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Microbiology > Antibiotics, Antifungals, Antiviral > Flashcards

Antibiotics, Antifungals, Antiviral Flashcards

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1
Q

Adverse effects of Tetracyline

A

1) Retardation of Bone growth (do not give to kids below 8)

2) Teratogenic

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2
Q

Mechanism of Action of Tetracycline/Doxycylcine

A

Acts by inhibiting the 30s subunit of bacterial ribosome that results in protein synthesis;

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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

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4
Q

MOA of Fluoroquinolone

A

DNA Gyrase inhibitor (topoisomerase II) (bacteriocidal)

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5
Q

Adverse Effects of chloramphenicol

A

1) Causes bone marrow depression; may lead to aplastic anemia
2) Gray baby syndrome

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6
Q

Adverse effects of clindamycin

A

1) Causes pseudomembranous colitis

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7
Q

Spectrum of clindamycin

A

1) Not useful against gram negative

2) Anaerobes

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8
Q

Spectrum of linezolid

A

1) Used when nothing else works

2) Blocks 50s subunit

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9
Q

Adverse effects of linezolid

A

1) Very expensive

2) Bone marrow suppression (anemia, thrombocytopenia, neutropenia)

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10
Q

Spectrum of chloramphenicol

A

Broad specturm of gram positive and negative; also anaerobic; inhibits 50s leading to protein synthesis inhibition

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11
Q

1) Methicillin
2) Naficillin
3) Oxacillin
4) Dicloxacillin

A

think: MET a NAsty Ox

Penicillinase resistant penicillin

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12
Q

Mechanism of action for rifampin

A

1) DNA dependent RNA polymerase inhibitor

2) Also used prophylacticly for H. influenzae

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13
Q

Adverse effects of vancomycin

A

1) Nephrotoxicity
2) Ototoxicity
3) Red man syndrome

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14
Q

Spectrum of Metronidazole

A

Used to treat anaerobic flora

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15
Q

What are the first line drugs for myobacterium tuberculosis?

A

RIPES

Rifampin
Isonaziad
Pyrazinamide
Ethambutol
Streptomycin
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16
Q

Mechanism of Action for Isonaziad

A

inhibits myoclic acid formation

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17
Q

Adverse effects of Isonaziad

A

1) Hepatotoxicity

2) B6 deficiency (lead to neuropathy)

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18
Q

Ceftriaxone MOA

A

1) 3rd generation cephalosporin

2) Active against gram negative rods

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19
Q

Antibiotic that inhibits DNA synthesis and works well against anaerobic bacteria

A

Metronidazole

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20
Q

Antibiotic that inhibits DNA synthesis and works well against anaerobic bacteria

A

Metronidazole

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21
Q

1) Ticarcillin
2) Piperacillin
3) Carbenicillin
4) Azlocillin

A

Anti-pseudomonal penicillins

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22
Q

What is Pen G used for?

A

1) Syphyilis (Treponema pallidum)
2) Gram positive
3) Gram negatives (Neisseria meningitidis)

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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)

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24
Q

Ciprofloxacin MOA

A

Fluoroquinolone that acts as a DNA gyrase (topoisomerase II) inhibitor

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25
Q

What are the names of the macrolides?

A

1) Erythromycin
2) Clarithromycin
3) Azithromycin

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26
Q

What is the MOA of macrolides?

A

1) Inhibit 50s ribosomal subunit

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27
Q

What are the adverse effects of macrolides?

A

1) Safest antibiotics

2) Abdominal pain

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28
Q

What drugs that affect the function of the bacterial ribosome are orally taken?

A

CLEan T

1) Chloramphenicol and clindamycin
2) Linezolid
3) Erythromycin (and all macrolides i.e. clarithromycin, azithromycin)
4) Tetracylcine and Doxycycline

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29
Q 
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
A

think: mean GNATS

Aminoglycosides

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30
Q

What are the adverse effects of aminoglycosides?

A

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

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31
Q

What are the adverse effects of fluoroquinolones (-floxacins)?

A

1) Damage to cartilage (avoid in children)
2) Tendonitis
3) Increased risk of C. difficile (psuedomembranous colitis)

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32
Q

What is the spectrum for fluoroquinolones?

A

1) Gram negative
2) Not good against anaerobes
3) Facultative intracellular organisms

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33
Q

MOA of Trimethoprim

A

1) Inhibits the reduction of dihydrofolate to tetrahydrofolate
2) Results in inhibition of DNA synthesis

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34
Q

MOA of Sulfamethoxazole

A

1) Inhibits production of tetrahydrofolate by acting as a PABA analog
2) PABA is required for the production of tetrahydrofolate

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35
Q

What two drugs act by inhibiting the production of tetrahydrofolate?

A

1) Trimethoprim

2) Sulfamethoxazole

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36
Q

What is the spectrum covered by Trimethoprim and Sulfamethoxazole?

A

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)

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37
Q

What is Isoniazid structurally similar to?

A

Vitamin B6

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38
Q

How is amoxicillin given? Ampicillin?

A

1) Oral

2) IV

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39
Q

What are amoxicillin and Ampicillin used against?

A

think: HELPSS kill Enterococci
1) Haemophilus influenzae
2) E. coli
3) Listeria monocytogenes
4) Proteus mirabilis
5) Salmonella
6) Shigella
7) Enterococci

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40
Q

Clavulanic Acid
Sulbactam
Tazobactam

A

think: supporting CAST

Beta lactamase inhibitors

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41
Q

What is given with penicillin like drugs to reduce effects of beta lactamase in bacteria

A

Beta lactamase inhibitors

1) Clavuronic acid
2) Sulbactam
3) Tazobactam

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42
Q

What bacteria are typically not covered by cephalosporins?

A

think: LAME
1) Listeria
2) Atypicals (chlamydia, Mycoplasma)
3) MRSA
4) Enterococci

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43
Q

MOA of Aztreonam

A

Monobactam resistant to beta lactamase; prevents peptidoglycan cross linking

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44
Q

Spectrum of Aztreonam

A

Gram negative rods only

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45
Q

MOA of Imipenem

A

Broad based beta lactamase resistant carbapenem; wide spectrum

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46
Q

What is always given with Imipenem

A

1) Cilastatin “keeps it lastin”

2) Decreases inactivation of drug in renal tubules

47
Q

MOA of Vancomycin

A

1) Inhibits cell wall peptidoglycan formation

2) Selective for gram positives only

48
Q

MOA of Aminoglycosides

A

1) Inhibits formation of 30s/initiation complex

49
Q

What are the tetracylcines used for?

A

1) Borrelia burgdorferi
2) Mycoplasma pneumonaie
3) Rickettsia
4) Chlamydia (if azithromycin doesn’t work)

50
Q

Azithromycin
Clarithromycin
Erythromycin

A

Macrolides

51
Q

MOA of Macrolides

A

Inhibit protein synthesis by blocking translocation; binds to 50s

52
Q

MOA of chloramphenicol

A

Binds to 50s subunit and blocks peptidyltransferase

53
Q

What is the clinical use for clindamycin

A

1) Anaerobic infections (treats anaerobes above the diaphragm)

54
Q

MOA of sulfonamides

A

PABA antimetabolite that inhibits dihydropteroate synthase

55
Q 
Ciprofloxacin
Norfloxacin
Levofloxacin
Sparfloxacin
Enoxacin
A

Fluoroquinolones

56
Q

Clinical use for Fluoroquinolones

A

Gram negative rods of urinary and GI tract

57
Q

Clinical use for Metronidazole

A

think: GET GAP
1) Giardia
2) Entamoeba
3) Trichomonas
4) Gardnerella vaginalis
5) Aneroges
6) H. pylori

58
Q

Prophylaxis for Myobacterium avium complex

A

Azithromycin

59
Q

Adverse effects of rifapmin

A

1) Stimulates p450 (think: BCG PQR)
2) Causes Red/orange body fluids
3) Rapid resistance when used alone

60
Q

MOA of ethambutol

A

1) Inhibits the formation of carbohydrate polymerization by blocking Arabinosyltransferase

61
Q

Adverse effect of ethambutol

A

Optic neuropathy

62
Q

Treatment for Pneumocystis pneumona

A

TMP/SMX

63
Q

Mechanism of Action for Ribavirin

A

Synthetic guanosine analog that inhibits viral mRNA synthesis by inhibiting IMP dehydrogenase

64
Q

Uses for Ribavirin

A

Used for the treatment of RSV

65
Q

Adverse Effects of Ribavirin

A

1) Teratogenic
2) Renal failure
3) Anemia

66
Q

What is used to treat Influenzae A

A

Amantadine and rimantidine

67
Q

Mechanism of action for Amantadine and rimantidine

A

Inhibits the uncoating of viral nucleic acids leading to the inhibition of viral replication

68
Q

Mechanism of action for Zanamivir and Oseltamivir

A

They act as viral neuramindase inhibitors

69
Q

MOA of Oseltamivir

A

sialic acid that inhibits the neuraminidases of influenza A and B

70
Q

Treatment for CMV induced retinitis

A

1) Ganciclovir
2) Foscarnet
3) Cidofovir
Note: all inhibit viral DNA polymerase

71
Q

Viral DNA polymerase inhibitor; Pyrophosphate analog that can chelate calcium and causes renal wasting of magnesium

A

Foscarnet

72
Q

What should be given prophylactically to pregnant mother with HIV to protect the infant?

A

1) Zidovudine (retroviral reverse transcriptase inhibitor)

73
Q

Treatment for HSV

A

Acyclovir

74
Q

What type of virus loses its virulence when exposed to ether?

A

Enveloped viruses

75
Q

MOA of Amphotericin and Nystatin

A

1) Bind to ergosterol and make pores

2) Nystatin for topical use

76
Q

MOA of Azoles

A

Inhibit fungal ergosterol synthesis

77
Q

Fluconazole
Ketoconazole
Clotrimazole
Miconazole

A

Azoles

78
Q

Adverse of Azoles

A

1) Gynecomastia (decreased testosterone synthesis)

2) Inhibition of p450 system

79
Q

MOA of Flucytosine

A

1) Inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil (inhibits purine synthesis)
2) Used for systemic infections with amphotericin B

80
Q

MOA of Caspofungin and micafungin

A

Inhibit glucan synthesis

81
Q

MOA of Griseofulvin

A

1) Interferes with microtubule function

2) Used for oral treatment of superficial infections

82
Q

MOA of chloroquine

A

Blocks detoxifcation of heme into hemozoin; heme accumulates and is toxic to plasmodia

83
Q

Lopinavir
Aazanavir
Ritonavir

A

think: Navir tease a Protease

Protease inhibitor

84
Q

MOA of Protease inhibitors

A

1) Prevent maturation of new virues by inhibiting HIV-1 protease (pol gene)

85
Q

Adverse effect of Ritonavir

A

Inhibits p450 system

think: PICK EGS

86
Q 
Tenofovir
Abacavir
Lamivudine
Zidovudine
Didanosine
A

Reverse transcriptase inhibitor

87
Q

What do reverse transcriptase inhibitors require?

A

Phosphorylation

88
Q

MOA of Raltegravir

A

Inhibits HIV genome integration into host cell (Integrase inhibitor)

89
Q

What drugs inhibit DNA polymerase without phosphorylation

A

Cidofovir

90
Q

What viral drug class requires phosphorylation to be active?

A

Nucleoside reverse transcriptase inhibitors

91
Q

What is the only nucleoside reverse transcriptase inhibitor that does not require phosphorylation?

A

Tenofovir

92
Q

What is the suffix that protease inhibitors have?

A

-navir

93
Q

Drugs that act similarly to NRTI, but do not require phosphorylation

A

Non-nucleoside Reverse transcriptase inhibitors

94
Q 
Lopinavir
Atazanavir
Darunavir
Fosamprenavir
Saquinavir
A

Protease inhibitors

95
Q

MOA of protease inhibitors

A

1) Prevent maturation of new viruses by inhibiting the production of HIV-1 protease (pol gene)

96
Q

Nevirapine
Efavirenze
Delavirdine

A

NNRTI

97
Q

MOA of ganciclovir

A

1) Guanosine analog that inhibits viral DNA polymerase

2) Requires a viral kinase

98
Q

MOA of acylcovir

A

Guanosine analog that inhibits viral DNA polymerase by chain termination; requires viral kinase

99
Q

What does the killed influenza virus vaccine prevent future attacks from influenza (orhomyxo neg ssRNA)?

A

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
Q

What type of immune receptors do killed vaccines produce? Live attenuated?

A

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
Q

What mechanisms do the live attenuated virus vaccine inhibit with future infection of virus?

A

1) Inhibits viral replication
2) Inhibits viral progeny release
3) Increases CD8 response

102
Q

MOA of Terbinafine

A

Inhibits fungal enzyme squalene epoxidase

103
Q

What is Terbinafine used for?

A

1) Treatment for dermatophytes

104
Q

Adverse effects of griseofulvin

A

1) Increases activity of p450

2) Teratogenic

105
Q

Treatment for Candidasis

A

Nystatin (both oral and vaginal)

106
Q

What is the only NNRT drug that does not require phosphorylation?

A

Tenofovir

107
Q

What are the three drug classes used against HIV?

A

1) Protease inhibitors (-navir)
2) Nucleoside Reverse Transcriptase inhibitors
3) Non-nucleotide Reverse Transcriptase inhibitors
4) Integrase inhibitors

108
Q

Raltegravir

A

Integrase inhibitor

109
Q

Navirapine
Efazvirenz
Delavirdine

A 
NNRT inhibitors (Non-nucleotide reverse transcriptasse inhbitiors)
think: Navier, Efa off, okay let's DELA gate
110
Q

MOA of tetracylcine

A

1) Acts on the 30s ribosome by interfering with the binding of aminoacyl tRNA to the A site

111
Q

MOA of chloramphenicol

A

1) Acts on the 50s ribosome subunit by inhibiting peptidyltransferase enzyme (transfer of amino acid from A to P site

112
Q

MOA of erythromycin and clindomycin

A

1) Acts on the 50s ribosome subunit and inhibits translocation

113
Q

Adverse effect of ethambutonal

A

optic retinitis

Microbiology (10 decks)

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