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Disease and Defense Unit 3 > Antibiotic Overview > Flashcards

Antibiotic Overview Flashcards

1
Q

Drugs that affect cell wall synthesis (3)

A

vancomycin
cephalosporins
carbapeneins

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2
Q

What is different in the cell was of bacteria that permits targeted therapy?

A

Well for one they HAVE a cell wall

Also - proteoglycan composition (fungi don’t have this, neither do mycoplasma, so keep that in mind)

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3
Q

Drugs that affect bacterial cell membrane

A

Polymyxins

daptomycin

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4
Q

What composition of cell wall allows eukaryote vs fungi distinction?

A

Ergosterol is found in fungi while cholesterol is found in humans

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5
Q

Drugs that inhibit 50S ribosomal subunit in bacteria

A

Erythromycin (macrolides)

Clindamycin

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6
Q

Drugs that inhibit 30S ribosomal subunit

A

tetracycline
streptomycin
tobramycin (aminoglycoside)
amikacin

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7
Q

Drugs that inhibit tRNA in bacteria

A

mupirocin

linezolid

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8
Q

Drugs that inhibit DNA gyrase

A

quinolones

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9
Q

Drugs that inhibit RNA-directed RNA polymerase

A

rifampin

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10
Q

Drugs that inhibit DNA replication in bacteria

A

metronidazole

nitrofuratonin

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11
Q

Drugs that inhibit folic acid metabolism/synthesis

A

trimethoprim

sulfonamide

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12
Q

Why is folic acid inhibition drugs used in bacteria and not eukaryotes?

A

Bacteria MUST synthesize folate while eukaryotes like us can just obtain it through diet

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13
Q

What are the three modes of drug resistance?

A
  1. ) Natural (intrinsic) resistance
  2. ) Escape
  3. ) Acquired Resistance (subtypes: chromosomal resistance and plasmid mediated resistance)
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14
Q

Resistance via altered binding site - penicillin binding proteins

A

Occurs in MRSA, pneumoniae, enterococci (gram + cocci)

Resistance to beta lactam antibiotics (penicillins, cephalosporins, carbapenems)

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15
Q

Resistance via altered binding site - DNA gyrase

A

Occurs in S. aureus, Pseudomonas

Resistance to flouroquinolones

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16
Q

Resistance via altered binding site - peptidoglycan sidechain

A

Occurs in enterococci (VRC) and staph (VRSA)

Resistance to vancomycin

17
Q

Resistance via enzymatic degradation - beta-lactamase

A

Occurs in s. auerus, p. aeruginosa, enterococci

Resistance to beta lactams (penicillins, cephalosporins, carbapenems)

18
Q

Resistance via altered binding site - 50S ribosome methylation

A

Occurs in strep, staph and enterococci (gram + cocci)

Resistance to erythromycin, clindamycin

19
Q

Resistance via enzymatic degradation - acetyl-phospho-adenylyl

A

Occurs in enterococci

Resistance to aminoglycosides

20
Q

Resistance via enzymatic degradation - acetyltransferases

A

Occurs in staph, strep, neisserria

Resistance to chloromphenicol.

21
Q

Resistance via bypass pathway - overproduction of PABA/thymidine nucleotides

A

Occurs in strep

Resistance to sulfanomides

22
Q

Resistance via decreased entry

A

p. auruginosa - to beta lactams
pseudomonas - to flouroquinolones
e. coli + pseudomonas - to aminoglycosides

23
Q

Resistance due to efflux pump

A

Occurs in step, staph and entero
To tetracyclines, macrolides

Occurs ALSO in pseudomonas
To flouroquinolones

24
Q

What are the features of “bactericidal” drugs

A

Inhibit cell wall synthesis
Disrupt cell membrane fxn
Interference w/ DNA fxn or synthesis

Preferred for severe infections, quick and irreversible, compensate for pts w/ impaired host defense and required for treatment of infections located in immune sanctuaries (such as the CNS/endocarditis)

25
Q

What are the features of “bacteriostatic” drugs

A

Inhibition of protein synthesis

Inhibition of intermediary metabolic pathways

26
Q

What is the IMPORTANT exception of protein synthesis inhibition drugs that ISNT bacteriostatic?

A

aminoglycosides are BACTERIOCIDAL lol

27
Q

What are some examples of beneficial selective distribution?

A

Clindamysin in bone (osteomyelitis)
Macrolides in pulm. cells (URIs->pneumonia)
Tetracyclines in gingival crevicular fluid and sebum (periodontis + acne)
Nitrofurantoin is quick urine excretion (UTIs!)

28
Q

What are some examples of TOXIC selective distribution?

A

Aminoglycosides in inner ear and renal brush boder (ototoxicity + nephrotoxicity)
Tetracyclines bind Ca2+ in developing bone and teeth (abnormal bone growth and tooth discoloration!)

29
Q

What is renal dosing

A

Select dose or frequency dependent of pt’s renal fxn. Monitored by serum creatinine (SCr) and estimation of creatinine clearence (CrCl)

30
Q

Concentration-dependent killing

A

antibiotics that kill faster in doses that result in high initial Cp levels

SUCH AS! flouroquinolones, aminoglycosides!

31
Q

Time dependent killing

A

kill best when Cp is above MIC for longer durations

SUCH AS! beta lactams, vancomycin, macrolides

32
Q

Post-antibiotic effect

A

antibiotics that continue action ater Cp < MIC. Less frequent dosing.

SUCH AS! AGs, FQs, macrolides, beta lactrams (gram + > gram - )

Disease and Defense Unit 3 (8 decks)

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