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MAD > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

beta-lactam classes

A

penicillin
cephalosporin
carbapenem
monobactam

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2
Q

penicillin subclasses

A

aminopenicillin (amoxicillin, ampicillin), anti-staphylococcal penicillin (methicillin, oxacillin, nafcillin), anti-pseudomonal penicillin (ticarcillin, piperacillin)

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3
Q

aminopenicillin examples

A

amoxicillin, ampicillin

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4
Q

anti-staphylococcal penicillin examples

A

methicillin, nafcillin

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5
Q

anti-pseudomonal penicillin examples

A

ticarcillin, piperacillin

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6
Q

beta-lactam mechanism

A

binds to the penicillin binding proteins (PBPs) in the cell wall –> inhibits cross-linking of peptidoglycan

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7
Q

beta-lactam resistance mechanisms

A

beta-lactamases
altered penicillin binding proteins (MRSA)- resistance transferred via MecA operon
decreased permeability (Pseudomonas)

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8
Q

penicillin mechanism

A

binds to the penicillin binding proteins (PBPs) in the cell wall –> inhibits cross-linking of peptidoglycan

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9
Q

penicillin resistance

A

beta-lactamases
altered penicillin binding proteins (MRSA)- resistance transferred via MecA operon
decreased permeability (Pseudomonas)

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10
Q

cephalosporin examples

A 
cefazolin (1st gen)
cefoxitin (2nd gen)
ceftriaxone (3rd gen)
gefepime (4th gen)
ceftaroline (MRSA active)
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11
Q

monobactam examples

A

aztreonam

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12
Q

cephalosporin mechanism

A

binds to the penicillin binding proteins (PBPs) in the cell wall –> inhibits cross-linking of peptidoglycan

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13
Q

cephalosporin resistance mechanisms

A

altered penicillin binding proteins

beta lactamases

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14
Q

monobactam mechanism

A

binds to the penicillin binding proteins (PBPs) in the cell wall –> inhibits cross-linking of peptidoglycan

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15
Q

monobactam target

A

only have activity against gram negative aerobes (but does not include pseudomonas)

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16
Q

carbapenem examples

A

imipenem, meropenem, ertapenem

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17
Q

carbapenem mechanism

A

binds to the penicillin binding proteins (PBPs) in the cell wall –> inhibits cross-linking of peptidoglycan

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18
Q

carbapenem resistance mechanism

A

decreased permeability of GNR outer membrane through loss of porins (i.e. Pseudomonas)
carbapenemases (broad spectrum beta lactamases)
carbapenem resistance enterobacteracae (CRE)

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19
Q

carbapenem target

A

everything except MRSA, enterococci and listeria

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20
Q

vancomycin mechanism

A

interferes with cell wall synthesis by binding to d-alanine-d-alanine

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21
Q

MLS group

A

macrolides, clindamycin (lincosamides), streptogramins (no longer used)

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22
Q

MLS group mechanism

A

inhibits protein synthesis by binding to the ribosome

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23
Q

macrolide examples

A

erythromycin, clarithromycin, azithromycin

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24
Q

macrolide mechanism

A

inhibit protein synthesis by binding to ribosome

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25
Q

macrolide resistance mechanism

A

ribosomal methylation

drug efflux

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26
Q

clindamycin mechanism

A

inhibit protein synthesis by binding to ribosome

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27
Q

clindamycin resistance mechanism

A

ribosomal methylation

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28
Q

aminoglycoside examples

A

streptomycin, gentamicin, amikacin, tobramycin

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29
Q

aminoglycoside mechanism

A

inhibits protein synthesis by binding to ribosome

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30
Q

aminoglycoside resistance mechanism

A

enzymatic inactivation (i.e. sulfation, acetylation, phosphorylation)

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31
Q

tetracycline mechanism

A

inhibits protein synthesis by binding to ribosome

32
Q

tetracycline resistance mechanism

A

altered ribosome

drug efflux

33
Q

glycyclcycline example

A

tigecycline

34
Q

glycyclcycline mechanism

A

inhibits protein synthesis by binding to ribosome

35
Q

glycylcycline resistance mechanism

A

drug efflux

36
Q

co-trimoxazole example

A

trimethoprim/sulfamethoxazole (TMP/SXT)

37
Q

TMP/SXT mechanism

A

blocks biosynthesis of nucleic acids (targets folic acid formation)

38
Q

TMP/SXT resistance mechanism

A

increased production of dihydrofolate reductase

39
Q

fluoroquinolone examples

A

ciprofloxacin, levofloxacin, moxifloxacin

40
Q

fluoroquinolone mechanism

A

inhibits DNA gyrase and topoisomerase

41
Q

fluoroquinolone resistance mechanism

A

DNA gyrase/topoisomerase mutation

drug efflux

42
Q

rifampin (rifamycin) mechanism

A

inhibits DNA dependent RNA polymerase (inhibits protein synthesis at the translation level)

43
Q

rifampin (rifamycin) resistance mechanisms

A

mutations in the DNA dependent RNA polymerase

44
Q

lipopeptide examples

A

daptomycin

45
Q

lipopeptide mechanism

A

Ca2+ dependent increase in membrane permeability to potassium

46
Q

oxazolidine examples

A

linezolid, tedizolid

47
Q

oxazolidine mechanism

A

inhibits protein synthesis at level of ribosomal translation

48
Q

polymyxin examples

A

polymyxin B, colistin

49
Q

polymyxin mechanism

A

intercalates with LPS in gram negative membrane

50
Q

cephalosporin target

A

gram negative bacteria and MRSA (ceftaroline)

51
Q

ceftriaxone target

A

can cross the blood-brain barrier –> **use for meningitis

52
Q

aminoglycoside target

A

gram negative only, no activity against anaerobes

53
Q

fluoroquinolone benefit

A

very bioavailable

54
Q

aminoglycoside consequence

A

**high toxicity to therapeutic ratio

55
Q

polymyxin consequence

A

toxic

56
Q

fidaxomicin target

A

only used to treat Clostridium difficile

nonabsorbable oral drug

57
Q

rifampin use

A

always use in combination with another drug to protect rifampin

58
Q

rifampin benefit

A

gets past biofilm layer

59
Q

beta-lactam pharmacodynamics

A

time above MIC

60
Q

aminoglycoside pharmacodynamics

A

peak MIC

61
Q

fluoroquinolone pharmacodynamics

A

AUC/MIC

62
Q

antibiotics used in synergy

A

ampicillin and aminoglycosides to treat enterococci

63
Q

antifungals used in synergy

A

amphotericin B and flucytosine to treat cryptococcus

64
Q

drugs that cross the blood-brain barrier

A

ceftriaxone (antibiotic), fluconazole (anti-fungal)

65
Q

type 1 allergic reaction to beta-lactams

A

immediate hypersensitivity- IgE/mast cell mediated

66
Q

type 2 allergic reaction to beta-lactams

A

innocent bystandard- adherence of a drug as a hapten to a cell, leads to hemolytic anemia

67
Q

type 3 allergic reaction to beta-lactams

A

“Arthus” immune complex- serum sickness; fever, glomerulonephritis, arthritis, adenopathy

68
Q

type 4 allergic reaction to beta-lactams

A

delayed hypersensitivity- T cell mediated, usually after 7-10 days of antibiotics; presents with a rash

69
Q

antibiotics that target the cell wall

A

beta lactams (penicillin, cephalosporins, carbapenems, monobactam), vancomycin

70
Q

antibiotics that bind the ribosome (to inhibit protein synthesis)

A

macrolides, clindamycin, aminoglycosides, tetracyclines, glycylcycline

71
Q

antibiotics that target DNA gyrase and topoisomerase

A

fluoroquinolones

72
Q

antibiotics that target DNA dependent RNA polymerase

A

rifampin

73
Q

antibiotics that inhibit protein synthesis at the level of ribosomal translation

A

oxazolidine

74
Q

antibiotics that increase membrane permeability

A

lipopeptides

75
Q

antibiotics that intercalate with LPS

A

polymyxins

MAD (7 decks)

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