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Pharmacology > Antibiotics > Flashcards

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
Q

Uses for Antistaphylococcal Penicillins (and which drug)

A

very narrow spectrum

MSSA- nafcillin

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26
Q

Uses for Natural Penicillins (and which drug)

A

narrow spectrum
most strep/ gram +; treponema (syphilis)
Pen G

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27
Q

Uses for Aminopenicillins (and which drug)

A

broad spectrum
gram + and some -
amoxicillin

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28
Q

Uses for Antipseudomonal Penicillin

A

very broad spectrum
gram + and most -; pseudomonas
piperacillin

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29
Q

First Generation Cephalosporins

A

cephalexin

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30
Q

Second Generation Cephalosporins

A

cefaclor

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31
Q

Third Generation Cephalosporins

A

cefotaxime, ceftriaxone

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32
Q

Fourth Generation Cephalosporins

A

cefepime

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33
Q

Fifth Generation Cephalosporins

A

ceftaroline

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34
Q

MoA of Cephalosporins

A

inactivates PBPs (transpeptidase)

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35
Q

Resistance of Cephalosporins

A

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

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36
Q

Treating Meningitis

A

3rd Gen- cefotaxime, ceftriaxone

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37
Q

Cephalosporin not only excreted by the kidneys

A

ceftriaxone

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38
Q

Cephalosporin that can’t be used on kids

A

ceftriaxone- causes biliary sludging

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39
Q

Adverse Affects of Cephalosporins

A

hypersensitivity
mild rash to pens- use
anaphylaxis to pens- avoid

40
Q

Uses for 1st Gen Cephalosporins (and which drug)

A

narrow spectrum
for surgical prophylaxis
strep/ staph (gram +)
cephalexin

41
Q

Uses for 2nd Gen Cephalosporins (and which drug)

A

broad spectrum
surgical prophylaxis of anaerobes- bacteroids
cefaclor

42
Q

Uses for 3rd Gen Cephalosporins (and which drug)

A

very broad spectrum
gram + and -
meningitis- ceftriaxone and cefotaxime
gonorrgea- ceftriaxone

43
Q

Uses for 4th Gen Cephalosporins (and which drug)

A

very broad spectrum
gram + and -
hospital acquired infections
cefepime

44
Q

Uses for 5th Gen Cephalosporins (and which drug)

A

MRSA

ceftaroline

45
Q

Example of Carbapenems

A

imipenem

46
Q

Imipenem should be combined with….

A

cilastatin

stops imipenem from being cleaved

47
Q

Carbapenems

A

broadest spectrum of antibiotics

resistant to most B lactamases

48
Q

Uses for Carbapenems

A

empiric therapy

given IV

49
Q

Resistance of Carbapenems

A

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

50
Q

MoA to Carbapenems

A

inactivates PBPs (transpeptidase)

51
Q

Adverse Effects of Carbapenems

A

hypersensitivity

seizures in renal dysfunction

52
Q

Monobactams

A

B lactam ring not fused to another ring

no cross sensitivity to penicillin

53
Q

Vancomycin

A

inhibits cell wall synthesis by blocking transglycosylase at the D-Ala-D-Ala terminal

54
Q

Vancomycin Resistance

VRSA

A

changes D-Ala-D-Ala to D-Ala-D-lactate

55
Q

Use for Vancomycin

A

hospital acquired MRSA

56
Q

Administering Vancomycin

A

IV
adjust for renal failure
orally for C. diff

57
Q

Adverse Effects of Vancomycin

A

red man syndrome- histamine flushing of upper body if given too quickly (<1 hour)

58
Q

Bacitracin

A

used topically for gram +

combined with neomycin and polymyxin

59
Q

Polymyxin

A

used topically for gram -

combined with neomycin and bacitracin

60
Q

Types of 30S Drugs

A

Tetracyclines

Aminoglycosides

61
Q

Types of 50S Drugs

A

Macrolides

Clindamycin

62
Q

Tetracyclines MoA

A

bind to 30S

block access of tRNA at A site, preventing addition of AA

63
Q

Bacteriostatic Drugs

A

Tetracyclines- doxycycline
Macrolides- “thromycin”
Sulfonamides

64
Q

Uses of Tetracyclines (and which drug)

A

rickettsia- Rocky Mountain Spotted Fever
borrelia- Lyme disease
doxycycline

65
Q

Resistance of Tetracyclines

A

by Mg dependent active efflux

66
Q

Patients on Tetracyclines should not take…..

A

dairy products

antacids

67
Q

Adverse Effects of Tetracyclines

A

gastric discomfort
phototoxicity
deposits in bone/ teeth of kids
discoloration and hypoplasia, stunts growth

68
Q

Example of Aminoglycosides

A

gentamicin

69
Q

MoA of Aminoglycosides

A

induces misreading of mRNA
inhibits translocation
kills

70
Q

Uses of Aminoglycosides (and which drug)

A

aerobic gram -
synergistic with piperacillin for pseudomonas
gentamicin

71
Q

Resistance for Aminoglycosides

A

enzyme mediated inactivation of drug

72
Q

Adverse Effects of Aminoglyosides

A

ototoxicity (esp w/ loops)

neuromuscular paralysis- Ach block

73
Q

Macrolides MoA

A

bind to 50S

inhibit aminoacyl translocation reaction

74
Q

Examples of Macrolides

A

“thromycin”

75
Q

Uses of Macrolides (and which drug)

A 
CA pneumonia
legionella
mycobacterium avium
chlamydia trachomatis
backup to pen allergens
76
Q

Resistance to Macrolides

A

methylation of binding site

77
Q

Adverse Effects of Macrolides

A

increase GI motility and gastric emptying

given to diabetics to force

78
Q

MoA of Clindamycin

A

binds to 50S

inhibits aminoacyl translocation reaction

79
Q

Use for Clindamycin

A

anaerobic pathogens- bacteroides

80
Q

Adverse Effects of Clindamycin

A

superinfection of C. difficile

81
Q

Types of Antifolates

A

Sulfonamides

Trimethoprim; TMP/ SMX

82
Q

MoA of Sulfonamides

A

compete with PABA for dihydropteroate synthase and prevents folic acid synthesis

83
Q

Adverse Effects of Sulfonamides

A

hypersensitivity- Stephens- Johnson syndrome

84
Q

MoA of Trimethoprim

A

inhibits dihydrofolate reductase

85
Q

Use of Trimethoprim

A

UTI- E. coli
CA MRSA
pnemocystitis jiroveci pneumonia

86
Q

Adverse Effects of Trimethoprim

A

bone marrow suppression

anemia

87
Q

Use of Metronidazole

A 
anaerobes and parasites
bacteroides, clostridium
trichomonas, entamoeba, giarda
gardnerella
"GET BaC on the Metro, G!"
88
Q

No Kidney Adjust

A

ceftriaxone, doxycycline, metronidazole

89
Q

Adverse Effects of Metronidazole

A

metallic taste in mouth

cant drink alcohol

90
Q

MoA of Fluoroquinolones

A

inhibit DNA gyrase (topoisomerase 2)- prevents relaxation of supercoils- break and die

91
Q

Use of Fluoroquinolones

A

gram -
UTIs
CA pneumonia- levoflaxin and femifloxacin

92
Q

Examples of Fluoroquinolones

A

“floxacin”

93
Q

Resistance to Fluoroquinolones

A

mutation of DNA gyrase

94
Q

Adverse Effects of Fluoroquinolones

A

tendonitis and tendon rupture

95
Q

Patients taking Fluoroquinolones should avoid…..

A

antacids

Pharmacology (12 decks)

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