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My Step 1 > Antibiotics > Flashcards

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
Q

trimethoprim expected side effect

A

Causes megaloblastic anemia, leukopenia, granulocytopena. Messing up DHF reductase so messes up normal cells. Help with folinic acid.

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26
Q

Dapsone treats

A

Lepromatous leprosy. Similar to sulfonamides

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27
Q

Sulfonamides are toxic to

A

Kidneys. Tubulointerstitial nephritis. Also cause kernicterus in infants by displacing other stuff from albumin!

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28
Q

No fluoroquinolones in what young population ? Why?

A

None in pregnant woman bc possible damage to cartilage

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29
Q

No fluoroquinolones in old people because?

A

can cause tendonitis or tendon rupture

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30
Q

Daptomycin is great but can mess up?

A

Muscles - myopathy or rhabdomyolysis

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31
Q

Daptomycin is useless In?

A

Pneumonia bc surfactant takes it up and inactivates it

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32
Q

Daptomycin only for what kind of bacteria why?

A

Only for gram positive cocci. Bc can’t get through an outer membrane. Essentially aggregates in a membrane and causes it to leak

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33
Q

Metranidazole is awesome because

A

It creates free radical metabolites inside of bacterial and protozoa. Just can’t have it when drinking alcohol.

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34
Q

Dapsone vs daptomycin

A

Dapsone is a drug like a sulfonamide used for leprosy. Daptomycin is great for many resistant gram positive because it destroys cell membranes

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35
Q

Rifamycin + dapsone is great because

A

the riamyson delays resistance to dapsone

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36
Q

Why is rifambutin better than rifampin for HIV patients with TB

A

Rifambutin doesn’t rifAMP the cyp450 system

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37
Q

What does isoniazid rely on?

A

Relies on KatG a gene that encodes catlase peroxidase needed to activate isoniazid

38
Q

Isoniazid is a problem becasue

A

Its neurotoxic and hepatotoxic but you give B6

39
Q

What is the advantage of pyrazinamide over other antimycobacterials

A

It needs an acidic environment to work so works great to hit the TB that are in macrophages

40
Q

RIPE complications

A

Rifampin - red orange pee. Cyp450 rifAMP
Isoniazid - neurotox (B6) hepatotox
Pyrazinamide - hyperuricemia, hepatotox
Ethambutol - optic neuropathy = color blind

41
Q

What do you hit VRE with

A

LInezolid or streptogramins = quinipristin and dalfopristin

42
Q

What do you hit multidrug resistant pseudo and acinebacter

A

polymixins B and E (polymixin E is colistin)

43
Q

Rifampin hits what part of cells

A

RNA polymerase

44
Q

AmpoB is bad because

A

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
Q

Azoles work by

A

Inhibiting cyp450 and prevent ergosterol sytnhesis. Also inhibit this enzyme in the human liver!

46
Q

Which azole for systemic mycosis?

A

Itraconazole

47
Q

Which azole for topical fungal

A

Clotrimazole and miconazole

48
Q

Azole for candida infections and crypto suppression

A

Fluconazole

49
Q

What is terbinafine for

A

Dermatophytoses

50
Q

Terbinafine affects what sensation

51
Q

Echinocandins inhibit synthesis of?

52
Q

Griseofulvin used for

A

dermatophytes. Messes up microtubules

53
Q

Griseofulvin is a dirty drug and causes

A

Induces Cyp450. Teratogen, carcinomgen,

54
Q

Suramin and melarsoprol for

A

Trypanosoma brucei

55
Q

Nfiurtimox for

56
Q

Sodium stibogluconate for

A

Leishmaniasis

57
Q

Pyrimethamine for

A

toxoplasmosis

58
Q

How does chloroquine work

A

It prevents detox of heme so heme builds up and kills plasmodium

59
Q

artemether/lumefantrine for?

A

P falciparum

60
Q

Atovaquone proguanil for

A

P falciparum

61
Q

LIfe threatening malaria treat with

A

Quinidine or artesunate

62
Q

For herpes zoster use

A

Famciclovir

63
Q

Side effect of cyclovirs

A

Obstructive crystalline nephropathy -> acute renal failure

64
Q

ganciclovir problems?

A

Lueko, neutro, thrombopenia. Renal toxic. Seems to be worse than acyclovir. Don’t use with other immunosuppression drugs

65
Q

Why do aids viral infections need special drugs

A

Their CMV and HSv get thymidine kinase deficiency virus so can’t rely on acyclovir or ganciclovir

66
Q

foscarnet problems?

A

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
Q

foscarnet for?

A

CMV in aids patients and HSV that is acyclovir resistant

68
Q

How do you reduce cidofovir toxicity

A

give with probenecid and IV saline

69
Q

How are cidofovir and foscarnet similar

A

Both inhibit viral DNA polymerase. Cidofovir only needs cellular kinase. Foscarnet also does RNA polymerase and HIV reverse transcriptase.

70
Q

Foscarnet mechanism

A

Its a pyrofosphate analog that binds to pyrophosphage-binding site of enzymes

71
Q

Major protease inhibitor side effect is?

A

Effects on the gut. get lipodystrophy and hyperglycemia. ALso GI intolerance

72
Q

Why is ritonavir so great

A

It boosts the other drugs by being a cyp450 inhibitor

73
Q

What is unique about tenofovir

A

Only nucleotide. All other NRTIs are nucleosides and must be phosphorylated to be active

74
Q

what is safest NRTI

A

Lamuvidine because cytosine analog

75
Q

Major side effect of ziduvodine

76
Q

What NRTI causes pancreatitis

A

Didanosine

77
Q

All NRTIs cause?

A

Bone marrow suppression that can be reversed with GCSF

78
Q

Why are NNRTIs better than NRTIs

A

Bind at different site. Don’t need to be phosphorylated

79
Q

What drug causes vivid dreams and CNS symptoms (HIV drug)

A

Efavirenz a NNRTI

80
Q

List three NNRTI

A

Efavirenz, Delaviridine, Nevirapine

81
Q

What does Maraviroc bind to

A

CCR-5 on T cell surface preventin gbinding with gp120

82
Q

IFN Beta is for?

A

Multiple sclerosis

83
Q

IFN gamma is for/

A

chronic granulomatous disease

84
Q

Ribavirin used for what two disease

A

HCV and RSV. It inhibits synthesis of guanine nucleotides by comp inhiiting IMP dehydrogenase

85
Q

How does simeprevir work

A

a HCV protease inhibitor

86
Q

How does Sofosbuvir work

A

Inhibits HCV RNA dependent RNA Polymerase. chain terminate.

87
Q

disinfection vs sterilization

A

disinfection is reducing counts to safe level. Sterilization = remove self-propagating biological entities

88
Q

Main sporicidal infection control

A

Autoclave (may be), hydrogen peroxide, Iodine and iodophors.

89
Q

Sulfonamides in pregnancy cause

A

kernicterus

90
Q

clarithryomycin in pregnancy

A

embryotoxic

91
Q

aminoglycosides in pregnancy

A

ototoxicity

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