to D-ala-D-Lac (VRE)

Question 14

Vancomycin - AEs

Answer 14

Red man syndrome and NOT:

Nephrotoxicity-ototoxicity-thrombophlebitis

Question 15

Vancomycin - Uses

Answer 15

Gram + ONLY
Reserved for MDR, such as MRSA
C diff (oral), S. epidermidis, non-VR enterococci

Question 16

Aminoglycosides - MOA

Answer 16

BacteriCIDAL bc they cause 3 things:
Misreading of mRNA
Inhibit 30S ribosomal subunit
Block translocation

Question 17

Aminoglycosides - AEs

Answer 17

Nephrotoxicity (ATN), ototoxicity (hearing and vestibular), neuromuscular blockade, teratogen (deafness, ototoxicity)

Question 18

Tetracyclines - MOA

Answer 18

Inhibit 30S subunit (bacteriostatic)

Question 19

Tetracyclines - Uses

Answer 19

Atypical pneumonias, acne, tick-borne diseases (Rickettsia, Borrelia), MRSA

Question 20

Tetracyclines - AEs

Answer 20

GI, photosensitivity, teeth discoloration - contraindicated in children under 8 and pregnancy due to this.

Question 21

Daptomycin - MOA

Answer 21

Glycopeptide that inserts its lipid tail into the cell wall, causing pores in membrane, leading to depolarization and then cell death (bactericidal)

Question 22

Daptomycin - AEs

Answer 22

Myopathy, rising CPK should be monitored

Question 23

Monobactams/Carbapenams - MOA

Answer 23

B lactams, inhibit cell wall synthesis
Especially resistant to b-lactamases
Reserved for serious infections

Question 24

Monobcatams & carbapenams - AEs

Answer 24

Lower seizure threshold
Rash
GI - diarrhea

Question 25

Chloramphenichol - MOA

Answer 25

50S inhibitor reversibly binds | Bacteriostatic

Question 26

Chloramphenical - AEs

Answer 26

Reversible anemia Irreversible aplastic anemia Grey baby syndrome

Question 27

Linezolid - MOA

Answer 27

50S inhibitor (bacteriostatic)

Question 28

Linezolid - AEs

Answer 28

Thrombocytopenia (MC AE) Serotonin syndrome (weak MAO-I) optic neuropathy peripheral neuropathy (glove & stocking)

Question 29

Metronidazole - MOA

Answer 29

Gets metabolized into a free radical, which then causes ds DNA breaks

Question 30

Metronidazole - AEs

Answer 30

Disulfiram-like reaction, GI upset, metallic taste

Question 31

Fluorquinolones - MOA

Answer 31

Inhibit DNA gyrase (topo II) and topo IV which leads to increased supercoiling Bactericidal

Question 32

Fluoroquinolones - AEs

Answer 32

GI upset, superinfection, rash, headache, dizziness Leg cramps/myalgias Contraindicated for pregnancy, nursing, children Cartilage damage in babies/children Tendon damage/rupture in elderly Cipro: CYP inhibitor

Question 33

Sulfonamides - MOA

Answer 33

Inhibit DHPS, affectign folate synthesis

Question 34

Sulfonamides - AEs

Answer 34

Hypersensitivity reactions (sulfa allergy), Stevens-Johnson, kernicterus in infants, G6PD oxidative trigger, nephrotoxic, photosensitivity, CYP inhibitor

Question 35

Dapsone - MOA and Use

Answer 35

Inhibits dihydropteroate synthase (like sulfonamides) | Used for leprosy and pneumocystis prophylaxis (if TMP-SMX or pentamidine not used)

Question 36

Clindamycin - MOA

Answer 36

Inhibits 50S ribosomal subunit | Prevents formation of the initiation complex

Question 37

Clindamycin - AEs

Answer 37

C diff diarrhea