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Skin > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Beta-lactams

A

Penicillins (natural, antistaphylococcal, extended-spec, and antipseudomonal)
Cephalosporins (1-5)
Carbapenems
Monobactams

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2
Q

Cell-wall synthesis inhibitors

A

beta-lactams (PBPs = no synthesis of stable cell wall), vanco (transglycosylase = prevent binding of peptidoglycans, bacitracin (interferes with transport across cell)
Bactericidal, time-dependent

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3
Q

Cell membrane disruption

A

polymyxin, daptomycin

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4
Q

Classes that inhibit protein synthesis

A

Tetracyclines (30S), macrolides (50S), and aminoglycosides (30S - bactericidal)

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5
Q

Classes that inhibit nucleic acid synthesis

A

RNA polymerase inhibitor - rifampin

DNA replication inhibitor - Fluoroquniolones (cirpfloxacin)

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6
Q

Classes that inhibit folic acid synthesis

A

Trimethoprim and sulfonamides (sulfamethoxazole)

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7
Q

Streptococcus treatments

A

Penicillin V
Amoxicillin
Cephalexin
Amoxicillin+clavulanic acid

Allergy to beta-lactam: azithromycin, clarithromycin, clindamycin

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8
Q

MSSA treatments

A 
Nafcillin
Oxacillin
Dicloxacillin
Cephalexin
Amoxicillin+clauvulanic acid
3rd gen cephalosporins for severe infections

Allergy to beta-lactams: azithromycin, clarithromycin, clindamycin

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9
Q

MRSA treatments

A 
Ceftaroline (moderate)
Vanco (severe)
Dapto (severe)
SMX/TMP (mild-moderate)
Doxy (moderate)
Minocycline (moderate)
Clindamycin (moderate)
Linezolid (severe)
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10
Q

Extended spectrum penicillins treat these gram-

A 
Haemophilus influenzae
Heliobacter pylori
Escherichia coli
Listeria monocytogenes
Proteus mirabilis
Salmonells
Shigells
Enterococci
(HHELPSSE)
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11
Q

Superinfection

A
  • Broad-spectrum antibiotics (frequent: extended-spec penicillins, cephalosporins, clindamycin, fluoroquinolones; occasionally: TMP/SMX, macrolides)
  • organisms: Clostridium difficile (pseudomembranous colitis), Staphylococcus aureus (entercolitis), candida albicans (vagina and mouth infections)
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12
Q

Activity of cephalosporins moving from 1st to 4th gen

A

Increasing activity against g-, beta-lactamase, pseudomonas, anaerboes; increasing ability to cross BBB

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13
Q

1st gen cephalosporins

A
  • Cephalexin, cefazolin
  • g+ (staph and strep, PEcK - proteus mirabilis, E.coli, and Klebsiella pneumoniae
  • UTI
  • SSTI caused by staph and strep like cellulitis or abscess
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14
Q

Vancomycin use

A

MRSA, Enterocolitis, C. diff, enterococci

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15
Q

Vanco adverse effects

A

Nephrotoxicity
Ototoxicity
Thrombophlebitis
Red man syndrome - histamine release (pre-treat with anti-histamine and slow infusion rate)

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16
Q

Vanco resistance

A

D-ala-D-ala to D-ala-D-lactate

17
Q

Dapto clinical use

A

Staph aureus (including MRSA), enterococcus faecalis and faecium, strep pyogenes (GAS)

18
Q

Dapto major side effects

A

Myopathy (elevated CK)

19
Q

Spectrum of polymyxins

A

g- (mostly aerobes - pseudomonas)

20
Q

Clinical use of polymyxins

A

Significant toxicity with systemic use so topical; systemic use limited to serious infections

21
Q

Side effects of polymyxin

A

Nephrotoxicity and neurotoxicity

22
Q

SMX and TMP MOA

A

p-Aminobenzoic acid converted to dihydropteroic acid via dihydropteroate synthase (inhibited by sulfonamides); dihydropteroic acid converted to dihydrofolate via dihydrofolate reductase (inhibited by trimethoprim)

23
Q

SMX/TMP clinical use

A
  • MSSA and mild-moderate MRSA
  • UTI
  • respiratory tract infections (H. influenzeae, strep pneumoniae - increased resistance)
  • enterocolitis (shigella)
  • traveler’s diarrhea (E. coli and shigella)
  • otitis media
24
Q

SMX side effects

A

Allergies (fever, nausea, vomiting, diarrhea, rash, dermatitis, Steven Johnson syndrome); hematological disorders (megaloblastic anemia, leukopenia, granulocytopenia, thrombocytopenia, hemolytic anemia in pt with G6PD deficiency)

25
Q

Side effect unique to SMX

A

kernicterus in newborns (drug displaces bilirubin from albumin»free bilirubin deposist in basal ganglia and subthalamic nuclei»encephalopathy

26
Q

Tetracyclines MOA

A

Bind to 30S of bacterial ribosome, blocking access of aminoacyl-tRNA to mRNA-ribosome complex

27
Q

Clinical use of tetracyclines

A

MRSA, anthrax, mycoplasma pneumonia, chlamydia, rickettsiae, Lyme, GI

28
Q

Tetracyclines side effects

A

GI distress, photosensitivity, discoloration of teeth in children, inhibition of bone growth in children (tetracycline binds to Ca)

29
Q

Macrolides MOA

A

Binds to 50S to inhibit peptide transfer

30
Q

Macrolides clinical use

A

Substitute for penicillins, strep and staph (not MRSA), more on g-

31
Q

Major side effects of macrolides

A 
MACRO
gi Motility
Arrythmia
acute Cholestatis hepatitis
Rash
eosinOphilia
32
Q

Clindamycin MOA

A

50S subunit

33
Q

Clindamycin clinical use

A

strep and staph; anaerobic infections

34
Q

Side effects of clindamycin

A

Fever, diarrhea, superinfection: pseudomembranous colitis

35
Q

Linezolid MOA

A

50S

36
Q

Clinical use of linezolid

A

broad g+
MRSA
VRE

37
Q

Side effects of linezolid

A

bone marrow suppression (thrombocytopenia, anemia, neutropenia), optic and peripheral neuropathy, serotonin syndrome when administered with SSRIs

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