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I and I > antimicrobial > Flashcards

antimicrobial Flashcards

1
Q

narrow spectrum

A

active against Gram-positive or Gram-negative, aerobic or anaerobic bacteria

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2
Q

eg of narrow spectrum

A

Vancomycin, colistin, azteronam

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3
Q

Broad spectrum

A

active against Gram-positive and Gram-negative, aerobic and anaerobic)

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4
Q

eg of broad spectrum

A

Third generation cephalosporin, piperacillin

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5
Q

Extended spectrum

A

very wide range activity it may not cover small number of pathogens

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6
Q

eg of extended spectrum

A

Carbapenem, tigycycline

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7
Q

what drugs act on cell wall synthesis ?

A 
cycloserine 
vancomycin 
bacitracin
penicillin
cephalosporin
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8
Q

what drugs act on dna gyrase?

A

nalidixic acid

quinolones

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9
Q

what drug act on dna dependent rna polymerase ?

A

rifampicin

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10
Q

what drugs act on protein synthesis by inhibiting 50s?

A

erythromycin
chloramphenicol
clindamycin

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11
Q

what drugs act on protein synthesis by inhibiting 30s?

A 
tetracycline 
spectinomycin
streptomycin 
gentamicin 
tobramycin 
amikacin
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12
Q

what drug acts on cell membrane ?

A

polymyxins

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13
Q

what drugs act on folic acid metabolism?

A

trimethoprim

sulfonamides

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14
Q

drugs Inhibit Cell wall synthesis how?

A

acting on formation of peptidoglycan

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15
Q

Inhibitors of bacterial cell wall synthesis

A

β-lactam act on the final stages of peptidoglycan synthesis

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16
Q

what are the β-lactams

A

penicillin
cephalosporin
carbapenem
monobactam

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17
Q

β-lactams characteristics

A

All share β-lactam ring

Principal target is Transpeptidase

All bound to penicillin binding proteins (PBP)

PBP are involved in cell wall construction ( Bactericidal)

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18
Q

penicillin structure

A

5-membered thiazolinering fused to β-lactam ring

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19
Q

first natural penicillin is produced by ?

A

penicillium

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20
Q

resistance to penicillin is a result of what?

A

enzymes = penicillinases

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21
Q

negatives of penicillin

A

Breakdown by gastric acidity (poorly absorbed by mouth)

Very rapid excretion by the kidney

Narrow spectrum

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22
Q

6-Aminopenicillanic acid (6-APA) is better than benzyl penicillin in terms of what?

A

Antibacterial activity ( broader spectrum)

Stability to bacterial β-lactamases

Pharmacokinetic properties ( better absorption)

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23
Q

group 1 penicillin aka

A

parenteral penicillin

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24
Q

what are the parenteral penicillins?

A

Benzyl penicillin

Procaine penicillin (long acting)

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25
Q

group 2 penicillin aka

A

Oral penicillin

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26
Q

what is a kind of Oral penicillin?

A

Penicillin V

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27
Q

Classifications of penicillin is on the basis of ….

A

antibacterial spectra

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28
Q

group 3 aka

A

Anti-staphylococcal penicillin

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29
Q

whats a kind of Anti-staphylococcal penicillin?

A

Cloxacillin

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30
Q

group 4 aka

A

Extended-spectrum penicillin

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31
Q

what are Extended-spectrum penicillin active against?

A

Enterobacteriacea except Pseudomonas

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32
Q

what are the kinds of Extended-spectrum penicillin?

A

Ampicillin

Amoxicillin

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33
Q

group 5 aka

A

penicillin active against Pseudomonas aeruginosa

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34
Q

what is an example of penicillin active against Pseudomonas aeruginosa?

A

Piperacillin

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35
Q

group 6 aka

A

β-lactamase-resistant penicillin

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36
Q

β-lactamase-resistant penicillin is active against what?

A

gram negative only

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37
Q

whats an example of β-lactamase-resistant penicillin?

A

Temocillin

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38
Q

what causes Hypersensitivity reaction Anaphylactic reaction ( rare, rapid reaction within minutes, nausea, vomiting , dyspnea and coma, fatal) as side effects?

A

penicillin

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39
Q

what causes Purities and urticarial reaction (develop within 1-3days )
Skin eruptions usually maculopapularrashes (commonest) as side effects?

A

penicillin

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40
Q

what causes Hemolytic anemia and thrombocytopenia

Neurotoxicity with high doses (rare) as side effects?

A

penicillin

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41
Q

cephalosporin structure

A

6-membered dihydrothiazinering fused to a β-lactam ring

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42
Q

cephalosporins are derivatives of ….

A

7-aminocephalosporanicacid (7-ACA)

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43
Q

Cephalosporin advantages over penicillin

A

More stable to enzymes ( Staphylococcus penicillinases)

Broader spectrum

Less prone to cause hypersensitivity

Oral and parenteral preparations

44
Q

penicillin is better than cephalosporin in that…

A

more active against Enterococci

45
Q

cephalosporin 1st gen

A

Cephalexin

Cephazolin

46
Q

cephalosporin 2nd gen

A

Cefuroxime

Cefoxitin

47
Q

cephalosporin 3rd gen

A

Cefotaxime
Ceftriaxone
Ceftazidime (antipseudomonal)

48
Q

cephalosporin 4th gen

A

Cephepime

49
Q

cephalosporin 1st gen active against

A

Wide range of Gram-positive and negative except (Pseudomonasand Haemophilus)

Streptococcus, Staphylococcus, Enterobacteriacae

50
Q

cephalosporin 2nd gen active against

A

Wide range of Gram-positive and negative including Haemophilusand anaerobes

51
Q

Cefuroxime: like cephalexin plus …

A

active against Haemophilusand S. pneumoniae

52
Q

cephalosporin 3rd gen active against

A

Wide range but more anti-Gram-negative than second generation

53
Q

Cefotaxime: active against

A

Enterobactericae, Haemophilusand S. pneumoniae and not active against Pseudomonasspp

54
Q

cephalosporin 4th gen is

A

Anti-Gram-negative

55
Q

cephepime

A

active against Enterobacteriacaeand Pseudomonas

56
Q

what causes Local pain and thrombophlebitis at site of injection +
Hypersensitivity reaction in 0.5-10% of patients (10% cross reaction with penicillin allergy) as side effects?

A

cephalosporin

57
Q

what causes Hepatotoxicity and Gastrointestinal disturbance as side effects?

A

cephalosporin

58
Q

what causes Thrombocytopenia and Pseudomembranous colitis?

A

cephalosporin

59
Q

Monobactams aka

A

Monocyclic β-lactam antibiotics

60
Q

example of monobactam

A

Aztreonam

61
Q

Aztreonam

A

Narrow spectrum (anti-Gram-negative aerobic bacilli)

Bactericidal

Stable to bacterial enzymes

62
Q

what drug is isolated from Streptomyces’s?

A

Carbapenem

63
Q

what drug has Potent activity against a broad range of Gram-positive and negative bacteria?

A

Carbapenem

64
Q

what drug is Resistant to lysisby β-lactamases?

A

Carbapenem

65
Q

what are 2 important carbapenems?

A

Imipenem

Meropenem

66
Q

Imipenem char

A

Not stable, it need to be combined with cilastatinto be more stable
Safe
Broad spectrum
Seizures and transient changes in liver enzymes are main side effects

67
Q

Meropenem

A

Stable and broad spectrum

Side effects .. Similar toimipenem

68
Q

Glycopeptides

A

Vancomycin& Teicoplanin

69
Q

Glycopeptides Mode of action

A

Act on cell wall synthesis at a stage prior to B-lactams

Not act on PBP & not inactivated by B-lactamases enzymes

70
Q

what drug has these characteristics ?
Activity is restricted to Gram-positive bacteria only

Poorly absorbed from GI

IM injections are painful

A

Glycopeptides

71
Q

what drug has these characteristics ?
Nephrotoxic Ototoxic
Reversible neutropenia and thrombocytopenia

A

Glycopeptides

72
Q

_______ is less nephrotoxic than vancomycin

A

Teicoplanin

73
Q

Glycopeptides Clinical use

A

MRSA

Patient allergic to penicillin or cephalosporin with Staphylococcus or Streptococcal infections

74
Q

…… indirectly inhibit DNA synthesis

A

Sulphonamides& Trimethoprim

75
Q

________ directly inhibit DNA-gyrase

A

Quinolones

76
Q

________ bind to bacterial ribosome and inhibit protein synthesis

A

Nitrofurantoin

77
Q

________ inhibit DNA dependent RNA polymerase

A

Rifampicin

78
Q

true or false Sulphonamides& Trimethoprim act on same stages of folic acid synthesis

A

false

79
Q

Sulphonamide inhibit ……. while man cell require performed vitamin ( basis of selective toxicity)

A

early stages of folic acid synthesis and bacteria cannot utilize exogenous source of the vitamin

80
Q

Trimethoprime act on…… (selectively it has high affinity for bacterial enzymes)

A

later stages of folic acid synthesis by inhibiting dihydrofolate reductase

81
Q

sulfonamide char

A

Broad spectrum of activity

Well absorbed after oral administration

82
Q

some side effects of sulfonamide

A

Crystalluria and hematuria

Hypersensitivity (fever and rash) or urticarial rashes

Stevens-Johnson syndrome (rare but could be fatal)

83
Q

what does sulfonamide cause in patients with G6PD deficiency?

A

hemolytic anemia

84
Q

what drug causes Megaloblastic anemia and Liver damage as side effects?

A

sulfonamide

85
Q

what drug is contraindicated in pregnancy because it interferes with bilirubin transfer in fetus?

A

sulfonamide

86
Q

trimethoprim is active against what?

A

Gram-positive aerobic bacteria and Enterobactericaeae

87
Q

what drug is rapidly absorbed from GI?

A

trimethoprim

88
Q

whats the most commons side effect of trimethoprim?

A

olic acid deficiency may lead to megaloblasticanemia if used for long time

89
Q

whats mainly used for uti in combo with sulfonamide

A

trimethoprim ( as cotrimoxazole)

90
Q

Nitrofurantoin moa

A

Act on bacterial mRNA, ribosomal proteins

91
Q

what is well absorbed orally?

A

Nitrofurantoin

92
Q

what drug is used for uti?

A

Nitrofurantoin

93
Q

side effects of Nitrofurantoin

A

Nausea and vomiting

Peripheral neuropathy

Hemolysis in patients with G6PDdeficiency

94
Q

quinolones structure

A

dual ring

95
Q

quinilones moa

A

inhibiting DNA gyrase (topoisomerase) this will inhibit DNA replication

96
Q

4-quinolones

A

naladixicacid

97
Q

Fluoroquinolones

A

Ciprofloxacin

98
Q

Ciprofloxacin characteristics

A

More potent

Broader spectrum (UTI, Osteomyelitis, STD, Pneumonia)

Better absorption and distribution (oral & parenteral)

99
Q

quinolones side effects

A

GI ( nausea, vomiting & diarrhea)

Pseudomembranous colitisSkin rash

CNS (benign intracranial hypertension) and psychosis

Thrombocytopenia

100
Q

Metronidazole structure

A

5-nitroimidazole

101
Q

Metronidazole moa

A

Exert its effect by reduction of the nitro group to amine under low redox potential

102
Q

Metronidazole active against

A

obligate anaerobes & helicobacter and protozoa (T. vaginalis, Giardia, E. histlolytica)

103
Q

what drug is rapidly and completely absorbed from GI?

A

Metronidazole

104
Q

Metronidazole side effects

A

CNS, confusion and seizures

Peripheral neuropathyGI (nausea, vomiting & diarrhea)

Neutropenia (reversible)

Metallic taste

Rash and pruritis

105
Q

what drug causes metallic taste

A

Metronidazole

106
Q

what drug causes Pseudomembranous colitis?

A

quinolones

I and I (10 decks)

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