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Antibiotics 2 Flashcards

1
Q

New Beta-Lactams: 1. Monobactam - Buzzword, MOA, Use, Resistance (6)

A

Buzzword: Aztreonam

MOA: Binds to PBP’s 1a and 3 and inhibits transpeptidation

Use: Given IV against G-ve

No cross sensitivity to penicillins

Resistant to Beta-lactamse

Syngergistic to aminoglycosides

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2
Q

New Beta-Lactams: 2. Carbapenem - Buzzword and MOA

A

Buzzwords: Imipenem/Cilastatin/Meropenem

MOA:

Imipenem is rapidly metabolized by renal dipeptidase

Cilastatin is a specific inhibitor of dipeptidase

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3
Q

New Beta-Lactams: 2. Carbapenem - Indications and Resistant to?

A

Rx of serious infections

Resistant to Beta-lactamase

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4
Q

New Beta-Lactams: 2. Carbapenem - Given Against and Side Effects

A

Given IV against G+ve, G-ve, and ANAEROBES

Side effects: Seizure with renal dysfunction (Imipenem)

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5
Q

Vancomycin: Defined, Against and MOA

A

Is a bactericidal that is NOT a pencillin or cephalosporin

Against: G+ve ONLY

MOA: Inhibits bacterial cell wall, elongation of peptidoglycan chains

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6
Q

Vancomycin: Buzzword and What it’s not effective against

A

Buzzwords: IV effective against MRSA

Oral effective against Clostridium difficile (pseudomembranous colitis)

Not effective against G-ve

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7
Q

Vancomycin: Adverse Effects (4) and Resistance (2)

A
  1. Redman/redneck Syndrome
    Chills, fever, rash, red face and neck
    Why? Histamine release
  2. Ototoxcity
  3. Hypersensitivty
  4. Nephrotoxcity

Resistance: VRSA and VRE

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8
Q

Macrolides: Buzzwords (3)

A
  1. Erythromycin
  2. Azithromycin
  3. Clarithromycin
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9
Q

Macrolides: Drug of choice for? (2)

A
  1. Community acquired pneumonia

2. Mycoplasma pneumoniae

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10
Q

Macrolides: Not effective against?

A

MRSA

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11
Q

Macrolides: Side Effects (3)

A

Erythromycin estolate causes cholestatic jaundice

*Binds to motilin receptors –> diarrhea

Reversible ototoxicity

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12
Q

Macrolides: Erythromycin Use and Side Effects

A

Good against Staph, Strep, Mycoplasma, and Legionella

Side effects: GI problems (diarrhea and vomiting), High dose (prolonged QT interval)

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13
Q

Macrolides: Azithromycin

A

As good as erythromycin

Chlamydial urethritis

Lesser side effects than erythromycin

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14
Q

Macrolides: Clarithromycin - Use, and Buzzword

A

As good as erythromycin

H. Influenza and H. Pylor

Buzzword: Good against MAC
Mycobacterium avium complex in AIDS patient
**Inhibits CYP450

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15
Q

What’s an alternative to pencillin for H. Pylori?

A

Metronidazole

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16
Q

New Class Related to Macrolides: Ketolides - Buzzword and Side Effects

A

Buzzword: Telithromycin (similar to azithromycin)

Side effects:
Prolonged QT interval
Inhibits CYP450

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17
Q

Anaerobic Infections - Bacteroids: Clindamycin - Use and Buzzword

A

Use: Oral infections

Buzzword: Risk for Antibiotic-Associated Pseudomembranous Colitis (AAPMC)

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18
Q

Anaerobic Infections - Bacteroids: Metronidazole - Use and Buzzword

A

Use: Intraabdominal

Buzzword: RX of AAPMC

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19
Q

Metronidazole: Bactericidal mechanism is?

A

Unknown

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20
Q

Metronidazole: Protozoal Drug of Choice (3)

A
  1. Giardia Lamblia
  2. Trichomonas vaginalis
  3. Entamoeba histolytica
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21
Q

Metronidazole: Bacterial Drug of Choice (3)

A
  1. AAPMC
  2. Bacteroids Fragilis
  3. G. Vaginalis
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22
Q

Metronidazole: Adverse Effects (3)

A
  1. Furry tongue, glossitis
  2. Peripheral neuropathy
  3. Disulfiram-like Action
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23
Q

Disulfiram-like action Drugs (5)

A
  1. Metronidazole
  2. Cefamandole
  3. Cefoperazone
  4. Cefotetan
  5. Griseofulvin
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24
Q

Tetracyclines: Drugs (4)

A
  1. Tetracycline
  2. Doxycycline
  3. Minocycline
  4. Demeclocycline
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25
Q

Tetracyclines: Good for (6)

A
  1. Chlamydia
  2. Rickettsia
  3. Mycoplasma
  4. Brucella
  5. Yersinia
  6. Vibrio cholera
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26
Q

Tetracyclines: Used in?

A

Patients allergic to penicillin

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27
Q

Tetracyclines: What should be avoided with tetracyclines?

A

Dairy product EXCEPT Doxycycline and Minocycline

Because it reduces absorption (chelators)

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28
Q

Tetracyclines: Demeclocycline inhibits and is the rx for?

A

Inhibits ADH

Rx for SIADH

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29
Q

Tetracyclines: Doxycycline penetrates and is used in?

A

The prostate and used in prostatitis and Lyme disease

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30
Q

Tetracyclines: Adverse Reaction 1

A
  1. Contraindicated in children younger than 8 years old

Why? Causes permanent discoloration of teeth

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31
Q

Tetracyclines: Adverse Reaction 2

A

Use sunscreen and protective clothing when outdoors

Why? Phototoxcity

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32
Q

Tetracyclines: Adverse Reaction 3

A

Outdated tetracycline: Fanconi like Syndrome (Kidneys)

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33
Q

Tetracyclines: Adverse Reaction 4

A

Hepatotoxicity seen more in pregnant women

34
Q

Tetracyclines: Adverse Reaction 5

A

Nephrogenic Diabetes Insipidus (Demeclocycline)

35
Q

Tetracyclines: Adverse Reaction 6

A

Vestibular ototoxcity (Minocycline)

36
Q

Tetracyclines: All tetracyclines, EXCEPT DOXYCYCLINE require?

A

Dose adjustment in renal impairment

37
Q

Tetracycline: Tigecycline - Defined (2)

A

Semisynthetic derivative fo minocycline

Increased affinity to the 30S and decreased susceptibility to resistance

38
Q

Tetracycline: Tigecycline - Buzzword (2)

A

Rx of skin and soft tissue infection caused by MRSA

Rx of intra-abdominal infections caused by G+ve and G-ve organisms

39
Q

Fluoroquinolones: Drugs (6)

A
  1. Ciprofloxacin
  2. Norfloxacin
  3. Ofloxacin
  4. Enoxacin
  5. Sparfloxacin
  6. Trovafloxacin
40
Q

Fluoroquinolones: Buzzword

A

Analogues of Nalidixic acid

41
Q

Fluoroquinolones: Drug of choise for?

42
Q

Second choice for Anthrax?

A

Penicillins or tetracyclines

43
Q

Fluoroquinolones: Good against

A

Gram -ve sepsis (PO)

E.g. Cipro for E. Coli and UTIs

44
Q

Fluoroquinolones: Cipro and Olfo for?

A

Single dose for gonorrhea

45
Q

Fluoroquinolones: Spar and Olfo

A

Spar - resistant pneumococcus

Oflo - Chlamydia

46
Q

Fluoroquinolones: Contraindication (2)

A
  1. Pregnancy

2. Careful if <18 years old –> inhibits chondrocytes

47
Q

What’s best for gonorrohea?

A

Single shot of ceftriaxone

48
Q

Fluoroquinolones: Black Box Warnings for?

A

Tendinitis risk (as well as for steroid infection)

49
Q

Aminoglycosides: Use and Drugs (7)

A

Use: LIFE-THREATENING gram negative

  1. Gentamycin
  2. Tobramycin
  3. Paromomycin
  4. Amikacin
  5. Neomycn
  6. Kanamycin
  7. Streptomycin
50
Q

Aminoglycosides: Buzzword and Type of Transport

A

Gram -ve infections

Active transport by O2 dependant system

51
Q

Aminoglycosides: Used In Combo 1

A
  1. Endometritis: Triple Antibiotcs

Gentamycin + Ampicillin + Metronidazole

52
Q

Aminoglycosides: Used in Combo 2

A
  1. Enterococcus infection:

Synergistic with ampicillin

53
Q

Aminoglycosides: Used in Combo 3

A
  1. Pseudomonal infection

Synergistic with extended spectrum pencillin

54
Q

Aminoglycosides: Adverse Effect 1 - Ototoxicity (2%)

A

Auditory: Irreversible (cochlear), high pitch 1st

Vestibular: Reversible

55
Q

Aminoglycosides: Adverse Effect 2 - Nephrotoxicty (7%)

A

Proteinuria, hypokalemia, and acute tubular necrosis

56
Q

Aminoglycosides: Adverse Effect 3 - Neuromuscular Blockage

A

Decrease pre-junctional release of Ach

57
Q

Aminoglycosides: All aminoglycosides require?

A

Dose adjustment in renal failure

58
Q

Aminoglycosides: Drug Interactions 1 - Enhanced Ototoxicity (2)

A

Furosemide, Ethacrynic Acid

59
Q

Aminoglycosides: Drug Interactions 2 - Enhanced Neprotoxicty (4)

A
  1. Amphotericin B
  2. Vancomycin
  3. Cisplatin
  4. Cyclosporin
60
Q

Aminoglycosides: Spectinomycin is, use, and MOA ?

A

NOT AN AMINOGLYCOSIDE

Rx of gonorrhea (After 1st choice of ceftriaxone shot)

MOA: Inhibitis protein syntheisis by binding to 30S

Doesn’t cause misreading of the genetic code

61
Q

Linezolid: Defined (2)

A

Synthetic oxazolidinedione

Binds to the 23S RNA component of the 50S ribosomal subunit

62
Q

Linezolid: Buzzword

A

Good against MRSA and VRE

63
Q

Linezolid: Adverse Effects (2)

A

Thrombocytpenia

Serotonin Toxicity by weakly inhibiting MAO

64
Q

Mupiricin: Buzzword and Use

A

Topically for impetigo caused by streptococci and staphylococci

To eradicate nasal carriers of MRSA in health care workers

65
Q

Sulfonamides: Sulfisoxazole

A

Rx of UTI and Nocardial infection

66
Q

Sulfonamides: Sulfasalazine

A

Rx of Ulcerative Colitis

67
Q

Sulfonamides: Sulfacetamide

A

Rx of Trachoma (Topical)

68
Q

Sulfonamides: Silver sulfadiazine

A

Rx of burns (Topical)

69
Q

Sulfonamides: Sulfadiazine and Pyrimethamine

A

Rx of Toxoplasmosis

70
Q

Sulfonamides: Trimethoprim/Sulfamethoxazole

A

Rx of Pneumocystis Jirovecii Pneumonia (PCP)

71
Q

Sulfonamides: Side Effects (4)

A
  1. Hypersensitivity (erythemia multiforme) —-> rash to Steven Johnson Syndrome (toxic endodermal necrolysis)
  2. Hemolysis in GP6D deficiency
  3. Photosensitivty
  4. Crystalluria
72
Q

Sulfonamides: Contraindication

A

3rd trimester of pregnancy

Cross BBB –> Kernicterus

73
Q

Sulfonamides: Drug Interactions (2)

A
  1. Increase warfarin activity

2. Increase phenytoin activity

74
Q

Trimethoprin/Sulfamethoxazole (TMX-SMX)/Co-Timoxazle: Buzzword

A

Drug of choice for prophylaxis and rx of PCP

Second choice: Rx of salmonella, chancroid, MRSA

75
Q

Trimethoprin/Sulfamethoxazole (TMX-SMX)/Co-Timoxazle: Adverse Effects (4)

A
  1. Thrombocytopenia
  2. Leukopenia
  3. GI Distress in AIDS patients
  4. Hemolysis
76
Q

Urinary Tract Anti-septics (2)

A

Methenamine mandelate

Nitrofurantoin (when UTI is resistant to Cipro or Sulfas)

77
Q

Urinary Tract Analgesic and Buzzword

A

Phenazopyridine

Produce orange to red urine that may stain clothing

78
Q

Broad Spectrum Antibacterial (not prescribed anymore) and Buzzword

A

Chloramphenicol

Side effect: Apalastic anemia and gray baby syndrome

79
Q

MRSA means Staph Aureus is resistant to?

A

Methicillins: Ox/Clox/Diclox/Naf

80
Q

First choice to treat MRSA?

A

Vancomycin

81
Q

If you have Vancomycin Restiant E and Staph Aureus (VRE and VRSA) then?

A

First choice: Linezolid

Quinipristin/Dalfopristin

82
Q

Other Drugs for MRSA

A

5th gen cephalosporin

TMX/SMX?

M3 Pharm B3 (10 decks)

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