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MID I > Antibiotics Fun Facts > Flashcards

Antibiotics Fun Facts Flashcards

1
Q

Penicillin G is IV or IM; penicillin VK is

A

oral

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2
Q

Amoxicillin has better absorption than ampicillin because

A

the –OH group makes it stable in stomach acid

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3
Q

co-formulation with beta-lactamase inhibitors

A

bad GI side effects

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4
Q

Bulky, so avoids beta-lactamases; undergo biliary excretion (not renal)

A

anti-staphococcal penicillins (Nafcillin, oxacillin, dicloxacillin)

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5
Q

Used often in immuno-compromised hosts or health care-associated infections

A

anti-pseudomonal (broad/extended spectrum) penicillins (with beta-lactamase inhibitors) (Ticarcillin-clavulanate, Piperacillin-tazobactam)

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6
Q

Beware EBSLs, AmpC, pumps

A

monobactams (aztreonam)

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7
Q

Cephalexin is oral, cefazolin is

A

IV

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8
Q

has increased beta-lactam stability

A

2nd generation cephalosporins (cefoxitin, cefotetan, cefuroxime)

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9
Q

IV, IM; easily get into the CNS; dual biliary and renal excretion

A

3rd generation cephalosporins: ceftriaxone, cefotaxime, cefpodoxime

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10
Q

has been associated with biliary sludge

A

ceftriaxone

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11
Q

cephalosporins that can get easily into CNS

A

3rd generation cephalosporin: Ceftazidime, 4th generation cefepime

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12
Q

broadest cephalosporin

A

4th generation cephalosporin: cefepime

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13
Q

BROAD SPECTRUM; excellent CNS penetration, but can cause seizures in cases of renal insufficiency

A

carbapenems (imipenam-clastatin, meropenam)

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14
Q

Preferable to use a beta-lactam over ____; IM/IV; need to control the speed of the drip to avoid Red Man Syndrome; possible renal/ototoxicity

A

vancomycin

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15
Q

Inhibits formation of the 50S ribosome, blocking transpepsidation or translocation

A

macrolides (in general)

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16
Q

in a plasmid, so it can confer resistance to a lot of macrolides

A

Erm gene

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17
Q

GI symptoms, possibility of cholestatic hepatis, possibility of pyloric stenosis in kids

A

erythromycin

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18
Q

inhibits CYP3A

A

erythromycin

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19
Q

risk of death in QT syndrome

A

erythromycin

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20
Q

Well absorbed orally or parenterally, biliary excretion

A

erythromycin

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21
Q

Well absorbed, 2-4 day half life

A

azythromycin

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22
Q

Well absorbed, 3-7 day half life

A

clarithromycin

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23
Q

High bone concentrations, can cause diarrhea (predisposing drug for C. diff!), allergy

A

clindamycin ( a lincosamide)

24
Q

Narrow therapeutic window with significant toxicity; rarely used due to concerns about resistance

A

aminoglycosides (gentamicin, tobramycin)

25
Interferes with mRNA translational accuracy at the 30S ribosome causing misreading and premature chain termination
aminoglycosides (gentamicin, tobramycin)
26
Best absorption IM, metabolized by the kidney
aminoglycosides (gentamicin, tobramycin)
27
High levels of nephr- and ototoxicity!!
aminoglycosides (gentamicin, tobramycin)
28
Main mechanism of resistance is efflux pumps
doxycycline (a tetracycline)
29
doxycycline route of delivery
primarily oral (can be IV)
30
Excellent tissue distribution, excreted in feces, concentrated in bile
doxycycline (a tetracycline)
31
Toxicity: GI, photosensitivity, teeth discoloration
doxycycline (a tetracycline)
32
Binds to peptidyl transferase, component of 50S risobomal subunit
chloramphenicol. Don't use! Gray babies!
33
Well distributed throughout the body, including CSF
Toxicity: thrombocytopenia, myelosuppresion, peripheral, and optic neuropathy
34
Binds to the 50S ribosomal subunit and inhibits formation of the initiation complex
linezolid (an oxalidinine)
35
linezolid route of administration
Oral administration
36
Toxicity: thrombocytopenia, myelosuppresion, peripheral, and optic neuropathy
linezolid (an oxalidinine)
37
Not frequently used clinically. Parenteral only. Toxicity: phlebitis, myalgias, arthralgias
streptogramins (quinupristin and dalforpristin)
38
Mechanism: bind NDA-DNA gyrase complex blocking further DNA replication; also block separation of interlocked, replicated DNA molecules
fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)
39
Increased resistance over the past 10 years, maybe because of use in animal feed
fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)
40
Oral, with excellent tissue distribution and intracellular concentration; decreased oral absorption following co-administration of metal cations; eliminated mostly by kidneys
fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)
41
Toxicty: GI, CNS, allergic sx, photosensitivity, liver abnormalities, JOINT symptoms, QT prolongation, peripheral neuropathy
fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)
42
Interferes with the synthesis of folic acid; Reduced resistance because of the sequential steps involved with folic acid synthesis
sulfas (trimethoprim-sulfamethoxazole)
43
Oral and parenteral; well distributed; partially metabolized in the liver and excreted in the urine
sulfas (trimethoprim-sulfamethoxazole)
44
Toxicity: rash, fever, GI, nephrotoxicity, (rare) hepatitis, megaloblastic anemia, Steven Johnson syndrome in AIDS patients
sulfas (trimethoprim-sulfamethoxazole)
45
Binds and inserts into the cytoplasmic membrane in a calcium dependent process on Gram positives oligomerization channel formation ion leakage cell death
daptomycin
46
daptomycin route of administration
only pareneteral
47
Monitor CPK for myopathies
daptomycin
48
resistance results from alteration of phospholipids in the cytoplasmic membrane
daptomycin
49
Diffuses across the bacterial membrane and breaks down into free radicals that damage bacterial DNA and macromolecules
metronidazole
50
metronidazole route of administration
Oral, rectal, vaginal, parenteral, excreted in the urine
51
Well tolerated but disulfiram effect with alcohol
metronidazole
52
Modifies LPS with reduction in surface charge
polymixins
53
Nephro and neurotoxicity
polymixins
54
Binds to 30S region of the ribosome and prevents access of aminoacyl tRNA molecules to the mRNA ribosome-peptide complex
doxycycline
55
"Buy AT 30, CCEL at 50"
30s inhibitors: aminoglycosides, tetracyclines. 50s inhibitors: Chloramphenicol, Clindamycin, Erythromycin, Linezolid
56
vanco: well tolerated, but NOT trouble free.
Nephrotoxicity, Ototoxicity, Thrombophlebitis (and redman)
57
trimethoprim (in sulfa TMP-SMX) effects
Treats Marrow Poorly: anemia, leukemia, granulocytopenia (may ease with folic acid)

MID I (8 decks)

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