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Pharmacology > Antibiotics > Flashcards

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
Q

What is the mechanism of action of vancomysin?

A

Binding to D-Ala to prevent the addition of NAM-NAG

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26
Q

What group of ABx does vancomycin belong to?

A

glycopeptides

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27
Q

What is vancomysin’s spectrum of action?

A

Gram + aerobes and anaerobes

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28
Q

What causes the resistance to vancomycin?

A

The changing of the D-Ala-D-Ala

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29
Q

What are the side effects of vancomycin?

A

Ototoxicity and nephrotoxicity

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30
Q

What is the MOA of fosfomycin?

A

Inhibition of enolpyruvate so NAM can’t be synthesized anymore

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31
Q

What is fosfomycin used for?

A

Broad spectrum UTIs

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32
Q

What group does gentamicin belong to?

A

Aminoglycosides

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33
Q

What is the spectrum for gentamicin?

A

Gram negative aerobes

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34
Q

What is the mechanism of action for gentamicin?

A

Binding to the 30S subunit blocking the initiation complex and causing misreading of the mRNA

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35
Q

Describe the resistance that has developed against aminoglycosides.

A

Bacterial kinase and acetyltransferase inactivation of the antibiotics

36
Q

What symptoms does the ototoxicity cause due to the aminoglycosides?

A

Tinnitus, ataxia, dizziness due to cochlear and vestibular damage

37
Q

When shouldn’t aminoglycosides be used?

A

Pregnancy and Myasthenia gravis

38
Q

How does the structure of aminoglycosides affect its distribution?

A

No CNS, lungs, or eye penetration; low oral availability since it’s a large hydrophilic molecule

39
Q

How do tetracyclines affect protein synthesis?

A

Bind to the 30S subunit and inhibit translation by binding to the A site of mRNA causing bacteriostatic effects

40
Q

Tetracyclines can be used to treat…

A

atypical bacteria, tick borne illnesses, and protozoans

41
Q

What can cause decreased absorption of tetracyclines?

A

Taking with a divalent cation

42
Q

Why shouldn’t doxycycline be used in children?

A

Binds to Ca and deposits there causing discoloration of teeth and accumulates in bones

43
Q

What other side effects does doxycycline have?

A

Photosensitivity reactions

44
Q

How has resistance developed against tetracyclines?

A

Increased efflux out of the bacterial cell and alteration of the ribosomes

45
Q

What ABx is a macrolide?

A

Azithromycin

46
Q

Azithromycin binds to which ribosomal subunit?

A

50S

47
Q

What is the spectrum of azithromycin?

A

G+/G- aerobes and anaerobes; atypical bacteria

48
Q

What contributes to the resistance against azithromycin?

A

Increased efflux transporters

49
Q

How can the azithromycin resistance be overcome?

A

Increase the dose

50
Q

Which CYP450 is inhibited by azithromycin?

A

CYP3A4

51
Q

What are the adverse effects of azithromycin?

A

GI irritation, hepatotoxicity, prolonged QT interval

52
Q

What ABx binds to the 50S subunit and blocks peptide bond formation?

A

Clindamycin

53
Q

What enzyme is blocked by clindamycin?

A

Peptidyl transferase

54
Q

What is the spectrum of clindamycin?

A

G+ anaerobes

55
Q

What is the major side affect of clindamycin?

A

C. diff infection

56
Q

What antibiotic belongs to the oxazolidiones group?

A

Linezoid

57
Q

What is the mechanism of action of linzoid?

A

Binds to the 23S rRNA of the 50S subunit

58
Q

What is the spectrum of linezoid?

A

G + aerobes

59
Q

In addition to MRSA, what other resistant variant can linezoid go after?

A

VRSA

60
Q

What drug interaction do you need to be aware of when using linezoid?

A

MAOIs; could result in serotonin syndrome

61
Q

What neuropathies could result with linezoid use?

A

Optic and peripheral neuropathy

62
Q

Ciprofloxacin belongs to which group of ABx?

A

Fluoroquinolones

63
Q

What does ciprofloxacin bind to and what is the the result?

A

Binds to DNA-topoisomerase complexes; inhibition of DNA synthesis (bactericidal)

64
Q

What is the unique adverse effect of fluoroquinolones?

A

Tendon rupture

65
Q

What can reduce the absorption of ciprofloxacin?

A

divalent cations

66
Q

Ciprofloxacin binds to what in gram + bacteria?

A

Topoisomerase IV

67
Q

Ciprofloxacin binds to what in gram - bacteria?

A

DNA gyrase

68
Q

What is the spectrum of metronidazole?

A

Obligate anaerobes, microaerophilic bacteria; anaerobic protozoa

69
Q

the MOA of action of metronidazole causes what action to the bacteria DNA via what?

A

Loss of helical structure due to free radicals

70
Q

What drug causes dark red urine?

A

metronidazole

71
Q

What do you need to educate patients on on when using metronidazole?

A

avoidance of alcohol due to disulfiram-like reaction

72
Q

Sulfamethoxazole is an analog of what?

A

PABA

73
Q

How does SMX work to stop growth of the bacteria?

A

competitive inhibition of dihydropteroic acid

74
Q

When shouldn’t you use SMX?

A

patients with G6PD deficiency

75
Q

How does the bacteria synthesize its folic acid?

A

Pleridine, PABA, and glutamate

76
Q

What is TMP inhibiting? and what is the effect of this?

A

DHFR; blocks reduction of dihydrofolate to tetrahydrofolate

77
Q

What happens if you use TMP in a patient that is folate-deficient?

A

bone marrow suppression

78
Q

Co-trimoxazole is a combo of which two drugs?

A

SMX and TMP

79
Q

What is the spectrum of co-trimoxazole?

A

Aerobic G+ and G- and opportunistic fungal pathogens

80
Q

Daptomycin belongs to which group of ABx?

A

cyclic lipoproteins

81
Q

MOA of daptomycin?

A

insertion of the lipophilic tail into the plasma membrane to form an efflux channel

82
Q

Spectrum of daptomycin?

A

Gram +

83
Q

Adverse effects of daptomycin?

A

myopathy and eosinophilic pneumonia

84
Q

Colistin binds to what on the outer membrane of what kind of bacteria?

A

(-) charged LPS and phospholipids of outer membrane of Gram - bacteria

85
Q

What are the adverse effects of colistin?

A

Nephrotoxicity and neurotoxicity

Pharmacology (4 decks)

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