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ID > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

Detail the mechanism of action of sulfonamides.

A

Inhibit folic acid synthesis
Compete with PABA for dihydropteroate synthase
Bacteriostatic

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2
Q

Detail the mechanism of action of fluoroquinolones.

A

Inhibit DNA gyrase

Bactericidal

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3
Q

Define an antimetabolite.

A

A drug, through chemical similarity, inhibits normal cellular metabolism

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4
Q

What compound do sulfonamides mimic?

A

PABA

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5
Q

What enzyme is inhibited by trimethoprim?

A

Dihydrofolate reductase

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6
Q

Define sequential blockade.

A

Combined action of 2 drugs that inhibit sequential steps in a pathway of bacterial metabolism

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7
Q

Is the combination of trimethoprim + sulfamethoxazole bactericidal or bacteriostatic?

A

Bactericidal

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8
Q

Trimethoprim-sulfamethoxazole is established to be effective against what opportunistic protozoal infection in an AIDS patient?

A

Toxoplasmosis

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9
Q

What drug class is effective at treating diarrhea caused by gram - pathogens?

A

Fluoroquinolones

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10
Q

List 3 fluoroquinolones.

A

Ciprofloxacin
Levofloxacin
Moxifloxacin

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11
Q

What compounds interfere with fluoroquinolone absorption?

A

Multivalent cations

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12
Q

What effect do fluroquinolones and aminoglycosides have on normal flora after the plasma concentration of the drug has fallen below the minimum inhibitory concentration?

A

Postantibiotic effects- continued inhibition of bacterial growth

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13
Q

What infections are fluroquinolones effective at treating?

A

Urogenital and GI tract infections due to gram negative organisms

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14
Q

What are the major antibiotics that inhibit bacterial wall synthesis?

A 
Penicillins
Cephalosporins
Carbapenems
Monobactams
Vancomycin
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15
Q

Define bactericidal.

A

Kills bacteria

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16
Q

Define bacteriostatic.

A

Does not kill bacteria, but inhibits growth

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17
Q

What drug classes are considered beta-lactam antibiotics?

A

Penicillins
Cephalosporins
Carbapenems

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18
Q

Define beta-lactmases.

A

Bacterial enzymes that hydrolyze the beta-lactam ring of certain beta-lactam antibiotics

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19
Q

Define minimal inhibitory concentration.

A

Lowest concentration of a drug capable of inhibiting growth of an organism

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20
Q

Penicillins are polar compounds and are not metabolized extensively; usually, they are excreted in the urine via glomerular filtration and tubular secretion. What drug inhibits the latter process?

A

Probenecid- used to treat gout

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21
Q

Are beta-lactam antibiotics bactericidal or bacteriostatic?

A

Bactericidal

22
Q

What are inhibitors of bacterial penicillinases?

A

Clavulanic acid
Sulbactam
Tazobactam

23
Q

What is the mechanism of penicillin resistance responsible for MRSA and PRSP?

A

Structural changes in PBP

24
Q

Which penicillin is administered parenterally? Which penicillin is administered orally?

A

Parenterally- Penicillin G

Orally- Penicillin V

25
Q

Penicillin G is clinically useful in the treatment of infections caused by what organisms?

A

Common streptococci
Meningococci
Gram positive rods
Spirochetes

26
Q

Is penicillin used to treat gonorrhea? Syphilis?

A

Gonorrhea- no

Syphilis- yes

27
Q

What drugs have a wider spectrum of antibacterial activity than penicillin G, but remain susceptible to penicillinases?

A

Extended spectrum penicillins- Ampicillin, Amoxicillin

Antipseudomonal penicillins- Piperacillin (adds coverage for gram negatives)

28
Q

What toxicities are associated with the penicillins?

A

Allergy

GI disturbances

29
Q

Interstitial nephritis is associated with what penicillin?

A

Methicillin

30
Q

What penicillin is associated with neutropenia?

A

Nafcillin

31
Q

Penicillin can cause a rash and hemolytic anemia, contrast the hypersensitivity reactions associated with each.

A

Rash- type 1

Hemolytic anemia- type 2

32
Q

Detail the mechanism of action of the cephalosporins.

A

Bind to PBPs- bactericidal

33
Q

Are MRSA strains resistant to cephalosporins?

A

Yes

34
Q

What are examples of first generation cephalosporins?

A

Cephalexin (po)

Cefazolin (parenteral)

35
Q

What are examples of second generation cephalosporins?

A

Cefuroxime

Cefaclor

36
Q

What are examples of third generation cephalosporins?

A

Ceftriaxone
Ceftazidime
Cefdinir
Cefepime

37
Q

What are examples of fourth generation cephalosporins?

A

Cefepime

Ceftaroline

38
Q

Sinus, ear, and respiratory infections caused by H. influenzae or M. catarrhalis can be treated with what class of drugs?

A

Second generation cephalosporins

39
Q

What generation of cephalosporins have good penetration of the BBB?

A

Third

40
Q

A patient has a history of anaphylaxis to penicillins, can they be treated with a cephalosporin?

A

No

41
Q

What are examples of carbapenems?

A

Imipenem

Ertapenem

42
Q

Why is cilastatin given with imipenem IV?

A

Inhibits dehydropeptidase- enzyme in kidney that degrades imipenem

43
Q

Carbapenems are useful for what types of infections?

A

Infections caused by organisms resistant to other antibiotics

44
Q

Where does vancomycin bind?

A

D-Ala-D-Ala terminal of bacterial wall peptidoglycan

45
Q

What confers vancomycin resistance in strains of enterococci and staphylococci?

A

Replacement of terminal D-Ala by D-lactate

46
Q

Bacitracin inhibits cell wall synthesis in gram-positive organisms, however, it is reserved for topical use, why?

A

Nephrotoxic

47
Q

Daptomycin is active against vancomycin resistant strains of enterococci and staphylococci, why should creatine phosphokinase me monitored in a patient being treated with this drug?

A

Daptomycin can cause myopathy

48
Q

A 33-year-old man was seen in a clinic with a complaint of dysuria and urethral discharge of yellow pus. He had a painless clean-based ulcer on the penis and nontender enlargement of the regional lymph nodes. Gram stain of the urethral exudate showed gram-negative diplococci within PMNs. What is the most appropriate treatment of gonorrhea in this patient?

A

Ceftriaxone IM as single dose

49
Q

You want to start a patient with renal failure on imipenem, why must the dosing be adjusted for this patient?

A

Imipenem is hydrolyzed by renal dehydropeptidase, in the setting of renal failure toxic levels of the drug can cause CNS toxicity (seizures)

50
Q

What is the mechanism by which pneumococci are resistant to penicillin G?

A

Changes in chemical structure of penicillin binding protein

ID (28 decks)

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