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Step 1 Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Class and MOA of penicillin?

A

Beta-lactam which blocks transpeptidase cross-linking of peptidoglycan in cell wall.

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2
Q

Penicillin is used for which organisms?

A

Gram + (S. pneumoniae, S. pyogenes, Actinomyces)
Gram - cocci (N. meningitidis)
Spriochetes (T. pallidum)

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3
Q

Class and MOA of amoxicillin/ampicillin?

A

Beta-lactam which blocks transpeptidase cross-linking of peptidoglycan in cell wall

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4
Q

Amoxicillin is used against which organisms?

A

H. influenzae, H. pylori, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, Enterococci

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5
Q

Which penicillinase-resistant penicillins are effective against S. aureus (MSSA)?

A

Dicloxacillin, nafcillin, oxacillin

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6
Q

What organism is piperacillin/ticarcillin effective against?

A

Pseudomonas spp. and gram - rods

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7
Q

Name three beta-lactamase inhibitors.

A

Clavulanic acid, sulbactam, tazobactam

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8
Q

MOA of cephalosporins?

A

Beta-lactams which inhibit cell wall synthesis

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9
Q

Organisms covered by 1st generation cephalosporins?

A

Cefazolin and cephalexin

Gram + cocci, proteus mirabilis, E. coli, Klebsiella pneumonia

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10
Q

Organisms covered by 2nd generation cephalosporins?

A

Cefoxitin, cefaclor, cefuroxime

Anaerobes, Gram + cocci, H. influenzae, Enterobacter aerogenes, Neisseria spp., Proteus, E. coli, Klebsiella, Serratia

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11
Q

Organisms covered by 3rd generation cephalosporins?

A

Ceftriaxone, cefotaxime, ceftazidime
Resistant gram - organisms, borrelia burgdorferi
Ceftazidime covers pseudomonas

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12
Q

Organisms covered by 4th generation cephalosporins?

A

Cefepime

Increased activity against gram + including pseudomonas

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13
Q

Organisms covered by 5th generation cephalosporins?

A

Ceftaroline
Broad gram + and gram - coverage including MRSA
Does not cover pseudomonas

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14
Q

MOA of carbapenems?

A

Inhibit peptidoglycan crosslinking

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15
Q

What should be administered with imipenem?

A

Cilastatin to decrease renal inactivation of the drug

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16
Q

Organisms covered by carbapenems?

A

Gram + cocci, gram - rods, anaerobes

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17
Q

Class and MOA of aztreonam?

A

Monobactam. Blocks peptidoglycan cross linking by linking by binding to penicillin binding protein 3. No cross allergy with penicillins.

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18
Q

MOA of vancomycin? Is it susceptible to beta-lactamases?

A

Inhibits peptidoglycan formation by binding D-ala D-ala portion of precursors. Not susceptible to beta-lactamases?

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19
Q

Organisms covered by vancomycin?

A

Gram + organisms including MRSA, S. epidermidis, some enterococcus, and C. difficile (oral administration)

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20
Q

Name six types of antibiotics that inhibit protein synthesis

A

30S inhibitors: aminoglycosides, tetracyclines

50S inhibitors: chloramphenicol, clindamycin, erythromycin, linezolid

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21
Q

Examples of aminoglycosides?

A

Gentamycin, neomycin, amikacin, tobramycin, streptomycin

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22
Q

MOA of aminoglycosides?

A

Inhibit initiation complex by binding 30S subunit

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23
Q

Organisms covered by aminoglycosides?

A

Gram - rods

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24
Q

MOA of tetracyclines?

A

Block attachment of ammoniacal-tRNA to 30S subunit

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25
Q

Organisms covered by tetracyclines?

A

Borrelia burgdorferi, mycoplasma pneumoniae, rickettsia, chlamydia

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26
Q

MOA of chloramphenicol?

A

Blocks peptidyltransferase at 50S subunit

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27
Q

Organisms covered by chloramphenicol?

A

MENINGITIS: H. influenzae, N. meningitidis, S. pneumoniae

Rickettsia rickettsii

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28
Q

MOA of clindamycin?

A

Blocks translocation/peptide transfer at 50S subunit

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29
Q

Organisms covered by clindamycin?

A

Anaerobic infections above the diaphragm (Bacteroides spp., Clostridium perfringens) and group A strep

30
Q

Class and MOA of linezolid?

A

Oxazolidinones

Blocks formation of initiation complex by binding 50S subunit

31
Q

Organisms covered by linezolid?

A

Gram + species, notably MRSA and VRE

32
Q

Examples of macrolides?

A

Azithromycin, clarithromycin, erythromycin

33
Q

MOA of macrolides?

A

Block translocation by binding 50S subunit

34
Q

Organisms covered by macrolides?

A

Atypical pneumonias (mycoplasma, chlamydia, legionella), STI’s (chlamydia), gram + cocci, B. pertussis

35
Q

Two antimetabolite antibiotics?

A

Trimethoprim and sulfonamides

36
Q

MOA of trimethoprim?

A

Inhibits bacterial dihydrofolate reductase to inhibit nucleic acid synthesis

37
Q

MOA of sulfonamides?

A

Para-aminobenzoic acid antimetabolites inhibit dihydropteroate synthase

38
Q

Organisms covered by TMP-SMX?

A

S. pneumoniae, H. influenzae, UTIs (E. coli), shigella, salmonella, pneumocystis jirovecii, toxoplasmosis prophylaxis

39
Q

Organisms covered by sulfonamides?

A

Sulfamethoxazole, sulfisoxazole, sulfadiazine

Gram +, gram -, Nocardia, Chlamydia

40
Q

Examples of fluoroquinolones?

A

Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin

41
Q

MOA of fluoroquinolones?

A

Inhibit prokaryotic enzymes topoisomerase II and IV

42
Q

Organisms covered by fluoroquinolones?

A

Gram - rods of GU and GI tracts, Pseudomonas, Neisseria, some gram + organisms

43
Q

MOA of daptomycin?

A

Lipopeptide that disrupts cell membrane of gram + cocci

44
Q

What organisms does daptomycin cover? In what organ is it ineffective?

A

S. aureus skin infections (MRSA), bacteremia, endocarditis, VRE
Inactivated by surfactant, ineffective against pneumonia

45
Q

MOA of metronidazole?

A

Forms free radical metabolites that damage DNA

46
Q

What organisms are covered by metronidazole?

A

Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, anaerobes (Bacteroides, C. difficile), H. pylori

47
Q

Drugs used to treat TB?

A

Rifampin, Isoniazid, Pyrazinamide, Ethambutol

Prophylaxis: isoniazid

48
Q

Drugs used to treat M. avium-intracellulare?

A

Azithromycin or clarithromycin + ethambutol

49
Q

Treatment for lepromatous leprosy? Tuberculoid?

A

Lepromatous: dapsone, rifampin, clofazimine
Tuberculoid: dapsone, rifampin

50
Q

MOA of rifampin?

A

Inhibits DNA-dependent RNA polymerase

51
Q

What is rifampin used as prophylaxis for?

A

Meningococcal prophylaxis and chemoprophylaxis in contacts of children with HIB

52
Q

MOA of isoniazid?

A

Decrease synthesis of mycolic acids needed for cell wall.

53
Q

What bacterial enzyme does isoniazid require?

A

Bacterial catalase peroxidase converts it to an active metabolite

54
Q

MOA of ethambutol?

A

Blocks arabinosyltransferase which decreases carbohydrate polymerization in mycobacterium cell wall

55
Q

Prophylaxis for endocarditis before procedures?

A

Amoxicillin

56
Q

Prophylaxis for gonorrhea exposure?

A

Ceftriaxone

57
Q

Prophylaxis for recurrent UTI?

58
Q

Prophylaxis for pregnant women with GBS?

A

Penicillin G

59
Q

Prophylaxis for gonococcal conjunctivitis in newborn?

A

Erythromycin ointment

60
Q

Prevention of post surgical infection due to S. aureus?

61
Q

Prophylaxis of strep pharyngitis with hx of rheumatic fever?

A

Benzathine penicillin G, oral penicillin V

62
Q

Prophylaxis for syphilis exposure?

A

Benzathine penicillin G

63
Q

Antibiotics that cover pseudomonas?

A

Extended-spectrum beta-lactams, cefepime, ceftazidime, carbapenems, aztreonam, coprofloxacin, aminoglycosides, polymixins

64
Q

Antibiotics that cover MDR pseudomonas and MDR acinetobacter?

A

Polymyxins B and E (colistin)

65
Q

Antibiotics that cover MRSA?

A

Vancomycin, daptomycin, linezolid, tigecycline, ceftaroline

66
Q

Antibiotics that cover VRE?

A

Linezolid, streptogramins (quinupristin, dalfopristin), daptomycin, tigecycline

67
Q

Prophylaxis for HIV?

A

CD4 < 200: TMP-SMX for pneumocystis pneumonia
CD4 < 100: TMP-SMX for toxoplasmosis
CD4 < 50: azithromycin/clarithromycin for MAC

68
Q

Antibiotics that cover anaerobes?

A

Penicillins with a beta-lactamase inhibitor (augmented, unasyn, zosyn), second-generation cephalosporins, carbapenems, chloramphenicol, clindamycin, metronidazole, moxifloxacin, tigecycline

69
Q

Best antibiotic for broad spectrum gram negative coverage?

A

Aztreonam. Fluoroquinolones are also good for gram -

70
Q

What major bugs does tigecycline cover?

A

MRSA and VRE

71
Q

What does quinupristin/dalfopristin cover?

A

Vancomycin resistent enterococcus faecium (not faecalis), MRSA, group A strep infections

Step 1 Pharmacology (4 decks)

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