Antimicrobrials Flashcards
What are the two toxicities of penicillins?
hypersensitivity and hemolytic anemia
Which has a greater oral bioavailability, ampicillin or amoxicillin?
amoxicillin
What six bugs can be treated with ampicillin/amoxicillin?
H. flu
E. coli
Listeria
Proteus
Salmonella
Shigella
What would be the most severe reaction of ampicillin/amoxicillin?
pseudomembrane colitis
What are the three penicillinase-resistant lactams?
Naficillin
Dicloxacillin
Oxacillin
Are the penicillinase-resistant lactams used to treat MRSA?
no
What are the two beta-lactim anti-pseudomonals?
Piperacillin and Ticeracillin
What other drug are Piperacillin and Ticeracillin administered with?
beta-lactamase inhibitors
What are the three β-lactamase inhibitors?
Sulbactam
Tazobactam
Clavulanic acid
Which cephalosporin can cover MRSA?
Ceftaroline
Which four bacteria are not covered by cephalosporins?
Listeria
Atypicals
MRSA
Enterococci
What are the two first generation cephalosporins?
Cefalexin and Cefazolin
What three bugs are the first generation cephalosporins effective against?
Proteus
E. coli
Klebsiella
What are the three 2nd generation cephalosporins?
Cefaclor
Cefoxitin
cefuroxime
What are the bugs treated by 2nd generation cephalosporins?
H. flu
Enterobacter
Klebsiella
Proteus
E. coli
Klebsiella
Serratia
What two bugs does Ceftriaxone treat?
meningitis and gonorrhea
What are the two cephalosporins for Pseudomonas?
Ceftazidime
Cefepime
What is the fourth generatuon cephalosporin?
Cefepime
What is cefepime active against?
Pseudomonas
What is the 5th generation cephalosporin?
Ceftoraline
What is ceftoraline not active against?
Pseudomonas
Which class of drugs would display nephrotoxicity upon co-administration with cephalosporins?
Aminoglycosides
Which β-lactam class of drugs can cause a Vitamin K deficiency?
Cephalosporins
What is the MOA of Aztreonam?
penicillin binding protein
What class of drugs is Aztreonam synergistic with?
Aminoglycoside
What type of bacteria does aztreonam display activity against?
gram-negative rods ONLY
What other drug are piperacillin and tazobactam used with?
β-lactam inhibitors
What is the most important side effect of Carbapenems?
seizure
What is the MOA of carbapenems?
β-lactam
What enzyme can inactivate carbapenems?
Dehydropeptidase
Does vancomycin work only on gram-positives or gram-negatives?
positives
What are the three toxicities of vancomycin?
Nephro
Oto
Thrombophlebitis
What are two techniques to decrease Red Man Syndrome?
coadministration with anti-histamines
slow infusion
What would a bug resistant to vancomycin have in its cell wall?
D-ala-D-lac
Are aminoglycosides static or cidal?
cidal
Are tetracyclines static or cidal?
static
Is chloramphenicol static or cidal?
static
Is clindamycin static or cidal?
static
Is erythromycin static or cidal?
static
What ribosomal subunit does linezolid target?
50S
What ribosomal subunit does chloramphenicol target?
50S
What ribosomal subunit does clindamycin target?
50S
What are the three MOAs of aminoglycosides?
inhibit formation of initiation complex
cause misreading of mRNA
block translocation
What do aminoglycosides require for activity?
oxygen
Which aminoglycoside is used for surgery?
Neomycin
What is the use of aminoglycosides?
severe gram-negative infections
Which class of antimicrobials can cause neuromuscular blockage?
Aminoglycosides
Which antibiotic can be a teratogen?
aminoglycoside
What is the MOA of tetracyclines?
prevent attachment of aminoacyl-tRNA
Which tetracycline is fecally eliminated and can be used in patients with renal failure?
doxycycline
Which class of antibiotics absorption can be limited with divalent cations?
tetracyclines
Which class of antibiotics tends to accumulate intra-cellularly?
tetracycline
Are tetracyclines contraindicated in pregnancy?
yes
What can tetracyclines inhibit in adolescents?
inhibit long-bone growth
How is resistance against tetracyclines created?
efflux pumps
What is the MOA of macrolides?
inhibit peptide translocation
What specific ribosomal subunit is targeted by macrolides?
23 rRNA
What STD is treated with a macrolide?
Chlamydia
What class of drug is used for strep throat in a patient with a penicillin allergy?
Macrolide
What is the M of MACRO?
gut motility issues
What is the A of MACRO? By what mechanism?
arrhythmia
QT prolongation
What is the C of MACRO?
Cholestatic hepatitis
What is the R of MACRO?
rash
What is the O of MACRO?
Eosinophilia
What does chloramphenicol block?
peptidyltransferase
What two conditions is chloramphenicol used?
Meningitis and RMSF
How is resistance to chloramphenicol generated?
plasmid acetyltransferase
What does clindamycin block?
peptide transfer (translocation)
Is clindamycin used for anaerobes above or below the diaphragm?
above
Which single aerobe is clindamycin effective against?
Group A Strep
What do sulfonamides inhibit the synthesis of?
folate
What STD can sulfonamides be effective against?
Chlamydia
What antimicrobial can displace albumin from bound substances?
Sulfonamides
What are sulfa drugs an analogue of?
PABA
What enzyme do sulfa drugs inhibit?
Dihydropteroate synthase
Which two antimicrobials inhibit Dihydrofolate Reductase?
Trimethoprim
Pyrimethamine
What two enzymes do fluoroquinolones inhibit?
DNA topoisomerase two and four
What is another name for DNA Topoisomerase Two?
DNA gyrase
What must fluoroquinolones not be taken with?
antacids
What is the broad target of fluroquinolones?
Gram-negative rods of GI and urinary system
In what three groups of people are fluorquinolones contraindicated?
pregnant women
nursing mothers
children under 18
Presnidone can cause tendon rupture if taken with what antimicrobial?
fluoroquinolones
What are the three drugs for tuberculoid and lepromatous leprosy?
Rifampin
Dapsone
Clofazime
What enzyme is needed for INH to be effective?
catalase-peroxidase
What drug is used as prophylaxis for TB?
INH
What two drugs are used for meningococcal prophyaxis?
Rifampin and ciprofloxacin
What enzymedoes rifampin inhibit?
DNA dependent RNA polymerase
What drug does rifampin delay resistance to? What disease
Dapsone
Leprosy
Why is rifabutin preferred over rifampin in HIV patients?
less inhibition of p450
What TB drug is effective in the acidic phagosome?
Pyrazinamide
What are the two main toxicities of Pyrazinamide?
gout and liver
What drug blocks Arabinosyltransferase?
Ethambutol
What is the function of Arabinosyltransferase?
carbohydrate incorporation into cell wall
What is the toxicity of Ethambutol?
red-green color blind
What drug is used to treat endocarditis during dental procedures?
Penicillin
What drug is used for prophylaxis for Gonorrhea?
Ceftriaxone
What drug is used for GBS in pregnant women?
Penicillin
What drug is used for conjunctivitis for neonates born to a mother with Chlamydia or Neisseria?
Erythromycin
Which drug is used for S. aureus post-surgical infection?
Cefazolin
What drug is used for strep throat?
Penicillin
What drug is used for syphillis?
Penicillin G
What single drug is used for MAC prophylaxis?
Azithromycin
What drug is used as prophylaxis for Toxo?
TMP/SMX
Which drug is used for VRE?
Linezolid
Which antimicrobial can cause serotonin syndrome?
Linezolid
Which anti-fungal requires supplementation with electrolytes?
Amphotericin B
Which two electrolytes need to be supplemented during Amphotericin use?
potassium and magnesium
Which anti-fungal can cause fever and chills?
amphotericin
Which anti-fungal can cause hypotension?
amphotericin
What reaction is inihibited by Azoles? Catalyzed by what enzyme?
lanosterol to ergosterol
14-α-Demethylase
What drug for cryptococcal meningitis prophyaxis?
Fluconazole
Which azole for dimorphic fungi?
Itraconazole
What is flucytosine an analogue of?
5-flurouracil
What is the toxicity of flucytosine?
bone marrow suppression
What do echinocandins inhibit the synthesis of?
β-glucan
What is the main bug Echinocandins are used to treat?
invasive Aspergillis
What family of anti-fungals can cause flushing? Mediatated by what?
Echinocandins
histamine
What enzyme is inhibited by terbinafine?
squalene epoxidase
What anti-fungal deposits in keratin containing tissue?
Griseofulvin
What is the drug for Toxo?
Pyrimethamine
What anti-fungal can act as a teratogen?
Griseofulvin
What are the two drugs for Trypanosoma Brucei?
Suramin and Melarsoprol
What is the drug for T. cruzi?
Nifurtimox
What is the drug for Leishmania?
Sodium stibogluconate
What is the MOA of chloroquine?
blocks detoxification of heme into hemozoin
What is the only plasmodium species not treated by Chloroquine?
Falciparum
What two drugs is P. falciparum treated with?
Atovaquone and proquanil
What is the mechanism of resistance to Chloroquine?
pump
What are the two toxicities of Chloroquine?
Retinopathy and pruritus
What drug for flukes?
praziquantel
What is the CCR5 antagonist?
Maraviroc
What is the HIV fusion inhibitor?
Enfuvirtide
What is the integrase inhibitor?
Raltegravir
Which two viruses is interferon-α used to treat?
HBV and HCV
Which two viruses is RIbavirin used to treat?
HCV and RSV
What is Ribavirin an analogue of?
Guanine
What is acyclovir an analogue of?
Guanosine
What is gangciclovir an analogue of?
Guanosine
What drug is used for acyclovir resistant HSV?
Cidofovir
What are the MOAs of cidofovir and foscarnet?
viral DNA polymerase inhibitors
What enzyme does Ribavirin inhibit?
Inosine Monophosphate
What are the two toxicities of Ribavirin?
hemolytic anemia
teratogen
Drugs that end in -lovir are effective against which two viruses?
HSV and VZV
Which -lovir is used specifically for HSV?
Famciclovir
What is the toxicity of drugs that end in -lovir?
crystalline nephropathy
What is the toxicity of gangciclovir?
panytopenia
What is foscarnet an analogue of?
Pyrophosphate
What is the toxicity of foscarnet?
nephro
What enzyme does cidofovir inhibit?
viral DNA polymerase
What is the toxicity of cidofovor?
nephro
Which anti-viral is coadministered with Probenecid?
Cidofovir
Which protease inhibitor can cause hematuria?
Indinavir
What is a common toxicity for Protease inhibitors?
Nephrotoxicity
What is the common toxicity for all NRTIs?
bone marrow suppression
What are the two common toxicities for NNRTIs?
rash and hepatotoxicity
What is the integrase inhibitor?
Raltegravir
What is the toxicity of Raltegravir?
Hypercholesterolemia
What inhibits gp41?
Enfuvirtide
What inhibits CCR5? Prevents is from binding?
Maraviroc
gp120
What are the two toxicities of interferons?
Neutropenia and myopathy
Which macrolide is embryotoxic?
Clathiromycin
Which carbapenem has a decreased risk of seizures?
Meropenem
What drug is used to treat Strep in patients allergic to penicillin?
Macrolide
What effect of chloramphenicol is dose-independent?
aplastic anemia
What effect of chloramphenicol is dose-dependent?
anemia
Which two specific bacteria is Clindamycin used treat?
Clostridium and Bacteroides
What three classes of antibiotics are known to cause Pseudomembrane Colitis?
Clindamycin
Ampicillin
Cephalosporins
What are the two atypically named fluoroquinolones?
Enoxacin
Nalidixic acid
What is the most common side effects of fluoroquinolones?
GI Upset
Tendonitis caused by fluoroquinolones is dramictally increased with consumption with what other drug?
Glucocorticoids
What drug is used as prophylaxis for meningococcal?
Rifampin
What drug for dimorphic fungi?
Itraconazole
Which antifungal can decrease the synthesis of testosterone?
Ketoconazole
What is the toxicity of azoles?
liver
What is the function of β-glucan?
cross-links chitin
Which class of anti-fungals is particularly good at treating fungal infections of the toenails and fingernails?
Terbinafine
What is the drug for flukes?
Praziquantel
Which antiviral can cause Ataxia?
Amantadine
What drug is used for CMV retinitis?
Cidofovir
Which HAART is known to cause megaloblastic anemia?
Zidovudine
What are the three NNRTIs?
Nevirapine
Efavienz
Delavirdine
What are the two toxicities for NNRTIs?
rash and hepatotoxicity
What type of drug is Nalidixic Acid?
quinolone
Are cephalosporins cidal or static?
cidal
Which class of antibiotics can cause Vitamin K deficiency?
Cephalosporins
Which three drugs are used for treatment resistant MRSA?
Daptomycin
Linezolid
Vancomycin
Which antibiotic can cause an increase in CK and myopathy?
Daptomycin
Which specific ribosomal subunit does Linezolid cause?
23s
Name three toxicities of Linezoliod
thrombocytopenia
serotonin syndrome
optic neuritis
Are carbapenems beta-lactamase resistant or sensitive?
resistant
Which carbapenem is has a decreased risk of seizures?
Meropenem
Which carbapenem is resistant to Dehydropeptidase?
Meropenem
Which transmitters does permethrin block?
sodium
Which transmitters does malathion block?
Ach
Which transmitters does Lindane block?
GABA
Which anti-fungal is synergistic with Amphotericin B?
Flucytosine
What is the MOA of Bacitracin?
inhibits peptide transfer into bacterial cell wall
Which class of antibiotic causes ototoxicity with loop diuretics?
aminoglycoside
Which class of antibiotic is inactivated by modification? Which three modifications?
aminoglycosides
acetyl/phosphor/adenylation
What is the mechanism of resistance to macolides?
methylation of 23s ribosome
Are fluoroquinolones static or cidal?
cidal
Fluoroquinolones can cause tendon rupture especially with administration of what other drug?
Prednisone
Can linezolid cause pancytopenia?
yes
Which antimicrobial can have a metallic taste?
metronidazole
Which antigen does plasmodium bind?
duffy
What two drugs for life threatening malaria in US? Elsewhere?
US = quinidine or artesunate
Elsewhere = quinine
Which three “-lovir’s” are in the same class?
Acyclovir
Famciclovir
Valacyclovir
What is gangciclovir an analogue of?
Guanosine
Which anti-viral can cause major electrolyte disturbances?
Foscarnet
What functional group do NRTIs lack?
3’ OH
Which NRTI is a nucleotide?
Tenofivir
Which NNRTI produces vivid dreams and CNS symptoms?
Efavirenz
Which metabolic problem can nucleosides NRTIs causes?
lactic acidosis
What three drugs are used for HCV therapy?
ribavirin
simeprevir
sofosbuvir
What is the MOA of Simeprevir?
protease inhibitor
What is the MOA of Sofosbuvir?
RNA dependent RNA polymerase inhibitor
