Antibiotic Classes Flashcards

1
Q

Natural Penicillins - G (IV) and V (oral)

A

beta-lactam targets transpeptidase (PPG synth),gram+, use for strep, meningococcus, syphillis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Penicillnase-resistant penicillins. Eg. methicillin, oxacillin, cloxacillin, dicloxicillin

A

beta-lactam, resistant to some beta-lactamses, use for Staph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Extended spectrum penicillins. Eg. ampicillin, amoxicillin, carbenicillin, pipericillin

A

beta-lactam with improved activity against gram-, less effective against gram+, often used with beta-lactamase inhibitor, used for uncomplicated UTI, otitis media, community pneumonia, H. flu, listeria meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Beta-lactamase inhibitors (give examples)

A

clavulanate (w/ amoxicillin = Augmentin), sulbactam, tazolbactam… are examples of what?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pencillin side effects

A

hypersensitivity - rash/hives; or anaphylaxis… are side effects of what? Nausea and vomiting are not side effects. C. diff colonization is not common because these drugs tend not to have broad gram- coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cephalosporins

A

inhibit peptidoglycan synth, have 6 member ring adjacent to beta-lactam, wider spectrum than penicillins, beta-lactamase resistant, have 4 generations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

1st Gen. Cephalosporins

A

beta-lactam with adjacent 6 membered ring. active against gram+ including Staph (but not MRSA), moderate against gram-‘s such as E. coli and Klebsiella; used for community UTI and resp infections; one used for surgical prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2nd Gen. Cephalosporins

A

beta-lactam with adjacent 6-membered ring. increased gram- coverage, used for otitis media in children, H. flu, resp infection, UTIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3rd Gen. Cephalosporins

A

beta-lactam with adjacent 6 membered ring with less gram+ coverage, more gram-. Used for hospital gram- septicemia, inPt pneumonia and UTIs, can penetrate CNS; used for gonoccocal infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4th Gen. Cephalosporins - Cefipine

A

beta-lactam with adjacent 6 membered ring with enhanced activity to enterobacte.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Side effects of Cephalosporins

A

hypersensitivity (like penicillins, 5% of people have cross-reactivity), coverage of gram- causes increased risk of C. diff colonization. These are side effects of what ABx class?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Macrolides, eg. Azithromycin, erythromycin

A

binds reversibly to 50s ribosome, preventing translation -> Bacteriostatic. broad activity against gram+, some gram-. Used for community pneumonia, skin infections (not MRSA), upper resp tract inf, atypical pathogens such as Legionella, Chlamydia, Mycoplasma; often used when Pts allergic to penicillins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Aminoglycosides, eg. streptomycin, gentamycin, tobramycins, amikacin, neomycin

A

binds irreversibly to 30s ribosome ->Bacteriocidal. Transport into bacteria requires ATP, so won’t touch anaerobes. Synergistic with beta-lactams that damage cell wall. Good gram- coverage, particularly against Pseudomonas. Must be given IV or IM. Toxicity limits the use (ototoxicty, nephrotoxicity). Used for Pseudomonas, serious pneumonia, complicated UTIs. Can be used with beta lactams for endocarditis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the pneumonic CLEan TAg stand for?

A

Pneumonic that tells you that Chloramphenicol/Clindamycin, Linezolid, and Azythromycin (and other macrolides) bind to the 50s subunit of the ribosome; and that Tetracycline and Aminoglycosides bind the 30s subunit. (50s is top of home plate, 30s is bottom)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Quinalones/Fluoroquinalones; levofloxacin, norfloxacin, ciprofloxacin

A

binds DNA gyrase. Targets gram-. Used for MDR Pseudomonas, eneterics (E. coli, salmonella, shigella, campylobacter), complicated UTIs, enterococci. Can be taken orally. Because kills gram- broadly, can lead to C. diff colonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which classes of drugs target nucleic acid synthesis?

A

quinalones/fluoroquinalones, metronidazole, rifamycins (What to these classes of drugs target?)

17
Q

Sulfonamides, eg. sulfamexazole

A

inhibits folic acid pathway. Bacteriostatic for both gram+ and gram-. Often used synergistically with trimethoprim for Strep and H. flu, gram- enterics, pneumocystis (seen w/ AIDS).

18
Q

Trimethoprim

A

inhibits folic acid pathway (downstream of sulfonamides). Used synergistically with sulfonamides to target both gram- and gram+.

19
Q

Sides effects of trimethoprim/sulfamexazole (Bactrim)

A

hypersensitivity; inhibits warfarin metabolism -> high warfarin levels / bleeding (What ABx causes these side effects?)

20
Q

Ciprofloxacin

A

a fluoroquinalone. Best gram- coverage among FQs, almost no gram+ activity. Used for UTIs, pseudomonas, GI/intraabdominal infections (often with Flagyl - metronidazole)

21
Q

Levofloxacin

A

“Respiratory Fluoroqinalone.” great for gram+, esp Strep pneumo. less good for Pseudomonas. Not good for Staph aureus. “good for atypicals”

22
Q

Moxifloxacin

A

a respiratory FQ with 0 urine activity and 0 Pseudomonas activity.

23
Q

Carbapenems (Imipenemem, meropenem, ertapenem, doripenem)

A

Super powerful beta-lactams. Inhibit PBPs. Resistance to beta-lactamases. Bacteriocidal. Usu given IV. Highly active against gram+, gram-, aerobic, and anaerobic. Empiric therapy for critically ill Pts; “last resort for E. coli and Klebsiella.” Metabolised by dehydropeptidase - often coadministered with cilastatin to inhibit dehydropeptidase.

24
Q

How does resistance to Carbapenems happen?

A

These are mechanisms of resistance to what class of drug? NDM-1 beta-lactamase. Lack of the OprD porins of gram- rods (esp. Pseudomonas) through which this drug enters them.

25
Q

Monobactams - i.e. Aztreonam

A

beta-lactam w/ side chains (no adjacent ring). Narrow spectrum. Only active against Gram- aerobes. Used for Pts allergic to penicillin.

26
Q

Vancomycin

A

This glycopeptide targets D-Ala-D-Ala terminus to prevent peptidoglycan crossbridge formation (upstream of beta-lactams). Given IV (unless GI infection) as poorly absorbed from gut. Excellent gram+ coverage (such as MRSA, Strep - though inferior to oaxacillin for MRSA). Oral used for C. diff.

27
Q

Notable vancomycin side effect

A

Red Man Syndrome

28
Q

Bacitracin

A

This drug is a mixture of peptides used topically. Not effective against Staph.

29
Q

Tetracyclines - the T in CLEAN TAg. Ex doxycline.

A

Block 30s subunit. Broad spectrum and bacteriostatic. Used for acne, chronic bronchitis, Lyme disease, mycoplasma pneumo, Rickettsia, Chlamydia, travelers diarrhea, inPt UTI (w/ a cephalosporin)

30
Q

Notable tetracycline side effects

A

Discolored teeth. GI upset and phototoxic dermatitis are notable side effects of which class of drugs?

31
Q

Chloramphenicol - the C in CLEAN TAg

A

binds to the 50s subunit. Very wide spectrum. Used for meningitis if bug unknown and Pt allergic to penicillin. Rocky Mountain Spotted Fever if tetracycline contraindicated. Only used to last resort due to rare but deadly side effect

32
Q

Notable chloramphenicol side effect

A

Aplastic anemia (wipes out the bone marrow) is a rare (1 in 20 - 40 thousand) but usually-fatal side effect of which drug?

33
Q

Oxaolidone (Linezolid) - the L in Clean Tag

A

Binds to the 50s subunit. Bacteriostatic. Active against staph, strep, enterococci. IV or PO. Often used w/ beta-lactam for hospital pneumonia and Staph (including MRSA). Side effect: myelosupression. High cost!

34
Q

Notable Linezolid side effect

A

Myelosuppression, indicating weekly CBC, is a side effect of which drug?

35
Q

Lincosamides (Clindamycin) - the C in Clean Tag

A

50s subunit binder. Bacteriocidal. No gram- activity. Excellent gram+ activity including Staph aureus and Strep. Good anaerobic coverage. Doesn’t penetrate CNS. Often used w/ beta lactam for serious strep or Staph infection (inhibits toxin production). Major side effect: diarrhea w/ pseudomembranous colitis.

36
Q

Metronidazole (aka Flagyl)

A

good anti-parasitic. Must be activated by target bug. induces dsDNA breaks. Used for protozoans such as Trichomonas, Giardia, various Amebic infectiosn. Also good for anaerobes and C. diff (when Vanco doesn’t work)

37
Q

Rifamycins

A

Anti-TB drugs. inhibits RNA polymerase. Bactericidal -> orange urine. Active against gram+ and mycobaceteria