Antibiotics Flashcards

1
Q

Inactivated by lung surfactant

A

daptomycin

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2
Q

Does not treat bacteremia well

A

tigecycline

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3
Q

Combo that inhibits folic acid synthesis

A

Bactrim: trimethoprim + sulfamethoxazole

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4
Q

Combo for cell wall penetration and bactericide

A

penicillin (ampicillin) + aminoglycoside

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5
Q

(3) drugs that exhibit post-antibiotic effects

A

fluoroquinolones, aminoglycosides

vancomycin

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6
Q

(4) drug classes that prevent cross-linking by inhibit transpeptidases

A

penicillins
cephalosporins
carbapenems
aztreonam

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7
Q

Drug that inhibits peptidoglycan synthetase and polymerization of linear peptide (cx w/ D-alanyl-D-ala precursor)

A

vancomycin

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8
Q

Chloramphenicol MoA

A

inhibits peptidyl transferase and peptide band formation

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9
Q

(3) drugs that inhibit 50s ribosome

A

erythromycin
clindamycin
lincomycin

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10
Q

Tetracycline MOA

A

inhib. binding of aminoacyl tRNA to ribosome; 30s

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11
Q

Streptogramins and Linezolid MOA

A

23s ribosome

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12
Q

Polymixin B and Colistin MOA

A

cationic detergents

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13
Q

Anti-fungals

A

azole and polyene antifungals

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14
Q

Rifampin MOA

A

Block initiation by binding holoenzyme

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15
Q

Fluoroquinolone MOA

A

block topoisomerase II (DNA gyrase)

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16
Q

Isoniazid and ethambutol MOA

A

inhib. lipid synthesis

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17
Q

Sulfonamides and trimethoprim MOA

A

prevents synthesis of folic acid

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18
Q

(3) Dangerous Drug Interactions

A

bactrim/erythromycin + warfarin
cipro + theophylline
linezolid + SSRIs

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19
Q

Relevant G+ microbes (3)

A

staph
strep
enterococcus

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20
Q

Piddly G- microbes (7)

A
haemophilus
moraxella
morganella
shigella
salmonella
providencia
neisseria
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21
Q

Fence G- microbes

A

PEK:
proteus
E. coli
Kleb

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22
Q

G- SPACE bugs

A
serratia
pseudomonas
acinetobacter
citrobacter
enterobacter
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23
Q

Atypical G- (3) + their associations

A

chlamydia (STD)
mycoplasma (walking pneumonia)
legionella (contaminated water towers)

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24
Q

Anaerobes (3)

A

peptostreptococcus
bacteroides
clostridium

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25
Q

Ace In the Hole

A

Aztreonam (penicillin anaphylaxis)

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26
Q

“Last Resort” Abx

A

Colistin

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27
Q

MOA of Penicillins

A

inhibition of transpeptidases, transglycosylases, D-ala carboxykinases

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28
Q

Penicillin for rheumatic fever prophylaxis

A

IM Benzathine Penacillin

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29
Q

Which penicillins are effective against penG-resistant bugs (i.e. antistaphylococcal)?

A

IV: oxacillin, nafcillin
PO: cloxacillin, dicloxacillin

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30
Q

Aminopenicillins: Drugs, Coverage, Adverse Effects

A

ampicillin, amoxicillin
strep+enterococcus+some piddly+some fence
more diarrhea b/c poor absorption (take w/ food)

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31
Q

Carboxypenicillins: Drugs, MOA, Coverage, Adverse Effects

A
ticarcillin, carbenicillin
incr. permeability of cell wall
strep, piddly/PEK, SpACE
ticarcillin: high Na load
carboxy group messes w/ platelets
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32
Q

Ureidopenicillins: Drugs, Coverage

A

piperacillin, mezlocillin

strep, enterococcus, PEK, SPACE, bacteroides

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33
Q

Zosyn

A

piperacillin + tazobactam
*most prescribed in US
additionally covers staph and anaerobes

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34
Q

Timentin

A

ticarcillin + clavulanic acid

additionally covers staph and anaerobes

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35
Q

Causes of eosinophilia

A
NAACP:
neoplasm
asthma
allergies
connective tissue
parasites
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36
Q

Adverse effects of penicillin use (general)

A

Interstitial Nephritis
Pseudomembranous Colitis (c. dif infx)
Hypersensitivity
Anaphylaxis

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37
Q

Reaches inflamed meninges at high doses

A

3rd generation cephalosporins (ceftriaxone)

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38
Q

Combo: imipenem + cilastatin

A

Prevents renal metabolism

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39
Q

Imipenem, meropenem, doripenem coverage

A

everything but atypicals (incl. enterococcus)

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40
Q

Ertapenem coverage

A

staph, strep
anaerobes
PEK

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41
Q

Aztreonam coverage

A

G- (incl. SPACE)

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42
Q

Aminoglycoside MOA

A

bind outer membrane, rearrange LPS, uptake and trap, bind 50s and 30s

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43
Q

Top 3 most prescribed aminoglycosides

A

tobramycin
gentamicin
amikacin

44
Q

PO aminoglycoside

A

neomycin

45
Q

Adverse effects of aminoglycosides

A

nephrotoxicity
ototoxicity
intx w/ neuromuscular blockades

46
Q

Aminoglycoside coverage

A

G- through SPACE

enterococcus (in combo w/ ampicillin)

47
Q

Hartford Nomogram for aminoglycosides

A

7 mg/kg

48
Q

Desired trough levels for aminoglycosides

A

less than 2 mcg/ml

49
Q

1st generation cephalosporins:

coverage and formulations

A

staph, strep, piddly
po: cephalexin
IV: cefazolin

50
Q

2nd generation cephalosporins (non-cephamycins):

coverage and formulations

A

staph, strep, h. flu, M. cat,PEK

po and IV: cefuroxime

51
Q

2nd generation cephalosporins (cephamycins):

coverage and formulations

A

staph, strep, h. flu, m. cat, PEK, anaerobes

IV: cefoxitin, cefotetan

52
Q

3rd generation cephalosporins:

coverage and formulations

A

strep, SpACE

IV: ceftriaxone

53
Q

3rd generation cephalosporins (antipseudomonal):

coverage and formulations

A

poor G+, SPACE

IV: ceftazidime

54
Q

4th generation cephalosporins:

coverage and formulations

A

staph, strep, SPACE

IV: cefepime

55
Q

5th generation cephalosporins:

coverage and formulations

A

staph (inc. MRSA), strep, [sometimes] enterococcus, SpCaE

IV: ceftaroline

56
Q

Penicillin of choice for killing enterococcus

A

ampicillin

57
Q

Augmentin

A

amoxicillin + clavulanic acid

adds staph and anaerobes

58
Q

Unasyn

A

ampicillin + sulbactam

59
Q
Vancomycin:
what conditions? (3)
coverage?
adverse effects?
dosing concerns?
A

gold standard for osteomyelitis, endocarditis, pneumonia
G+ (incl. MRSA) (indications: β-lactam problems)
red man syndrome, thrombophlebitis, nephrotoxicity, ototoxicity, & usual stuff
individualized dosing

60
Q

Synercid:
MOA?
coverage?
administration method?

A

quin: 50s, inhib chain formation; termination
dalfo: inhib elongation
MRSA, PCN-res strep pneumo, VRE faecium,
PICC or central line

61
Q

Linezolid:
bioavailability?
coverage?
adverse rxns?

A

PO = IV
Resistant G+
thrombocytopenia, superinfx (yeast)
Serotonin storm (w/ SSRI)

62
Q

Mupirocin:

usage?

A

Decolonization of MRSA in nares (topical)

63
Q

Colistin:
coverage?
adverse effects?
active/inactive form?

A

SPACE, resistant PEK
nephrotox, neurotox
prodrug form when administered

64
Q

Fosfomycin:
usage?
advantages?

A

MDR UTI

one dose!

65
Q

Tigecycline:
what conditions?
coverage?

A

complicated skin infx, complicated intra-abdom. infx, community-acquired pneumonia
MRSA, VRE, G- CRE, acinetobacter, anaerobes

66
Q

Daptomycin:
what conditions?
coverage?
adverse effects?

A

osteomyelitis, endocarditis, complicated skin and soft tiss. infx
G+ MRSA and VRE
rhabdo, eosinophilic pneumonia (rare)

67
Q

Telavancin:
semi-synthetic analogue of what?
adverse effects?

A

vancomycin

nephrotox, red man syndrome, QT prolongation, pancreatitis (rare)

68
Q

Cephalosporins that can cause bleeding and alcohol intolerance

A

cefamandole

cefoperazone

69
Q

Cephalosporin for surgical prophylaxis

A

cefazoline

70
Q

Cephalosporins that cover anaerobes

A

TanFox:
cefotetan
cefoxitin

71
Q

Indications for cephalosporins

A

community and nosocomial pneumonia
meningitis
skin and soft tissue

72
Q

Sulfonamides:

MOA, MOR, spectrum

A

dihydropteroate synthase
incr. PABA, decr. permeability
MRSA, strep, anthrax, PEK, spaCE, toxoplasma, chlamydia, nocardia

73
Q

Sulfonamides:

adverse effects

A

nephrotoxicity (crystalluria–hydrate well)

kernicterus

74
Q

Sulfonamides:

excretion, usage

A

acute UTI, toxoplasmosis, nocardiosis, malaria, rheumatic fever

75
Q

Trimethoprim:

MOA, spectrum

A

dihydrofolate reductase

MRSA, strep, anthrax, PEK, spaCE, pneumocystis carinii

76
Q

Trimethoprim:

excretion, adverse effects, usage

A

80% unchanged glom.
Exacerbate folate def.
UTI, proph for traveler’s diarrhea

77
Q

Bactrim:

usage, drug intx

A

“not that sick” but MRSA shows up, UTI, RTI, GI, STDs, otitis media, stenotrophomonas maltophilia
warfarin, methotrexate

78
Q

Nitrofurantoin:

spectrum, adverse rxns

A

MRSA, strep, enterococcus, pEK, spaCE
peripheral neuropathy
pulmonary rxns: acute, subacute, chronic

79
Q

Nitrofurantoin:

excretion, when NOT to use, usage

A

linear (do not use if CrCL

80
Q

Methenamine:

activation conditions, usage, absorption/degradation, adverse effects

A

Needs hydrolysis in acidic environment to form formaldehyde
UTI proph
High bioavailability, but enterically-coated
ammonia byproducts hard on liver, acidosis

81
Q

Macrolides:

drugs, MOA, MOR

A

erythromycin, clarithromycin, azithromycin

reversible: 50s (static)
decr. permeability, alter 50s bind site, esterases

82
Q

Erythromycin absorption forms and caveats

A

erythromycin base: inactivated by gastric acid
base, stearate, ethylsuccinate: don’t take w/ food
estolate: not affected by food

83
Q

erythromycin:

adverse effects

A

abdominal cramps, thrombophlebitis, cholestatic hepatits (esp. in preggos)
QT prolongation, ototox

84
Q

clarithromycin and azithromycin: adverse effects

A

headache, dizziness, allgx

85
Q

Macrolide drug intx

A

erythro and clarithro metabolites can cx w/ p-450’s: decr. metabolism of theophylline, warfarin, carbamazepine, cyclosporine
azithro does not cx

86
Q

Macrolide:

spectrum, indications

A

all: staph, strep, atypicals
clarithro/azithro: H. flu, M. cat, mycobacterium avium complex
clarithro: H. pylori
PNC allgx pts, CAP, atypicals

87
Q

Prevpak

A

amoxicillin + PPI + clarithro

88
Q

Clindamycin:
MOA, spectrum
IV dose vs. PO dose?

A

bind 50s
(30-40%)MRSA, staph, strep, anaerobes, toxoplasmosis (if allgx to sulfonamide)
IV dose higher than oral

89
Q

Clindamycin:

Adverse rxns?

A

C. Dif

hepatotoxicity

90
Q

Chloramphenicol:

MOA, pharmacokinetics, indications

A

reversib. 50s of 70s
Suspension better than IV, 30-50% CSF penetration w/o inflamm., metabolism varies in kids
bacterial meningitis, rickettsial infx

91
Q

Chloramphenicol:

spectrum

A

G+, G-, aerobes, anaerobes, rickettsia, chlamydia

92
Q

Chloramphenicol:

adverse effects

A

reversible bone marrow depression: anemia, leukopenia, thrombocytopenia
idiosyncratic aplastic anemia
childhood leukemia
gray baby syndrome (newborns and drug accumulation >50 mcg/ml)

93
Q

Abx that affect birth control

A

rifampin

maybe tetracyclines and ampicillin

94
Q

Quinolone:

MOA, pharmacokinetics, MOR

A

topo II and topo IV
high bioavailability, but differs among drugs
high unchanged renal excretion
alter DNA gyrase, permeability, efflux, *overuse

95
Q

Quinolone:

adverse effects

A
photosensitivity
QT prolongation
nephrotox
CNS changes in elderly
Tendon rupture (esp. w/ steroids)
arthropathy (esp. in
96
Q

Quinolone that can cause hypoglycemia

A

gatifloxacin

97
Q

Quinolone:

drug intx

A

cipro w/ theophylline (levo is safe)
all w/ antacids/iron/sucralfate/etc
w/ warfarin (levo is safe)

98
Q

Quinolone:

coverage

A

staph/strep: levo, moxi, gemi
SPACE: cipro, levo
SpACE, anaerobes: moxi
atypicals: levo, moxi, cipro (chlamydia-res)

99
Q

Quinolones for strep pneumo?

A

levo, moxi, gemi

100
Q

Quinolone that cannot treat UTI?

A

moxi

101
Q

Renally-eliminated tetracyclines

A

tetra, oxy, deme

102
Q

Hepatobiliary-eliminated tetracyclines

A

doxy, mino

103
Q

Tetracycline:
adverse rxn
drug intx

A

photosensitivity, discolored teeth (

104
Q

Tetracycline:

spectrum

A

staph, strep, h. flu, neisseria, atypicals, rickettsia (doxy)

105
Q

Tetracycline:

usage, + demeclocycline special use

A

rocky mountain spotted fever, mycoplasma pneumonia, chlamydia, acne, h. pylori, vibrio cholerae/vulnificus, borrelia burgdorferi

SIADH

106
Q

Brucellosis treatment

A

tetracycline + gentamicin