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Antimicrobials Flashcards

1
Q

oseltamivir

A

PO
inhibition of release of influenza from infected cell
Tx: Influenza A and B
AE: skin rxn rare
Ci: dose adjust in renal impairment, neuropsychiatric

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2
Q

zanamivir

A

inhalation
inhibition of release of influenza from infected cell
Tx: Influenza A and B
AE: viral infection
CI: PULMONARY (bronchospasm: need bronchodilator)

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3
Q

amantadine

A 
PO
inhibition of viral entry or uncoating
Tx: Influenza A, PARKINSONS 
AE: neuro, orthostatic hypotension
CI: narrow angle glaucoma, breastfeeding
Excretion: RENAL
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4
Q

rimantadine

A

PO
inhibition of viral entry or uncoating
Tx: Influenza A

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5
Q

ribavirin

A

inhalation, IV
inhibition of viral nucleic acid synthesis
Tx: RSV, human metapenumovirus, hantavirus
AE: fatigue, myalgia, BBB: HEMOLYTIC ANEMIA and TERATOGEN (all trimesters and M/F)
Need routine: CBC and Hct/Hgb

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6
Q

cidofovir

A

IV
inhibition of viral DNA synthesis (DNA polymerase inhibition)
Tx: Adenovirus
AE: neuro, hematologic, BBB: RENAL

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7
Q

acyclovir

A

IV
inhibition of viral DNA synthesis (DNA polymerase inhibition)
viral thimidylate kinaseactivate to triphosphate form
Tx: Varicella-zoster virus
AE: elevated hepatic enzymes, HYDRATE to prevent renal precipitation, neutropenia

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8
Q

valacyclovir

A

PO

prodrug for acyclovir

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9
Q

flucytosine

A

PO
converted to 5-FU
noncompetitive inhibitor thymidylate synthase
Tx: cryptococcus
AE: anemia, BLOOD DYSCRASIAS, agranulocytosis

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10
Q

amphotericin B

A

IV
bind sterols and increase membrane permeability
Tx: severe fungal infections
AE: metabolite nephrotoxic (pore in membrane); anemia (due to kidney damage)
lipid formula: less nephrotoxic
CI: hypokalemic drugs
lpid formula: less nephrotoxic

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11
Q

azoles

A

inhibition of lanosterol-14a-sterol demethylase: inhibition of ergosterol synthesis
CYP metabolism: 2C9, 2C19, 3A4
Res: Aspergillus: mutation in promoter region of CYP51A that encodes MOA enzyme

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12
Q

itraconazole

A

azole

low oral absorption

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13
Q

fluconazole

A

azole

crosses BBB

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14
Q

isoniazid

A

PO
inhibit mycolic acid synthesis
induces CYP, distributes to CSF, placenta, breastmilk
AE: peripheral neruopathy (use B6: PYRIDOXINE), hepatotoxicity, allergic rxn
CI: antacids, LEVODOPA, increases acetaminophen toxicity
Tx: TB
fast ACETYLATORS: less effective

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15
Q

rifampin

A

PO: impaired by food, para-aminosalicylic acid
inhibits beta subunit of DNA-dependent RNA pol
CSF distribution
CYP inducer (NOT 2D6)
Tx: TB, meningococcal infection, MRSA
AE: ORANGE secretions, HEPATOTOXIC, GI, nervous system, chills, aches, fever
CI: CYP drugs, oral anticoagulants, oral contraceptives, probenecid

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16
Q

pyrazinamide

A

PO
unknown MoA: pyrazinamidase converts to pyrazinoic acid (pH too low for growth)
CSF, breast milk distribution
Tx: TB
AE: HEPATOTOXICITY, ARTHRALGIA, HYPERURICEMIA

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17
Q

ethambutol

A

PO
inhibits arabinosyl transferase: increased all permeability
CSF, placenta, breastmilk distribution
Tx: TB adjunct
AE: OPTIC neuritis (acuity, color discrimination, reduced visual field), allergic rxn, HYPERURICEMIA
CI: antacids

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18
Q

macrolides

A

MYCIN
50s ribosomal inhibitor: blocks translation
Tx: CAP and/or bronchitis
AE: cholestatic jaundice, QT PROLONGATION

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19
Q

erythromycin

A

1st gen. macrolide
Tx: CAP
CYP3A4/Pgp inhibitior
AE: hepatotoxicity in pregnant women

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20
Q

azithromycin

A

3rd gen. macrolide

Tx: CAP, bronchitis

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21
Q

tetracycline

A

CYCLINE
30s ribosomal inhibitor: block translation
AE: TEETH DISCOLORATION, GI, PHOTOSENSITIVITY, CARDIOTOXIC, decrease bone growth
CI: pregnancy (bone, teeth), nursing (photosensitive infant)

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22
Q

doxycycline

A

tetracyline

Tx: CAP, bronchitis

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23
Q

fluoroquiniolones

A

FLOXACIN
DNA gyrase inhibitor preventing DNA replication
Tx: CAP
AE: tendon rupture, cartilage damage in children, QT PROLONGATION
CI: adjust for renal impairment, pregnancy

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24
Q

levofloxacin

A

fluoroquinolone

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25
Q

penicillins

A

CILLIN
block cell wall cross-linking by binding to PBP
AE: hypersensitivity

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26
Q

amoxicillin

A

broad spectrum penicillin
Tx: CAP, bronchitis
with CLAVULONIC ACID
better oral bioavailability than ampicillin

27
Q

piperacillin

A

broad spectrum penicillin
with TAZOBACTAM
Tx: nocosomial pneumonia
AE: decreased coagulation

28
Q

clavulanic acid

A

B-lacatmase inhibitor

with AMOXICILLIN or AMPICILLIN

29
Q

tazobactam

A

beta lactamase inhibitor

with PIPERACILLIN

30
Q

carbopenem

A

blocks cell wall cross linking
AE: penicillin hypersensitivity, SEIZURES
CI: adjust for renal
CILASTATIN

31
Q

meropenem

A

carbopenem
Tx: CAP
CILASTATIN

32
Q

cephalosporins

A

CEF or CEPH
inhibition of cell wall cross-linking by binding PCB
AE: GI, hypersensitivity
CI: adjust for renal impairment (not needed for cefuroxime or ceftriaxone)
resistance: alter permeablility of outer membrane in gram -

33
Q

cefazolin

A

1st gen. cephalosporin

Tx: CAP

34
Q

cefuroxime

A

2nd generation cephalosporin

Tx: CAP

35
Q

3rd generation cephalosporin

A

ceftriaxone
ceftazidime
Tx: CAP, nocosomial pneumonia

36
Q

ciprofloxacin

A

fluoroquinolone

Tx: CAP (reserved for ICU), P. aeurginosa, bronchitis

37
Q

ceftriaxone

A

3rd gen cephalosporin

Tx: lung abscess

38
Q

ceftazidime

A

3rd gen cephalosporin

Tx: pseudomonas

39
Q

cefepime

A

4th gen. cephalosporin

Tx: CAP, nocosomial pneumonia, pseudomonas

40
Q

aminoglycosides

A

gentamicin

30s ribosomal inhibitor

41
Q

gentamicin

A

aminoglycoside

42
Q

Tx of outpatient CAP

A

macrolide or doxycycline

43
Q

Tx of outpatient CAP with COPD with steroids with steroids or antibiotics in last 3 months

A

fluoroquinolone or
amox/clav or
2nd gen macrolide with/out cephalosporin

44
Q

Tx of outpatient Cap with COPD (no steroids or antibiotics in 3 months)

A

2nd gen macrolide or doxycycline

45
Q

Tx of CAP in nursing home

A

fluoroquinolone or
amox/clav or
2nd gen macrolide with/out cephalosporin

46
Q

Tx of hospital ward CAP

A

fluoroquinolone or
amox/clav or
2nd or 3rd gen macrolide with/out cephalosporin

47
Q

Tx of CAP in ICU

A

3rd gen cephalosporin

with/out macrolide or piperacillin/tazobactam or flouroquinolone

48
Q

Tx of CAP in ICU with P. aeruginosa

A

antipseudomonal fluoroquinolone with B-lactam or

macrolide and 2 antipsuedomonal agents

49
Q

antipseudomoal agents

A 
ciprofloxacin
aminoglycosides
meopenem
piperacillin/tazobactam
3rd gen cephalosporins
50
Q

posaconazole

51
Q

voriconazole

52
Q

cycloserine

A 
PO
cell wall synthesis inhibitor: D-ala analog
CSF, placenta, breast milk distribution
Tx: TB (MDR), M. avium complex, UTI
AE: CNS
CI: alcohol (seizures), epileptics
53
Q

ethionamide

A

peptide synthesis inhibitor: analog of isoniazid
CSF distribution
AE: GI, neuro (give PYRIDOXINE), hepatic
Tx: TB

54
Q

capreomycin

A

IM
MoA unknown
Tx: TB (XDR): LAST LINE
AE: nephrotoxic, ototoxic, eosinophilia, electrolytes, acute RTN

55
Q

clarithomycin

A

macrolide
Tx: bronchitis
AE: TERATOGEN, caution with breastfeeding

56
Q

aminoglycosides

A

30s ribosomal inhibitor
Tx: CAP
AE: NEPHROTOXIC, OTOTOXIC, neuromuscular paralysis, TERATOGEN
CI: adjust for renal impair

57
Q

imipenem

A

carbopenem
Tx: nocosomial pneumonia
give with: CILASTATIN

58
Q

cilastatin

A

inhibitor of renal dehydropeptidase I

stops renal inactivation of CARBAPENEMS

59
Q

aztreonam

A

monobactam: PCB inhibitor
Tx: nosocomial pneumonia

60
Q

ampicillin

A

broad spectrum penicillin
with CLAVULANIC ACID
Tx: aspiration pneumonia

61
Q

vancomycin

A

inhibits cell wall peptidoglycan synthesis: D-ala, D-ala
Tx: nosocomial pneumonia
AE: RED MAN syndrome, NEPHROTOXIC, OTOTOXIC

62
Q

clindamycin

A

lincosamide: inhibits 50s
Tx: aspiration pneumonia, lung abscess
AE: GI

63
Q

metronidazole

A

nitroimidazole: free radical metabolites in cell that damages DNA
Tx: lung abscess, nosocomial infection
AE: metallic taste, DISULFIRAM rxn, expiramental mutagen/carcinogen

Pulm (11 decks)

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