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Micro Remediation > Antibacterials: Summaries > Flashcards

Antibacterials: Summaries Flashcards

1
Q

Inhibitors of cell wall synthesis:

Antibacterials

Resistance

Other

A

Beta-lactams (penicillins, cephalosporins, monobactams, carbapenems)
Vancomycin
Fosfomycin

Gram+: PBP affinity
Gram-: efflux, porins, beta-lactamases
Vanco: target site & thickened cell wall

B: most commonly used antibiotics
V: gram+ if IV, C. difficile if orally
F: urinary tract infections

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2
Q

Inhibitors protein synthesis:

Antibacterials

Resistance

A 
Aminoglycosides
Macrolides
Tetracyclines, Tigecycline
Clinamycin
Linezolid

Target site
Efflux pumps
Enzymatic modification

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3
Q

Inhibitors DNA/RNA synthesis:

Antibacterials

Resistance

Other

A

TMP/SMX
Rifamycins (rifampin)
Fluoroquinolones
Fidamoxicin

All: target site
FQ: efflux & enzymatic modification

R: red/orange discoloration, drug-drug interactions
FQ: Moxifloxacin
F: C. difficile

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4
Q

DNA damaging agents:

Antibacterials

Other

A

Nitrofurantoin
Metronidazole

N: urinary tract infections, causes pulmonary fibrosis
M: anaerobes, C. difficile

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5
Q

Cell membrane damaging agents:

Antibacterials

Resistance

A

Daptomycin
Polymyxins

Complex or still in process

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6
Q

Concentration Dependent Drugs (4)

A

Aminoglycosides
Quinolones
Daptomycin
Metronidazole

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7
Q

Time Dependent Drugs (3)

A

Beta-lactams
Linezolid
TMP/SMX

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8
Q

Exposure Dependent Drugs (6)

A 
Vancomycin
Polymyxins
Tigecycline
Tetracyclines
Macrolides
Clindamycin
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9
Q

One-Sided Antibiotics:

Gram+ (7)

A

Vancomycin (when given IV)

Daptomycin

Linezolid

Rifampin

Oxa-/Naf-/Dicloxa-cillin (penicillinase-resistant penicillins, good for strep & esp staph)

Fidaxomicin

Penicillin

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10
Q

One-Sided Antibiotics:

Gram- (4)

A

Polymyxins

Ceftazidime (only 3rd generation ceph w/ activity for pseudomonas, much better for – than +)

Ciprofloxacin (FQ not great for strep, whereas Levo & Moxi were much better)

Aztreonam (only monobactam, doesn’t have cross-reactivity for pts w/ penicillin allergies)

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11
Q

One-Sided Antibiotics:

Gram+ & Anaerobes (1)

Gram- & Gram+ Synergy (1)

Anaerobes & C. difficile

A

Clindamycin

Aminoglycoside

Metronidazole

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12
Q

Gram+ Bacteria:

Cell Wall

Important Bugs (3)

A

Thick, made of peptidoglycan

  • Streptococcus spp. (S. penumoniae)
  • Staphylococcus spp. (S. aureus)
  • Enterococcus spp. (E. faecalis, E. faecium)
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13
Q

Gram- Bacteria:

Cell Wall

Important Bugs (5)

A

Thin, protected by an outer cell membrane

  • Haemophilus influenzae
  • Proteus mirabilis
  • Enterobacteriaceae (Escherichia coli, Klebsiella pneumonia, Enterobacter spp.)
  • Pseudomonas aeruginosa
  • Acinetobacter spp.
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14
Q

Anaerobic Bacteria:

Properties (3)

Important Bugs (4)

A
  • Grow in absence of oxygen
  • Some pathogenic, others less
  • Can be gram+ or gram-
  • Bacteroides fragilis (most problematic, lives in gut)
  • Clostridium spp.
  • Peptostreptococcus
  • Propionibacterium
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15
Q

Atypical Bacteria:

Properties (3)

Important Bugs (4)

A
  • Community > Hospital acquired
  • Lack a cell wall, can’t gram stain
  • Drugs that inhibit cell wall synth will be inactive against atypicals
  • Chlamydia spp.
  • Legionella pneumonia
  • Mycoplasma pneumonia
  • Rickettsia reckettssii
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16
Q

Drugs Against Pseudomonas Aeruginosa

A

P. aeruginosa: gram-

For P-Ts, Carb not Erta & FQ not Moxi TACC PA

Piperacillin/tazobactam
Carbapenems (not Erta)
Fluoroquinolones (not Moxi)
Ticarcillin-clavulanate
Aztreonam
Cefepime
Ceftazidime
Polymyxins
Aminoglycosides
17
Q

Drugs Against Methicillin-Resistant S. aureus (MRSA)

A

MRSA: gram+

Drugs To Confidently Treat Very Lethal Commensals

Daptomycin
TMP/SMX
Ceftaroline
Tetracyclines/Tigecycline
Vancomycin
Linezolid
Clindamycin
18
Q

Drugs Against Vancomycin-Resistant Enterococcus (VRE)

A

VRE: gram+

Learn VRE Drugs for Test

Linezolid
Daptomycin
Tigecycline

19
Q

Drugs Against Anaerobes

A

Antibiotics covering Bacteroides typically have broad-spectrum anaerobic activity

These Many Meds Can Confidently Cover Bacteroides

Tigecycline
Moxifloxacin
Metronidazole
Cefoxitin
Clindamycin
Carbapenems
Beta-lactam + Beta-lactamase Inhibitors
20
Q

Drugs Against Atypicals

A

No cell wall: Legionella, Mycoplasma pneumoniae, Chlamydia pneumoniae

Three Fair Meds

Tetracyclines
Fluoroquinolones
Macrolides

21
Q

Summary of Spectrum of Activity of Cephalosporins:

1st –> 2nd –> 3rd generation

None cover…

Cefoxitin

Ceftaroline

Cefepime

A

Go from more G+ to more G-

Enterococcus

Covers Bacteroides & MSSA (poorly)

ONLY beta-­‐lactam w/ MRSA coverage

4th generation, has broadest spectrum

22
Q

Key Toxicities:

Nephrotoxicity (3)

A

Aminoglycosides
Polymyxins
Vancomycin

23
Q 
Key Toxicities:
Clostridium difficile (2)
A

Clindamycin

Fluoroquinolones

24
Q

Key Toxicities:

Seizures / CNS (2)

A

Imipenem

Fluoroquinolones

25
Q

Key Toxicities:

Myopathy (1)

A

Daptomycin

26
Q

Key Toxicities:

Rash (3)

A

TMP/SMX
Beta-lactams
Vancomycin (Red Man’s)

27
Q 
Key Toxicities:
Pulmonary Fibrosis (1)
A

Nitrofurantoin

28
Q

Key Toxicities:

Myelosuppression (1)

A

Linezolid

29
Q

Key Pharmacokinetics:

Fe/Ca/Mag/Al & Bioavailability (2)

A

Fluoroquinolones

Tetracyclines

30
Q

Key Pharmacokinetics:

Beta-lactam, but NO renal adjustments (2)

A

Ceftriaxone

Penicillinase-resistant PCNs

31
Q

Key Pharmacokinetics:

FQ, but NO renal adjustment (1)

A

Moxifloxacin

32
Q

Key Pharmacokinetics:

Commonly used agents for CNS infections (moderate penetration) (3)

A

3rd/4th generation Cephalosporins
Meropenem
Vancomycin

33
Q 
Key Pharmacokinetics:
Low Vd (not useful for CNS) (4)
A

Aminoglycosides
Polymyxins
Daptomycin
Nitrofurantoin

Micro Remediation (30 decks)

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