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Step 1 AB > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Mechanism of Penicillin ABx

A

Bind Penicillin binding proteins (transpeptidases)
Block transpeptidase cross linking of peptidoglycan cell wall
Activate autolytic enzymes

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2
Q

Clinical use of Penicillin G (IV) and V (oral)

A

Gram positives

Syphilis (spirochetes)

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3
Q

S/E of Penicillin G and V

A

Hypersensitivity

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4
Q

Mechanism of resistance to Penicillin G/V

A

Penicillinase in bacteria (B lactamase that cleaves B lactam ring)

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5
Q

Which penicillin ABx is used for the following?

a. Syphilis
b. UTI
c. Pseudomonas
d. Neonatal infection

A

a. Penicillin G
b. Amoxicillin
c. Ticarcillin, Piperacillin
d. Ampicillin (plus Gentamicin)

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6
Q

Patient with mononucleosis is given a drug and develops full body rash. What were they given?

A

Amoxicillin

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7
Q

Which has greater oral bioavailability; Amoxicillin or Ampicillin?

A

Amoxicillin has greater oral bioavailability

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8
Q

Penicillinase-resistant Penicillins

A

Nafcillin, Oxacillin, Dicloxacillin

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9
Q

Clinical use for Penicillinase-resistant Penicillins

A

Staph aureus

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10
Q

Anti-pseudomonal Penicillins

A

Piperacillin, Ticarcillin

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11
Q

Beta lactamase inhibitors

A

Clavulonic acid
Tazobactam
Sulbactam

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12
Q

Organisms NOT covered by Cephalosporins (LAME)

A

Listeria
Atypicals (Chlamydia, Mycoplasma)
MRSA
Enterococci

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13
Q

Clinical use of:

a. 1st generation Cephalosporins
b. 2nd gen Cephalosporins
c. 3rd gen Cephalosporins
d. 4th gen Cephalosporins

A

a. Gram positives, Proteus, E. coli, Klebsiella (UTI, URI, Prophylaxis for Viridans strep endocarditis, prior to surgery)
b. Gram positives, PEcK plus H. influenzae, Enterobacter, Neisseria, Serratia
c. Serious gram negative infections; Ceftriaxone - meningitis, gonorrhea, Lyme disease; Ceftazidime - Pseudomonas
d. Cefepime - Pseudmonas, broad coverage

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14
Q

S/E of Cephalosporins

A

Disulfiram like reaction
Vit K deficiency
Cross reactivity with Penicillins = Hypersensitivity
Increased nephrotoxicity with Aminoglycosides

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15
Q

ABx to avoid in pregnancy

A 
Tetracyclines - discolored teeth and inhibits bone growth
Fluoroquinolones - cartilage rupture
Aminoglycosides - nephro/oto toxicity
Clarithromycin - Embryotoxic
Sulfonamides - Kernicterus
Metronidazole - Mutagenesis
Ribavirin - Teratogenic
Griseofulvin - Teratogenic
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16
Q

Why is Imipenem administered with Cilastatin?

A

Cilastatin inhibits renal dehydropeptidase I to decrease the inactivation of Imipenem in renal tubules

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17
Q

Use of Carbapenems

A

WIDE spectrum

Does NOT cover MRSA

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18
Q

S/E of Carbapenems

A

Significant side effects

Seizures and CNS toxicity at high levels

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19
Q

Use of Aztreonam

A

Gram negative rods ONLY; for Penicillin allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides

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20
Q

Mechanism of Vancomycin

A

Binds D-ala-D-ala portion of cell wall precursors and inhibits cell wall peptidoglycan formation

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21
Q

Use of Vancomycin

A

MRSA, C. difficile (oral)

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22
Q

S/E of Vancomycin

A

Nephrotoxic, Ototoxic, Thrombophlebitis, Red man syndrome

23
Q

Cause of Red Man Syndrome

A

When taking Vancomycin there is nonspecific mast cell degranulation causing widespread release of histamine and diffuse flushing

24
Q

Protein synthesis inhibitor Abx

A

Buy AT 30, CCEL at 50
Aminoglycosides
Tetracycline

Chloramphenicol
Clindamycin
Erythromycin - Macrolides
Linezolid

25
Mechanism of Aminoglycosides
Binds 30s subunit and causes misreading of RNA | REQUIRES 02 FOR UPTAKE
26
Use of Aminoglycosides
Gram negative rods (Neonatal infections) | Neomycin for bowel surgery
27
Why are Aminoglycosides not effective against anaerobes?
They require O2 for uptake
28
S/E of Aminoglycosides
Nephrotoxicity (worse with Cephalosporins), Ototoxicity, Teratogen
29
Mechanism of Tetracyclines
Binds 30s subunit and prevents attachment of amino-acyl tRNA
30
What should you avoid while taking Tetracyclines?
Milk (Calcium) , Antacids (Calcium or Mg), Iron - they disrupt absorption of the drug
31
Clinical use of Tetracyclines (VACUUM The BedRoom)
``` Vibro cholera Acne Chlamydia Ureaplasma Tularemia Mycobacterium pneumoniae Borrelia Rickettsia ```
32
Why are Tetracyclines effective against Rickettsie and Chlamydia?
They can accumulate intracellularly.
33
S/E of Tetracycline
Discoloration of teeth Inhibition of bone growth Photosensitivity
34
S/E of Chloramphenicol (and cause of this)
Gray baby syndrome - they lack UDP glucuronyl transferase
35
S/E of Clindamycin
Pseudomembranous colitis
36
Use of Linezolids
MRSA | VRE
37
Mechanism of Macrolides
Erythromycin, Clarithromycin, Azithromycin - they bind 23sRNA of 50s subunit and block translocation
38
Use of Macrolides
Atypical pneumonias (Mycoplasma, Legionella, Chlamydia) STIs (Chlamydia) URIs B. pertussis
39
Toxicity of Macrolides
Motility issues, Arrhythmia caused by long QT, acute Cholestatic hepatitis, Rash, Eosinophilia Increases serum concentration of theophylline and anticoagulants Clarithryomycin and Erythromycin inhibits p450 enzymes
40
Mechanism of Trimethoprim
Inhibits dihydrofolate reductase
41
Use of Trimethoprim
Used in combo with Sulfonamides for UTIs, Shigella, Salmonella, PCP prophylaxis and treatment, Toxoplasmosis prophylaxis
42
Sulfonamides mechanism
Inhibits folate synthesis (PABA antimetabolites inhibit dihydropteroate synthase)
43
Sulfa drugs (Sulfa Pills Frequently Cause Terrible Acute Symptoms)
``` Sulfasalazine Probenecid Furosemide Celecoxib Thiazides/TMP-SMX Acetazolamide Sulfonylureas ```
44
Mechanism of Nitrofurantoin
Reduced by bacterial proteins to a reactive intermediate that inactivates bacterial ribosomes
45
Use for Nitrofurantoin
UTI cystitis by E. coli or Staph saprophyticus | Safe in pregnancy
46
Mechanism of Fluoroquinolones
Inhibits prokaryotic enzymes topoisomerase II (DNA gyrase) and IV
47
What can you not take while taking Fluoroquinolones?
Antacids - inhibits absorption
48
S/E of Daptomycin
Myopathy, Rhabdomyolysis
49
Why is Daptomycin NOT used for pneumonia?
It avidly binds and is inactivated by Surfactant
50
Mechanism of Daptomycin
Disrupts cell membrane
51
Mechanism of Metronidazole
Forms toxic free radical metabolites in bacterial cell that damage DNA - ANTIprotozoal
52
Use of Metronidazole
``` Giardia Entamoeba Trichomonas Gardnerella vaginalis Anaerobes H. pylori ```
53
S/E of Metronidazole
Disulfiram like reaction (flushing, tachycardia, hypotension) with alcohol

Step 1 AB (29 decks)

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