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Microbiology 1 > Antibiotics > Flashcards

Antibiotics Flashcards

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1
Q

antibiotics

A

molecules produced by microorganisms that kill other microorganisms or inhibit their growth; streptomyces, bacillus, penicillium, cephalosporium

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2
Q

selective toxicity

A

central concept of antimicrobial action; the growth of the infecting organism is selectively inhibited or the organism is killed without damage to the cells of the host

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3
Q

ideal agent

A
  1. low in toxicity to host’s cells
  2. should not induce hypersensitivity
  3. low dose
  4. host should not destroy or excrete the drug until it has functioned
  5. no resistance
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4
Q

penicillin

A

streptococcal pharyngitis, pneumococcal pneumonia, meningitis, endocarditis

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5
Q

bactericidal

A

kills, important for serious infection or when natural ability is impaired

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6
Q

bacteriostatic

A

inhibits bacterial growth, allowing host defenses to catch up

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7
Q

examples of bactericidals

A

beta-lactams, vancomycin, aminoglycosides, quinolones, anti-TB, anti-folates

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8
Q

examples of bacteriostatics

A

tetracyclines, macrolides, anti-folates, clindamycin, chloramphenicol

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9
Q

inhibition of cell wall synthesis

A

vancomycin, bacitracin, penicillins, cephalosporins, monobactams, carbapenems

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10
Q

inhibition of folic acid metabolism

A

trimethoprim, sulfonamides, dapsone

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11
Q

action on cell membrane

A

polymyxins, platensimycin

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12
Q

50S inhibitors (protein synthesis)

A

macrolides, chloramphenicol, clindamycin, oxazolidinones

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13
Q

30S inhibitors (protein synthesis)

A

tetracycline, spectinomycin, aminoglycosides

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14
Q

inhibition of DNA directed RNA polymerase

A

rifampin, fidaxomicin

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15
Q

inhibition of DNA synthesis

A

metronidazole

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16
Q

inhibition of gyrase/topoisomerase

A

quinolones

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17
Q

penicillin G and penicillin V

A

limited spectrum; beta-lactamase sensitive

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18
Q

ampicillin and amoxicillin

A

broad spectrum

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19
Q

methicillin

A

beta-lactamase resistant; acid labile; for gram pos

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20
Q

oxacillin

A

beta-lactamase resistant; acid stable; for gram pos

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21
Q

carbenicillin

A

extended spectrum; pseudomonas

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22
Q

When does penicillin inhibit peptidoglycan synthesis?

A

at transpeptidase step

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23
Q

are penicillins bactericidal or bacteriostatic?

A

cidal, require active growth

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24
Q

penicillin mechanism of resistance

A

beta lactamases or penicillin binding protein mutations

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25
Q

penicillin side effects

A

allergy (use macrolides instead), stevens johnson syndrome, diarrhea, colitis

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26
Q

cephalosporins

A

broader spectrum, more resistant to beta-lactamase, low cross reaction with penicillins

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27
Q

disadvantages of cephalosporins

A

less potent but more expensive; still around 40% of antibiotics prescribed

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28
Q

cefamycins

A

subset of second generation of cephalosporins and are more stable to beta-lactamases

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29
Q

beta-lactamase

A

enzyme in bacteria that can break structure of some beta-lactam antibiotics

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30
Q

cephalosporin mechanism of action

A

inhibits peptidoglycan biosynthesis at transpeptidation step

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31
Q

are cephalosporins cidal or static?

A

cidal, require active growth

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32
Q

cephalosporins not used for _

A

listeria, atypical/anaerobes (except cefoxitin), MRSA (except ceftaroline), or enterococci (LAME)

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33
Q

cephalosporin mechanism of resistance

A

PBP mutations

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34
Q

cephalosporin toxicity

A

OK for penicillin allergy; colitis

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35
Q

carbapenems/monobactam MofA

A

inhibit peptidoglycan biosynthesis at transpeptidation biosynthesis

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36
Q

Are carbapenems/monobactams cidal/static?

A

cidal, require active growth

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37
Q

carbapenems/monobactems spectrum

A

not usually first resort; pseudomonas

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38
Q

carbapenems/monobactems mechanism of resistance

A

beta-lactamase

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39
Q

carbapenems/monobactems side effects

A

allergy, colitis

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40
Q

bacitracin MofA

A

inhibits dephosphorylation of lipid intermediate in cell wall

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41
Q

vancomycin MofA

A

prevents precursor from being added to growing chain in cell wall

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42
Q

is vancomycin cidal/static?

A

cidal, requires active growth

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43
Q

vancomycin spectrum

A

gram(+) cocci including MRSA and enterococci; not gram (-)

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44
Q

vancomycin mechanism of resistance

A

change of D-ala-D-ala to D-ala-D-lactate or D-ala-D-ser

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45
Q

vancomycin side effects

A

GI, diarrhea, nausea, nephrotoxicity

46
Q

polymyxins

A

target lipid A biosynthesis & phosphatidylethanolamine; cidal

47
Q

polymyxin spectrum

A

gram(-) only; colistin, topical (neosporin)

48
Q

polymyxins side effects

A

nephrotoxicity and neurotoxicity

49
Q

polymyxins mechanism of resistance

A

mutations in lipid A biosynthesis

50
Q

rifampin inhibits _

A

DNA to mRNA

51
Q

quinolones/metronidazole inhibit _

A

DNA replication

52
Q

bactericidal protein synthesis inhibitors are _

A

irreversible; aminoglycosides

53
Q

aminoglycosides MofA

A

inhibit protein synthesis at 30S ribosomal subunit

54
Q

aminoglycosides are static/cidal?

A

cidal

55
Q

aminoglycosides spectrum

A

gram negative (pseudomonas) and some gram(+) in synergy with pen; anaerobes

56
Q

aminoglycosides mechanism of resistance

A

acetylation, adenylation, phosphorylation

57
Q

AG toxicity

A

ototoxicity, nephrotoxicity, not for pregnant women

58
Q

chloramphenicol toxicity

A

limits clinical use by causing aplastic anemia (bone marrow suppression) or gray baby syndrome

59
Q

chloramphenicol MofA

A

reversibly binds to 50S to inhibit protein synthesis by preventing peptide bond formation

60
Q

chloramphenicol static/cidal?

A

static, broad spectrum

61
Q

chloramphenicol primary uses

A

salvage therapy for meningitis, enterococcus, atypicals, conjunctivitis

62
Q

tetracyclines MofA

A

inhibit protein synthesis at 30S

63
Q

tetracyclines static/cidal?

A

static

64
Q

tetracyclines spectrum

A

+/-, atypicals, excellent for intracellulars, anti-protozoal

65
Q

penicillin DOC

A

syphilis, GASM GAB, Lyme disease, MSSAca

66
Q

carbapenems DOC

A

febrile neutropenia

67
Q

AG DOC

A

plague, tularemia

68
Q

tetracycline DOC

A

chlamydia, rickettsia, lyme, brucella, Q fever, anthrax, malaria

69
Q

tetracycline mechanism of resistance

A

efflux pump

70
Q

tetracycline side effects

A

CI in pregnant women and <12; bones/teeth, hepatoxicity, phototoxicity

71
Q

lincomycin MofA

A

interference with peptide bond formation at 50S; static

72
Q

lincomycin is effective against _

A

anaerobes; bacteriodes fragilis, malaria

73
Q

problems with lincomycin

A

may induce overgrowth of C. difficile and macrolide-clindamycin resistance

74
Q

lincosamides (clindamycin) spectrum

A

gram(+) cocci; anaerobes, good tissue penetration for soft tissue infections; not for enterococci or aerobic gram (-)

75
Q

lincosamides mechanism of resistance

A

methylation of 23S rRNA; usually confers cross-resistance to macrolides

76
Q

macrolides MofA

A

inhibit protein synthesis at 50S at 23S rRNA

77
Q

macrolides static/cidal?

A

static

78
Q

macrolides spectrum

A

gram(+), alternative for pen allergy, atypicals

79
Q

macrolides mechanism of resistance

A

23S methylation or subunit mutations

80
Q

macrolides toxicity

A

GI issues, macrolide-induced clindamycin resistance

81
Q

oxazolidinones

A

new class of agents synthesized from scratch

82
Q

oxazolidinones MofA

A

inhibit protein synthesis at 50S (23S specifically)

83
Q

oxazolidinones static/cidal?

A

static

84
Q

oxazolidinones spectrum

A

gram(+) cocci including MRSA; not for gram negative due to efflux pumps

85
Q

oxazolidinones mechanism of resistance

A

chromosomal mutation of 23S or L3/L4, 23S methylation, efflux pumps

86
Q

oxazolidinones side effects

A

headache, insomnia, GI, yeast infections

87
Q

rifamycins should not be used as _

A

monotherapy due to emergence of spontaneous resistance

88
Q

rifamycins MofA

A

inhibit bacterial transcription at RNA polymerase step

89
Q

rifamycins static/cidal?

A

cidal

90
Q

rifamycins spectrum

A

used in conjunction with other drugs for TB and leprosy, prophylaxis for meningitis (NOT ACTIVE MENINGITIS)

91
Q

rifamycin mechanism of resistance

A

chromosomal RNA polymerase beta subunit mutations

92
Q

rifamycin side effects

A

GI, hepatotoxicity, decrease BC effectiveness

93
Q

ciprofloxacin (fluoroquinolones)

A

mostly gram(-); pseudomonas and MSSA

94
Q

levofloxacin (fluoroquinolone)

A

mostly gram(+); pneumococcus and pseudomonas

95
Q

moxifloxacin (fluoroquinolones)

A

atypicals, anaerobes

96
Q

quinolones static/cidal?

A

cidal

97
Q

quinolones MofA

A

gyrase/topoisomerase inhibitor

98
Q

quinolones spectrum

A

mostly gram(-) and some gram(+) [strep, steph], atypicals

99
Q

quinolones mechanism of resistance

A

DNA gyrase chromosomal mutations or efflux pump

100
Q

quinolones side effects

A

GI, dizziness, headache, CI in pregnancy, nerve damage, colitis

101
Q

metronidazole MofA

A

inhibits DNA replication but requires activation by a nitroreductase in microaerophiles, anaerobes, protozoa (prodrug)

102
Q

metronidazole static/cidal?

A

cidal

103
Q

metronidazole spectrum

A

atypicals, microaerophiles, anaerobes, protozoa, C. diff

104
Q

metronidazole DOC

A

many GI and diarrheal diseases - vaginosas, trich, amoeba, giardia (NOT for yeast infections)

105
Q

metronidazole side effects

A

GI, dizziness, dry mouth and metallic taste; CI with alcohol

106
Q

anti-folate examples

A

sulfonamides (no PABA –> DHA) and trimethoprim (no DHA –> THA)

107
Q

anti-folates static/cidal?

A

static (1drug), cidal (2 drugs)

108
Q

anti-folates spectrum

A

gram(+/-)

109
Q

anti-folates mechanism of resistance

A

duplicate enzyme production that is resistant to drug

110
Q

anti-folate side effects

A

allergies, stephens johnson syndrome

Microbiology 1 (5 decks)

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