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Antibiotics Flashcards

1
Q

What simple antibiotic kills enterocci

A

ampicillin/amoxicillin

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2
Q

Gut problems with amp/amox

A

pseudomembranous colitis

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3
Q

Cephalosporins miss?

A

LAME = listeria, Atypicals, Mycoplasma, Enterococci

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4
Q

Cephalosporin heme toxicity

A

hemolytic anemia, vitamink K deficiency (mess up the vitamin K epoxide reductase)

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5
Q

Cephalosporins increase nephrotox with?

A

aminoglycosides

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6
Q

Imipenem ust go with

A

cilastatin, reduces renal dehydropeptidase 1 that inactivates drug. Similar to how you use probenecid to prevent renal excretion of pencillins

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7
Q

major toxicity of carbapenems, which one has les stoxicity

A

Seizures. Meropenem has less toxicity

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8
Q

What is aztreonam for?

A

A monobactam so one purpose. For gram negative rods. For penicillin allergic patients who cannot tolerate aminoglycosides bc renal insufficiency

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9
Q

3 Major toxicities for vancomycin

A

NOT = nephrotoxicity, ototoxicity, thrombophlebitis

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10
Q

What is unique about reaction in red man syndrome

A

The histamine release is not IgE mediated. Can prevent with antihistamines and slow infusions

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11
Q

Only bacteriacidal protein synthesis inhibitor

A

Aminoglycosides

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12
Q

aminoglycosides are dirty because

A

NNOT = nephrotoxic, neuromuscular blockade, ototoxicity, teratogen.

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13
Q

Two ways to resist aminoglycosides

A

Can modify drug by acetylation, phosphorylation, adenylation. Or prevent drug penetrating through wall

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14
Q

Magical property of a specific tetracycline?

A

Doxycycline is fecally eliminated so can be used in patients with renal failure

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15
Q

Tetracycline can’t be taken with and how does this realte to toxicity

A

Inhibited absorption when taken with Ca milk, antacids, iron containing things. (any divalent). All side effects are from complexing with Ca in the teeth bone.

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16
Q

Grey baby syndrome

A

Chloramphenicol bc babies lack liver UDP glucuronyl transferase.

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17
Q

Chloramphenicol kills the?

A

Kills blood cells. Get anemia and then aplastic anemia dose dependent

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18
Q

Why are tetracyclines good against rickettsia organisms?

A

They accumulate intracellularly

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19
Q

Tetracycline resistance by?

A

Reduced uptake or increased efflux of drug (most others inactivate in some way

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20
Q

Problems with using linezolid

A

Bone marrow suppression. Peripheral neuropathy. Serotonin syndrome

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21
Q

Serotonin syndrome in antibiotcs

A

Linezolid

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22
Q

Macrolides bind specifically to

A

23S rRNA

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23
Q

Which macrolide doesn’t inhibit cyp450

A

Azithromycin

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24
Q

Macrolides do a lot of side effects

A 
MACRO
M = motility
A = arrhythmia from prolonged QT
C = cholestatic hepatitis
R = rash
O = eOsinophilia
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25
trimethoprim expected side effect
Causes megaloblastic anemia, leukopenia, granulocytopena. Messing up DHF reductase so messes up normal cells. Help with folinic acid.
26
Dapsone treats
Lepromatous leprosy. Similar to sulfonamides
27
Sulfonamides are toxic to
Kidneys. Tubulointerstitial nephritis. Also cause kernicterus in infants by displacing other stuff from albumin!
28
No fluoroquinolones in what young population ? Why?
None in pregnant woman bc possible damage to cartilage
29
No fluoroquinolones in old people because?
can cause tendonitis or tendon rupture
30
Daptomycin is great but can mess up?
Muscles - myopathy or rhabdomyolysis
31
Daptomycin is useless In?
Pneumonia bc surfactant takes it up and inactivates it
32
Daptomycin only for what kind of bacteria why?
Only for gram positive cocci. Bc can't get through an outer membrane. Essentially aggregates in a membrane and causes it to leak
33
Metranidazole is awesome because
It creates free radical metabolites inside of bacterial and protozoa. Just can't have it when drinking alcohol.
34
Dapsone vs daptomycin
Dapsone is a drug like a sulfonamide used for leprosy. Daptomycin is great for many resistant gram positive because it destroys cell membranes
35
Rifamycin + dapsone is great because
the riamyson delays resistance to dapsone
36
Why is rifambutin better than rifampin for HIV patients with TB
Rifambutin doesn't rifAMP the cyp450 system
37
What does isoniazid rely on?
Relies on KatG a gene that encodes catlase peroxidase needed to activate isoniazid
38
Isoniazid is a problem becasue
Its neurotoxic and hepatotoxic but you give B6
39
What is the advantage of pyrazinamide over other antimycobacterials
It needs an acidic environment to work so works great to hit the TB that are in macrophages
40
RIPE complications
Rifampin - red orange pee. Cyp450 rifAMP Isoniazid - neurotox (B6) hepatotox Pyrazinamide - hyperuricemia, hepatotox Ethambutol - optic neuropathy = color blind
41
What do you hit VRE with
LInezolid or streptogramins = quinipristin and dalfopristin
42
What do you hit multidrug resistant pseudo and acinebacter
polymixins B and E (polymixin E is colistin)
43
Rifampin hits what part of cells
RNA polymerase
44
AmpoB is bad because
Nephrotoxic. Messes up electrolytes especially hypoK and hypoMg. Get anemia from decreased EPO. IV thrombophlebitis. Many of toxic effects are because it binds to cholesterol in human cells and causes disruption. AKA kidney.
45
Azoles work by
Inhibiting cyp450 and prevent ergosterol sytnhesis. Also inhibit this enzyme in the human liver!
46
Which azole for systemic mycosis?
Itraconazole
47
Which azole for topical fungal
Clotrimazole and miconazole
48
Azole for candida infections and crypto suppression
Fluconazole
49
What is terbinafine for
Dermatophytoses
50
Terbinafine affects what sensation
Taste
51
Echinocandins inhibit synthesis of?
B glucan
52
Griseofulvin used for
dermatophytes. Messes up microtubules
53
Griseofulvin is a dirty drug and causes
Induces Cyp450. Teratogen, carcinomgen,
54
Suramin and melarsoprol for
Trypanosoma brucei
55
Nfiurtimox for
T cruzi
56
Sodium stibogluconate for
Leishmaniasis
57
Pyrimethamine for
toxoplasmosis
58
How does chloroquine work
It prevents detox of heme so heme builds up and kills plasmodium
59
artemether/lumefantrine for?
P falciparum
60
Atovaquone proguanil for
P falciparum
61
LIfe threatening malaria treat with
Quinidine or artesunate
62
For herpes zoster use
Famciclovir
63
Side effect of cyclovirs
Obstructive crystalline nephropathy -> acute renal failure
64
ganciclovir problems?
Lueko, neutro, thrombopenia. Renal toxic. Seems to be worse than acyclovir. Don't use with other immunosuppression drugs
65
Why do aids viral infections need special drugs
Their CMV and HSv get thymidine kinase deficiency virus so can't rely on acyclovir or ganciclovir
66
foscarnet problems?
Get weird electrolyte abnormalities hypo/hyper Ca. hypohyper phos. hypoK hypoMg. chelate Ca leads to renal wasting. The low Mag inhibits PTH preventing calcium absorption.
67
foscarnet for?
CMV in aids patients and HSV that is acyclovir resistant
68
How do you reduce cidofovir toxicity
give with probenecid and IV saline
69
How are cidofovir and foscarnet similar
Both inhibit viral DNA polymerase. Cidofovir only needs cellular kinase. Foscarnet also does RNA polymerase and HIV reverse transcriptase.
70
Foscarnet mechanism
Its a pyrofosphate analog that binds to pyrophosphage-binding site of enzymes
71
Major protease inhibitor side effect is?
Effects on the gut. get lipodystrophy and hyperglycemia. ALso GI intolerance
72
Why is ritonavir so great
It boosts the other drugs by being a cyp450 inhibitor
73
What is unique about tenofovir
Only nucleotide. All other NRTIs are nucleosides and must be phosphorylated to be active
74
what is safest NRTI
Lamuvidine because cytosine analog
75
Major side effect of ziduvodine
anemia
76
What NRTI causes pancreatitis
Didanosine
77
All NRTIs cause?
Bone marrow suppression that can be reversed with GCSF
78
Why are NNRTIs better than NRTIs
Bind at different site. Don't need to be phosphorylated
79
What drug causes vivid dreams and CNS symptoms (HIV drug)
Efavirenz a NNRTI
80
List three NNRTI
Efavirenz, Delaviridine, Nevirapine
81
What does Maraviroc bind to
CCR-5 on T cell surface preventin gbinding with gp120
82
IFN Beta is for?
Multiple sclerosis
83
IFN gamma is for/
chronic granulomatous disease
84
Ribavirin used for what two disease
HCV and RSV. It inhibits synthesis of guanine nucleotides by comp inhiiting IMP dehydrogenase
85
How does simeprevir work
a HCV protease inhibitor
86
How does Sofosbuvir work
Inhibits HCV RNA dependent RNA Polymerase. chain terminate.
87
disinfection vs sterilization
disinfection is reducing counts to safe level. Sterilization = remove self-propagating biological entities
88
Main sporicidal infection control
Autoclave (may be), hydrogen peroxide, Iodine and iodophors.
89
Sulfonamides in pregnancy cause
kernicterus
90
clarithryomycin in pregnancy
embryotoxic
91
aminoglycosides in pregnancy
ototoxicity

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