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Unit 1 ID+LC > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

Minimum inhibitory concentration (MIC)

A

stops growth

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2
Q

Minimum bactericidal concentration (MBC)

A

kills 99%

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3
Q

bacteriostatic vs

bacteriocidal

A

stops growth/reproduction of bacteria

Kills bacteria directly

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4
Q

Broad spectrum antimicrobials

A
  1. Chloramphenicol
  2. Tetracycline
  3. Sulfonamides
  4. Trimethoprim

*assume everything else is narrow if it isnt also on extended antimicrobials list

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5
Q

Extended use antimicrobials

A
  1. Aminoglycosides
  2. Macrolides
  3. Streptogramins
  4. Extended spec- PCNs
  5. Cephalosporins
  6. Carbapenems
  7. FQ

*assume everything else is narrow if it isnt also on broad spect. antimicrobials list

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6
Q

Cell wall synthesis inhibitors

A
  1. B lactams
    - PCNs, Cephalo, Carbapen, Monobactams
  2. Glycopeptides
    - Bacitracin
    - Vancomycin
  3. Cycloserine (TB)
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7
Q

Penicillins

  • MOA
  • Pharmacokinetics (excretion)
  • Adverse rxn
A

MOA: Inhibit cell wall synth, bactericidal

Pharmacokinetics:
Renal excretion

Adverse:
Anaphylaxis (Type I)
Rash (Type III)
Convulsions at high dose

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8
Q

Which of the PCNs are good oral and which good IV?

A

All are good oral except:

  1. PCN G (IV/IM)
  2. Anti-pseudomonal (IV)
    - Piperacillin (B lactamase inhib)

All rest are good oral

  1. Pen V
  2. PCNase resistant
    - Methicillin
    - Oxacillin
  3. Extended spectrum
    - Ampicillin
    - Amoxicillin (w/ B lactam inhib)
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9
Q

Which are harder to treat? Gram - or Gram +?

A

Gram - : thin cell wall
- like a thin bullet proof vest - diff to penetrate

(Gram + have thick cw: like thick dry wall which absorbs more)

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10
Q

Spectrum/Uses (targets) of:
Pen G
Pen V

A

Gram +/- cocci,

Gram + bacilli, most anaerobes

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11
Q

Spectrum/Uses (targets) of:

Penicillinase resistant PCNs

A

B-lactamase producing S. aureus

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12
Q

Spectrum/Uses (targets) of:

Extended spectrum PCNs

A

Now PCN can target Gram -

*ie: enterobacteriaceae, H. flu, E. coli

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13
Q

Spectrum/Uses (targets) of:

Antipseudomonal (PCN)

A

Less Gram + (like nl PCN) and more Gram -

  • remember gram - are harder to treat
  • Ie: pseudomonas, bacteroides
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14
Q

List Cephalosporins (182)
1st gen:
2nd gen:
3rd gen:

A

1st gen:
- Cefazolin, Cephalexin

2nd gen:
- Cefoxitin, Cefaclor, Cefuroxime

3rd gen:
- Ceftriaxone, Cefoxatime, ceftazidime

4th:
- Cefipine

5th:
- Ceftaroline

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15
Q

Pharmacokinetics of Cephalosporins

- which one can distribute well to CSF?

A

Most IV, some po

3rd gen distributes well to CSF
- Ceftriaxone, cefoxatime, ceftazidime

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16
Q

Protein synthesis inhibitors

A
  1. Cloramphenicol
  2. Clindamycin
  3. Oxazolidinones*
    - Linezolid
  4. Macrolides
  5. Streptogramins**
  6. AG
  7. TCN
  8. Rhupirocin
17
Q

Which protein synthesis inhibitors target 30s and which at 50s bacterial subunit? (leaving hu 80s unaffected)

A

buy AT 30, CCEL at 50
(184)

30s:
Aminoglycosides (cidal)
Tetracycline (static)

50s:
Chloramphenicol
Clindamycin (cidal)
Erythromycin (static)
Linezolid
18
Q

List aminoglycosides

A

(184) “mean” for ameanoglycoside

mean GNATS

Gentamycin
Neomycin
Amikacin
Tobramycin
Streptomycin
19
Q

Toxicity for aminoglycosides

A

(184) “mean” GNATS caNNOT kill anaerobes

Nephrotoxicity
Neuromuscular block
Ototoxicity (esp with loop diuretic)
Teratogen

20
Q

Spectrum of Aminoglycosides

A

Med spectrum Gram - aerobes

TB

21
Q

All protein synthesis inhibitors have GOOD po and IV pharmacokinetics, except ____ which is only good po, and _____ which is only good IV

A

Tetracycline: good po
- renal/biliary excret

Streptogramins: IV only
- hepatic elim

22
Q

Tetracycline (TCN, doxycycline, minocycline) toxicity

A
  1. GI distress (interacts with metal ions in antacids/milk)
  2. Discoloration of teeth and inhibit bone growth in children (bone distribution)
  3. Photosensitivity
  4. Fungal Superinfections
23
Q

Spectrum/use of tetracyclines

A

drugs ability to accumulate intracellularly makes them very effective against Rikettsia and Chalmydia

  1. Rikettsia
  2. Chlamydia
  3. Borrelia (spirochete)
  4. M. pneumonia
24
Q

Pharmacokinetic of macrolides

A

Good PO + IV

  • Concetrates in lungs
  • Hepatic metabolism to active metabolite
  • Biliary elim
25
MOA of macrolides
Macrolides block macroSLIDES | - bind to 23S rRNA of the 50s subunit and inhibit protein synthesis
26
Toxicity of macrolides
MACRO toxicity for macrolides ``` Motility issues (GI) Arrythmia Cholestatic hepatitis Rash eOsiniphilia ``` Drug interactions due to inhibition of P450
27
CLinical use of macrolides
atypical pneumonias - Mycoplasma - Chlamydia - Legionella STIs - chlamydia GPC - streptococcal infxn in pts allergic to PCN B. pertussis
28
Chloramphenicol clinical use
Broad spectrum 1. Meningitis - H. flu - N. meningitidis - S. pneumoniae 2. Rocky Mt spotted fever - Rikettsia rikettsii
29
Chloramphenicol toxicity
1. Anemia (dose dep) 2. aplastic anemia 3. gray baby syndrome - in premature infants bc they lack liver UDP glucuronyl transferase
30
Chloramphenicol pharmacokin
Good PO, IV, distrib (CNS/CSF) Metabolized via glucuronidation *gray baby syndrome can result in premature infants
31
Clindamycin (185) | Pharmacokinetics
Good PO and IV (Like most protein synthesis inhibitors) Penetrates into bone Hepatic metabolism (treats anaerobic infxns above the diaphragm vs metronidazole which tx below)
32
Clindamycin (185) adverse rxns
Pseudomembranous colitis (c. diff overgrowth) Fever, severe diarrhea
33
Clinical use of Clindamycin
Narrow spectrum 1. Oral infxn 2. Anaerobic infections in aspiration pneumonia - Bacteroides, C. perfringens 3. Lung abscesses 4. invasive GAS (gram +) **
34
Which two groups of Protein synth inhibitors can cover Vanco resistant Enterococcus faecium (VREF)?
Streptogramins - Synercid Oxazolidinones - Linezolid *both inhibit at 50s subunit
35
MOA and Pharmacokinetic of Streptogramins (pristins) and Oxazolidinones (linezolid)
protein synth at 50s subunit IV *linezolid can give good PO too
36
Adverse rxns of streptogramins
Inhibits CytP450 | - increase plasma lvl of drugs
37
Adverse rxns of oxazolidinones
``` Serotonin Syndrome: - HA - D/N (gastro) Inhibits MAO - muscle rigidity - seizure ``` Peripheral neuropathy Bone marrow suppression
38
Which antimicrobial agent to use against G+ species INCLUDING MRSA and VRE
Oxazolidinones | - Linezolid

Unit 1 ID+LC (32 decks)

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