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PPP Spring Final > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

MOA of Beta-lactam Antibiotics

A

Inhibit transpeptidase

bactericidal

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2
Q

Mechanisms of Resistance to Penicillins

A

Penicillinases
Structural changes in PBP’s
Impaired penetration of drug to target

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3
Q

Name the First Generation Penicillins

A 
Penicillin G (IV)
Penicillin V (PO)
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4
Q

Indications of First Generation Penicillins

A

Beta-lactamase sensitive, Narrow spectrum
Gram + = Strep. pyogenes
Gram - = Neisseria meningitidis
Spirochetes = Trep. pallidum (syphilis) DOC

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5
Q

Adverse Effects of Penicillins

A

Hypersensitivity

GI Distress - Diarrhea

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6
Q

Name common second generation penicillins

A

Oxacillin
Dicloxacillin
Nafcillin

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7
Q

Indications of Second Generation Penicillins

A

Beta-lactamase resistant

Only MSSA and streptococci

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8
Q

Name common third generation penicillins

A

Amoxicillin

Ampicillin

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9
Q

Indications of Third Generation Penicillins

A

Beta-lactamase sensitive
Gram + = Listeria monocytogenes
HElP

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10
Q

Indications of Third Generation Penicillins + Beta-lactamase Inhibitors

A 
Strep
Staph
Enterococcus
Listeria
HNPEK 
Anaerobes
Borrelia burgdorferi
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11
Q

Indications of Piperacillin + Beta-lactamase Inhibitor

A 
Strep
Staph
Listeria
Enterococcus
HNPEK 
CaPES
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12
Q

HElP

A

H. Influenza
E. Coli
Proteus

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13
Q

HNPEK

A 
H. Influenza
Neisseria
Proteus
E. Coli
Klebsiella
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14
Q

CaPES

A

Citrobacter
Pseudomonas
Enterobacter
Serratia

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15
Q

Name common first generation cephalosporins

A

Cefazolin

Cephalexin

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16
Q

Indications for first generation cephalosporins

A

Surgical prophylaxis
Strep
Staph
PEK

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17
Q

Adverse Effects of Cephalosporins

A

Hypersensitivity
GI distress
Nephrotoxicity

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18
Q

Name common second generation cephalosporins

A

Cefuroxime
Cefoxitin
Cefotetan

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19
Q

Indications of second generation cephalosporins

A

Strep
Staph
HNPEK

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20
Q

Special indication of Cefuroxime

A

Meningitis

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21
Q

Special indication of Cefoxitin

A

B. Fragilis

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22
Q

Special indication of Cefotetan

A

B. Fragilis

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23
Q

Which cephalosporins can cause the disulfiram reaction?

A

Cefoxitin

Cefotetan

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24
Q

Name common third generation cephalosporins

A

Ceftriaxone
Cefotaxime
Ceftazidime

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25
Q

Indications of third generation cephalosporins

A 
Strep
Staph
HNPEK 
CaPES*** 
Sepsis
Meningitis
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26
Q

Which third generation cephalosporin is the only one indicated of Pseudomonas?

A

Ceftazidime

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27
Q

Indications of Cefepime

A

Empirical treatment of nosocomial infections

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28
Q

CI in pregnancy

A

Aminoglycosides
Telavancin
Fluoroquinolones

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29
Q

Bactericidal

A 
Glycopeptide
Daptomycin
Aminoglycoside
Quinolones
Metronidazole
Beta-lactams
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30
Q

Bacteriostatic

A 
Sulfonamide
Clindamycin
Streptomycin
Tetracycline
Chloramphenicol
Linezolid
Macrolides
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31
Q

Nephrotoxic

A

Cephalosporins
Aminoglycosides
Telavancin

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32
Q

Indications of Ceftaroline

A

Broad spectrum including MRSA

No pseudomonas

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33
Q

Indications of Aztreonam

A

HNPEK

CaPES

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34
Q

Name common carbapenems

A

Imipenem

Meropenem

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35
Q

Indications of Carbapenems

A

Broadest-spectrum beta-lactams
Gram + = cocci
Gram - = rods (including pseudomonas)
Anaerobes

empiric treatment for life-threatening infections

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36
Q

Adverse Effects of Carbapenems

A

GI distress
Hypersensitivity
CNS effects - with imipenem

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37
Q

How must imipenem be administered?

A

Give with cilastatin to prevent breakdown in the kidneys

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38
Q

Indications of Vancomycin

A 
Only Gram +
Strep
MRSA
Enterococci
C. diff (oral)
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39
Q

Adverse Effects of Vancomycin

A

“Red man” hypersensitivity

Ototoxicity

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40
Q

MOA of Vancomycin

A

Bind to D-Ala-D-Ala in peptidoglycan to prevent cross-linking
Bactericidal

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41
Q

MOA of Daptomycin (lipopeptide)

A

Intercalates into bacterial inner membrane = disturbs homeostasis
Bactericidal

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42
Q

Indications of Daptomycin

A

VRSA
VRE
MRSA
cannot use for pneumonia, inactivated by surfactant

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43
Q

Adverse Effects of Daptomycin

A

Myopathy and muscle weakness

do not use with statins

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44
Q

MOA of Telavancin

A

Bind to D-Ala-D-Ala to prevent cross-linking and incorporates into the cell membrane

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45
Q

Indications of Telavancin

A

VRE

MRSA

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46
Q

Adverse Effects of Telavancin

A

GI distress
CNS effects (insomnia, HA)
Nephrotoxic BBW
Teratogenic BBW

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47
Q

MOA of Aminoglycosides

A

Binds 30S subunit and prevents initiator tRNA from binding P-site
Bactericidal

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48
Q

Indications of Aminoglycosides

A

Gram - aerobes

49
Q

Adverse Effects of Aminoglycosides

A

Nephrotoxic
Ototoxic
Neuromuscular blockade

50
Q

Contraindications of Aminoglycosides

A

Renal disease
Hearing impairment
Pregnancy

51
Q

Name common aminoglycosides

A

Gentamicin
Tobramycin
Amikacin
Streptomycin

52
Q

MOA of Oxazolidinones

A

Binds 50S complex and prevents initiator tRNA from binding P-site
Bacteriostatic

53
Q

Indications of Oxazolidinones

A

Mainly gram +
VRSA
VRE
MRSA

54
Q

Name common oxazolidinones

A

Linezolid

Tedizolid

55
Q

Adverse effects of oxazolidinones

A

GI distress

Linezolid = hematologic problems, and optic/peripheral neuropathy

56
Q

DDI of Linezolid

A

SSRIs

Tyramine-containing foods

57
Q

MOA of Tetracyclines

A

Reversibly binds to 30S subunit to inhibit tRNA at the A-site
Bacteriostatic

58
Q

Indications of Tetracyclines

A

Gram + = Prop. acnes
Gram - = Brucella
Others
Tigecycline also works against VRE, MRSA, VRSA

59
Q

Adverse Effects of Tetracyclines

A 
Tooth enamel dysplasia
Irregularities in bone growth
GI distress
Phototoxicity
C. diff
60
Q

DDI’s of Tetracyclines

A

Cations

61
Q

Resistance of Tetracyclines

A

Increased efflux or impaired influx

62
Q

Name common tetracyclines

A

Tetracycline
Doxycycline
Minocycline
Tigecycline (IV only)

63
Q

MOA of Chloramphenicol

A

Binds 50S subunit and inhibits peptidyltransferase

64
Q

Indications of Chloramphenicol

A

Wide Spectrum - Gram +,-, aerobes, and anaerobes

Reserved for life-threatening infections (meningitis, brain abscesses)

65
Q

Adverse Effects of Chloramphenicol

A 
Blood dyscrasias
Aplastic anemia
BM suppression
"Gray baby" syndrome
Rash
Fever
66
Q

DDI’s of Chloramphenicol

A

CYP450 inhibitor - do not use with anything metabolized by CYPs

67
Q

MOA of Clindamycin

A

Binds to the 50S subunit and inhibits the translocation of peptidyl-tRNA
Bacteriostatic

68
Q

MOA of Macrolides

A

Binds to the 50S subunit and inhibits the translocation of peptidyl-tRNA
Bacteriostatic

69
Q

Indications of Clindamycin

A

Narrow spectrum
Gram + bacteria
Anaerobes above the diaphragm

70
Q

Adverse Effects of Clindamycin

A 
N/V/D
C. diff
Rash 
Fever
Agranulocytosis
71
Q

Name common macrolides

A

Erythromycin
Azithromycin
Clarithromycin
Telithromycin

72
Q

Indications of Macrolides

A

LegMAC

73
Q

LegMAC

A

Legionella
Mycobacterium
Atypical pneumonia (via mycoplasma)
Campylobacter

74
Q

Special indication of Telithromycin

A

can also tx CAP

75
Q

Adverse Effects of Macrolides

A

GI distress due to increased motility (good for gastroparesis)
Hepatotoxicity
QT prolongation

76
Q

Additional AE of Telithromycin

A

Hepatitis/liver failure

77
Q

MOA of Synercid (quinupristin/dalfopristin)

A

Binds to the 50S subunit and inhibits the translocation of peptidyl-tRNA

Bacteriostatic

78
Q

Indications of Synercid

A

Bactericidal if used in combo with multidrug resistant gram + = VRSA, MRSA, VRE

79
Q

MOA of Sulfonamides

A

Inhibit folic acid synthesis through competitive antagonism of DHFS

80
Q

Indications of Folic Acid Inhibitors

A

Staph aureus
HPEK
Pneumo jiroveci

81
Q

MOA of Trimethoprim

A

Competitive inhibition of DHFR

82
Q

Adverse Effects of Folic Acid Inhibitors

A 
N/V/D
Steven-Johnson Syndrome
Photodermatitis
Leukopenia
Kernicterus
Hemolytic anemia in G6PD deficiency
Crystallization of urine
Hyperkalemia
83
Q

Resistance of Sulfonamides

A

Increased production of essential metabolite and decreased affinity of DHFS

84
Q

Resistance of Trimethoprim

A

Increased production of DHFR and reduced permeability

85
Q

DDIs of Bactrim

A

Drugs metabolized by CYPS
ACEI’s
K+ sparing diuretics

86
Q

MOA of Fluoroquinolones

A

Direct inhibition of type II and IV topoisomerase

87
Q

Indications of Norfloxacin

A

HNPEK

CAPES

88
Q

Adverse Effects of Fluoroquinolones

A 
N/V/D
Dizziness
Insomnia
Seizures
Photosensitivity
Rashes
Arthropathy
Tendonitis/tendon rupture
QT prolongation
89
Q

Contraindications of Fluoroquinolones

A

Pregnancy
Children
Myasthenia gravis
Tendonitis

90
Q

DDI’s of Fluoroquinolones

A

Cations - take 2 hours before or 4 hours after cations

Other QT prolonging drugs

91
Q

Indications of second generation fluoroquinolones

A 
HNPEK
CAPES
Shigella
Campylobacter
Salmonella
Some Gram+
92
Q

Name common second generation fluoroquinolones

A

Ciprofloxacin

Ofloxacin

93
Q

Indications of third/fourth/respiratory fluoroquinolones

A 
Gram + aerobes
HNPEK
CAPES
Shigella
Campylobacter
Salmonella
Atypical pneumonia
94
Q

Moxifloxacin & Gemifloxacin - additional coverage

A

Anaerobes

95
Q

Name common third/fourth/respiratory fluoroquinolones

A

Levofloxacin
Moxifloxacin
Gemifloxacin

96
Q

MOA of Metronidazole

A

Reduction of nitro=group leads to free radicals causing DNA damage and bacterial cell death

97
Q

Indications of Metronidazole

A

Clostridium

Bacteroides
Fusobacterium
Prevotella

Giaridia
Trichomonas
Entamoeba

98
Q

Adverse Effects of Metronidazole

A 
N/V/D
Metallic taste
Furry tongue
Disulfiram reaction
Peripheral neuropathy
99
Q

DDI’s of Metronidazole

A

Alcohol

Warfarin

100
Q

Penicillin that isn’t renally excreted

A

Nafcillin

Oxacillin

101
Q

Cephalosporin that isn’t renally excreted

A

Ceftriaxone

102
Q

Penicillin - with or without food?

A

1-2 hrs before or after meal

103
Q

Oral Ampicillin is only for _____

A

GI infections

104
Q

All Beta lactams & glycoprotein antibiotics (with some exceptions) are excreted ____

A

renally

105
Q

Which quinolone/fluoroquinolone does not need dose adjustments with renal failure?

A

Moxifloxacin

106
Q

The only bactericidal protein synth inhibitor is _____

A

aminoglycosides

107
Q

The only short acting tetracycline is ____

A

tetracycline

108
Q

Tetracycline absorption is ____ by food

A

Impaired

109
Q

How is Tigecycline eliminated?

A

Bile

110
Q

Chloramphenicol needs adjustments for ____ & ____

A

Liver dysfxn

Neonates

111
Q

Which three classes bind to 50S subunit and inhibits the translocation of Peptidyl-tRNA from acceptor to donor site → prevent protein synthesis ?

A

Macrolides
Lincosamides
Streptogramins

112
Q

How does food affect macrolides?

A

Decreases absorption but makes it better tolerated

113
Q

Which protein synthesis inhib can pass the BBB

A

Oxazolidinones

Chloramphenicol

114
Q

Which prot synth inhib have significant activity against anaerobes?

A

Chloramphenicol

Clindamycin

115
Q

Which prot synth inhib require renal dose adjusments

A

AG
Tetracycline
Minocycline

116
Q

Which prot synth inhib are mainly used agains MRSA, VRSA, and VRE?

A

Oxazolidinones
Tigecycline
Streptogramins

117
Q

Which prot synth inhib is used against MRSA, VRSA, and VRE, and is available PO?

A

Oxazolidinones

118
Q

Which drug inibits the 30S subunite

A

AG

Tetracycline

PPP Spring Final (2 decks)

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