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M3 Pharm B3 > Antibiotics 1 > Flashcards

Antibiotics 1 Flashcards

1
Q

1st MOA of Antibiotics: Inhibition of cell wall synthesis

A

Bind to cytoplasmic-protein-binding proteins (PBPs) –> inhibit transpeptidation –> inhibit cross-linking of bacterial cell wall

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2
Q

1st MOA of Antibiotics: Inhibition of cell wall synthesis - Buzzword (6)

A

Penicillins

Cephalosporins

Imipenam

Meropenem

Aztreonam

Vancomycin: inhibits peptidoglycan synthase binds to D-Alanine

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3
Q

2nd MOA of Antibiotics: A - Interfere with the formation of initiation complex: Buzzword (2)

A

Aminoglycoside (30S)

Linezolid (50S)

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4
Q

2nd MOA of Antibiotics: A - Interfere with the formation of initiation complex: How is it a bactericidal?

A

Misread of genetic code carried by mRNA –> incorporation of wrong amino acid

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5
Q

2nd MOA of Antibiotics: B - Interfere with incorporation of next amino acid: Buzzword (2)

A

Tetracyclines (30S)

Dalfospristin & Quinupristin (50S)

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6
Q

2nd MOA of Antibiotics: B - Interfere with incorporation of next amino acid: How is it a bacteriostatic?

A

Inhibit the insertion of aminoacyl t-RNA into “A” site

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7
Q

2nd MOA of Antibiotics: C - Interfere with formation of peptide bond Buzzword and how is it a bacteriostatic? (2)

A

Chloramphenicol

Bacteriostatic by inhibition of peptidyltransferase

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8
Q

2nd MOA of Antibiotics: D - Interefere with Translocation Buzzword and how is it a bacteriostatic? (3)

A

Macrolide (50S)

Clindamycin (50S)

Bacteriostatic by inhibiting translocation of peptidyl-tRNA from acceptor to donor site

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9
Q

Inhibitors of Bacterial Protein Synthesis: Drugs that affect the 30S ribosomal subunit - Aminoglycosides (4)

A
  1. Gentamicin
  2. Neomycin
  3. Streptomycin
  4. Spectinomycin
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10
Q

Inhibitors of Bacterial Protein Synthesis: Drugs that affect the 30S ribosomal subunit - Tetracyclines (4)

A
  1. Doxycycline
  2. Minocycline
  3. Tetracycline
  4. Tigecycline
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11
Q

Inhibitors of Bacterial Protein Synthesis: Drugs that affect the 50S ribosomal subunit - Macrolide and Ketolide Antibiotics (4)

A
  1. Azithromycin
  2. Clarithromycin
  3. Erythromycin
  4. Telithromycin
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12
Q

Inhibitors of Bacterial Protein Synthesis: Other Antibiotics binding the 50s subunit (3)

A
  1. Chloramphenicol
  2. Clindamycin
  3. Quinupristin-Dalfopristin
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13
Q

Inhibitors of Bacterial Protein Synthesis: Other Protein Synthesis Inhibitors (2)

A
  1. Mupirocin

2. Linezolid

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14
Q

3rd MOA of Antibiotics: Inhibition of Folic Acid Synthesis - Buzzword 1 (2)

A

Sulfonamide

Inhibits dihydropteroate synthetase

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15
Q

3rd MOA of Antibiotics: Inhibition of Folic Acid Synthesis - Buzzword 2

A

Trimethoprim and Pyrimethamine

Inhibits dihydrofolate reductase

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16
Q

4th MOA of Antibiotics: Inhibtion of Nucleic Acid Synthesis Buzzword 1 (2)

A

Fluroquinolones

Inhibit DNA gyrase (Topoisomerase II)

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17
Q

4th MOA of Antibiotics: Inhibtion of Nucleic Acid Synthesis Buzzword 2 (2)

A

Rifampin

Inhibits DNA-dependant RNA polymerase

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18
Q

Mechanism of Resistance: Beta-lactamase cleavage of drugs B-lactam ring Buzzword (2)

A
  1. Penicillins

2. Cephalosporins

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19
Q

Mechanism of Resistance: Production of conjugating enzymes that increase drug clearance Buzzword (1)

A

Aminoglycosides

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20
Q

Mechanism of Resistance: Formation of acetylating enzymes that inactivate drugs Buzzword (1)

A

Chloramphenicol

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21
Q

Mechanism of Resistance: Methylation of base in RNA that alter drugs binding Buzzword(1)

A

Macrolides

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22
Q

Mechanism of Resistance: Production of active transport systems that push drugs out of the cell Buzzword (1)

A

Tetracyclines

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23
Q

Mechanism of Resistance: Formation of PABA, increase resistance to inhibiton of dihydropteroate synthetase Buzzword (1)

A

Sulfonamides

24
Q

Mechanism of Resistance: Increase transport systems to push drugs out and increase resistance to inhibition of topoisomerase II Buzzword

A

Fluoroquinolonees

25
Q

Antibiotic Resistance

A

R-factor plasmid-mediated transmission

Selection of resistant cells

26
Q

Antibiotics Combination: Additive Effect

27
Q

Antibiotics Combination: Synergistic Effect

A

1 + 1 = 3

Penicillins + Aminoglycosides

28
Q

Antibiotics Combination: Antagonistic Effect

A

1 + 1 = 0

Penicillin + Tetracyclines in pneumococcal meningitis

29
Q

Antibiotics Combination: Clinically (2)

A

Bacteriostatic: Active host defense dependant

Bacteriocidal: immunocompromised

30
Q

Antibiotics Combination: Examples of conditions (1)

31
Q

Bacteria: Gram +ve (Purple) (3)

A
    1. Staphylococcus
      1. Streptococcus
      2. Clostridium
32
Q

Bacteria: Gram -ve (Pink/Red) (5)

A
  1. E. Coli
  2. Neisseria
    * 3. Pseudomonas
  3. Bacteroids
  4. Klebsiella
33
Q

Staph Aureus (G+): Types (4)

A
  1. Non-penicillinase Producing
  2. Penicillinase Producing
  3. Methicillin Resistant Staph Aureus (MRSA)
  4. Vancomycin Resistant Staph Aureus (VRSA)
34
Q

Antibiotics Story: 1

A

First (1): It penicillins: good against Gram +ve –> Strep and Staph

Buzz word: Pencillin VK (Oral) and Penicillin G (IV-IM)

35
Q

Antibiotics Story: 2

A

Some penicillanase producing staph aureus appeared so they came up with

  1. Penicillin resistant penicillins (5):
    1. Oxacillin (IV)
    2. Cloxacillin (PO)
    3. Dicloxacillin (PO)
    4. Nafcillin (IV)
      (Ox/Clox/Diclox/Naf)
    5. Methicillin (only used in lab)

Good against staph aureus

36
Q

Staph Aureus (G+): MRSA Buzzword

A

VANCOMYCIN

Vancomycin is NOT A PENICILLIN

37
Q

Antibiotics Story: 3 - Broad Spectrum Antibiotics (Aminopenicillins) Buzzword and Use

A

Buzzword: Amoxicillin and Ampicillin

Good against:
Strep
G-ve bacteria
BUT NOT STAPH AUREUS

38
Q

Antibiotics Story: 4 - Extended Spectrum Penicillins (antipseudomonads) Buzzwords, Use, and Solution for Staph

A

Buzzword: Piperacillin - Ticarcillin - Carbenicillin

Good against:
Strep
G-ve (*Including psedumonas)
NOT STAPH AUREUS

39
Q

Since broad and extended spectrum didn’t cover staph aureus, what did they do?

A

Came up with Beta-lactamase inhibitors

Buzzword: Clavulanate and Sulbuctam

and combined it with broad and extended spectrum to cover everything including staph aureus

40
Q

Drugs good against G+ve and G-ve BUT NOT MRSA (4 pairs)

A
  1. Amoxacillin/Clavulanate (sinusitis, strep throat, acute pharyngitis)
  2. Ampicillin/Sulbactum
  3. Pipercilin/Tazobactam (pseudomonas
  4. Ticarcillin/Calvulunate
41
Q

1st Caution with Antibiotics

A

Always, always, always assess for allergies

42
Q

2nd Caution with Antibiotics

A

If allergic to penicillin, they’ re also allergic to cephalosporins

43
Q

3rd Caution with Antibiotics

A

If normal flora is disturbed during antibiotic therapy –> superinfection caused by microorganisms resistant to the given antibiotics

Signs of superinfections
Black, furry overgrowth on the tongue

Loose or foul smelling stools

Vaginal itching or discharge in women

44
Q

4th Caution with Antibiotics

A

Avoid taking oral penicillin and acidic juices or soda

Why? It reduces drug absorption

45
Q

5th Caution with Antibiotics and buzzwords for bacterial resistance

A

Always, always, always teach the patient about completeing the full therapeutic course, even if they’re feeling better

Why? Risk for resistant organism

Buzzwords for bacterial resistance

  1. Patient stops takes antibiotics
  2. Environmental disperion of liquid antibiotics
  3. Antibiotics are prescribed to Rx viral infection
46
Q

Cephalosporins: 1st Generation of 5 and Buzzword

A

Good against G+ve

Cefazolin: Surgical prophylaxis

Cephalothin: Renal tubular necrosis

N CNS entry

47
Q

Cephalosporins: 2nd Generation of 5 and buzzwords

A

Good against G-ve

No CNS entry EXCEPT CEFUROXIME

Cefotetan: Rx for bacteroid fragilis (disulfiram like action)

Cefaclor: some serum sickness

48
Q

Cephalosporins: 3rd Generation of 5 and buzzwords

A

Good against G-ve and Pseudomonas

Enter CNS except cefoperazone*

*Side effects: Pseudomembranous colitis

Ceftriaxone IV single dose for gonorrhea

Cefixime (PO)

49
Q

Cephalosporins: 3rd Generation of 5 - Rx for biliary sludge with cholecystitis like illness (2)

A
  1. Ceftriaxone

2. Cefoperazone

50
Q

Cephalosporins: 4th Generation of 5 and Drug

A

Good against G+ve

As good as third

Cefepime IV

51
Q

Cephalosporins: 5th Generation of 5 (2)

A
  1. Ceftaroline: High affinity for PBP2a in oxacillin resistant staphylococci
    • GOOD AGAINST MRSA)
  2. Ceftobiprole:
    GOOD AGAINST MRSA and PENICILLIN RESISTANT STREPTOCOCCI
52
Q

Cephalosporins: Dose adjustment in renal impairment except? (2)

A

Ceftriaxone

Cefoperazone

53
Q

Cephalosporins: If patient is allergic to penicillins?

A

Don’t prescribe cephalosporins

If G+ve: use Macrolides

If G-ve: use Aztreonam

54
Q

Cephalosporins: Are not effective against? (5)

A
  1. Chlamydia
  2. Mycoplasma
  3. Listeria
  4. MRSA
  5. Enterococci
55
Q

Bacitracin (3)

A

Derived from a bacillis subtilis

Inhibits cell wall peptidoglycan by blocking bactoprenol

Used topically for infections caused by G+ve cocci

56
Q

Fosfomycin (2)

A

Blocks the formation of UDP-MurNAc (UDP-N-acetylmuramic acid), a first step in cell wall peptidoglycan synthesis

Single dose for uncomplicated UTI

57
Q

Augmentin (Amox/Clav) is good for?

A

Skin lesions when cause is unknown

M3 Pharm B3 (10 decks)

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