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2014 Rapid Review > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Bind PBPs to inhibit cross-linking of PG. Used for some gram +, N meningitis, T pallidum. Beta-lactamase sensitive

A

Penicillin G, V

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2
Q

PCN SE

A

HSR, hemolytic anemia

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3
Q

PCN MOR

A

Beta lactamase

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4
Q

Bind PBPs to inhibit cross-linking of PG. Used for H flu, E coli, Listeria, Proteus, Salmonella, Shigella, enterococci (HELPSS kille enterococci). Beta lactamase sensitive.

A

Ampicillin, Amoxicillin (better oral availability)

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5
Q

Ampicillin SE

A

HSR, rash, pseudomembraous colitis

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6
Q

Ampicillin MOR

A

Beta lactamase

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7
Q

Bind PBPs to inhibit cross-linking of PG. Resistant to beta-lactamase due to bulky R group

A

oxacillin, nafcillin, dicloxacillin

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8
Q

Oxacillin CU

A

MSSA (MRSA has an altered PBP target site)

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9
Q

Oxacillin SE

A

HSR, interstitial nephritis

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10
Q

Antipseudomonals

A

Ticarcillin, piperacillin

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11
Q

Piperacillin CU

A

Pseudomonas and gram negative rods, with beta-lactamase inhibitors

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12
Q

Beta lactamase inhibitors

A

Clavulanic acid, sulbactam, taxobactam

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13
Q

Pipercillin SE

A

HSR

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14
Q

Cefazolin, Cephalein

A

1G - Gram + and Proteus, E coli, Klebsiella (PEcK)

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15
Q

Cefoxitin, Cefaclor, Cefuroxime

A

2G - H flu, Enterobacter, Neisseria, Proteus, E coli, Klebsiella, Serratia (HEN PEcKS)

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16
Q

Ceftriaxone

A

3G - Serious gram negative infections, esp meningitis and gonorrhea

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17
Q

Ceftazidime

A

3G - Serious gram negative infections, esp Pseudomonas

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18
Q

Cefepime

A

4G - increased activity against Pseudomonas and gram +

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19
Q

Ceftaroline

A

5G - MRSA (broad gram + and - coverage, but not pseudomonas)

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20
Q

Cephalosporin SE

A

HSR, vitamin K deficiency, increase nephrotoxicity of aminoglycosides

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21
Q

Monobactam that binds PBP3 to inhibit cross-linking of PG. Beta-lactmase resistant. Synergistic with aminoglycosides

A

Aztreonam

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22
Q

Aztreonam CU

A

Gram neg rods only!

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23
Q

Carbapenem must be administered with this inhibitor of renal dehydropeptidase I to decrease inactivation of drug in renal tubuels

A

cilastin

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24
Q

Carbapenem SE

A

CNS toxicity (seizures) at high plasma levels.

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25
Q

Binds D-Ala-D-Ala to prevent PG synthesis

A

Vanco

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26
Q

Vanco CU

A

GRAM POS ONLY

  • MRSA
  • Enterococci
  • C diff
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27
Q

Vanco SE

A

Nephrotoxicity, Ototoxicity, Thrombophlebitis, Red man syndrome (prevent with anti-histamine pretreatment)

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28
Q

Van MOR

A

D-ala-D-ala to D-ala-D-lac

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29
Q

30S inhibitors

A

Aminoglycosides and tetracyclines

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30
Q

50S inhibitors

A

Chloramphenicol, Clindamycin, Macrolides, Linezolid

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31
Q

Aminoglycosides (Mean GNATS cannot kill anaerobes)

A

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

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32
Q

Prevent formation of inhibition complex –> misreading of mRNA, block translation

A

Aminoglycosides

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33
Q

Aminoglycoside CU

A

Severe gram neg rod infxns. Ineffective against anaerobes

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34
Q

Aminoglycoside SE

A

Nephrotoxicity, NMB, Ototoxicity, Teratogen

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35
Q

Aminoglycoside MOR

A

Bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, or adenylation

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36
Q

Binds 30s and prevents attachment of aa-tRNA

A

Tetracycline

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37
Q

tetracycline CU

A

Borrelia, M pneumo, Rickettsia, Chlamydia (concentrates intracellularly)

38
Q

tetracycline SE

A

Discoloration of teeth and inhibition of bone growth in kids and fetuses, GI distress, photosensitivity

39
Q

tetracycline MOR

A

decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps

40
Q

Macrolides

A

Azithromycin, Clarithromycin, Erythromycin

41
Q

Bind 50S. Inhibit protein synthesis by blocking translocation

A

Macrolides (macroslides)

42
Q

Macrolide CU

A

Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (Chlamydia), gram positive cocci (strep infection in pats allergic to PCN)

43
Q

Macrolide SE

A 
MACRO
Motility
Arrhythmia (prolonged QT)
Cholestatic hepatitis 
Rash
eOsinophilia
P450 inhibitor
44
Q

Macrolide MOR

A

Methylation of 23S binding site prevents bidng of drug

45
Q

Blocks peptidyltransferase at 50s (blocks peptide bond formation)

A

Chloramphenicol

46
Q

Chloramphenicol CU

A

Meningitis (H. flu, Neisseria, Strep pneumo) and Rickettsia rickettsii

47
Q

Chloramphenicol SE

A

Anemia, aplastic anemia, gray baby (baby lacks liver UDP -glucuronyl transferase)

48
Q

Chloramphenicol MOR

A

Plasmid encoded acetyltransferase inactivates the drug

49
Q

Blocks peptide transfer (translocation) at 50S.

A

Clindamycin

50
Q

Clindamycin CU

A

Anaerobes above the diaphragm (i.e. lung abscess, vs metronidazole for anaerobes below the diaphragm). Also invasive group A strep infection?

51
Q

Clindamycin SE

A

Pseudomembranous colitis (C. diff),

52
Q

Inhibit folate synthesis. PABA antimetabolites inhibits dihydropteroate synthase.

A

sulfonamides

53
Q

Sulfonamide SE

A

HSR, hemolysis if G6PD deficient, nephrotoxicity, kernicterus in infants, photosensitivity, displace other drugs from albumin (warfarin)
p450 inhibitor

54
Q

Sulfonamide MOR

A

Altered bacterial dihydropteroate synthase, decreased uptake, or increased PABA synthesis.

55
Q

Inhibits bacterial DHFR

A

trimethoprim

56
Q

TMP-SMX CU

A

UTIs, shigella, salmonella, PCP tx and prophylaxis, toxo prophylaxis

57
Q

Trimethoprim SE

A

Megaloblastic anemia, leukopenia, granulocytopenia (may alleviate with supplemental folinic acid)

58
Q

Inhibit DNA gyrase (topo II) and topo IV.

A

Fluoroquinolone

59
Q

Fluoroquinolone CU

A

Gram neg robs of Urinary and GI tracts (incl Pseudomonas), Neisseria, some gram pos

60
Q

Fluoroquinolone SE

A

tendon rupture, prolonged QT, teratogen

Cipro inhibits P450

61
Q

Fluoroquinolone MOR

A

Chromosome encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pumps

62
Q

Forms free radical toxic metabolites in the bacterial cell that damage DNA

A

Metronidazole

63
Q

Metronidazole CU

A

GET GEP on the metro!
Giardia, Entamoeba, Trichomonas,
Gardnerella, Anaerobes, Pylori

64
Q

Metronidazole SE

A

Disulfiram-like reaction (flushing, tachycardia, hypotension) with alcohol, headache, metallic tast

65
Q

Decreased synthesis of mycolic acids. Bacterial catalase peroxidase (encoded by KatG) needed to convert this drug to active metabolite.

A

Isoniazid

66
Q

INH SE

A

Neurotoxicity, hepatotoxicity, vitamin B6 deficiency, drug-induced lupus. Pyridoxine can prevent neurotoxicity, lupus

67
Q

Inhibits DNA-dependent RNAP

A

Rifampin, rifabutin

68
Q

Rifampin SE

A

P450 inducer; orange body fluids; rifabutin favored in HIV+ pts due to less p450 stimulation.

69
Q

Mechanism uncertain. Though to acidify intracellular environment via conversion to pyrazinoic acid. Effective in acidic pH of phagolysosomes where TB engulfed by macrophages is found

A

Pyrazinamide

70
Q

Pyrazinamide SE

A

Hyperuricemia, hepatotoxicity

71
Q

Decreased carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

A

Ethambutol

72
Q

Ethambutol SE

A

Optic neuropathy (red-green color blindness)

73
Q

Prophylaxis against endocarditis with surgical or dental procedures

A

PCN

74
Q

Prophylaxis against gonorrhea

A

Ceftriaxone

75
Q

Prophylaxis against recurrent UTIs

A

TMP-SMX

76
Q

Prophylaxis against meningococcal infxn

A

Cipro (DOC, adults); Rifampin (kids)

77
Q

Prophylaxis against maternal-fetal transmission of group B strep

A

Ampicillin

78
Q

Prophylaxis against gonococcal or chlamydial conjunctivitis in newborn

A

erythromycin eye drops

79
Q

Prophylaxis against post surgical Staph aureus inxn

A

Cefazolin

80
Q

Prophylaxis against strep pharyngitis in child with prior rheumatic fever

A

PCN

81
Q

Prophylaxis against syphilus

A

Benzathine PCN G

82
Q

Prophylaxis against PCP + Toxo in HIV+ pt

A

TMP-SMX

83
Q

Prophylaxis against MAC

A

Azithromycin

84
Q

MRSA tx

A

vanco, (daptomycin, linezolid (can cause serotonin syndrome), tigecyline, ceftaroline

85
Q

VRE tx

A

linezolid, streptogramins (quinupriston/dalfopriston)

86
Q

Daptomycin MOA

A

depolarizes cell membrane

87
Q

Daptomycin SE

A

myopathy, inc CPK, inactivated by pulmonary surfactant

88
Q

Linezolid MOA

A

inhibits protein systhesi sby bindg to 50 S

89
Q

Linezolid SE

A

Thrombocytopenia, neuritis, serotonin syndrome

90
Q

Ceftazidime

A

3G, serious gram negs, esp Pseudomonas

2014 Rapid Review (10 decks)

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