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Antimicrobial Flashcards

1
Q

Drugs the block viral penetration

A
  1. Enfuvirtide
  2. Maravoric
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2
Q

Macrolides adverse affect

A
  1. Stimulate motilin receptors causing GI distress (Clarithromycin is the least)
  2. Reversible deafness at high doses
  3. Increase QT interval
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3
Q

Most likely cause of pseudomembranous colitis

A

Clindamycin

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4
Q

First generation cephalosporins cover

A
  1. Gram + cocci
  2. E. coli
  3. Klebsiella
  4. Proteus
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5
Q

Pyrantel pamoate mechanism of action

A

NM agonist leading to spastic paralysis

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6
Q

DOC for Trichomoniasis

A

Metronidazole

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7
Q

Penicillins and cephalosporins mechanism of resistance

A

Beta-lactamases that cleave the beta-lactam ring strucutre changing penicillin-binding proteins

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8
Q

Which Azole enters CSF

A

Fluconazole

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9
Q

DOC for Trypanosomiasis (African)

A

Arsenicals

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10
Q

Acyclovir adverse affects

A
  1. Crystalluria (maintain hydration)
  2. Neurotoxicity
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11
Q

Linezolid mechanism of action

A
  • Binds to 50S and inhibits formation of initiation complex
  • Prevents formation of N-formylmethionyl-tRNA-robosome-mRNA ternary complex
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12
Q

Ganciclovir adverse affects

A
  1. Hematotoxicity (leukopenia, thrombocytopenia)
  2. Mucositis, fever, rash
  3. Crystalluria
  4. Seizures in OD
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13
Q

Drugs the inhibit viral DNA polymerases

A
  1. Acyclovir
  2. Foscarnet
  3. Ganciclovir
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14
Q

Affect of food on Itraconazole

A

Increase absorption

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15
Q

Griseofulvin adverse affects

A

Disulfiram

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16
Q

Fluctosine Mechanism of action

A
  • Activated by fungal cytosine deaminase to 5-FU then after triphosphorylation is incorportaed into fungal RNA
  • also inhibits thymidylate sythase decreasing thymine when it is in 5-fluorodeoxyurine monophosphate (5-Fd-UMP) form
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17
Q

AG spectrum

A
  1. Gram - rods
  2. TB
  3. Bubonic plague
  4. Tularemia
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18
Q

Cefaclor is

A

Second generation cephalosporin

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19
Q

Streptomycin used for

A

AG

  1. TB
  2. DOC for Bubonic plague and tularemia
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20
Q

Drugs that inhibit viral aspartate protease

A

-Navir

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21
Q

Drugs that inhibit nucleic synthesis

A
  1. Fluoroquinolones
  2. Rifampin
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22
Q

DOC for Toxoplasmosis

A

Pyrimethamine and sulfadiazine

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23
Q

Very narrow Spectrum penicillins are

A

Beta-lactamase resistant

  1. Nafcillin
  2. Methicillin
  3. Oxacillin
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24
Q

INH mechanism of action

A
  1. Inhibits mycolic acid synthesis
  2. Requires converstion by catalase
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25
Q

Macrolide drugs:

A

-THROMYCIN

  1. Erythromycin
  2. Azithromycin
  3. Clarithromycin
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26
Q

Vancomycin covers

A
  1. MRSA
  2. Enterococci
  3. C. Diff
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27
Q

Drugs that inhibit viral reverse transcriptase

A
  1. Zalcitabine
  2. Nevirapine
  3. Efavirenz
  4. -Dine (Pyrimidine)
  5. -Sine (Purine)
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28
Q

Ceftriaxone is

A

Third generation cephalosporin given IM

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29
Q

Cefotetan is

A

Second generation Cephalosporin

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30
Q

Foscarnet adverse affects

A
  1. Nephrotoxicity with ATN
  2. Avoid Pentamidine IV (increases Nephrotoxicity and HypoCa)
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31
Q

DOC for Trypanosomiasis (Chagas disease)

A

Nifurtimox

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32
Q

Ampicillin covers

A
  1. G + cocci but not staph
  2. E. coli
  3. H. Influenzae
  4. Listeria
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33
Q

Fluoroquinolone adverse affects

A
  1. Tendonitis, tendon rupture
  2. Phototoxicity, rash
  3. CNS (insomnia, dizziness, headache)
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34
Q

Aminoglycoside CHX:

A

Bactericidal

Needs O2 Dependent uptake (Anaerobes are resistant)

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35
Q

What penicillins are excreated in bile:

A
  1. Nafcillin
  2. Oxacillin
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36
Q

Second generation cephalosporin CNS entry

A

None other Cefuroxime

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37
Q

Extended spectrum Penicillins are

A

Antipseudomonal

Beta lactamase sensitive

  1. Ticarcillin
  2. Piperacillin
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38
Q

Terbinafine used for

A

Dermatophytes

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39
Q

Sulfonamides mechanism of resistance

A
  • Change in sensitivity to inhibition of target enzyme.
  • Increase formation of PABA
  • Use os exogenous Folic Acid
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40
Q

DOC for Amebiasis infection

A

Metronidazole

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41
Q

Cefazolin is

A

First generation Cephalosporin

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42
Q

Doxycycline used for

A

Tetracycline

Prostitis because it collects in prostatic fluid

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43
Q

Ketoconazole Co-DOC for

A

Paracoccidiodes and back up for Blastomyces and Histoplasma

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44
Q

Polyenes are

A
  1. Amphotericin B
  2. Nystatin
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45
Q

Drugs that inhibit viral RNA polymerase

A
  1. Foscarnet
  2. Ribavirin
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46
Q

Demeclocycline used for

A

Tetracycline

Used in SIADH because it blocks ADH receptors

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47
Q

Macrolides and clindamycin mechanism of action

A

Bind to 50S and inhibit translocation

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48
Q

INH mechanis of resistance

A

Deletion of katG gene

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49
Q

INH adverse affects

A
  1. Hepatitis (age dependent)
  2. Peripheral neuritis (give B6)
  3. Sideroblastic anemia (give B6)
  4. SLE in slow acetylators
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50
Q

Cefotaxime is

A

Third generation cephalosporin given parenteral

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51
Q

Carbepenems are

A
  1. Imipenem
  2. Meropenem
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52
Q

Sulfonamides inhibits

A

Dihydropteroate synthetase preventing converstion of Dihydropteroid acid

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53
Q

Fluroquinolones inhibit

A

Topoisomerase 2 (DNA gyrase) and topoisomerase 4 (seperates replicated DNA during cell division)

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54
Q

Drugs that inhibit viral neuraminidase

A
  1. Zanamivir
  2. Oseltamivier
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55
Q

Narrow spectrum Penicillins are:

A

Pen G and Pen V

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56
Q

Ethambutol mechanism of action

A

Inhibits synthesis of arabinogalactan (part of cell wall)

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57
Q

Fluoroquinolones spectrum

A
  1. UTI
  2. STD: Chlamydia, gonorrhea
  3. Gram - skin, soft tissue and bone infections
  4. Diarrhea due to Shigella, Salmonella, E. coli, Campylobacter
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58
Q

Extended spectrum Penicillins cover

A
  1. Gram - rods
  2. Psedomonas
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59
Q

Lamivudine adverse affects

A

Least toxic of the NRTIs but some GI and Neutropenia

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60
Q

Cephalexin is

A

First generation cephalosporin

61
Q

Carbepenem mechanism of action

A

Same as penicillin and cephalosporin but are Beta-Lactamase resistant

62
Q

Trimethoprim-sulfamethoxazole spectrum

A
  1. DOC in Nocardia
  2. Listeria (backup)
  3. Gram - (E. coli, Salmonella, Shigella, H. influenzae)
  4. Gram + (Staph, MRSA, Strep)
  5. Pneumocystis jiroveci
  6. Toxoplasma gondii
63
Q

Rifampin adverse affects

A
  1. Hepatitis
  2. Induction of P450 (give Rifabutin instead)
  3. Red-Orange metabolites
64
Q

Didanosine Adverse affects

A
  1. Pancreatitis
  2. Peripheral neuopathy, hyperuricemia, liver dysfunction
65
Q

Tetracycline adverse affects

A
  1. Tooth enam dysplasia and decreas bone growth in children
  2. Photoxicity (Demeclocycline, doxycycline)
  3. GI distress
  4. Vestibular dysfunction (Minocycline)
  5. Liver dysfunction during pregnancy
66
Q

Vancomycin mechanism of action

A

Binging to D-ala-D-ala to sterically hinder the tranglycosylation reaction and preventing elongation of peptidoglycan chains

67
Q

FAST drugs not used in pregnancy

A
  • F: Fluoroquinolones
  • A: AG
  • S: Sulfonamides
  • T: Tetracycline
68
Q

Which cephalosporin is eliminated in the bile?

A

Ceftriaxone

69
Q

Praziquantel used for

A
  1. Cestodes (tapeworms)
  2. Trematodes (flukes)
70
Q

Macrolides DOC for

A

Community acquired pneumonia

71
Q

Tetracycline mechanism of action

A

Binds to 30S and inhibites AA incorportation by blocking the attachment of aminoacyl tRNA to acceptor site

72
Q

Acyclovir used for

A

non-resistant HSV and VZV

73
Q

Aminoglycosides mechanism of action

A
  • Binds to 30S and inhibits formation of initiation complex
  • Interfere with initiation codon function by blocking association of 50S ribosomal subunit with mRNA-30S causing misreading of code
  • Incorporates wrong AA
74
Q

Amoxicillin covers

A
  1. G + cocci but not staph
  2. E. coli
  3. H. Influenzae
  4. Borreilia
  5. H. Pylori
75
Q

AG mechanism of resistance

A

Formation of enzymes that inactivate drugs via conjugation reactions that transfer acetyl, phosphoryl or adenylyl groups

76
Q

Fluconazole DOC for

A

Esophageal and invasive Candidiasis and Coccidioidomycoses

77
Q

Ribavirin adverse affects

A
  1. Hematotoxic
  2. Upper airway irritation
  3. Teratogenic
78
Q

Chloramphenical mechanism of action

A

Bind to 50S to inhibit formation of peptide bond by inhibiting activity of peptidyl-transferase

79
Q

Drugs that block viral uncoating

A
  1. Amantadine
  2. Ramaltidine
80
Q

Itraconazole and Voriconazole DOC for

A

Blastomycoses, Sporotrichoses, aspergillosis

Back up for mycoses and candidiasis

81
Q

Clinical value of Clindamycin

A

Accumulates in bone so good for Gram + osteomyelitis

82
Q

Fluoroquinolones mechanism of resistance

A
  • Change in sensitivity to inhibition of target enzymes
  • Increase activity of transport system that promotes drug efflux
83
Q

Macrolides and Clindamycin mechanism of resistance

A
  • Formation of methytransferases that alter drug binding site on the 50S ribosomal subunit
  • Active transport out of cells
84
Q

First generation cephalosporins CNS entry

85
Q

Drugs the inhibit bacterial cell wall

A
  1. Penicillin
  2. Cephalosporin
  3. Imipenem/Meropenem
  4. Aztreonam
  5. Vancomycin
86
Q

Ribavirin mechanism of action

A
  • Monophosphorylated form inhibits IMP dehydrogenase
  • Triphosphate inhibits viral RNA polymerase and end-capping of viral RNA
87
Q

First generation cephalosporins are commonly used for

A

Surgical prophylaxis

88
Q

Cefixime is

A

third generation cephalosporin given Orally

89
Q

Which tetracycline is excreted via liver?

A

Doxycycline

90
Q

Dalfopristin/quinupristin (streptogramins) mechanism of action

A

Binds to 50S and inhibites AA incorportation by blocking the attachment of aminoacyl tRNA​ to acceptor site

91
Q

Second generation cephalosporin cover

A
  1. Increase Gram - coverage
  2. some anaerobes
92
Q

Terbinafine adverse affects

A
  1. GI distress
  2. Rash
  3. Headache
  4. Increase liver function test
93
Q

Drugs that inhibit bacterial proten synthesis

A
  1. AG
  2. Chloramphenicol
  3. Macrolides
  4. Tetracyclines
  5. Streptogramins
  6. Linezolid
94
Q

Acyclovir mechanism of action

A
  • Phosphorylated by viral thymidine kindase
  • Phosphorylated Acyclovir inhibits viral DNA polymerase
  • Incorporated into DNA and acts as a chain terminator
95
Q

Polyenes mechanism of action

A

Interact with ergosterol in funal membrane to form artificial pores which disrupt membrane permeability

96
Q

Affect of antacid on Ketoconazole

A

Decrease absorption

97
Q

Linezolid adverse affects

A

Bone marrow suppression (platelets) causes bleeding

98
Q

Imipenem is given with what to decrease metabolim to a nephrotoxic metabolite

A

Cilastatin

99
Q

DOC for Leishmaniasis

A

Stibogluconate

100
Q

Tetracycline spectrum

A
  1. Chlamydia
  2. Mycoplasma
  3. H. Pylori
  4. Rickettsia
  5. Borrelia
  6. Brucella
  7. Vibrio
  8. Treponema (backup drug)
101
Q

Drugs for intestinal nematodes (worms)

A
  1. Mebendazole
  2. Pyrantel pamoate
102
Q

Tigercycline used for

A

Tetracycline

complicated skin, soft tissue, and intestinal infections due to resistant gram +, gram -, and anarobes

103
Q

Praziquantel mechanism of action

A

Increase Ca influx leading to increase vacuolization

104
Q

Clindamycin spectrum

A
  1. Very narrow
  2. Gram + Cocci
  3. Anaerobes
105
Q

Griseofulvin mechanism of action

A

deposits in newly formed keratin and disrupts microtubule structure

106
Q

Vancomycin elimination:

A

Via renal filtration

Conteract dose with renal impairment

107
Q

Trimethoprim or pyrimethamine adverse affects

A

Bone marrow suppression (leukopenia)

108
Q

Amp B DOC for

A
  1. Aspergillus
  2. Candida
  3. Cryptococcus
  4. Histoplasma
  5. Mucor
  6. Sporothrix
109
Q

Griseofluvin used for

A

Dermatophytes orally

110
Q

AG drugs:

A
  1. Gentamicin
  2. Tobramcyin
  3. Amikacin
  4. Streptomycin
  5. -MYCIN
111
Q

Third generation cephalosporins CNS entry

A

Yes and are important in empiric managment of meningitis and sepsis

112
Q

Aztreonam mechanism of action

A

Same as penicillin and cephalosporins but Resistant to Beta-Lactamases

113
Q

Aztreonam is used for

A

IV for Gram - rods

114
Q

Ethambutol adverse affects

A

Retrobular neuritis causing decrease vision and red-green discrimination

115
Q

Drugs that inhibit Folic Acid Synthesis

A
  1. Sulfonamides
  2. Trimethoprim
  3. Pyrimethamine
116
Q

Terbinafine mechanism of action

A

Inhibits squaliene epoxidase decreasing ergosterol

117
Q

Macrolides spectrum

A
  1. Gram + cocci
  2. Atypical organisms
  3. Legionella
  4. Campylobacter jejuni
  5. MAC
  6. H. pylori
118
Q

Raltegravir mechanism of action

A

Integrase inhibitor

119
Q

Third generation cephalosporins cover

A
  1. Gram + and Gram - cocci
  2. N. gonorrhea
  3. Gram - rods
120
Q

AZOLES mechanism of action

A

Fungicidal that interfere with the synthesis of ergosterol by inhibiting 14-alpha-demethylase (funal P450) that converts lanosterol to ergosterol

121
Q

Zidovudine adverse affects

A
  1. Hematotoxicity
  2. Myalgia, myopathy and peripheral neuropathy
122
Q

Tetracyclines Mechanism of resistance

A

Pumps out the drug

123
Q

Cefepime is

A

Fourth generation cephalosporin give in IV

124
Q

Mebendazole mechanism of action

A

Decrease glucose uptake and decrease microtubular structure

125
Q

Ribavirin Clinical uses

A
  1. Hep C and RSV
  2. Lassa fever
  3. Hantavirus
126
Q

DOC for Giardiasis

A

Metronidazole

127
Q

Carbepenem adverse affects

A
  • GI distress
  • Drug fever (partial cross- allergenicity with Pen)
  • CNS effects: seizures
  • Renal dysfunction with Imipenem
128
Q

Rifampin mechanism of action

A

inhibits DNA-dependent RNA polymerase

NA synthesis inhibitor

129
Q

Caspofungin (Echinocandins) mechanism of action

A

Inhibit synthesis of Beta-1,2 glucan

130
Q

Azoles adverse affect

A

Decreas synthesis of steriods including cortisol and testosterone leading to:

  1. Decreased Libido
  2. Gynecomastia
  3. Menstrual irregularities
131
Q

Penicillin mechanism of action

A

Interact with cytoplasmic membrane-binding proteins (PBP) to inhibit transpeptidation reaction involved in cross-liking the final steps in cell-wall synthesis

132
Q

Drugs that cause phototoxicity

A
  • Tetracycline
  • Sulfonamides
  • Quinolones
133
Q

Carbepenem cover

A
  1. Gram + cocci
  2. Gram - rods
  3. Anaerobes
134
Q

Vancomycin adverse affects

A
  1. Red-man syndrome (histamine release. Give corticosteroids or antihistamine)
  2. Ototoxicity
  3. Nephrotoxicity
135
Q

Fluconazole prophylaxis for

A

Cryptococcal meningitis

136
Q

What is Jarisch-Herxheimer reaction

A

Adverse affect of penicillin use with Syphilis when the toxins are released into circulation

137
Q

Chloramphenicol mechanism of resistance

A

Formation of inactivation acetyltransferases

138
Q

Narrow spectrum Penicillins cover

A
  1. Streptococci
  2. Pneumococci
  3. Meningococci
  4. Treponema pallidum
139
Q

Fluoroquinolone drugs

A

-floxacins

140
Q

Cefuroxime is

A

Second generation cephalosporin

141
Q

Trimethoprim and pyrimethamine inhibits

A

Dihydrofolate reductase inhibiting conversion of DHF to THF

142
Q

Minocycline used for

A

Tetracycline

Meningococcal carrier state because of high conc in saliva and tears

143
Q

Very narrow Spectrum Penicillins cover

A

Known or suspected Staphlococci

144
Q

Extended spectrem Penicillins (aminopenicillins) are

A

Beta-lactamase sensitive

  1. Ampicillin
  2. Amoxicillin
145
Q

AG adverse affects

A
  1. Nephrotoxicity (enhanced with Vanco, Amph B, Cisplatin, Cyclosporine)
  2. Ototoxicity (enhanced with Loop Diuretics)
  3. NMJ block with decreased release of ACh
146
Q

What penicillin undergoes enterohepatic cycling but excreted via kidneys

A

Ampicillin

147
Q

Cephalosporns are LAME

A
  • L: Listeria
  • A: Atypical
  • M: MRSA
  • E: Enterococci
148
Q

Sulfasalazine used in

Pharmacology (12 decks)

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