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step 1 pharm > antibiotics > Flashcards

antibiotics Flashcards

1
Q

penicillin moa

A

bind PBPs (transpeptidases) and block transpeptidase cross-linking for peptidoglycan; activate autolytic enzymes

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2
Q

penicillin clinical use

A

gram +, neisseria meningitidis, and syphilis

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3
Q

penicillin tox

A

hypersensitivity reactions, hemolytic anemia

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4
Q

penicillin resistance

A

penicillinase in bacteria (beta-lactamase) cleaves beta-lactam ring

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5
Q

aminopenicillins (drugs)

A

amoxicillin, ampicillin

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6
Q

aminopenicillin clinical use

A

extended-specturm penicillin - H. flu, e. coli, listeria, proteus, salmonella, shigella, enterococci

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7
Q

penicillinase resistant penicillins

A

oxacillin, nafcillin, dicloxacillin

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8
Q

penicillinase resistant penicillin clinical use

A

s. aureus

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9
Q

aminopenicillin resistance

A

penicillinase in bacteria (beta-lactamase) cleaves beta-lactam ring

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10
Q

penicillinase resistant penicillins mechanism

A

binds PBPs; bulky R group blocks access of beta latamase to the beta lactam ring

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11
Q

beta-lactamase inhibitors

A

clavulanic acid, sulbactam, tazobactam

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12
Q

first generation cephalosporins (drugs)

A

cefazolin and cephalexin

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13
Q

1st gen cephalosporins use

A

proteus, e.coli, klebsiella, gram + cocci

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14
Q

2nd gen cephalosporin drugs

A

cefoxitin, cefaclor, cefuroxime

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15
Q

2nd gen cephalosporin use

A

h. flu, enterobacter, neisseria, proteus, E.coli, klebsiella, serratia, Gram + cocci

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16
Q

3rd gen. cephalosporin drugs

A

ceftriaxone, cefotaxiime, ceftazidime

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17
Q

3rd gen cephalosporin use

A

serious gram negative infections resistant to other beta lactams

ceftriaxone: meningitis and gonorrhea
ceftazidime: pseudomonas

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18
Q

4th gen cephalosporin drug

A

cefepime

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19
Q

cefepime use

A

pseudomonas and gram +

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20
Q

5th generation cephalosporin drug

A

ceftaroline

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21
Q

ceftaroline use

A

broad gram + and gram - coverage, including MRSA; does not cover pseudomonas

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22
Q

cephalosporin toxicity

A

hypersensitivity, vit K deficiency, low cross-reactivity with PCN, increased nephrotoxicity of aminoglycosides

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23
Q

aztreonam moa

A

monobactam resistant to beta lactamases; prevents peptidoglycan crosslinking by binding PBP-3; synergistic with ahminoglycosides

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24
Q

aztreonam use

A

gram negative rods only; no activity against gram + or anaerobes; nontoxic

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25
Q

carbapenems drugs

A

imipenem, meropenem, ertapenem, doripenem

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26
Q

carbapenem moa

A

broad-spectrum beta-lactamase resistant

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27
Q

imipenem administration

A

must be given with cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of the drug in renal tubules

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28
Q

carbapenem clinical use

A

gram + cocci, gram-neg. rods and anaerobes; wide spectrum;

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29
Q

carbapenem toxicity

A

GI, skin rash, CNS toxicity, seizures (esp. meropenem)

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30
Q

vancomycin moa

A

inhibits cell wall synthesis by binding D-ala D-ala portion of cell wall precursors

31
Q

vancomycin clinical use

A

gram + only; MRSA, enterococci, and C. difficile

32
Q

vancomycin toxicity

A

nephrotoxicity, ototoxicity, thrombophlebitis, diffuse flushing - red man syndrome

33
Q

vancomycin resistance

A

modification of D-ala D-ala to D-ala D-lac

34
Q

aminoglycosides drugs

A

gentamicin, neomycin, amikacin, tobramycin, streptomycin

35
Q

aminoglycoside moa

A

inhibit formation of initiation complex and cause misreading of mRNA; also block translocation;

36
Q

aminoglycoside use

A

severe gram neg. rod infection; require O2 for uptake so ineffective against anaerobes;
neomycin for bowel surgery

37
Q

aminoglycoside resistance

A

bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, or adenylation

38
Q

tetracyclines drugs

A

tetracycline, doxycycline, minocycline

39
Q

tetracycline moa

A

bind 30S and prevent attachment of ammoniacal-tRNA; limited CNS penetration;

40
Q

doxycycline metab

A

fecally eliminated so it can be used in renal failure; do not take with milk or antacids (Ca or Mg) or iron preparation because divalent cations inhibits its absorption in the gut

41
Q

tetracycline use

A

intracellular microbes: borrelia burgdorferi, m. pneumoniae, rickettsia, and chlamydia; can be used to treat acne

42
Q

tetracycline toxicity

A

GI, discoloration of teeth and inhibition of bone growth in children, photosensitivity; contraindicated in pregnancy and children

43
Q

tetracycline resistance

A

decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps

44
Q

macrolides drugs

A

azithromycin, clarithromycin, erythromycin

45
Q

macrolide moa

A

bind to the 23S of the 50S and block translocation

46
Q

macrolide use

A

atypical pneumonias, STDs, and pram + cocci

47
Q

macrolide toxicity

A

GI motility issues, arrhythmia due to QT prolongation, acute cholestatic hepatitis (erythromycin), rash, eosinophilia, cyp inhibition

48
Q

macrolide resistance

A

methylation of the 23S rRNA-binding site

49
Q

chloramphenicol moa

A

blocks peptidyltransferase at 50S

50
Q

chloramphenicol use

A

limited due to toxicity; meningitis and RMSF

51
Q

chloramphenicol toxicity

A

anemia, aplastic anemia, gray baby syndrome,

52
Q

chloramphenicol resistance

A

plasmid-encoded acetyltransferase inactivates the drug

53
Q

clindamycin moa

A

blocks peptide transfer at 50S

54
Q

clindamycin use

A

anaerobic infections in aspiration pneumonia, lung abscesses, and oral infections; also invasive GAS infections

55
Q

clindamycin toxicity

A

pseudomembranous colitis, fever, diarrhea

56
Q

sulfonamides drugs

A

sulfamethoxazole, sulfisoxazole, sulfadiazine

57
Q

sulfonamide moa

A

inhibit folate synthesis; para-aminobenzoic acid (PABA) antimetabolites inhibit dihydropteroate synthase

58
Q

sulfonamides use

A

gram +, gram-, nocardia, chlymidai; simple UTI

59
Q

sulfonamides toxicity

A

hypersensitivity reactions; hemolysis in G6PD deficient, nephrotoxic (tubulointerstitial nephritis), photosensitivity, kernicterus in infants, displaces other drugs from albumin (e.g. warfarin) causing increased drug levels

60
Q

sulfonamide resistance

A

altered enzyme (bacterial dihydropteroate synthase), decreased uptake, or increased PABA synthesis

61
Q

trimethoprim moa

A

inhibits DHFR

62
Q

trimethoprim use

A

used with sulfonamides, never alone;
UTIs, shigella, salmonella,
pneumocystis jirovecii and toxoplasmosis prophylaxis in AIDS

63
Q

trimethoprim toxicity

A

megaloblastic anemia, leukopenia, granulocytopenia

64
Q

fluoroquinolones drugs

A

ciprofloxacin and other -floxacin drugs

65
Q

fluoroquinolone moa

A

inhibts DNA gyrase (topo II) and topo IV; cannot be used with antacids

66
Q

fluoroquinolone use

A

gram negative rods of urinary and GI tracts including pseudomonas, neisseria; some gram + organisms

67
Q

fluoroquinolone toxicity

A

GI, superinfection, tendonitis, tendon rupture, leg cramps, myalgias
contraindicated in pregnancy
some cause QT prolongation

68
Q

Fluoroquinolone resistance

A

chromosome-encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pumps

69
Q

metronidazole moa

A

forms free radical toxic metabolites in the bacteria cell that damage DNA

70
Q

metronidazole toxicity

A

disulfiram-like reaction with alcohol, metallic taste

71
Q

metronidazole use

A

GET GAP on the metro: guard, entamoeba, trichomonad, gardeners vaginalis, anaerobes (bacteroides and c. diff) H. pylori

72
Q

linezolid moa

A

binds 23S of 50S

73
Q

linezolid use

A

VRE and MRSA

74
Q

linezolid toxicity

A

serotonin syndrome

step 1 pharm (20 decks)

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