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Antimicrobials Flashcards

1
Q

Which drugs have DNA replication as their site of antimicrobial action?

A

Quinolones

Metronidazole

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2
Q

Which drugs have cell wall synthesis as their site of antimicrobial action?

A 
Beta lactams
Vancomycin
Daptomycin
Isoniazid
Ethambutol
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3
Q

Which drugs have protein synthesis (ribosome S30) as their site of antimicrobial action?

A

Aminoglycosides
Tetracyclines
Tigecycline

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4
Q

Which drugs have protein synthesis (ribosome S50) as their site of antimicrobial action?

A 
Chloramphenicol
Macrolides
Clindamycin
Linezolid
Streptogramins
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5
Q

Which drugs have antimetabolites as their site of antimicrobial action?

A

Sulfonamides

Trimethoprim

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6
Q

Which drugs have RNA synthesis as their site of antimicrobial action?

A

Rifampicin

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7
Q

Which drugs have membrane permeability as their site of antimicrobial action?

A

Polymixen

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8
Q

What is the site of antimicrobial action of beta lactams?

A

Cell wall synthesis

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9
Q

What is the site of antimicrobial action of vancomycin?

A

Cell wall synthesis

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10
Q

What is the site of antimicrobial action of isoniazid?

A

Cell wall synthesis

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11
Q

What is the site of antimicrobial action of ethambutol?

A

Cell wall synthesis

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12
Q

What is the site of antimicrobial action of aminoglycosides?

A 
Protein synthesis (ribosome S30) 
Reversible
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13
Q

What is the site of antimicrobial action of tetracyclines?

A 
Protein synthesis (ribosome S30)
Reversible
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14
Q

What is the site of antimicrobial action of chloramphenicol?

A 
Protein synthesis (ribosome S50)
Irreversible
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15
Q

What is the site of antimicrobial action of macrolides?

A 
Protein synthesis (ribosome S50)
Irreversible
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16
Q

What is the site of antimicrobial action of clindamycin?

A 
Protein synthesis (ribosome S50)
Irreversible
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17
Q

What is the site of antimicrobial action of sulfonamides?

A

Antimetabolites

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18
Q

What is the site of antimicrobial action of trimethoprim?

A

Antimetabolites

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19
Q

What is the site of antimicrobial action of polymixen?

A

Membrane permeability

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20
Q

What is the site of antimicrobial action of rifampicin?

A

RNA synthesis

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21
Q

What are the four kinds of beta lactams?

A

Penicillin
Cephalosporins
Carbapenems
Monobactams

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22
Q

Name the kinds of penicillins

A

Natural
Beta-lactamase resistant
Broad-spectrum
Extended-spectrum (antipseudomonal)

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23
Q

Name natural penicillins

A

Benzylpenicillin (pen G)

Phenoxymethylpenicillin (pen V)

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24
Q

Name beta-lactamase resistant penicillins

A 
Oxacillin
Cloxacillin
Flucloxacillin
Dicloxacillin
Methicillin
Nafcillin
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25
Q

Name broad-spectrum penicillins

A

Amoxicillin

Ampicillin

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26
Q

Name extended-spectrum (antipseudomonal) penicillins

A

Piperacillin
Ticarcillin
Indanyl carbenicillin

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27
Q

Name thee kinds of cephalosporins

A

1st generation
2nd generation
3rd generation
4th generation

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28
Q

Name 1st generation cephalosporins

A

Cefadroxil
Cefazolin
Cephalexin
Cephalothin

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29
Q

Name 2nd generation cephalosporins

A 
Cefaclor
Cefamandole
Cefprozil
Cefuroxime
Cefotetan
Cefoxitin
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30
Q

Name 3rd generation cephalosporins

A 
Cefdinir
Cefixime
Cefoperazone
Cefotaxime
Ceftazidime
Ceftibuten
Ceftizoxime
Ceftriazone
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31
Q

Name 4th generation cephalosporins

A

Cefepime

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32
Q

Name carbapenems

A

Imipenem
Meropenem
Ertapenem

33
Q

Why is imipenem combined with cilastatin?

A

Cilastatin inhibits dehydropeptidase, the enzyme which renally degrades imipenem. It is combined intravenously with imipenem in order to protect it from dehydropeptidase and prolong its antibacterial effect.

34
Q

Name monobactams

35
Q

What is the spectrum of monobactams?

A

Aerobic gram -

36
Q

Name beta lactamase inhibitors

A

Clavulanic acid
Sulbactam
Tazobactam

37
Q

What is the spectrum of natural penicillins?

A 
Gram + cocci
Gram + bacilli
Gram - cocci
Anaerobes
Spirochetes
38
Q

What is the spectrum of beta lactamase resistant penicillins?

A

Strep
Step

NOT enterococci, anaerobes, gram- cocci, gram - bacilli

39
Q

What is the spectrum of broad-spectrum penicillins

A 
Gram + cocci
Gram + bacilli
Gram - cocci
Anaerobes
Spirochetes
AND
Gram - bacilli
- salmonella, shigella (2GIT)
- e coli, proteus mirabilis (2UTI)
- H influenza, pertussis (2 resp)
40
Q

What is the spectrum of extended-spectrum penicillins?

A 
Gram + cocci
Gram + bacilli
Gram - cocci
Anaerobes
Spirochetes
AND
Pseudomonas
AND
Gram - bacilli (KEEPS)
- klebsiella
- ecoli
- enterobacter
- proteus
- serratia
41
Q

What coverage extends with increasing cephalosporin generation?

42
Q

What is the spectrum of 1st generation cephalosporins?

A 
Gram(+) cocci:
• Staph. aureus* (* Except MRSA)
• Staph. epidermidis
• Strep. pneumoniae
• Strep. pyogenes
• Anaerobic streptococci

Gram(-) bacilli:
• E. coli
• Klebsiella pneumoniae
• Proteus mirabilis

43
Q

What is the spectrum of 2nd generation cephalosporins?

A 
Gram(+) cocci:
• Strep. pneumoniae
• Strep. pyogenes
• Anaerobic streptococci
Gram(-) cocci:
• N. gonorrhoeae

Gram(-) bacilli:
• Enterobacter aerogenes
• E. coli
• H. influenza
• Klebsiella pneumoniae
• Proteus mirabilis
44
Q

What is the spectrum of 3rd generation cephalosporins?

A 
Gram(-) cocci:
• N. gonorrhoeae
Gram(-) bacilli:
• Enterobacter aerogenes
• E. coli
• H. influenza
• Klebsiella pneumoniae
• Proteus mirabilis
• Pseudomonas aeruginosaGram(-) cocci:
• N. gonorrhoeae

Gram(-) bacilli:
• Enterobacter aerogenes
• E. coli
• H. influenza
• Klebsiella pneumoniae
• Proteus mirabilis
• Pseudomonas aeruginosa
45
Q

What is the spectrum of 4th generation cephalosporins?

A

Wide antibacterial spectrum and
excellent coverage of gram(+) and
gram(-) organisms

46
Q

What are cephamycins active against and which is the most potent?

A

Anaerobes eg bacteroides fragilis

Cefoxitin

47
Q

What is the spectrum of carbapenems?

A

Broadest of all beta lactams
Gram +
Gram -
Anaerobes

48
Q

Which beta lactams have the broadest bacterial coverage and why?

A

Carbapenems
[ ] dependent killing and postantibiotic effect

vs
Other beta lactams
Time dependent killing and no antibiotic effect

49
Q

What is the spectrum of imipenem?

A 
GRAM(-) BACILLI:
• Acinetobacter species
• Citrobacter species
• Enterobacter species
• E. coli
• Gardnerella vaginalis
• H. influenza
• Klebsiella species
• Proteus species
• Providencia species
• Salmonella species
• Serratia species
• Pseudomonas aeruginosa***
(*** Resistant strains reported)

GRAM(-) COCCI:
• Neisseria meningitidis** (** Including penicillinase producing
strains.)
• Neisseria gonorrhoeae

GRAM(+) COCCI:
• Staph. aureus* (*MRSA are resistant)
• Staph. epidermidis
• Enterococcus faecalis
• Streptococcus Group A, B & C
• Strep. pneumoniae

ANAEROBIC ORGANISMS:
• Clostridium species
• Peptococcus species
• Peptostreptococcus species
• Propionibacterium species
• Bacteroides species (e.g. B. fragilis)
• Fusobacterium species

OTHER:
• Actinomyces
• Nocardia species

50
Q

Name macrolides

A

Erythromycin
Clarithryomycin
Azithromycin
Telithromycin

51
Q

How is erythromycin excreted?

A

Bile -> enterohepatic -> urine

52
Q

How is azithromycin excreted?

A

Bile -> enterohepatic -> urine

53
Q

How is clarithromycin excreted?

A

Renal + hepatic -> urine

54
Q

Name side effects of macrolides

A

GIT disturbances
Cholestatic jaundice
Ototoxicity

55
Q

Name contraindications for macrolides

A

Liver dysfunction

Renal dysfunction

56
Q

What is important about 30S vs 50S

A 
30S = reversible
50S = irreversible
57
Q

Name tetracyclines

A

Tetracycline
Doxycyline
Minocycline
Demeclocycline

58
Q

Which tetracycline provides therapeutic levels in CSF?

A

Minocycine

59
Q

Name side effects of tetracyclines

A

GIT discomforty
Bone deposition
Phototoxicity
Vestibular problems

60
Q

Name contraindications for tetracyclines

A

Pregnancy
Breastfeeding
Children <8yo

61
Q

Name side effects of cotrimoxazole

A 
Skin rash
NV
Haematological disturbances
- megaloblastic anemia
- leukopenia
- thrombocytopenia
62
Q

What does trimethroprim inhibit?

A

Dihydrofolate reductase

63
Q

Which drug is linked to Gray baby syndrome?

A

Chloramphenicol

64
Q

Name the side effects of chloramphenicol

A

Anemias
Gray baby syndrome
Drug interactions (CYP450)

65
Q

What is important concerning lipophilic drugs and the brain?

A

They cross the BBB

66
Q

What is clostridium difficile always resistant to?

A

Clindamycin

67
Q

Name side effects of clindamycin

A

Skin rashes

Pseudomembranous colitis

68
Q

Name aminoglycosides

A 
Amikacin
Gentamicin
Tobramycin
Streptomycin
Neomycin
69
Q

Name side effects of aminoglycosides

A

Ototoxicity
Nephrotoxicity
Neuromuscular paralysis
Skin rash w/ neomycin

70
Q

Name 1st generation fluoroquinolones

A

Nalidixic acid

71
Q

Name 2nd generation fluoroquinolones

A

Ciprofloxacin
Norfloxacin
Ofloxacin

72
Q

Name 3rd generation fluoroquinolones

A

Gatifloxacin
Levofloxacin
Moxifloxacin
Sparfloxacin

73
Q

Name 4th generation fluoroquinolones

A

Trovafloxaci

74
Q

Name side effects of fluoroquinolones

A

GIT disturbances
Headaches and dizziness
Phototoxicity
Drug interaction (CYP450)

75
Q

Name contraindications for fluoroquinolones

A

Pregnancy
Breast feeding
<18 yo
Arrythmias

76
Q

Which drugs inhibit DNA gyrase?

A

Quinolones

77
Q

Which drugs inhibit folate synthesis?

A

Trimethoprim

Sulfamethoxazole

78
Q

Which drugs create free radicals?

A

Metronidazole

Nitrofurantoin

Pharmacology (32 decks)

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