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Antimicrobials Flashcards

1
Q

Which antibiotic affect cell wall synthesis? (general FAMILIES, and the “other” ones )

A

Beta-lactam, Bacitracin, Vancomycin, Cycloserine, isoniazid, ethambutol, ethionamide

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2
Q

Beta lactam antibiotics

  1. Mechanism of action
  2. Weakness? (ie: if a bacteria has this it might survive)
  3. Uses
  4. Types
A
  1. Mechanism: inhibit transpeptidation (final crosslinking step in peptidoglycan synthesis inhibited) and activate autolytic enzymes
  2. Weakness: beta-lactamases, anything without PBP (penicilling binding protein) and bacteria with autolysin inhibitors.
  3. Used in combination with beta lactamase inhibitors
  4. Penicillins, cephalosporins, monobactams, carbapenems, aztreonam, Imipenem
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3
Q

B-lactam side effects

A

Allergies:

  • pen>ceph>mono

Toxicity:

  • ​​​carba (seizures)>ceph (thrombophlebitis) >pen >mono
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4
Q

Natural Penicillin (G or V)

  1. Mechanism
  2. used against?
  3. V is stable against?
A
  1. Inhibits transpeptidase (beta-lactam antibiotic)
  2. gram + bacteria
  3. Pen V is acid resistant
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5
Q

Penicillins that are resistant to beta-lactamase

A

Nafcillin, oxacillin, cloxacillin

(Naf for Staph)

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6
Q

These penicillins can **work on gram(+) and gram(-) **!

A
  • called **expanded spectrum **
  • Ampicillin (amino penicillin), piperacillin, mezlocillin, tiracillin
  • Tiracillin battles pseudonomas
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7
Q

these penicillins are acid resistant

A
  • Amoxycillin (amino-penicillin), Pen V (natural), oxacillin
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8
Q

Common penicillin + beta lactamase drug combos

A
  • **augmentin= **amoxicillin + clavulanic acid
  • Ampicillin + sulbactam
  • Zosyn, Tazomed= piperacillin + tazobactam
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9
Q

Penicillin vs cephalosporin?

A

Cephalosporine are less sensitive to beta-lactamases

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10
Q

Cephalosporins- First generation ​

  1. What kind of antibiotic is this?
  2. Effective against?
  3. Types?
A
  1. Beta-lactam
  2. gram+ bacteria for prophylaxis only because bacteria readily develop resistance to it
  3. cephalexin, cephalothin, cefazolin
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11
Q

Cephalosporins- Second generation

  1. What kind of antibiotic is this?
  2. Effective against?
  3. Types?
A
  1. beta lactam
  2. Gram (+), gram (-), bacteroides, NOT PSEUDOMONAS, increased resistance to b-lacatamase
  3. cefaclor, cefuroxime, cefoxitin
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12
Q

Cephalosporins- 3rd generation

  1. What kind of antibiotic is this?
  2. Effective against?
  3. Types?
  4. Why is this so special?
A
  1. beta-lactam
  2. gram+, gram-, pseudomonas, MRSA, VRE (vancomycin resistent enterococci)
  3. ceftazimid, cephotaxime, cephtriaxone, cefdinir
  4. broadest spectrum of activity, crosses BBB
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13
Q

Cephalosporins- 4th generation

  1. MOA
  2. effective against
  3. types?
A
  1. beta-lactam
  2. G+ and G-, broadest of 5 generations
  3. Cefepime
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14
Q

Cephalosporin 5th Generation

  1. MOA
  2. used against?
  3. types?
A
  1. beta-lactam
  2. MRSA, drug resistant S Pnemoniae, NOT PSEUDMONOMS
  3. ceftaroline
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15
Q

Monobactams

  1. mechanism?
  2. Effective against?
  3. types?
  4. Resistant to?
A
  1. Beta lactam (inhibits transpeptidase and activates autolytic enzymes)
  2. Gram (-) ONLY (not against G+ or anaerobes)
  3. aztreoname
  4. Fully resistant to b-lactamases
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16
Q

Carbaoenems

  1. Mechanism of action
  2. Effective against
  3. types
  4. Down-side?
A
  1. beta-lactam
  2. broad spectrum G+ and G-
  3. imipenem, ertapenem, meropenem (less toxic)
  4. toxic

pen=pan= broad spectrum

penem= “pen him!” = kill him = it’s toxic —-I’m trying :-/

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17
Q

Bacitracin

  1. Mechanism of action
  2. Used on?
  3. Side effects
  4. structural feature we should know?
A
  1. blocks bactoprenol dephosphorylation
  2. topical on G+ with other drugs
  3. poorly absorbed, renal toxicity
  4. LARGE!!! cannot cross G- membrane, poorly absorbed
18
Q

Glycopeptides Antibiotics

  1. MOA
  2. Weak against
  3. Used for?
  4. Types
  5. What should be know about shape?
A
  1. binds the end of the aa chain to block transglycosylation and transpeptidation
  2. VanA plasmid and VanB chromosome-use ala-lactate instead of ala-ala
  3. resistant staph, staphylococci, enterococci, NOT G- BACTERIA
  4. Vancomycin, Telavancin,
  5. Large- given via IV because can’t be absorbed by GI tract. Also won’t go into gram- bacteria
19
Q

Cycloserine

  1. MOA
  2. Uses
  3. What else should we know?
A
  1. D-ala analog- inhibits alanine racemase
  2. sometimes for UTI, 2nd line drug for TB.
  3. neurtoxic, use carefully
20
Q

We kill the cell membrane.

A

Polymyxins (colistin) and daptomycin (cubcin)

THIS MEANS THEY CAN AFFECT OUR HUMAN MEMBRANES TOO!

21
Q

Polymyxin

  1. MOA
  2. Uses
  3. Type
A
  1. dissolves PE in G- membranes. We have PE too.
  2. Toxic. Used topically or as last resort for resistant bugs
  3. Colistin
22
Q

Daptomycin

  1. MOA
  2. Uses
  3. Types
A
  1. cyclic lipopeptide that dissolves in the membrane and disrupts membrane potential
  2. G+ cocci, MRSA- given IV with B-lactams
  3. Cubicin
23
Q

Antimetabolites

  1. MOA
  2. Weak against
  3. Used agaonst
  4. types
A
  1. inhibit PABA, DHF, THF, Pyrimidines =inhibition of protein/nucelic acid synthesis. I guess PABA gets incorporated into DHP?
  2. Things that make tons of PABA
  3. Nocardia. Synergistic with TMP and SMX for UTI, salmonella, shigella.
24
Q

Trimethoprin

  1. MOA
  2. part of what group of antibiotics?
A
  1. Inhibits dihydrofolate reductase= no folic acid
  2. part of the antimetbolics antibiotics
25
Q

Sulfoamides

  1. MOA
  2. types
  3. anything else?
A
  1. Inhibits PABA into dihydropteroic acid= inhibition of folic acid synthesis
  2. sulfmethaxozole, dapsone
  3. most common drug that causes erythema multiforme
26
Q

Nucleic acid inhibitors- families?

A
  1. Fluoroquinolones
  2. Fidaxomycin
  3. Rifamycin
  4. Metronidazole
27
Q

(Fluoro)quinolones

  1. MOA
  2. Weak against
  3. Why is “fluoro” there?
  4. Used for
  5. side effects
  6. Types
A
  1. inhibits DNA gyrase (this prevents the supercoiling; our cells use topoisomerase).
  2. anything with altered DNA gyrase
  3. its not very soluble, fluorunated Qs
  4. UTIs, G- and G+ infections, mycobacteria (2nd line) and pseudomonas
  5. prolonged QT interval
  6. Ciprofloxacin, moxifloxacin

​FLO-XACIN- flow- will help with your flow if you have a UTI from some nasty gyrating. FLO= FLOROquinolones.

28
Q

Fidaxomycin

  1. MOA
  2. Uses
  3. Types
A
  1. targets “switch region” loading clamp of RNA polymerase and prevents RNA polymerase and DNA interaction
  2. against C-dif instead of vanco, or vanco-resistant c-dif.
  3. Dificid

**Dificid for difficult c-dificile **

29
Q

Rifamycin

  1. MOA
  2. Weak against
  3. Uses (x3)
  4. Side effects
A
  1. blocks RNA polymerase elongation subunit
  2. anything with altered RNA polymerase ß subunit
  3. Uses: a) with isoniazid (inhibits synth of mycolic acid) in mycobacteria b)meningitis (crosses CNS) c) Blocks assembly of poxviruses
  4. orange sweat and urine

This is what they gave me once for a bad UTI. Or it was something else that makes your pee neon orange.

30
Q

Metronidazole

  1. MOA
  2. Uses
A
  1. Reduced complex with ferredoxin interacts with DNA and breaks DNA strands (makes free radicals).–DAMAGES DNA
  2. Giardia (protozoa), anaerobic bacteria (clostridium, bacteriodes)

All those are gut problems. If you eat off the METRO floor you’re probably gonna get the squirts.

Also-Ferredoxin–remember Farrah’s uncle took this for his giardia (somehow he got c.dif?).

31
Q

Families that inhibit protein synthesis

A

aminoglycosides, tetracyclines, macrolides, lincosamides

32
Q

Aminoglycosides

  1. MOA
  2. Weak against
  3. Used for?
  4. Types?
A
  1. bind 30s subunit, block initiation by binding tRNAfmet
  2. altered p12 ribosomal protein, aminoglycosidases, altered permeability (ie: streptococci)
  3. G- enterics, with cephalosproins or penicillin in surgery
  4. streptomycin, neomycin, gentamycin, tobramycin, amikacin

Almost all A/O-MYCINS are aminoglycosylides. if -THROMYCIN then it isn’t.

33
Q

Tetracyclines

  1. MOA
  2. Weak against
  3. used for
  4. side effects
  5. types
A
  1. inhibits binding of charged tRNA to A-site of 30s subunit
  2. efflux pumps
  3. Rickettsia, chlamydia, mycoplasms
  4. Toxicity, diziness, ringing in ears, flyorescen teeth and puss (WTF), bone damage to newborns CLASS D PREGNANCY RISK (IE DO NOT USE)
  5. doxycycline, tigecycline

Cyclines will PSYCH you out. Super toxic. Apparently make glow in the dark teeth and puss. (he wrote poss, i’m realizing he could have meant piss, too?)

34
Q

Chloramphenicol

  1. MOA
  2. Resistance
  3. Uses
A
  1. translocation reaction inhibited (peptidyl transferase 50S)
  2. chloramphenical acetyl transferase (CAT)
  3. no longer used, resistant and toxic
35
Q

Macrolides

  1. MOA
  2. weak to
  3. uses
  4. side effects (what else has this side effect?)
  5. types
A
  1. binds rRNA and inhibits translocation
  2. methylated RNA
  3. G+, some G-
  4. long QT (remember fluoroquinolones?), increase CV death
  5. erythromycin, carithromycin, azithromycin, telithromycin

Azithromycin= z-pack

If you’re a MACRO-LYER then THRO-MY-CIN away? Also, you have to MACRO-LIE to me to get me to take something thatll fuck my QT interval up.

36
Q

Lincosamides

  1. MOA (what else does this?)
  2. Uses
  3. Side effects
  4. types
A
  1. bind rRNA and inhibit translocation (macrolides)
  2. anaerobes, antimalarial. Does not cross CNS
  3. Can disrupt native fluora
  4. Clindamycin
  • This is one MYCIN that isn’t an aminoglycoside
  • use of clindamycin= c. diff colonization
  • Lincosamides are LINKed with Macrolides via mechanism.
  • Clinda-clean dat colon- kill some native flora.
37
Q

Nitrofurantoid

  1. mechanism
  2. use
A
  1. inhibits 30S
  2. used for UTIs
38
Q

Mupirosin

  1. MOA
  2. Use
A
  1. Inhibits synthesis of isoleucyl-tRNA
  2. topical for G+ bacteria
39
Q

Methenamine

  1. MOA
  2. Uses
A
  1. release formaldehyde in acidic urine
  2. UTI
40
Q

Streptogramins

  1. MOA
  2. Used for
  3. type
A
  1. inhibit 50S
  2. treat VRE (vancomycin resistent enterococci) and VRSA (vancomycin resistent staph aureus)
  3. synercid = quinupristin + dalfopristin

GRAMINS (dunno if this is anywhere else…but) GRANs (grams) are pretty tight, even when shit is vanco resistant.

41
Q

Oxazolidinones

  1. MOA
  2. uses
  3. type
A
  1. inhibit 50S subunit
  2. treat VRE and MRSA
  3. Linezolid

Microbiology-Bacteria (3 decks)

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