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Microbiology > Antibiotics > Flashcards

Antibiotics Flashcards

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1
Q

Penicillin

A
  • GPCs, GPRs, GNc, spirochetes
  • Bind PBP (transpeptidase) and inhibits PG cross-linking
  • Also activates autolytic enzymes
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2
Q

Nafcillin, Oxacillin, Dicloxacillin

A
  • MSSA

* Penicillinase-resistant (bulky R group)

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3
Q

Ampicillin, Amoxicillin

A
  • UTI, neonatal, prophylaxis for bacterial endocarditis

* HELPSS kill Enterococci (H. flu, E. coli, Listeria, Proteus, Salmonella, Shigella)

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4
Q

Ticarcillin, Piperacillin

A

*Pseudomas, GNR

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5
Q

Clavulonic acid, Sulbactam, Tazobactam

A

Beta-lactamase inhibitors

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6
Q

Cefazolin, Cephalexin

A
  • 1st gen cephalosporins
  • UTI, dental procedures
  • GPCs + PEcK (Proteus, E. coli, Klebsiella)
  • Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
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7
Q

Cefoxitin, Cefaclor, Cefuroxime

A
  • 2nd gen cephalosporins
  • GPCs + HEN PEcKS (H. flu, Enterobactor aerogenes, Neisseria spp., Serratia)
  • Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
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8
Q

Ceftriaxime, Cefotaxime, Ceftazidime

A
  • 3rd gen cephalosporins
  • Serious resistant GNs, S. pneumo, GBS (break rule of less GP coverage as go down generations)
  • Ceftriaxone for meningitis, gonorrhea
  • Ceftazidime for psuedomonas
  • Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
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9
Q

Cefipime

A
  • 4th gen cephalosporin
  • Pseudomonas, GPs
  • Do not cover LAME (Listeria, atypical chlamydia/mycoplasma, MRSA, Enterococcus)
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10
Q

Aztreonam

A
  • Binds PBP3, beta-lactamase resistant

* GNR only! for patient with penicillin allergy or renal toxicity

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11
Q

Imipenem/Cilastatin, Meropenem

A
  • Big guns for life-threatening infections with GPC, GNR, anaerobes, covers eneterococci
  • No MRSA coverage
  • Tox: seizures!
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12
Q

Vancomycin

A
  • Binds D-ala-D-ala
  • For MRSA, enterococci
  • Tox: NOT (nephro, oto, thrombophlebitis), Red Man syndrome (give histamine and slow infusion)
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13
Q

Streptomycin, Tobramycin, Amikacin, Neomycin, Gentamicin

A
  • Aminoglycosides (STAND) caNNOT kill anaerobes
  • Inhibit 30S (initiation)
  • For severe GNRs
  • NNOT tox: nephro, oto, teratogenic (avoid in preg d/t oto), neurotoxic
  • Resistance via acetylation, phosphorylation, adenylation by transferases
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14
Q

Tetracycline, Doxycycline, Demeclocycline, Minocycline

A
  • Inhibit 30S (aa-tRNA attachment)
  • For VACUUM THe BedRoom (vibrio cholera, acne, chlamydia, ureaplasma urealyticum, mycoplasma, tularemia, h.pylori, burellia, ricketssia)
  • Milk, antacids, iron tablets inhibit aborption
  • Resistance via efflux
  • Tox to teeth, long bone growth (avoid in preg)
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15
Q

Azithromycin, Erythromycin, Clarithromycin

A
  • Macrolides inhibit 50S (23S) (translocation)
  • For PUS (atypical PNA, URI, STDs)
  • Tox: MACRO (motility, arrhythmia long QT, cholestatic hepatitis, rash, eOsinophilia)
  • Resistance via 23S methylation
  • Clarithro is embryotoxic (avoid in preg)
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16
Q

Chloramphenicol

A
  • Inhibits 50S peptidyltransferase
  • For SHiN
  • Tox gray baby (no UDP glucuronyl transferase) (avoid in preg), aplastic anemia
  • Resistance via plasmid acyltransferase
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17
Q

Clindamycin

A
  • Inhibits 50S (transpeptidation)

* For anaerobes above diaphragm (aspiration PNA)

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18
Q

Sulfamethoxazole (SMX), Sulfisoxazole, Sulfadiazine

A
  • Metabolized to PABA, which inhibits dihydropepteroate synthase
  • Avoid in pregnancy d/t kernicterus
19
Q

Trimethoprim

A
  • Inhibits DHF reductase

* For UTI, PNA (shigella, salmonella, PCP)

20
Q

Ciprofloxacin, other floxacins

A
  • Fluoroquinolones inhibit topoisomerase II (gyrase) and IV
  • Antacids inhibit absorption
  • Teratogenic - damage tendons, cartilage (avoid in pregnancy)
  • Nalidixic acid is a quinolone
21
Q

Metronidazole

A
  • Free radical damage

* For anaerobes below diaphragm, GET GAP (giardia, enteroeba, trichomonas, gardnerella, anaerobes, h. pylori)

22
Q

TB therapy

A
  • Rifampin inh RNA pol, Revs up P450, Red/orange fluids, Rapid resistance if alone
  • INH: decreases mycolic acid synthesis, give with B6 to prevent neuro and hepatotox; R via KatG
  • Pyrazinamide: works in low pH of phagolysosomes
  • Ethamutol inhibits arabinosyltransferase, decreasing carbohydrate polymerase; tox red-green blind and decreased vision
23
Q

MAC therapy

A

RASE: Rifampin, Azithromycin (CD<50), Streptomycin, Ethambutol

24
Q

Leprosy therapy

A

Dapsone, Rifampin (to delay dapsone resistance), Clofazimine (for lepromatous form)

25
Q

Ampho B

A
  • Binds ergosterol and tears holes in membrane
  • For serious systemic mycoses, intrathecally for meningitis
  • Nephrotoxic (supplement K+, Mg2+), IV phlebitis, etc.
26
Q

Nystatin

A
  • Same as Ampho B but topical

* Swish and swallow for oral candidiasis, topical for diaper rash and vaginal candidiasis

27
Q

Azoles

A
  • Inhibit P450 that turns lanosterol into ergosterol
  • For local and less serious mycoses (fluconazole for crypto meningitis suppression)
  • Inhibits hormone synthesis (gynecomastia), liver dysfunction
28
Q

Flucytosine

A
  • Met. to 5-FU, inhibits DNA and RNA synthesis

* For systemic infections (combines with Ampho B for Crypto meningitis)

29
Q

Caspofungin, Micafungin

A
  • Inhibits B-glucan synthesis, inhibiting cell wall
  • For invasive aspergillosis, candida
  • Histamine release causes GI, flushing
30
Q

Terbinafine

A
  • Inhibits squalene epoxidase
  • For dermatophytoses, esp. onychomycosis bc deposits in nails
  • Live and visual tox
31
Q

Griseofulvin

A
  • Interferes with microtubule function, disrupting mitosis
  • Deposits in keratin tissues (nails), for dermatophytes (tinea, ringwormm)
  • Teratogenic (avoid in preg), carcinogenic, increases P450 (Warfarin)
32
Q

Toxoplasmosis

A

Pyrimethamine, Sulfamethamine

33
Q

Trypanosoma brucei

A

Suramin and Melarsoprol

34
Q

T. cruzi

A

Nifurtimox

35
Q

Leishmaniasis

A

Sodium Stibogluconate

36
Q

Malaria

A
  • Chloroquine blocks heme detox to hemozoin -> heme accumulates and damages plasmodia (falciparum are resistant with pump); retinopathy tox
  • Tx falciparum with artemether/lumifantrine or atovaquone/proguanil
  • Life-threatening malaria use quinidine (elsewhere quinine) or artisunate
37
Q

Helminths

A

Mebendazole, Pyrantel Pamoate, Ivermectin, Diethylcarbamazine, Praziquantel
*Praziquantel for flukes (trematodes e.g. Schistosoma)

38
Q

Amantadine

A
  • Blocks viral penetration and uncoating, causes release of DA from nerve terminals (PD tx)
  • Resistance via M3 protein
  • SE anticholinergic
  • Ravantamine is modified form that does not cross BBB
39
Q

Zanamivir, Oseltamivir

A
  • Inhibit neuraminidase, decreasing progeny release
  • For influenza A, B, H1N1, H5N1
  • Lots of resistance
40
Q

Ribavirin

A
  • Inhibits guanine synthesis by competitively inhibiting IMP dehydrogenase
  • For RSV (adults), HCV
  • Tox hemolytic anemia, teratogen (avoid in preg)
41
Q

Acyclovir

A
  • Phosphorylated by thymidine kinase -> guanosine analog -> triphosphate by cellular enzymes -> inhibits viral DNA polymerase by chain term.
  • For active HSV, VZV (weak EBV, no CMV)
  • Valacyclovir better oral availability
  • Famciclovir for herpes zoster
42
Q

Ganciclovir

A
  • 5’ phosphorylated by CMV viral kinase -> guanosine analog -> inhibits viral DNA polymerase
  • For CMV, esp. immunocompromised
  • Valganciclovir better oral availability
  • More toxicity that acyclovir (BM suppression, renal)
  • R via mutated DNA pol or absent kinase
43
Q

Foscarnet

A
  • Pyrophosphate analog that inhibits DNA pol. without activation
  • For CMV retinitis when ganciclovir fails, HSV when acyclovir fails
  • Nephrotox
44
Q

Cidofovir

A
  • Inhibits DNA pol. without activation
  • For CMV retinitis, acyclovir-resistant HSV
  • Nephrotox (prevent with probenecid and IV saline)

Microbiology (6 decks)

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