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Block 1: Pharmacology > Antibiotics Overview > Flashcards

Antibiotics Overview Flashcards

1
Q

What are Antibiotics?

A

Chemicals that inhibit or kill Microorganisms (Bacteria ONLY)
(WILL NOT WORK ON VIRUSES)

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2
Q

Selective Toxicity?

A

Harm Bacteria without harming our cells

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3
Q

Ideal Antibiotic?

A

Kill Bacteria with no side effect (Penicillin G)

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4
Q

Types of Antibiotics?

A

-Bacteriostatic
-Bactericidal
-Sulfonamides

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5
Q

(Types of Antibiotics)
Bacteriostatic?

A

(Inhibit bacterial cell replication)
STATEC:
-Tetracyclines
-Erythromycin
-Chloramphenicol

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6
Q

(Types of Antibiotics)
Bactericidal?

A

(Causes microbial cell death and lysis)
PACS A PUNCH:
-Penicillins
-Aminoglycosides (Gentamycin, Tobramycin)
-Cephalosporins

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7
Q

Sulfonamides?

A

(Either -cidal or -static according to environment)
“Surfs Between -cidal and -static”

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8
Q

Targets for Drug?

A

-Cell Wall Synthesis
-DNA –> RNA
-Protein Synthesis
-Cell Membrane
-Folic Acid

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9
Q

(Targets for Drug)
Cell Wall Synthesis?

A

(PCCMV)
“I hit a wall, Please Come C My Vehicle”
-Penicillin (G, Ampicillin)
-Cephalosporin (Ceftriaxone, Ceftaroline)
-Carbapenems (Imipenam)
-Monobactams (Aztreonam)
-Vancomycin (Tricyclic Glycopeptide)

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10
Q

(Targets for Drug)
DNA –> RNA?

A

(MR. Q)
-Quinolones DNA gyrase, Replication (Ciprofloxacin, Levofloxacin)
-Rifampin (RNA Polymerase)
-Metronidazole (Damage DNA)

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11
Q

(Targets for Drug)
Protein Synthesis?

A

(MAT C)
-Tetracyclines (Doxycycline)
-Aminoglycosides (Gentamycin, Tobramycin)
-Chloramphenicol
-Macrolides: Azithromycin, Erythromycin

(Both make 70s)
(50s: Macrolides, Chloramphenicol, Lincosamides, Streptogramins, Oxazolidines)
(30s: Tetracycline, Glycylcyclines, Aminoglycosides)

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12
Q

(Targets for Drug)
Cell Membrane?

A

(PD)
“Daps the Membrane, punch a hole in the Membrane”
-Polymyxins
-Daptomycin

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13
Q

(Targets for Drug)
Folic Acid?

A

-Trimethoprim
-Sulfonamides (Sulfamethoxazole)

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14
Q

Treatment for C. Diff?

A

Vancomycin

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15
Q

Resistant Bacteria in GI system?

A

-C. Diff
-C. Albicin

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16
Q

Empiric Therapy?

A

When there is not enough time to wait for lab test, so you make an Educated guess based on guidelines

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17
Q

Ideal situation for when a patient presents with symptoms of possible bacterial infection is to?

A

Identify via Lab Tests

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18
Q

Drugs of Choice for Empiric Therapy “First Choice”?

A
  • Treponema pallidum, Syphillis (Penicillin G)

-Mycobacterium tuberculosis (RIPE) (Rifampin + Isoniazid + Pyrazinamide + Ethambutol)

-Psuedomonas aeruginosa, Pneumonia
(PTT) (Piperacillin/Tazobactam + Tobramycin)
(B. Lactam/B. Lactamase Inhibitor + Aminoglycoside)

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19
Q

(Drugs of Choice for Empiric Therapy “First Choice”)
Treponema pallidum, Syphilis?

A

Penicillin G

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20
Q

(Drugs of Choice for Empiric Therapy “First Choice”)
Mycobacterium tuberculosis?

A

(RIPE)
-Rifampin
-Isoniazid
-Pyrazinamide
-Ethambutol

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21
Q

(Drugs of Choice for Empiric Therapy “First Choice”)
Pseudomonas aeruginosa, Pneumonia?

A

(PTT)
-Piperacillin/Tazobactam
-Tobramycin

-B. Lactam/B. Lactamase Inhibitor + Amigoglycoside

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22
Q

AGE?

A

-Neonates
-Children
-CHF
(Increase Gentamicin (NOT a Contraindication))

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23
Q

(AGE)
Neonates?

A

-Chloramphenicol –> Gray Baby Syndrome (lower dose)
-Sulfonamides –> Kernicterus or Toxic Encephalopathy (Contraindication)

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24
Q

(AGE)
Children?

A

Tetracycline –> Bone growth/Teeth discoloration

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25
(AGE) CHF?
Ticarcillin disodium/Clavulanate potassium --> Edema/Arrythmia
26
Pregnancy Contradications?
(MFSAT) "MF SAT" -Metronidazole -Fluoroquinolones -Sulfonamides -Antifolate drugs (Try) -Tetracyclines
27
Synergy?
-Cell Wall Synthesis Inhibitor (Penicillin) + Protein Synthesis Inhibitor (Aminoglycoside) -Sequential Pathway, beta-Lactamase Inhibitor: TazoBactam
28
(Synergy) Penicillins + Aminoglycosides?
Penicillins: -Penicillin G -Ampicillin -Piperacillin Aminoglycosides: -Gentamicin -Tobramycin -Amikacin
29
Penicillins?
(All B-Lactams) -Mechanisms of Action -Pharmacokinetics -Side Effects -Mechanisms of Resistance
30
(Penicillins) Mechanisms of Action?
-Inhibit peptidoglycan transpeptidase (Cross-Linking) -Penicillin Binding Protein (PBP) -Trigger autolysins
31
(Penicillins) Pharmacokinetics?
Majority undergo renal clearance (ALL ANTIBIOTICS)
32
(Penicillins) Side Effects?
-NVD -Superinfection of GI Tract: C. Diff -Allergy
33
(Penicillins) Mechanisms of Resistance?
-Changes in PBP -Tolerance: deficiency in autolytic enzymes -Changes in porins (Gram -) beta-Lactamase
34
NVD?
-Nausea -Vomiting -Diarrhea
35
Cephalosporins (B-Lactam)?
-Cefazolin 1st (PEKS) -Cefoxitin 2nd (HEN PEK) -Ceftriaxone 3rd (ACES) -Cefepime 4th (Gram +) -Ceftaroline 5th
36
If allergic to Penicillin, probably allergic to?
Cephalosporins
37
Monobactam (B-Lactam)?
Aztreonam (Give if Allergic to Penicillin) (mostly G-rods) -Side effects: 1% of B-Lactam allergic patients
38
What Drug to use if Patient is allergic to Penicillin?
Aztreonam (Monobactam (B-Lactam))
39
(Cephalosporins (B-Lactam)) Cefazolin?
1st (PEKS) -Proteus mirabilis -Escherichia coli -Klebsiella pneumonia
40
(Cephalosporins (B-Lactam)) Cefoxitin?
2nd (HEN PEK) -Haemophilus influenzae -Enterobacter aerogenes -Neisseria gonorrhoeae
41
(Cephalosporins (B-Lactam)) Ceftriaxone?
3rd (ACES) -Acinetobacter calcoaceticus -Citrobacter diversus -Enterobacter cloacae -Serratia marcescens
42
(Cephalosporins (B-Lactam)) Cefepime?
4th (Gram +)
43
Cephalosporins (B-Lactam) has same Mechanism of Action/Resistance?
Same as Penicillin
44
Do not give to patients with a history of severe penicillin reaction?
Cephalosporins (B-Lactams)
45
Tricyclic Glycopeptide (Cell Wall Synthesis)?
(Vancomycin) Mechanisms of Action: -Inhibitor of peptidoglycan synthase (attaches to NAG and NAM), binds to D-Ala-D-Ala Therapeutic Uses: -Primarily G+: MRSA, MRSE, Serious multi-drug resistance infections (Clostridioides difficile (PO)) Mechanisms of Resistance: -D-Ala-D-Ala --> D-Ala-D-Lactate -VRE (Vancomycin resistant enterococci) = overproduce D-ALA
46
Tricyclic Glycopeptide (Cell Wall Synthesis) Mechanisms of Action?
-Inhibitor of peptidoglycan synthase (attaches to NAG and NAM) -Binds to D-Ala-D-Ala
47
Tricyclic Glycopeptide (Cell Wall Synthesis) Therapeutic Uses?
Primarily G+: MRSA, MRSE, Serious multi-drug resistance infections (Clostridioides difficile (PO))
48
Tricyclic Glycopeptide (Cell Wall Synthesis) Mechanisms of Resistance?
-D-Ala-D-Ala --> D-Ala-D-Lactate -VRE (Vancomycin resistant enterococci) = overproduce D-ALA
49
Cyclic Lipopeptide (Cell Wall Synthesis)?
-Daptomycin (DAPS HOLES) -Mechanism of Action: Binds to cell membrane, forms pores -Therapeutic use: Primarily G+: MRSA, VRE
50
Tetracyclines (Protein Synthesis Inhibitor, 30s A site)?
-Bacteriostatic (TEC) -Doxycycline primarily fecally eliminated --> OK with renal failure -Contraindicated during pregnancy
51
Doxycycline primarily fecal eliminated but ok with?
Renal Failure
52
Glycylcyclines?
Tigecycline (Reserved for: Difficult to treat infection) -MOA: 30s Protein Synth Inhibitor -Increase risk of mortality, contradiction in pregnancy -Tiger = Mortality
53
Tiger = ?
Mortality
54
Macrolides?
Erythromycin, Azithromycin -MOA: 50s, Protein Synth Inhibitor -USE: Chlamydia, URTI -Side Effects: Prolong QTc interval -MOR: Methylation of 23 rRNA-binding site, prevents binding
55
Macrolides used for?
-Upper Respiratory Tract Infections -Chlamydia
56
Lincosamides?
"CCC" (Clindamycin, Ca-mrsa, CDAD) -MOA: Protein Synth Inhibitors, 50s Ribosomal Unit -USE: CA-MRSA -Side Effects: CDAD
57
Streptogramins?
Quinopristin/Dalfopristin (In Same Dose) *Synergy* -MOA: Binds to 50s ribosome subunit, Bactericidal
58
Aminoglycosides?
Gentamicin, Tobramycin -MOA: 30s ribosomal -Bactericidal -Synergistic with B-Lactams (PCCM)
59
Sulfonamides?
Sulfamethoxazole, Trimethoprim (-DFHR) -S= Inhibition of Dihydropteroate synthase -T= Inhibition of Dihydrofolate reductase (Both Inhibit Folic Acid Synth) -Side Effects: Rash: Sulfa allergy, SJS, TEN
60
SJS do not take?
Sulfonamides

Block 1: Pharmacology (9 decks)

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