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Neurological Medicine > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Treatment of Mycobacterium tuberculosis?

A

Isoniazid, Rifampin, Ethambutol, Pyrazinamide

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2
Q

Mechanism of Isoniazid

A

Inhibits mycolic acids, which is a component of mycobacterial cell wall

*Fast liver acetylators will require higher dose!

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3
Q

Mechanism of Rifampin

A

RED tears; inhibits DNA-dependent RNA polymerase

induces formation of drug-metabolizing enzymes (CYP450)

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4
Q

Mechanism of Ethambutol

A

inhibits cell wall synthesis by binding arabinosyl transferase

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5
Q

Treatment of Cryptococcus neoformans?

A

Liposomal Amphotericin and Flucytosine, followed by fluconazole until negative culture for 3-12 months

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6
Q

Characteristics of Cryptococcus neofromans

A
  • inhaled as spores
  • disseminated hematogenously to CNS in immunocompromised
  • stains with India ink or latex agglutination
  • common in Africa
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7
Q

Mechanism of Amphotericin B

A
  • Disrupts plasma membranes of fungi creating holes allowing leaking of electrolytes
  • BROAD spectrum (yeasts and molds)
  • liposomal form enters CNS
  • nephrotoxic due to binding of cholesterol
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8
Q

Mechanism for Fluconazole

A

-binds fungal P450 to block ergosterol synthesis
-Spectrum: systemic mycoses (dimorphic fungi and yeast)
-Substrate for efflux pump in brain
-Drug-Drug interactions, hepatoxicity, neurotoxicity - AVOID when Prego
Resistance: altered CYP450, increased efflux

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9
Q

Treatment for Candida albicans?

A

Fluconazole or

Flucytosine with Amphotericin B

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10
Q

Mechanism of Flucytosine (5-FC), Itraconazole, Voriconazole (CNS)

A
  • Antimetabolite converted to 5-Fluorouracil - DNA/RNA synthesis inhibitor
  • NARROW spectrum (yeast)
  • penetrates CNS
  • can cause bone marrow suppression
  • Resistance: loss of converting enzyme; co-treat with Amphotericin B to increase uptake
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11
Q

Treatment for Hypori influenza Type B

A

Rifampin as meningococcal prophylaxis

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12
Q

Mechanism for Ceftriaxone (3rd Generation Cephalosporin)

A

Cell wall inhibitor that binds to penicillin binding proteins; penetrates CNS

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13
Q

Treatment for Neisseria gonorrhoeae

A

Ceftriaxone

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14
Q

Empiric treatment of bacterial meningitis

A

Ceftriaxone and Vancomycin

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15
Q

Treatment for Neisseria meningitis

A

Ceftriaxone

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16
Q

Empiric treatment of brain abscess

A

Ceftriaxone and Metronidazole

17
Q

Mechanism of Penicilin

A

Cell wall inhibitor that binds to penicillin binding proteins; Gram Positive only

18
Q

Treatment of intrapartum prophylaxis for Strptococcus agalactiae (Strep B)

A

Penicillin

19
Q

Mechanism of Amoxicillin, Ampicillin

A

Cell wall inhibitor that binds to penicillin binding proteins
-often administered with clavulanate to inactivate enzymatic degradation by beta-lactamases

20
Q

Treatment for otitis media

A

Amoxicillin

21
Q

Treatment for sinusitis

A

Amoxicillin

22
Q

Treatment for Listeria monocytogenes meningitis

A

Ampicillin and Gentamicin

23
Q

Mechanism of Aztreonam

A

Cell wall inhibitor that binds to penicillin binding proteins

24
Q

Empiric treatment for meningitis if beta-lactam allergy?

A

Aztreonam and Vancomycin

25
Q

Mechanism of Vancomycin

A

Cell wall inhibitor that binds to the D-alanine-D-alanine shielding it from the transpeptidation reaction

26
Q

Treatment for MRSA

A

Vancomycin (Gram Positive)

27
Q

Mechanism for Gentamicin and Amikacin (Aminoglycosides)

A

Protein synthesis inhibitor that binds to the 30S ribosomal subunit
-can cause ototoxicity

28
Q

Mechanism for Acyclovir and Gancyclovir

A
  • Prodrugs that must be phosphorylated by viral thymidine kinase leading to its selectivity
  • Inhibits viral DNA polymerase and leads to chain termination
  • Only effects against ACTIVE virus
29
Q

Treatment for Herpes Simplex Virus 1

A

Acyclovir

30
Q

Treatment for Herpes Simplex Virus 2

A

Acyclovir

31
Q

Treatment for Cytomegalovirus

A

Gancyclovir

32
Q

Treatment for Pseudomonas

A

Cefepime

33
Q

Mechanism of Cefepime

A
  • Cell wall inhibitor that binds to penicillin binding proteins
  • 4th generation cephalosporin
  • BROAD spectrum (Gram + and -)
34
Q

Treatment for E. coli K1+

A

Ceftriaxone and Carbapenem

35
Q

Mechanism for Carbapenem

A
  • Cell wall inhibitor that binds to penicillin binding proteins, rendering beta-lactamases inactive
  • BROAD spectrum, Last resport

Neurological Medicine (8 decks)

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