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Antibiotics Flashcards

1
Q

penicillin G used where?

A

IM, IV

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2
Q

penicillin V used where?

A

oral

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3
Q

mechanism of penicillin G/V

A

structure mimics D-ala-D-ala, bound by transpeptidases prevents cross-linking of peptidoglycan cell wall

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4
Q

penicillin G used for:

A

T. pallidum (syphilis)

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5
Q

SEs of penicillins

A

hypersensitivity rxns

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6
Q

resistance to penicillins mediated by

A

production of B-lactamase which cleaves the B-lactam ring in the chemical structure, rendering it non-functional

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7
Q

amoxicillin and ampicillin are _____ to B-lactamase

A

sensitive

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8
Q

amoxicillin uses ____ route, ampicillin uses ____ route

A

oral, IV

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9
Q

use of amoxicillin/ampicillin

A

H. infuenzae, H. pyloria, E. coli, Enterococcus, Listeria, Proteus, Salmonella, Shigella (HHEELPSS)

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10
Q

SEs of amoxicillin/ampicillin

A

hypersensitivity rxns

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11
Q

resistance to amoxicillin/ampicillin mediated by

A

B-lactamase production

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12
Q

B-lactamase inhibitors are added to _____ and include _____.

A
  • amoxicillin, ampicillin, piperacillin, ticarcillin

- clavulanic acid, sulbactam, tazobactam

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13
Q

B-lactamase resistant penicillins include:

A

nafcillin, dicloxacillin, oxacillin (due to bulky R group which blocks enzyme)

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14
Q

clinical use of nafcillin, dicloxacillin, oxacillin

A

MSSA

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15
Q

SEs of nafcillin, dicloxacillin, oxacillin

A

hypersensitivity rxns

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16
Q

Which penicillins can be used to treat Pseudomonas and gram negatives as well?

A

piperacillin, ticarcillin + B-lactamase inhibitor

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17
Q

mechanism of cephalosporins

A

same as penicillin, except less susceptible to B-lactamases (D-ala-D-ala analogue which is bound by transpeptidase and prevents cross-linking of peptidoglycan cell walls)

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18
Q

cefazolin and cephalexin are:

A

1st gen cephalosporins

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19
Q

cefazolin and cephalexin are used for:

A

Gram positive cocci, Proteus, E. coli, Klebsiella (PEcK)

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20
Q

cefaclor, cefoxitin, cefuroxime are:

A

2nd gen cephalosporins (Fake Fox Fur)

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21
Q

cefaclor, cefoxitin, cefuroxime are used for:

A

Gram positive cocci, H. influenza, Enterobacter, Neisseria, Serratia, Proteus, E. Coli, Klebsella (HENS PEcK)

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22
Q

ceftriaxone, cefotaxime, cefpodoxime, ceftazidime are:

A

3rd generation cephalosporins

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23
Q

Which third generation cephalosporin covers Pseudomonas?

A

ceftazidime

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24
Q

Cefepime is a ___ gen cephalosporin

A

4th

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25
Q

coverage by cefepime includes

A

Gram positives, Gram negatives, Pseudomonas

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26
Q

Ceftaroline is a ___ gen cephalosporin

A

5th

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27
Q

coverage by ceftaroline includes

A

Gram positives, Gram negatives, MRSA, Listeria, Enterococcus

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28
Q

SEs of cephalosporins

A

hypersensitivity rxns independent of penicillin allergies

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29
Q

mechanism of resistance to cephalosporins

A

structural change in transpeptidases such that they no longer bind the drug

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30
Q

carbapenems are B-lactamase ____

A

resistant

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31
Q

coverage of carbapenems includes

A

Gram positive cocci, Gram negative rods, anaerobes

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32
Q

SEs of carbapenems include:

A

GI distress, skin rash, seizures

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33
Q

mechanism of aztreonam

A

like penicillin, but works specifically at transpeptidase PBP3

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34
Q

coverage of aztreonam includes

A

gram negative rods, used instead of aminoglycosides in pts with renal dysfunction

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35
Q

mechanism of vancomycin

A

bind to D-ala-D-ala portions of cell wall precursors and prevent peptidoglycan formation

36
Q

SEs of vancomycin include

A

nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome (prevent with antihistamines and slow infusion rate)

37
Q

mechanism of resistance to vancomycin

A

D-ala-D-ala –> D-ala-D-lac (develops via transposition VRE –> S. aureus)

38
Q

aminoglycosides include:

A

gentamicin, neomycin, amikacin, tobramycin, streptomycin (GNATS)

39
Q

mechanism of aminoglycosides

A

30S - inhibition of initiation complex, cause mRNA misreading, block translocation

40
Q

aminoglycosides require ____ to function so are unable to kill ____

A

oxygen, anaerobes

41
Q

aminoglycosides display ____ with B-lactam abx

42
Q

SEs of aminoglycosides

A

nephrotoxicity, neuromuscular blockage, ototoxicity, teratogen

43
Q

mechanism of tetracyclines

A

30S - prevent attachment of aminoacyl-tRNA

44
Q

Do not take tetracyclines with:

A

Ca 2+, Mg 2+, Fe 2+

45
Q

clinical use of tetracyclines

A

Lyme dz, M. pneumoniae, Rickettsia, Chlamydia, acne (they accumulate intracellularly)

46
Q

SEs of tetracyclines

A

GI distress

47
Q

teratogenicity of tetracyclines

A

discoloration of teeth, inhibition of bone growth, photosensitivity

48
Q

coverage of tigecycline includes

A

anaeoribic, Gram +, Gram -, MRSA, VRE, deep tissue infections

49
Q

mechanism of chloramphenicol

A

50S - blocks peptidyltransferase

50
Q

clinical use of chloramphenicol

A

meningitis (S. pneumo, H. influenzae, N. meningitidis) and Rickettsia in developing countries

51
Q

SEs of chloramphenicol

A

aplastic anemia, gray baby syndrome in premies

52
Q

mechanism of clindamycin

A

50S - blocks translocation of peptide chain

53
Q

clinical use of clidamycin

A

aerobic infections above the diaphragm, GAS

54
Q

SEs of clindamycin

55
Q

mechanism of linezolid

A

50S - prevents formation of initiation complex

56
Q

clinical use of linezolid

A

Gram + species, MRSA, VRE

57
Q

SEs of linezolid

A

BM suppression, peripheral neuropathy, serotonin syndrome (has MAOI activity)

58
Q

mechanism of macrolides

A

50S - block translocation by binding 23S rRNA

59
Q

clinical use of macrolides includes

A
  • atypical PNA
  • Chlamydia STD
  • B. pertussis
  • gram + cocci
60
Q

SEs of macrolides

A

GI dysmotility, QT prolongation, cholestatic hepatitis, rash, eosinophilia (MACRO)

61
Q

mechanism of sulfonamides

A

PABA analoge, inhibition of dihydropteroate synthase

62
Q

SEs of sulfonamides

A

hypersensitivity rxns, hemolysis with G6PD, interstitial nephritis, SJS

63
Q

sulfonamides cause _____ in infants

A

kernicterus

64
Q

dapsone is similar to ____

A

sulfonamides

65
Q

dapsone used for:

A
  • leprosy with rifamoin +/- clofazimine

- PCP ppx in sulfa allergic cats

66
Q

Can dapsone be used in G6PD def?

67
Q

mechanism of TMP, pyrimethamine

A

inhibits dihydrofolate reductase

68
Q

SEs of TMP, pyrimethamine

A

BM suppression

69
Q

mechanism of fluoroquinolones

A

inhibit prokaryotic DNA gyrase (topoisomerase II)

70
Q

clinical use of fluoroquinolones

A

GI/GU Gram negatives, otitis externa

71
Q

SEs of fluoroquinolones

A
  • cartilage damage - pregnant women (teratogen), nursing mothers, < 18 yo
  • spontaneous tendon rupture (> 60 yo)
72
Q

mechanism of daptomycin

A

lipopeptide that creates transmembrane channels membranes of gram positive cocci

73
Q

clinical use of daptomycin

A

MRSA, VRE - cannot be used for pneumonia since it is inactivated by surfactant

74
Q

SEs of daptomycin

A

myopathy, rhabdomyolysis

75
Q

mechanism of action of metronidazole

A

formation of toxic free radical metabolites inside bacterial cells that damage DNA

76
Q

clinical use of metronidazole

A

giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes below the diaphragm, H. pylori

77
Q

SEs of metronidazole

A

metallic taste, disulfiram-like rxn with EtOH

78
Q

Prophylaxis for those who are high risk for endocarditis prior to undergoing surgical/dental procedures

A

amoxicillin

79
Q

Prophylaxis for gonorrhea exposure

A

ceftriaxone

80
Q

Prophylaxis for recurrent UTIs

81
Q

Prophylaxis for meningococcus exposure

A

ceftriaxone, cipro, rifampin

82
Q

Prophylaxis for GBS

A

intrapartum penicillin G or ampicillin

83
Q

Prophylaxis for gonococcal conjunctivitis in neonates

A

erythromycin eye ointment

84
Q

Prophylaxis for post-op S. aureus skin infxns

85
Q

Prophylaxis for GAS dz in child with prior ARF

A

penicillin G or V

86
Q

Prophylaxis for syphilis exposure

A

penicillin G

Pharmacology (22 decks)

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