Antibiotics Flashcards by Matthew Crabtree

Q

Cycloserine mechanism

A

Cell wall synthesis

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Q

Vancomycin mechanism

A

Cell wall synthesis

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Q

Bacitracin mechanism

A

Cell wall synthesis

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Q

Penicillins mechanism

A

Cell wall synthesis

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Q

Cephalosporins mechanism

A

Cell wall synthesis

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Q

Monobactams mechanism

A

Cell wall synthesis

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Q

Carbapenems mechanism

A

Cell wall synthesis

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Q

Actinomycin mechanism

A

RNA elongation

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Q

Nalidixic acid mechanism

A

DNA gyrase (quinolone)

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Q

Ciprofloxacin mechanism

A

DNA gyrase (quinolone)

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Q

Novobiocin mechanism

A

DNA gyrase

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Q

Rifampin mechanism

A

DNA-directed RNA polymerase

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Q

Streptovaricins mechanism

A

DNA-directed RNA polymerase

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Q

Erythromycin (macrolides) mechanism

A

Protein synthesis (50S) inhibition

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Q

Chloramphenicol mechanism

A

Protein synthesis (50S) inhibition

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Q

Clindamycin mechanism

A

Protein synthesis (50S) inhibition

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Q

Lincomycin mechanism

A

Protein synthesis (50S) inhibition

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Q

Tetracycline mechanism

A

Protein synthesis (30S) inhibition

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Q

Spectinomycin mechanism

A

Protein synthesis (30S) inhibition

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Q

Gentamicin, tobramicin mechanism

A

Protein synthesis (30S) inhibition

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Q

Kanamycin (aminoglycoside) mechanism

A

Protein synthesis (30S) inhibition

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Q

Amikacin mechanism

A

Protein synthesis (30S) inhibition

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Q

Nitrofuran mechanism

A

Protein synthesis (30S) inhibition

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Q

Mupirocin mechanism

A

Protein synthesis (tRNA)

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Puromycin mechanism

Protein synthesis (tRNA)

Polymixins mechanism

Cytoplasmic membrane structure

Trimethoprim mechanism

Folic acid metabolism

Sulfonamides mechanism

Folic acid metabolism

[...] is the only commercially available monobactam

Aztreonam

Those with PCN allergies will not have allergies to [...[

Aztreonam

List the ß-lactam drug classes

Penicillins, cephalosporins, carbapenems, (monobactams)

Tx for MSSA

All ß-lactams except PCN and ampicillin. Nafcillin and cefazolin are drugs of choice

Tx for pneumococcus

Cefotaxime, ceftriaxone

Tx for pseudomonas aeruginosa

Piperacillin/tazobactam, ceftazidime, cefepime, meropenem, imipenem, aztreonam

[...] are prokinetic and cause diarrhea

Macrolides

Do not give [...] to a patient with ileus

Macrolides

List the macrolides

Erythromycin, gentamicin, azithromycin

Antimicrobial spectrum of macrolides

Respiratory gram positives and negatives, intracellular atypical pathogens (mycoplasma, chlamydia, legionella)

For atypical pathogens, [...] are effective and [...] are ineffective

Macrolides (first line) and fluoroquinolones (second line); ß-lactams (don't use)

Side effects of fluoroquinolones

Long QT, hyperglycemia, interaction with warfarin

List the fluoroquinolones

Ciprofloxacin, moxifloxacin, levofloxacin

Fluoroquinolones with anti-pneumococcal properties

Moxifloxacin, levofloxacin

Fluoroquinolones with anti-pseudomonal properties

Ciprofloxacin, levofloxacin

Side effect of tetracyclines

Photosensitivity

This tetracycline is also antimalarial

Doxycycline

List the tetracyclines

Doxycycline, tetracycline, minocycline

Coverage of the tetracyclines

Respiratory gram positive and negative, and atypical pathogens. Tetracycline is less effective than doxycycline or minocycline

Drug options for resistant gram positives

Vancomycin, linezolid, daptomycin

Side effects of linezolid

BM suppression and neuropathy (also very expensive)

Daptomycin is ineffective against [...]

Pneumonia (bound by surfactant)

[...]% of bronchitis is bacterial

10%

Tx for bacterial sinusitis

Amoxicillin-clavulanate (first line), fluoroquinolones (if PCN allergy in adults)

[...]% of pharyngitis is bacterial

15%

Tx for Strep throat

PCN or amoxicillin (first line), 1st gen cephalosporin (for minor PCN allergy), clindamycin or macrolide (for anaphylactic PCN allergy)

[...]% of otitis media is bacterial

75%

Tx for OM

High dose amoxicillin (first line), add clavulanate (if on PCN for a month already), 2nd or 3rd generation cephalosporin (if PCN allergy)

Tx approach for community acquired pneumonia

Use broad spectrum, then de-escalate after sputum results come int

Tx for CAP outpatients

Macrolides or doxycycline (if previously healthy), antipneumococcal fluoroquinolone or macrolide with ß-lactam (if co-morbidities)

Tx for CAP inpatients (non-ICU)

ß-lactam with macrolide (first line), anti-pneumococcal fluoroquinolone (if PCN allergy)

Tx for CAP inpatients (ICU)

Antipneumococcal fluoroquinolone (always), and add ß-lactam with macrolide (first line), or add aztreonam (if PCN allergy)

Tx for CAP if pseudomonas suspected

Antipseudomonal fluoroquinolone (always), and add antipneumococcal fluoroquinolone, antipseudomonal ß-lactam (tazobactam + piperacillin), cefepime, or meropenem

Tx for CAP if MRSA suspected

Add vancomycin or linezolid

Tx for CAP if aspiration suspected

Add clindamycin to cover oral anaerobes if not already covered

How long to treat for CAP

5 day minimum, afebrile for 2-3 days, and in stabile condition

[...] is the only cephalosporin with antipseudomonal activity

Ceftazidime

Tx for HCAP with no risk of MDRO

Ceftriaxone or ampicillin/sulbactam or ertapenem or fluoroquinolone

Tx for HCAP with risk of MDRO

Antipseudomonal ß-lactam plus antipseudomonal fluoroquinolone (or aminoglycoside) plus vancomycin or linezolid (if MRSA suspected)