Antibiotics, Antifungals, Antiviral Flashcards
1
Q
Adverse effects of Tetracyline
A
1) Retardation of Bone growth (do not give to kids below 8)
2) Teratogenic
2
Q
Mechanism of Action of Tetracycline/Doxycylcine
A
Acts by inhibiting the 30s subunit of bacterial ribosome that results in protein synthesis;
3
Q
Anti-Ribosomal Antibiotics
A
CLEan TAgS
C- Chloramphenicol, Clarithromycin (macrolide) and Clindamycin
L- Linezolid
E- Erythromycin (macrolide)
T- Tetracycline and Tigecycline
Ag- Aminoglycosides
Spectinomycin
CLEan - inhibits 50s TAg - inhibits 30s
4
Q
MOA of Fluoroquinolone
A
DNA Gyrase inhibitor (topoisomerase II) (bacteriocidal)
5
Q
Adverse Effects of chloramphenicol
A
1) Causes bone marrow depression; may lead to aplastic anemia
2) Gray baby syndrome
6
Q
Adverse effects of clindamycin
A
1) Causes pseudomembranous colitis
7
Q
Spectrum of clindamycin
A
1) Not useful against gram negative
2) Anaerobes
8
Q
Spectrum of linezolid
A
1) Used when nothing else works
2) Blocks 50s subunit
9
Q
Adverse effects of linezolid
A
1) Very expensive
2) Bone marrow suppression (anemia, thrombocytopenia, neutropenia)
10
Q
Spectrum of chloramphenicol
A
Broad specturm of gram positive and negative; also anaerobic; inhibits 50s leading to protein synthesis inhibition
11
Q
1) Methicillin
2) Naficillin
3) Oxacillin
4) Dicloxacillin
A
think: MET a NAsty Ox
Penicillinase resistant penicillin
12
Q
Mechanism of action for rifampin
A
1) DNA dependent RNA polymerase inhibitor
2) Also used prophylacticly for H. influenzae
13
Q
Adverse effects of vancomycin
A
1) Nephrotoxicity
2) Ototoxicity
3) Red man syndrome
14
Q
Spectrum of Metronidazole
A
Used to treat anaerobic flora
15
Q
What are the first line drugs for myobacterium tuberculosis?
A
RIPES
Rifampin Isonaziad Pyrazinamide Ethambutol Streptomycin
16
Q
Mechanism of Action for Isonaziad
A
inhibits myoclic acid formation
17
Q
Adverse effects of Isonaziad
A
1) Hepatotoxicity
2) B6 deficiency (lead to neuropathy)
18
Q
Ceftriaxone MOA
A
1) 3rd generation cephalosporin
2) Active against gram negative rods
19
Q
Antibiotic that inhibits DNA synthesis and works well against anaerobic bacteria
A
Metronidazole
20
Q
Antibiotic that inhibits DNA synthesis and works well against anaerobic bacteria
A
Metronidazole
21
Q
1) Ticarcillin
2) Piperacillin
3) Carbenicillin
4) Azlocillin
A
Anti-pseudomonal penicillins
22
Q
What is Pen G used for?
A
1) Syphyilis (Treponema pallidum)
2) Gram positive
3) Gram negatives (Neisseria meningitidis)
23
Q
What is the difference between PenG and PenV?
A
1) PenG is acid labile
2) PenV is acid stabile (can pass through stomach)
24
Q
Ciprofloxacin MOA
A
Fluoroquinolone that acts as a DNA gyrase (topoisomerase II) inhibitor
25
What are the names of the macrolides?
1) Erythromycin
2) Clarithromycin
3) Azithromycin
26
What is the MOA of macrolides?
1) Inhibit 50s ribosomal subunit
27
What are the adverse effects of macrolides?
1) Safest antibiotics
| 2) Abdominal pain
28
What drugs that affect the function of the bacterial ribosome are orally taken?
CLEan T
1) Chloramphenicol and clindamycin
2) Linezolid
3) Erythromycin (and all macrolides i.e. clarithromycin, azithromycin)
4) Tetracylcine and Doxycycline
29
```
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
```
think: mean GNATS
Aminoglycosides
30
What are the adverse effects of aminoglycosides?
Think: A Mean Guy punches in the VIII round right in your kidney and causes damage to your neuromusclature
1) CN VIII toxicity (hearing loss, vertigo)
2) Renal toxicity
3) Complete neuromuscular blockade
31
What are the adverse effects of fluoroquinolones (-floxacins)?
1) Damage to cartilage (avoid in children)
2) Tendonitis
3) Increased risk of C. difficile (psuedomembranous colitis)
32
What is the spectrum for fluoroquinolones?
1) Gram negative
2) Not good against anaerobes
3) Facultative intracellular organisms
33
MOA of Trimethoprim
1) Inhibits the reduction of dihydrofolate to tetrahydrofolate
2) Results in inhibition of DNA synthesis
34
MOA of Sulfamethoxazole
1) Inhibits production of tetrahydrofolate by acting as a PABA analog
2) PABA is required for the production of tetrahydrofolate
35
What two drugs act by inhibiting the production of tetrahydrofolate?
1) Trimethoprim
| 2) Sulfamethoxazole
36
What is the spectrum covered by Trimethoprim and Sulfamethoxazole?
Think: TMP/Smx
1) T (respiratory tree) - covers Streptococcus pneumo and H. influenzae
2) M (mouth) - covers gram negatives that cause diarrhea
3) P (pee) - covers E. coli
4) S (syndrome) - covers Pneumocystis carinii pneumonia (PCP)
37
What is Isoniazid structurally similar to?
Vitamin B6
38
How is amoxicillin given? Ampicillin?
1) Oral
| 2) IV
39
What are amoxicillin and Ampicillin used against?
think: HELPSS kill Enterococci
1) Haemophilus influenzae
2) E. coli
3) Listeria monocytogenes
4) Proteus mirabilis
5) Salmonella
6) Shigella
7) Enterococci
40
Clavulanic Acid
Sulbactam
Tazobactam
think: supporting CAST
Beta lactamase inhibitors
41
What is given with penicillin like drugs to reduce effects of beta lactamase in bacteria
Beta lactamase inhibitors
1) Clavuronic acid
2) Sulbactam
3) Tazobactam
42
What bacteria are typically not covered by cephalosporins?
think: LAME
1) Listeria
2) Atypicals (chlamydia, Mycoplasma)
3) MRSA
4) Enterococci
43
MOA of Aztreonam
Monobactam resistant to beta lactamase; prevents peptidoglycan cross linking
44
Spectrum of Aztreonam
Gram negative rods only
45
MOA of Imipenem
Broad based beta lactamase resistant carbapenem; wide spectrum
46
What is always given with Imipenem
1) Cilastatin "keeps it lastin"
| 2) Decreases inactivation of drug in renal tubules
47
MOA of Vancomycin
1) Inhibits cell wall peptidoglycan formation
| 2) Selective for gram positives only
48
MOA of Aminoglycosides
1) Inhibits formation of 30s/initiation complex
49
What are the tetracylcines used for?
1) Borrelia burgdorferi
2) Mycoplasma pneumonaie
3) Rickettsia
4) Chlamydia (if azithromycin doesn't work)
50
Azithromycin
Clarithromycin
Erythromycin
Macrolides
51
MOA of Macrolides
Inhibit protein synthesis by blocking translocation; binds to 50s
52
MOA of chloramphenicol
Binds to 50s subunit and blocks peptidyltransferase
53
What is the clinical use for clindamycin
1) Anaerobic infections (treats anaerobes above the diaphragm)
54
MOA of sulfonamides
PABA antimetabolite that inhibits dihydropteroate synthase
55
```
Ciprofloxacin
Norfloxacin
Levofloxacin
Sparfloxacin
Enoxacin
```
Fluoroquinolones
56
Clinical use for Fluoroquinolones
Gram negative rods of urinary and GI tract
57
Clinical use for Metronidazole
think: GET GAP
1) Giardia
2) Entamoeba
3) Trichomonas
4) Gardnerella vaginalis
5) Aneroges
6) H. pylori
58
Prophylaxis for Myobacterium avium complex
Azithromycin
59
Adverse effects of rifapmin
1) Stimulates p450 (think: BCG PQR)
2) Causes Red/orange body fluids
3) Rapid resistance when used alone
60
MOA of ethambutol
1) Inhibits the formation of carbohydrate polymerization by blocking Arabinosyltransferase
61
Adverse effect of ethambutol
Optic neuropathy
62
Treatment for Pneumocystis pneumona
TMP/SMX
63
Mechanism of Action for Ribavirin
Synthetic guanosine analog that inhibits viral mRNA synthesis by inhibiting IMP dehydrogenase
64
Uses for Ribavirin
Used for the treatment of RSV
65
Adverse Effects of Ribavirin
1) Teratogenic
2) Renal failure
3) Anemia
66
What is used to treat Influenzae A
Amantadine and rimantidine
67
Mechanism of action for Amantadine and rimantidine
Inhibits the uncoating of viral nucleic acids leading to the inhibition of viral replication
68
Mechanism of action for Zanamivir and Oseltamivir
They act as viral neuramindase inhibitors
69
MOA of Oseltamivir
sialic acid that inhibits the neuraminidases of influenza A and B
70
Treatment for CMV induced retinitis
1) Ganciclovir
2) Foscarnet
3) Cidofovir
Note: all inhibit viral DNA polymerase
71
Viral DNA polymerase inhibitor; Pyrophosphate analog that can chelate calcium and causes renal wasting of magnesium
Foscarnet
72
What should be given prophylactically to pregnant mother with HIV to protect the infant?
1) Zidovudine (retroviral reverse transcriptase inhibitor)
73
Treatment for HSV
Acyclovir
74
What type of virus loses its virulence when exposed to ether?
Enveloped viruses
75
MOA of Amphotericin and Nystatin
1) Bind to ergosterol and make pores
| 2) Nystatin for topical use
76
MOA of Azoles
Inhibit fungal ergosterol synthesis
77
Fluconazole
Ketoconazole
Clotrimazole
Miconazole
Azoles
78
Adverse of Azoles
1) Gynecomastia (decreased testosterone synthesis)
| 2) Inhibition of p450 system
79
MOA of Flucytosine
1) Inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil (inhibits purine synthesis)
2) Used for systemic infections with amphotericin B
80
MOA of Caspofungin and micafungin
Inhibit glucan synthesis
81
MOA of Griseofulvin
1) Interferes with microtubule function
| 2) Used for oral treatment of superficial infections
82
MOA of chloroquine
Blocks detoxifcation of heme into hemozoin; heme accumulates and is toxic to plasmodia
83
Lopinavir
Aazanavir
Ritonavir
think: Navir tease a Protease
Protease inhibitor
84
MOA of Protease inhibitors
1) Prevent maturation of new virues by inhibiting HIV-1 protease (pol gene)
85
Adverse effect of Ritonavir
Inhibits p450 system
| think: PICK EGS
86
```
Tenofovir
Abacavir
Lamivudine
Zidovudine
Didanosine
```
Reverse transcriptase inhibitor
87
What do reverse transcriptase inhibitors require?
Phosphorylation
88
MOA of Raltegravir
Inhibits HIV genome integration into host cell (Integrase inhibitor)
89
What drugs inhibit DNA polymerase without phosphorylation
Cidofovir
90
What viral drug class requires phosphorylation to be active?
Nucleoside reverse transcriptase inhibitors
91
What is the only nucleoside reverse transcriptase inhibitor that does not require phosphorylation?
Tenofovir
92
What is the suffix that protease inhibitors have?
-navir
93
Drugs that act similarly to NRTI, but do not require phosphorylation
Non-nucleoside Reverse transcriptase inhibitors
94
```
Lopinavir
Atazanavir
Darunavir
Fosamprenavir
Saquinavir
```
Protease inhibitors
95
MOA of protease inhibitors
1) Prevent maturation of new viruses by inhibiting the production of HIV-1 protease (pol gene)
96
Nevirapine
Efavirenze
Delavirdine
NNRTI
97
MOA of ganciclovir
1) Guanosine analog that inhibits viral DNA polymerase
| 2) Requires a viral kinase
98
MOA of acylcovir
Guanosine analog that inhibits viral DNA polymerase by chain termination; requires viral kinase
99
What does the killed influenza virus vaccine prevent future attacks from influenza (orhomyxo neg ssRNA)?
1) vaccine gives increased immunity to the Hemaglutin
2) Hemaglutin is important in the binding to the sialic acid
3) Vaccinated pt. cells recognize the HA and prevent virus from entering via receptor mediated endocytosis
100
What type of immune receptors do killed vaccines produce? Live attenuated?
1) killed = MHC class II (antigens are outside of cell and must be endocytized)
2) live, attenuated = MHC class I (live viruses enter the cell and present antigens in the cytoplasm)
101
What mechanisms do the live attenuated virus vaccine inhibit with future infection of virus?
1) Inhibits viral replication
2) Inhibits viral progeny release
3) Increases CD8 response
102
MOA of Terbinafine
Inhibits fungal enzyme squalene epoxidase
103
What is Terbinafine used for?
1) Treatment for dermatophytes
104
Adverse effects of griseofulvin
1) Increases activity of p450
| 2) Teratogenic
105
Treatment for Candidasis
Nystatin (both oral and vaginal)
106
What is the only NNRT drug that does not require phosphorylation?
Tenofovir
107
What are the three drug classes used against HIV?
1) Protease inhibitors (-navir)
2) Nucleoside Reverse Transcriptase inhibitors
3) Non-nucleotide Reverse Transcriptase inhibitors
4) Integrase inhibitors
108
Raltegravir
Integrase inhibitor
109
Navirapine
Efazvirenz
Delavirdine
```
NNRT inhibitors (Non-nucleotide reverse transcriptasse inhbitiors)
think: Navier, Efa off, okay let's DELA gate
```
110
MOA of tetracylcine
1) Acts on the 30s ribosome by interfering with the binding of aminoacyl tRNA to the A site
111
MOA of chloramphenicol
1) Acts on the 50s ribosome subunit by inhibiting peptidyltransferase enzyme (transfer of amino acid from A to P site
112
MOA of erythromycin and clindomycin
1) Acts on the 50s ribosome subunit and inhibits translocation
113
Adverse effect of ethambutonal
optic retinitis
