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PANCE > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

What is the mechanism of action of Beta-Lactams and what are examples of Beta-Lactams

A

Inhibit Cell Wall Production

Penicillins (Penicillin, Ampicillin, Amoxicillin) and Cephalosporins (Cephalexin, Cefuroxime, Ceftriaxone)

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2
Q

What is the mechanism of action of Glycopeptides and what are examples of Glycopeptides

A

Inhibit Cell Wall Production

Vancomycin

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3
Q

What is the mechanism of action of Macrolides and what are examples of Macrolides

A

Inhibit Protein Synthesis (50S Ribosome)

Erythromycin, Clarithromycin, Azithromycin

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4
Q

What is the mechanism of action of Tetracylines and what are examples of Tetracyclines

A

Inhibit Protein Synthesis (30S Ribosome)

Tetracycline, Minocycline, Doxycycline

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5
Q

What is the mechanism of action of Fluoroquinolones and what are examples of Fluoroquinolones

A

Inhibit DNA synthesis

Ciprofloxacin, Levofloxacin, Moxifloxacin

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6
Q

What is the mechanism of action of Metronidazole

A

Inhibits DNA synthesis by altering DNA

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7
Q

What is the mechanism of action of Trimethoprim-Sulfamethoxazole and what is another name for TMP-SMX

A

Inhibits Folic Acid Synthesis

Bactrim

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8
Q

What drugs are considered Bacteriocidal and what does this mean

A

Kills bacteria

Beta-Lactams, FQ, Glycopeptides, Aminoglycosides, Metronidazole

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9
Q

What drugs are considered Bacteriostatic and what does this mean

A

Stop the reproduction of bacteria

Tetracyclines, Macrolides, Sulfonamides

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10
Q

What drugs are excreted renally

A 
Beta-Lactams
Glycopeptides
FQ
Tetracyclines
Aminoglycosides
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11
Q

What drugs are excreted hepatically

A

Ceftriaxone
Macrolides
Metronidazole

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12
Q

What drugs can increase an INR

A

Metronidazole
Bactrim
Macrolides, FQ

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13
Q

What drugs can decrease an INR

A

Rifampin

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14
Q

What drugs have a risk of causing dysrhythmias

A

Macrolides (Azithromycine)

Fluoroquinolones

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15
Q

What drugs are associated with permanent sensorineural hearing loss

A

Aminoglycosides (Gentamicin)

Vancomycin

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16
Q

What drugs are assocaited with transient vestibular dysfunction (dizziness, N/V)

A

Minocycline

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17
Q

What drugs have been known to cause Acute Tubular Necrosis and other nephrotoxicites

A

Aminoglycosides, like Gentamicin

Vancomycin

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18
Q

What are some side effects of Metronidazole

A

N/V/D, Abdominal Cramps

Flushing, Tachycardia, Headache

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19
Q

What drug can cause Red Man Syndrome and what is it

A

A hypersensitivity reaction that causes pruritis and erythematous rash typically on the face, neck and chest
Vancomycin

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20
Q

What drug causes Discolored Teeth and in what age does this matter

A

Tetracyclines (Doxycycline)

Don’t use in kids less than 8 years old

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21
Q

What drug is associated with Red Lobster Syndrome and what is it

A

Red/Orange discoloration of urine, tears, and body excretions
Rifampin

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22
Q

What drug is associated with Yellow Babies

A

Sufonamides

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23
Q

What drugs are associated with causing C.Diff

A 
Oral Aminopenicillins (Amoxicillin and Augment)
Clindamycin
Oral Cephalosporins (Cephalexin)
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24
Q

What does a pregnancy category B, C, and D mean

A

B: No risk found in humans
C: Not enough research to determine safety
D: Adverse reactions in humans

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25
Q

What are drugs that are pregnancy category B

A 
Beta-Lactams
Clindamycin
Erythromycin/Azithromycin
Metronidazole (except in 1st trimester, where its D)
Oral Vancomycin
26
Q

What are drugs that are pregnancy category C

A

Clarithromycin
FQ
Bactrim
IV Vancomycin

27
Q

What are drugs that are pregnancy category D

A

Aminoglycosides

Tetracyclines

28
Q

What are drugs that can cause complications in pregnancy and give examples

A 
FAST
FQ: Arthropathy
Aminoglycosides: CN 8 Toxicity
Sulfonamides: Newborn Kernicterus
Tetrayclines: Tooth/Bone Problems
29
Q 
What is the Mechanism of action of Penicillins
How is it excreted
Side Effects
What are they used for
-Natural (Penicillin G, Penicillin VK)
-Anti-Staph (Nafcillin, Dicloxacillin)
-Aminopenicillins (Ampicillin, Amoxicillin)
-Unasyn/Augmentin
-Zosyn
A

Stop cell wall synthesis
Renal Excretion
SE: Hypersensitivity reactions, Diarrhea
Natural PCN: Strep. Pharyngitis, Cellulitis, Syphilis
Anti-Staph PCN: Skin and Soft Tissue Infections (S. Auerus particularly)
Aminopenicillins: Otitis Media, Endocarditis Prophylaxis, Lyme Disease in kids <8 yrs old
Unasyn/Augmentin: Animal/Human Bites, Otitis Media, Sinusitis, Dental Infections
Zosyn: Nosocomial Infections

30
Q 
What is the Mechanism of action of Cephalosporins
How is it excreted
Side Effects
What are they used for
-1st Gen (Cefazolin, Cephalexin)
-2nd Gen (Cefuroxime)
-3rd Gen (Cefpodoxime, Cefdinir)
-3rd Gen Parenteral (Ceftriaxone)
-4th Gen (Ceftazidime, Cefepime)
-5th Gen (Ceftaroline)
A

Stop cell wall synthesis
Renal Excretion
SE: Hypersensitivity rxns, Diarrhea, Serum-like Sickness, Biliary Sludging
1st Gen: Skin and Soft Tissue, Perioperative Prophylaxis
2nd Gen: Otitis Media, Sinusitis, COPD Exac.
3rd Gen: Otitis Media, Sinusitis, COPD Exac.
Ceftriaxone: CAP, Meningitis, Gonorrhea, Abdominal Infections
4th Gen: Pseudomonas, Enterobacter Nosocomials
5th Gen: MRSA

31
Q

What is the Mechanism of action of Glycopeptides
How is it excreted
Side Effects
What are they used for

A

Inhibits cell wall synthesis
Renal Excretion
SE: Ototoxicity, Nephrotoxicity, Red Man Syndrome
Vancomycin: Moderate to severe C.Diff, MRSA, MSSA in PCN allergic pts

32
Q

What is the Mechanism of action of Tetracyclines
How is it excreted
Side Effects
What are they used for

A

Inhibits 30S bacterial ribosome
Split Excretion
SE: Photosensitivity, CI in pregnant women and kids <8yrs
Sinusitis, CAP, Tick-Borne Disease (Lyme, Ricettsial, Ehrlichiosis)

33
Q

What is the Mechanism of action of Macrolides
How is it excreted
Side Effects
What are they used for

A

Inhibits 50S bacterial ribosome
SE: QT Prolongation with Azithromycin especially
Erythromycin: N/V/D
Clarithromycin: Metallic Taste
Pharyngitis, Otitis Media, COPD Exac., CAP, Urethritis, Cervicitis, PUD, H.Pylori (Clarithromycin)

34
Q

What is the Mechanism of action of Lincosamide
How is it excreted
Side Effects
What are they used for

A

Inhibits 50S bacterial ribosome
SE: Diarrhea (can cause C.Diff)
Clindamycin: Coveres anaerobes, used a lot in PCN allergic pts

35
Q

What is the Mechanism of action of Aminogycosides
How is it excreted
Side Effects
What are they used for

A

Inhibits 30S bacterial ribosome
Renal Excretion
SE: Nephrotoxic, Ototoxic
Gentamicin: Nosocomial Infections

36
Q

What is the Mechanism of action of Fluoroquinolones
How is it excreted
Side Effects
What are they used for

A

Inhibit bacterial DNA Topoisomerases
Split Excretion
SE: QT Prolongation, Arthropathy, Tendinopathy, CNS Toxicity, Photosensitivity, Dysglycemia
Cipro is a non-Respiratory FQ, so most Gram Negatives in Upper and Lower UTI, Enteric Infections, Traveler’s Diarrhea
Levoflox and Moxifloxacin is Respiratory FQ, Sinusitis, CAP

37
Q

What is the Mechanism of action of Bactrim
How is it excreted
Side Effects
What are they used for

A

Inhibits Folate Synthesis
Inhibits CYP2C9
Careful with use with ACE/ARB
Renal Excretion
SE: Hypersensitivity Reactions, Hemolytic Anemia in G6PD
Used in P. jiroveci (PCP) Pneumonia, Lower UTIs, MRSA

38
Q

What is the Mechanism of action of Nitroimidazoles
How is it excreted
Side Effects
What are they used for

A

DNA Damage
Hepatic Excretion
SE: Metallic taste, Disuliram-like Reaction (Flushing, N/V/D, Headaches, Tachycardia)
Metronidazole, Tinidazole: Bacterial Vaginosis, C.Diff, Giardiasis and Trichomoniasis

39
Q

What is the mechanism of action of Nitrofurans
How is it excreted
Side Effects
What are they used for

A

Renal Excretion
SE: Long-Term use may cause pulmonary fibrosis
Nitrofurantoin (Macrobid): Lower UTI (Cystitis)

40
Q

What drug do you use for latent TB

What are some side effects

A

Isoniazid
Hepatitis
Peripheral Neuropathy (give Vitamin B6 to prevent this)

41
Q

What are some side effects of Rifampin

What is it used for

A

Red Lobster Syndrome
Hepatitis
Used for TB

42
Q

What are some side effects of Pyrazinamide

What is it used for

A

Hyperuricemia
Non-gouty polyarthrlagia
Used for TB

43
Q

What are some side effects of Ethambutol

What is it used for

A

Optic Neuritis, Red/Green color dysfunction

Used for TB

44
Q

What are examples of Anti-Herpetic Antivirals
What are side effects
What are they used to treat

A

Acyclovir, Valacyclovir, Famciclovir
Headache, GI Intolerance
Treat HSV, VZV

45
Q

What are examples of Anti-Influenza Antivirals
What are side effects
What are they used to treat

A

Oseltamivir (Tamiflu), Zanamavir (Relenza)
Treats Influenza A and B
Zanamavir associated with bronchospasms

46
Q

What is Amphotericin B
What is used for
What are side effects

A

A polyene used to treat deep fungal infections like Cryptococcus, Blastomyces
SE: Nephrotoxicity

47
Q

What is Nystatin
What is it used for
What are side effects

A

Polyene used for Thrush

48
Q

What are examples of Topical (skin) Azoles

A

Clotrimazole
Econazole
Miconazole

49
Q

What are examples of Topical (vaginal) Azoles

A

Miconazole
Terconazole
Tioconazole

50
Q

What are examples of Topical (oral) Azoles

A

Clotrimazole

Miconazole

51
Q

What are examples of Systemic Azoles

A

Fluconazole (Diflucan)
Ketoconazole
Itraconazole

52
Q

What are some uses for Azoles
What are side effects
What are some things to be careful with use

A

Used for Candida infections (esophagitis, vulvovaginitis)
Well-Tolerated
Inhibits CYP2C9 (Warfarin)
Renal Excretion

53
Q

What is Terbinafine
What is it used for
What are side effects

A

Used for Onychomycosis or Cuteaneous dermatophyte infections

SE: Hepatotoxic

54
Q

What is the gold standard to treat Methycillin-Susceptible S. Auerus Bacteria (oral abx)
What is 2nd line
What can you use as an alternative if PCN allergy

A

Dicloxacillin is gold standard
Cephalexin is 2nd line
Doxycycline, Bactrim, Clindamycin if PCN allergy

55
Q

What is the gold standard to treat Methycillin-RESISTANT S. Auerus Bacteria (oral abx)

A

Doxycycline
Bactrim
Clindamycin

56
Q

What drug can you use against Psuedomonas (oral abx)

A

Ciprofloxacin

Levofloxacin

57
Q

What can you use against Vancomycin-Resistant Enterococcus (oral abx)

A

Linezolid and Tedizolid

58
Q

What is the gold standard for use against Anaerobes (oral abx)

A

Metronidazole or Augmentin (Amoxicillin/Clavulante)

Clindamycin 2nd line

59
Q

What is the gold standard for use against Methicillin-SUSCEPTIBLE S. Aureus (Parenteral)
2nd line, 3rd line

A

Nafcillin is gold standard
Cefazolin is 2nd line
Vancomycin in 3rd line

60
Q

What is the gold standard for use against Methicillin-RESISTANTS. Aureus (Parenteral)
Other options

A

Vancomycin is gold standard
Linezolid and Tedizolid
Daptomycin

61
Q

What are drugs to use against Pseudomonas (Parenteral)

A

Piperacillin/Tazobactam
Ceftazidime or Cefepime
Ciprofloxacin or Levofloxacin

62
Q

What is the Gold Standard against Anaerobic (Parenteral)

A

Beta-Lactams like Piperacillin/Tazobactum
Carbapenems
Metronidazole

PANCE (8 decks)

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