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Pharmacology > Antibacterials > Flashcards

Antibacterials Flashcards

1
Q

Drugs that inhibit cell wall synthesis

A

penicillins, vanomycin, carbapenems and cephalosporin

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2
Q

Drugs that affect protein synthesis

A

macrolides, tetracycline, and aminoglycosides

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3
Q

Drugs that affect transcription mechanisms

A

FQs

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4
Q

Drugs that affect metabolic pathways

A

sulfamethoxazole and trimethoprim

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5
Q

is sulfamethoxazole bactericidal or bacteriostatic

A

bacteriostatic because is is an antimetabolite

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6
Q

sulfamethoxazole is always sombined with

A

trimethoprim

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7
Q

Mechanism of sulfamethoxazole

A

prevents synthesis of folic acid

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8
Q

major use of sulfamethoxale

A

UTIs and otitis media

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9
Q

Do not use sulfamethoxazole in?

A

pregnant women, breastfeeding women or infants under 2 months of age

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10
Q

Rare side effect of sulfamethoxazole?

A

stevens johnson syndrome

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11
Q

Are beta lactam antibiotics bacteriostatic or bacteriocidal?

A

bacteriocidal because they cause lysis and death

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12
Q

3 groups of beta lactam antibiotics?

A

penicillins, cephalosporins and carbapenems

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13
Q

beta lactam antibiotics interfere with

A

cell wall synthesis

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14
Q

oral penicillin?

A

penicillin V

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15
Q

IV penicillin?

A

penicillin G

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16
Q

penicillins are active against?

A

most gram positive and some gram negative

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17
Q

what type of cell wall is more difficult to treat with antibiotics?

A

gram negative because it has 3 layers. the outer membrane is difficult to penetrate.

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18
Q

beta lactamase

A

enzyme produced by bacteria that destroys the beta lactam ring which is critical for drug activity

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19
Q

use penicillins with _______ to prevent penicillinase

A

clavulanic acid

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20
Q

Most common adverse effect with penicillins

A

allergy

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21
Q

cephalosporins and pharmacologically and structurally related to

A

penicillins

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22
Q

are cephalosporins bactericidal or bacteriostatic?

A

bactericidal because they cause lysis of the bacteria

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23
Q

as there is progression from 1st generation cephalosporins to 5th generation there is?

A
  1. increased activity towards gram negative

2. better ability to resist destruction by beta lactamases

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24
Q

Best generation of cephalosporins for gram positive coverage

A

first generation

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25
Q

first generation cephalosporins are used for?

A

surgical prophylaxis, URIs and otitis media

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26
Q

first generation cephalosporins have?

A

excellent gram positive coverage

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27
Q

Second generation cephalosporins do not?

A

kill anerobes

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28
Q

second generation cephalosporins have?

A

good gram positive coverage and better gram negative coverage then 1st generation

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29
Q

What is the most potent cephalosporin group for gram negative bacteria?

A

third generation

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30
Q

third generation cephalosporins can?

A

easily pass the meninges and diffuse into CSF for treatment of meningitis

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31
Q

Which generation of cephalosporins have the greates spectrum for gram positive?

A

fourth generation

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32
Q

fifth generation cephalosporins are used for?

A

MRSA infections

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33
Q

Patients with mild allergies to penicillin can?

A

take cephalosporins but with caution

34
Q

adverse effects of cephalosporin

A

GI upset (most common), bleeding, thrombophlebitis and hemolytic anemia

35
Q

Carbapenem prototype?

A

Imipenem

36
Q

Drug group that are all parenterally given?

A

Carbapenems (imipenem)

37
Q

Drug that is reserved for difficult to treat infections and only used in hospital?

A

Imipenem (a carbapenem)

38
Q

Drug group that is effective against gram positive, gram negative and anerobes?

A

Carbapenems (imipenem)

39
Q

Drug that has a resistance to Beta Lactamases

A

Carbapenems (imipenem)

40
Q

Is imipenem bacteriastatic or bacteriocidal?

A

bacteriocidal. It weakens the cell wall causing lysis and death

41
Q

Drug that inhibits cell wall synthesis but does not contain a beta lactam ring?

A

vanomycin

42
Q

Drug used only in hospital to reduce chance of resistance?

A

Vanomycin

43
Q

uses of vanomycin?

A

IV for MRSA and PO for C.Diff

44
Q

Major adverse effect of vanomycin?

A

Infusion related reactions – vanomycin must be infused slowly

45
Q

Rapid infusion of vanomycin causes

A

Red Man (redneck) syndrome

46
Q

Vanomycin must be infused for

A

60 mins or more

47
Q

Imipenem is used with ______ to inhibit breakdown in the kidneys

A

cilastatin

48
Q

Principa toxicity of vanomycin

A

nephrotoxicity

49
Q

Prototype of macrolides

A

erythromycin

50
Q

is erythromycin (a macrolide) bacteriostatic or bactericidal?

A

Bacteriostatic but could be bacteriocidal depending on concentration and bacterial susceptibility

51
Q

Mechanism of erythromycin

A

binds to 50s subunit and blocks addition of new amino acids to the growing polypeptide chain

52
Q

Tetracyclines are

A

broad spectrum antibiotics

53
Q

are tetracyclines bacteriostatic or bactericidal

A

bacteriostatic.

54
Q

Mechanism of tetracyclines

A

inhibit protein synthesis by binding to 30s subunit. Addition of new amino acids to polypeptide chain is prevented.

55
Q

Major adverse effects of tetracycline?

A
  1. Binds to metal ions and forms insoluble complexes (chelation) that cannot be absorbed
  2. Strong affinity for calcium so will cause discolouration of teeth when theyre being formed
56
Q

the metal ions that form insoluble complexes with tetracycline are found in?

A

milk products, supplements, some laxitives and most antacids

57
Q

When taking tetracycline with metal ions..?

A

administer tetracycline 1 hour before or 2 hours after

58
Q

contraindications of tetracycline

A

do not use in children under 8 or in pregnant/breastfeeding women

59
Q

GI disturbances of tetracycline

A

superinfection, diarrhea and C.Diff

60
Q

tetracycline is antagonistic to?

A

bacteriocidal antibiotics so they must be taken at least an hour apart

61
Q

prototype of aminoglycosides

A

gentamicin

62
Q

aminoglycosides (gentamicin) have a?

A

narrow spectrum

63
Q

Mechanism of gentamicin (aminoglycosides)

A

binds to 30s subunit to inhibit protein synthesis. Death results from insertion of abnormal proteins that cause lysis.

64
Q

Is gentamicin bactericidal and bacteriostatic?

A

Bactericidal, it is the only protein synthesis inhibitor that is lethal

65
Q

All aminoglycosides carry a positive charge meaning?

A

they must all be parenterally given because drugs with a charge cannot cross membranes

66
Q

Gentamicin (aminoglycoside) is used for?

A

treatment of serious infections due to aerobic gram negative bacilii

67
Q

Gentamicin is commonly used with _____ for a synergistic efffect?

A

vanomycin

68
Q

Major Adverse effects of gentamicin (aminoglycoside)

A

nephrotoxicity and ototoxicity

69
Q

Nephrotoxicity is?

A

reversible because cells are regenerated

70
Q

ototoxicity is?

A

irreversible because cells are not replaced

71
Q

How does Gentamicin produce ototoxicity and nephrotoxicity?

A

it binds tightly to renal tissue and readily penetrates the endolymph and perilymph

72
Q

Dosage changes of gentamicin for people with kidney disease?

A

reduce dose or increase dosing interval

73
Q

Ototoxicty with gentamicin can be made worse by?

A

loop diuretics

74
Q

risk of ototoxicity with gentamicin is associated with?

A

increased lowest levels between doses, not the peak level and prolonged exposure

75
Q

There is an increased risk of nephrotoxity when gentamicin is combined with?

A
  • vanomycin
  • cyclosporine (immunosuppresant)
  • amphotericin B (antifungal)
76
Q

prototype of FQs

A

ciprofloxacin

77
Q

ciprofloxacin (an FQ) is used most commonly for

A

UTIs

78
Q

Is ciprofloxacin (an FQ) bactericidal or bacteristatic?

A

bacteriocidal.

79
Q

Mechanism of ciprofloxacin (an FQ)

A

inhibits enzymes needed for DNA replication and cell division. Alters DNA and prevents supercoiling.

80
Q

Ciprofloxacin (an FQ) indications

A

major gram negative use and some gram positive

Pharmacology (27 decks)

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