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2nd Year - Pharmacology > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

Aminoglycosides

A

Aerobic and facultative gram negative bacteria

Inhibits prtoein synthesis at the 30s subunit Lysis of cell envelope

DOC: enterobacter, E. coli, K. pneumoniae, Proteus, Serratia, P. aeruginosa

PK:

  • Not absorbed in the GIT (administered parenterally)
  • Low protein binding High concentration in the renal cortex and inner ear
  • Significant post-antibiotic effect
  • Once-a-day because it is concentration dependent

ADRs:

  • Ototoxicity
  • Nephrotoxicity
  • Neurotoxicity
  • Hypersensitivity
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2
Q

Virulence factor and MOT of Pseudomonas aeruginosa

A

Endotoxin

Direct contact

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3
Q

Beta Lactams: Enumerate Penicillinase-resistant penicillins

A

Nafcilin

Methicillin

Oxacillin

Cloxacillin

Flucloxacillin

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4
Q

ADR of Nafcillin

A

Neutropenia

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5
Q

ADR of Methicllin

A

Nephrotoxicity

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6
Q

Indications:

  • Pneumonia/bronchopnuemonia for children 6 months to 3 years old
  • Gram positive streptococcus
  • Gram negative H. influenzae
  • UTI
  • Salmonella infection (typhoid fever, carriers)
A

Aminopenicillins

  • ampicillin
  • amoxicillin
  • bacampicillin
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7
Q

Drug of choice for Shigella

A

Ampicillin

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8
Q

Extended Spectrum Penicillins

A
  • Targets grame negative bacteria
  • Pseudomonal penicillins
  • Carbenicillin
  • Ticarcillin
  • Mezlocillin
  • Piperacillin (Tazocin)
  • Azlocillin
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9
Q

Penicillin

A

Spectrum: gram positive (mainly), extended spectrum PCNs also target gram negatives

MOA:

  • binds to PBPs
  • analogs of the D-al-D-ala terminal sequence
  • inhibits transpeptidase enzyme

PK:

  • Poor oral absorption
  • acid labile (PCN G, Methicillin)
  • amoxicillin: good absorption
  • Nafcillin: biliary clearance
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10
Q

Clearance of Nafcillin

A

Biliary Clearance

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11
Q

Probenecid and Penicllin drug interaction

A

Probenecid inhibits secretion of PCN

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12
Q

ADR of Nafcillin

A

Nafcillin: neutropenia

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13
Q

ADR of Oxacillin

A

Hepatitis

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14
Q

ADR of Methicillin

A

Interstitial nephritis

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15
Q

First generation cephalosporins, spectrum, indications

A

Cephalexin, Cefazolin

Spectrum: Staphyloccous, streptococci

Indications: UTI, minor staph infections, minor cellulitis or tissue abscess

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16
Q

Second generation cephalosporins, spectrum of activity

A

Cefuroxime

Cefaclor

Cefoxitin

Spectrum: Gram positive and gram negative

Indicatoions: mixed infections such as diabetic foot ulcers and asphyxiation pneumonia

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17
Q

Cefuroxime is effective for

A

Community acquired pneumonia

Crosses BBB

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18
Q

Penicillin effective againts Bacteroides

A

Cefoxitin

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19
Q

Penicllin effective against H. influenzae

A

Cefamandole

Cefuroxime

Cefaclor

20
Q

Third generation ceophalosporins, spectrum, indications

A

Aerobic gram negative organisms

  • aerobic gram negative bacterial meningitis
  • biliary tract infection
21
Q

Aztreonam: spectrum of activity, MOA, advantage over aminoglycosides and cephalosporins, PK

A

MOA: Binds to PBPs, interferes with cell wall synthesis

Spectrum:

  • Only for aerobic gram negtaive rods, including pseudomonas
  • beta lactamas resistant gram negative rods

PK: not absorbed orally

Advantages:

  • not nephrotoxic
  • remains bactericidal under anaerobic conditions
  • safe to those with anaphylactic reactions to penicillin
22
Q

Carbapenems, MOA, spectrum

A

Carbapenems:

  • Imipenem
  • meropenem
  • Ertapenem

MOA:

  • Bind to PBPs
    • PBP1: bacterial wall’s constant diameter
    • PBP2: extends the bacterial cell wall in any direction
  • Resistant to most beta lactamases

Spectrum: Broad

  • Grame positive cocci
  • Gram negative rods
  • Anaerobes
23
Q

Carbapenems are inactivated by

A

Renal dihydropeptidases –> low renal concetration

24
Q

Carbapenem which inhibits renal dihydropeptidase

A

Cilastatin

25
Q

Beta lactamas inhibitors with negligible antibacterial activity

A
  • Clavulanic acid
  • Sulbactam
  • Tazobactam
26
Q

Indications and adverse effects of chloramphenicol

A

Indications:

  • H. influenzae
  • N. meningitides
  • Bacteroides
  • Salmonella

ADRs:

  • Bone marrow depression: aplastic anemia
  • anemia
  • Gray baby syndrome
  • GIT effects
27
Q

Lincosamides, Indications, ADRs

A

Lincosamides:

  • Lincomycin
  • Clindamycin

Indications:

  • anaerobes
  • gram positive infections (clindamycin)
  • osteomyelitis
  • acne

ADRs:

  • Pseudomembranous colitis
  • superinfection
28
Q

Metronidazole, spectrum of activity, ADRs

A

Indications:

  • effective ageainst amoeba
  • amoeba-like organisms
  • anaerobic infections (gas gangrene)
    • E. histolytica
    • trichomonas
    • giardia lambdia
    • balantidum

ADRs: disulfiram-like ractions

29
Q

Macrolides, spectrum of activity, indications, ADRs

A

Spectrum: gram (+) aerobic bacteria, some gram (-), atypical agents that cause atypical pneumonia

Indications:

  • DOC for Campylobacter, mycoplasma, or Legionella
  • alterantive to beta lactam allergy

ADRs: Liver toxicity (erythromycin estolate)

30
Q

Erythromycin, absorption, excretion, adverse drug reactions

A

Absorption: duodenum, impeded by food

Excretion: biliary excretion, not removed by dialysis

ADRs: intestinal gastric irritation, nausea, vomiting, diarrhea, GI intolerance

31
Q

Clarythromycin, advantage over erythromycin, spectrum of activity

A

Lower incidence of GI intolerance

active against mycobacterium avium complex, m. leprae, toxoplasma gondii, H. influenza

32
Q

Azithromycin, administration, indication

A

Administration: Once a day dosing, given for 3-5 days

Indication:

  • prohylaxis of Mycobacterium avium intracellulare complex,
  • Chlamydia sp.
33
Q

Quinolones, mechanism and mode of action, spectrum of acitivity, ADRs, contraindication

A

Quinolones:

  • Ciprofloxacin
  • levofloxacin

MOA: inhibits DNA gyrase and topoisomerase IV, bactericidal

Spectrum: broad spectrum

ADR: arthropathy

Contrainidications: not for children less than 18 y/o

34
Q

Sulfonamides, MOA, Indications, Contraindications

A

MOA: inhibits folic acid synthesis

Indications:

  • uncomplicated UTI
  • malaria
  • toxoplasmosis
  • pneumocustis carinii in AIDS

Contraindications:

  • Infants less than 2 months old: kernicterus
  • pregnant lactating mothers: neural tube defects
35
Q

Tetracyclines, Spectrum of activity, Indications, ADRs, Contraindications

A

Spectrum: Broad

DOC: mycoplasma, chlamydia, rickettsia, vibrios

Secondary use: syphilis, respiratory infections, leptospirosis, acne

ADRs:

  • GIT
  • photosensitivity
  • hepatotoxicity
  • nephrotoxicity
  • minocycline: vestibular toxicity
36
Q

Vancomycin, MOA, spectrum of activity, indications, ADRs

A

MOA: inhibits synthesis of bacterial cell wall by inhibiting transglycosidase, binds to D-ala-d-ala terminus

Spectrum: narrow: only on cocci

Indications: DOC for serious drug resistant gram positive organisms

ADRs:

  • Thrombophlebitis
  • Nephrotoxic
  • Ototoxic
  • Hypersensitivity: red man syndrome, hypotension, pain and spasm syndrome
37
Q

Main clinical use for streptogramins

A

Treatment of vancomycin-resistant strains of enterococcus faecium

38
Q

Bacitracin is good against __

A

Staphylococcus aureus

39
Q

Urinary antiseptics

A

Nitrofurantoin

Methenamine hippurate: acidifies urine and releases formaldehyde

Phenazopyridine

40
Q

Sulfonamides are primarily metablized by what mechanism

A

Acetylation

41
Q

The most important reason for limited clinical use of chloramphenicol

A

Potential for bone marrow suppression

42
Q

Tetracyclines are avoided in pregnancy because of

A

Enamel dysplasia in the offspring

43
Q

Which antimicrobial group has neuromuscular blocking actions

A

Aminoglycosides

44
Q

Which anti-TB drug causes hyperuricemia

A

Pyrazinamide

45
Q

Which antimalarial is ototoxic and contrainidicated in 3rd trimester of pregnancy

A

Quinine

2nd Year - Pharmacology (18 decks)

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