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Antibiotics Flashcards

1
Q

How is penicillin bactericidal?

A

Binds to PBPs…can’t form wall
Inhibit cross-linkages b/w peptidoglycan chains
Increases autolysis

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2
Q

When is penicillin used?

A

Gram+
T. pallidum (syphilis)
N. meningitidis

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3
Q

What are the potential side effects to penicillin?

A

Hypersensitivity
Hemolytic anemia
Thrombocytopenia

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4
Q

What are the Penicillinase-Resistant Penicillins?

A

Methicillin (Not used clinically)
Nafcillin
Oxacillin
Dicloxacillin

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5
Q

What is the difference between the Penicillinase-Resistant Penicillins and Penicillin?

A

The addition of large R groups prevents beta-lactamase actions

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6
Q

What are the aminopenicillins?

A

Ampicillin

Amoxicillin (more orally available)

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7
Q

What can aminopenicillins be used to treat?

A

Gram+

Some Gram-

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8
Q

What Gram-‘s do aminopenicillins treat?

A

“Aminopenicillins HELPSES with many Gram-“

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9
Q

What is the ‘H’ in “HELPSES” for aminopenicillin treatment of Gram-‘s?

A

H. influ

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10
Q

What are the ‘E’s in “HELPSES” for aminopenicillin treatment of Gram-‘s?

A

Enterococci

E. coli

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11
Q

What is the ‘P’ in “HELPSES” for aminopenicillin treatment of Gram-‘s?

A

Proteus mirabilis

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12
Q

What are the ‘S’s in “HELPSES” for aminopenicillin treatment of Gram-‘s?

A

Salmonella

Shigella

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13
Q

What can happen if a person with mono is given an aminopenicillin?

A

A full-body rash

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14
Q

What are the carboxy penicillins?

A

Ticarcillin
Pipercillin
Carbenicillin

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15
Q

What are carboxy penicillins used for?

A

Pseudomonas

Gram+

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16
Q

What are cephalosporins?

A

Basically, penicillin…only less susceptible to penicillinases

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17
Q

What are the first generation cephalosporins?

A

Cefazolin

Cephalexin

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18
Q

What do cefazolin and cephalexin treat?

A

Gram+ cocci

Some Gram-‘s (“PEcK”)

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19
Q

What does the ‘P’ in “PEcK”…for 1st generation cephalosporins…stand for?

A

Proteus mirabilis

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20
Q

What does the ‘Ec’ in “PEcK”…for 1st generation cephalosporins…stand for?

A

E. coli

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21
Q

What does the ‘K’ in “PEcK”…for 1st generation cephalosporins…stand for?

A

Klebsiella pneumo

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22
Q

What are the second generation cephalosporins?

A

There are like 4 of ‘em…just know the 2 first gen, 1 4th gen, and that the third gen have a ‘t’ or ‘d’ shortly after the ‘cef’

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23
Q

What do the 2nd generation cephalosporins treat?

A

Gram+ cocci

More Gram-‘s

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24
Q

What gram-‘s do 2nd generation cephalosporins treat?

A

HENS PEcK

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25
Q

What does the “PEcK” in “HENS PEcK”…for 2nd generation cephalosporins…stand for?

A

Same as 1st gen

Proteus mirabilis
E. coli
Klebsiella

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26
Q

What does the ‘H’ in “HENS”…for 2nd generation cephalosporins…stand for?

A

H. influ

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27
Q

What does the ‘E’ in “HENS”…for 2nd generation cephalosporins…stand for?

A

Enterobacter

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28
Q

What does the ‘N’ in “HENS”…for 2nd generation cephalosporins…stand for?

A

N. meningitidis

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29
Q

What does the ‘S’ in “HENS”…for 2nd generation cephalosporins…stand for?

A

Serratia marcescens

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30
Q

What are the third generation cephalosporins?

A

Ceftriaxone
Cefotaxime
Ceftazidime
Cefdinir (Otitis Media)

(t or d shortly after def)

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31
Q

When are 3rd generation cephalosporins used?

A

Serious gram-‘s resistant to other beta-lactams

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32
Q

When is ceftriaxone used?

A

Meningitis

Gonorrhea

33
Q

When is ceftazidime used?

A

Pseudomonas

34
Q

What is the 4th generation cephalosporin?

A

Cefepime

35
Q

When can cefepime be used?

A

Pseudomonas (and other gram-s)

Gram+ organisms

36
Q

What toxicities are seen with cephalosporins?

A

Hypersensitivity
Vitamin K deficiency
Nephrotoxicity with aminoglycosides
Disulfiram reaction

37
Q

Does penicillin sensitivity cross react with cephalosporins?

A

No…these patients may be given cephalosporins

38
Q

What can’t cephalosporins treat?

A

“Cephalosporins are LAME against some bugs”

Listeria
Atypicals (Mycoplasma, chlamydia)
MRSA (except 5th gen)
Enterococci

39
Q

What is the MoA of aztreonam?

A

Inhibits cell wall synthesis by binding to PBP3

40
Q

When is aztreonam used?

A

Gram- rods only…and if aminoglycosides aren’t tolerated

41
Q

Does penicillin sensitivity cross-react with aztreonam?

A

No…penicillin sensitive patients can be given aztreonam

42
Q

What are the carbapenems?

A

Imipenem/cilastatin
Meropenem
Ertapenem
Doripenem

43
Q

When are carbapenems used?

A

Gram+ cocci
Gram- rods
Anaerobes
Pseudomonas

Empiric treatment of life-threatening infections

44
Q

When aren’t carbapenems used?

A

MRSA

45
Q

What are some potential side effects of carbapenems?

A

GI distress
Skin rash
Seizures (imipenem/cilastatin)

46
Q

Why is cilastatin always coupled to imipenem?

A

Cilastatin inhibits imipenem deactivation in the renal tubules

47
Q

What is the MoA of vancomycin?

A

Binds to D-ala D-ala…inhibits glycopeptide polymerization

48
Q

When is vancomycin used?

A

MRSA
C. diff (oral…usually metronidazole)
Staph e endocarditis

49
Q

What are the side effects of vancomycin?

A

“NOT”
Nephrotoxicity
Ototoxicity
Thrombophlebitis

Red Man Syndrome

50
Q

“Mean GNATS caNNOT kill anaerobes”…what class of drugs is this for?

A

A”mean”oglycosides

51
Q

What are the aminoglycosides?

A 
"GNATS"
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
52
Q

What are the side effects of aminoglycosides?

A 
"caNNOT"
Nephrotoxicity
Neuromuscular blockade
Ototoxicity (with loop diuretics)
Teratogen (ototoxicity)
53
Q

When aren’t aminoglycosides useful?

A

Anaerobes…obviously

54
Q

When are aminoglycosides used?

A

Severe gram- rod infections

Synergistic to beta-lactams

55
Q

What is the MoA of aminoglycosides?

A

Prevents ribosomal initiation complex formation by binding to 30S

Causes misreading of mRNA and blocks translocation

56
Q

What is the MoA of tetracyclines?

A

Inhibit A site by binding to 30S

57
Q

What are the tetracyclines?

A

Tetracycline
Doxycycline
Minocycline
Demeocycline

58
Q

When is the mnemonic for when tetracyclines are used?

A

“VACUUM THe BedRoom”

59
Q

What does the ‘V’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

Vibrio cholerae

60
Q

What does the ‘A’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

Acne

61
Q

What does the ‘UU’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

Ureaplasma Urealytica

62
Q

What does the ‘M’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

Mycoplasma pneumo

63
Q

What does the ‘T’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

Tularemia

64
Q

What does the ‘H’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

H. pylori

65
Q

What does the ‘B’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

Borrelia burgdorferi

66
Q

What does the ‘R’ in “VACUUM THe BedRoom”…the uses of tetracycline…stand for?

A

Rickettsia rickettsii

67
Q

What are the toxicities associated with tetracyclines?

A

GI distress
Discoloration of teeth and inhibition of bone growth in kids
Photosensitivity

NOT FOR PREGGERS

68
Q

What are the macrolides?

A

Azithromycin
Clarithromycin
Erythromycin

69
Q

What is the MoA of macrolides?

A

“Macrolides…more like macroslides”

Inhibit translocation by binding to the 23S of the 50S

70
Q

What other drugs also inhibit translocation by binding to the 50S?

A

Clindamycin
Linezolid
Streptogramins

71
Q

When is clindamycin used?

A

Anaerobes above the diaphragm

Metronidazole is used for anaerobes below the diaphragm

72
Q

What is the risk with clindamycin?

A

Pseudomembranous colitis (C. diff)

73
Q

When is linezolid used?

A

Outpatient MRSA or VRE

74
Q

What is the streptogramin?

A

Quinupristin/Dalfopristin

75
Q

When is Q-pristin/D-pristin used?

A

MRSA
VRE
Staph and strep skin infections

76
Q

What are some side effects of Q-pristin/D-pristin?

A

Hepatotoxicity
Pseudomembranous colitis

Inhibits p450

77
Q

What is the MoA of chloramphenicol?

A

Inhibits peptidyltransferase by binding to the 50S

78
Q

When is chloramphenicol used?

A

Meningitis (H. influ, N. meningitidis, Strep pneumo)

79
Q

What are some possible side effects of chloramphenicol?

A

Anemia (dose dependent)

Gray Baby Syndrome (in premies)

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