Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations 5 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Beta lactam structure

A

Analogs of D-alanyl-D-alanine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Beta lactam cidal and or static

A

Cidal - inhibits cell wall synthesis and more susceptible to lysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mechanism of Beta Lactams

A

Inhibit Transpeptidases (PBPs) that remove one alanine from a peptidoglycan polymer and cross link other alanine to antoher adjacent polymer

Form covalent bonds

Can’t form rigid 3D sturcutre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Regular, ES, anti staph, Anti psueod penicillins and routes

A

Penicillin G (I)
Amoxicillin (O)
Nafcillin (I)
Peperacillin (I)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Resistance to Beta lactam and example of each

A

beta lactamases cleave lactam ring (Staph aureus)

Mutated PBPs have decreased binding affinities (MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Each lactamase

A

Hydrolyzes a different set of beta-lactams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Penicillin spectrum

A

Braod

+,-, anaerobes, spirochetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Regular pen coverage

A

Good for anaerobes and spirochetes but not gram -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ES penicillins coverage

A

Improved gram - coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anti staph penicillins coverage

A

Best for Non-MRSA staph

Only strand resistant to some beta-lac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anti pseudo pen coverage

A

Improved of P aeruginosa and other gram - bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to ES and anti pseudo penicillins get into gram negative bacteria

A

Have side chains that can go through porins…these are + charged chains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pen absorption

A

Oral bioavailability is poor

Amoxicillin is good for oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pen distribtuion

A

Do not enter bone or CNS

G used for neurosyphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pen elimination

A

Rapid renal elimination so short duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pen dosing

A

Most in milligrams
G in IUs
V in either mg or IUs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Adverse effects of penicillins

A

Rare

Superinfections (more likely with broader)
Serizures (at very high levels, caution with epileptics)
Skin rashes (ES can cause non-allergic rash with mono)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is common is penicillins

A

Hypersensitivity reactions…most serious being anaphylaxis and least being skin rashes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

All penicillins cross react

A

With each other and at a lower frequency with other beta lactams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cephalosporins we need to know and generation

A

1 - cefazolin (I)
3 - Ceftiaxone (I)
4 - Cefepime (I)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ceph spectrum and how different than penicillins

A

+, - , anaerobes, spirochetes

better at gram - than pen
More stable against lactamases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cefazolin use

A

Highest against gram + and anaerobes

Wound infections and surgicial prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ceftriaxone use

A

More serious gram - bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cefepime use

A

Similar to ceftriaxone but more psuedomonas activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Ceph resistance

A

Lactamases (decreased with later generations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

ESBLs

A

On some strains of gram - bacilli…resistant to 3rd gen cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Ceph absorption

A

Oral are there for 1-3 gen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Ceph elimination

A

Most are short and secreted by kidney

Ceftriaxone undergoes biliary elimination and longer T1/2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Ceph deistribtuoon

A

Moves to restricted better than pen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ceph toxicity

A

Hypersensitivity (can use with pts who have a delayed penicillin reaction)
Superinfections (with broader spect)
Nephrotoxicity (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Carbapanems we need to know

A

Meropenem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Carbapenems are improvement because

A

Very broad spectrum and insentivie to lactamases that destroy cephs and pens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Most important use for carbapenems

A

Difficult to treat gram negative bacteria (entero, klebsiella)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Carbapenems spectrum

A

+, -, anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Carb resistance

A

Typically due to non-lactamase mechanism

Recent spread of metallo beta lactamases in Klebsiella pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Cilastatin

A

Used with imipenem to decreased effect of renal dehydropeptidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Absorptions Carb

A

Only injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Distributon Carb

A

Go to bone, CNS, restricted compartments well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Adverse effects of Carb

A

Seizures…decrease valproate levels, whcih is important anti-epileptic drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Beta lactamase inhibitors

A

Clavulanic acid

Bind to catalytic site and extend spectrum of beta lactams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Augmentin

A

Amox and clavulanic acid

42
Q

Augmentin example useful in

A

Beta-lactamase producing strands of gram-negative bacteria

43
Q

Glycopeptide example and route

A

Vancomycin (I,O)

44
Q

Vancomycin strucutre

A

Large and hydropihlic

45
Q

Vancomycin mechanism

A

Inhibits transglycosylase that attaches new monomers to polymer…earlier step than beta-lactams

46
Q

Vanco spectrum

A

+ and anaerobes…totally insensitive to lactamases and PBPs

47
Q

Vancomycin used for

A

MRSA…pen still preferred for other S aureus strains

Severe C dif induced diarrhea

48
Q

Resistance to vancomycin

A

High level - D-lactate replaces bidning sites D-alanine

Low level - Vancomycin creep due to increased production of peptidoglycan

49
Q

Vancomycin absorption

A

Oral form not absorbed but used for GI infections

50
Q

Vanco elimination

A

Renal

51
Q

Distribution of Vanco

A

Penetrates BBB when inflamed

52
Q

Vanco adverse effect

A

Nephrotoxicity

53
Q

Red Man Syndrome

A

Histmaine release during infusion of Vancomycin…prevent by slow infusion and pre-admin of antihistamines

Hypotension and vasodilation

54
Q

Protein suppression is normally

A

Bacteriostatic…can survive by going dormant

55
Q

Which bind to 30S and 50S subunits

A

30 - aminoglycosides

50 - lincosamides and oxazolidinones

56
Q

Linezolid inhibits

A

Assembly of 70S complex

57
Q

Aminoglycosides inhibit

A

Early elongation of new amino acid binding to the A site

58
Q

Lincosamides inhibit

A

Late elongation - bond formed between existing peptide at P site and new amino acid at A site

59
Q

Aminoglycoside example and form

A

Gentamicin (I,T)…bactericidal

60
Q

Aminoglycoside structure

A

Polycations…sugars with glycosydic links

61
Q

Aminoglycoside mechanism

A

Binds to and changes conformation of the 30S subunit and causes miscoding…miscoded protein disrupt membrane

62
Q

aminoglycoside type of killing

A

Concentration dependent killing with a long post-antibiotic effect

63
Q

Resistance to aminoglycoside

A

Acetylase inactivates

64
Q

Aminoglycoside scope

A

Some positive, more negative

No anaerobes because transport dependent on membrane potential

65
Q

Aminoglycoside absorp

A

Not absorbed orally

66
Q

Aminoglycoside distribution

A

Dont enter restricted well

67
Q

Aminoglycoside elimination

A

Renal so short T1/2

68
Q

Main use of aminoglycosides

A

Hospital setting for serious

Often combined with beta lactams

69
Q

Aminoglycoside adverse effects

A

Nephrotoxicity (reversible)
Ototoxicity (partially reversible)
Vestibular toxicity (partially reversible at best)

70
Q

How can you elimate nephrotoxicity of aminoglycoside

A

Keep trough concentrations low and avoid other nephrotoxic drugs

71
Q

Dosing of aminoglycosides

A

Once daily allows peaking of the concentration so more killing and saturation of renal uptake

3 times daily is other way

72
Q

Lincosamide example and route

A

Clindamycin (I, O, T, vaginal)

73
Q

Clindamycin routes and why

A

Oral and injection dosage for systemic
Topical for acne vulgaris
Vaginal for bacterial vaginosis

74
Q

Clindamycin spectrum

A

Gram positive and anaerobes…especially anaerobes

75
Q

Clindamycin absorp

A

Very good oral

76
Q

Clindamycin distribution

A

Very good except CNS…good for bone

77
Q

Clindamycin elimination

A

Hepatic oxidation…in feces for long time

78
Q

Clindamycin adverse effects

A

Diarrhea, thrombocytopenia…most likely to cause C dif

79
Q

Clindamycin most useful as

A

Beta lactam alternative for treating anaerobic infections…also for some S aureus infection

80
Q

Oxazolidinone example and route

A

Linezolid (I,O) - cidal or static depnding

81
Q

Resistance to Linezolid

A

Binding site mutation or methylation

82
Q

Linezolid spectrum

A

Gram positive only…good for multi drug resistant gram + cocci

83
Q

Linezolid side effects

A

Mild to moderate thrombocytopenia
Peipheral neurotixicity sometimes
Serotonin syndrome

84
Q

Linezolid absorption

A

Excellent oral

85
Q

Distribution of linezolid

A

Well distributed including CNS

86
Q

Linezolid elimination

A

Mostly through non-enzymatic hepatic oxidation

87
Q

Sulfonamides example, route, and what they mimic

A

Sulfamethoxazole (I,O)…mimics PABA

Trimethoprim (I, O, T) - acts on DHFRs…mimics Folate

88
Q

Human vs bacteria - folate

A

Bacteria only have dihydropteroate synthase that sulfonamides inhibit
Both have DHFR that trimethoprim acts on

89
Q

Folates needed for

A

Synthesis of nucleosides and nucleic acids

90
Q

Why use SMX-TMP

A

Similar kinetics and less reistance

Cidal when given together

91
Q

SMX-TMP spectrum

A

+, -, intracellular

92
Q

Uses of SMX-TMP

A

Urinary tract and community acquired MRSA

93
Q

Resistance to SMX-TMP

A

Mutated sulfonamide binding site

94
Q

Sulf absorp

A

Good oral

95
Q

Sulf elimination

A

Both hepatic and renal…get concentrations in urine

96
Q

Sulf distribution

A

Good into restircted compartments like CNS

Some bind to albumin

97
Q

Sulfonamides and pregnancy

A

Neonates have large amounts of bilirubin…sulfonamides compete with binding to albumin freeing bilirubin…leads to encephalopathy

98
Q

Sulfonamides toehr side effects

A

Crystal in urine…prevent with fluids
Hemolytic anemia
Hypersensitivity

99
Q

Don’t use trimethoprim if

A

Patient has folate definiciency induced anemia

100
Q

Stevens-Johnson syndrome

A

Most serious reacton to SMX-TMP

Foundations 5 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions