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Pharmacology > Antimicrobials > Flashcards

Antimicrobials Flashcards

Learn the major classes of antimicrobials, the drugs in each, what class a drug belongs to, and the mechanism of action of each class. Specific resistance mechanisms and pharmacokinetics/ROA indications are not covered. MOA = mechanism of action

1
Q

4 ways bacteria resist antimicrobials

A

Alter receptor target; decrease entry in or out of; alter metabolic pathway; inactivate drug directly

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2
Q

Mechanisms of antimicrobial action

A

Inhibit: cell wall synthesis, protein synthesis, folic acid synthesis, or DNA/RNA synthesis

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3
Q

Penicillins mechanism of action

A

Inhibit cell wall synthesis by binding to transpeptidase, a PBP, preventing cell wall peptidoglycan layer synthesis

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4
Q

Natural penicillins

A

Penicillin G and V

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5
Q

Penicillin G ROE

A

IM or IV

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6
Q

Natural penicillins microbe targets

A

G+

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7
Q

Penicillin V ROE

A

oral on empty stomach

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8
Q

Ampopenicillins

A

Ampicillin and amoxicillin

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9
Q

Ampopenicillins ROE

A

Enteral or parenteral

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10
Q

Penicillinase-resistant penicillins

A

dicloxacillin, methicillin, oxacillin, nafcillin

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11
Q

Penicillinase-resistant penicillins are named because

A

Side groups prevent B-lactmases from degrading them

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12
Q

Irreversible B-lactamase inhibitors

A

Clavulanic acid, sulbactam, tazobactam

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13
Q

People allergic to penicillins shouldn’t take this class of antibiotics

A

Cephalosporins

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14
Q

B-lactams MOA

A

cell wall synthesis

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15
Q

Vancomycin MOA

A

cell wall synthesis

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16
Q

Trimethoprim MOA

A

Folic acid synthesis (dihydrofolate reductase inhibition)

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17
Q

Sulfonamides MOA

A

Inhibits folic acid production (dihydropteroate synthetase inhibition - upstream from Trimethoprim)

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18
Q

Quinolones MOA

A

DNA synthesis

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19
Q

Rifampin MOA

A

Inhibits bacterial RNA polymerase; used for mycobacterial infections

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20
Q

Chloramphenicol MOA

A

Protein synthesis - 50S

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21
Q

Macrolides MOA

A

Protein synthesis - 50S

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22
Q

Clindamycin MOA

A

Protein synthesis - 50S

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23
Q

Tetracyclines MOA

A

Protein synthesis - 30S

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24
Q

Aminoglycosides MOA

A

Protein synthesis - 30S

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25
Q

Monobactams MOA

A

Cell wall synthesis

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26
Q

Carbapenems MOA

A

Cell wall synthesis

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27
Q

These penicillin classes are used to treat G+

A

Natural penicillins and penicillinase-resistant penicillins

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28
Q

These penicillin classes are used to treat G-

A

Aminopenicillins and antipseudomonal penicillins

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29
Q

Antipseudomonal penicillins

A

Carbenicillin, ticarcillin, mezlocillin, piperacillin

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30
Q

This drug when administered orally is limited in use to treating UTIs

A

carbenicillin

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31
Q

B-lactamase inhibitors

A

Clavulanic acid, sulbactam, tazobactam

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32
Q

Combine this class of drug with penicillins to broaden spectrum

A

Irreversible B-lactamase inhibitors

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33
Q

Carbapenems

A

imipenem/cilastatin, doripenem, ertapenem, meropenem

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34
Q

Carbapenems - bactericidal or bacteriostatic?

A

Bactericidal

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35
Q

Carbapenems have this advantage over penicillins and cephalosporins

A

B-lactamase resistant

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36
Q

Other cell wall disrupters

A

telavancin, vancomycin

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37
Q

Vancomycin MOA

A

Blocks polymerization and cross-linking of peptidoglycan by binding to Ala-Ala pair

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38
Q

Cycloserine MOA

A

Blocks cell wall synthesis in G+ and G-

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39
Q

Cycloserine is usually reserved for this disease

A

TB

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40
Q

Polymyxin B MOA

A

Disrupts PM in all G- except Proteus

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41
Q

Aminoglycosides

A

Amikacin, gentamicin, kanamycin, netilmicin, streptomycin, tobramycin, neomycin

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42
Q

Aminoglycosides are limited to treating this type of bacterial infection

A

G-

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43
Q

Major side effects of aminoglycosides

A

Ototoxicity and nephrotoxicity via accumulation due to high water solubility

44
Q

Antimicrobial effect observed even as aminoglycoside [plasma] decreases

A

Postantibiotic effect - translation still inhibited

45
Q

Tetracyclines

A

tetracycline, minocycline, doxycycline, demeclocycline, oxytetracycline, tigecycline

46
Q

Absorption of tetracyclines may be inhibited by these

A

Divalent cations (Ca2+, Mg2+) = don’t take with milk or antacids!

47
Q

This tetracycline is safest for patients with renal dysfunction and say why

A

Doxycycline because it is excreted in feces

48
Q

Lincosamides

A

clindamycin

49
Q

Clindamycin MOA

A

Binds 50S subunit and prevent translation

50
Q

Macrolides

A

erythromycin + anything = macrolide; clarithromycin, azithromycin

51
Q

Erythromycins have this significant cardiovascular side effect - except one member of the class

A

Prolong TQ interval which can lead to fatal arrythmia - azithromycin doesn’t do this

52
Q

Ketolides

A

Telithromycin

53
Q

Ketolides MOA

A

Bind 50S in two different domains, requiring 2 mutations to develop resistance

54
Q

Retapamulin MOA

A

A “pleuromutlin” antibiotic that blocks protein synthesis by interfering with peptidyl transferase, preventing 50S formation

55
Q

Penicillin G

A

Natural penicillin (readily destroyed in acidic environments so only IV or IM)

56
Q

Penicillin V

A

Natural penicillin (oral administration on empty stomach)

57
Q

Ampicillin

A

Aminopenicillin (enteral or parenteral)

58
Q

Amoxicillin

A

Aminopenicillin (enteral or parenteral)

59
Q

Dicloxacillin

A

Penicillinase-resistant penicillins

60
Q

Dicloxacillin

A

Penicillinase-resistant penicillins

61
Q

Methicillin

A

Penicillinase-resistant penicillins

62
Q

Oxacillin

A

Penicillinase-resistant penicillins

63
Q

Nafcillin

A

Penicillinase-resistant penicillins

64
Q

Carbenicillin

A

Antipseudomonal penicillin

65
Q

Ticarcillin

A

Antipseudomonal penicillin

66
Q

Mezlocillin

A

Antipseudomonal penicillin

67
Q

Piperacillin

A

Antipseudomonal penicillin

68
Q

Clavulanic acid

A

B-lactamase inhibitor

69
Q

Sulbactam

A

B-lactamase inhibitor

70
Q

Tazobactam

A

B-lactamase inhibitor

71
Q

Iminipenem/clastatin

A

Carbapenems

72
Q

Doripenem

A

Carbapenems

73
Q

Ertapenem

A

Carbapenems

74
Q

Meropenem

A

Carbapenems

75
Q

Telavancin

A

Other cell wall inhibitors

76
Q

Vancomycin

A

Other cell wall inhibitors

77
Q

Cycloserine

A

Other cell wall inhibitors

78
Q

Polymyxin B

A

Other cell wall inhibitors

79
Q

Amikacin

A

Aminoglycosides (protein synthesis inhibitors)

80
Q

Gentamicin

A

Aminoglycosides

81
Q

Kanamycin

A

Aminoglycosides

82
Q

Netilmicin

A

Aminoglycosides

83
Q

Streptomycin

A

Aminoglycosides

84
Q

Tobramycin

A

Aminoglycosides

85
Q

Neomycin

A

Aminoglycosides

86
Q

Tetracyclines are easy to name because

A

they all have -cycline

87
Q

Clindamycin

A

Lincosamide

88
Q

Erythromycin and its derivatives

A

Macrolides

89
Q

Clarithromycin

A

Macrolides

90
Q

Azithromycin

A

Macrolides

91
Q

Telithromycin

A

Ketolides

92
Q

Streptogramins are a combination of these

A

Quinupristin and dalfopristin

93
Q

Sulfa-anything

A

Sulfonamides

94
Q

Any-floxacin

A

Fluoroquinolones

95
Q

Fluoroquinolones MOA

A

Inhibit DNA synthesis (DNA gyrase or topoisomerase IV)

96
Q

Daptomycin

A

Lipopeptides

97
Q

Linezolid MOA

A

Binds 50S subunit preventing 70S formation

98
Q

Mupirocin has a unique MOA and usability because…

A

No cross-resistance risk; inhibits tRNA that transports isoleucine

99
Q

Metronidazole MOA

A

Absorbed only be anaerobes and some protozoans; its metabolism generates toxic metabolites that inhibit DNA synthesis (mutagenic and possibly carcinogenic so contraindicated during 1st trimester)

100
Q

Nitazoxanide MOA

A

Interferes with pyruvate electron transfer, necessary for anaerobic matabolism

101
Q

Tinidazole MOA

A

Damages DNA and inhibits further synthesis (thus is mutagenic and possibly carcinogenic and contraindicated during 1st trimester)

102
Q

Daptomycin MOA

A

Binds to bacterial PM and disrupts membrane potential, causing rapid depolarization and inhibition of DNA/RNA/protein synthesis (so unique that no cross-resistance known)

103
Q

Rifaximin MOA

A

Binds bacterial RNA polymerase

104
Q

Isoniazid MOA

A

Inhibits mycolic acid synthesis, which is required by mycobacteria

105
Q

Pyrazinamide MOA

A

Unclear (but we have to know it?) but may lower pH in tubercle cavity

106
Q

Ethambutol MOA

A

Inhibits RNA synthesis (mycobacteria)

107
Q

Clofazimine MOA

A

Inhibits mycobacterial RNA polymerase

Pharmacology (3 decks)

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