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Antibiotics > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

antiseptic

A

kills and inhibits organisms on body

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2
Q

disinfectant

A

kills and inhibits organisms on inanimate objects

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3
Q

sterilization

A

all organisms killed

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4
Q

common antiseptics in surgery

A 
iodophors (betadine) - good for GPCs, GNRs, and poor fungi
Chlorhexidine gluconate (Hibiclens) - good for GPCs, GNRs, and fungi
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5
Q

Inhibitors of cell wall synthesis

A

PCNs, cephalosporins, carbapenems, monobactems, vancomycin

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6
Q

Inhibitors of 30s ribosome and protein synthesis

A

tetracycline, aminoglycosides (tobramycin, gentamicin), linezolid

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7
Q

Inhibitors of 50s ribosome and protein synthesis

A

erythromycin, clindamycin, chloramphenicol, synercid

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8
Q

Inhibitor of DNA helicase (gyrase)

A

quinolones

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9
Q

Inhibitor of RNA polymerase

A

rifampin

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10
Q

Metronidazole (flagyl)

A

produces oxygen radicals that breakup DNA

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11
Q

Sulfonamides

A

PABA analogue, inhibit purine synthesis

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12
Q

Trimethoprim

A

inhibits dihydrofolate reductase, inhibits purine synthesis

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13
Q

Bacteriostatic antibiotics

A

chloramphenicol, tetracycline, clindamycin, erythromycin (all have reversible ribosomal binding), bactrim

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14
Q

Aminoglycosides

A

have irreversible binding to ribosome and are considered bactericidal

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15
Q

PCN resistance

A

plasmids for beta-lactamase

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16
Q

Transfer of plasmids

A

most common method of antibiotic resistance

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17
Q

MRSA

A

resistance caused by mutation of cell wall binding protein

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18
Q

VRE

A

resistance develops from mutation in cell wall binding protein

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19
Q

Gentamicin resistance

A

resistance due to modifying enzymes leading to decrease in active transport

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20
Q

Vanc level

A

peak 20-40 ug/mL; trough 5-10 ug/mL

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21
Q

Gentamicin

A

peak 6-10 ug/mL; trough < 1 ug/mL

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22
Q

Peak too high

A

decrease amount of each dose

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23
Q

Trough too high

A

decrease frequency of doses (increase time interval between doses)

24
Q

PCN

A

GPCs – strep, syphilis, beta-hemolytic strep, anthrax;

GPRs – Neisseria meningitides, clostridium perfringens; not effective against Staph or Enterococcus

25
Q

Oxacillin / nafcillin

A

anti-staph PCNs (staph only)

26
Q

Ampicllin / amoxicillin

A

same as PCN; GPCs – strep, syphilis, beta-hemolytic strep, anthrax; GPRs – Neisseria meningitides, clostridium perfringens; also picks up Enterococci

27
Q

Unasyn (ampicllin / sulbactam) and Augmentin (amoxicillin / clavulanic acid)

A

broad spectrum, pick up GPCs (staph and strep), GNRs, +/- anaerobic coverage, effective for enterococci;
not effective for pseudomonas, acinetobacter, or serratia
Sulbactam and clavulanic acid are beta lactamase inhibitors

28
Q

Ticarcillin / piperacillin

A

antipseudomonal PCNs; GNRs - enterics, Pseudomonas, Acinetobacter, Serratia
side effects: inhibits platelets, high salt load

29
Q

Timentin (ticarcillin / clavulanic acid) and Zosyn (piperacillin / sulbactam)

A

broad spectrum, pick up GPCs (staph and strep), GNRs, anaerobes, enterococci, Pseudomonas, Acinetobacter, Serratia
side effects: inhibits platelets, high salt load

30
Q

First generation cephalosporins (cefazolin, cephalexin)

A

GPCs - staph and strep
not effective for enterococcus; does not penetrate CNS; cefazolin (ancef) has longest half-life best for ppx
side effects: can produce positive Coombs test

31
Q

Second generation cephalosporins (cefoxitin, cefotetan, cefuorxime)

A

GPCs, GNRs, +/- anerobic coverage, Pseudomonas, Acinetobacter, Serratia; lose some staph activity; not effective for enterococcus; effective only for community acquired GNRs; cefotetan has longest half life best for ppx; side effects: prolonged PT

32
Q

Third generation cephalosporins (ceftriaxone, ceftazidime, cefepime, cefotaxime)

A

GNRs mostly, +/- anaerobic coverage, Pseudomonas, Acinetobacter, Serratia; not effective for enterococcus
side effectis: cholestatic jaundice and sludging in gallbladder (ceftriaxone)

33
Q

Monobactam (aztreonam)

A

GNRs; picks up Pseudomonas, Acinetobacter, Serratia

34
Q

Carbapenems (meropenem / imipenem)

A

broad spectrum, GPCs, GNRs, anaerobes
not effective for MEPP: MRSA, Enterococcus, Proteus, Pseudomonas
cilastatin - prevents renal hydrolysis of the drug and increases half-life
side effects: seizures

35
Q

Bactrim

A

GNRs, +/- GPCs;
not effective for enterococcus, pseudomonas, acinetobacter and serratia
side effects: teratogenic, allergic rxns, renal damage, Stevens-Johnson syndrome (erythema multiforme), hemolysis in G6PD-deficient patients

36
Q

Quinolones (cipro-, levo-, trovafloxacin)

A

GPCs, mostly GNRs, Pseudomonas, Acinetobacter, Serratia; not effective for enterococcus; 40% of MRSA sensitive; same efficacy PO and IV

37
Q

Aminoglycosides (gentamicin, tobramycin, amikacin)

A

GNRs, good for Pseudomonas, Acinetobacter, Serratia; not effective for anaerobes (need O2),
resistance due to modifying enzymes leading to decreased active transport,
synergistic with ampicillin for enterococcus (facilitate aminoglycoside penetration)
side effects: reversible nephrotoxicity, irreversible ototoxicity

38
Q

Erythromycin (macrolides)

A

GPCs; best for community acquired PNA and atypical PNA
side effects: nausea (PO), cholestasis (IV)
also bind motilin receptor and is prokinetic for bowel

39
Q

Vancomycin (glycopeptides)

A

GPCs, enterococcus, c diff (PO), MRSA
binds cell wall proteins
resistance develops from change in cell wall-binding sites
side effects: HTN, Redman syndrome (histamine release), nephrotoxicity, ototoxicity

40
Q

Synercid (streptogramin, quinupristin-dalfopristin)

A

GPCs; includes MRSA, VRE

41
Q

Linezolid (oxazolidinones)

A

GPCs; includes MRSA, VRE

42
Q

Tetracycline

A

GPCs, GNRs, syphilis
side effects: tooth discoloration in children
can interfere with beta-lactams

43
Q

Clindamycin

A

anaerobes, some GPCs, good for aspiration PNA, can be used to treat C. perfringens
side effects: pseudomembranous colitis

44
Q

Metronidazole

A

anaerobes

side effects: disulfiram-like reaction, peripheral neuropathy

45
Q

Amphotericin

A

binds sterols in wall and alters membrane permeability

side effects: nephrotoxic, fever, decreased potassium, hypotension, anemia

46
Q

fluconazole / ketoconazole

A

not all candida spp. are sensitive

47
Q

prolonged broad spectrum antibiotics + fever

A

fluconazole

48
Q

possible fungal sepsis

A

amphotericin

49
Q

Isoniazid

A

anti-TB; inhibits mycolic acids

side effects: hepatotoxicity, B6 deficiency

50
Q

Rifampin

A

anti-TB; inhibits RNA polymerase

side effects: hepatotoxicity, GI symptoms, high rate of resistance

51
Q

Pyrazinamide

A

anti-TB

side effect: hepatotoxicity

52
Q

Ethambutol

A

anti-TB

side effect: retrobulbar neuritis

53
Q

Acyclovir

A

antiviral; inhibits DNA polymerase, usually used for HSV infections, can be used for EBV

54
Q

Ganciclovir

A

antiviral; used for CMV infections

side effects: decreased bone marrow, CNS toxicity

55
Q

Effective for enterococcus

A

vanc, timentin/zosyn, ampicillin/amoxicillin, or gentamicin with ampicillin

56
Q

Effective for Pseudomonas, Acinetobacter, Serratia

A

ticarcillin/piperacillin, timentin/zosyn, third generation cephalosporins, aminoglycosides (gentamicin and tobramycin), meorpenem/imipenem (resistance can develop in Pseudomonas), or fluoroguinolones; double cover pseudomonas

57
Q

Perioperative antibiotics

A

used to prevent incisional wound infections; need to be given within 2 hours before incision

Antibiotics (1 decks)

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