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Antibiotics Flashcards

1
Q

Name the DNA topoisomerases (class & names)

A

Fluoroquinolones => “-oxacin”

Quinolone => nalidixic acid

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2
Q

Name ABx that damages DNA

A

metronidazole

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3
Q

name ABx that disrupts bacterial mRNA synthesis (RNA polymerase)

A

rifampin

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4
Q

Which ABx bind to protein synthesis 50S subunit? class & name

A

Chloramphenicol
Clindamycin
Linezolid

Macrolides=> Azithromycin, Clarithromycin, Erythromycin

Streptogramins=> Quinupristin, Dalfopristin

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5
Q

Which ABx bind to protein synthesis 30S subunit? class & name

A

Aminoglycosides=> gentamicin, neomycin, amikacin, tobramycin, streptomycin

Tetracyclines=> tetracycline, doxycycline, minocycline

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6
Q

What are the Folic acid synthesis (DNA methylation) inhibitors? What is the difference in them?

A

Sulfonamides (block PABA to DHF) => Sulfamethoxazole, sulfisoxazole, sulfadiazine

Trimethoprim blocks DHF to THF

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7
Q

What are the two types of cell wall synthesis inhibitors?

A

Peptidoglycan synthesis

Peptidoglycan cross-linking

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8
Q

What are the cell wall peptidoglycan synthesis inhibitors?

A

Glycopeptides=> vancomycin, bacitracin

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9
Q

What are the cell wall peptidoglycan cross linking inhibitors?

A

Penicillinase sensitive penicillins => Pen G, V; Ampicillin, Amoxicillin

Penicillinase-resistant penicillins => oxacillin, nafcillin, dicloxacillin

Antipseudomonals=> ticarcillin, piperacillin

Cephalosporins

Carbapenems=> Imipenem, meropenem, ertrapenem, doripenem

Monobactams => aztreonam

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10
Q

Name one individual drug from each class of cephalosporins

A

1=> cephazolin, cephalexin

2=> Cefoxitin, cefaclor, cefuroxime

3=> ceftriaxone, cefotaxime, ceftazidime

4=> Cefipime

5=> Ceftaroline

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11
Q

What treats anaerobes above the diaphragm? what treats anaerobes below the diaphragm?

A

Clindamycin above

Metronidazole below

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12
Q

What does Metronidazole treat?

A

GET GAP on the Metro!
Giardia, Entamoeba, Trichomonas
Gardnerella vaginalis, Anaerobes (Bacteroides, C. dif), H. Pylori

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13
Q

What is the “Triple therapy” against H. pylori?

A

PPI, metronidazole, clarithromycin

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14
Q

If M. tuberculosis is suspected in the area of the patient, what can be used for prophylaxis?

A

Isoniazid

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15
Q

What is the Tx for M. tuberculosis?

A

RIPE

Rifampin, Isoniazid, Pyrazinamide, Ethambutol

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16
Q

What is the prophylaxis of M. avium-intracellulare?

A

Azithromycine, rifabutin

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17
Q

What is the Treatment for M. leprae?

A

Long term treatment w/ dapsone & rifampin for tuberculoid form

Add clofazimine for lepromatous form

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18
Q

What is a meningococcal prophylaxis agent?

A

rifamycin=> rifampin, rifabutin

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19
Q

What can be used as chemoprophylaxis in contacts of children w/ H. flu type B?

A

Rifamycin=> rifampin, rifabutin

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20
Q

What are the 4 Rs of Rifampin?

A

RNA polymerase inhibitor
Ramps up microsomal cytochrome P-450
Red/orange body fluids
Rapid resistance if used alone

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21
Q

Why is rifabutin favored over rifampin in HIV patients?

A

Rifampin ramps up p-450 but rifabutin does not

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22
Q

Antimicrobial prophylaxis for Endocarditis w/ surgical or dental procedures

A

penicillins

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23
Q

Antimicrobial prophylaxis for Gonorrhea

A

Ceftriaxone

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24
Q

Antimicrobial prophylaxis for Hx of recurrent UTIs

A

TMP-SMX

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25
Q

Antimicrobial prophylaxis for Meningococcal infection

A

ciprofloxacin (DOC), rifampin for children

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26
Q

Antimicrobial prophylaxis for Pregnant women carrying GBS

A

Ampicillin

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27
Q

Antimicrobial prophylaxis for prevention of gonococcal or chlamydial conjunctivitis in newborn

A

erythromycin ointment

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28
Q

Antimicrobial prophylaxis for prevention of post-surg infection due to S. aureus

A

Cefazolin

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29
Q

Antimicrobial prophylaxis for prophylaxis of strep pharyngitis in child w/ prior rheumatic fever

A

oral penicillin

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30
Q

Antimicrobial prophylaxis for Syphilis

A

Benzathine penicillin G

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31
Q

HIV patient with CD4 < 200 cells/mm3 - what is the necessary prophylaxis & what infection is it given for?

A

TMP-SMX for Pneumocystis pneumonia

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32
Q

HIV patient with CD4 < 100 cells/mm3 - what is the necessary prophylaxis & what infection is it given for?

A

TMP-SMX for Pneumocystis pneumonia & toxoplasmosis

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33
Q

HIV patient with CD4 < 50 cells/mm3 - what is the necessary prophylaxis & what infection is it given for?

A

Azithromycin for Mycobacterium avium complex

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34
Q

HIV patients who cannot tolerate TMP-SMX may be given what? what is the risk assoc?

A

Aerosolized pentamidine but does not prevent toxoplasmosis

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35
Q

What is the Tx for MRSA?

A

vancomycin, daptomycin, linezolid (can cause serotonin syndrome), tigecycline, ceftaroline

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36
Q

What is Tx for VRE?

A

linezolid and streptogramins (quinupristin/dalfopristin)

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37
Q

Name the anti fungal that inhibits lanosterol synthesis. Name the enzyme that is blocked

A

Squalene epoxidase is blocked by

terbinafine

38
Q

Name the anti fungal that inhibits cell wall synthesis

A

Echinocandins => caspofungin, micafungin, anidulafungin

39
Q

Name the anti fungal that forms membrane pores

A

Polyenes => amphotericin B, nystatin

40
Q

Name the anti fungal that inhibits nucleic acid synthesis

A

5-flucytosine

41
Q

Name the anti fungal that inhibits ergosterol synthesis. Name the enzyme that is blocked

A

14-alpha-demethylase blocked by

Azoles=> fluconazole, ketoconazole, clotrimazole, miconazole, itraconazole, voriconazole

42
Q

Tx for toxoplasmosis

A

pyrimethamine

43
Q

Tx for Trypanosoma brucei

A

suramin & melaroprol

44
Q

Tx for T. cruzi

A

nifurtimox

45
Q

Tx for leishmaniasis

A

sodium stibogluconate

46
Q

MOA for chloroquine

A

blocks detoxification of heme into hemozoin so heme accumulates & toxic to plasmodia

47
Q

Why should chloroquine not be used for P. falciparum?

A

resistance is too high due to membrane pump that decreases intracellular concentration of drug

48
Q

Tx for P. falciparum

A

artemether/lumefantrine or atovaquone/proguanil

49
Q

For life threatening malaria, what Rx should be used?

A

quinidine (quinine) in US or artesunate

50
Q

Toxicity of chloroquine

A

retinopathy;

pruritis (esp in dark skinned individuals)

51
Q

What is the mechanism of action for Rx in the Tx of helminths? name the treatments

A

immobilize

Mebendazole, pyrantel pamoate, ivermectin, diethylcarbamazine, praziquantel

52
Q

What Rx is for flukes (trematodes) such as Schistosoma?

A

Praziquantel

53
Q

For HIV antiviral therapy, what are the primary locations of attack of Rx?

A

fusion; reverse transcriptase; integrase inhibitors; protease inhibitors (proteolytic processing)

54
Q

Name the protease inhibitors for HIV retroviral therapy

A

Lopinavir; Atazanavir; darunavir; fosamprenavir; saquinavir; ritonavir; indinavir

55
Q

Name the integrase inhibitors for HIV retroviral therapy

A

raltegravir

56
Q

Name the fusion inhibitors for HIV retroviral therapy

A

attachment=> maraviroc

penetration=> enfuvirtide

57
Q

Name the reverse transcriptase inhibitors for HIV retroviral therapy

A

NRTI=> Tenofovir, Emtricitabine, abacavir, lamivudine, zidovudine, didanosine, stavudine

NNRTI=> nevirapine, efavirenz, delaviridine

58
Q

Other than HIV therapy, what are the targets of other antiviral therapy?

A

Protein synthesis;
Uncoating;
nucleic acid synthesis;
release of progeny virus

59
Q

Name the Rx responsible for inhibiting protein synthesis via preventing binding of virus. Also name what disease it is used in

A

Interferon-alpha => HBV, HCV

60
Q

Name the Rx responsible for blocking uncoating of the virus once inside the cell

A

Amantadine & Rimantadine => no longer used for influenza due to resistance

Amantadine used in Parkinson’s

61
Q

Name the Rx responsible for blocking the release of viral progeny & disease assoc

A

Neuraminidase inhibitors => zanamivir & oseltamivir for Influenza A & B

62
Q

Name the Rx & enzyme that is blocked to prevent nucleic acid synthesis from occurring. Also name disease

A

Guanine nucleotide synthesis => ribavirin => RSV, HCV

viral DNA polymerase inhibitors => foscarnet & cidofovir for CMV & HSV (if HSV is acyclovir resistant)

Guanosine analogs => acyclovir for HSV, VZV; ganciclovir for CMV

63
Q

When should HAART begin?

A

when patients have AIDS defining illness;
low CD4 cell counts (< 500 cells/mm3);
or high viral load

64
Q

What makes up the HAART regimen?

A

Regimen consists of 3 drugs to prevent resistance:
[2 nucleoside reverse transcriptase inhibitors (NRTIs)] +
[1 non-nucleoside reverse transcriptase inhibitor (NNRTI) OR 1 protease inhibitor OR 1
integrase inhibitor]

65
Q

How are protease inhibitors recognized?

A

ALL protease inhibitors end in -navir

66
Q

Which protease inhibitor is assoc with DDI?

67
Q

How do protease inhibitors in HIV work?

A

Block the HIV-1 protease (pol gene) which is responsible for assembly thus preventing maturation of new viruses

68
Q

What are the toxicities assoc w/ HIV protease inhibitors?

A

hyperglycemia, GI distress;
lipodystrophy; nephropathy;
Hematuria (indinavir)

69
Q

What is the MOA for NRTIs?

A

competitively inhibit nucleotide binding to reverse transcriptase & terminate DNA chain which lacks an OH group

70
Q

What is the structure of the NRTIs?

A

All are nucleosides while Tenofovir is a nucleoTide

71
Q

What is used for general prophylaxis & during pregnancy to decrease risk of fetal transmission? What ADE is specifically assoc w/ this Rx?

A

zidovudine (ZDV, formerly AZT)

anemia

72
Q

NRTIs are associated w/ bone marrow suppression. How can this be treated?

A

reversed w/ G-CSF & erythropoietin

73
Q

ADE of tenofovir

74
Q

Common ADE w/ all NRTIs

A

bone marrow suppression & peripheral neuropathy

75
Q

Lactic acidosis is an ADE of what NRTIs?

A

nucleosides

76
Q

What NRTI is assoc w/ pancreatitis?

A

didanosine

77
Q

MOA for NNRTIs & name the Rx

A

Efavirenz, nevirapine, delaviridine

Bind to reverse transcriptase at different site from NRTIs & do NOT require phosphorylation to be active or compete w/ nucleotides

78
Q

What ADEs are assoc w/ all NNRTIs?

A

rash & hepatotoxicity

79
Q

ADE of efavirenz

A

vivid dreams & CNS symptoms are common

80
Q

Which NNRTIs are contraindicated in pregnancy?

A

Delaviridine & efavirenz

81
Q

Name the Rx & MOA for integrate inhibitors. What is the assoc ADE?

A

Raltegravir => inhibits HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrate

ADE=> hypercholesterolemia

82
Q

Name the Rx & MOA for the fusion inhibitors. ADE assoc

A

Enfuvirtide bind gp41 to inhibit viral entry => skin run at injxn

Maraviroc binds CCR-5 on surface of T cells & monocytes

83
Q

Name the specific type of interferon used for each of its disease associations

A

IFN-alpha=> chronic HBV, HCV, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

IFN-Beta=> MS

IFN-gamma=> chronic granulomatous disease

84
Q

result of giving sulfonamides in pregnancy

A

kernicterus

85
Q

result of giving aminoglycosides in pregnancy

A

ototoxicity

86
Q

result of giving fluoroquinolones in pregnancy

A

cartilage damage

87
Q

result of giving clarithromycin in pregnancy

A

embryotoxic

88
Q

result of giving tetracyclines in pregnancy

A

discolored teeth, inhibition of bone growth

89
Q

result of giving ribavirin (antiviral) in pregnancy

A

teratogenic

90
Q

result of giving griseofulvin (antifungal) in pregnancy

A

teratogenic

91
Q

result of giving chloramphenicol in pregnancy

A

“gray baby”

FA: random (15 decks)

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