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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
What are drugs that are pregnancy category B
``` Beta-Lactams Clindamycin Erythromycin/Azithromycin Metronidazole (except in 1st trimester, where its D) Oral Vancomycin ```
26
What are drugs that are pregnancy category C
Clarithromycin FQ Bactrim IV Vancomycin
27
What are drugs that are pregnancy category D
Aminoglycosides | Tetracyclines
28
What are drugs that can cause complications in pregnancy and give examples
``` FAST FQ: Arthropathy Aminoglycosides: CN 8 Toxicity Sulfonamides: Newborn Kernicterus Tetrayclines: Tooth/Bone Problems ```
29
``` 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 ```
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
``` 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) ```
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
What is the Mechanism of action of Glycopeptides How is it excreted Side Effects What are they used for
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
What is the Mechanism of action of Tetracyclines How is it excreted Side Effects What are they used for
Inhibits 30S bacterial ribosome Split Excretion SE: Photosensitivity, CI in pregnant women and kids <8yrs Sinusitis, CAP, Tick-Borne Disease (Lyme, Ricettsial, Ehrlichiosis)
33
What is the Mechanism of action of Macrolides How is it excreted Side Effects What are they used for
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
What is the Mechanism of action of Lincosamide How is it excreted Side Effects What are they used for
Inhibits 50S bacterial ribosome SE: Diarrhea (can cause C.Diff) Clindamycin: Coveres anaerobes, used a lot in PCN allergic pts
35
What is the Mechanism of action of Aminogycosides How is it excreted Side Effects What are they used for
Inhibits 30S bacterial ribosome Renal Excretion SE: Nephrotoxic, Ototoxic Gentamicin: Nosocomial Infections
36
What is the Mechanism of action of Fluoroquinolones How is it excreted Side Effects What are they used for
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
What is the Mechanism of action of Bactrim How is it excreted Side Effects What are they used for
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
What is the Mechanism of action of Nitroimidazoles How is it excreted Side Effects What are they used for
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
What is the mechanism of action of Nitrofurans How is it excreted Side Effects What are they used for
Renal Excretion SE: Long-Term use may cause pulmonary fibrosis Nitrofurantoin (Macrobid): Lower UTI (Cystitis)
40
What drug do you use for latent TB | What are some side effects
Isoniazid Hepatitis Peripheral Neuropathy (give Vitamin B6 to prevent this)
41
What are some side effects of Rifampin | What is it used for
Red Lobster Syndrome Hepatitis Used for TB
42
What are some side effects of Pyrazinamide | What is it used for
Hyperuricemia Non-gouty polyarthrlagia Used for TB
43
What are some side effects of Ethambutol | What is it used for
Optic Neuritis, Red/Green color dysfunction | Used for TB
44
What are examples of Anti-Herpetic Antivirals What are side effects What are they used to treat
Acyclovir, Valacyclovir, Famciclovir Headache, GI Intolerance Treat HSV, VZV
45
What are examples of Anti-Influenza Antivirals What are side effects What are they used to treat
Oseltamivir (Tamiflu), Zanamavir (Relenza) Treats Influenza A and B Zanamavir associated with bronchospasms
46
What is Amphotericin B What is used for What are side effects
A polyene used to treat deep fungal infections like Cryptococcus, Blastomyces SE: Nephrotoxicity
47
What is Nystatin What is it used for What are side effects
Polyene used for Thrush
48
What are examples of Topical (skin) Azoles
Clotrimazole Econazole Miconazole
49
What are examples of Topical (vaginal) Azoles
Miconazole Terconazole Tioconazole
50
What are examples of Topical (oral) Azoles
Clotrimazole | Miconazole
51
What are examples of Systemic Azoles
Fluconazole (Diflucan) Ketoconazole Itraconazole
52
What are some uses for Azoles What are side effects What are some things to be careful with use
Used for Candida infections (esophagitis, vulvovaginitis) Well-Tolerated Inhibits CYP2C9 (Warfarin) Renal Excretion
53
What is Terbinafine What is it used for What are side effects
Used for Onychomycosis or Cuteaneous dermatophyte infections | SE: Hepatotoxic
54
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
Dicloxacillin is gold standard Cephalexin is 2nd line Doxycycline, Bactrim, Clindamycin if PCN allergy
55
What is the gold standard to treat Methycillin-RESISTANT S. Auerus Bacteria (oral abx)
Doxycycline Bactrim Clindamycin
56
What drug can you use against Psuedomonas (oral abx)
Ciprofloxacin | Levofloxacin
57
What can you use against Vancomycin-Resistant Enterococcus (oral abx)
Linezolid and Tedizolid
58
What is the gold standard for use against Anaerobes (oral abx)
Metronidazole or Augmentin (Amoxicillin/Clavulante) | Clindamycin 2nd line
59
What is the gold standard for use against Methicillin-SUSCEPTIBLE S. Aureus (Parenteral) 2nd line, 3rd line
Nafcillin is gold standard Cefazolin is 2nd line Vancomycin in 3rd line
60
What is the gold standard for use against Methicillin-RESISTANTS. Aureus (Parenteral) Other options
Vancomycin is gold standard Linezolid and Tedizolid Daptomycin
61
What are drugs to use against Pseudomonas (Parenteral)
Piperacillin/Tazobactam Ceftazidime or Cefepime Ciprofloxacin or Levofloxacin
62
What is the Gold Standard against Anaerobic (Parenteral)
Beta-Lactams like Piperacillin/Tazobactum Carbapenems Metronidazole

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