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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
Q

Interferes with mRNA translational accuracy at the 30S ribosome causing misreading and premature chain termination

A

aminoglycosides (gentamicin, tobramycin)

26
Q

Best absorption IM, metabolized by the kidney

A

aminoglycosides (gentamicin, tobramycin)

27
Q

High levels of nephr- and ototoxicity!!

A

aminoglycosides (gentamicin, tobramycin)

28
Q

Main mechanism of resistance is efflux pumps

A

doxycycline (a tetracycline)

29
Q

doxycycline route of delivery

A

primarily oral (can be IV)

30
Q

Excellent tissue distribution, excreted in feces, concentrated in bile

A

doxycycline (a tetracycline)

31
Q

Toxicity: GI, photosensitivity, teeth discoloration

A

doxycycline (a tetracycline)

32
Q

Binds to peptidyl transferase, component of 50S risobomal subunit

A

chloramphenicol. Don’t use! Gray babies!

33
Q

Well distributed throughout the body, including CSF

A

Toxicity: thrombocytopenia, myelosuppresion, peripheral, and optic neuropathy

34
Q

Binds to the 50S ribosomal subunit and inhibits formation of the initiation complex

A

linezolid (an oxalidinine)

35
Q

linezolid route of administration

A

Oral administration

36
Q

Toxicity: thrombocytopenia, myelosuppresion, peripheral, and optic neuropathy

A

linezolid (an oxalidinine)

37
Q

Not frequently used clinically. Parenteral only. Toxicity: phlebitis, myalgias, arthralgias

A

streptogramins (quinupristin and dalforpristin)

38
Q

Mechanism: bind NDA-DNA gyrase complex blocking further DNA replication; also block separation of interlocked, replicated DNA molecules

A

fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)

39
Q

Increased resistance over the past 10 years, maybe because of use in animal feed

A

fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)

40
Q

Oral, with excellent tissue distribution and intracellular concentration; decreased oral absorption following co-administration of metal cations; eliminated mostly by kidneys

A

fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)

41
Q

Toxicty: GI, CNS, allergic sx, photosensitivity, liver abnormalities, JOINT symptoms, QT prolongation, peripheral neuropathy

A

fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin)

42
Q

Interferes with the synthesis of folic acid; Reduced resistance because of the sequential steps involved with folic acid synthesis

A

sulfas (trimethoprim-sulfamethoxazole)

43
Q

Oral and parenteral; well distributed; partially metabolized in the liver and excreted in the urine

A

sulfas (trimethoprim-sulfamethoxazole)

44
Q

Toxicity: rash, fever, GI, nephrotoxicity, (rare) hepatitis, megaloblastic anemia, Steven Johnson syndrome in AIDS patients

A

sulfas (trimethoprim-sulfamethoxazole)

45
Q

Binds and inserts into the cytoplasmic membrane in a calcium dependent process on Gram positives oligomerization channel formation ion leakage cell death

A

daptomycin

46
Q

daptomycin route of administration

A

only pareneteral

47
Q

Monitor CPK for myopathies

A

daptomycin

48
Q

resistance results from alteration of phospholipids in the cytoplasmic membrane

A

daptomycin

49
Q

Diffuses across the bacterial membrane and breaks down into free radicals that damage bacterial DNA and macromolecules

A

metronidazole

50
Q

metronidazole route of administration

A

Oral, rectal, vaginal, parenteral, excreted in the urine

51
Q

Well tolerated but disulfiram effect with alcohol

A

metronidazole

52
Q

Modifies LPS with reduction in surface charge

A

polymixins

53
Q

Nephro and neurotoxicity

A

polymixins

54
Q

Binds to 30S region of the ribosome and prevents access of aminoacyl tRNA molecules to the mRNA ribosome-peptide complex

A

doxycycline

55
Q

“Buy AT 30, CCEL at 50”

A

30s inhibitors: aminoglycosides, tetracyclines. 50s inhibitors: Chloramphenicol, Clindamycin, Erythromycin, Linezolid

56
Q

vanco: well tolerated, but NOT trouble free.

A

Nephrotoxicity, Ototoxicity, Thrombophlebitis (and redman)

57
Q

trimethoprim (in sulfa TMP-SMX) effects

A

Treats Marrow Poorly: anemia, leukemia, granulocytopenia (may ease with folic acid)

MID I (8 decks)

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