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Step I > antimicrobials > Flashcards

antimicrobials Flashcards

1
Q

folic acid synthesis inhibitors

A

sulfonamides (blocks PABA ->DHF)

trimethoprim (blocks DHF -> THF)

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2
Q

peptidoglycan synthesis inhibitors

A

glycopeptides: Bactracin, Vanco

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3
Q

Peptidoglucan cross linking inhibitors

A 
penicillins 
antipsuedomonals
cephalopsprins
carbapenems
monobactams
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4
Q

penicillinase-sensitive penicillins

A

amoxicillin
ampicillin
penicillin G, V

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5
Q

penicillinase-resistant

A

dicloaxcillin
nafcillin
oxacillin

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6
Q

antipseudomonals

A

piperacillin

ticarcillin

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7
Q

carbapenems

A

-penem

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8
Q

monobactams

A

aztreonam

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9
Q

30s inhibitors

A

aminoglycosides

tetracycline

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10
Q

aminoglycosides

A 
GNATS
genatmicin
neomycin
amikacin
tobramycin
streptomycin
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11
Q

tetracyclines

A

doxycyclin
minocyclin
tetracyclin

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12
Q

50s inhibitors

A 
chloramphenicol
clindamycin
linezolid
macrolides
streptogramins
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13
Q

macrolides

A

azithromycin
clarithromycin
erythromycin

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14
Q

streptogramins

A

dalfoprisitn

quinupristin

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15
Q

mRNA synthesis inhibitors

A

rifampin

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16
Q

Damages DNA

A

metronidazole

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17
Q

DNA topisomerase inhibitors

A

florquinolones

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18
Q

penicillin G,V mode of admin

A

penicillin G- IV/IM

penicillin V- PO

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19
Q

penicillin G, V uses

A

gram +
some gram - cocci (N. meningitidis) and spirochetes (T. pallidum)
bacteriacidal

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20
Q

ADR of penicillin G,V

A

hypersensitivity rxn

hemolytic anemia

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21
Q

amoxicillin, ampicillin mode of admin

A

amOxicillin higher oral bioavailability then ampicillin

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22
Q

amoxicillin, ampicillin uses

A 
bactericidal, still penicillinase sensitive 
wider spectrum then penicillin
HHELPSS
H. influenza
H. pylori
E. coli
Listeria
Proteus
Salmonella
Shigella
enterococci
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23
Q

amoxicillin, ampicillin ADRs

A

hypersensitivity rxn
rash
pseudomembranous colitis

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24
Q

Dicloxacillin, nafcilllin, oxacillin MOA

A

same as penicillin
but narrow spectrum
pencillinase resistance d/t bulky R group which blocks access

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25
Q

dicloxacillin, nafcillin, oxacillin uses

A

S. aureus (not MRSA)

naf for staph

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26
Q

dicloxacillin, nafcillin, oxacillin ADRs

A

hypersensitivity rxn

interstitial nephritis

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27
Q

piperacillin, ticarcillin MOA

A

same as penicillin

extended spectrum

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28
Q

piperacillin, ticarcillin uses

A

pseudomonas
gram neg rods
susceptible to penicillinase so combo w/beta lactamase inhibitor

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29
Q

piperacillin, ticarcillin ADRs

A

hypersensitivity rxn

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30
Q

beta lactamase inhibitors

A

CAST
Clavulanic Acid
Sulbactam
Tazobactam

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31
Q

cephalosporins MOA

A

beta-lactams that inhibit cell wall synthesis, but less susceptible to pencillinases
bactericidal

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32
Q

what organisms are NOT covered by cephalosporins

A 
LAME
listeria
atypical (Chlaymyida, mycoplasma)
MRSA (exception, cefaroline 5th gen does cover MRSA)
Enterocicci
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33
Q

1st generation cephalosporins

A

have pH
cefazolin (exception)
cephalexin

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34
Q

uses of 1st gen

A 
\+PEcK
gram + cocci
proteus
E.coli
Klebsiella
used prior to surgery to prevent S. aureus
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35
Q

2nd gen

A

Family celebrating w/Foxy cousin drinking Tea, wearing Fur
cefoxitin
cefuroxime

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36
Q

2nd gen uses

A 
HEN PEcKS
H. influenza
Enterobacter
Neisseria
Proteus
E.coli
Klebsiella
Serratia
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37
Q

3rd gen

A

ceftriaxone
cefotaxime
ceftazidine

38
Q

3rd gen uses

A

serious gram neg
ceftriaxone- meningitis, gonorrhea, Lyme
Ceftazidime- pseudo

39
Q

4th gen

A

cefepime

40
Q

4th gen uses

A

gram neg

increased activity against pseudo and gram +

41
Q

5th gen

A

ceftaroline

42
Q

5th gen uses

A

broad gram neg and pos
includes MRSA
does NOT cover pseudo

43
Q

cephalospoin ADRs

A 
hypersensitivity rxn
autoimmune hemolytic anemia
disulfram-like rxn
vit K deficiency
cross reactive w/penicillins
increase nephrotoxicity of aminoglycosides
44
Q

carbapenems MOA

A

broad spectrum, beta lactamase resistant

administer w/cilastatin to decrease inactivation of drug in renal tubules

45
Q

carbapenems uses

A

gram + cocci, gram - rods, and anaerobes

significant side effects limit use

46
Q

carbapenems ADRs

A

GI
skin rash
CNS toxicity -> seizures

47
Q

monobactams general

A

synergistic w/aminoglycosides

no cross reactivity w/penicillin

48
Q

monobactams uses

A

gram neg rods only

for penicillin allergic pts and those w/renal insufficiency who cannot tolerate aminoglycosides

49
Q

monobactams ADRs

A

usually nontoxic, can cause GI upset

50
Q

vanco MOA

A

D-ala D-ala binding blocks cell wall synthesis

51
Q

vanco uses

A 
gram + only
MRSA
S. epidermidis
Enterococci
C. difficile (PO)
52
Q

ADRs vanco

A

Nephrotoxic
Ototoxic
Thrombophlebitis
Red man flush

53
Q

aminoglycosides MOA

A

bactericidal
30S
require O2 for uptake, so no effect on anaerobes

54
Q

aminoglycosides uses

A

severe gram - rods

synergisitc w/beta lactams

55
Q

aminoglycoside ADRs

A

Nephrotoxic
Neuromuscular blockade
Ototoxic
Teratogen

56
Q

aminoglycoside mechanism of resistance

A

bacterial transferase enzymes inactivate drug via acetylation, phosphorylation, or adenylation

57
Q

tetracyclines MOA

A

bacteriostatic
bind 30s
limited CNS penetration
DO not take w/milk, antacids, or Fe b/c block absorption
Doxy ok in renal failure b/c fecally eliminated

58
Q

tetracyclines uses

A

Borrelia burgerdorferi
M. pneumoniae
accumulates intracellularly -> rickettsia and Chlaymida
also for acne

59
Q

tetracycline ADRs

A

GI
discoloration of teeth and inhibition of growth in kids
photosensitivity
CI in prego

60
Q

tetracycline resistance

A

decrease uptake and/or increase efflux

61
Q

chloramphenicol MOA

A

blocks 50s

bacteriostatic

62
Q

chloramphenicol uses

A

meningitis (H. influenza, N. meningitidis, S. penumoniae)
RMSF
limited use d/t toxcicities, but good in 3rd world cause cheap

63
Q

chloramphenicol ADRs

A

anemia
aplastic anemia
gray baby syndrome (lack UDP-glucuronyl transferase)

64
Q

chloramphenicol resistance

A

plasmid encoded acetyltransferase inactivates drug

65
Q

clindamycin MOA

A

50s

bacteriostatic

66
Q

clindamycin uses

A

anaerobic infections (bacteroides, C. perfringens)
invasive grp A strep
treats anaerobic infections above diaphragm (metronidazole below)

67
Q

clindamycin ADRs

A

pseudomembranous colitis
fever
diarrhea

68
Q

oxazolidinoles (linezolid) MOA

A

50s

69
Q

oxazolidinoles uses

A

gram + including MRSA and VRE

70
Q

oxazolidinoles ADRs

A

bone marrow suprresion
peripheral neuropathy
serotonin syndrome

71
Q

oxazolidinoles resistance

A

point mutation in ribosomal RNA

72
Q

Macrolides MOA

A

50s

bacteriostatic

73
Q

macrolides uses

A

atyical penumonias (Chlamydia, legionella, mycoplasma)
STIs (chlamydia)
gram + cocci
B. pertussis

74
Q

macrolides ADRs

A 
MACRO
GI Motility issues
Arrhythmia (prolonged QT)
acute Cholestatic hepatitis
Rash
eOsinophilia 
clarithromycin and erythromycin inhibit cytochrome P-450
75
Q

macrolides resistance

A

methylation of 23S rRNA binding site

76
Q

trimethoprim MOA

A

inhibits DHF reductase

bacteriostatic

77
Q

trimethoprim uses

A 
combo w/sulfa (TMP-SMX)
UTIs
Shigella
Salmonella
Pneumocystis jirovecii
toxoplasmosis prophylaxis
78
Q

trimethoprim ADRs

A

megaloblastic anemia
leukopenia
granulocytopenia
TMP - treats marrow poorly

79
Q

sulfonamides MOA

A

inhibit folate synthesis

bacteriostatic (bacteriocidal when combo with TMP)

80
Q

sulfonamide uses

A 
gram +
gram -
nocardia
chlamydia
triple sulfas or SMX for UTI
81
Q

sulfonamide ADRs

A 
hypersensitivity rxn
hemolysis if G6PD deficient
nephrotoxic
photosensitivity
kernicterus in infants
displace other drugs from albumin (warfarin)
82
Q

sulfonamides resistance

A

altered enzyme
decrease uptake
increase PABA synthesis

83
Q

floroquinlones MOA

A

inhibit prokaryotic enzymes topoisomerase II (DNA gyrase)
bacteriocidal
cannot be taken w/antacids

84
Q

floroquinolones uses

A

gram neg rodes of UTI and GI tract
pseudo, Neisseria
some gram +

85
Q

floroquinolones ADRs

A 
GI
superinfections
skin rashes 
HA
dizziness
leg commonly leg cramps and myalgias 
CI in prego, nursing,
86
Q

floroquinolones resistance

A

efflux pumps

87
Q

daptomycin MOA

A

lipopeptide disrupts cell membrane of gram +
S. aureus skin infections (especially MRSA)
bacterimia
endocarditis
VRE
not used for pneumonia (inactivated by surfactant)

88
Q

daptomycin ADRs

A

myopathy

rhabdomyolysis

89
Q

metronidazole MOA

A

toxic free radical metabolites that damage DNA
bactericidal
antiprotozoal

90
Q

metronidazole uses

A 
GET GAP on Metro 
Giardia
Entamoeba
Trichomonas
Garderelaa
Anaerobes (bacteroides, C. diff)
H. pylori 
Tx of anaerobic infection below diaphragm (clindamycin above)
91
Q

metronidzole ADRs

A

disulfiram like rxn w/alcohol
HA
metallic taste

Step I (22 decks)

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