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Boards Drugs > Antimicrobial > Flashcards

Antimicrobial Flashcards

1
Q

Block Peptidoglycan Crosslinking

A
  • Penicilin, cephalosporin, azotreonam, imipenim

- Bind to PBP and prevent crosslinking

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2
Q

Block peptidoglycan Synthesis

A

Vancomycin

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3
Q

Block Nucleotide production

A
  • Trimethoprim blocks DHFR

- Sulfamethoxazole blocks PABA sythase

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4
Q

Block Topoisomerase

A

-Flouroquinolones

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5
Q

Block RNA polymerase

A

-Rifampin

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6
Q

Damage DNA

A

-Metronidazole

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7
Q

Block 50S ribosome

A
  • CELL

- Macrolides, Clindamycin, Chloramphenicol, Lincosamide, linzolid, streptogrammins

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8
Q

Block 30S

A

-Aminoglycosides and tetracyclines

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9
Q

Penicilin

A
  • Binds to PBP and prevents crosslinking
  • Effective against gram positive and some gram negative
  • Treponema, GAS, Strep Pneumo, Actinomyces
  • SE: Hapten mediated hypersensitivity (hemolysis)
  • Susceptible to beta lactamase
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10
Q

Methiciln, oxacilin etc

A
  • Bulky side group means lower risk of peniclinase
  • Used specifically for MSSA
  • Mutation in PBP
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11
Q

Ampicilin

A
  • INcreased effectivness against gram negatives
  • H Flu, Listeria, E Coli, Salmonella, SHhigella, etc
  • Give with clauvulonate to reduce beta lactamases
  • S/E: Pseudomembrane colitis
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12
Q

Piperacilin, ticracilin

A
  • Used for pseudomonas

- GIve with tazobactam a beta lactamase inhibitor

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13
Q

Beta Lactamase inhibitors

A

-Suicide inhibitors

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14
Q

Cephalosporins

A

-Beta lactams that are wider spectrum and less vulnerable to beta lactamases

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15
Q

Cefazolin (1st gen)

A

-Used as prophylaxis against MSSA and for surgical procedures

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16
Q

Cefoxitin

A

-INcreased use for H flu etc, replaced by 3rd gen

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17
Q

Ceftriaxonem ceftazadime

A
  • Used for NIsseria, and serious gram negative infections

- Crosses BBB and is part of meningitis prophylaxis

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18
Q

Cefepime 4th gen

A

-Used against pseudomonas

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19
Q

Ceftaroline

A

-Can be used for MRSA

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20
Q

Azotreonam

A
  • Gram negative rods only
  • Resistant to beta lactams
  • Given to pen allergic patietns who can’t take aminoglycosides because of renal failure
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21
Q

Imipenem/Cilastatin, meropenam

A
  • Wide spectrum and effective
  • Resistant to beta lactamases
  • Always give with cilastatin to prevent destruction in kidney
  • Usually saved for severe life thretening infections
  • Causes siezures and has seen limited use because of this
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22
Q

Vancomycin

A
  • Inhibits peptidoglycan synthesis
  • Gram positive only, MRSA or C Dif not given metronidazole
  • S/E: Oto and nephrotoxicity. Red mann’s syndrome (Avoid with anti-histamines), thrombophlebitis,
  • Resistance due to mutations of Ala-Ala to Ala-Lactate
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23
Q

Protein Synthesis Inhibitors

A
  • 30S are aminoglycosides and tetracyclines
  • 50s are Clindamycin, macrolides, chloramphenicol, linezolid, lincosamide, Streptogrammins (Dalfoprastone, quinipristin)
  • Majority of resistance is by acetylation or methylation of ribosomes
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24
Q

Aminoglycosides

A
  • Inhibit initation and cause misreading of early protein synthesis
  • Cidal and synergistic with beta lactams
  • Ototoxicity (worse with loop diuretics)
  • Nephrotoxicity (worse with cephalosporins)
  • Can also cause neuromuscular blockade and is a teratogen
  • Must be taken up with oxygen and are not effective agatinst anaerobes
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25
Q

Tetracyclines

A

Bind to 30S and prevent attachment of aminoacyl tRNA

  • Static activity
  • Highly effective against bone and intracellular organisms because of tendency to accumulate intracellularl
  • Zoonotics, ricketsia, chlamydia, Borellia, etc
  • Cause discoloration and disformation of bones teratogen
  • Most cannot be given to renally impaired, but doxyxlycine can
  • Can’t be taken with divalent cations or else absorption will be messed up
  • Photosensitivity is also a S/E
  • Resistance by efflux pumps
26
Q

Macrolides

A
  • Bind to 50s subunit and prevent translocation
  • Static
  • Used against atypical Pneumonias, STD’s and gram positives that are allergic to penicilin
  • Motilin agonist causes GI problems including cholestatic hepatitis
  • Also inhibits P450s and can cause elevations in warfarin
  • Prolonged QT
  • Methylation of Ribosime is resistance
27
Q

Chloramphenicol

A
  • Binds 50s and prevents translocation
  • Rarely used because of risk of aplastic anemia and gray baby syndrome (decreased UDP gluconyrl transerase)
  • Used only as last resort against atypical meningitis
  • Resistance by acetylation
28
Q

Clindaymycin

A
  • Used against anaerobes only not active against aerobes
  • Used to treat infections above diaphragm, metronidazole below (oral infections and aspiration pneuonias)
  • Can cause pseudomembranous colitis
29
Q

Sulfonamides

A
  • Block Dihydroberopterin synthesis leading to decreased PABA, competitive inhibitors
  • Use is mainly for UTI’s and PCP
  • PRevent Thymidine synthesis
  • Sulfa reactions,
  • Also displace bilirubin, warfarin etc from albumin and can cause kernicterus
  • Resistance by increasig PABA production
30
Q

Trimethoprime

A
  • Inhibits DHFR
  • Used for PCP etc
  • Can cause megaloblastic anemia and BM supression
  • Leucovarin can rescue
31
Q

Flouroquinilones

A
  • Inhibit toposimerase II and IV
  • Bacteriocidal activity
  • Absorption will be inhibited by divalent cations
  • Can cause tendonous rupture and impaired collagen synthesis in fetus
32
Q

Metronidazole

A
  • Generates free radicals that damage and destroy DNA
  • Bacteriocidal
  • Used for anaerobes and protozoal infections below diaphragm
  • Disulfaram reaction and metallic taste
33
Q

TB Drugs

A
  • MTB is RIPE
  • MAI is atypical pneumonia treated with azythromycin, prophylax once CD4 drops low
  • Leparae is Daptomycin, Rifampin, and clofroinox (guanosine)
34
Q

INH

A
  • Prevents synthesis of mycolic acids
  • Can be used alone as prophylaxis
  • Causes depletion of vitamin B6
  • Neurotox (supplement B6 to minimize)
  • Hepatotox
35
Q

Rifampin

A
  • Inhibits RNA polymerase in bacteria
  • Not used as monotherapy for TB
  • Can be used to prophylax against H Flu and Meningitids
  • Causes red orange body fluids and reduces T1/2 of other drugs (increases P450s)
36
Q

Pyrazinamide

A
  • May cause acidity in phagolysosomes

- Minimal S/E with Hypeuricemia and hepatotox

37
Q

Ethambutol

A
  • Impairs arabinotransferase and inhibits sugar incorporation into wall
  • Caues red Green Color blindness
38
Q

VRE

A

-Streptogrammins and linezolid

39
Q

MRSA

A

-Vanco and ceftaroline

40
Q

Amphoteracin B

A
  • Binds ergosterol in membrane and creates pores causing cell death
  • Strong with severe painful chills and nephrotoxicity, give with Mg, K, and fludis to minimize kidney damage.
  • Doesn’t cross BBB, give intrathecally
41
Q

Azoles

A
  • Prevent ergosterol synthesis P450 enzyme
  • Gynecomastia and inhibit steroid synthesis
  • Block P450 and increase drug concentraions of others
  • Prophylax in HIV
42
Q

Nystatin

A

-Same as amphoteracin by applied topically

43
Q

Flucytosine

A
  • Converted to 5-FU intracellularly, strong and given for severe infections
  • Causes BM supression by inhibiting Thymidine synthesis at thymitidylate synthase
44
Q

Caspofungin

A
  • Inhibits D glucan insertion into cell wall

- Weaker and more mild

45
Q

Terbenafine

A
  • Squalene epoxidase inhibits

- Minimal S/E, can be used chronically for dermatophytes

46
Q

Griseofulvin

A
  • Inhibits MT polymerization
  • Activator of P450s
  • Teratogen, Carcinogen
47
Q

Chloroquine

A
  • Used for malaria, prevents heme breakdown to hemazolin and thus accumulates to toxic levels inside RBC and kills malaria
  • Give primaquine for ovale/vivax
  • Quinidine for serious infections
  • Resistance because of efflux pump
  • S/E: Retinopathy
48
Q

Zanamavir, oseltamavir

A

-Inhibit viral neuraminidase and prevent release of Flu A and B

49
Q

Ribairan

A
  • Inhibits IMP dehydratase leading to decreaed guanine production and dereased synthesis
  • Paraflu, RSV, Hep C
50
Q

IFN B

A

-MS

51
Q

INF A

A

-Hep C, increase MHC, increase DNAase, decrease translation machinery

52
Q

IFN gamma, IL-8

A

Increase intracellular killing by macrophages in CGD

53
Q

Acyclovir

A

ACtivated by TK, inhibits viral DNA pol
Minimal S/E
-HSV and VZV

54
Q

Ganciclovir

A

Activated by CMV kinase

  • Inhibits DNA pol
  • Nephrotoxicity and BM supression
55
Q

Foscarnet

A
  • Non kinase activated inhibitor of DNA pol
  • Nephrotox
  • Used in refractory cases
56
Q

Cidofivir

A
  • Non kinase activated inhibitor of DNA pol

- Nephrotoxicity, give with probenacid

57
Q

HARRT

A

2 NTRIs and then 1 (NNTRI, Prtoease, or integrase inhibitor)

58
Q

NTRI

A

Need to be phosphprylated to work (Except for tenofivir)
-BM supression and nephrotoxicity
Zidovudine can be used as prophylaxis to babies

59
Q

NNTRI

A

Do not need to be phosphorylated and bind at different site than NTRI

60
Q

Protease inhibtiors

A
  • end in Navir

- Metabolic syndrome and lipdystrophy

61
Q

Ralteravir

A

Integrase inhibitor

-S/E is hypercholesterolemia

62
Q

Marivaroc

A

CCR5 inhibtitor

Boards Drugs (18 decks)

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