Antimicrobials Flashcards
What is the mechanism of action of Beta-Lactams and what are examples of Beta-Lactams
Inhibit Cell Wall Production
Penicillins (Penicillin, Ampicillin, Amoxicillin) and Cephalosporins (Cephalexin, Cefuroxime, Ceftriaxone)
What is the mechanism of action of Glycopeptides and what are examples of Glycopeptides
Inhibit Cell Wall Production
Vancomycin
What is the mechanism of action of Macrolides and what are examples of Macrolides
Inhibit Protein Synthesis (50S Ribosome)
Erythromycin, Clarithromycin, Azithromycin
What is the mechanism of action of Tetracylines and what are examples of Tetracyclines
Inhibit Protein Synthesis (30S Ribosome)
Tetracycline, Minocycline, Doxycycline
What is the mechanism of action of Fluoroquinolones and what are examples of Fluoroquinolones
Inhibit DNA synthesis
Ciprofloxacin, Levofloxacin, Moxifloxacin
What is the mechanism of action of Metronidazole
Inhibits DNA synthesis by altering DNA
What is the mechanism of action of Trimethoprim-Sulfamethoxazole and what is another name for TMP-SMX
Inhibits Folic Acid Synthesis
Bactrim
What drugs are considered Bacteriocidal and what does this mean
Kills bacteria
Beta-Lactams, FQ, Glycopeptides, Aminoglycosides, Metronidazole
What drugs are considered Bacteriostatic and what does this mean
Stop the reproduction of bacteria
Tetracyclines, Macrolides, Sulfonamides
What drugs are excreted renally
Beta-Lactams Glycopeptides FQ Tetracyclines Aminoglycosides
What drugs are excreted hepatically
Ceftriaxone
Macrolides
Metronidazole
What drugs can increase an INR
Metronidazole
Bactrim
Macrolides, FQ
What drugs can decrease an INR
Rifampin
What drugs have a risk of causing dysrhythmias
Macrolides (Azithromycine)
Fluoroquinolones
What drugs are associated with permanent sensorineural hearing loss
Aminoglycosides (Gentamicin)
Vancomycin
What drugs are assocaited with transient vestibular dysfunction (dizziness, N/V)
Minocycline
What drugs have been known to cause Acute Tubular Necrosis and other nephrotoxicites
Aminoglycosides, like Gentamicin
Vancomycin
What are some side effects of Metronidazole
N/V/D, Abdominal Cramps
Flushing, Tachycardia, Headache
What drug can cause Red Man Syndrome and what is it
A hypersensitivity reaction that causes pruritis and erythematous rash typically on the face, neck and chest
Vancomycin
What drug causes Discolored Teeth and in what age does this matter
Tetracyclines (Doxycycline)
Don’t use in kids less than 8 years old
What drug is associated with Red Lobster Syndrome and what is it
Red/Orange discoloration of urine, tears, and body excretions
Rifampin
What drug is associated with Yellow Babies
Sufonamides
What drugs are associated with causing C.Diff
Oral Aminopenicillins (Amoxicillin and Augment) Clindamycin Oral Cephalosporins (Cephalexin)
What does a pregnancy category B, C, and D mean
B: No risk found in humans
C: Not enough research to determine safety
D: Adverse reactions in humans
What are drugs that are pregnancy category B
Beta-Lactams Clindamycin Erythromycin/Azithromycin Metronidazole (except in 1st trimester, where its D) Oral Vancomycin
What are drugs that are pregnancy category C
Clarithromycin
FQ
Bactrim
IV Vancomycin
What are drugs that are pregnancy category D
Aminoglycosides
Tetracyclines
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
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
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
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
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)
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)
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
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
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
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
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
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)
What drug do you use for latent TB
What are some side effects
Isoniazid
Hepatitis
Peripheral Neuropathy (give Vitamin B6 to prevent this)
What are some side effects of Rifampin
What is it used for
Red Lobster Syndrome
Hepatitis
Used for TB
What are some side effects of Pyrazinamide
What is it used for
Hyperuricemia
Non-gouty polyarthrlagia
Used for TB
What are some side effects of Ethambutol
What is it used for
Optic Neuritis, Red/Green color dysfunction
Used for TB
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
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
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
What is Nystatin
What is it used for
What are side effects
Polyene used for Thrush
What are examples of Topical (skin) Azoles
Clotrimazole
Econazole
Miconazole
What are examples of Topical (vaginal) Azoles
Miconazole
Terconazole
Tioconazole
What are examples of Topical (oral) Azoles
Clotrimazole
Miconazole
What are examples of Systemic Azoles
Fluconazole (Diflucan)
Ketoconazole
Itraconazole
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
What is Terbinafine
What is it used for
What are side effects
Used for Onychomycosis or Cuteaneous dermatophyte infections
SE: Hepatotoxic
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
What is the gold standard to treat Methycillin-RESISTANT S. Auerus Bacteria (oral abx)
Doxycycline
Bactrim
Clindamycin
What drug can you use against Psuedomonas (oral abx)
Ciprofloxacin
Levofloxacin
What can you use against Vancomycin-Resistant Enterococcus (oral abx)
Linezolid and Tedizolid
What is the gold standard for use against Anaerobes (oral abx)
Metronidazole or Augmentin (Amoxicillin/Clavulante)
Clindamycin 2nd line
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
What is the gold standard for use against Methicillin-RESISTANTS. Aureus (Parenteral)
Other options
Vancomycin is gold standard
Linezolid and Tedizolid
Daptomycin
What are drugs to use against Pseudomonas (Parenteral)
Piperacillin/Tazobactam
Ceftazidime or Cefepime
Ciprofloxacin or Levofloxacin
What is the Gold Standard against Anaerobic (Parenteral)
Beta-Lactams like Piperacillin/Tazobactum
Carbapenems
Metronidazole
