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POD > Antibiotics > Flashcards

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
Ace In the Hole
Aztreonam (penicillin anaphylaxis)
26
"Last Resort" Abx
Colistin
27
MOA of Penicillins
inhibition of transpeptidases, transglycosylases, D-ala carboxykinases
28
Penicillin for rheumatic fever prophylaxis
IM Benzathine Penacillin
29
Which penicillins are effective against penG-resistant bugs (i.e. antistaphylococcal)?
IV: oxacillin, nafcillin PO: cloxacillin, dicloxacillin
30
Aminopenicillins: Drugs, Coverage, Adverse Effects
ampicillin, amoxicillin strep+enterococcus+some piddly+some fence more diarrhea b/c poor absorption (take w/ food)
31
Carboxypenicillins: Drugs, MOA, Coverage, Adverse Effects
``` ticarcillin, carbenicillin incr. permeability of cell wall strep, piddly/PEK, SpACE ticarcillin: high Na load carboxy group messes w/ platelets ```
32
Ureidopenicillins: Drugs, Coverage
piperacillin, mezlocillin | strep, enterococcus, PEK, SPACE, bacteroides
33
Zosyn
piperacillin + tazobactam *most prescribed in US additionally covers staph and anaerobes
34
Timentin
ticarcillin + clavulanic acid | additionally covers staph and anaerobes
35
Causes of eosinophilia
``` NAACP: neoplasm asthma allergies connective tissue parasites ```
36
Adverse effects of penicillin use (general)
Interstitial Nephritis Pseudomembranous Colitis (c. dif infx) Hypersensitivity Anaphylaxis
37
Reaches inflamed meninges at high doses
3rd generation cephalosporins (ceftriaxone)
38
Combo: imipenem + cilastatin
Prevents renal metabolism
39
Imipenem, meropenem, doripenem coverage
everything but atypicals (incl. enterococcus)
40
Ertapenem coverage
staph, strep anaerobes PEK
41
Aztreonam coverage
G- (incl. SPACE)
42
Aminoglycoside MOA
bind outer membrane, rearrange LPS, uptake and trap, bind 50s and 30s
43
Top 3 most prescribed aminoglycosides
tobramycin gentamicin amikacin
44
PO aminoglycoside
neomycin
45
Adverse effects of aminoglycosides
nephrotoxicity ototoxicity intx w/ neuromuscular blockades
46
Aminoglycoside coverage
G- through SPACE | enterococcus (in combo w/ ampicillin)
47
Hartford Nomogram for aminoglycosides
7 mg/kg
48
Desired trough levels for aminoglycosides
less than 2 mcg/ml
49
1st generation cephalosporins: | coverage and formulations
staph, strep, piddly po: cephalexin IV: cefazolin
50
2nd generation cephalosporins (non-cephamycins): | coverage and formulations
staph, strep, h. flu, M. cat,PEK | po and IV: cefuroxime
51
2nd generation cephalosporins (cephamycins): | coverage and formulations
staph, strep, h. flu, m. cat, PEK, anaerobes | IV: cefoxitin, cefotetan
52
3rd generation cephalosporins: | coverage and formulations
strep, SpACE | IV: ceftriaxone
53
3rd generation cephalosporins (antipseudomonal): | coverage and formulations
poor G+, SPACE | IV: ceftazidime
54
4th generation cephalosporins: | coverage and formulations
staph, strep, SPACE | IV: cefepime
55
5th generation cephalosporins: | coverage and formulations
staph (inc. MRSA), strep, [sometimes] enterococcus, SpCaE | IV: ceftaroline
56
Penicillin of choice for killing enterococcus
ampicillin
57
Augmentin
amoxicillin + clavulanic acid | adds staph and anaerobes
58
Unasyn
ampicillin + sulbactam
59
``` Vancomycin: what conditions? (3) coverage? adverse effects? dosing concerns? ```
gold standard for osteomyelitis, endocarditis, pneumonia G+ (incl. MRSA) (indications: β-lactam problems) red man syndrome, thrombophlebitis, nephrotoxicity, ototoxicity, & usual stuff individualized dosing
60
Synercid: MOA? coverage? administration method?
quin: 50s, inhib chain formation; termination dalfo: inhib elongation MRSA, PCN-res strep pneumo, VRE faecium, PICC or central line
61
Linezolid: bioavailability? coverage? adverse rxns?
PO = IV Resistant G+ thrombocytopenia, superinfx (yeast) Serotonin storm (w/ SSRI)
62
Mupirocin: | usage?
Decolonization of MRSA in nares (topical)
63
Colistin: coverage? adverse effects? active/inactive form?
SPACE, resistant PEK nephrotox, neurotox prodrug form when administered
64
Fosfomycin: usage? advantages?
MDR UTI | one dose!
65
Tigecycline: what conditions? coverage?
complicated skin infx, complicated intra-abdom. infx, community-acquired pneumonia MRSA, VRE, G- CRE, acinetobacter, anaerobes
66
Daptomycin: what conditions? coverage? adverse effects?
osteomyelitis, endocarditis, complicated skin and soft tiss. infx G+ MRSA and VRE rhabdo, eosinophilic pneumonia (rare)
67
Telavancin: semi-synthetic analogue of what? adverse effects?
vancomycin | nephrotox, red man syndrome, QT prolongation, pancreatitis (rare)
68
Cephalosporins that can cause bleeding and alcohol intolerance
cefamandole | cefoperazone
69
Cephalosporin for surgical prophylaxis
cefazoline
70
Cephalosporins that cover anaerobes
TanFox: cefotetan cefoxitin
71
Indications for cephalosporins
community and nosocomial pneumonia meningitis skin and soft tissue
72
Sulfonamides: | MOA, MOR, spectrum
dihydropteroate synthase incr. PABA, decr. permeability MRSA, strep, anthrax, PEK, spaCE, toxoplasma, chlamydia, nocardia
73
Sulfonamides: | adverse effects
nephrotoxicity (crystalluria--hydrate well) | kernicterus
74
Sulfonamides: | excretion, usage
acute UTI, toxoplasmosis, nocardiosis, malaria, rheumatic fever
75
Trimethoprim: | MOA, spectrum
dihydrofolate reductase | MRSA, strep, anthrax, PEK, spaCE, pneumocystis carinii
76
Trimethoprim: | excretion, adverse effects, usage
80% unchanged glom. Exacerbate folate def. UTI, proph for traveler's diarrhea
77
Bactrim: | usage, drug intx
"not that sick" but MRSA shows up, UTI, RTI, GI, STDs, otitis media, stenotrophomonas maltophilia warfarin, methotrexate
78
Nitrofurantoin: | spectrum, adverse rxns
MRSA, strep, enterococcus, pEK, spaCE peripheral neuropathy pulmonary rxns: acute, subacute, chronic
79
Nitrofurantoin: | excretion, when NOT to use, usage
linear (do not use if CrCL
80
Methenamine: | activation conditions, usage, absorption/degradation, adverse effects
Needs hydrolysis in acidic environment to form formaldehyde UTI proph High bioavailability, but enterically-coated ammonia byproducts hard on liver, acidosis
81
Macrolides: | drugs, MOA, MOR
erythromycin, clarithromycin, azithromycin reversible: 50s (static) decr. permeability, alter 50s bind site, esterases
82
Erythromycin absorption forms and caveats
erythromycin base: inactivated by gastric acid base, stearate, ethylsuccinate: don't take w/ food estolate: not affected by food
83
erythromycin: | adverse effects
abdominal cramps, thrombophlebitis, cholestatic hepatits (esp. in preggos) QT prolongation, ototox
84
clarithromycin and azithromycin: adverse effects
headache, dizziness, allgx
85
Macrolide drug intx
erythro and clarithro metabolites can cx w/ p-450's: decr. metabolism of theophylline, warfarin, carbamazepine, cyclosporine azithro does not cx
86
Macrolide: | spectrum, indications
all: staph, strep, atypicals clarithro/azithro: H. flu, M. cat, mycobacterium avium complex clarithro: H. pylori PNC allgx pts, CAP, atypicals
87
Prevpak
amoxicillin + PPI + clarithro
88
Clindamycin: MOA, spectrum IV dose vs. PO dose?
bind 50s (30-40%)MRSA, staph, strep, anaerobes, toxoplasmosis (if allgx to sulfonamide) IV dose higher than oral
89
Clindamycin: | Adverse rxns?
**C. Dif** | hepatotoxicity
90
Chloramphenicol: | MOA, pharmacokinetics, indications
reversib. 50s of 70s Suspension better than IV, 30-50% CSF penetration w/o inflamm., metabolism varies in kids bacterial meningitis, rickettsial infx
91
Chloramphenicol: | spectrum
G+, G-, aerobes, anaerobes, rickettsia, chlamydia
92
Chloramphenicol: | adverse effects
reversible bone marrow depression: anemia, leukopenia, thrombocytopenia idiosyncratic aplastic anemia childhood leukemia gray baby syndrome (newborns and drug accumulation >50 mcg/ml)
93
Abx that affect birth control
rifampin | maybe tetracyclines and ampicillin
94
Quinolone: | MOA, pharmacokinetics, MOR
topo II and topo IV high bioavailability, but differs among drugs high unchanged renal excretion alter DNA gyrase, permeability, efflux, *overuse
95
Quinolone: | adverse effects
``` photosensitivity QT prolongation nephrotox CNS changes in elderly Tendon rupture (esp. w/ steroids) arthropathy (esp. in ```
96
Quinolone that can cause hypoglycemia
gatifloxacin
97
Quinolone: | drug intx
cipro w/ theophylline (levo is safe) all w/ antacids/iron/sucralfate/etc w/ warfarin (levo is safe)
98
Quinolone: | coverage
staph/strep: levo, moxi, gemi SPACE: cipro, levo SpACE, anaerobes: moxi atypicals: levo, moxi, cipro (chlamydia-res)
99
Quinolones for strep pneumo?
levo, moxi, gemi
100
Quinolone that cannot treat UTI?
moxi
101
Renally-eliminated tetracyclines
tetra, oxy, deme
102
Hepatobiliary-eliminated tetracyclines
doxy, mino
103
Tetracycline: adverse rxn drug intx
photosensitivity, discolored teeth (
104
Tetracycline: | spectrum
staph, strep, h. flu, neisseria, atypicals, rickettsia (doxy)
105
Tetracycline: | usage, + demeclocycline special use
rocky mountain spotted fever, mycoplasma pneumonia, chlamydia, acne, h. pylori, vibrio cholerae/vulnificus, borrelia burgdorferi SIADH
106
Brucellosis treatment
tetracycline + gentamicin

POD (7 decks)

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