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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Types of antibiotics

A

1 bactericidal

2. Bacteriostatic

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2
Q

Bactericidal antibiotics

A 
Vancomycin
Fluoroquinolones
Penicillins
Aminoglycosides
Metronidazole

Very Finely Proficient at Murder

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3
Q

Bacteriostatic antibiotics

A 
Erythromycin
Clindamycin
Sulfamethoxazole
Trimethoprim
Tetracycline
Chloramphenicol

ECSTaTiC

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4
Q

natural penicillin
narrow spectrum
for streptococcal, pneumococcal, meningococcal infections, syphilis
SE: hypersensitivity, GI disturbances, seizures
RENAL TUBULAR REABSORPTION INHIBITED BY PROBENECID
INACTIVATED BY BETA-LACTAMASE (PENICILLINASE)

A 
Penicillin G (parenteral)
Penicillin V (oral)
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5
Q

isoxazolyl penicillin (anti-staphylococcal)
very narrow spectrum
for STAPHYLOCOCCAL INFECTIONS
SE: hypersensitivity, cross allergenicity with other penicillins, GI disturbances, INTERSTITIAL NEPHRITIS, NEUTROPENIA
RESISTANT TO INACTIVATION BY BETA-LACTAMASE (PENICILLINASE)

A

methicillin (interstitial nephritis)

nafcillin (neutropenia), oxacillin, cloxacillin, dicloxacillin

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6
Q 
amino penicillin
extended spectrum
for HELPSE infections
SE: PSEUDOMEMBRANOUS COLITIS, rash
INACTIVATED BY BETA-LACTAMASE
ENHANCED EFFECT WHEN USED WITH BETA-LACTAMASE INHIBITORS (CLAVULANIC ACID, SULBACTAM)
SYNERGISTIC EFFECT WITH GLYCOSIDES
A

Ampicillin (IV)

Amoxicillin (oral)

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7
Q

anti-pseudomonal penicillin
SE: hypersensitivity, cross-allergenicity, GI disturbances,
INACTIVATED BY BETA-LACTAMASE
ENHANCED EFFECT WHEN USED WITH BETA-LACTAMASE INHIBITORS (CLAVULANIC ACID, SULBACTAM)
SYNERGISTIC EFFECT WITH GLYCOSIDES AGAINST PSEUDOMONAS

A

Piperacillin

Ticarcillin, Carbenicillin

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8
Q

Beta-Lactamase RESISTANT drugs

A
  1. 4th generation cephalosporins
  2. monobactam (aztreonam)
  3. isox. benz.
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9
Q

1st gen cephalosporin
gram + coverage
for SURGICAL PROPHYLAXIS, BONE INFECTIONS
SE: hypersensitivity
INCREASES nephrotoxicity of aminoglycosides

A

cefazolin

cefadroxil, cephalexin, cephalothin, cephapirin, cephradine

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10
Q

which microbes are covered by spectrum of activity of 1st gen cephalosporins?

A

PEcKs FIRST

Proteus mirabilis
E. Coli
Klebsiella pneumoniae

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11
Q

2nd gen cephalosporin
addded coverage for Haemophilus, Enterobacter, and Neisseria
SE: hypersensitivity, DISULFIRAM REACTION
INCREASES nephrotoxicity of aminoglycosides

A

cefaclor
cefamandole, cefmetazole, cefonicid, cefuroxime, cefprozil, ceforanide, cefoxitin, cefotetan, loracarbef

DISULFIRAM REACTION: cefamandole, cefotetan

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12
Q

3rd gen cephalosporin
SE: hypersensitivity
SYNERGISTIC EFFECT WITH AMINOGLYCOSIDES

A

cefoperazone
cefotaxime, ceftazidime, ceftizoxime, ceftriaxone, cefixime, cefpodoxime proxetil, cefdinir, cefditoren pivoxil, ceftibuten, moxalactam

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13
Q 
4th gen cephalosporin
wide coverage against gram + and gram - bacteria, MRSA
SE: hypersensitvity
RESISTANT TO BETA-LACTAMASE
BROAD GRAM NEG ACTIVITY
A

cefepime

ceftaroline

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14
Q

carbapanem
wide coverage against gram + and gram - bacteria
SE: hypersensitvity, CNS toxicity (confusion, encephalopathy, SEIZURES)
for SERIOUS LIFE THREATENING INFECTIONS

A

Imipinem-Cilastatin
Ertapenem, Meropenem, Doripenem

Cilastatin inhibits renal metabolism
Hydrolysis of imipenem by dihydropeptidase

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15
Q 
monobactam
for GRAM NEG RODS
RESISTANT TO BETA LACTAMASE
NO CROSS-ALLERGENICITY WITH PENICILLINS
NO ACTIVITY AGAINST GRAM POSITIVE BACTERIA OR ANAEROBES
A

aztreonam

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16
Q

anti-pseudomonal cephalosporins

A

ceftazidime
cefepime
cefoperazone

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17
Q

beta-lactamase inhibitor
SE: hypersensitivity
usually combined with amoxicillin, ampicillin, piperacillin

A

clavulanic acid

sulbactam, tazobactam

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18
Q 
glycopeptide
binds to D-Ala-D-Ala
for MRSA, PSEUDOMEMBRANOUS COLITIS
SE: Red Man Syndrome, Nephrotoxicity, Ototoxicity
for SERIOUS LIFE-THREATENING INFECTIONS
A

vancomycin

teicoplanin, dalbavancin, telavancin

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19
Q

treatment for Red Man Syndrome

A

slowing rate of infusion

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20
Q

drugs of last resort

A 
Imipinem
Amikacin
Meropenem
Linezolid
Streptogramins
Vancomycin
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21
Q

peptide antibiotic
SE: nephrotoxicity
for TOPICAL USE ONLY DUE TO MARKED NEPHROTOXICITY

A

bacitracin

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22
Q

blocks incorporation of D-Ala into pentapeptide
for DRUG-RESISTANT TB (2ND LINE DRUG)
SE: NEUROTOXICITY (TREMORS, SEIZURES, PSYCHOSIS)

A

cycloserine

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23
Q

binds to cell membrane causing depolarisation and rapid cell death
for gram + infections (sepsis, endocarditis)
SE: myopathy
inactivated by pulmonary surfactants

A

daptomycin

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24
Q

inactivates enzyme UDP-acetylglycosamine-3-enolpyruvyltransferase
for uncomplicated UTI
SAFE FOR PREGNANT PATIENTS

A

fosfomycin

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25
Q

bacterial protein synthesis inhibitors

A

30s
Aminoglycosides
Tetracyclines

50s
Chloramphenicol
Erythromycin (macrolides)
Linezolid
Lincosamides (clindamycin)
Streptogramins
26
Q

broad spectrum bacterial protein synthesis inhibitor
binds 50s subunit
BACTERIOSTATIC
for MENINGITIS
SE: APLASTIC ANEMIA, GRAY BABY SYNDROME
inhibits hepatic drug-metabolising enzymes causing many drug interactions

A

chloramphenicol

27
Q

moderate spectrum bacterial protein synthesis inhibitor
macrolide
binds 50s subunit
BACTERIOSTATIC
SE: cholestatic hepatitis, hepatotoxicity, QT prolongation, drug interactions

A

erythromycin (alternative for penicillin allergic patients)
azithromycin (highest Vd and slowest elimination)
clarithromycin
telithromycin (used for macrolide resistance)

28
Q

ALL macrolides inhibit CYP450 enzymes EXCEPT for

A

azithromycin

29
Q

broad spectrum bacterial protein synthesis inhibitor
tetracycline
binds 30s subunit
BACTERIOSTATIC
for atypical infections (M. pneumoniae, chlamydiae, rickettsiae, and Vibrio)
SE: tooth enamel dysplasia/discoloration, photosensitivity

A

tetracycline

doxycycline, minocycline (vestibulotoxicity) tigecyline (broadest spectrum and least resistance), demeclocycline

30
Q

narrow spectrum bacterial protein synthesis inhibitor
lincosamide
binds 50s subunit
BACTERIOSTATIC
for ANAEROBIC INFECTIONS
SE: PSEUDOMEMBRANOUS COLITIS (C. difficile overgrowth)

A

clindamycin
lincomycin

cross-resistance between clindamycin and macrolides is common

31
Q

narrow spectrum bacterial protein synthesis inhibitor
streptogramin
binds 50s subunit
BACTERICIDAL
for MRSA, VRSA, VRE
SE: arthralgia-myalgia syndrome
INHIBITS CYP450 ENZYMES causing multiple drug interactions

A

quinupristin-dalfopristin

32
Q 
narrow spectrum bacterial protein synthesis inhibitor
oxazolidinone
binds to 23s of 50s subunit
BACTERIOSTATIC
for MRSA, VRSA, VRE
A

linezolid

33
Q

post-antibiotic effect of aminoglycosides

A

killing action continues when plasma levels have declined below measurable levels
greater efficacy when administered as single large dose

34
Q

pharmacokinetics of aminoglycosides

A

not absorbed after oral administration
limited tissue perfusion
glomerular filtration is major mode of excretion

35
Q

aminoglycoside
binds to 30s subunit
BACTERICIDAL
SE: nephrotoxicity (reversible), ototoxicity (irreversible)
synergistic effects with beta-lactam antibiotics and vancomycin

A

gentamicin
tobramycin

most vestibulotoxic and nephrotoxic aminoglycosides

36
Q

aminoglycoside
binds to 30s subunit
BACTERICIDAL
for PSEUDOMONAS, MDR-TB (2ND LINE DRUG)
SE: nephrotoxicity (reversible), ototoxicity (irreversible)
synergistic effects with beta-lactam antibiotics
LEAST RESISTANCE BUT NARROWEST THERAPEUTIC WINDOW

A

amikacin

37
Q 
aminoglycoside
binds to 30s subunit
BACTERICIDAL
for TB
SE: nephrotoxicity (reversible), ototoxicity (irreversible), CONGENITAL DEAFNESS
synergistic with beta-lactam antibiotics
administered IM
A

streptomycin

38
Q

aminoglycoside
binds to 30s subunit
BACTERICIDAL
for BOWEL PREP FOR ELECTIVE SURGERY, HEPATIC ENCEPHALOPATHY
SE: nephrotoxicity (reversible), ototoxicity (irreversible), NEUROMUSCULAR BLOCKADE
limited to TOPICAL AND ORAL USE

A

neomycin

kanamycin (most ototoxic), paromomycin

39
Q

reverses neuromuscular blockade sec to aminoglycosides

A

gluconate and neostigmine

40
Q

most ototoxic aminoglycosides

A

kanamycin, amikacin

41
Q

most vestibulotoxic aminoglycosides

A

tobramycin, gentamicin

42
Q

most nephrotoxic aminoglycosides

A

tobramycin, gentamicin

43
Q

skin reactions common with which aminoglycosides

A

neomycin and streptomycin

44
Q

nucleic acid synthesis inhibitors
anti-folate sulfonamide
BACTERIOSTATIC
for BURN INFECTIONS
SE: ACUTE HEMOLYSIS IN G6PD DEFICIENCY, HYPERSENSITIVITY, KERNICTERUS
displaces protein blinding of other drugs/bilirubin

A

silver sulfadiazine

mafenide acetate

45
Q

nucleic acid synthesis inhibitors
anti-folate sulfonamide
BACTERICIDAL
seuqential BLOCKADE OF DIHYDROFOLATE SYNTHASE & REDUCTASE
for UTI, PCP
SE: ACUTE HEMOLYSIS IN G6PD DEFICIENCY, HYPERSENSITIVITY, KERNICTERUS
displaces protein blinding of other drugs/bilirubin

A

co-trimoxazole

46
Q

antibiotic for anaerobic infections above diaphragm vs. below diaphragm

A

clindamycin: above diaphragm
metronidazole: below diaphragm

47
Q

long-acting sulfonamide

A

sulfadoxine

48
Q

DOC for toxoplasmosis

2nd line for malaria

A

sulfadoxine-pyrimethamine

49
Q

co-administered with leucovorin to limit bone marrow toxicity

A

pyrimethamine

50
Q

aminoglycoside
binds to 30s subunit
BACTERICIDAL
for DRUG RESISTANT GONORRHEA, GONORRHEA IN PENICILLIN-ALLERGIC PATIENTS
SE: nephrotoxicity (reversible), ototoxicity (Irreversibl), anemia

A

spectinomycin

51
Q

generation of fluoroquinolones that is NOT fluorinated

A

1st gen: for UTI

nalidixic acid, cinoxacin, rosoxacin, oxolinic acid

52
Q

2nd gen fluoroquinolone
inhibits DNA replication
BACTERICIDAL
for UTI, ATYPICAL PNEUMONIA, TB (2ND LINE DRUG)
SE: GI DISTRESS, TENDONITIS, TENDON RUPTURE
AVOID USING IN YOUNG CHILDREN & PREGNANT WOMEN (chelates Ca)

A

ciprofloxacin

ofloxacin, norfloxacin, lomefloxacin, enoxacin

53
Q

DOC for UTI

A

ciprofloxacin

54
Q

3rd gen fluoroquinolone
inhibits DNA replication
BACTERICIDAL
for LUNG INFECTIONS by gram + cocci, ATYPICAL PNEUMONIA
SE: GI distress, TENDINITIS, QT PROLONGATION
AVOID USING IN YOUNG CHILDREN & PREGNANT WOMEN

A

levofloxacin
sparfloxacin, moxifloxacin, gemifloxacin

enhances toxicity of methylxanthines (theophylline)

grepafloxacin withdrawn due to severe cardiotoxicity (arrhythmias)
gatifloxacin SE: DM

55
Q

4th gen fluoroquinolone
inhibits DNA replication
BACTERICIDAL
ENHANCED ACTIVITY AGAINST ANAEROBES
SE: GI distress, TENDINITIS, QTc prolongation, hepatotoxicity
AVOID USING IN YOUNG CHILDREN & PREGNANT WOMEN
enhances toxicity of methylxanthines (theophylline)
WIDEST SPECTRUM OF ACTIVITY AMONG FLUOROQUINOLONES

A

trovafloxacin

alatrofloxacin

56
Q

nitroimidazole, anti-protozoal
reactive reduction by ferredoxin FORMING FREE RADICALS THAT DISRUPT ETC
BACTERICIDAL
for ANAEROBIC infections, VAGINITIS, PSEUDOMEMBRANOUS COLITIS
SE: GI irritation, metallic taste, DISULFIRAM REACTION

A

metromidazole

tinidazole

57
Q

disrupts protein, RNA, DNA synthesis
BACTERICIDAL
for UNCOMPLICATED UTI (except PROTEUS and PSEUDOMONAS)
SE: skin rashes, PULMONARY FIBROSIS & INFILTRATES

A

nitrofurantoin

58
Q

topical anti-infective
pseudomonic acid
BACTERICIDAL
for GRAM + COCCI, minor skin infections

A

mupirocin

59
Q 
cationic detergents
BACTERICIDAL
for GRAM - bacteria
proteus and neisseria resistant
TOPICAL USE ONLY
A

polymyxin B

polymyxin E

60
Q 
macrocyclic, narrow spectrum
inhibits bacterial protein synthesis
BACTERIOSTATIC
GRAM + bacteria
ORPHAN DRUG STATUS FOR C. DIFFICILE IN CHILDREN
A

fidaxomicin

Pharmacology (31 decks)

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