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PoD 2 > Antimicrobial Therapy - Allman > Flashcards

Antimicrobial Therapy - Allman Flashcards

1
Q

Bactericidal agent

A

penicillin, cephalosporin

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2
Q

Bacteriostatic agent

A

sulfonamides

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3
Q

Narrow Abx

A

Pen G, Nafcillin

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4
Q

Broad Abx

A

Piperacillin/Tazobactam

Imipenem

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5
Q

Synergy

Trimethoprim/sulfamethoxazole

A

sequential inhibition of folic acid synthesis

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6
Q

Synergy

Penicillin/Aminoglycoside

A

Increased penetration of aminoglycoside as penicillin breaks down cell wall
- enterococcus
Different site for mechanism of action
- psudomonas

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7
Q

Antagonism

A

Bacteriostatic on bactericidal

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8
Q

Post antibiotic effect (PAE)

A

persistent effect of an antimicrobial on bacterial growth following brief exposure of organism to a drug

  • Aminoglycoside and fluoroquinolones
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9
Q

two parts of pharmacodynamics

A

Concentration and time dependent killing

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10
Q

Concentration dependent killing

A
  • peak concentration
  • optimal when conc exceeds 10x MIC

Quinolones, Aminoglycoside (AMG)

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11
Q

Time dependent killing

A

amnt of time [ ] stays above MIC (40-50%)

B-lactam Abx

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12
Q

Inhibitors of Cell Wall synthesis

A

Penicillin/Cephalosporins/Carbapenems/Aztreonam
Vancomycin
Bacitracin
Cycloserine

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13
Q

Penicillin/Cephalosporins/Carbapenems/Aztreonam

A

Prevents cross linking of peptidoglycan strands by inhibiting transpeptidases

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14
Q

Vancomycin

A

inhibits peptidoglycan synthetase and polymerization of linear peptide

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15
Q

Inhibitors of protein synthesis/structure

A 
AMG 
Chloramphenicol
Erythromycin/clindamycin/lincomycin
Tetracyclines
Streptogramins/Linezolid
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16
Q

AMG

A

inhibits 30 S ribosome

Causes misreading of mRNA

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17
Q

Chloramphenicol

A

inhibits peptidyl transferase and peptide band formation

18
Q

Erythromycin/clindamycin/lincomycin

A

inhibits 50 S ribosome

19
Q

Tetracyclines

A

inhibits binding of aminoacyl tRNA to ribosome

30 S ribosome

20
Q

Streptogramins/Linezolid

A

23 S ribosome

21
Q

Interference with Cell Membrane function

A

Polymixin B, Colistin

Fungal: Azole and polyene antifungals

22
Q

Polymixin B, Colistin

A

Cationic detergent

23
Q

Interference with DNA/RNA synthesis

A

Rifampin

Fluoroquinolones

24
Q

Rifampin

A

inhibits DNA-dependent RNA polymerase

25
Q

Fluoroquinolones

A

Interferes with supercoiling of DNA by action on DNA gyrase (topoisomerase II)

26
Q

Inhibitors of Metabolism

A

Isoniazid, ethambutol

Sulfonamides, trimethoprim

27
Q

Isoniazid, ethambutol

A

Inhibits lipid synthesis

28
Q

Sulfonamides, trimethoprim

A

Prevents synthesis of folic acid

29
Q

Empiric therapy

A

Culture site before starting Abx

Gram stains - very informative for selection of empiric Abx

30
Q

Distribution of Meningitis

A

Penetration into CNS when meninges are inflammed vs uninflammed

Ceftriaxone vs Unasyn

31
Q

Considerations for drug distribution

A

Urine concentration
Bone penetration
Lung Tissue penetration
Skin and soft tissue concentration

32
Q

Example of concurrent medication inference with abx

A

Antacids with quinolones and tetracycline

33
Q

Examples of abx inference with concurrent agent

A
  • Bactrim or erythromycin with warfarin
  • ciprofloxacin with theophylline
  • Linezolid with SSRIs
34
Q

microbial resistance results from

A

environmental exposure to Abx
mutation
adaptation
gene transfer

multiple resistance – plasmids

can develop during therapy or is intrinsic

35
Q

Mechanisms of Resistance

A
  • Increased drug inactivating enzyme activity
  • Alter cell wall/membrane permeability
  • altered binding site/receptor of drug
  • drug efflux
  • increase endogenous metabolite
36
Q

Dose related toxicities for

Imipenem

Amphotericin

Cefazolin

A

Imipenem - seizures

Amphotericin - nephrotoxicity

Cefazolin - Neutropenia (dose and duration)

37
Q

Idiosyncratic reaction for:

chloramphenicol

A

aplastic anemia

38
Q

What should be used for Abscess?

A 
Antibiotic therapy (not enough)
Drainage of area
39
Q

Superinfection

A

alt normal flora from removal of inhibitory influences in the body

  • due to broad spectrum abx
  • enterobacteriaceae (PEK, SE)
  • Candida spp.
  • Clostridium difficile (Psuedomembranous colitis)
40
Q

Which abx gets inactivated by lung surfactant?

A

Daptomycin

41
Q

Where is the highest concentration of Abx found?

A

Urinary concentration

PoD 2 (14 decks)

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