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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
Q

Mechanism of Aminoglycosides

A

Binds 30s subunit and causes misreading of RNA

REQUIRES 02 FOR UPTAKE

26
Q

Use of Aminoglycosides

A

Gram negative rods (Neonatal infections)

Neomycin for bowel surgery

27
Q

Why are Aminoglycosides not effective against anaerobes?

A

They require O2 for uptake

28
Q

S/E of Aminoglycosides

A

Nephrotoxicity (worse with Cephalosporins), Ototoxicity, Teratogen

29
Q

Mechanism of Tetracyclines

A

Binds 30s subunit and prevents attachment of amino-acyl tRNA

30
Q

What should you avoid while taking Tetracyclines?

A

Milk (Calcium) , Antacids (Calcium or Mg), Iron - they disrupt absorption of the drug

31
Q

Clinical use of Tetracyclines (VACUUM The BedRoom)

A 
Vibro cholera
Acne
Chlamydia
Ureaplasma
Tularemia
Mycobacterium pneumoniae
Borrelia
Rickettsia
32
Q

Why are Tetracyclines effective against Rickettsie and Chlamydia?

A

They can accumulate intracellularly.

33
Q

S/E of Tetracycline

A

Discoloration of teeth
Inhibition of bone growth
Photosensitivity

34
Q

S/E of Chloramphenicol (and cause of this)

A

Gray baby syndrome - they lack UDP glucuronyl transferase

35
Q

S/E of Clindamycin

A

Pseudomembranous colitis

36
Q

Use of Linezolids

A

MRSA

VRE

37
Q

Mechanism of Macrolides

A

Erythromycin, Clarithromycin, Azithromycin - they bind 23sRNA of 50s subunit and block translocation

38
Q

Use of Macrolides

A

Atypical pneumonias (Mycoplasma, Legionella, Chlamydia)
STIs (Chlamydia)
URIs
B. pertussis

39
Q

Toxicity of Macrolides

A

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
Q

Mechanism of Trimethoprim

A

Inhibits dihydrofolate reductase

41
Q

Use of Trimethoprim

A

Used in combo with Sulfonamides for UTIs, Shigella, Salmonella, PCP prophylaxis and treatment, Toxoplasmosis prophylaxis

42
Q

Sulfonamides mechanism

A

Inhibits folate synthesis (PABA antimetabolites inhibit dihydropteroate synthase)

43
Q

Sulfa drugs (Sulfa Pills Frequently Cause Terrible Acute Symptoms)

A 
Sulfasalazine
Probenecid
Furosemide
Celecoxib
Thiazides/TMP-SMX
Acetazolamide
Sulfonylureas
44
Q

Mechanism of Nitrofurantoin

A

Reduced by bacterial proteins to a reactive intermediate that inactivates bacterial ribosomes

45
Q

Use for Nitrofurantoin

A

UTI cystitis by E. coli or Staph saprophyticus

Safe in pregnancy

46
Q

Mechanism of Fluoroquinolones

A

Inhibits prokaryotic enzymes topoisomerase II (DNA gyrase) and IV

47
Q

What can you not take while taking Fluoroquinolones?

A

Antacids - inhibits absorption

48
Q

S/E of Daptomycin

A

Myopathy, Rhabdomyolysis

49
Q

Why is Daptomycin NOT used for pneumonia?

A

It avidly binds and is inactivated by Surfactant

50
Q

Mechanism of Daptomycin

A

Disrupts cell membrane

51
Q

Mechanism of Metronidazole

A

Forms toxic free radical metabolites in bacterial cell that damage DNA - ANTIprotozoal

52
Q

Use of Metronidazole

A 
Giardia
Entamoeba
Trichomonas
Gardnerella vaginalis
Anaerobes
H. pylori
53
Q

S/E of Metronidazole

A

Disulfiram like reaction (flushing, tachycardia, hypotension) with alcohol

Step 1 AB (29 decks)

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