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Bacteriology Lectures > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Beta Lactam Goups

A

Penicillins, Cephalosporins, Monobactams, Carbapenems

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2
Q

General Beta Lactam MOA

A

Inhibits transpeptidation

activates autolysin in cell wall

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3
Q

Beta Lactam Resistance

A

Beta-lactamases

Lack PBP (transpeptidase)

Autolysin mutations

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4
Q

Beta-Lactam side effects

A
  • *Allergy** (pen>ceph>mono)
  • *Toxicity**
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5
Q

How to most effectively use beta lactams?

A

Use with beta lactamase inhibitors

Clavulanic acid

Sulbactam

Tazobactam

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6
Q

Penicillin method of delivery

A

Injection

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7
Q

Acid resistant penicillins best against ______

A

Gram +

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8
Q

Acid resistant penicillins

A

Amoxicillin

PenV

Oxacillin

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9
Q

Expanded spectrum penicillins

A

Ampicillin

Piperacillin

Mezlocillin

Ticarcillin

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10
Q

These penicillins are resistant to beta lactamase but have _____ activity

A

These have lower activity

Nafcillin

Oxacillin

Cloxacillin

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11
Q

Common pairs for penicillin

A

Augmentin (Amox + CA)

Ampicillin + Sulbactam

Zosyn, Tazomed (Piperacillin + tazobactam

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12
Q

1st gen Cephs (Properties and Rx)

A

G +, Prophylaxis only

Cephalexin, Cephalothin, Cefazolin

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13
Q

2nd gen cephs (use and Rx)

A

Gram + and -

Used for bacterioides and not pseudomonas

Cefalcor, cefuroxime, cefoxitin

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14
Q

3rd gen ceph (use and Rx)

A

Gram + and -

Use for pseudomonas – **Penetrates CNS (avoid overuse)

Ceftazidine, Cefotaxime, Ceftriaxone

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15
Q

4th gen ceph (use and Rx)

A

Expanded spectrum

Cefepime

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16
Q

5th gen ceph (use and Rx)

A

MRSA and drug-resistant Staph Pneumoniae

Cephtaroline

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17
Q

Monobactams are resistant to ______

A

beta lactamases

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18
Q

Monobactams used for _____

A

Gram (-) only

*no anaerobes

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19
Q

Monobactam Rx

A

Aztreonem

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20
Q

Carbapenems use and Rx

A

Broad spec for Gram + and -

Imipenem, Meropenem

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21
Q

Monobactam structure

A

monocyclic beta lactam ring

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22
Q

Bacitracin MOA and use

A

Blocks dephosphorylation of bactoprenol

Use synergistically for Gram +

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23
Q

Bacitracin side effects

A

Poor absorption

Renal toxicity

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24
Q

Glycopeptides MOA

A

Blocks transglycosylation and transpeptidation

*binds to terminal amino acid

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25
Glycopeptides use
Used for _Staphylococci_ and _Enterococci_ **Not** for Gram -
26
Glycopeptide resistance
**Ala-Lactate** at the end instead of **Ala-Ala** on pentapeptide \*Chromosomal genes for VanB, Plasmid genes for VanA
27
Glycopeptide Rx
**Vancomycin, Telavancin**
28
Cycloserine MOA
**D-Ala** analog inhibits ALA Racemase
29
Cycloserine use
UTI 2nd line Tx for TB
30
Cycloserine side effects
Neurotoxic (seizures)
31
Isoniazid & Ethionamide use and MOA
Used for _Mycobacterium_ **Inhibits pyridoxine step** in myoclic acid synthesis
32
Isoniazid & Ethionamide taken with \_\_\_\_\_\_\_? Why?
_Pyridoxine_ Inhibits host B6
33
Ethambutol use and MOA
Used for _Mycobacterium_ Inhibits **arabinosyl transferase** (stops synth of *arabinogalactan*)
34
Ethambutol resistance
Rapid! Use synergistically
35
Pyrazinamide Use and MOA
Used for Mycobacterium Activated by Pyrazinamase from MB, **Inhibits _trans-translation_**
36
Drugs to use for confirmed Mycobacterium infection
Pyrazinamide, Ethambutol, Isoniazid & Ethionamide + Rifampin
37
Polymyxins MOA
Dissolve _phosphatidylethanolamine_ in Gram - membrane \*\*also in host!
38
Polymyxins Sides
Renal toxicity | (use topically or as a last resort)
39
Polymyxins are synergistic with ______ and \_\_\_\_\_\_\_?
Bacitracin + Neosporin
40
Daptomycin structure and MOA
Cyclic lipopeptide Dissolves in membrane to **disrupt membrane potential**
41
Daptomycin use and Rx
USed for _Gram +_ cocci, **_MRSA_** **Cubicin**
42
Daptomycin delivery It's synergistic with \_\_\_\_\_
Given intravenously Synergistic with Beta Lactams
43
Sulfonamides MOA and use
Inhibits PABA --\> DHF -\> THF -\> Pyrimidines Used for **Nocardia** (still susceptible)
44
SxT synergistic for \_\_\_\_\_\_
UTI, Salmonella, Shigellla
45
Sulfonamides Resistance
_PABA overproduction_ | (altered enzymes)
46
Fluoroquinolones MOA and Rx
Inhibit _DNA gyrase_ ## Footnote **Ciprofloxacin, Moxifloxacin**
47
Fluoroquinolones Resistance
Mutated DNA gyrase Drug exclusion
48
Fluoroquinolones solublility? How do we deal with this?
It is NOT very soluble, so it is fluorinated for UTI treatment
49
Fluoroquinolones use
Gram - or + Mycobacterium (2nd line) Pseudomonas
50
Fidaxomycin MOA and properties
Targets "switch region" of _RNA Polymerase_ (no DNA) Minimally absorbed, Narrow Spectrum
51
Fidaxomycins Rx
Dificid
52
Fidaxomycins use
Alternative to Vancomycin for VanR C.diff
53
Rifamycin MOA
Blocks RNA polymerase elongation subunit
54
Rifamycin use and Rx
Blocks _Poxvirus_ assembly Used for _Meningitis_ b/c it enters CNS Used for _Mycobacterium_ **Rifampin**
55
Rifamycin resistance
Mutation in _Beta subunit_ of RNApol
56
Rifamycin sides
Excreted in sweat and urine (orange)
57
Rifamycin used with _____ to do what?
_Isoniazid_ to delay resistance in mycobacterium
58
Metronidazole structure and MOA
Partially reduced complex with ferredoxin _breaks DNA_ (free radical)
59
Metronidazole use
Used against _anaerobic_ bacteria *(bacterioides, clostridium)* _Antiprotozoal_ *(Giardia)*
60
Aminoglycosides MOA and Rx
Binds _30S subunit_ (blocks initiation-- no tRNA-fMet) ## Footnote **streptomycin, neomycin, gentamycin, tobramycin, amikacin**
61
Aminoglycosides resistance
Altered _P12_ ribosomal protein _Aminoglycosidases_ Altered _permeability_ of drug
62
Aminoglycosides uses Synergistic with \_\_\_\_\_\_\_
Used for _G- enterics_ Synergistic with Cephalosporins or Penicillins
63
Tetracycline MOA and Rx
Inhibits binding of aa-tRNA to A-site of ribosome (30S subunit) Doxycycline, Tigecycline
64
Tetracycline resistance
Efflux pumps
65
Tetracycline sides
Toxicity Dizziness Tinnitus Fluorescent teeth Newborn bone damage replace flora
66
Tetracycline uses
Rickettsia Chlamydia Mycoplasmas
67
Chloramphenicol MOA
Inhibits peptidyl-transferase reaction | (50S)
68
Chloramphenicol resistance
Chloramphenicol Acetyl-Transferase | (CAT)
69
Chloramphenicol uses
No longer a drug of choice because of resistance and toxicity
70
Macrolides MOA and Rx
Binds to rRNA and inhibits translocation (50S) ## Footnote **Clarithromyicn, Erythromycin, Azythromycin**
71
Macrolide resistance
Methylation of rRNA
72
Macrolide use
Used for Gram + and *some* Gram -
73
Lincosamides MOA and Rx
Binds to rRNA and inhibits translocation ## Footnote **Clindomycin**
74
Lincosamides resistance
Long term use carries risk for C. diff colonization
75
Lincosamides use
Used for anaerobes (bacterioides) Anti-malarial NOT to CNS
76
Nitrofurantoin MOA and use
Inhibits 30S Use for UTI (concentrates in urine)
77
Mupirosin MOA
\*\*Inhibits ISOLEUCINE-tRNA synthase (important?)
78
Mupirosin use
Topical use for Gram+ MRSA
79
Streptogramins MOA and use
Inhibits 50S Use for VRE and VRSA
80
Streptogramin combo
quinupristin + dalfopristin
81
Oxazolidinones MOA, use and Rx
_Inhibit 50S_ Use for *VRE* and *VRSA* **Linezolid**
82
Methenamine MOA and use
Releases **formaldehyde** in acidified urine for _UTI_ --\> cross links proteins

Bacteriology Lectures (14 decks)

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