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PHARM > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

PCNase-Susceptible
Narrow Spectrum
Tx: Gonorrhea, Syphilis
PCN G, PCN V, Benzathine PCN

A

Natural Penicillins

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2
Q

PCNase-Resistant
Narrow Spectrum (minimal to no gram - activity)
MSSA
Methicillin, nafcillin, oxacillin, dicloxacillin
Hepatic excretion: nafcillin, oxacillin

A

Anti/staphylococcal Penicillins

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3
Q 
PCNase-Susceptible
Aminopenicillins
Broad Spectrum
Similar to PCN G, more gram- bacilli coverage 
Amoxicillin, ampicillin
A

Extended Coverage Penicillins

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4
Q 
PCNase-Susceptible
Extended Spectrum
Broad + pseudomonas coverage
Piperacillin, ticarcillin
Parenteral only
A

Anti/pseudomonal Penicillins

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5
Q 
Beta-lactam
Bactericidal
Stronger resistance against B-lactamases
5 generations 
Gen 1→5 = + gram- and anaerobe coverage
Gen 1→5 = + resistance against B-lactamases
A

Cephalosporins

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6
Q

Only commercially available b-lactam of its class that can take on MRSA. Reserved for complicated skin conditions as well as community-acquired pneumonia. Broad spectrum. Advanced generation. Pro-drug.

A

Ceftaroline

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7
Q

Renal dosage adjustments for cephalosporins except for 3rd generation _____, which is hepatically metabolized.

A

Ceftriaxone

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8
Q

Extremely broad coverage (nearly than all other antimicrobials. Pseudomonas coverage. None active against MRSA, though. Renal adjustments. Imipenem, Meropenem, Ertapenem, Doripenem.

A

Carbapenems

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9
Q 
Aztreonam
Relatively B-lactamase resistant
Gram - coverage
Renal adjustment
Not resistant to ESBLs
A

Monobactams

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10
Q 
Non-B-lactam
Gram +
Glycopeptide
Most widely used in US hospitals
Tx: C. difficle, MRSA
Binds precursors for cell wall biosynthesis
MRSE
Nephrotoxic, ototoxic, RED MAN
A

Vancomycin

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11
Q 
Non-B-lactam
Gram +
\$\$$
Tx of skin, skin MRSA, Skin VRE
[dependent]
Cell membrane rapid depolarization
No good for tx of peneumonia due to surfactants 
Can cause rhabdo
Stop Statins
A

Daptomycin

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12
Q 
Non-B-lactam
Vanco/Dapto alternative
for resistant gram+ including MRSA
[dependent]
Vanco synthetic derivative 
fetal risk
QT interval prolongation 
foamy urine
A

Telavancin

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13
Q

Non-B-lactam

treatment UTI due to E. coli/E. faecalis

A

Fosfomycin

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14
Q

Non-B-lactam
“detergent-like” effect
[dependent]
Gram -

A

Polymyxin

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15
Q

Tetracyclines: “Like My Chronic CRAP”

A

Lyme, Mycoplasma Pneumonia, Cholera, Chlamydia, Rocky Mtn Spotted Fever, Acne, Peptic Ulcer

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16
Q

Protein Synthesis Inhibitor
Broad specturm
Bacteriostatic
Gram +/-, others
Crosses placenta
Enters bones and dentition due to calcification
Avoid dairy, antacids, iron while taking
Demeclocycline, doxycycline, minocycline, tetracycline

A

Tetracyclines

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17
Q

___cycline can be taken with/or without food.

A

Minocycline

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18
Q

Absorption of demclocycline, doxycycline and tetracycline are ____ by food.

A

reduced

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19
Q

Only minocycline and doxycycline achieve therapeutic levels in ____.

A

CSF

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20
Q

_____ is a drug of choice in renal impairment.

A

Doxycycline

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21
Q 
Gastric discomfort 
Limit in pediatrics (discolored teeth)
Hepatotoxicity
Phototoxicity (sunburn)
Dizziness, vertigo, tinnitus
Contraindicated for pregnancy, breast-feeding
A

Tetracyclines

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22
Q

Protein Synthesis Inhibitor
Tigecycline (minocycline derivative)
Tx for complicated skin and soft tissue infections
Tx for intra-abd infections
Developed for TCN class resistant organisms**

A

Glycylcyclines (Tigecycline)

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23
Q 
Protein Synthesis Inhibitor 
Broad spectrum 
(MRSA, VRE, b-lactamase gram -, resistant strep)
Penetrates tissues well, low [plasma] 
adverse: n/v, pancreatitis hepatotoxic,
A

Glycylcyclines (Tigecycline)

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24
Q 
Protein Synthesis Inhibitor
Amikacin, Gentamicin, Neomycin, Streptomycin, Tobramycin
Parenteral, EXCEPT neomycin (top/oral)
Often combined with B-lactams
Nephro/ototoxic 
Neomycin: contact derm
A

Aminoglycosides

25
Q 
Protein Synthesis Inhibitor
Azithromycin, Clarithromycin, Erythromycin, Telithromycin
Broad spectrum 
Bacteriostatic
Bactericidal at higher does
50s binding
Hepatic metabolism 
CP450, EXCEPT azithromycin 
Can lead to drug toxicities
A

Macrolides

26
Q

Azithromycin and erythromycin should be taken ____ food.

A

without

27
Q

Clarithromycin should be taken ____ food.

A

with

28
Q

Protein Synthesis Inhibitor
Hepatic Metabolism
CP450
Strong inhibitors: medication hx/reconciliation is important.
Clarithromycin is eliminated by the kidneys and the liver
Can prolong QT (ketolides also can do this)
Ototoxic, Gastric distress, jaundice
Hepatic contraindications

A

Macrolides

29
Q

Telithromycin: box warning for pts with ____ ____.

A

myasthenia gravis

30
Q

Corynebacterium diphtheriae, Bordatella pertussis

A

Erythromycin

31
Q

Good choice for those patients with B-lactam PCN allergy

A

Erythromycin

32
Q

Chlamydial infection, legionnaires, mycoplasma pneumonia

A

Azithromycin

33
Q

Z-pack loading dose on day one, then four more; commonly prescribed; long half-life

A

Azithromycin

34
Q

Mycobacterium Avium Complex (MAC)

A

Azithromycin

35
Q 
Protein Synthesis Inhibitor
Macrocyclic
Narrow Spectrum (gram +/anaerobes)
Costly
RNA polymerase inhibitor
C.diff tx
Adverse: n/v, abd pain, hyper. rxns
Not recommended for pts w/ macrolide allergies
A

Fidaxomycin (Dificid)

36
Q 
Protein Synthesis Inhibitor
Broad spectrum
Reserved for life threatening infections, IV
Intensive care
50s, peptidyl transferase inhibitor
A

Chloramphenicol

37
Q

Protein Synthesis Inhibitor
Bacteriostatic, with +dose could become ~cidal
CSRA (Chlamydia, Spirochetes, Ricketessiae, anaerobes)
Hepatically metabolized
Adverse: Anemias, GRAY BABY
Weak inhibition of CYP2C9

A

Chloramphenicol

38
Q 
Protein Synthesis Inhibitor 
Lincosamide
IV/oral
GI intolerance
Cross-resistance with erythromycin 
Bacteriostatic 
gram +  (MRSA, anaerobes)
A

Clindamycin

39
Q

Protein Synthesis Inhibitor
Distributes well, poor CSF
Adverse: diarrhea, causes C. diff
Accumulation in renal/hepatic impairment

A

Clindamycin

40
Q

What beta-lactamase inhibitor was known to cause diarrhea?

A

Clavulanic acid

41
Q

Protein Synthesis Inhibitor
Developed to combat resistant gram + organisms
(MRSA, VRE, PCN resistant strep)
Binds to the “23s Ribosomal RNA” of the 50s subunit, which inhibits 70s action
Mycobacterium tuberculosis tx
Dapto alternative for tx of VRE

A

Linezolid

42
Q 
Protein Synthesis Inhibitor 
no required renal adjustments
Oral/IV
Bacteriostatic 
Bacteriocidal against Streptocooci
Gram + main clinical use
adverse: n/v/d/headache; rash; thrombocytopenia
MAO activity
A

Linezolid

43
Q

Glycopeptide

A

Vancomycin

44
Q

Tigecycline

A

Glycylcycline

45
Q

Amikacin, Gentamicin, Neomycin, Streptomycin, Tobramycin

A

Aminoglycosides

46
Q

Azithromycin, Clarithromycin, Erythromycin, Telithromycin

A

Macrolides

47
Q

____ derived from erythromycin.

A

Ketolide

48
Q

50s subunit (ex: erythromycin)

A

Macrolides

49
Q

costly Macrocyclic (similar macrolide structure)

A

Fidaxomycin (dificid)

50
Q

50s; peptidyl transferase inhibitor

A

Chloramphenicol

51
Q

tx: CSRA

A

Chloramphenicol

52
Q

Lincosamide

A

Clindamycin

53
Q

“23s of rRNA” of the 50s→70s formation inhibition

A

Linezolid

54
Q

Main clinical use = tx for drug resistant gram +

A

Linezolid

55
Q

MAO activity

A

Linezolid

56
Q

Used only against PCNase producing strands of S. aureus; MSSA

A

Anti/staphylococcal penicillins

57
Q

Amoxicillin/clavulanate (augmentin)

A

PCN Combo with B-lactamase inhibitor

58
Q

Cephalosporin eliminated by the liver; 3rd gen

A

Ceftriaxone

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