Antibiotics

Question 1

Beta Lactams

Answer 1

Include penicillins, cephalosporins, carbapenems, aztreonam, and all bind to the penecillin binding protiens. -cidal

Question 2

Macrolides

Answer 2

Static Broad spectrum
include clindamycin, azithromycin, and clarithromycin, Bind 23S subunit of 50S subunit inhibiting translation.
AE: GI discomfort, long QT, CYP3A4

Question 3

Clindamycin

Answer 3

macrolide which inhibits 23S subunit of 50s, inhibiting translation.
AE: GI discomfort, long QT, CYP3A4

Question 4

Azithromycin

Answer 4

macrolide which inhibits 23S subunit of 50s, inhibiting translation.
AE: GI discomfort, long QT, CYP3A4

Question 5

Clarithromycin

Answer 5

macrolide which inhibits 23S subunit of 50s, inhibiting translation.
AE: GI discomfort, long QT, CYP3A4 MISCARRIAGE

Question 6

Aztreonam

Answer 6

only used for gm- rods

Question 7

zanamivir

Answer 7

poor oral bioavail. >7years, inhaled, avoid in pts with asthma and pulmonary disease. treats the flu

Question 8

Secondary flu infection

Answer 8

Strep pnumo> staph aures> group A strep

Question 9

Community acquired pneumonia

Answer 9

cough, fever, pleuritic chest pain., infiltrate on radiography
treat empiracally, broad spectrum- doxycycline or macrolide (mycin)

Question 10

Fluoroquinolones

Answer 10

gemifloxacin, levofloxacin, moxifloxacin. -cidal, inhibit top II and IV, broad spectrum.
Resistance: efflux, mutations in top.
AE: GI, tendinopathies

Question 11

gemifloxacin

Answer 11

-cidal, inhibit top II and IV, broad spectrum.
Resistance: efflux, mutations in top.
AE: GI, tendinopathies

Question 12

Levofloxacin

Answer 12

-cidal, inhibit top II and IV, broad spectrum.
Resistance: efflux, mutations in top.
AE: GI, tendinopathies

Question 13

moxifloxacin

Answer 13

-cidal, inhibit top II and IV, broad spectrum.
Resistance: efflux, mutations in top.
AE: GI, tendinopathies

Question 14

mycoplasma pneumonia

Answer 14

walking pneumonia, no gram stain. treated best with cephalosporins. Use Doxycycline and azithromycin. don’t use beta lactams. Difficult to prevent due to long length of infectious period. Diagnosis via IgM

Question 15

Doxycycline

Answer 15

Tetracycline bacteriostatic, binds 30 S subunit preventing tRNA attachment. resistance: reduced uptake and efflux.
AE: photosensitivity and discoloration of teeth. dont take with milk.

Question 16

MRSA

Answer 16

treat with Vancomycin or linezolid. do not use daptomycin because it is inactivated by pulmonary surfactant.

Question 17

Pseudomonas aeruginosa

Answer 17

treat with two antibiotics including piperacillin/ tazobactam, cefepime (4th gen.), imipenem/cilastatin, aztreonam

Question 18

klebsiella pneumoniae

Answer 18

extended spectrum beta-lactamase, treat with colistin- polymyxin E

Question 19

Linezolid

Answer 19

targets 50S subunit and inhibits protein synthesis, treats gm+ especially MRSA, staph, enterococci, strep

Question 20

vancomycin

Answer 20

binds to D-Ala D-Ala dipeptide and inhibits transglycosylation. gm+

Question 21

Polymyxin E/ Colistin

Answer 21

Binds phosphatidylethanolamine creating holes in membrane
Spectrum: MDR gm-
AE: nephrotoxicity
little resistance

Question 22

histoplasma capsulatum

Answer 22

fungal infection, bird shit. treat with amphotericin or itraconazole

Question 23

amphotericin B

Answer 23

binds ergosterol creating holes in the membrane active against yeast and molds. long half life.
AE: toxic bind cholesterol. Nephrotoxicity.

Question 24

Voriconazole

Answer 24

binds fungal P-450 enzyme (ERG11) blocking ergosterol, avoid during pregnancy