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Antimicrobials > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Inhibits cell wall synthesis?

A

Penicillin
BLI
Cephalosporins
Carbapenems
Monobactam (aztreonam)
Glycopeptides - vanco, teico
Bacitracin
Fosfomycin

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2
Q

Inhibits 30s protein synthesis

A

TAG
T - Tetracyclines
A - Aminoglycosides
G - Glycyclines (tigecycline_

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3
Q

Inhibits 50s protein synthesis

A

MLS MOCK FM
M - Macrolides (E,AZM)4
L - Lincosamide (Clinda)
S - Streptogramin
M - Macrocyclic (Fidaxomicin)
O - Oxazolidinone (Linezolid)
C - Chloramphenicol
K - Ketolide
F - Fusidic Acid
M - Mupirocin

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4
Q

Cell membrane

A

Colistin
Polymyxin
Lipopeptides (Dapto)

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5
Q

Nucleic acid synthesis

A

Quinolones - Naldixic acid
Fluoroquinolones - Cipro, Levo
Metronidazole
Nitrofurantoin

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6
Q

Folic acid synthesis

A

Sulfonamide - sulfamethoxazole
DHFR inhibitor - Trimethoprim

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7
Q

Red man sydrome?

A

Vancomycin
Rifampicin

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8
Q

Grey baby syndrome

A

Chloramphenicol

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9
Q

Steven Johnson syndrome

A

SXT

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10
Q

Serotonin syndrome

A

Linezolid

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11
Q

Bactericidal drugs

A

Not So Very Finely Proficient At Cell Murder
N - Nitrofurantoin
S - Streptogramin (except E.faecium)
V - Vancomycin
F - Fluoroquinolones
P - Penicillin
A - Aminoglycosides
C - Cephalosporins
M - Metronidazole

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12
Q

Bact static drugs

A

L’ ECSTaTiC
L - Linezolid
E - Erythromycin
C - Clindamycin
S - Sulfamethoxazole
T - Trimethoprim
T - Tetracycline
C - Chloramphenicol

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13
Q

AB with anaerobic cover?

A

Amox clav
Pip taz
Imipenem or meropenem
Clindamycin
Metronidazole

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14
Q

AB with antibiofilm cover

A

Fluoroquinolones for GN
Rifampicin or other rifamycins for Staph

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15
Q

CYP3A4 inhibitors

A

Ketoconazole
Itraconazole
Erythromycin
Clarithromycin
Streptogramin

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16
Q

CYP3A4 inducer

A

Rifampicin

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17
Q

CYP3A4 substrates

A

Ritonavir
Saquinavir
Indinavir
Nelfinavir

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18
Q

Drugs to avoid in G6PD deficiency

A

Cotrim
Chloramphenicol
Dapsone
Primaquine
Tafenoquine
Furazolidone
Nitrofurantoin

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19
Q

Antibiotics avoided in pregnancy

A

Tetracyclines, also avoid b. feeding

Aminoglycosides - auditory, vestibular nerve damage, risk greater in 2nd and 3rd trimester

Cotrim - teratogenic risk in 1st trimester

Quinolones - assoc with arthropathy in animal studies

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20
Q

Penicillin anaphylaxis rate?

A

0.004-0.5%

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21
Q

Which penicillin given to pt with EBV causes rash?

A

Ampicillin after 5-9 days of treatment

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22
Q

BLI causing cholestatic jaundice?

A

Clavulanic component

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23
Q

Anti MRSA cephalosporins?

A

Ceftobiprole, Ceftaroline

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24
Q

Organisms inr R to cephalosporins?

A

LAME
L - listeria

A - atypical organisms mycoplasma, chlamydia

M - MRSA

E - enterococcus

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25
Q

Cephalosporins causing biliary sludging?

A

Ceftriaxone

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26
Q

Carbapenem used for OPAT

A

Ertapenem because of long half life

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27
Q

Interaction with valproic acid

A

Carbapenems reduces seizure threshold

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28
Q

Monobactam R to ESBL but not to AMPC

A

Aztreonam

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29
Q

Bacitracin R and S?

A

Baci R - GAS
Baci S - GBS

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30
Q

Vanco int R organisms?

A

Leuconostoc

Pediococcus

Lactobacillus

Erysipelothrix rhusiopathiea

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31
Q

Teico int R?

A

S. haemolyticus

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32
Q

Glycopeptide resistant genes?

A

Van A, B, C, D, E, G

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33
Q

Aminoglycoside resistance in Pseudomonas?

A

Efflux pumps - activation of Mec XY pump

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34
Q

Resistance for aminoglycosides?

A

Aminoglycoside modifying enzymes

Acetyltransferases (AACs)

Nucleotidyltransferases
(ANTs)

Phosphotransferases (APHs)

35
Q

only macrolide used for gram negative bacilli?

A

Azithromycin - Salmonella

36
Q

What confers R to macrolides, lincosamides, and streptogramin?

A

alterations in 23rRNA by methylation of adenine - MLSb phenotype encoded by erm (erythromycin ribosomal methyalase ) gene

37
Q

Macrolide?+ amiodarone = side effect?

A

Clarithromycin interacts with amiodarone causing prolonged QT interval

38
Q

Macrolide?+ carbamazepine = side effect?

A

Clarithromycin interacts with carbamazipine increasing the concentration of carba

39
Q

Daptomycin not given for pulmonary infections, why?

A

Interacts invitro with pulmonary surfactants resulting in inhibition of antibacterial activity

40
Q

Linezolid heamatological side effect?

A

Thrombocytopenia, neutropenia and pancytopenia - causes easy bruising in patients

41
Q

Chloramphenicol heamatological side effects?

A

Anemia, leucopenia, Thrombocytopenia

42
Q

What tetracycline + carbamezipine is not used?

A

Doxycycline and carbamazipine - reduced doxy levels in treatment

43
Q

Prolonged mino therapy side effects?

A

skin, nail, sclera pigmentation

idiopathic intracranial hypertension due to prolonged use (all tetracyclines)

44
Q

which antibiotic causes deposition in growing bones, teeth?

A

Tetracyclines

45
Q

General side effects of tetracyclines?

A

Photosensitivity, vertigo, angioedema, black hairy tongue

46
Q

Sulfonamide contraindicated in blood dyscrasias?

A

Trimethoprim - can lead to disorders of haematopoiesis so regular blood counts needed if prolonged treatment

47
Q

Sulfonamide contraind with methotrexate? causes?

A

Trimethorpim - causes fatal myelosuppresion because folate antagonists and risk of haematological side effects

48
Q

Which fluoroquinolone interacts with phenytoin? causes?

A

Ciprofloxacin + phenytoin causes reduced concentration of phenytoin

49
Q

Which fluoroquinolone contraind in risk for prolonged QT?

A

Moxifloxacin

50
Q

Side effects of polymyxins?

A

Nephrotoxicity
Neurotoxicity

51
Q

MOA of cefiderocol?

A

Strongly binds to free iron in the extracellular space

52
Q

Resistance mech of cefiderocol for MBL?

A

Zinc hydrolysis renders cefiderocol ineffective

53
Q

Antileprotic drugs?

A

Dapsone

Clofazimine

Rifampicin

54
Q

MOA of dapsone, S.E, check what deficiency in patient?

A

Inhibits synthesis of dihydrofolic acid

Dapsone syndrome (fever, skin rash +/- lymphadenopathy)

Check G6PD deficiency in patient otherwise causes haemolysis

55
Q

MOA of clofazimine, S.E?

A

Anti inflammatory properties

Skin discolouration (reversible), small bowel edema/ subacute obstruction (prolonged use)

56
Q

Rifampicin in leprosy?

A

Most effective antileprotic, renders patient non infectious within days of starting therapy

57
Q

Systemic inflammatory complications in leprosy treatment?

A

Can happen before, during, or years after treatment

  1. Reversal reactions (type 1 reactions) - rx with aspirin or prednisolone if complicated
  2. Erythema nodosum leprosum (type 2 reactions) - rx with aspirin, prednisolone or thalidomide
58
Q

MOA Isoniazid, Rifampicin, Pyrazinamide, Ethambutol?

A

Isoniazid - inhibits mycolic acid synthesis

Rifampicin - inhibits RNA polymerase

Pyrazinamide - creates acidic environment within cytoplasm so inhibits enzymes, disrupts cell membrane function and RNA synthesis

Ethambutol - disrupts cell wall synthesis

59
Q

Which Tb drug is good for both intracellular and extracellular bacilli?

A

Isoniazid and Rifampicin

60
Q

Anti tb drug good vs extracellular fast growing bacilli in neutral to slightly alkaline pH media?

A

Streptomycin

61
Q

Which anti tb drug effective vs slow growing intracellular bacilli and in acidic pH medium?

A

Pyrazinamide

62
Q

Mutation in which genes gives R to isoniazid?

A

inhA (mycolic acid synthesis)

katG (catalase peroxidase)

oryR - ahpC

63
Q

Which tb drugs interacts with contraceptives?

A

Rifampicin - tell pts to have back up for contraceptives

64
Q

Anti tb drugs causing arthralgia

A

Pyrazinamide, ethambutol, isoniazid
(HZE)

65
Q

MOA of delaminid and pretomanid?

A

Inhibition of mycolic acid synthesis like isoniazid

66
Q

MOA of bedaquiline?

A

binds to ATP synthase so inhibits ATP synthesis leading to cell death

67
Q

Anti TB drugs causing reversible hypothyroidism?

A

Ethionamide

Prothionamide

Para aminosalicyclic acid (PAS)

so monitor TFT when using any of these drugs

68
Q

Anti tb drugs causing prolonged QT interval?

A

Bedaquiline

Delaminid

Moxifloxacin

Clofazimine (antileprosy drug) when given with bedaquiline

69
Q

Anti tb drug that can induce seizures?

A

Moxifloxacin

70
Q

Anti tb drug that causes neuro effects and and rash?

A

Cycloserine

71
Q

Rifampicin can be safely be given along with what all antiretrovirals?

A

Emtricitabine

Enfuvirtide

Lamivudine

TDF

72
Q

Best anti tb drug for CNS penetration?

A

Ethionamide

Prothionamide

Pyrazinamide

Cycloserine

73
Q

“good” anti tb drug for CNS penetration?

A

Quinolones

Linezolid

74
Q

“able to”anti tb drug for CNS penetration in absence of meningeal inflammation

A

Isoniazid

Rifampicin

75
Q

“poor” anti tb drug for CNS penetration?

A

Bedaquiline

76
Q

anti tb drugs DOES NOT penetrate even with inflammation

A

Ethambutol

Streptomycin

77
Q

anti tb drugs used in CNS TB

A

Pyrazinamide

Quinolones

Ethionamide or prothiomide

Cycloserine or amikacin

78
Q

Asplenia increased risk for what organisms?

A

Capsulated organisms - HI, SP, NM

Capnocytophaga

Babesia

Bordetella pertussis

S. aureus

79
Q

Anti TB drug that interferes with contraceptives?

A

Rifamycin’s (Rifampicin, Rifampin) tell patient to have back up contraceptive method

80
Q

Arthralgia causing anitb drugs?

A

Isoniazid
Pyrazinamide

81
Q

Which Mycobacteria is inherently resistant to Pyrazinamide?

A

M. bovis - if preliminary AST indicated monoresistance consider this organism

82
Q

Resistant genes mutations for
Isoniazid?
Rifamycins?
Pyrazinamide?
Ethambutol?

A

Isoniazid
inhA
katG
oryR - ahpC

Rifamycins
rpoB

Pyrazinamide
pncA (pyrazinamidase)

Ethambutol
embCAB operon

83
Q

A serum dilution test that measures the effectiveness of a patient’s serum in fighting microbes during antibiotic therapy

A

schlichter test

Antimicrobials (6 decks)

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