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Antibiotic classes Flashcards

1
Q

Give examples of aminoglycosides?

A

E.g. Gentamycin, Neomycin, Amikacin, Tobramycin, Streptomycin

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2
Q

Describe the MAO of aminoglycosides?

A

Bactericidal; irreversible inhibition of initiation complex through binding of 30S subunit -> misreading of mRNA. Also block translocation.

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3
Q

When are aminoglycosides indicated?

A

Gram-neg rod (e.g. E. coli, Klebsiella, Pseudamonas aeruginosa).

Aerobic bacteria
Ineffective against anaerobes (require O2 for uptake)

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4
Q

What is the MAO of penicillin?

A

Block transpeptidase cross-linking of peptidoglycan in cell wall. Activate autolytic enzymes

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5
Q

When is penicillin indicated?

A
  • Mostly gram pos organisms (e.g. S pneumonia, S pyogenes, Actinomyces)
  • Gram neg cocci (N meningitides)
    Spirochetes (T pallidum)
  • Penicillinase sensitive
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6
Q

Give examples of penicillinase-sensitive penicillin?

A

E.g. Amoxicillin, ampicillin, aminopenicillin

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7
Q

When is penicillinase-sensitive penicillin indicated?

A

Extended-spectrum penicillin (e.g. H influenzae, H pylori, E coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci)

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8
Q

Describe the MAO of penicillinase-sensitive penicillin?

A

Block peptidoglycan cross-linking in cell wall.
Wider spectrum. Penicillinase sensitive.
Combine with clauvanic acid to protect against destruction by B-lactamase.

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9
Q

Give examples of penicillinase-resistant penicillins?

A

E.g. Dicloxacillin, Nafcilin, Oxacillin

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10
Q

When are penicillinase-resistant penicillins indicated?

A

S aureus (except MRSA)

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11
Q

Describe the MAO of penicillinase-resistant penicillins?

A

Block peptidoglycan cross-linking in cell wall.
Narrow spectrum.
Penicillinase resistance because bulky R group blocks access of B-lactamase to B-lactam ring.

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12
Q

Give examples of B-lactamase inhibitors?

A

e.g. (mnemonic CAST)

Clauvanic acid, sulbactam, Tazobactam

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13
Q

When are B-lactamase inhibitors indicated?

A

Often added to penicillin antibiotics to protect antibiotic from destruction by B-lactamase (Penicillinase)

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14
Q

Desribe the MAO of cephalosporins?

A

B lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal

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15
Q

Give examples and indications for 1st generation cephalosporins?

A 
1st generation (e.g. Cefazolin, cephalexin)
• Gram pos cocci (e.g. Staph aureus), gram neg rods (PEcK- Proteus mirabilis, E coli, Klebsiella pneumonia)
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16
Q

Give examples and indications for 2nd generation cephalosporins?

A

2nd generation (e.g. Cefaclor, Cefoxitin, Cefuroxime)
• Gram pos cocci (Staph, Strep, enterococcus)
• Gram neg (HENS PEcK- H influenzae, Enterobacter, Nisseria spp, Serratia, Proteus, E coli, Klebsiella)

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17
Q

Give examples and indications for 3rd generation cephalosporins?

A 
3rd generation (e.g. ceftriaxone, cefotaxime, Ceftazidime
• Serious gram neg infections resistant to other B lactams
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18
Q

Give examples and indications for 4th generation cephalosporins?

A 
4th generation (e.g. cefepime)
• Gram neg organisms (increased activity against Pseudomonas)
• Gram pos organisms
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19
Q

Give examples and indications for 5th generation cephalosporins?

A 
5th generation (e.g. ceftaroline)
• Broad gram pos and neg coverage, including MRSA
• Does NOT cover pseudomonas
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20
Q

Give examples of Carbapenems?

A

Imipenem, meropenem, ertapenem, doripenem

21
Q

Describe the MAO of Carbapenems?

A

Imipenem is a broad-spectrum, β-lactamase– resistant carbapenem.
Always administered with cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules.

22
Q

When are carbapenems indicated?

A

Gram ⊕ cocci, gram ⊝ rods, and anaerobes

Wide spectrum, but significant side effects limit use to life-threatening infections or after other drugs have failed.

23
Q

Give an example of a Monobactam?

A

Aztreonam

24
Q

What is the MAO of Monobactams?

A

Less susceptible to β-lactamases.
Prevents peptidoglycan cross-linking by binding to penicillin- binding protein 3. Synergistic with aminoglycosides.
No cross-allergenicity with penicillins.

25
Q

What are Monobactams prescribed?

A

For penicillin-allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides.
Gram ⊝ rods only—no activity against gram ⊕ rods or anaerobes.

26
Q

Describe the MAO of vancomycin?

A

Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors. Bactericidal against most bacteria (bacteriostatic against C difficile).
Not susceptible to β-lactamases.

27
Q

When should vancomycin be prescribed?

A

Gram ⊕ bugs only—serious, multidrug-resistant organisms, including MRSA, S epidermidis, sensitive Enterococcus species, and Clostridium difficile (oral dose for pseudomembranous colitis).

28
Q

Give examples of Tetracylcines?

A

Tetracycline, doxycycline, minocycline

29
Q

Describe the MAO of tetracyclines?

A

Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration. Doxycycline is fecally eliminated and can be used in patients with renal failure.

Note: Do not take tetracyclines with milk (Ca2+), antacids (Ca2+ or Mg2+), or iron-containing preparations because divalent cations inhibit drugs’ absorption in the gut.

30
Q

When are tetracyclines indicated?

A

Borrelia burgdorferi, M pneumoniae, Rickettsia, Chlamydia, acne

31
Q

Describe the MAO of chloramphenicol?

A

Blocks peptidyltransferase at 50S ribosomal subunit.

Bacteriostatic.

32
Q

When is chloramphenicol indicated?

A

Meningitis (Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae) and Rocky Mountain spotted fever (Rickettsia rickettsii).

33
Q

Describe the MAO of clindamycin?

A

Blocks peptide transfer (translocation) at 50S ribosomal subunit. Bacteriostatic.

34
Q

When is clindamycin indicated?

A 
Anaerobic infections (eg, Bacteroides spp., Clostridium perfringens) in aspiration pneumonia, lung abscesses, and oral infections. 
- Treats anaerobic infections above the diaphragm vs metronidazole (anaerobic infections below diaphragm).

Also effective against invasive group A streptococcal infection.

35
Q

Name some macrolides?

A

Azithromycin, clarithromycin, erythromycin.

36
Q

Describe the MAO of macrolides?

A

Inhibit protein synthesis by blocking translocation (“macroslides”); bind to the 23S rRNA of the 50S ribosomal subunit. Bacteriostatic.

37
Q

When are macrolides indicated?

A

Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STIs (Chlamydia), gram ⊕ cocci (streptococcal infections in patients allergic to penicillin), and B pertussis.

38
Q

What are some SE of macrolide use?

A 
MACRO: 
M- gastrointestinal Motility issues
A- Arrhythmia caused by prolonged QT interval
C- acute Cholestatic hepatitis
R- Rash
O- eOsinophilia
39
Q

Name some sulfonamides?

A

Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine.

40
Q

Describe the MAO of sulfonamides?

A

Inhibit dihydropteroate synthase, thus inhibiting folate synthesis.
Bacteriostatic (bactericidal when combined with trimethoprim).

41
Q

When are sulfonamides indicated?

A

Gram-⊕, gram ⊝, Nocardia, Chlamydia.

Sulfamethoxazole for simple UTI.

42
Q

What is the mechanism of action of trimethoprim?

A

Inhibits bacterial dihydrofolate reductase.

Bacteriostatic.

43
Q

When is trimethoprim indicated?

A

Used in combination with sulfonamides -> sequential block of folate synthesis.

Combination used for UTIs, Shigella, Salmonella, Pneumocystis jirovecii pneumonia treatment and prophylaxis, toxoplasmosis prophylaxis.

44
Q

Name some flouroquinolones?

A

Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin

45
Q

Describe the MAO of flouroquinolones?

A

Inhibit prokaryotic enzymes topoisomerase
II (DNA gyrase) and topoisomerase IV.
Bactericidal.
Note: Must not be taken with antacids.

46
Q

When are flouroquinolones indicated?

A

Gram ⊝ rods of urinary and GI tracts (including Pseudomonas), Neisseria, some gram ⊕ organisms.

47
Q

Describe the MAO of metronidazole?

A

Forms toxic free radical metabolites in the bacterial cell that damage DNA.
Bactericidal, antiprotozoal.

48
Q

When is metronidazole indicated?

A 
("GET GAP" mnemonic) 
G- Giardia
E- Entamoeba
T- Trichomonas
G- Gardnerella vaginalis, 
A- Anaerobes (Bacteroides, C difficile)
P- H. Pylori

Pharmacology (19 decks)

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