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Antimicrobials Flashcards

1
Q

What drug classes inhibit cell wall synthesis?

A

Cephalosporins
Penicillins
Bacitracin

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2
Q

Which drug class inhibits the transfer of peptidoglycan?

A

Bacitracin

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3
Q

How do penicillins and cephalosporins inhibit cell wall synthesis?

A

Inhibit cross linking of peptidoglycan

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4
Q

Which drug classes inhibit the 30s protein subunit?

A

Aminoglycosides (tobra gent 30)

Tetracyclines

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5
Q

Which drug classes inhibit the 50s protein subunit?

A

“CCM”
Chloramphenicol
Clindamycin
Macrolides

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6
Q

What are the 2 aminoglycosides?

A

Tobramycin

Gentamycin

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7
Q

What drugs inhibit the synthesis of folic acid?

A

Sulfonamides
Trimethoprim
Pyrimethamine

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8
Q

What drugs interfere with DNA gyrase and Topoisomerase IV?

A

Fluoroquinolones

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9
Q

Which antimicrobial drug class has 2 mechanisms of action?

A

Fluoroquinolones

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10
Q

Most antibiotics have what side effects in common?

A

GI upset

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11
Q

Which drug inhibits the transfer of peptidoglycan into the cell wall?

A

Bacitracin (+)

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12
Q

What is bacitracin(+) most often used for?

A

Blepharitis

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13
Q

What 2 drugs make up polysporin?

A 
Bacitracin(+)
Polymyxin B (-)
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14
Q

What are the 2 penicillins for boards?

A

Amoxicillin

Dicloxacillin

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15
Q

What is the MOA of amoxicillin and dicloxacillin?

A

Inhibit transpeptidase (cross linking)

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16
Q

Amoxicillin and dicloxacillin have what gram coverage?

A

Amoxicillin (+)(-)

Dicloxacillin (+)

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17
Q

What combo make Augmentin?

A

Amoxicillin (+)

Clavulonic acid

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18
Q

Why is clavulonic acid added to augmentin?

A

Penicillinase inhibitor

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19
Q

Dicloxacillin is capable of handling which infection, MRSA or MSSA?

A

MSSA

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20
Q

What are the adverse effects of penicillins?

A

Hypersensitivity, including SJS

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21
Q

Are penicillins safe in pregnancy?

A

Yes

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22
Q

Why do cephalosporins and penicillins have cross sensitivity?

A

Both have a beta-lactam ring

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23
Q

What are the contraindications for penicillins?

A

Type 1 hypersensitivity

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24
Q

What are the 2 cephalosporins for boards?

A

Cephalexin (+)

Ceftriaxone (+)(-)

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25
Q

What is the cephalosporin MOA?

A

Inhibit transpeptidase

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26
Q

Which generation of cephalosporins add gram (-) coverage to go along with the gram (+) coverage?

A

Gen 3 and 4

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27
Q

Cephalexin should not be used in isolation if what infection is suspected?

A

MRSA

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28
Q

Which cephalosporin will have gram (-) coverage: Cephalexin or Ceftriaxone?

A

Ceftriaxone (+)(-)

-3rd generation cephalosporin

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29
Q

What are the possible adverse reactions to cephalosporins?

A

Destroy intestinal microflora

Alter absorption of Vit K - excess blood thinning when combined with warfarin

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30
Q

What are the aminoclycosides?

A

Gentamicin

Tobramycin

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31
Q

What is the MOA of aminoglycocides?

A

Protein synthesis inhibitor - block 30s subunit

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32
Q

What gram coverage do aminoglycosides offer?

A

Gram (-) (+)

Better (-) coverage than (+)

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33
Q

What drugs classes block the 30s subunit?

A

Aminoglycosides

Tetracyclines

34
Q

Before the arrival of fluoroquinolones, what drug class was first-line therapy for ocular bacterial infections?

A

Aminoglycosides

35
Q

What drugs work on the 50s subunit?

A

“CCM”
Chloramphenicol
Clindamycin
Macrolides

36
Q

What are the 2 known adverse effects of aminoglycosides?

A

SPK

Delayed re-epithelialization

37
Q

How do tetracyclines function as antibacterials?

A

Block the 30s subunit

38
Q

Are tetracyclines bactericidal, or bacteriostatic?

A

Bacteriostatic

39
Q

Why is doxycyline commonly Rxed for meibomianitis?

A

Decreases the release if free fatty acids

40
Q

What are the 3 common reasons to Rx doxycycline?

A

Meibomianitis
Acne rosacea
Chlamydial ocular infections - trachoma, inclusion

41
Q

Why are tetracyclines supposed to be taken without food?

A

Dairy, antacids, and iron impair GI tract absorption of tetracyclines

42
Q

Which tetracycline is the exception to the “no food” rule?

A

Doxycycline

43
Q

Why are tetracyclines contraindicated in renal failure?

A

Excreted via kidneys

44
Q

Why is doxycycline safe in renal failure, when other tetracyclines aren’t?

A

Excreted in fecal matter

45
Q

What are the contraindications of tetracyclines?

A

Pregnancy
Kids
Renal failure

46
Q

What are the possible side effects of tetracyclines?

A 
Pseudotumor cerebri
Bone growth retardation (kids)
Tooth discoloration (kids)
47
Q

Minocycline has 2 additional adverse effects. What are they?

A

Blue sclera

Conj pigmented cysts

48
Q

What are the 50s blocker drug classes?

A

“CCM”
Chlormaphenicol
Clindamycin/Lincomycin
Macrolides

49
Q

What gram coverage does chloramphenicol offer?

A

Gram (+)(-)

50
Q

What are the 2 major adverse effects of chloramphenicol?

A

Aplastic anemia - fatal

Optic neuritis

51
Q

How do macrolides function as antibacterials?

A

50s subunit protein blockers

52
Q

What are the macrolide drugs?

A

“ACE-mycins”
Azithromycin
Clarithromycin
Erythromycin

53
Q

Why might azithromycin cause GI upset?

A

It is to be taken on an empty stomach

54
Q

Which of the macrolides is commonly used as prophylaxis for neonatal gonorrhea?

A

Erythromycin

55
Q

Why isn’t erythromycin used more frequently?

A

Resistance

56
Q

Azithromycin (Azasite) contains what preservative, making it an issue in CL wearers?

57
Q

How do clindamycin and lincomycin work as antibacterials?

A

50s subunit blockers

58
Q

What 3 drugs are recommended for MRSA?

A

Clindamycin
Trimethoprim-sulfamthoxazole
Doxycycline

59
Q

How do trimethoprim and pyrimethamine act as antibacterials?

A

Inhibit DHF reductase, stopping folate synthesis

60
Q

DHF reductase catalyzes which step of folate synthesis?

61
Q

Which drugs inhibit the first step of folate synthesis?

A

Sulfonamides

62
Q

Are sulfonamides bacteriostatic or bactericidal?

A

Bacteriostatic

63
Q

What gram coverage to sulfonamides offer?

A

Gram (+)(-)

64
Q

What are the ophthalmic adverse effects attributed to sulfonamides?

A

SJS
Photosensitization
Contact dermatitis
Burning/stinging

65
Q

What are the systemic adverse effects attributed to sulfonamides?

A

Myopic shift
SJS
Infant kernicterus

66
Q

What drugs commonly induce SJS?

A

Sulfonamides
Amoxicillin
Trimethoprim-sulfamethoxazole

67
Q

What gram coverage do trimethoprim and pyrimethamine offer?

A

Gram (+)(-)

68
Q

Trimethoprim is not effective against which bug?

A

Pseudomonas

69
Q

What are the common adverse reactions to trimethoprim and pyramethamine?

A

Bone marrow suppression

-aplastic anemia

70
Q

What are the MOAs of fluoroquinolones?

A

Inhibit DNA gyrase

Inhibit Topoisomerase IV

71
Q

What are the 2nd generation fluoroquinolones?

A

Ciprofloxacin

Ofloxacin

72
Q

What is the 3rd generation fluoroquinolone?

A

Levofloxacin

73
Q

What are the 4th generation fluoroquinolones?

A

Gatifloxacin
Moxifloxacin
Besifloxacin

74
Q

As newer generations of fluoroquinolones arise, what gram coverage is increasing?

75
Q

Fluoroquinolones are known to be potent inhibitors of what gram bacteria?

76
Q

What fluoroquinolones may be used orally?

A

Ciprofloxacin

Moxifloxacin

77
Q

What are the adverse effects of oral fluoroquinolones?

A

Damage to cartilage formation
Inhibition of bone growth
Tendinitis

78
Q

What are the contraindications of oral fluoroquinolones?

A

Pregnancy

Kids - under 18

79
Q

Topical fluoroquinolones are approved for what age range?

A

> 1 year old

80
Q

What are the bacteriostatic agents?

A

Tetracyclines
Trimethoprim
Sulfacetamide
Erythromycin

81
Q

What are the bactericidal agents?

A 
Penicillins
Cephalosporins
Bacitracin
Aminoglycosides
Fluoroquinolones

Pharm (13 decks)

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