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MIS > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Cell Wall Antibiotics

A

Beta Lactams

Glycopeptics

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2
Q

Protein Synthesis Inhibitors

A

30S
Tetracycline, Doxocyclin
Aminoglycosides (Tobramycin, Amikacin, Gentamycin)
50S
Clindamycin
Macrolides (Azithromycin, Clarithromycin, Erythromycin)
Linezolid

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3
Q

Nucleic Acid Inhibitors

A

Flouroquinolones

Metronidazole (DNA Damage)

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4
Q

Anti-Metabolites

A

Sulfonamides

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5
Q

Anti Tuberculosis

A

Isoniazid
Rifampin
Pyrazinamide

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6
Q

Beta Lactam Category

A

penicillins
cephalosporins
carbapenems
monobactams

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7
Q

Beta Lactam Mechanism

A

Inhibition of bacterial cell wall synthesis by acylating transpeptidases

Mechanism of Resistance: B-lactamase inhibitors

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8
Q

Side Effects of Beta Lactams

A

Generally well tolerated unless patient is hypersensitive/allergic and then can lead to rashes, fever and other bad things

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9
Q

Glycopeptics

A

VANCOMYCIN
MOA:
- Only effects gram + bacteria
- Inhibits cell wall synthesis (binds D-Ala-D-Ala terminus of pentapeptide

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10
Q

Resistance to Glycopeptics

A

Substrate modification (D-ala-D-ala to D-ala-D-lactate) through VanA transposon

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11
Q

Side Effects of Glycopeptics

A 
10% of all cases
MINOR:
-  Tissue irritation, chills, fever
MAJOR:
-  Ototoxicity and Nephrotoxicity
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12
Q

Tetracyclines include …

A

Includes:

  • Tetracycline
  • Doxocyclin
  • Tigecycline
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13
Q

Tetracyclines work by …

A

inhibiting protein synthesis. Bind irreversibly to the 30S subunit of the bacterial ribosome. Blocks the aminoacyl-tRNA to acceptor site on mRNA-ribosome complex

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14
Q

Tetracyclines resistance

A

Impaired influx or increased efflux by active transport protein
Ribosome protection via interfering proteins

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15
Q

Tetracyclines side effects

A

GI - nausea, vomiting, diarrhea
Bony structures - can be deposited in bones of growing fetus
Renal Tubular Acidosis
Hepatic function impairment in patients with hepatic issues

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16
Q

Aminoglycosides include …

A

Tobramycin
Amikacin
Gentamycin

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17
Q

Aminoglycosides work by …

A

Irreversibly inhibiting protein synthesis by binding the 30S. Interfers with the initiation complex, misreading of mRNA, breaks up polysome into nonfunctional monosomes

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18
Q

Aminoglycosides resistance

A
  • production of transferase enzyme (inactivates Aminoglycosides)
  • Impaired entry (porin protein mutation)
  • Receptor protein on 30S is deleted or altered
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19
Q

Aminoglycosides side effects

A

Increase when drug is taken for more than 5 days!
OTOTOXICITY
NEPHROTOXICITY
RESPIRATORY PARALYSIS

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20
Q

Macrolides include …

A

Erthromycin
Clarithromycin
Azithromycin

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21
Q

Macrolides works by …

A

Inihibtion of protein synthesis by binding the 50S subunit (blocks exit channel)

Most effective against gram positive bacteria

22
Q

Macrolides resistance

A
  • Reduced permeability
  • Production of Esterases that hydrolyze macrolides
  • Ribosomal protection via inhibitory proteins
23
Q

Macrolides Side Effects

A

Anorexia, nausea, vomiting, diarrhea

Erythromycin –> Acute cholestatic hepatitis and inhibits cytochrome p450

24
Q

Linezolid works by …

A

preventing bacterial protein synthesis by binding to 23S ribosomal RNA of the 50S subunit. Bacteriostatic

25
Q

Linezolid resistance

A

primarily due to efflux pumps

26
Q

Linezolid side effects

A

Hematogenic - duration-dependent bone marrow suppression, neuropathy, and optic neuritis
Serotonin Syndrome

27
Q

Flouroquinolones include …

A

Ciprofaxin, levofloaxin, moxifloaxin

28
Q

Flouroquinolones works on ..

A

both gram positive and negative

29
Q

Flouroquinolones works by …

A

Inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV
Interferes with transcription (II), translation (II), and chromosome segregation during mitosis (IV)

30
Q

Flouroquinolone resistance

A

Target Modification
Target production
Drug Modification

31
Q

Flouroquinolone side effects

A

Generally well tolerated
Contraindicated for patients with QTc interval prolongation
May damage cartilage (not usually recommended <18)
Tendonitis

32
Q

Metronidazole used for …

A

ANAEROBIC bacteria!!! C. Diff colitis

33
Q

Metronidazole works by …

A

Disturbing ETC, reduced by ferredoxin, results in products that are toxic to anaerobic cells

34
Q

Sulfonamides

A

usually combined with inhibitor of dihydrofolate reductase (trimethoprim) for UTI

35
Q

Metronidazole side effects

A

Nausea, diarrhea, stomatitis, peripheral neuropathy

AVOID ALCOHOL … ADH inhibitor

36
Q

Sulfonamides work on ..

A

Gram positive and negative

37
Q

Sulfonamides work by ..

A

antifolate, many bacteria cannot use exogenous folate, must synthesize it from PABA and Sulfonamidesare PABA analogs

38
Q

Sulfonamide Resistance

A
  • Overproduction of PABA
  • Production of different enzymes w/ low Sulfonamide affinity
  • Impair permeability
39
Q

Sulfonamide Side Effects

A

Megablastic Anemia, Leukopenia, Granulocytopenia
Nausea, Vomiting , Fever
Vasculitis, renal damage, CNS disturbance

40
Q

Isoniazid

A

Most active drug for TB treatment

41
Q

Isoniazid works by …

A
  • Inhibits my colic acid synthesis, an essential component of the cell wall
  • Forms covalent bond with acyl carrier protein
42
Q

Isoniazid resistance

A

Caused by over expression of inna gene, which encodes an NADH-dependent acyl carrier protein reductase
*Occurs often so a combination therapy is required

43
Q

Isoniazid side effects

A 
Hepatotoxic - may cause hepatitis.  
Peripheral Neuropathy (give pyridoxine to prevent)
44
Q

Rifampin

A

Used in conjunction with isoniazid

45
Q

Rifampin works on ….

A

Both gram + and -

46
Q

Rifampin works by …

A

Binding beta subunit of bacterial RNA polymerase. Bactericidal for mycobacteria

47
Q

Rifampin resistance

A

Point mutations in rpoB, the gene for B subunit of the RNA polymerase

48
Q

Rifampin side effects

A
  • Rashes, thrombocytopenia, nephritis

Strong induction of cyto p450 and thus increases rate of elimination of drugs

49
Q

Pyrazinamide

A

Used in conjunction to isoniazid and rifampin

50
Q

Aztreonam

A

Monobactam

Gram negative rod aerobes only

MIS (23 decks)

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