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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
What does the "PEcK" in "HENS PEcK"...for 2nd generation cephalosporins...stand for?
Same as 1st gen Proteus mirabilis E. coli Klebsiella
26
What does the 'H' in "HENS"...for 2nd generation cephalosporins...stand for?
H. influ
27
What does the 'E' in "HENS"...for 2nd generation cephalosporins...stand for?
Enterobacter
28
What does the 'N' in "HENS"...for 2nd generation cephalosporins...stand for?
N. meningitidis
29
What does the 'S' in "HENS"...for 2nd generation cephalosporins...stand for?
Serratia marcescens
30
What are the third generation cephalosporins?
Ceftriaxone Cefotaxime Ceftazidime Cefdinir (Otitis Media) (t or d shortly after def)
31
When are 3rd generation cephalosporins used?
Serious gram-'s resistant to other beta-lactams
32
When is ceftriaxone used?
Meningitis | Gonorrhea
33
When is ceftazidime used?
Pseudomonas
34
What is the 4th generation cephalosporin?
Cefepime
35
When can cefepime be used?
Pseudomonas (and other gram-s) | Gram+ organisms
36
What toxicities are seen with cephalosporins?
Hypersensitivity Vitamin K deficiency Nephrotoxicity with aminoglycosides Disulfiram reaction
37
Does penicillin sensitivity cross react with cephalosporins?
No...these patients may be given cephalosporins
38
What can't cephalosporins treat?
"Cephalosporins are LAME against some bugs" Listeria Atypicals (Mycoplasma, chlamydia) MRSA (except 5th gen) Enterococci
39
What is the MoA of aztreonam?
Inhibits cell wall synthesis by binding to PBP3
40
When is aztreonam used?
Gram- rods only...and if aminoglycosides aren't tolerated
41
Does penicillin sensitivity cross-react with aztreonam?
No...penicillin sensitive patients can be given aztreonam
42
What are the carbapenems?
Imipenem/cilastatin Meropenem Ertapenem Doripenem
43
When are carbapenems used?
Gram+ cocci Gram- rods Anaerobes Pseudomonas Empiric treatment of life-threatening infections
44
When aren't carbapenems used?
MRSA
45
What are some potential side effects of carbapenems?
GI distress Skin rash Seizures (imipenem/cilastatin)
46
Why is cilastatin always coupled to imipenem?
Cilastatin inhibits imipenem deactivation in the renal tubules
47
What is the MoA of vancomycin?
Binds to D-ala D-ala...inhibits glycopeptide polymerization
48
When is vancomycin used?
MRSA C. diff (oral...usually metronidazole) Staph e endocarditis
49
What are the side effects of vancomycin?
"NOT" Nephrotoxicity Ototoxicity Thrombophlebitis Red Man Syndrome
50
"Mean GNATS caNNOT kill anaerobes"...what class of drugs is this for?
A"mean"oglycosides
51
What are the aminoglycosides?
``` "GNATS" Gentamicin Neomycin Amikacin Tobramycin Streptomycin ```
52
What are the side effects of aminoglycosides?
``` "caNNOT" Nephrotoxicity Neuromuscular blockade Ototoxicity (with loop diuretics) Teratogen (ototoxicity) ```
53
When aren't aminoglycosides useful?
Anaerobes...obviously
54
When are aminoglycosides used?
Severe gram- rod infections Synergistic to beta-lactams
55
What is the MoA of aminoglycosides?
Prevents ribosomal initiation complex formation by binding to 30S Causes misreading of mRNA and blocks translocation
56
What is the MoA of tetracyclines?
Inhibit A site by binding to 30S
57
What are the tetracyclines?
Tetracycline Doxycycline Minocycline Demeocycline
58
When is the mnemonic for when tetracyclines are used?
"VACUUM THe BedRoom"
59
What does the 'V' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
Vibrio cholerae
60
What does the 'A' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
Acne
61
What does the 'UU' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
Ureaplasma Urealytica
62
What does the 'M' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
Mycoplasma pneumo
63
What does the 'T' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
Tularemia
64
What does the 'H' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
H. pylori
65
What does the 'B' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
Borrelia burgdorferi
66
What does the 'R' in "VACUUM THe BedRoom"...the uses of tetracycline...stand for?
Rickettsia rickettsii
67
What are the toxicities associated with tetracyclines?
GI distress Discoloration of teeth and inhibition of bone growth in kids Photosensitivity NOT FOR PREGGERS
68
What are the macrolides?
Azithromycin Clarithromycin Erythromycin
69
What is the MoA of macrolides?
"Macrolides...more like macroslides" Inhibit translocation by binding to the 23S of the 50S
70
What other drugs also inhibit translocation by binding to the 50S?
Clindamycin Linezolid Streptogramins
71
When is clindamycin used?
Anaerobes above the diaphragm | Metronidazole is used for anaerobes below the diaphragm
72
What is the risk with clindamycin?
Pseudomembranous colitis (C. diff)
73
When is linezolid used?
Outpatient MRSA or VRE
74
What is the streptogramin?
Quinupristin/Dalfopristin
75
When is Q-pristin/D-pristin used?
MRSA VRE Staph and strep skin infections
76
What are some side effects of Q-pristin/D-pristin?
Hepatotoxicity Pseudomembranous colitis Inhibits p450
77
What is the MoA of chloramphenicol?
Inhibits peptidyltransferase by binding to the 50S
78
When is chloramphenicol used?
Meningitis (H. influ, N. meningitidis, Strep pneumo)
79
What are some possible side effects of chloramphenicol?
Anemia (dose dependent) | Gray Baby Syndrome (in premies)

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