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First Aid Micro > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

How to administer Penicillin G?

A

IV and IM

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2
Q

How to administer Penicillin V?

A

oral

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3
Q

MoA of Penicillin G, V

A

Bind penicillin-binding proteins (transpeptidase)
Block transpeptidase cross-linking of peptidoglycan
Activate autolytic enzymes

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4
Q

Toxiticty of Penicillin G & V

A

Hypersensitivity rxn, hemolytic anemia

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5
Q

Ampicillin and Amoxicillin used to treat:

A

H. influenzae, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, entercocci

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6
Q

Ampicillin and Amoxicillin Toxicity

A

Hypersensitivity rxn, Rash, Pseudomembranous colitis

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7
Q

Penicillinase-resistant penicillins

A

Oxacillin, Nafcillin, Dicloxacillin - because bulky R group blocks access of beta-lactamase to beta-lactam ring

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8
Q

How to treat S. aureus but not MRSA

A

Oxacillin, Nafcillin, Dicloxacillin

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9
Q

Toxicity of Oxacillin, Nafcillin, Dicloxacillin

A

Hypersensitivity rxn and interstitial nephritis

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10
Q

Antipseudomonals

A

Ticarcillin, Piperacillin

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11
Q

Beta-lactamase inhibitors

A

Clavulanic Acid, Sulbactam, Tazobactam (CAST)

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12
Q

MoA of Cephalosporins

A

Inhibit cell wall synthesis, bactericidal

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13
Q

First Generation Cephalosporin

A

Cefazolin and Cephalexin

against gram positive cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae

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14
Q

Drug used prior to Sx to prevent S. aureus wound infections.

A

Cefazolin

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15
Q

2nd Generation Cephalosporin

A

Cefoxitin, Cefaclor, Cefuroxime
Gram positive cocci, H. infleunza, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumonia, Serratia marcescens

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16
Q

3rd Generation Cephalosporin

A

Ceftriaxone, Cefotaxime, Ceftazidine

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17
Q

Tx for meningitis and gonorrhea

A

Ceftriaxone

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18
Q

Tx for Pseudomonas

A

Ceftazidime

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19
Q

4th Generation Cephalosporin

A

Cefepime, increase activity against Pseudomonas and gram positive organism

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20
Q

5th Generation Cephalosporin

A

Ceftaroline

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21
Q

Toxicities for Cephalosporins

A

Hypersensitivity reactions, Vitamin K deficiency, increased nephrotoxicities of aminoglycosides

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22
Q

Clinical Use for Aztreonam

A

Gram negative rods only

for penicillin-Ax pts and those with renal insufficiency

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23
Q

MoA of Carbapenems

A

Broad-spectrum, beta-lacatmase resistant

Administer with cilastatin to decreased inactivation of drug in renal tubules

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24
Q

Toxicities of Carbapenems

A

GI distress, skin rash, and CNS toxicity (seizures) at hgih plasma levels

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25
Q

MoA of vancomycin

A

inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors

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26
Q

Used to Tx MRSA and C. diff

A

Vancomycin

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27
Q

Red Man Syndrome

A

Caused by Vancomycin, prevent with pretreatment with antihistamines) - nephrotoxicity, ototoxicity, thrombophlebitis and diffuse flushing

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28
Q

30S inhibitors

A

Aminoglycosides (bactericidal)

Tetracycline (bacteriostatic)

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29
Q

50S inhibitors

A

Chloramphenicol, Clindamycin, Erythromycin (macrolides), Linezolid

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30
Q

Aminoglycosides

A

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

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31
Q

Mechanism of Aminoglycosides

A

bactericidal, inhibit formation of initiation complex and cause misreading of mRNA.
Block translocation
Require O2 for uptake

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32
Q

Toxicity of Aminoglycosides

A

Nephrotoxicity, Neuromuscular blockade, Ototoxicity, Teratogen

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33
Q

MoA of Tetracyclines

A

Binds 30S and prevent attachment of aminoacyl-tRNA, limited CNS penetration

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34
Q

How Doxycycline is eliminated

A

Fecally, thus can be used in patients with renal failure

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35
Q

What can’t you eat with Tetracyclines

A

calcium, antacids or iron-containing preparations because of divalent cations

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36
Q

This drug is able to accumulate intracellularly therefore kills Chlamydia and Rickettsia

A

Tetracyclines

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37
Q

Toxicity of Tetracyclines

A

discolors teeth and inhibits bone growth in children, photosensitivity

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38
Q

Macrolides

A

Azithromycin, Clarithromycin, Erythromycin

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39
Q

MoA of Macrolides

A

Iinhibit protein synthesis by blocking translocation
Binds 23S of rRNA of the 50S ribosomal subunit
Bacteriostatic

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40
Q

Toxicity of Macrolides

A

GI motility, Arrhythmia from porlonged QT, acute Cholestatic Hepatitis, Rash, Eosinophilia

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41
Q

Blocks peptidyltransferase at 50S ribosomal subunit. Bacteriostatic

A

Chloramphenicol

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42
Q

Mechanism of resistance is plasmid-encoded acetyltransferase inactivates this drug.

A

Chloramphenicol

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43
Q

Toxicity is Chloramphenicol

A

Anemia (dose dependent), Aplastic Anemia, Gray Baby Syndrome (in premature infants because they lack liver UDP-glucuronyl transferase)

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44
Q

Causes Pseudomembranous colitis

A

Clindamycin

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45
Q

Treats anaerobes above the diaphragm

A

Clindamycin

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46
Q

Treats anaerobes below the diaphragm

A

Metronidazole

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47
Q

If a bacteria methylate 23S rRNA binding site, it prevents this set of drugs from working

A

Macrolides (end in -mycin)

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48
Q

If bacteria have a plasmid-encoded pumps to decrease uptake or increase efflux, it preventsthis set of drugs from working

A

Tetracyclines (including doxycycline and minocycline)

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49
Q

MoA of Sulfonamides

A

Inhibit folate synthesis. PABA antimetabolites inhibit dihydropteroate synthase.

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50
Q

Hemolysis if G6PD deficient from this drug

A

Sulfonamides

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51
Q

This drug could cause nephrotoxicity (tubulointerstitial nephritis)

A

Sulfonamides

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52
Q

MoA of Trimethoprim (TMP)

A

Inhibits bacterial dihydrofolate reductase

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53
Q

TMP-SMX Used for

A

UTIs, Shigella, Salmonella, Pneumocystis jirovecii, toxoplasmosis prophylaxis

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54
Q

Toxicity from Trimethoprim

A

Megaloblastic Anemia, Leukopenia, Granulocytopenia

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55
Q

Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV.

A

Fluoroquinolones (end in -floxacin)

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56
Q

Drug that can cause tendonitis, tendon rupture, leg cramps, and myalgias.

A

Fluoroquinolones (end in -floxacin)

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57
Q

Reason not to use Fluorquinolones in Pregnant, Nursing mothers and children <18years old

A

Damages cartilage

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58
Q

This drug with my resistant if the bacteria gets a chromosome-encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pumps.

A

Fluoroquinolones

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59
Q

MoA of Metronidazole

A

Forms free radical metabolites in bacteria cell that damage DNA

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60
Q

Triple Therapy for H. pylori

A

PPI, Clarithromycin, Metronidazole

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61
Q

Patient drinks alcohol with the drug and it causes sveer flushing, tachy cardia, hypotension

A

Metronidazole causing a Disulfram-like reaction

62
Q

Tx of M. tuberculosis

A

RIPE

Rifampin, Isoniazid, Pyrazinamide, Ethambutol

63
Q

Tx for MAC

A

Azithromycin or Clarithromycin + Ethambutol

can add rifabutin or ciprofloxacin

64
Q

Prophylaxis for MAC

A

Azithromycin, Rifabutin

65
Q

Long Term treatment for M. leprae

A

Dapsone and Rifampin for tuberculoid form

Add clofazimine for lepromatous form

66
Q

Decrease mycolic acid synthesis

A

Isoniazid

67
Q

What enzyme is needed for Isoniazid to work?

A

Bacterial catalase-peroxidase encoded by KatG

68
Q

Toxicity of Isoniazid

A

Neurotoxicity, Hepatotoxicity

69
Q

What is needed to prevent neurotoxicity, lupus when taking Isoniazid.

A

Pyridoxine (Vit B6)

70
Q

Inhibits DNA-dependent RNA polymerase

A

Rifamycins like Rifampin & Rifabutin

71
Q

Which Rifamycin is prefered in HIV patients?

A

Rifabutin because less effect on P450

72
Q

Side effect of Rifampin

A

Orange Urine and Sweat

73
Q

Toxicity of Pyrazinamide

A

Hyperuricemia and Hepatotoxicity

74
Q

MoA of Ethambutol

A

decrease carbohydrate polymerization by blocking arabinosyltransferase

75
Q

Causes Optic Neuropathy (red-green colorblindness)

A

Ethambutol

76
Q

Medication you give to prevent endocarditis with surgery of dental procedures

A

Penicillins

77
Q

Tx for Gonorrhea

A

Ceftriaxone

78
Q

Hx of recurrent UTIs

A

TMP-SMX

79
Q

Pregnant Woman Carrying Group Strep B

A

Ampicillin

80
Q

Prevention of Post-Sx infection due to S. aureus

A

Cefazolin

81
Q

Prophylaxis of Strep pharyngitis in child with prior rheumatic fever

A

Oral penicillin

82
Q

Syphilis

A

Benzathine penicillin G

83
Q

Prevention of gonococcal or Chlamydial conjunctivitis in newborn

A

erythromycin ointment

84
Q

medicine you give when CD4 <200cells/mm^3

A

TMP-SMX to prevent pneumocystis pneumonia

85
Q

medicine you give when CD4 <100cells/mm^3

A

TMP-SMX to prevent pneumocystic pneumonia and toxoplasmosis

86
Q

medicine you give when CD4 <50cells/mm^3

A

mycobacterium avium complex

87
Q

Tx for MRSA

A

vancomycin, daptomycin, linezolid (can cause serotonin syndrome), tigecycline, ceftaroline

88
Q

Tx for VRE

A

linezolid and streptogramins (quinupristin/dalfopristin)

89
Q

MoA of Amphotericin B

A

Binds ergosterol; forms membrane pores that allow leakage of electrolytes

90
Q

What you need to supplement with Amphotericin B

A

Potassium and Magnesium

91
Q

Organ primarily affected by Amphotericin B

A

Kidneys

92
Q

Tx of Oral Thrush

A

Nystatin

93
Q

Prevents the conversion of lanosterol to ergosterol by inhibiting P450

A

Azoles

94
Q

Toxicity of Azoles

A

inhibits testosterone (gynecomastia, esp with ketoconazole), liver dysfunction (inhibits P450)

95
Q

Used with amphotericin B to stop systemic fungal infections

A

Flucytosine

96
Q

MoA of Flucytosine

A

inhibits DNA and RNA biosynthesis by conversio to 5-fluorouracil by cytosine deaminase

97
Q

Toxicity of Flucytosine

A

Bone Marrow Suppression

98
Q

Used for invasive aspergillosis and Candida

A

Echinocandins (ends in -fungin)

99
Q

Inhibits fungal enzyme squalene epoxidase

A

Terbinafine

100
Q

Clinical use of terbinafine

A

Dermatophtoses esp onychomycosis

101
Q

Toxicity of Terbinafine

A

GI upset, HA, hepatotoxicity, taste disturbance

102
Q

Oral Tx of superficial infections, inhibits growth of dermatophytes (tinea, ringworm)

A

Griseofulvin

103
Q

MoA of Griseofulvin

A

interferes with icrotubule fucntino thus disrupting mitosis. Deposits in keratin areas like nails

104
Q

Tx of T. cruzi

A

Nifurtimox

105
Q

Tx of Leishmaniasis

A

Sodium Stibogluconate

106
Q

Tx for T. brucei

A

suramin and melarsorprol

107
Q

MoA or Chloroquine

A

Blocks detoxification of heme into hemozoin. Heme accumulates and us toxuc to plasmodia

108
Q

Toxicity of Chloroquine

A

retinopathy, pruritis (esp if dark skinned)

109
Q

Tx of Schistosoma

A

Praziquantal

110
Q

Inhibits influenza neuramindase to decreased the release of progeny virus

A

Zanamivir, Oseltamivir

111
Q

Tx of RSV and chronic HepC

A

Ribivirin

112
Q

MoA of Ribavirin

A

Inhibits synthesis of guanine nucleotides, competitively inhibits IMP dehydrogenase

113
Q

Toxicity of Ribavirin

A

Hemolytic Anemia

114
Q

Used for Herpes Zoster

A

Famciclovir

115
Q

Prodrug for HSV and VZV

A

Valacyclovir (prodrug of acyclovir)

116
Q

MoA of Acyclovir, Famciclovir, Valacyclovir

A

monophosphorylated by HSV/VZV thymidine kinase

117
Q

Toxicity of Acyclovir, Famciclovir, Valacyclovir

A

obstructive crystalline nephrotoxicity and acute renal failure is not hydrated

118
Q

These drugs won’t work if there is mutated thymidine kinase

A

Acyclovir, Famciclovir, Valacyclovir

119
Q

Used for CMV

A

Ganciclovir

120
Q

MoA of Ganciclovir

A

5’-monophosphate formed by CMV viral kinase. Guanosine analog.
Triphosphate formed by cellular kinases

121
Q

Toxicity of Ganciclovir

A

leukopenia, neutropenia, thrombocytopenia, renal toxicity

122
Q

MoA of Foscarnet

A

Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme.

123
Q

Drug for CMV retinitis in IC pts when gnciclovir fails, acyclovir resistant HSV

A

Foscarnet and Cidofovir

124
Q

Foscarnet Toxicity

A

Nephrotoxicity

125
Q

HAART Therapy Drugs

A

2 NRTIs + 1 NNRTI or 1 protease inhibitor or 1 integrase inhibitor

126
Q

Ends in -navir

A

Protease inhibitor

127
Q

Protease inhibitors prevent what part in HIV infection?

A

prevents the maturation of new viruses

128
Q

Toxicities from Protease Inhibitors

A

hyperglycemia, GI intolerane, Lipodystrophy

nephropathy and hematuria for indinavir

129
Q

MoA of NRTIs

A

competitively inhibit nucleotide binding to RT and terminate DNA chain (lack a 3’OH group)

130
Q

What to give with NRTI to prevent BM suppression

A

granulocyte colony-stimulating factor (G-CSF) and erythropoietin

131
Q

general prophylaxis and during pregnancy to decrease risk of fetal transmission

A

Zidovudine (ZDV) an NRTI

132
Q

A nucleotide NRTI

A

Tenofovir, doesn’t need to be phosphorylated

133
Q

3 NNRTIs

A

Efavirenz, Nevirapine, Delavirdine

134
Q

Common S/E of NNRTIs

A

Rash and hepatotoxicity

135
Q

S/E associated with Efavirenz

A

Vivid Dreams and CNS symptoms

136
Q

Efavirenz and Delavirdine are C/I in

A

Pregnancy

137
Q

Inhibits HIV integration into host cell by eversibly inhibiting HIV integrase

A

integrase Inhibitor Raltegravir

138
Q

S/E of Raltegravir

A

Hypercholesterolemia

139
Q

Binds gp41, inhibiting viral entry

A

Enfuvirtide, a fusion inhibitor

140
Q

Binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120

A

Maravioc, a fusion inhibitor

141
Q

Clinical use of IFN-alpha

A

chronic hepatitis B and C, Kaposi Sarcoma, Hairy Cell Leukemia, Condyloma acuminatum, renal cell carcinoma, malignant melanoma

142
Q

Clinical use of IFN-beta

A

Multiple Sclerosis

143
Q

Clinical use of IFN-gamma

A

Chronic Granulomatous Disease

144
Q

Sulfonamides in Pregnancy causes

A

Kernicterus

145
Q

Aminoglycosides during Pregnancy causes

A

Ototoxicity

146
Q

Fluoroquinolones during Pregnancy causes

A

Cartilage Damage

147
Q

Clarithromycin during Pregnancy causes

A

Embryotoxic

148
Q

Ribavirin during Pregnancy

A

Teratogenic

149
Q

Griseofulvin during Pregnancy

A

Teratogenic

150
Q

Chloramphenicol during Pregnancy

A

Gray Baby Syndrome

First Aid Micro (7 decks)

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