Antibiotics Flashcards
Bacteriacidal Drugs
Very Finely Proficient At Murder Vancomycin Fluoroquinolone Penicillin Aminoglycoside Metronidazole
Inhibits Transpeptidation -> Crosslinks the linear peptidoglycan layer
Activates Autolytic Enzyme
Penicillins
Beta lactamases formation
Structural change in Target PBPs
Changes in Porin Structure
Penicillin Resistance
Binds to PBP, Inhibits transpeptidation
DOC for Syphillis
Renal tubular absorption inhibited by Probenecid
Increased activity against enterococci if given with aminoglycosides
Can cross BBB of Meninges are inflamed
Penicillin
Isoxazolyl Penicillin (Anti Staphylococcal)
CONDOM Cloxacillin Oxacillin Nafcillin Dicloxacillin Methicillin
For Staphylococcal infections
CONDOM
Interstitial Nephritis
Methicilin
Neutropenia
Biliary clearance
Nafcillin
Infections due to enterococci
HELPSE (Haemophilus influenza, E. coli, Listeria, Proteus Mirabilis, Salmonella, Enterococci )
SE: Pseudomembranous colitis
Amino Penicillin (Extended Spectrum)
DOC Pseudomembranous colitis
Metronidazole
Antipseudomonal Penicillin
Takes Care of Pseudomonas
Ticarcillin
Carbenicillin
Piperacillin
Synergistic effect with aminoglycosides against Pseudomonas
Enhanced effect with beta lactamase inhibitors
Greater activity against gram - infections, due to KEPs
Takes Care of Pseudomonas
Ticarcillin
Carbenicillin
Piperacillin
Cephalosporins with non renal excretion
Cefoperazone
Ceftriaxone
1st Generation Cephalosporins
FADer help me FAZ my PHarma boards! CeFADroxil CeFAZolin CePHalotin CePHapirin CePHradine CePHalxine
For Surgical Prophylaxis, Bone infections, Gram +
Complete cross allergenicity (Partial with Penicillins)
Minimal effect on Gram Neg
PEcKs first
Proteus
E. coli
Klebsiella
FADer help me FAZ my PHarma boards! CeFADroxil CeFAZolin CePHalotin CePHapirin CePHradine CePHalxine
2nd Gen Cephalosporin
FURy FOX FAMilies and Drinking TEa CeFURoxime CeFOXitin CeFAMandole CefoTEtan
FAC LORA's FONe the PROFesional AZOLE CeFAClor LORAcarbef CeFONicid CefPROzil CefmetaAZOLE
Added coverage for infections in Haemophilus Enterobacter and Neiserria + PEcKs
Second HEN PEcKs
Cefuroxime - improved activity against Pseudomonas and Haemophilus
Cefotetan and Cefoxitin - good activity against B. fragilis and thus are used for abdominal and pelvic infections
2nd Gen Cephalosporins FURy FOX FAMilies and Drinking TEa CeFURoxime CeFOXitin CeFAMandole CefoTEtan
FAC LORA's FONe the PROFesional AZOLE CeFAClor LORAcarbef CeFONicid CefPROzil CefmetaAZOLE
Have Renal Excretion except
Cefoperazone and Ceftriaxone
TRY mo iihi ang PERA
Can Penetrate the BBB Except
Cefoperazone and Cefixime
BBBulshit can be Fixed by PERA
Most active Cephs against PRSA
Ceftriaxone and Cefoxime
Fox Tries PRSA (Pizza)
DOC Gonorrhea
Ceftriaxone and Cefixime
Try to Fix Gonorrhea
Third Gen Cephalosporins
Disulfiram Reaction - CefoPERAzone
FEnge PO PERA to TRI to FIX TAX ng TIBU na TAZmanian devil na nag tiTIZ CeFEtamet CefPOdoxime CefPERAzone CefTRIaxone CeFIXime CefoTAXime CefTIBUten CefTAZ CefTIZoxime
Anti Pseudomonal Cephalosporins
FEnge PERA TAZ please
4th Gen Cephalosporins
CAROLINE’s PIRcIngs are EPIc
MRSA Cephalosporin
Ceftaroline
Caroline and MRSA
Carbapenems
PENEMS
For Serious infections such as Pneumonia and Sepsis
Carbapenems
Beta Lactams with CNS toxicity (Confusion, Encephalopathy and Seizures)
Carbapenems
Inhibits Renal Metabolism of Imipenem
Cilastin (Carbapenem - Cilastin)
Carbapenem non active against Pseudomonas and Acinetobacter
Ertapenem (Maarte siya)
Monobactam
Aztreonam
Resistant to Beta Lactamase
SE: Vertigo
No cross allergenicity with Penicillins
No activity against gram positive or anaerobes
Monobactam - Aztreonam
Vietnam resistance has no air no positives
Beta Lactamase Inhibitors
Most active: Plasmid BLac > Chromosomal BLac
Clavulanic
Sulbactam
Tazobactam
SE: Cholestatic Jaundice
Beta lactamase inhibitors
Class: Glycopeptide
Binds to D-Ala- D- Ala
Inhibits TRANGLYCOLSILATION
Prevent ELONGATION
for MRSA and Pseudomembranous Colitis
SE: RED Man Syndrome
Vancomycin
Dybala tiec the Van to Tel Aviv
Tx for Red Man Syndrom
Slowing infusion flow
VRSA and VRE
Due to D-Ala-D-Ala Lactate formation
Drugs of LAst Resort
I AM your Last Shot At Victory Imipinem Amikacin Linezolid Streptogramins Vancomycin
Peptide Antibiotic
Bacitracin
Interferes with late stage cell wall synthesis in gram + organisms
Only for Gram +
SE: Nephrotoxicity (Topical Use)
Reserved for Topical Use only due to Nephrotoxicity
Bacitracin
Late siya kaya nasa Bac siya
Blocks incorporation of D-Ala into PENTAapeptide side chain
For Drug resistant Tuberculosis (2nd Line)
SE: Neurotoxicity
Cycloserine
DEPolarization causing rapid cell death
Gram +, Sepsis and Endocarditis
SE: Myopathy
Inactivated by Pulmonary Surfactants
NOT Bactericidal
Daptomycin
DAPolarization
Inactivates UDP-N-Acetylglucosamine-3-enoplyruvatetransferase
Fosfomycin
Protein Synthesis Inhibitor Antibiotics
AT CELLS
Aminoglycoside Tetracycline Chloramphenicol Erythromycin Lincosamides Linezolid Streptogramins
Broad Spectrum Protein Synthesis Inhibitor
Chloramphenicol
Inhibits Transpeptidation at 50s -> Bacteriostatic
For Meningitis
SE: Gray Baby Syndrome, Aplastic Anemia
Resistance due to formation of acetyltransferase that inactivates the drug
Chloramphenicol
Binds to 30s subunit
M. pneumonia, chlamydia, ricketsiae, Vibrio
Tetracycline (TETry Subunit) - Cyclines
My clam has vibrated with rick
Tetracycline for SIADH
Demeclocycline (Deme may sayad)
Tetracycline with Vestibulotoxicity
Minocycline
Tx for Bronchitis
Doxycycline
Tetracycline with broadest spectrum and Longest T1/2
Only Tetracycline unaffected by resistance
Tigecycline - Tiger is broadest and longest cat, Tigasin
Tetracycline that is excreted in the bile
Doxycycline
Blocks aTTachment to T- RNA acceptor site
Tetracycline
Binds to 50s
Streptogramin
Erythromycin
Cyclophosphamide
50 pesos for Marco’s Pristine Clean Cyclops
Binds to 50s
Pertussis, Diptheria, Chlamydia - PeDiCure
SE: Cholestatic hepatitis, QT Prolongation, Rare Fulminant Hepatic Failure
Macrolides - Erythromycin
Pedicure kay Erin
Macrolide that does not inhibit CYP450
Azithromycin
Used for Macrolide resistance
Telithromycin
Binds to 50s subunit
For Endocarditis prophylaxis, PCP Pneumonia, Toxoplasmosis
SE: Pseudomembranous colitis
Resistance due to methylation binding sites
Lincosamide - Clindamycin
Clean Lincon
Anaerobic Infection
Above diaphragm - Clindamycin
Below Diaphragm - Metronidazole
Only one that Binds to 50s that is BACTERIACIDAL
For MRSA, VRSA, VRE
SE: Arthralgia, Myalgia Syndrome
Streptogramin - Quinupristin - Dalfopristin
Binds to 23S of 50 subunit
For MRSA,VRSA, VRE
SE: Optic Neuritis
Resistance due to decrease affinity of Drug to Binding site
Oxazolidinone - Linezolid
23 oxs line at ted
Concentration Dependent Killing Action
Post antibiotic effect
Not absorbed orally
Requires O2 for Transport
Aminoglycosides
Aminoglycosides synergistic with
Cell wall synthesis inhibitors
Aminiglycoside Mnemonics
GNATS canNOT kill anaerobes
Gentamicin Neomycin Amikacin Tobramycin Streptomycin Nephrotoxicity Ototoxicity Teratogen
Binds to 30s -> Protein synthesis inhibition
For aerobic gram negative bac
Ocular infections - Tobramycin
Gentamycin/ Tobramycin
Most vestibulotoxic and nephrotoxic Amingoglycosides
Gentamycin and Tobramycin
GenTo most toxic
Binds to 30s -> Protein synthesis inhibition
For Multi Drug Resistant TB (2nd line drug)
Least resistance but narrowest therapeutic window
Amikacin
Binds to 30s -> Protein synthesis inhibition
For Tularemia, Bubonic Plaque, Brucellosis
Streptomycin
DOC of Beaubonic plague
Streptomycin
Binds to 30s -> Protein synthesis inhibition
Bowel Preparation for elective surgery, Hepatic Encephaolopathy
Kanamycin most ototoxic
Paromomycin, Kanamycin, Neomycin
PAKANE
For Visceral leishmaniasis
Paromomycin
Limited to topical and oral use only
Neomycin
Binds to 30s -> Protein synthesis inhibition
For Drug resistant Gonorrhea
Spectinomycin
Most ototoxic aminoglycosides
Amikacin and Kanamycin KA - TengKA
Most vestibulotoxic
Tobramycin Gentomycin
Skin reactions
Neomycin and Strptomycin
Inhibits translocation process during protein synthesis, from Fusidium coccineum
Fusidic Acid
Bacteriostatic inhibitors of folic acid synthesis
Sulfonamides
Selective inhibitor of bacterial dihydrofolate reductase
Trimethoprim
Sulfonamide
Inhibit dihydropteroate synthase, bacteriostatic
For Burn Infections
SE: SJS/TEN, G6PD hemolysis, Kernicterus
Silver Sulfadiazide/ Mafenide Acetate
Sulfonamide
Sequential blockade of dihydropteroate synthase and dihydrofolate reductase , bactericidal
For HAM (Haemophilus, Aeromonas, Moraxella), P. jiroveci
SE: SJS/TEN, G6PD hemolysis, Kernicterus
TMP - SMX
DOC for Toxoplasmosis
2nd agent for Malaria
Sulfadiazine- Pyrimethamine
Coadministered with Leucovorin to limit bone marrow toxicity
Pyrimethamine
Increased level of unconjugated bilirubin at subcortical nuclei and basal ganglia
Kernicterus
Inhibits Topoisomerase II in gram neg
Inhibits Topoisomerase IV in gram pos
May cause damage of growing cartilage
Quinolones
M/C Cause of Quinolone Resistance
decrease IC accumulation of drug via efflux pumps
2nd Gen Quinolone
Ciprofloxacin
3rd Gen Quinolone
Levofloxacin/ Moxifloxacin (Vigamox)
4th Gen Quinolone
Trovafloxacin
Ciprofloxacin AE
Tendonitis
For Atypical Pneumonia/ Lung Infections
Levofloxacin
Levofloxacin AE
QT prolongation, Tendinitis
Trovafloxacin AE
Hepatotoxicity
Broad Spectrum Quinolones, enhanced activity against anaerobes
4th Gen Quinolones
Quinolone Most active agent against Gram neg organisms esp Pseudomonas
Ciprofloxacin
Quinolone that cannot be used in UTI
Moxifloxacin
Quinolone C. trachomatis
Ofloxacin
Quinolone that causes hyperglycemia
Gatifloxacin
Ferredoxin forming
Disrupt electron transport chain
Antiprotozoal, Vaginitis, Brain Abscess, ANAEROBIC
Metronidazole (DAZOLES)
DOC for Amoebiasis, Giardiasis and Pseudomembranous colitis
Metronidazole
Multiple reactive intermediates when acted by nitrofuran reductase
For Uncomplicated UTI (except Proteus and Pseudomonas - resistant)
SE: Pulmonary Infiltrates, Phototoxicity
Contraindicated in renal insufficiency
Nitrofurantoin - Nitrofuran
Topical antiinfective, Pseudmonic acid
Inhibits Staphylococcal isoleucyl tRNA synthase
For MRSA, Impetigo
SE: Burning stinging skin sensation, Epistaxis
Only used topically
Single OD dose can prevent recurrent UT
Mupirocin
Cationic Detergents
Disrupt bacterial cell membrane, bind and inactivate endotoxin
For salvage therapy of Acinetobacter, Enterobacteriaceae and Pseudomonas
Proteus and Neisseria - resistant
For topical use only
Polymyxin B
Macrocyclic, Narrow Spectrum
Binds to Sigma subunit of RNA polymerase
For gram + only, C. difficile in adults
Orphan Drug Status in C. difficile in children
Fidaxomicin