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Antibiotics Flashcards

1
Q

Which ABx is active against MRSA?

A

Ceftaroline

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2
Q

With increasing cephalosporin generations, how is the coverage changing?

A

Increasing G- coverage and less G+ coverage (until 4 and 5 which are broad spectrum)

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3
Q

1st generation cephalosporin?

A

Cefazolin

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4
Q

2nd generation cephalosporin?

A

Cefoxatin

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5
Q

3rd generation cephalosporin?

A

Ceftriaxone

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6
Q

4th generation cephalosporin?

A

Cefepime

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7
Q

5th generation cephalosporin?

A

Ceftaroline

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8
Q

First generation cephalosporin is active against?

A

MSSA and strep infections

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9
Q

Mechanism of action of Beta-Lactam inhibitors?

A

Interruption of the D-Ala-D-Ala by binding to the PBPs which inhibits the cross-linking of the cell wall

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10
Q

Penicillin V and G are active against?

A

G+ bacilli and cocci, most anaerobes

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11
Q

What causes resistance to penicillins?

A

B-lactamases which render the ABx ineffective because the B-lactam ring is broken

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12
Q

Nafcillin is active against?

A

MSSA and strep

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13
Q

How is nafcillin different from penicillin?

A

Bulkier R group which helps with inactivation by B-lactamases

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14
Q

Amoxicllin is part of which group of ABx?

A

Aminopenicillins

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15
Q

What enables amoxicillin to be more active than penicillin?

A

the amino group as an R group which helps get the ABx through the G- outer membrane

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16
Q

Piperacillin is active against which major group of infections?

A

Pseudomonas

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17
Q

What are the B-lactamases inhibitors?

A

-tazobactam and -clavulanate

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18
Q

Adverse effects of piperacillin?

A

NVD, neurologic reactions from high dose IV who have poor renal function, allergic reactions; SJS

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19
Q

Ceftriaxone is inactive against?

A

G- strains that express ESBLS

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20
Q

Aztreonam is part of which group of ABx

A

Monobactams

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21
Q

What is axtreonam’s spectrum of action?

A

Aerobic Gram Negative

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22
Q

Imipenum is paired with what to protect against kidney degradation?

A

Cilistatin

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23
Q

What is causing resistance to imipenum-cilistatin?

A

Class A KPC and Class B NDM-1 metalo-beta-lactamases

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24
Q

Aztreonam is a good alternative drug for patients with…?

A

Penicillin allergy or can’t handle a aminoglycoside

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25
What is the mechanism of action of vancomysin?
Binding to D-Ala to prevent the addition of NAM-NAG
26
What group of ABx does vancomycin belong to?
glycopeptides
27
What is vancomysin's spectrum of action?
Gram + aerobes and anaerobes
28
What causes the resistance to vancomycin?
The changing of the D-Ala-D-Ala
29
What are the side effects of vancomycin?
Ototoxicity and nephrotoxicity
30
What is the MOA of fosfomycin?
Inhibition of enolpyruvate so NAM can't be synthesized anymore
31
What is fosfomycin used for?
Broad spectrum UTIs
32
What group does gentamicin belong to?
Aminoglycosides
33
What is the spectrum for gentamicin?
Gram negative aerobes
34
What is the mechanism of action for gentamicin?
Binding to the 30S subunit blocking the initiation complex and causing misreading of the mRNA
35
Describe the resistance that has developed against aminoglycosides.
Bacterial kinase and acetyltransferase inactivation of the antibiotics
36
What symptoms does the ototoxicity cause due to the aminoglycosides?
Tinnitus, ataxia, dizziness due to cochlear and vestibular damage
37
When shouldn't aminoglycosides be used?
Pregnancy and Myasthenia gravis
38
How does the structure of aminoglycosides affect its distribution?
No CNS, lungs, or eye penetration; low oral availability since it's a large hydrophilic molecule
39
How do tetracyclines affect protein synthesis?
Bind to the 30S subunit and inhibit translation by binding to the A site of mRNA causing bacteriostatic effects
40
Tetracyclines can be used to treat...
atypical bacteria, tick borne illnesses, and protozoans
41
What can cause decreased absorption of tetracyclines?
Taking with a divalent cation
42
Why shouldn't doxycycline be used in children?
Binds to Ca and deposits there causing discoloration of teeth and accumulates in bones
43
What other side effects does doxycycline have?
Photosensitivity reactions
44
How has resistance developed against tetracyclines?
Increased efflux out of the bacterial cell and alteration of the ribosomes
45
What ABx is a macrolide?
Azithromycin
46
Azithromycin binds to which ribosomal subunit?
50S
47
What is the spectrum of azithromycin?
G+/G- aerobes and anaerobes; atypical bacteria
48
What contributes to the resistance against azithromycin?
Increased efflux transporters
49
How can the azithromycin resistance be overcome?
Increase the dose
50
Which CYP450 is inhibited by azithromycin?
CYP3A4
51
What are the adverse effects of azithromycin?
GI irritation, hepatotoxicity, prolonged QT interval
52
What ABx binds to the 50S subunit and blocks peptide bond formation?
Clindamycin
53
What enzyme is blocked by clindamycin?
Peptidyl transferase
54
What is the spectrum of clindamycin?
G+ anaerobes
55
What is the major side affect of clindamycin?
C. diff infection
56
What antibiotic belongs to the oxazolidiones group?
Linezoid
57
What is the mechanism of action of linzoid?
Binds to the 23S rRNA of the 50S subunit
58
What is the spectrum of linezoid?
G + aerobes
59
In addition to MRSA, what other resistant variant can linezoid go after?
VRSA
60
What drug interaction do you need to be aware of when using linezoid?
MAOIs; could result in serotonin syndrome
61
What neuropathies could result with linezoid use?
Optic and peripheral neuropathy
62
Ciprofloxacin belongs to which group of ABx?
Fluoroquinolones
63
What does ciprofloxacin bind to and what is the the result?
Binds to DNA-topoisomerase complexes; inhibition of DNA synthesis (bactericidal)
64
What is the unique adverse effect of fluoroquinolones?
Tendon rupture
65
What can reduce the absorption of ciprofloxacin?
divalent cations
66
Ciprofloxacin binds to what in gram + bacteria?
Topoisomerase IV
67
Ciprofloxacin binds to what in gram - bacteria?
DNA gyrase
68
What is the spectrum of metronidazole?
Obligate anaerobes, microaerophilic bacteria; anaerobic protozoa
69
the MOA of action of metronidazole causes what action to the bacteria DNA via what?
Loss of helical structure due to free radicals
70
What drug causes dark red urine?
metronidazole
71
What do you need to educate patients on on when using metronidazole?
avoidance of alcohol due to disulfiram-like reaction
72
Sulfamethoxazole is an analog of what?
PABA
73
How does SMX work to stop growth of the bacteria?
competitive inhibition of dihydropteroic acid
74
When shouldn't you use SMX?
patients with G6PD deficiency
75
How does the bacteria synthesize its folic acid?
Pleridine, PABA, and glutamate
76
What is TMP inhibiting? and what is the effect of this?
DHFR; blocks reduction of dihydrofolate to tetrahydrofolate
77
What happens if you use TMP in a patient that is folate-deficient?
bone marrow suppression
78
Co-trimoxazole is a combo of which two drugs?
SMX and TMP
79
What is the spectrum of co-trimoxazole?
Aerobic G+ and G- and opportunistic fungal pathogens
80
Daptomycin belongs to which group of ABx?
cyclic lipoproteins
81
MOA of daptomycin?
insertion of the lipophilic tail into the plasma membrane to form an efflux channel
82
Spectrum of daptomycin?
Gram +
83
Adverse effects of daptomycin?
myopathy and eosinophilic pneumonia
84
Colistin binds to what on the outer membrane of what kind of bacteria?
(-) charged LPS and phospholipids of outer membrane of Gram - bacteria
85
What are the adverse effects of colistin?
Nephrotoxicity and neurotoxicity

Pharmacology (4 decks)

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