Antibiotics: Concepts

Question 1

Main Bacteria: (GPC, GNC, GNR, Anae, Atyp)

1. ) Strep pneu leads to? (3)
2. ) Strep pyrogenes leads to?
3. ) Varidians step leads to?
4. ) Staph? (3)
5. ) Enterococcus? (3)
6. ) N. gonnorhea?
7. ) E. Coli? (4)
8. ) Pseudo aeur? (3)
9. ) C. diff?
10. ) Bacteriodes? (2)
11. ) Chlamydia? (3)
12. ) Myo. pneu?

Answer 1

• pnemonia, otitis media, menin, sinusitis
• pharyngitis
• endocarditis
• cutaneous infection, pneumonia, bacteremia
• bacteremia, mening., intraabdominal infections
• gonorrhea
• UTI, lower resp., bacteremias, travellers diarrhea
• nosocomial infections, UTI, pneumonia
• pseudomembranous colitis
• Intraabdominal/brain abscess
• Trachoma, CA-pneu, urethritis
• CA-pneu

Question 2

• 4 selective toxicities: Folate? Ribosome? Cell wall? Macromolec. difference with cell membrane?
• Resistance: Natural? Escape? Acquired?
• Distribution: Beneficial: Clindacin? Macrolides? Tetracyclines? Toxic: Aminoglycosides? Tetracyclines?
• Spectrum: Narrow? Extended? Broad?
• Cell wall synthesis inhibitors: Effect linear polymerization? Effect cross linking?

Answer 2

• Bacteria must synthesize it; 30/50s; synthesis of it; Chol in humans/ egosterol in fungi
• microbes lack target; microbes sensitive to drug but don’t die; mutation or plasmid transfer
• bone; pulm cells; gingiva; inner ear/kidneys; bind Ca which is bad for teeth/bones
• gram - OR +; both; both + atypical
• Vancomycin; Pen, Ceph

Question 3

1. ) Pen G: Hydrolyzed by?
2. ) Pen V: Resistant to?
3. ) Dicloxacillin resistant to? Spectrum?
4. ) Amox/ampicillin: Spectrum? Penetrate?
5. ) Piperacillin: Spectrum? Penetrate? Anti what? Taken how? Good with?
6. ) Clavulanic acid is what?
   - What penicillins work with MRSA?
   - Cephs spectrum? Lower suseptibility to?
7. ) Cephalexin taken? Cefazolin taken? Similar to?
8. ) Cefuroxime: Better activity against? (2)
9. ) Ceftriaxone: Taken how? Cross? Best against?
10. ) Vancomycin: Poor oral used for? All else?

Answer 3

• Acid
• Acid
• Penicillinase; narrow (cocci only)
• Extended; penetrate gram - porins
• Extended; gram - porins; pseudonomal; IV; aneorobes
• Beta lactamase inhibitor
• None
• Broader than pen; B lactamases
• oral; IV; amox
• gram - and aneorobes
• IV-IM only; CNS; gram -
• C diff; via IV

Question 4

• Protein synthesis inhibitors? (5)
• Site 1: Block initiation: Drug? Static?
• Site 2: Block tRNA access: Drug? Static?
• Site 3: Inhibit peptidyl transferase: Drug? Static?
• Site 4: Block trnaslocation: Drugs? Static?
  1. ) Macrolides: All go to? Not? C and E can inhibit? Prolonged what sometimes?
  a. ) Erythromycin: Metbaolism? Exctretion?
  b. ) Azithromycin: Taken with? Accumulates where? Metab to active by?
  c. ) Clarithromycin: Accumulates where? Metab? Elimination?
  2. ) Tetracyclines: Impaired by? Bio avail? Excretion? Don’t use in? Interact with? (2)
  3. ) Aminoglycosides: Not effective against? Why? Good absorption via? Accumulates where? Given in one big dose? Possible damage? (2) can inhibit?
  4. ) Chloramphenicol: Into CNS? 2 toxic effects?

Answer 4

• Macrolides, tetracyclines, clindamycin, aminoglycosides, chloaphenicol
• Aminogylcasides; cidal 30s
• Tetracyclines; static 30s
• Chlora; static 50s
• Clinda/macro; 50 s static
• fetus, brain; QT interval; CYP450
• Liver; bile
• Empty stomach; macs; liver
• Macs, liver; renal
• Milk products; highest; liver; prego/children; anticoagulants and antiacids
• Anaerobes; O2 dependent entry; IM; kidney/ear; yes; 8t cranial nerve/kidney; PCN’s
• Yes; Bone marrow; Gray baby syndrome

Question 5

Inhibitors of DNA function:

1. ) Fluoroquinolones: Target what? Static? AR’s? (2)
   a. ) Ciproflaxin: Taken how? Excretion?
   b. ) Levofloxacin: Taken how? Excretion?
   c. ) Moxiflaxacin: Taken how? Excretion? But?
2. ) Nitrofurantoin: Antiseptic for? Why? Static? Damage to? Absorption speed? Category what in pregos?
3. ) Metronidiazole: Pro drug? Static? Type of anion? Work well with? (2) CNS/bone? Metabolism? Breast milk excretion? Inhibits? Category in pregos?

Answer 5

• DNA gyrase/topoisomerase IV; Cidal; tendon rupture/QT prolongation
• Oral/IV - Renal
• Oral/IC - Renal
• Oral - Renal - No adjustments for renal function
• UTI; collects in renal tubules; cidal; DNA of bacteria; rapid; B
• Yes; cidal; radical; anaerobes/protoxoa; yes; hepatic; yes; aldehyde dehydrogenase; B