Antibiotics: Part 1 (Revised) Flashcards
Only effective against a few classes of bacteria.
Narrow Spectrum
Effective against a broad range of bacteria.
Broad Spectrum
A chemically modified narrow-spectrum agent used to increase effectiveness against more bacteria.
Extended Spectrum
Drug that inhibits growth and replication of bacteria.
Bacteriostatic
Drug that actually kills bacteria.
Bactericidal
Total amount of drug that is exposed to the body over time.
Area Under the Curve (AUC)
Lowest concentration of a drug that can prevent growth of the organism.
Minimum Inhibitory Concentration
Antibiotics that eradicate microbes based on the time for which bacteria are exposed to the antibiotics at a concentration higher than the minimum inhibitory concentration.
Time-dependent Antibiotics
What class of antibiotics are all “Time-dependent”
Carbapenems
Antibiotics where the rate and extent of killing increases as peak drug concentration increases.
Concentration Dependent Antibiotics
An affect that causes suppression of bacterial growth after a limited exposure to an antibiotic
Post-Antibiotic Effect
What classes of antibiotics work via Cell Wall Inhibition?
Beta Lactams
Aztreonam
Gylcopeptides
Lipopeptides
What families of antibiotics consist of Beta Lactams (which are also Cell Wall Inhibitors)
Penicillins
Cephalosporins
Carbapenems
What antibiotics work via Protein Synthesis Inhibition?
Clindamycin
Chloramphenicol
Linezolid
Erythromycin
Azithromycin
Tetracyclines
Aminoglycosides
What antibiotic works via Folate Antagonism?
Sulfonamides and Trimethoprim
(Bactrim)
What class of antibiotics work via the Inhibition of DNA Topoisomerases?
Fluoroquinalones
Bacteriostatic Antibiotics:
ECSTaTiC
Erythromycin
Clindamycin
Sulfamethoxazole
Trimethoprim
Tetracycline
Chloramphenicol
Bactericidal Antibiotics:
Very Finely Proficient At Cell Murder
Vancomycin
Fluoroquinalones
Penicillins
Aminoglycosides
Cephalosporins
Metronidazole
Beta-lactams and Monobactams consist of 4 different subcategories.
Penicillins
Cephalosporins
Carbapenems
Monobactam
The final step in synthesis of a bacterial cell wall is the cross-linking of adjacent peptidoglycan stands. What is this process called?
Transpeptidation
Beta-lactams and Monobactams work via competing for and binding to enzymes that catalyze transpeptidation and cross linking. What are the enzymes in this process known as?
Penicillin-Binding Proteins (PBPs)
All beta-lactams are bactericidal or bacteriostatic?
Bactericidal
What is the name of the bacterial enzymes that breaks the beta-lactam ring of antibiotics, making them ineffective.
Beta Lactamase
A high dose of Beta-Lacatams or Monobactams can cause what medical emergency?
Seizures
Accumulation of Beta-Lactams and Monobactams might occur if the dose of the antibiotics doesn’t adjust or account for what function in the body?
Renal Function
What are the two natural penicillins that we learned about in this lecture?
Penicillin G
Penicillin VK
Penicillin G and Penicillin VK are reliable against what two organisms?
Streptococci
Treponema pallidum
Penicillin G and Penicillin VK are the drugs of choice against what two diseases?
Syphilis (G)
Streptococcal Pharyngitis (VK)
What are the two Aminopenicillins that we learned about in this lecture?
Ampicillin
Amoxicillin
Ampicillin and Amoxicillin are reliable against what two organisms?
Enterococci
Streptococci
Amoxicillin is the drug of choice for what infection?
Otitis Media
Ampicillin is the drug of choice for what two infections?
Enterococci
Listeria monocytogenes
Ampicillin by itself is only bacteriostatic against enterococci, what must be added as a synergist to allow it to become bactericidal?
Aminoglycoside
What are three anti-staphylococcal penicillins that we learned about in this lecture?
(AKA - Penicillinase-Resistant Penicillins)
Nafcillin
Oxacillin
Methicillin
Nafcillin, Oxacillin, and Methicillin are reliable against what two organisms?
MSSA
Streptococci
Nafcillin, Oxacillin, and Methicillin are the drugs of choice for what infections?
SSTIs
Endocarditis (MSSA)
Why are Nafcillin, Oxacillin, and Methicillin preferred of Vancomycin for MSSA infections?
They are more rapidly bactericidal
What are the three pairs of Beta-Lactams + Beta-Lactamase Inhibitors that we learned about in this lecture?
Ampicillin + Sulbactam (Unasyn)
Amoxicillin + Clavulanate (Augmentin)
Piperacillin + Tazobactam (Zosyn)
Piperacillin + Tazobactam (Zosyn) is reliable against what organism?
Pseudomonas aeruginosa
Piperacillin + Tazobactam (Zosyn) and Ticarcillin + Clavulanate can be used to treat what type of nosocomial infection?
Hospital Acquired Pneumonia (HAP)
B-Lactams + B-Lactamase Inhibitors restore of the activity of antibiotics against B-Lactamase producing bacteria. This means they have no effect on resistance that is acquired through other means. Name two examples of organisms where this synergism would have no effect?
MRSA
PCN-resistant pneumococci
What is the most common drug allergy that is reported by patients?
Penicillin Allergy
What is the most common presentation of a penicillin allergy?
Rash
What percent of the population reports having a penicillin allergy?
10%
What percent of the population that reports have a penicillin allergy, actually has one?
10%
How do cephalosporins work? What is their mechanism of action?
Inhibition of Cell Wall Synthesis
(via binding to Penicillin Binding Proteins)
What generation of cephalosporins are able to penetrate the central nervous system?
3rd Gen.
What disease do 3rd Gen. Cephalosporins allows us to treat?
Meningits
What are the two 1st Gen. Cephalosporins that we learned about in this lecture?
Cefazolin
Cephalexin
Cefazolin and Cephalexin are reliable against what two organisms?
MSSA
Streptococci
Cefazolin and Cephalexin may be used to treat or prevent what diseases?
SSTIs and Endocarditis (MSSA)
Surgical Prophylaxis
What is the 2nd Gen. Cephalosporin that we learned about in this lecture that is considered to be for “Respiratory” treatments?
Cefuroxime
What organism is Cefuroxime reliable against?
H. influenzae
2nd Gen. Cephalosporins activity against H. influenzae differentiates it from what generation of cephalosporins?
1st Gen.
What are the two 2nd Gen. Cephalosporins that we learned about in this lecture that are considered to be for “Enteric” treatments?
Cefoxitin
Cefotetan
What organism is Cefoxitin and Cefotetan reliable against?
H. influenzae
Cefoxitin and Cefotetan may be used to treat what two types of infection and a prophylaxis for what type of surgery?
Abdominal and Gynecologic Infections
Abdominal Surgery Prophylaxis
Cefoxitin and Cefotetan are differentiated from other cephalosporins due to their activity against what organism?
Bacteroides fragilis
What two 3rd Gen. Cephalosporins did we focus on in this lecture?
Ceftriaxone
Ceftazidime
What organism is Ceftazidime reliable against?
Pseudomonas aeruginosa
Ceftriaxone + a macrolide or doxycycline can be used to treat what three diseases?
Community Acquired Pneumonia (CAP)
UTIs
Lyme Disease
Ceftriaxone is the drug of choice for what two infections?
Gonorrhea
Meningitis
What is the 4th Gen. Cephalosporin that we learned about in this lecture?
Cefepime
What organism is Cefepime reliable against?
Pseudomonas aeruginosa
What is the additive bonus of a 4th Gen. Cephalosporin over a 3rd Gen. Cephalosporin?
better Staph + Strep activity
What is the 5th Gen. Cephalosporin that we learned about in this lecture?
Ceftaroline
Ceftaroline has a high affinity for penicillin-binding protein 2a which allows it to be effective against what organism?
MRSA
Ceftaroline is similar to Ceftriaxone with the additional activity against what two organisms?
MRSA
E. faecalis
What are the two carbapenems that we learned about in this lecture?
Imipenem
Meropenem
Carbapenems are the drug of choice for what type of organism?
Extended-Spectrum Beta Lactamase producing GNRs
(ESBL)
What is the name of the Monobactam that we learned about during this lecture?
Aztreonam
What does Aztreonam have no activity against?
Gram (+) bacteria
Aztreonam is reliable against what two organisms?
Most GNRs
Pseudomonas
Aztreonam is often used in patients with what type of severe allergy?
B-lactam allergy
What class of oral antibiotics are a good option for treating Pseudomonas?
Fluoroquinalones
What class of IV antibiotics are a good option for treating Pseudomonas?
Carbapenems
What are the only two antibiotics discussed in this lecture that did not require renal dose adjustments?
Ceftriaxone
Nafcillin
What is the name of the Gylcopeptide antibiotic that was discussed in this lecture?
Vancomycin
How does Vancomycin work? What is the mechanism of action?
Inhibits cross-linking of linear peptidoglycans
What must be monitored when administering Vancomycin to a patient?
Drug Levels
What are three adverse drug reactions that Vancomycin might cause?
Nephrotoxicity
Ototoxicity
Red-Man Syndrome
What organism is Vancomycin reliable against and the drug of choice for?
MRSA
Why might you give Vancomycin orally to a patient?
Severe C. difficile infection
Why is Vancomycin not systemically distributed when taken orally?
Not absorbed by the GI tract
What is the name of the Lipopeptide that we learned about in this lecture?
Daptomycin
How does Daptomycin work? What is the mechanism of action?
Binds to the membrane of the bacteria and causes a depolarization of the bacteria. This results in the loss of membrane potential and results in death.
Daptomycin should be avoided in cases of what disease?
Pneumonia
What are two adverse drug reactions that when taking Daptomycin may occur?
Rhabdomyolysis (avoid with statins if possible)
Hepatic Effects
What are three aminoglycosides that we learned about in this lecture?
Gentamicin
Tobramycin
Amikacin
Are aminoglycosides bactericidal or bacteriostatic?
Bactericidal
How do aminoglycosides work? What is the mechanism of action?
Protein Synthesis Inhibition
(30s Subunit)
What must you monitor when administering a patient aminoglycosides?
Drug Levels
Are aminoglycosides given as a monotherapy or in a combination therapy?
Combination Therapy
What are the two adverse drug reactions we learned about that can occur due to Aminoglycosides?
Nephrotoxicity
Ototoxicity
What are some infections where aminoglycosides would be used as part of a combination therapy?
Sepsis
Cystic Fibrosis
Ventilator Associated Pneumonia
Febrile Neutropenia
Aminoglycosides have no coverage against Gram (+) bacteria. What antibiotics might you pair this with to gain that coverage?
Beta Lactams
Vancomycin