Antibiotic Agents Flashcards

1
Q

Bactericidal Antibiotics

A
Very Finely Proficient At Cell Murder
Vancomycin
Fluoroquinolones
Penicillins
Aminoglycosides
Cephalosporins
Metronidazole
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2
Q

Bacteriostatic Antibiotics

A
ECSTaTiC
Erythromycin
Clindamycin
Sulfamethoxazole
Trimetoprim
Tetracycline
Chloramphenicol
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3
Q

What Bacteriostatic antibiotics become bactericidal when combined?

A

TMP - SMX

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4
Q

Define: Lowest concentration capable of inhibiting growth of an organism

A

Minimum Inhibitory Concentration

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5
Q

MOA of Which Class of Drugs?
Binds to PBP
Inhibits Transpeptidation Reation
Activates Autolytic Enzymes

A

Beta Lactams

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6
Q

Mechanisms for Penicillin Resistance

A

Beta-lactamases
Structural changes in target PBPs
Changes in porin structures

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7
Q

Narrow spectrum Penicillin
Drug of Choice for Syphilis
SE: Hypersensitivity, cross-allergenicity with similar drugs, GI disturbances

A

Penicillin G

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8
Q

Renal Tubular Reabsorption of this drug is inhibited by Probenecid

A

Penicillin G

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9
Q

VERY NARROW spectrum Penicillin
DOC for Staphylococcal infections
SE: Hypersensitivity, cross allergenicity with similar drugs, GI disturbances, INTERSTITIAL NEPHRITIS, NEUTROPENIA
Resistant to beta-lactamase

A

Methicillin
(Naf/Oxa/Cloxacillin)

Use Naf for Staph.

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10
Q
Extended spectrum Penicillin
Drug for Enterococci, Listeria, E. Coli, Proteus, H. Influenzae, MORAXELLA
SE: Pseudomembranous Colitis, Rash
Inactivated by beta-lactamase
Enhanced with beta-lactamase inhibitors
Synergistic effect with aminoglycosides
A

AMPicillin (AMPed up Penicillin)

AmOxicillin) (greater Oral bioavailability

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11
Q

Extended spectrum penicillins are effective for the following organisms

A
Hemophilus influenza
E. Coli
Listeria
Proteus
Salmonella spp.
Enterococci

Amoxicillin HELPS kill Enterococci

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12
Q

Anti-pseudomonal Penicillin
Drug for Pseudomonas, Enterobacter, Klebsiella
SE: Hypersensitivity, Cross-allergenicity with similar drugs, GI disturbances
Inactivated by beta-lactamase
Enhanced with beta-lactamase inhibitors
Synergistic effect with aminoglycosides vs. Pseudomonas

A

Piperacillin

Ticarcillin, Carbenicillin

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13
Q

Anti-pseudomonal antibiotic with anti-platelet activity

A

Ticarcillin

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14
Q

Drugs for Pseudomonas

A

Takes Care of Pseudomonas
Ticarcillin
Carbenicillin
Piperacillin

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15
Q

First Generation Cephalosporin
Binds to PBP, inhibits transpeptidation
Drug for Surgical Prophylaxis, Bone Infection, E. Coli, Klebsiella, Proteus
SE: Hypersensitivity, partial cross-allergenicity with penicillins
Increases nephrotoxicity of aminoglycosides

A

CeFAZolin

FADer help me FAZ my PHarmacology boards

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16
Q

First Generation Cephalosporins

A
FADer help me FAZ my PHarmacology boards
CeFADroxil
CeFAZolin
CePHalothin
CePHradine
CePHalexine
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17
Q

Second Generation Cephalosporin
Can cross BBB
Drug for Haemophilus, Enterobacter, and Neisseria
SE: Hypersensitivity, Disulfiram reaction with CefaMANdole and CefoTETan
Increases nephrogenicity of aminoglycosides

A

Cefamandole

FOXy FAMily in FUR, drinking TEa
CeFOXitin, CeFAMandole, CeFURoxime, CefoTEtan
FAC! LORA the PROfessional AZhOLE is on the FONe.
CeFAClor, LORAcarbef, CefPROzil, CefmetaZOLE, CeFONicid

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18
Q

Second Generation Cephalosporins

A

FOXy FAMily in FUR, drinking TEa
CeFOXitin, CeFAMandole, CeFURoxime, CefoTEtan
FAC! LORA the PROfessional AZhOLE is on the FONe.
CeFAClor, LORAcarbef, CefPROzil, CefmetaZOLE, CeFONicid

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19
Q

Third Generation Cephalosporin
Drugs for Pseudomonas and Bacteroides
SE: Hypersensitivity, Disulfiram reaction with Cefoperazone
Synergistic with AMINOGLYCOSIDES

A
FEnge Po ng PERA to FIX my TTTTTv
CeFEtamet
CefPOdoxin
CefoPERAzone
CeFIXime
CefTriaxone
CefTazidime
CefoTaxime
CefTizoxime
CefTibuten
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20
Q

Third Generation Cephalosporin

A
FEnge Po ng PERA to FIX my TTTTTv
CeFEtamet
CefPOdoxin
CefoPERAzone
CeFIXime
CefTriaxone
CefTazidime
CefoTaxime
CefTizoxime
CefTibuten
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21
Q

Wide coverage against gram positive and gram negative bacteria
SE: Hypersensitivity
Resistant to Beta-lactamase

A

CefePime

Porth (4th)

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22
Q

Anti-Pseudomonal Cephalosporins

A

CefTAZidime 3rd
CeFEPime 4th
CefoPERAzone 3rd

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23
Q

Carbapenem
Wide coverage against gram positive and gram negative bacteria
SE: Hypersensitivity, CNS Toxicity (Confusion, Enceph, Seizures)
Reserved for serious life threatening conditions

A

Imipenem-Cilastatin

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24
Q

This drug inhibits renal metabolism of Imipenem

A

Cilastatin

With Imipenem, Kill is LASTIN with CiLAStaTIN

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25
``` Monobactam Drug for Gram (-) Rods, NO GRAM +/Anaerobe COVERAGE SE: superinfection Resistant to Beta-lactamase No cross allergenicity with penicillins ```
Aztreonam
26
Beta-lactamase inhibitor Inhibits inactivation of penicillins by bacterial penicillinase SE: Hypersensitivity Usually combined with Amoxicillin, Ampicillin, and Piperacillin
Clavulanic Acid | Sulbactam, Tazobactam
27
Glycopeptide Inhibits D-Ala D-Ala terminus of nascent peptidoglycan Drug for MRSA, Pseudomembranous colitis SE: Redman Syndrome, Nephrotoxicity, Ototoxicity Reserved for serious life threatening infections
Vancomycin
28
First line drug for Pseudomembranous Colitis
Metronidazole
29
Tx for Redman syndrome
Slow down infusion rate
30
Drugs of Last Resort
``` I AM your Last Shot at Victory Imipenem Amikacin Meropenem Linezolid Streptogrammins Vancomycin ```
31
Peptide Antibiotic Interferes with late-stage cel wall synthesis in Gram + bacteria SE: Nephrotoxicity Reserved for Topical Use only due to marked nephrotoxicity
Bacitracin
32
Antimetabolite Blocks incorporation of D-Ala 2nd line drug for Drug-Resistant TB SE: Neurotoxicity
Cycloserine
33
30s Inhibitors
Aminoglycosides Tetracyclines Buy AT 30
34
50s Inhibitors
``` Chloramphenicol Erythromycin (Macrolides) Lincosamides (Clindamycin) Linezolid Streptogrammins ``` CELLS at 50
35
Bactericidal Protein Synthesis Inhibitors
Aminoglycosides | Streptogrammins
36
``` Broad Spectrum Antibiotic Bacteriostatic Inhibits 50s Drug for Meningitis (esp Neisseria), Backup for Salmonella Rickettsia, Bacteroides SE: Aplastic Anemia, Gray Baby Syndrome ```
Chloramphenicol
37
Decreased RBC, Cyanosis and Cardiovascular Collapse Ashen Gray Skin Premature neonates with deficient glucuronosyltransferase
Gray Baby Syndrome
38
Binds to 30s subunit, Bacteriostatic Drug for M. Pneumoniae, Chlamydia, Rickettsiae, Vibrio, PUD, SIADH SE: Tooth enamel dysplasia/dyscoloration, Photosensitivity Tigecycline has broadest spectrum
Tetracycline (Doxycycline, Minocycline, Tigecycline, Demeclocyline) LAHAT NG MAY -CYCLINE
39
Tetracycline with broadest spectrum
Tigecycline
40
Antibiotic that should NOT be take with Milk
Tetracyclines | Decreased absorption
41
Tetracycline for Acne
Doxycycline
42
Drug of Choice for Cholera Class?
Tetracycline
43
Macrolide Binds 50s, bacteriostatic Prokinetic agent, stimulates GI motility SE: Cholestatic hepatitis, QT prolongation, Drug interactions
Erythromycin (Azithromycin, Clarithromycin, Telithromycin) LAHAT NG MY -THROMYCIN
44
All Macrolides inhibit CYP450 EXCEPT
Azithromycin
45
Macrolide with highest Vd and slowest elimination
Azithromycin
46
Macrolide used for macrolide resistance
Telithromycin
47
Lincosamide Binds 50s subunit, bacteriostatic Drug for Anaerobic infections, PCP Pneumonia SE: Pseudomembranous colitis (C. difficile overgrowth) Cross resistance between macrolides is common
Clindamycin | Lincomycin
48
DOC for Anaerobic infections ABOVE the diaphragm
Clindamycin
49
DOC for Anaerobic infections BELOW the diaphragm
Metronidazole
50
``` Streptogramin Binds 50s subunit, bactericidal Drug for MRSA, VRSA, VRE SE: Arthralgia-myalgia syndrome Inhibits CYP450 enzymes, causing multiple drug interactions ```
Quinupristin-Dalfopristin
51
Oxazolidinone Binds 50s subunit, bacteriostatic Drug for MRSA, VRSA, VRE, Listeria, Corynebacteria
Linezolid
52
Identify Mode of Antibacterial Action: | As the plasma level is above the MIC, an increasing proportion of the bacteria are killed at a more rapid rate
Concentration-Dependent Killing Action Seen in Aminoglycosides
53
Identify Mode of Antibacterial Action: | Efficacy is directly related to time above the MIC
Time-Dependent Killing Action
54
Greater efficacy when administered as a single large dose Toxicity depends on a critical plasma concentration Seen in which drug?
Postantibiotic effect Seen in aminoglycosides and fluoroquinolones
55
Identify class of Antibiotics: Not absorbed after oral Limited Tissue Penetration Glomerular Filtration is mode of excretion
Aminoglycosides
56
Aminoglycoside with narrowest therapeutic window
Amikacin
57
Antibiotics with this MOA are synergistic with Aminoglycosides
Cell Wall Inhibitors
58
Class of Antibiotics that require oxygen for reuptake | Binds to 30s
Aminoglycosides | Ineffective against anaerobes
59
Drugs with Postantibiotic Effect
Amikacin Levofloxacin Aminoglycosides Fluoroquinolones
60
Resistance to this drug arises from Group Transferases Changes to ribosomal binding site
Aminoglycosides
61
Aminoglycosides
``` mean GNATS canNOT kill anaerobes Gentamicin: Nephrotoxicity Neomycin: Ototoxicity Amikacin: Teratogen Tobramycin Streptomycin ```
62
Aminoglycoside that binds to 30s subunit, bactericidal Drug for aerobic gram - bacteria, endocarditis, ocular infections SE: Nephrotoxicity, Ototoxicity
Gentamicin | Tobramycin
63
Most vestibulotoxic and nephrotoxic aminoglycosides
Gentamicin | Tobramycin
64
Aminoglycoside Binds to 30s, bactericidal Drug for Pseudomonas, Drug Resistant TB (2nd line) SE: Nephrotoxicity, Ototoxicity
Amikacin
65
Aminoglycoside with the least resistance and narrowest therapeutic window
Amikacin
66
Aminoglycoside Binds to 30s, bactericidal Drug for TB, Tularemia, Bubonic Plague, Brucellosis SE: Nephrotoxic (reversible), Ototoxic (vestibulotoxic, Irreversible) Teratogen (Congenital Deafness) Administered IM
Streptomycin
67
``` Aminoglycoside Binds to 30s, bactericidal Drug for bowel preparation for elective surgery, hepatic encephalopathy, Visceral Leishmaniasis SE: Neuromuscular blockade Limited to topical and oral use ```
Neomycin | Kanamycin, Paromomycin
68
Neuromuscular blockade from Neomycin may be reversed with _____________ and _________
Calcium Gluconate | Neostigmine
69
Most Ototoxic Aminoglycosides
Kanamycin | Amikacin
70
Aminoglycoside Binds to 30s, bactericidal Drug for gonorrhea in penicillin-allergic and drugresistant pxs SE: Nephrotoxicity (reversible), Ototoxicity (irreversible), anemia
Spectinomycin
71
Most Nephrotoxic Aminoglycosides
Tobramycin | Gentamicin
72
Skin reactions are most common in which Aminoglycosides
Neomycin | Streptomycin
73
Short acting Sulfonamide
Sulfisoxazole
74
Intermediate acting Sulfonamide
Sulfamethoxazole
75
Long acting Sulfonamide
Sulfadioxine
76
Weakly acidic Resembles PABA Decreased solubility in Acidic Urine Class?
Sulfonamides
77
Similar to Folic acid Weak base High concentrations in prostatic and vaginal fluids Class?
Trimethoprim
78
Identify Drug Class: | MOA: competitive inhibitor of dihydropteroate synthesis
Sulfonamides
79
Identify Drug: | MOA: selective inhibitor of dihydrofolate reductase
Trimethoprim
80
Building block of DNA
Purines
81
Resistance to Antifolate drugs
decreased drugs increased substrate increased tolerance
82
Sulfonamide Bacteriostatic Drug for Burns SE: Acute hemolysis in G6PD deficiency, hypersensitivity, kernicterus Displaces protein binding of other drugs/bilirubin
Silver Sulfadiazine
83
Sequential blockade of dihydropteroate synthase and dihydrofolate reductase, bactericidal Drug for urinary tract, P. Jirovecci pneumonia SE: Acute hemolysis in G6PD deficiency, hypersensitivity, kernicterus Displaces protein binding of other drugs/bilirubin
Co-Trimoxazole
84
Toxicity of Sulfonamides
``` Hypersensitivity GI Distress Hematotoxicity Nephrotoxicity Drug Interactions ```
85
Increased levels of unconjugated bilirubin Due to immature BBB Bilirubin deposits in basal ganglia and subcortical nuclei Leading to hypo/hypertonia, lethargy, high-pitched cry, opisthotonos Identify Disease
Kernicterus
86
MOA of which class of antibiotics: Inhibits Topoisomerase II (DNA Gyrase) in Gram (-) organisms, Topoisomerase IV in Gram (+) organism Usually bactericidal Exhibits postantibiotic effect
Fluoroquinolones
87
``` Resistance of which class of antibiotics Efflux pumps changes in porin structure changes in the sensitivity ```
Fluoroquinolones
88
Fluroroquinolones
Nalidixic Acid Ciprofloxacin, Ofloxacin, Norfloxacin Levofloxacin Moxifloxacin, Gatifloxacin
89
Trend of Fluoroquinolone coverage | _________ generation, ________ Gram + activity
Increasing generation, increasing gram positive activity
90
Inhibits DNA gyrase and Topisomerase IV, bactericidal Drug for UTI, Atypical Pneumonia, 2nd line for TB SE: GI distress, Tendinitis and tendon rupture Avoid use in children and pregnant Enhances toxicity of methylxanthines (Theophylline)
Ciprofloxacin (Ofloxacin, Norfloxacin) FLUOROquinoBONES!
91
3rd Generation Inhibits DNA gyrase and topoisomerase IV, bactericidal Drug for atypical pneumonia and lung infections SE: GI distress, tendinitis, QTc prolongation (predispose to torsades) Avoid use in children and pregnant Enhances toxicity of methylxanthines (Theophylline)
Levofloxacin | Sparfloxacin, Grepafloxacin
92
Aminoglycoside that was withdrawn due to severe cardiotoxicity (arrhythmia)
Grepafloxacin
93
4th Generation Inhibits DNA gyrase, Topoisomerase IV, Bactericidal Drug with broad spectrum activity and enhanced activity versus ANAEROBES SE: GI distress, tendinitis, QTc prolongation, diabetes, hepatotoxicity Avoid use in children and pregnant Enhances toxicity of methylxanthines (Theophylline) Widest spectrum of activity
Moxifloxacin
94
Disrupts ETC by forming free radicals, Bactericidal Drug for Anaerobic or mixed intra abdominal infections, Vaginitis, Pseudomembranous colitis SE: GI Irritation, Metallic taste, Disulfiram Reaction
Metronidazole
95
Most common drug that causes Pseudomembranous colitis
Clindamycin
96
2nd line drug for Pseudomembranous colitis
Vancomycin
97
Dose of Metronidazole for Trichomonas infection
2grams
98
Bactericidal Drug used for UTI (except Proteus and Pseudomonas) only uncomplicated SE: Skin rashes, Pulmonary infiltrates
Nitrofurantoin
99
Pulmonary FIbrosis can be caused by the following drugs
``` BBBAN Me Bleomycin Busulfan Bromocriptine Amiodarone Nitrofurantoin Methotrexate ```