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Dental Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

G+ cocci and bacilli; some G- cocci; spirochetes (streptococcus, treponema pallidum, neisseria gonorrhoeae): penicillins G and penicillins V

A

natural penicillins

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2
Q

B lactamase producing staph (penicillinase resistant): nafcillin, oxacillin, dicloxacillin

A

anti-staphylococcal

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3
Q

same as Pen G, plus some G- rods and bacilli; not resistant to broad spectrum B lactamases in G- organisms (H. influenzae, E coli): ampicillin, amoxicillin, cyclacillin

A

extended spectrum

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4
Q

enteric G- rods, G- bacilli; usually combined with an aminoglycoside for serious infections (pseudomonas aeruginosa, H. influenzae): ticarcillin, mezclocillin, piperacillin

A

anti-pseudomonal

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5
Q

clavulanic acid, sulbactam, tazobactam

A

b lactamase inhibitors

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6
Q

amoxicillin and clavulanic acid (oral): B lactamase producing Staph

A

augmentin

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7
Q

ampicillin and sulbactam (parenteral)

A

unasyn

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8
Q

ticarcillin and clavulanic acid (parenteral)

A

timentin

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9
Q

piperacillin and tazobactam (parenteral): gram neg. bacilli; not pseudomonas

A

zosyn

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10
Q

penicillins that have biliary excretion

A

nafcillin and oxacillin

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11
Q

treat MRSA with…

A

vancomycin

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12
Q

diarrhea after oral dose is more common with …

A

ampicillin and augmentin

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13
Q

first gen. cephalosporin; similar spectrum to ampicillin; G+ cocci; some G- bacilli

A

cephalothin and cefazolin

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14
Q

second gen. cephalosporin; less active for G+ and more active for G-; H. influenza, N. meningitidis

A

cefoxitin, cefotetan, cefaclor

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15
Q

third gen. cephalosporin; enteric G-; reserve for very serious infections; crosses BBB; h. influenza, serratia

A

cefotaxime, ceftriaxone, ceftazidime, cefixime

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16
Q

b. fragilis

A

cefoxitin and cefotetan

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17
Q

pseudomonas

A

ceftazidime only

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18
Q

fourth gen cephalosporin; increase activity for G+, B lactamase producing organisms, broad spectrum

A

cefepime and ceftaroline

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19
Q

which 4th gen ceph? p. aeruginosa, klebsiella, e coli, enterobacter, citrobacter, proteus mirabilis

A

cefepime

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20
Q

which 4th gen ceph? s aureus (MRSA and MSSA), s pneumoniae, E coli, klebsiella, enterobacter, citrobacter

A

cerftaroline

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21
Q

no current cephs have activity for …

A

enterococcus

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22
Q

3rd gen; penetrate to CSF sufficiently to be useful for treatment of meningitis

A

cefotaxime and ceftriaxone

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23
Q

extra dose required after hemodialysis except for …

A

ceftriaxone

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24
Q

disulfiram like effects w/ alcohol for cephs with N-methylthiotetrazole side chain –> i.e. …

A

cefotetan

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25
Q

B lactam ring; more resistant to beta lactamase enzymes than penicillins and cephalosporins; broadest spectrum of any b lactam; IV

A

carbapenems-imipenem

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26
Q

carbapenems-imipenem is administered with … which inhibits dehydropeptidase and prevents breakdown in kidney and renal toxicity

A

cilastatin

27
Q

fixed combo of carbapenem and cilastatin

A

primaxin

28
Q

active against p. aeruginosa, resistant nosocomial gram negatives, role in empiric therapy

A

carbapenems

29
Q

carbapenem that doesnt require co administration with cilastatin; slightly less likely to cause seizures; active against imipenem resistant p. aeruginosa and extended spectrum b lactamases producing E coli and klesbsiella

A

meropenem

30
Q

carbapenem with longer serum half life; once a day dosing

A

ertapenem

31
Q

inhibits cell wall synthesis but with different site from other B lactams; narrow spectrum-primarily against G+; glomerular filtration half life a lot longer with renal impairment; nephrotoxicity which increases when in combo with aminoglycoside, cyclosporin, amphotericin; used against MRSA

A

vancomycin

32
Q

erythromycin, clindamycin, azithromycin

A

macrolides

33
Q

binds to 50s subunit and inhibits protein synthesis; bacteriostatic; narrow spectrum- high uptake in G+ and low in G-; oral but in protected form; concentrated in liver and excreted in bile; renal failure has no effect; inhibits cytochrome P450; can trigger heart arrhythmia; 2nd after Pen G for G+ infections

A

erythromycin

34
Q

more acid stable than erythromycin; absorption of oral dose increases with food; longer half life; slightly better activity against G+; similar in effectiveness to Pen Vs; slightly less inhibiting of cytochrome P450 than erythromycin but still does inhibit it;

A

clarithromycin

35
Q

more acid stable; very long half life; absorption of oral dose reduced with food; concentrates in macrophages, neutrophils and fibroblasts; increased penetration in G-; NO inhibition of CYP enzymes; small increased risk for cardiac death

A

azithromycin

36
Q

drug of choice for legionella, campylobacter, mycobacterium avium complex

A

azithromycin

37
Q

inhibition of protein synthesis; binds to 50S; cross resistance to the macrolide antibiotics; penetrates bone; spectrum includes many of the orodental pathogens; G+ cocci; anaerobic G+ and G-; prophylactic coverage with allergic to penicillin

A

clindamycin

38
Q

inhibition of protein synthesis by binding to 30S; bacteriostatic with reversible binding to ribosome; broad spectrum; G+ and G-; aerobic and anaerobic

A

tetracycline

39
Q

may be drug of choice for mycoplasma, chlamydia, rickettsiae; spirochetes

A

tetracycline

40
Q

resistance to one tetracycline provides resistance to …

A

all tetracyclines

41
Q

absorption inhibited by di- and trivalent cations; best absorbed in acidic conditions of stomach w/o antacids; concentrates in bone and teeth particularly when undergoing calcification; fetal conc. can be relatively high in bond and dentition; excreted to the bile

A

tetracycline

42
Q

which tetracyclines use hepatic excretion

A

minocycline and doxycycline

43
Q

adverse effects: avitaminosis (B vitamins produced by flora in gut); superinfections common; discoloration of teeth during development

A

tetracycline

44
Q

which tetracyline is more completely absorbed and least likely to cause problem

A

doxycycline

45
Q

induced staining of dentition in adults; vestibular toxicity

A

minocycline

46
Q

enzymatic reduction of drug by to cause effects on bacterial DNA replication; penetrates CSF; can by used to treat clostridium difficile; active against G- anaerobes found in acute orofacial infections, refractory/rapidly progressive periodontitis; protozoal infections; inhibits P450 isozyme; disulfiram effect

A

metronidazole

47
Q

ciprofloxacin, norfloxacin, sparfloxacin

A

fluoroquinolones

48
Q

inhibition of bacterial DNA gyrase, inhibits DNA synthesis, bacteriocidal; absorption decreases with antacids containing Al+++ and Mg++ and decreases with dietary supplements containing Fe++ and Zn++; accumulates in macrophages and leukocytes–>effective against intracellular organism (legionella); poor CSF penetration; half life increases with renal failure; broad spectrum

A

fluoroquinolones

49
Q

alterations in DNA gyrase binding is caused by mutation to … of DNA gyrase enzyme

A

QRDR gene

50
Q

resistance to fluoroquinolones becoming frequent in …

A

S. aureua and P. aeruginosa

51
Q

which generation of fluoroquinolones?: increased G- and systemic activity; improved pharmacokinetics; fewer side effects

A

2nd gen

52
Q

which generation of fluoroquinolones?: extended activity against G+; broad G- coverage

A

3rd gen

53
Q

which generation of fluoroquinolones?: activity against anaerobes along with G+ and G- of 3rd generation

A

4th gen

54
Q

which generation of fluoroquinolones?: ciprofloxacin, enoxacin, lomefloxacin, norfloxacin, ofloxacin

A

2nd gen

55
Q

which generation of fluoroquinolones?: grepafloxacin, levofloxacin, sparfloxacin

A

3rd gen

56
Q

which generation of fluoroquinolones?: gatifloxacin and moxifloxacin

A

4th gen

57
Q

fluoroquinolones have poor CSF penetration except …

A

ofloxacin

58
Q

adverse effects: prolongation of QT interval (3rd gen except levofloxacin); articular cartilage erosion (arthropathy) drug interactions: inhibition of P450 system

A

fluoroquinolones

59
Q

a fluroquinolone with definite risk of QTc prolongation

A

sparfloxacin

60
Q

fluoroquinolones with possible risk of QTc prolongation

A

gatifloxacin, gemifloxacin, levofloxacin, moxifloxacin, ofloxcin

61
Q

fluoroquinolone to avoid in patients with or suspected to have congenital long QT syndrome, hypokalemia, or receiving Class IA or Class III antiarrhythmic agents

A

ciprofloxacin

62
Q

inhibit utilization of PABA in the synthesis of folic acid; bacteriostatic; pass the placental barrier and into breast milk; hematologic disorders in G6PD deficiency; sulfonamide binds serum albumin and displaces other drugs

A

sulfonamides

63
Q

inhibits reduction of dihydrofolate to tetrahydrofolate; resistance comes from alteration in enzyme affinity; concentrates in prostate and vaginal fluids; synergistic with sulfonamides

A

trimethoprim

64
Q

trimethoprim-sulfamethoxazole combo

A

co-trimoxazole

Dental Pharmacology (30 decks)

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