Antibiotics

Question 1

Penicillin G/V

Answer 1

MOA: B-Lactam, inhibit cell wall, binds PBP

Use: G+ strep, staph, SYPHILIS

SE: Hypersensitivity, hemolytic anemia

Question 2

Aminopenicillin (PCNase sensitive)

-Ampicilli, amoxicillin

Answer 2

MOA: B-Lactam, inhibit cell wall
USE: ESBL: H flu, E coli, Listeria, Proteus, Salmonella, Shigella (HELPS) and enterococci
SE: Hypersensitivity, rash
Resistance: Penicillinase

Question 3

PCNase Resistant (Diclocicillin, Oxacillin)

Answer 3

MOA: B-Lactam

Use: S.Aureus (not MRSA)

SE: Hypersensitivity, interstitial nephritis

Question 4

ESBL (Piperacillin, Ticarcillin)

Answer 4

MOA: B-Lactam
Use: Pseudomonas, G- rods, Combine with B-lactamase inhibitors (Tazobactam, clavulonate, Sulbactam)

SE: Hypersensitivity

Question 5

Cefazolin, Cephalexin (1st Generation)

Answer 5

MOA: B-Lactams, more G- coverage
Uses: 1st Gen (Cefazolin/Cephalexin)- pre surgical S. Aureus, Proteus, E coli, Klebsiella (PEcK)

Question 6

Cefuroxime (2nd Generation)

Answer 6

Use: H flu, Enterobacter, Neisseria and PEcK

Question 7

Ceftriaxone (3rd Generation)

Answer 7

Use: G-, meningitis, gonorrhea, pneumococcal pneumonia (don’t bind to PBP2b)

Question 8

Cefepime (4th Gen)

Answer 8

Use: Pseudomonas and G+

Question 9

Monobactams (aztreonam)

Answer 9

MOA: B-Lactam
Use: G- Rods Only, non allergenic (lack the 5-6 member ring on penicillin)
SE: none, GI distress occasionally

Question 10

Carbapenems (imipenem, meropenem)

Answer 10

MOA: B-Lactam
Use: Life threatening G+, G- rods, and anaerobes. Must use CILASTIN with Imipenem to prevent degradation in Kidney
SE: GI, Rash

Question 11

Vancomycin

Answer 11

MOA: Prevents cell wall cross linkin, binds D-ala D-ala
Use: G+ ONLY, MRSA, C. Diff, enterococci
Resistance: Changes to D-ala D-Lac, can’t bind
SE: RED MAN SYNDROME

Question 12

Daptomycin

Answer 12

MOA: Inserts into Teichoic acids of G+
Use: VRE/VRSA
SE: Rhabdomyolysis

Question 13

Colistin

Answer 13

MOA: Binds LPS, destroys G-
Use: G-

Question 14

Linezolid

Answer 14

MOA: Inhibits Inititation Complex (50s ribosome)
Use: VRSA, MRSA
SE: Bone marrow suppression

Question 15

Aminoglycosides (Gentamicin, neomycin, amikacin, tobramycin, streptomycin)

Answer 15

MOA: Oxygen activated, misreading of mRNA, blocks Translation
Use: Severe G- AEROBES only
SE: Nephrotoxic (ATN), Neuromuscular block (dec. Ach release, Ototoxic)
Resistance: Acetylation

Question 16

Tetracyclines (Doxycycline)

Answer 16

MOA: Binds 30s ribosome, blocks tRNA attachement at A site
Use: Intracellular (chlamydia, rickettsia,) B. Burgdorferi, chlamydia
-Do not take with Ca+2, prevents absorption
-Fecal elimination of Doxy=safe in renal failure
SE: Teeth discoloration, Photosensitivity

Question 17

Macrolides (erithromycin, azithromycin, clarithromycin)

Answer 17

MOA: Blocks translocation (50s)
Use: Atypical (Mycoplasma, legionella, chlamydia), G+ cocci (strep in PCN allergies)
SE: Arrhythmia (QT), rash
Resistance: Methylation at 23rRNA site

Question 18

Chloamphenicol

Answer 18

MOA: blocks peptidyltransferase 50s
Use: Meningitis (H flu, Neisseria, Strep pneumo)
and RMSF
SE: Anemia, Grey Baby Syndrome (lack UDP glucouronyl transferase)

Question 19

Clindamycin

Answer 19

MOA: Blocks Transloacation 50s
Use: Anaerobes above disaphragm (bacteroides, C. Perforingens), GAS
SE: C Diff Colitis

Question 20

Sulfanomides (SMX, Dapsone)

Answer 20

MOA: Anti-metabolite (blocks Dihyropteroate Synthase)
Use: G+, G-, nocardia, chlamydia, UTIs
SE: Hemolysis in G6PD deficient, Photosensitivity, Kernicteurus

-Combo with TMP (bactrim)

Question 21

Trimethoprim (TMP)

Answer 21

MOA: DHFR inhibitor (anti-metabolite)
Use: UTI, PCP in HIV, Toxoplasmosis
SE: Hyperkalemia (triamterene analog), anemia

Question 22

Fluoroquinolones (ciprofloxacin, levofloxacin)

Answer 22

MOA: Inhibit DNA Gyrase (cipro), and Topoisomerase IV (levo)
Use: G- rods in UTI, Pneumonia, Neisseria, some G+
SE: TORSADES (QT), cartilage damage (CI in pregnancy)

Question 23

Metronidazole (Flagyl)

Answer 23

MOA: Free radical DNA damage
Use: Giardia Entamoeba Trichomonas, Gardrenella, anaerobes, H. Pylori (GET GAP), C. Diff
SE: Disulfram like rxn with EtOH, Metallic taste

Question 24

Isoniazid

Answer 24

MOA: Cell wall inhibitor
Use: TB tx and prophylaxis
Tox: Peripheral neuropathy (due to B6 deficiency), SLE syndrome, sideroblastic anemia (B6)

-Give pyridoxine (B6) concurrently

Question 25

Rifampin

Answer 25

MOA: RNA polymerase inhibitor
USE: TB
SE: induces p450, red/orange body fluids

Question 26

Pyrazinamide

Answer 26

MOA: unknown
Use: TB
SE: precipitates gout, hepatotoxic

Question 27

Ethambutol

Answer 27

MOA: blocks cell wall
Use: TB
SE: Optic neuropathy (red-green)