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Antibiotics Flashcards

1
Q

Source of infection in immunocompetent individuals

A

external

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2
Q

Source of infection in immunocompromised individuals

A

internal

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3
Q

Minimum Inhibitory Concentration

MIC

A

lowest concentration of antibiotic that inhibits bacterial growth
remove antibiotic- bacteria grows

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4
Q

Minimum Bactericidal Concentration

MBC

A

lowest concentration of antibiotic that kills bacteria

remove antibiotic- no growth

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5
Q

Microbiostatic Agents

A

inhibit growth of organisms but does not kill them

allows immune system to destroy

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6
Q

Excretes antibiotics

A

kidney

must adjust doses in renal failure

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7
Q

Synergy

A

2 antibiotics work at 2 different sites in same or different metabolic pathways

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8
Q

B Lactams

A

inhibit cell wall synthesis by targeting transpeptidase

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9
Q

Examples of B Lactams

A

Penicillins
Cephalosporins
Monobactam
Carbapenems

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10
Q

Example of Natural Penicillins

A

Penicillin G

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11
Q

Example of Antistaphylococcal Penicillins

A

nafcillin

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12
Q

Example of Amino Penicillins

A

amoxicillin

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13
Q

Example of Antipseudomonal Penicillins

A

piperacillin

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14
Q

MoA of Penicillins

A

inactivate PBPs that help synthesize cell walls via transpeptidase

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15
Q

Gram -

A

thin peptidoglycan wall with an outer membrane

stains pink

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16
Q

Gram +

A

thick peptidoglycan wall

stains purple

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17
Q

How do drugs get to the PM of Gram - bacteria?

A

enter through porins

must be small enough to fit

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18
Q

What antibiotic is too large to fit through porins?

A

vancomycin

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19
Q

B Lactamase Inhibitors

A

irreversibly bind to B lactamase to prevent breakdown of B lactams

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20
Q

B Lactamase Inhibitors should be combined with…

A

clavulanic acid

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21
Q

B Lactams not cleaved by B Lactamase

A

Antistaphylococcal

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22
Q

Resistance to Penicillin

A

no cell wall
decreased penetration through porins
transfer B lactamase to bacteria
modify PBP so drug cant bind

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23
Q

Penicillin that is not only excreted by the kidneys

A

antistaph

liver- no adjustment needed

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24
Q

Adverse Effects of Penicillin

A

hypersensitivity- rash or anaphylaxis

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25
Uses for Antistaphylococcal Penicillins (and which drug)
very narrow spectrum | MSSA- nafcillin
26
Uses for Natural Penicillins (and which drug)
narrow spectrum most strep/ gram +; treponema (syphilis) Pen G
27
Uses for Aminopenicillins (and which drug)
broad spectrum gram + and some - amoxicillin
28
Uses for Antipseudomonal Penicillin
very broad spectrum gram + and most -; pseudomonas piperacillin
29
First Generation Cephalosporins
cephalexin
30
Second Generation Cephalosporins
cefaclor
31
Third Generation Cephalosporins
cefotaxime, ceftriaxone
32
Fourth Generation Cephalosporins
cefepime
33
Fifth Generation Cephalosporins
ceftaroline
34
MoA of Cephalosporins
inactivates PBPs (transpeptidase)
35
Resistance of Cephalosporins
no cell wall decreased penetration through porins transfer B lactamase to bacteria modify PBP so drug cant bind
36
Treating Meningitis
3rd Gen- cefotaxime, ceftriaxone
37
Cephalosporin not only excreted by the kidneys
ceftriaxone
38
Cephalosporin that can't be used on kids
ceftriaxone- causes biliary sludging
39
Adverse Affects of Cephalosporins
hypersensitivity mild rash to pens- use anaphylaxis to pens- avoid
40
Uses for 1st Gen Cephalosporins (and which drug)
narrow spectrum for surgical prophylaxis strep/ staph (gram +) cephalexin
41
Uses for 2nd Gen Cephalosporins (and which drug)
broad spectrum surgical prophylaxis of anaerobes- bacteroids cefaclor
42
Uses for 3rd Gen Cephalosporins (and which drug)
very broad spectrum gram + and - meningitis- ceftriaxone and cefotaxime gonorrgea- ceftriaxone
43
Uses for 4th Gen Cephalosporins (and which drug)
very broad spectrum gram + and - hospital acquired infections cefepime
44
Uses for 5th Gen Cephalosporins (and which drug)
MRSA | ceftaroline
45
Example of Carbapenems
imipenem
46
Imipenem should be combined with....
cilastatin | stops imipenem from being cleaved
47
Carbapenems
broadest spectrum of antibiotics | resistant to most B lactamases
48
Uses for Carbapenems
empiric therapy | given IV
49
Resistance of Carbapenems
no cell wall decreased penetration through porins transfer B lactamase to bacteria modify PBP so drug cant bind
50
MoA to Carbapenems
inactivates PBPs (transpeptidase)
51
Adverse Effects of Carbapenems
hypersensitivity | seizures in renal dysfunction
52
Monobactams
B lactam ring not fused to another ring | no cross sensitivity to penicillin
53
Vancomycin
inhibits cell wall synthesis by blocking transglycosylase at the D-Ala-D-Ala terminal
54
Vancomycin Resistance | VRSA
changes D-Ala-D-Ala to D-Ala-D-lactate
55
Use for Vancomycin
hospital acquired MRSA
56
Administering Vancomycin
IV adjust for renal failure orally for C. diff
57
Adverse Effects of Vancomycin
red man syndrome- histamine flushing of upper body if given too quickly (<1 hour)
58
Bacitracin
used topically for gram + | combined with neomycin and polymyxin
59
Polymyxin
used topically for gram - | combined with neomycin and bacitracin
60
Types of 30S Drugs
Tetracyclines | Aminoglycosides
61
Types of 50S Drugs
Macrolides | Clindamycin
62
Tetracyclines MoA
bind to 30S | block access of tRNA at A site, preventing addition of AA
63
Bacteriostatic Drugs
Tetracyclines- doxycycline Macrolides- "thromycin" Sulfonamides
64
Uses of Tetracyclines (and which drug)
rickettsia- Rocky Mountain Spotted Fever borrelia- Lyme disease doxycycline
65
Resistance of Tetracyclines
by Mg dependent active efflux
66
Patients on Tetracyclines should not take.....
dairy products | antacids
67
Adverse Effects of Tetracyclines
gastric discomfort phototoxicity deposits in bone/ teeth of kids discoloration and hypoplasia, stunts growth
68
Example of Aminoglycosides
gentamicin
69
MoA of Aminoglycosides
induces misreading of mRNA inhibits translocation kills
70
Uses of Aminoglycosides (and which drug)
aerobic gram - synergistic with piperacillin for pseudomonas gentamicin
71
Resistance for Aminoglycosides
enzyme mediated inactivation of drug
72
Adverse Effects of Aminoglyosides
ototoxicity (esp w/ loops) | neuromuscular paralysis- Ach block
73
Macrolides MoA
bind to 50S | inhibit aminoacyl translocation reaction
74
Examples of Macrolides
"thromycin"
75
Uses of Macrolides (and which drug)
``` CA pneumonia legionella mycobacterium avium chlamydia trachomatis backup to pen allergens ```
76
Resistance to Macrolides
methylation of binding site
77
Adverse Effects of Macrolides
increase GI motility and gastric emptying | given to diabetics to force
78
MoA of Clindamycin
binds to 50S | inhibits aminoacyl translocation reaction
79
Use for Clindamycin
anaerobic pathogens- bacteroides
80
Adverse Effects of Clindamycin
superinfection of C. difficile
81
Types of Antifolates
Sulfonamides | Trimethoprim; TMP/ SMX
82
MoA of Sulfonamides
compete with PABA for dihydropteroate synthase and prevents folic acid synthesis
83
Adverse Effects of Sulfonamides
hypersensitivity- Stephens- Johnson syndrome
84
MoA of Trimethoprim
inhibits dihydrofolate reductase
85
Use of Trimethoprim
UTI- E. coli CA MRSA pnemocystitis jiroveci pneumonia
86
Adverse Effects of Trimethoprim
bone marrow suppression | anemia
87
Use of Metronidazole
``` anaerobes and parasites bacteroides, clostridium trichomonas, entamoeba, giarda gardnerella "GET BaC on the Metro, G!" ```
88
No Kidney Adjust
ceftriaxone, doxycycline, metronidazole
89
Adverse Effects of Metronidazole
metallic taste in mouth | cant drink alcohol
90
MoA of Fluoroquinolones
inhibit DNA gyrase (topoisomerase 2)- prevents relaxation of supercoils- break and die
91
Use of Fluoroquinolones
gram - UTIs CA pneumonia- levoflaxin and femifloxacin
92
Examples of Fluoroquinolones
"floxacin"
93
Resistance to Fluoroquinolones
mutation of DNA gyrase
94
Adverse Effects of Fluoroquinolones
tendonitis and tendon rupture
95
Patients taking Fluoroquinolones should avoid.....
antacids

Pharmacology (12 decks)

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