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Maddy - Antibiotics from MOD III > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

MOA: Penicillins

A
  • interfere with PBP to inhibit cell wall synthesis
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2
Q

Resistance: Penicillins

A
  • beta lactamases
  • altering porins
  • altering PBP
  • penicillin efflux pumps
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3
Q

Adverse Rxns: Penicillins

A
  • hypersensitivity

- N/V/D with high doses

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4
Q 
What antibiotic class?
Methicillin
Nafcillin
Oxacilin
Dicloxacillin
A

Penicillinase-Resistant Penicillins

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5
Q

MOA: Aminopenicillins

A
  • increased binding affinity to PBP

- increased penetration through outer membrane of Gram negative organisms

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6
Q

What antibiotic class?
Ampicillin
Amoxicillin

A

Aminopenicillins

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7
Q

MOA: Antipseudomonal Penicillins

A
  • interfere with PBP
  • often combined with B-lactamase inhibitor Tazobactam
  • broadest spectrum penicillin
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8
Q

MOA: Cephalosporins

A
  • interfere with PBP
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9
Q

Resistance: Cephalosporins

A
  • beta-lactamases
  • altering porins
  • altering PBP
  • cephalosporin efflux pump
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10
Q

compare general penicillins to aminopenicillins

A
  • aminopenicillins have better gram negative coverage, greater binding affinity to PBP, and greater penetration through outer membrane of gram negatives
  • also aminopenicillins are often paired with beta lactamase inhibitor
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11
Q

Adverse Rxns: Cephalosporins

A
  • type 1 hypersensitivity reaction
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12
Q

Organisms covered by Gen. 1 Cephalosporins

A

PEK
P: Proteus mirabilis
E: E. coli
K: Klebsiella

  • also gram (+) cocci
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13
Q

Organisms covered by Gen. 2 Cephalosporins

A 
HENS PEK
H: H. influenzae
E: Enterobacter
N: Neisseria
S: Serratia

P: Proteus mirabilis
E: E. coli
K: Klebsiella

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14
Q

What are Gen. 3 Cephalosporins used to treat

A

serious gram negative infections

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15
Q

What cephalosporin is the first line for meningitis

A

Ceftriaxone

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16
Q

Adverse Rxns: Ceftriaxone

A
  • jaundice in neonates

- biliary pseudolithiasis (gallstones)

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17
Q

What important bacterium is covered by Gen. 4 Cephalosporins

A

P. aeruginosa

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18
Q

What important bacteria are covered by Gen. 5 Cephalosporins

A

MRSA

P. aeruginosa

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19
Q

What antibiotic class?

Piperacillin

A

Antipseudomonal Penicillins

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20
Q

What antibiotic class?
Cefazolin
Cephalexin

A

Gen. 1 Cephalosporins

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21
Q 
What antibiotic class?
Cefaclor
Cefoxitin
Cefuroxime
Cefotetan
Cefmetazole
Cefprozil
A

Gen. 2 Cephalosporins

“2nd graders wear FAke FOX FUR to TEa parties”

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22
Q 
What antibiotic class?
Cefotaxime
Cefdinir
Ceftibuten
Ceftazidime
Ceftriaxone
Cefpodoxie proxetil
Cefditoren pivoxil
A

Gen. 3 Cephalosporins

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23
Q

What antibiotic class?

Cefepime

A

Gen. 4 Cephalosporins

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24
Q

What antibiotic class?
Ceftaroline fasamil
Ceftolozane

A

Gen. 5 Cephalosporins

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25
Q 
What antibiotic class?
Imipenem
Meropenem
Doripenem
Ertapenem
A

Carbapenems

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26
Q

MOA: Carbapenems

A
  • inhibit PBP

- can penetrate Gram negative bacteria

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27
Q

Resistance: Carbapenems

A
  • carbapenemases

- gram neg bacteria shrink down porin channels so it can’t fit through

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28
Q

Adverse Rxns: Carbapenems

A

(most often with Imipenem)

  • reactions at infusion site
  • rash
  • N/V/D
  • renal failure
  • seizures
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29
Q

What is required for use of Imipenem

A

combination with renal dipeptidase inhibitor (Celastin)

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30
Q

MOA: Monobactams

A
  • inhibits PBP
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31
Q

Adverse Rxns: Monobactams

A
  • increases serum aminotransferases

- skin rashes

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32
Q

Monobactams are used against what organisms

A
  • only gram negative

- only aerobes

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33
Q

What antibiotic class?

Aztreonam

A

monobactam

34
Q

MOA: glycopeptides and lipoglycopeptides

A
  • bind D-ALA-D-ALA and inhibits PBP, preventing extension and cross linking of peptidoglycans
  • lipoglycopeptides improve this binding
35
Q

What antibiotic class?

Vancomycin

A

glycopeptides

36
Q

What antibiotic class?
Telavancin
Dalbavancin
Oritavancin

A

Lipoglycopeptides

37
Q

How must Vancomycin be administered?

38
Q

Adverse Rxns: Glycopeptides and Lipoglycopeptides

A
  • infusion related reactions (hypotension, tachycardia, flushing
  • Red Man Syndrome
  • Nephrotoxicity
  • Ototoxicity
39
Q

What drug class?
Clavulanic Acid
Sulbactam
Tazobactam

A

Beta-lactamase inhibitors

40
Q

What beta-lactamase inhibitor is often paired with Piperacillin

A

Tazobactam

41
Q

MOA: Oxazolidinones

A
  • protein synthesis inhibitors
  • bind to P site on 50s to prevent formation of fMET tRNA complex
  • bacteriostatic (except bactericidal for strep)
42
Q

Resistance: Oxazolidinones

A
  • point mutations on 23SrRNA

- methyltransferases modify ribosome

43
Q

What drug class?
Linezolid
Tedizolid

A

Oxazolidinones

44
Q

Oxazolidinones are used against what organisms?

A
  • primarily gram (+)
  • MRSA
  • Vancomycin-RSA
45
Q

Adverse Rxns: Oxazolidinones

A

1) Myelosuppression (thrombocytopenia)
2) Mitochondrial toxicity (optic neuritis, peripheral neuropathy, lactic acidosis)
3) Drug-Drug Interaction (linezolid inhibits MOA which makes it interact with SSRIs –> Serotonin Syndrome)

46
Q

MOA: Macrolides and Ketolides

A
  • inhibit protein synthesis
  • binds to 50s
  • bacteriostatic
47
Q 
What drug class?
Erythromycin
Azithromycin
Clarithromycin
Fidaxomicin
A

Macrolides

48
Q

What drug class?

Telithromycin

49
Q

Resistance: Macrolides and Ketolides

A

1) active drug efflux
2) shielding of ribosome
3) degradation of antibiotic
4) 50s subunit mutations

50
Q

Adverse Rxns: Macrolides and Ketolides

A
  • N/V/D
  • anorexia
  • arrhythmias (QT elongation)
  • cholestatic hepatitis –> jaundice
  • Hypersensitivity
51
Q

What drug class?
Dalfopristin
Quinupristin

A

Streptogramins

52
Q

MOA: Streptogramins

A
  • bind to 50s
  • inhibit protein synthesis
  • bactericidal when combined

Quinupristin –> inhibits elongation
Dalfopristin –> enhances Quinupristin

53
Q

Streptogramins are used against what organisms?

A
  • gram (+) cocci (resistant strep, Penicillin resistant S. pneumoniae, MRSA)
  • some gram (-)
54
Q

Resistance: Streptogramins

A
  • inactivation of dalfopristin will render quinupristin inactive
  • altering quinupristin’s binding site on 50s
  • drug efflux
55
Q

Adverse Rxns: Streptogramins

A
  • infusion site reaction (pain, arthralgia, myalgia)
56
Q

MOA: Tetracyclines and Glycylcyclines

A
  • bind 30s, preventing aminoacyl tRNA from entering A site
  • bacteriostatic
  • accumulates intracellularly
57
Q 
What drug class?
Doxycycline
Tetracycline
Minocycline
Demeclocyline
A

Tetracyclines

58
Q

What drug class?

Tigecycline

A

Glycylcyclines

59
Q

Adverse Rxns: Tetracyclines and Glycylcyclines

A
  • GI irritation (N/V/D)
  • effects on bone and teeth (brown teeth in children)
  • risk of C. diff

**do not give in pregnancy

60
Q

Resistance: Tetracyclines and Glycylcyclines

A

1) decreases intracellular concentration of antibiotic
2) increased dislodging of antibiotic from target
3) enzymatically inactivated

61
Q

Tetracyclines and Glycylcyclines are used against what organisms?

A
  • mostly gram (+)

- anaerobes

62
Q

MOA: Aminoglycosides

A
  • bind to 30s
  • introduce errors in protein synthesis
  • bacteriocidal
63
Q 
What drug class?
Gentamycin
Neomycin
Tobramycin
Streptomycin
Amikacin
Paromomycin
A

Aminoglycosides

64
Q

Resistance: Aminoglycosides

A
  • anaerobes
  • enzymatic inactivation that prevents binding to 30s
  • decreased intracellular transport due to mutation or deletion of porins
  • mutations to 30s
65
Q

What are aminoglycosides often paired with?

A

a B-lactam to expand coverage to Gram positives

66
Q

Adverse Rxns: Aminoglycosides

A
  • nephrotoxicity
  • ototoxicity (vestibular damage and auditory damage)

**do not give to pregnany women

67
Q

MOA: Fluoroquinolones

A
  • inhibit bacterial topoisomerase (DNA gyrase) and topoisomerase IV
  • blocks cell division and separation of replicated chromosomal DNA
68
Q

Adverse Rxns: Fluoroquinolones

A
  • 3-17%: GI effects
  • C. diff
  • 1-11%: headaches/dizziness
  • tendon rupture
  • QT prolongation (Torsades de pointes)
69
Q

Resistance: Fluoroquinolones

A
  • mutations to quinolone binding region on DNA gyrase or topoisomerase IV
  • active drug efflux
  • increased shielding proteins
70
Q 
What drug class?
Ciproflaxacin
Levoflaxacin
Oflaxacin
Gemifloxacin
Gatifloxacin
Moxifloxacin
A

Fluoroquinolones

71
Q

MOA: Sulfonamides

A

mimic PABA and block PABA binding todihydropterase synthase, inhibition formation of tetrahydrofolate

72
Q

MOA: Trimethoprim

A

inhibits dihydrofolate reductase

73
Q

Resistance: Sulfonamides

A
  • bacterial overproduction of PABA
  • reduced binding of sulfamethoxazole to dihydropteroate synthase
  • increase mutation dihydropterase synthase
  • decreased bacterial permeability
74
Q

Resistance: Trimethoprim

A
  • decreased bacterial permeability
  • increased dihydrofolate reductase
  • increased mutation dihydrofolate reductase
75
Q

Adverse Rxns: TMP

A
  • anemia
  • leukopenia
  • granulocytopenia
76
Q

Adverse Rxns: SMX

A
  • N/V
  • photosensitivity
  • fever
  • urticaria
  • Stevens-Johnson Syndrome
77
Q

What drug class?

TMP-SMX

A

Sulfonamides and Benzylpyrimidines

78
Q

MOA: Polymyxins

A
  • act as cationic detergents to perturb the membrane of gram negatives
79
Q

What drug class?
Polymyxin B
Colistin

A

Polymyxins

80
Q

Resistance: Polymyxins

A
  • rare
  • Klebsiella and Actintobacter
  • all gram positives
81
Q

Adverse Rxns: Polymyxins

A
  • systemic parenteral administration leads to nephrotoxicity with neuro effects (slurred speech, vertigo, parasthesias, apnea, weakness)

(topicals are tolerated well)

Maddy - Antibiotics from MOD III (1 decks)

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