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Clinical Micro > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Another name for penicillin

A

Beta-lactam antibiotics

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2
Q

Is penicillin bactericidal?

A

Yes, kills the bacteria

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3
Q

What is transpeptidase?

A

Enzyme that catalyzes linkage in peptidoglycan cell wall

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4
Q

How does penicillin work?

A

It binds to and competitively inhibits transpeptidase

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5
Q

What is needed for penicillin to be successful?

A

1) penetrate cell layers
2) keep beta lactam ring intact
3) bind to transpeptidase

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6
Q

Ways bacteria can become resistant to penicillin

A

1) gram negative adjust porin channel so penicillin can’t pass outer plasma membrane
2) beta lactamase cleaves bond in Batman lactam ring
3) alter transpeptidase so that antibiotic cannot bind
4) actively pump out beta lactam

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7
Q

What type of penicillins is MRSA resistant to?

A

All penicillins

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8
Q

What are the types of penicillins?

A

1) penicillin G
2) aminopenicillins
3) penicillinase- resistant penicillins
4) anti-pseudomonal penicillins
5) cepalosporins
6) carbapenems

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9
Q

what antibiotics are included in antipseudomonal penicillins

A

Carboxypenicillins
Ureidiopenicillins
Monobactams

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10
Q

Basic description of cephalosporins

A
  • Beta lactam ring
  • Resistant to beta lactamase
  • Cover broad spectrum of gram positive and gram negative
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11
Q

Broadest spectrum beta lactam antibiotics

A

Carbapenems

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12
Q

What is penicillin G commonly used for?

A

Strep pneumo
Strep throat

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13
Q

What are the aminopenicillins?

A

Ampicillin and amoxicillin

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14
Q

What are ampicillin and amoxycillin best for?

A

One of few drugs effective against enterococcus
Listeria
Otitis media
Bronchitis
Sinusitis

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15
Q

What is amp-gent and what is it typically used for?

A

Ampicillin - gentamicin

More serious utis

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16
Q

Penicillinase resistant penicillins

A

Methecilin, nafacillin, oxacillin

Cloxacillin, dicloxacillin

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17
Q

What are penicillinase resistant penicillins best for?

A

Staph (other than MRSA) and gram positive skin infections

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18
Q

What are the antipseudomonal penicillins?

A

Carboxypenicillins and ureidopenicillins

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19
Q

What do the antipseudomonal penicillins work to trat?

A

Gram negatives, esp pseudomonas aeruginosa

Anaerobes

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20
Q

Examples of antipseudomonal penicillins

A

Ticarcillin, carbenicillin
Piperacillin, mezlocillin

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21
Q

What are beta lactamase inhibitors? Examples given in combo with other penicillins?

A

Inhibit beta lactamase

Examples:
1. Clavulanic acid (augmentin is amoxycilin + clavulanic acid)
2. Sulbactam (unasyn is ampicillin and sulbactam)
3. Tazobactam- zosy -Piperacillin and tazobactm

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22
Q

What organisms are resistant to cephalosporins?

A
  1. MRSA
  2. Enterococcus

Ceohalosporiniase producing organisms

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23
Q

Describe first generation ceohalosporins

A

Most effective against gram positive
Most have -ph in name

Cephalothib
Cephaprin
Cephradine
Ceophalexib
Exception cefazolin
Cefadroxil

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24
Q

Describe second gen cephalosporin

A

Okay at treating gram positives and gram negatives

Fam, fa, fur, fox, or tea in name

Cefamandole
Cefaclor
Cefuroxime
Cefoxitin
Cefotetan

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25
Q

Describe third generation cephalosporins

A

Beta lactam drugs
Better at treating gram negatives

T in name
Ceftriaxone
Ceftazidime
Cefotaxime
Ceftibuten

26
Q

Describe fourth generation ceohalosporin

A

Great gram negative coverage and good gram positive coverage
Beta lactam ring

Cefeopime

27
Q

How many generations of cephalosporins are there?

A

5

28
Q

What antibiotics are often given as prophy before surgery?

A

First gen cephalosporins

29
Q

Use for first generation cephalosporins

A

Pre surgery prophy

30
Q

What are second generation cephalosporins typically used for?

A

Otitis media
Sinusitis
Anaerobic gut bacteria
Prophy GI tract surgery

31
Q

What are the carbepenems?

A

Imipenem
Meropenem
Doripenem
Ertapenem

32
Q

What are third generation cephalosporins used for?

A

Community acquired pneumonia, meningitis,pyelonephritis, meningitis, pseudomonas

33
Q

Describe carbapenems

A

-Beta lactam antibiotics
-Resistant tibeta- lactamase (including EBSL)
-broadest antibacterial activity of any anyibiotic

34
Q

What antibiotic is a monobactams?

A

Aztreonam

35
Q

Describe monobactam

A
  • gram negative, aeerobic (only)
  • beta lactam ring
36
Q

What are monobactams used for?

A
  • Hospital acquired aerobic gram negatives (ex pseudomonas)
  • used in combo with antibiotics that kill gram positives
37
Q

What are the anti-ribosomal antibiotics

A

CLEAN TAG
C- choloramphenicol and clindamycin
L- linezoid
E- erythromycin
T- tetracycline and tigecycline
AG- aminoglycosides

38
Q

What conditions does clindamycin cover

A

Anaerobes
Bacterial vaginosis
Toxic shock syndrome from GAS or staph
Lung abscess

39
Q

What is the concern with clindamycin?

A

Can cause c. Diff, but most c. Diff cases from penicillins

40
Q

What are linezoid and tedizolos used for

A

Resistant bugs (MRSA, VRE
HAP

41
Q

What are the macrolides?

A

Erythromycin, azithromycin, clarithromycin, telithromycin

42
Q

What are macrolides typically used for?

A

-Atypical and community acquired pneumonia
- upper respiratory infections

43
Q

What is doxy used for?

A
  • chlamydia
  • walking pneumonia due to mycoplasma pneumonia
  • brucellosis
  • rickettsial diseases
  • acne
  • anthrax
44
Q

Describe aminoglycosides

A

-Kill aerobic gram-negative enteric organisms
- usually paired with penicillin to help pass through cell wall

45
Q

Rule to remember which antibiotics are aminoglycosides?

A
  • like macrolides they end in -mycin (streptomycin, gentamicin…etc
  • amikacin
46
Q

What are the first line drugs for TB

A

Isoniazid*
Rifampin*
Pyrazinamide
Ethambutol
Streptomycin

47
Q

Treatment for active TB

A

6 months rifampin regimen
- 4 drugs 2 months, then 2 drugs 4 months (second phase rifampin and isoniazid increases to 7 months of sputum culture still positive after first 2 months)

48
Q

Treatment for latent TB

A

9 months isoniazid
4 months rifampin

49
Q

Complication for TB treatment

A

Hepatotixicity

50
Q

Treat the following patients if the PPD is >= 5 mm

A
  1. Persons with HIV infection
  2. Persons with fibrotic changes in chest x-ray compatible with old healed tuberculosis
  3. Close contacts of persons with newly diagnosed active tuberculosis
  4. Patience with organ transplants and other immunosuppressed patients
51
Q

Treeat the following moderate risk patients if PPD is greater than 10 mm

A
  1. Persons with medical conditions that lower the immune system, like diabetes, prolonged steroid or immunosuppressive treatment, renal failure, and others
  2. Recent arrivals within the past 5 years from countries with a high prevalence of tuberculosis
  3. Persons who inject drugs
  4. Residence and employees of high risk settings, so just homeless shelters, long-term care facilities, prisons, and other healthcare facilities
  5. Recent PPD conversions within a two year period
  6. Healthcare workers
52
Q

What method of medication administration is required for tuberculosis

A

Direct observation therapy

53
Q

Describe fluoroquinolone

A
  • oral
  • penetrate tissues well
  • inhibit DNA gyrase
  • high drug level in target tissue
54
Q

What is the common ending of all fluoroquinolones

A

-floxacin
Example- ciprofloxacin

55
Q

What are fluoroquinolones (cipro) best for?

A

Gram negatives (pseudomonas, enterics, complicated UTIs, facultative intracellular pathogens (because concentrated in cells)

56
Q

Describe vancomycin

A

-Covers all gram positives
-Inhibits peptidoglycan production
-IV most of the time (not absorbed orally) oral for c. Diff
- increasing resistance

57
Q

What are the glycopeptide antibiotics?

A
  • vancomycin
  • telavancin
  • dalbavancin
  • orotavancin
58
Q

Newer antibiotic that kills gram positive bacteria, including VRE

A

Daptomycin

59
Q

Antimetabolite antibiotics that act synergistically to kill many gram positive and gram negative bacteria by inhibiting TH4 production

A

Trimethoprim and sulfamethoxazole

60
Q

What is the sulfa drug tmp-smp primarily used for?

A

Gram positive and gram negative aerobes
UTIs
Respiratory illness
Enterics
Preventative for Pneumocystis jirovechii when CD4 counts below 200

Clinical Micro (12 decks)

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