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Pharm Y2 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Penicillin MOA

A

Block transpeptidation by beta lactam ring binding penicilin binding proteins

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2
Q

ampicillin drug class

A

penicillin

good to treat gram-negative bacteria

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3
Q

methicillin drug class

A

penicillin

good for treating penicillin resistant Staph aureus

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4
Q

list 2 anti-pseudomona penicillins

A

carbenicillin
piperacillin

these are able to reach in pseudomonas tight pores

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5
Q

penicillin structure

A

beta lactam ring and thiazolidine ring

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6
Q

cephalosporin structure

A

beta lactam ring and dihydrothizine ring

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7
Q

cefazolin drug class

A

cephalosporin

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8
Q

cefotaxime drug class

A

cephalosporin

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9
Q

cefpodoxime drug class

A

cephalosporin

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10
Q

cephalosporins vs penicillins

A

cephalosporins are less susceptible to beta lactamases

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11
Q

carbapenems structure

A

beta lactam ring

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12
Q

carbapenems vs penicillins and cephalosporins

A

carbapenems are more resistant to beta lactamases and should be used as a last resort
active against broad spectrum

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13
Q

monobactams structure

A

monocyclic beta lactam

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14
Q

aztreonam drug class

A

monobactam

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15
Q

monobactams vs other beta lactams

A

resistant to most beta lactamases

active against many gram negative bacteria

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16
Q

vancomycin drug class

A

glycopeptide

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17
Q

teicoplnin drug class

A

glycopeptide

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18
Q

glycopeptide MOA

A

inhibits transpeptidation by binding NAG-NAM

weakly inhibit transfer of NAG-NAM disaccharide to peptidoglycan chains (transglycosylation)

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19
Q

use of glycopeptides

A

last resort for MRSA and antibiotic resistant strains of E. faecalis, S. pneumoniae, and S. epidermidis
broad spectrum for gram positives but not gram negatives since it is a large molecule (hard to cross gram -)

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20
Q

bacitracin MOA

A

binds undecaprenyl pyrophospate –> no recycling –> no NAG-NAM –> no peptidoglycan

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21
Q

bacitracin administration

A

topical (large so cannot be absorbed)

often combined with neomycin and polymyxin B

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22
Q

polymyxin B and E MOA

A

destabilize bacterial cell membranes by binding as detergents –> leakage

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23
Q

polymyxins B and E use

A

topical (significant toxicity)

active against most gram negatives and pseudomonas

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24
Q

Sulfamethoxazle drug class

A

sulfonamide

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25
Q

sulfonamide MOA

A

PABA analog
competitively inhibits synthesis of dihydrofolic acid (precursor for tetrahydrofolic acid: required for DNA synthesis)
thus, blocks bacterial DNA synthesis

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26
Q

trimethoprim (antifolate) MOA

A

DHF analog

competitively inhibits synthesis of tetrahydropholic acid which is required for bacterial DNA synthesis

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27
Q

fluoroquinolone MOA

A

bind/inhibit gyrase –> block DNA synthesis

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28
Q

ciprofloxacin drug class

A

fluoroquinolone

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29
Q

levofloxacin drug class

A

fluoroqinolones

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30
Q

fluoroquinolone use

A

broad spectrum

useful against pseudomonas auruginosa

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31
Q

Rifampin MOA

A

binds RNA polymerase –> inhibits protein synthesis

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32
Q

rifampin use

A

commonly used to trat mycobacterium tuberculosis

bacteria easily becomes resistant so often used in combo

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33
Q

macrolides/ketolides MOA

A

blocks peptide exit tunnel of 50S ribosomal subunit –> blocks protein synthesis

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34
Q

macrolide/ketolide use

A

broad spectrum

widely used resistance is common

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35
Q

erythromycin drug class

A

macrolide

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36
Q

telithromycin drug class

A

macrolide/ketolide

37
Q

puromycin-like MOA

A

bind A-site of 50S subunit–> block tRNA access –> inhibit protein synthesis

38
Q

clindamycin drug class

A

puromycin-like

39
Q

clindamycin use

A

anaerobic bacteria

40
Q

linezolid drug class

A

puromycin-like

41
Q

linezolid use

A

MRSA, VRE, and penicillin resistant strep pneumoniae

42
Q

tetracyclines/glycyclines MOA

A

binds A-site of 30S subunit (blocks tRNA access) –> inhibits protein synth

43
Q

tigecycline drug class

A

tetracycline/glycyclines

44
Q

aminoglycoside MOA

A

interfere with 30S ribosome subunit A site causing frequent mispairing –> synthesis of faulty proteins –> bactericidal

45
Q

streptogramins MOA

A 
block peptide exit tunnel of 50S ribosomal subunit
streptogramin A (quinupristin) and B (dalfopristin) are bacteriostatic on their own but if used together they are bactericidal
46
Q

streptogramins use

A

MRSA and most gram positives

47
Q

which 2 drug classes that imhibit protein synthesis are bactericidal

A

aminoglycosides and streptogramins (when both A and B are used)

48
Q

quinupristin drug class

A

streptogramin A

49
Q

dalfopristin drug class

A

streptogramin B

50
Q

Oxazolidimones MOA

A

Bind to 50s ribosome subunit to block protein synthesis

51
Q

Fluoroquinolones: cidal or static?

A

Cidal

Block DNA gyrase

52
Q

Metronidazole MOA

A

Block DNA gyrase

53
Q

Metronidazole: static or cidal?

A

Cidal

Blocks DNA gyrase

54
Q

Imipenem drug class

A

Carbapenems

55
Q

Meopenem drug class

A

Carbapenem

56
Q

Endopenem drug class

A

Carbapenem

57
Q

When is use of bactericidal antibiotic use indicated?

A

Invassive infection: endocarditis and meningitis

58
Q

List cidal antibiotics (7) used to treat endocarditis and meningitis

A 
Beta lactams
Fluoroquinolones
Vancomycin
Daptomycin
Aminoglycosides
Rifampin
Metronidazole
59
Q

What indicates use of bacteriostatic antibiotic drug use

A

Non invassive infections such as skin infections

60
Q

Chloramphenicol: static or cidal?

A

Static except cidal for:
H. Influenzae
S. Pneumoniae
N. Meningitides

61
Q

Linezolid: static or cidal?

A

Cidal against most strep

Static against MRSA and VRE

62
Q

Trimethoprim-sulfamethoxazole (Bactrim) use against MRSA?

A

It is rapidly cidal against MRSA in vitro but not a lot of data on it so not a drug of choice

63
Q

What is drug of choice for skin infections due to strep

A

Penicillins

No strep resistant to penicillins

64
Q

What is not covered by penicillins

A

S.aureus
Gram negatives
Bacteroides

65
Q

What is oxacillin’s coverage?

A

Gram positives, including S. Aureus

66
Q

When treating intra-abdominal infections, what species are important to cover?

A

Gram negatives and anaerobes

67
Q

What penicillin/beta lactamase inhibitor combo covers pseudomona

A

Piperacillin/tazobactam

68
Q

What carbapenems cover pseudomona

A

Meropenem and imipenem

69
Q

What is the contraindication of meropenem and imipenem use

A

It lowers the seizure threshold so not indicated for use in patients susceptible to seizures

70
Q

How does 1st generation cephalosporins differ from other generations

A

Covers all gram positives including staph aureus

71
Q

Ceftriaxone drug class and coverage

A

3rd generation cephalosporin
Covers all gram positives except s.aureus
Covers all gram negatives including pseudomonas

72
Q

Ceftaroline drug class and coverage

A

Extended spectrum cephalosporin
Good for MRSA
Does not cover anaerobic or bacteroides or pseudomona

73
Q

In penecillin allergies what two drug options can be used for pseudomona coverage

A

Azteronam

Aminoglycosides

74
Q

What are the side effects of aminoglycosides

A

Stay in system a long time following administration which causes a threat of causes:
Nephrotoxicity: reversible
Ototoxicity: non reversible

75
Q

Fluoroquinolone coverage

A

All aerobic gram neatives including pseudomona

Gram positives except s. Aureus

76
Q

Ciprofloxacin drug class

A

Fluoroquinolone

77
Q

Levofloxacin drug class

A

Fluoroquinolones

78
Q

What are some side effects of fluoroquinolones

A 
Can cause tendon rupture (especially weight bearing tendons such as achilles)
Decreased mental status in elderly
Prolonged Q-T syndrome
C. Diff. 
(Vitamins can decrease its absorption)
79
Q

What two fluoroquinolones are good for atypical organism use such as mycoplasma and legionella

A

Levoflaxicin and moxifloxacin

80
Q

When treating mouth infections, what coverage is important

A

Strep and oral anaerobes

81
Q

Clindamycin coverage

A

Good for above the diaphragm

Gram positive and anaerobe coverage including s. Aureus and MRSA but can induce MRSA resistance

82
Q

Metronidazole coverage

A

Anaerobes
Good for below the diaphragm (G.I. And G.U.)
(Patients cannot drink alcohol)

83
Q

Side effects of tetracyclines

A

Nausea/vomitting
Pill-induced esophaitis
Tetragenic (dont use in prenancy)
Photosensitivity

84
Q

Doxyccline uses

A 
Lyme disease
Malaria prophylaxis
Mycoplasma chlamydia
MRSA infections
Acne
85
Q

Bactrim (TMP-SMX; sulfa drug) sideeffects

A

Skin rash

Contraindicatedin pregnancy

86
Q

What are treatment obstions for initial episoides of non severe C. Diff

A

Oral vancomycin

FDX

87
Q

What treatment is indicated in fulminant C. Diff. Infections

A 
IV metronidazole
(Fulminant= sick)
88
Q

Daptomycin use

A

MRSA and VRE

Pharm Y2 (5 decks)

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