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Antibiotics Flashcards

1
Q

penicillin mechanism

A

inactivates transpeptidase from cross-linking peptidoglycan

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2
Q

penicillin clinical use

A 
gram positive (Strep pneumo, Staph pyogenes, Actinomyces)
Gram negative (Neisseria meningitis, treponema palladium)
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3
Q

penicillin reistance mechs

A

altered penicillin binding proteins (MRSA) and beta-lacatamases

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4
Q

oxacillin, nafcillin, dicloxacillin: what are they, uses?

A

beta-lactamase resistant cause R group. use for Staph aureus except for MRSA (use naf for staph”

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5
Q

Ampicillin, amoxicillin are what?

A

extended spectrum penicillin (still penicillinase sensitive)

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6
Q

beta-lactamase inhibitors

A

Clavulanic Acid, Sulbactam, Tazobactam (CAST)

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7
Q

ampicillin amoxicilin uses

A

same as penicillin but also HELPSS: H flu, E. coli, Listeria, Proteus mirabilis, Salmonella, Shigella

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8
Q

ampicillin and amoxicillin toxicity

A

ampicillin rash, pseudomembranous colitis (C diff)

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9
Q

Ticarcillin, piperaciliin

A

anti-pseudomonals (lactamse sensitive)

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10
Q

Cephalosporin mechanism

A

they are beta lactams that are penicillinase resistant

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11
Q

1st gen cephalosporins

A

cefazolin, cephalexin

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12
Q

1st gen cephalosporin uses

A

PEcK: proteusmirabilis, E. coli, Klebsiella

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13
Q

2nd gen cephalosporin names

A

cefoxitin, cefaclor, cefuroxime

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14
Q

2nd gen cephalosporin uses

A

gram + cocci, HEN PEcKS: H flu, Enterbacter aerogenes, Neisseria, Proteus, E. coli, Klebsiella, Serratia

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15
Q

3rd gen Cephalosporins

A

ceftriaxone, cefotaxime, ceftazidime

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16
Q

3rd gen cephalosporin uses

A

serious gram negative infxns. ceftriaxone: neisseria. ceftazidime: pseudomonas

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17
Q

4th gen cephalosporin name and use

A

cefepime, pseudomonas and gram positives

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18
Q

toxicity of cephalosporins

A

vitamin k def, nephrotox when used with aminoglycosides

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19
Q

what can be used synergistically with beta-lactams?

A

aminoglycosides

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20
Q

aztreonam mech and use

A

monobactam (a beta lactam resistant to degradation). only Gram negative rods and used in patients who can tolerate other stuff cause this has low toxicity

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21
Q

Imipenem/cilastatin, meropenem mech

A

broad spectrum beta lactam that is resistant to degrad. give with cilastatin to prevent inactivation in kidneys

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22
Q

imipenem/cilastatin, meropenem use

A

kills almost everything: gram + cocci, gram - rods, and anaerobes. but lots of sides so only use in life-threatening

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23
Q

imipenem/cilastatin, meropenem tox

A

Gi distress, skin rash, CNS tox

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24
Q

vancomycin mechanism

A

inhibits cell wall synthesis by binding to D-ala D-ala portion of precursor

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25
vancomycin uses
gram + only for serious drug-reistant bugs including MRSA, Enterococci, and C diff
26
vancomycin toxicity
NOT: nephrotox, ototox, thrombophlebitis | and Redman!!! causes diffuse flushing which can be treated with antihistamine
27
vancomycin resistance
D-ala D-ala changes to D-ala D-lac
28
which drugs hit 30S vs 50S
buy AT 30, CCEL at 50 30: Aminoglycosides, tetracyclines 50: Chloramphenicol, Clindamycin, Erythromycin, Linezolid
29
Aminoglycosides (names)
GNATS: gentamicin, neomycin, amikacin, tobramycin, streptomycin
30
drug given with bowel surgery
neomycin (aminoglycoside)
31
aminoglycoside mechanism
bind 30S and inhibits formation of initiation complex and misreading of mRNA/translocation
32
aminoglycoside uptake
requires ATP and oxygen. does not kill anaerobes
33
aminoglycoside use
synergistic with beta lactams, used for severe gram - rods
34
aminoglycoside toxicity
NNOT: nephrotoxicity (worse with cephalosporine), neuromuscular blockade, otoxicity (worse with furosimide), teratogen
35
aminoglycoside resistance
transferase enzymes inactivate it by PTMs
36
aminoglycoside mneumonic
Mean (aminoglyco) GNATS (names) caNNOT (tox) kill anaerobes
37
tetracyclin names
tetracycline, doxycyclin, demeclocycline, minocycline
38
tetracycline mechanism
bind 30S to prevent attachment of aminoacyl-tRNA.
39
tetracycline clinical notes (not targets but indications)
fecally eliminated (so for renal failure), no CNS penetrance, don't take with milk/antacids/iron or it won't be absorbed.
40
tetracycline uses (bugs)
borrelia burgdorferi, Mycobacterium pneumoniae, and it accumulates intracellularly so very effective against rickettsia and chlfamydia
41
tetracycline toxicity
GI distress, discoloration of teeth and retardation of bone growht in children, photosensitivity
42
tetracycline resistance mech
decrease uptake or increase efflux
43
Macrolides (names)
Azithromycin, clarithromycin, erythromycin (-thromycin)
44
macrolide mechanism
blocks ribosome slide (macroslide) by bindings 23S of 50S
45
macrolide uses
atypical pneumonias (mycoplasma, legionella), Chlamydia, and gram + cocci (for penicillin allergy)
46
macrolide toxicities
MACRO: motility issues, arrhthymia, cholestatic hepatitis, rash, eOsinophilia. also increases theophylline/anticoag serum concentration
47
macrolide resistance mech
methylation of 23S rRNA binding site
48
Chloramphenicol mech
blocks peptidyltransferase at 50S
49
chloramphenicol use
Meningiits (H flu, N meningitidis, S pneumo). | it sucks cause of tox but is cheap as fuck
50
chloramphenicol tox
anemia (dose dependent), aplastic anemia (dose dependent), gray baby syndrome
51
Clindamycin mech
blocks peptide transfer at 50S
52
clindamycin use
anaerobic infections, aspiration pneumonia. however may cause C diff
53
treating anaerobes
above diaphram: clindamycin | below diaphram: metronidazole
54
TMP-SMX name and mech
Sulfamethoxazole-Trimethoprim. they block different steps in bacterial folate (THF to DNA) synthesis
55
sulfonamides tox
like SMX. hypersen, hemolysis in G6PD, nephrotox, phototox, kernicterus in infant, displaces other drugs from albumin
56
TMP-SMX use
UTIs, Shigella, Salmonella, Pneumocystis jiroveciii
57
Fluoroquinolones and quinolone (names)
Ciprofloxacin (all -floxacin) and the one quinolone (nalidixic acid)
58
Flouroquinolone mechanism
inhibits dna gyrase (topoisomerase II) and topoisomerase IV
59
Fluoroquinolone use
gram - rods of urinary and GI tract, pseudo, neisseria
60
Fluoroquinolone tox
tendon rupture, tendonitis, superinfxn, skin rash, gi upset
61
fluoroquinolone resistance
chromosome via DNA gyras muts, or plasmid via efflux pumps
62
metronidazole mech
forms free radicals that damage DNA
63
metronidazole uses
kills bacteria and protozoa! GET GAP: giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes, h Pylori
64
Penicillin G vs V
G is IV/IM, V is oral
65
treatment for mycobacterium tuberculosis
prophylaxis: isoniazid treatment: RIPE: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
66
Isoniazid mech
decreases mycolic acid synth. bacterial catalase-peroxidase (KatG) needed to covert to active form.
67
Isoniazid side efects
INH Injures Neurons and Hepatocytes. B6 (pyridoxine) to prevent.
68
Rifampin mechanism
inhibits DNA-dependent RNA pol
69
Rifampin uses
TB, leprosy, meningococcal/h flu prophylaxis
70
Rifampin tox
activates P-450, Orange body fluids
71
RRRRifampin
RNA pol inhib, Revs up P-450, Red/orange body fluids, Rapid resistance if used alone
72
Pyrazinamide
mech unclear, helps acidicify phagolysosome (which MB sulfatides block)
73
Ethambutol
decreasese carbohydrate polymerization in mycobacterium cell wall (arabinosyltransferase). may cause optic neuropathy/color blindness

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