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PCM2 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Penicillin G

A

b-lactam

inhibits cell wall synthesis

DOC: Syphillis (benzathine), Streptococcal infections, Rheumatic fever prophylaxis

Other uses: N. Meningitis, Listeria, Anaerobes

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2
Q

Penicillin V

A

b-lactam

inhibits cell wall synthesis. can give orally.

DOC: Strep throat

Other uses: Listeria

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3
Q

Nafcillin

A

“antistaphylococcal” penicillin, b-lactamase resistant

Erratic, can’t be given orally. Excreted in bile, can be given in kidney failure.

DOC: MSSA

Other uses: Streptococci

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4
Q

Oxacillin

A

“antistaphylococcal” penicillin, b-lactamase resistant

DOC: MSSA

Other uses: Streptococci

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5
Q

Dicloxacillin

A

“antistaphylococcal” penicillin, b-lactamase resistant

DOC: MSSA

Other uses: Streptococci

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6
Q

Ampicillin

A

Extended-spectrum penicillin

DOC solo: Listeria, VRE, E. Faecium, E. Faecalis, Streptococci.

DOC with lactamase inhibitor: H. Influenzae, VRE, E. Faecium, E. Faecalis

Other uses solo: E. Coli, P. mirabilis, N. meningitis.

Other uses with lactamase inhibitor: Anaerobes, Klebsiella Listeria, Streptococci, E. Coli, P. mirabilis, N. Meningitis.

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7
Q

Amoxicillin

A

Extended-spectrum penicillin. Higher oral availability than other penicillin. Commonly given to kids and in pregnancy.

DOC solo: Streptococci

DOC with lactamase inhibitor: H. Influenzae

Other uses solo: E. Coli, P. Mirabilis, N. Meningitis

Other uses with lactamase inhibitor: Anaerobes, Klebsiella, Streptococci, E. Coli, P. mirabilis, N. Meningitis

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8
Q

Ticarcillin

A

Antipseudomonal Penicillin

Often given with lactamase inhibitor. Mainly used as an injectable treatment of Gram-negatives & moderate-severe infections of susceptible organisms.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

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9
Q

Piperacillin

A

Antipseudomonal Penicillin

Often given with lactamase inhibitor. Mainly used as an injectable treatment of Gram-negatives & moderate-severe infections of susceptible organisms.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

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10
Q

Cefazolin

A

1st gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella. Surgical prophylaxis!!!

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11
Q

Cephalexin

A

1st gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella.

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12
Q

Cefaclor

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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13
Q

Cefoxitin

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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14
Q

Cefotetan

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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15
Q

Cefamandole

A

2nd gen cephalosporin

b-lactam. less susceptible to lactamase.

Not DOC for anything.

Uses: Anaerobes, H. Influenza, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella

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16
Q

Ceftriaxone

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase.

DOC: N. gonorrhea, N. meningitis (empiric treatment of meningitis + prophylaxis), H. Influenzae, treatment of disseminated Lyme disease.

Other uses: MSSA, E. Coli, P. mirabilis, Klebsiella.

AE: Kerniecterus

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17
Q

Ceftazidime

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase

DOC: Pseudomonas

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18
Q

Cefoperazone

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase

Uses: Pseudomonas

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19
Q

Cefotaxime

A

3rd gen cephalosporin

b-lactam. less susceptble to lactamase

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20
Q

Cefixime

A

3rd gen cephalosporin

b-lactam. less susceptible to lactamase

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21
Q

Cefipime

A

4th gen cephalosporin

b-lactam. less susceptible to lactamase

Not DOC for anything

Use: Treatment of mixed infections with susceptible organisms: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, ESCAPPM, N. Gonorrhea, N. Meningitis

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22
Q

Ceftaroline

A

5th gen cephalosporin

b-lactam. less susceptible to lactamase

Not DOC for anything.

Use: MRSA skin infections with coinfecting Gram negatives. VRSA, MRSA, MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, N. Gonorrhea, N. Meningitis, H. Influenzae

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23
Q

Doripenem

A

Carbapenem.

Synthetic b-lactam. resist lactamase.

DOC: B-lactamase producing Gram negatives

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia

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24
Q

Ertapenem

A

Carbapenem.

Synthetic b-lactam. resist lactamase.

DOC: B-lactamase producing Gram negatives

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia

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25
Q

Imipenem

A

Carbapenem.

Synthetic b-lactam. resist lactamase.

DOC: B-lactamase producing Gram negatives

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia

AE: Forms nephrotoxic metabolite. Cilastatin can prevent this.

26
Q

Meropenem

A

Carbapenem.

Synthetic b-lactam. resist lactamase.

DOC: B-lactamase producing Gram negatives

Uses: MSSA, Streptococci, E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, N. Gonorrhea, N. Meningitis, H. Influenzae, Rickettsia

27
Q

Cilastatin

A

Dehydropeptidase I inhibitor

Averts nephrotoxicity due to Imipenem

28
Q

Aztreonam

A

Monobactam

Not DOC for anything. Treats Gram-negative infections in patients allergic to penicillin.

Uses: Effective against Aerobic Gram Negatives.
E. Coli, P. Mirabilis, Klebsiella, Pseudomonas, ESCAPPM

29
Q

Clavulanic Acid

A

B-lactamase inhibitor

Given with penicillins against lactamase-containing bacteria.

30
Q

Sulbactam

A

B-lactamase inhibitor

Given with penicillins against lactamase-containing bacteria.

31
Q

Tazobactam

A

B-lactamase inhibitor

Given with penicillins against lactamase-containing bacteria.

32
Q

Avibactam

A

B-lactamase inhibitor

Given with penicillins against lactamase-containing bacteria.

33
Q

Vancomycin

A

Bacterial glycoprotein, inhibits cell wall synthesis

DOC: C. Diff, MRSA, Staph Enterocolitis (orally)

Other uses: Listeria, E. Faecium, E. Faecalis, MSSA, Streptococci.

Treat G+ infections in pt with severe b-lactam allergy. Empiric treatment of infective endocarditis (in combo with an aminoglycoside). Penicillin resistant S Pneumoniae. Staphylococcal enterocolitis.

AE: Redneck, Ototoxic, Nephrotoxic, DRESS.

34
Q

Daptomycin

A

Bactericidal.

MOA: Calcium-dependent cell membrane depolarization.

Effective against resistant G+ organisms.

DOC: VRSA

Other uses: VRE, E. Faecium, E. Faecalis, MRSA, MSSA.

AE: Elevated Creatine phosphokinase (discontinue coadmin of statin).

35
Q

Bacitracin

A

Unique mechanism, no cross resistance. Cell wall synth inhibitor. Only used topically.

Effective against all G+

36
Q

Doxycycline

A

Tetracycline antibiotic

Passively diffusion & energy-dependent transport to inner membrane –> reversibly binds 30s subunit, prevents tRNA attachment.

Use- severe acne & rosea, empiric therapy of community-acquired & atypical pneumonia.

DOC: N. Gonorrhea, Rickettsia, Atypicals, Lyme Disease, Anthrax Prophylaxis.

Other uses: Syphillis (if pt allergic to penicillin), Streptococci, E. Coli, N. Meningitis, H. Influenzae

Other uses in combination: H. Pylori, Malaria, Plague Tularemia & Brucellosis

AE: Growth stunting, teeth hypoplasia, Pregnancy category D, Photosensitization.

37
Q

Minocycline

A

Tetracycline antibiotic

Passively diffusion & energy-dependent transport to inner membrane –> reversibly binds 30s subunit, prevents tRNA attachment.

Use- severe acne & rosea, empiric therapy of community-acquired & atypical pneumonia.

DOC: N. Gonorrhea, Rickettsia, Atypicals, Lyme Disease, Anthrax Prophylaxis.

Other uses: Syphillis (if pt allergic to penicillin), Streptococci, E. Coli, N. Meningitis, H. Influenzae

Other uses in combination: H. Pylori, Malaria, Plague Tularemia & Brucellosis

AE: Growth stunting, teeth hypoplasia, Pregnancy category D, Photosensitization.

38
Q

Tetracycline

A

Tetracycline antibiotic

Passively diffusion & energy-dependent transport to inner membrane –> reversibly binds 30s subunit, prevents tRNA attachment.

Use- severe acne & rosea, empiric therapy of community-acquired & atypical pneumonia.

DOC: N. Gonorrhea, Rickettsia, Atypicals, Lyme Disease, Anthrax Prophylaxis.

Other uses: Syphillis (if pt allergic to penicillin), Streptococci, E. Coli, N. Meningitis, H. Influenzae

Other uses in combination: H. Pylori, Malaria, Plague Tularemia & Brucellosis

AE: Growth stunting, teeth hypoplasia, Pregnancy category D, Photosensitization.

39
Q

Tigecycline

A

Glycylcycline antibiotic

Similar structurally to tetracyclines. Not subject to same resistance mechanisms.

Use: Treatment of complicated skin, soft tissue & intra-abdominal infections.

AE: Black Box FDA warning about increased mortality. Other AE similar to tetracyclines.

40
Q

Amikacin

A

Aminoglycoside Antibiotic

O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade.

DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin).

Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.

41
Q

Tobramycin

A

Aminoglycoside Antibiotic

O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade.

DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin).

Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.

42
Q

Streptomycin

A

Aminoglycoside Antibiotic

O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade.

DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin).

Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.

43
Q

Gentamicin

A

Aminoglycoside Antibiotic

O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade.

DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin). N. Gonorrhea (combined with azithromycin)

Other uses: Empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.

44
Q

Neomycin

A

Aminoglycoside Antibiotic

O2 dependent transport + Passive diffusion. Irreversibly binds 30s subunit- mRNA misleading, translocation blockade.

DOC only in combination: Empiric therapy of infective endocarditis (combined with Vancomycin).

Other uses: Bowel surgery, Adjunct for Hepatic Encephalopathy, empiric therapy of serious infections. E. Coli, P. mirabilis, Klebsiella, Pseudomonas, ESCAPPM

AE: Ototoxic, Nephrotoxic, Neuromusc Blockade (CI: Myasthenia gravis), Pregnancy Cat D.

45
Q

Erythromycin

A

Macrolide Antibiotic

Reversibly binds 23S part of 50S subunit. Less broad spectrum than other macrolides.

DOC: Whooping Cough (B Pertussis), Atypical pneumonia.

Other uses: Listeria, MSSA, Streptococci

AE: CYP450 inhibition (CI: Statin), QT prolongation (arrhythmias), hepatic abnormalities

46
Q

Clarithromycin

A

Macrolide Antibiotic

Reversibly binds 23S part of 50S subunit.

DOC: Atypical pneumonia.

Other uses: Listeria, MSSA, Streptococci

AE: CYP450 inhibition (CI: Statin), QT prolongation (arrhythmias)

47
Q

Azithromycin

A

Macrolide Antibiotic

Reversibly binds 23S part of 50S subunit. Less broad spectrum than other macrolides.

DOC: Atypical pneumonia, N. Gonorrhea (in combo with Gentamicin)

Other uses: Listeria, MSSA, Streptococci, E. Coli, H. Influenzae, Rickettsia, Syphillis.

AE: QT prolongation (arrhythmias), hepatic abnormalities

48
Q

Chloramphenicol

A

Enters cell by active transport. Binds 50s subunit, inhibits peptidyltransferase.

Not DOC for anything. Serious toxicity limits use to to severe resistant infection. High penetrability to site of infection.

Uses: VRE, E. Faecium, E. Faecalis, MSSA, Streptococci, E. Coli, P. mirabilis, Klebsiella, ESCAPPM, N. Meningitis, H. Influenzae, Rickettsia, Anerobes, Atypicals.

AE: Bone Marrow Depression - dose dependent, irreversible aplastic anemia. Gray baby syndrome (cyanosis).

49
Q

Clindamycin

A

Binds 50S subunit & blocks translocation.

Used against G+ anaerobes and some aerobes. Alternative prophylaxis in penicillin-allergic patients.

DOC: Anaerobes

Other uses: MRSA, MSSA, Streptococci

AE: Causes C Diff colitis.

50
Q

Quinupristin

A

Streptogramins

Always given with Dalfopristin (other Streptogramin). Bind separate sites on 50s subunit. Work synergistically.

Restricted to treatment of resistant Staph & Enterococci.

Use: VRE, MRSA, VRSA. E. Faecium, E. Faecalis, MSSA, Streptococci.

AE: CYP3A4 inhibitors. Headache.

51
Q

Dalfopristin

A

Streptogramins

Always given with Quinupristin (other Streptogramin). Bind separate sites on 50s subunit. Work synergistically.

Restricted to treatment of resistant Staph & Enterococci.

Use: VRE, MRSA, VRSA. E. Faecium, E. Faecalis, MSSA, Streptococci.

AE: CYP3A4 inhibitors. Headache.

52
Q

Linezolid

A

Bacteriostatic. Bacteriocidal vs Strep & C. Perfringens

Binds unique site on 23S part of 50S subunit, inhibits formation of 70S complex.

Not DOC for anything.

Use: Hits most G+ organisms. Used to treat multi-drug resistant infections. VRE, E. Faecium, E. Faecalis, VRSA, MRSA, MSSA, Strep,

Oral 100% available or IV, widely distributed inc CSF.

AE: MAO inhibitor- cheese reaction, 5HT syndrome. Long term: BM suppression, thrombocytopenia, optic & periph neuropathy, lactic acidosis.

53
Q

Fidaxomicin

A

Macrocyclic Antibiotic, Narrow Spectrum

Binds RNA Polymerase, inh protein synth.

Use: Treat C Diff colitis

AE: GI, safety not established in <18yo

54
Q

Mupirocin

A

Monoxycarbolic acid

Binds t-RNA synthase, inhibits protein synth.

Use: Intranasal MRSA elimination, topical MRSA, MSSA, Strep infections.

AE: Dermatologic- burning, edema, tenderness, dry skin, pruritus.

55
Q

Ciprofloxacin

A

2nd gen Fluoroquinolone

Inhibit topoisomerase 2 & 4.

Broad spectrum activity. Synergistic with B-lactams. Mostly against G- with some G+ and atypical activity.

Use: Traveler’s diarrhea, P. Aeruginosa (CF patients), Prophylaxis against meningitis.

AE: Photosensitivity, connective tissue problems (CI: Pregnancy, nursing, <18yo FDA BBB warning), Peripheral neuropathy.

56
Q

Levofloxacin

A

3rd gen Fluoroquinolone

Inhibit topoisomerase 2 & 4.

Broad spectrum activity. Synergistic with B-lactams. Expanded G- with improved G+ and atypical activity. Excellent against Strep Pneumo.

Use: Prostatitis, STDs (not syphilis), skin infections, acute sinusitis, bronchitis, TB, community-acquired pneumonia.

AE: Photosensitivity, connective tissue problems (CI: Pregnancy, nursing, <18yo FDA BBB warning), Peripheral neuropathy, QT prolongation.

57
Q

Moxifloxacin

A

4th gen Fluoroquinolone

Inhibit topoisomerase 2 & 4.

Broad spectrum activity. Synergistic with B-lactams. Expanded G- with improved G+ and atypical activity. Excellent against Strep Pneumo.

Use: Community-acquired pneumonia.

AE: Photosensitivity, connective tissue problems (CI: Pregnancy, nursing, <18yo FDA BBB warning), Peripheral neuropathy, QT prolongation.

58
Q

Cotrimoxazole

A

Combo of Trimethopril & Sulfamethoxazole.

Trimethoprim: Dihydrofolate reductase inhibitor
Sulfamethoxazole: Dihydropteroate synthase (PABA analog)

DOC: Uncomplicated UTI, Primary Care Prophylaxis, Nocardiosis

Other uses: Toxoplasmosis, Listeria, MRSA, MSSA, Strep, E Coli, P Mirabilis, Klebs, ESCAPPM, N Meningitis, H Influenzae, Anerobes, Atypicals.

AE Sulfa: Crystalluria (nephrotoxicity), Kernicterus, Hematopoietic disturbance (G6PD def), Hypersensitivity.

Trimetho: Antifolate effects.

Both: Dermatologic, GI, CI in pregnancy (esp 1st trimester)

59
Q

Metronidazole

A

Antimicrobial, amebicide, antiprotozoal.

Needs anerobic conditions for reductive bioactivation by ferredoxin, forms cytotoxic products which damage DNA.

Widely distributed. Hepatic elimination.

DOC: Anerobes

AE: Disulfiram-like effect, headache, dark urine, not advised in 1st trimester.

60
Q

Rifampin

A

Inhibits RNA polymerase

Used against Mycobacteria, also G+ and G-. WOrks against MRSA.

Use: TB, meningitis prophylaxis, H Influenzae prophylaxis, MRSA (with vancomycin), safe in pregnancy!

AE: CYP450 inducer. Thrombocytopenia, nephritis, rashes, liver dysfunction.

61
Q

Polymyxin B

A

Cationic Detergent

Binds & disrupts bacterial cell membrane, binds and inactivates endotoxin. Highly active against G-, but not G+.

Use: Topical treatment of infected superficial skin lesions. Systemic salvage therapy of resistant Acinetobacter, P aeruginosa, Enterobacteriaceae.

AE: Few if topical. Systemic- extremely nephrotoxic.

62
Q

Nitrofurantoin

A

Rapidly eliminated unchanged into urine where it’s reduced to active form which damages bacterial DNA.

Use: Uncomplicated UTI

AE: Anorexia, N/V, neuropathy, hemolytic anemia (G6PD def), pulmonary injury. CI: Renal insufficiency, late pregnancy, <1 month old.

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