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IBI Test 2 Leesy > B3.022 - Antimicrobial Drugs > Flashcards

B3.022 - Antimicrobial Drugs Flashcards

1
Q

What are the groups of ICWS

A

Penicillins
Cephalosporins
Beta Lactams
Others

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2
Q

What are the types of penicillins

A

Penicillins
Extended spectrum
Anti Staph
Anti Pseudomonal

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3
Q

What are the Extended spectrum penicillins

A

Ampicillin

Amoxacillin

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4
Q

What are the Anti Staph Penecillins

A

Methicillin
Nafcillin
Oxacillin

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5
Q

What are the Anti Pseudomonal drugs

A

Ticarcillin

Piperacillin

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6
Q

What are the 1st generation cephalosporins

A

Cephalexin

Cefazolin

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7
Q

What are the 2nd generation cephalosporins

A

Cefuroxime
Cefotetan
Cefaclor

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8
Q

What are the 3rd generation cephalosporins

A

Cefotaxime
Ceftriaxone
Ceftazidime

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9
Q

What are the 4th generation cephalosporin drugs

A

Cefepime

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10
Q

What are the other beta lactams

A 
Aztreonam
Imipenam
Meropenam
Clavulanic Acid
Tazobactam
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11
Q

What are the other cell wall synthesis inhibitors

A

Vancomycin
Bacitracin
Fosfomycin

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12
Q

What are the agents that affect cell membranes

A

Polymixin B and E

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13
Q

What are the types of protein synthesis inhibitors

A
  1. Tetracyclines
  2. Macrolides
  3. Aminoglycosides
  4. Others
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14
Q

What are the tetracyclines

A

Tetracycline
Doxycycline
Tigecycline

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15
Q

What are the macrolides

A

Erythromycin
Clarithromycin
Azithromycin
Telithromycin

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16
Q

What are the aminoglycosides

A

Gentamicin
Streptomycin
Tobramycin
Neomycin

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17
Q

What are the other IPSs

A

Chloramphenicol
Clindamycin
Streptogramins
Oxazolidinones

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18
Q

What are the types of inhibitors of folate dependent pathways

A
  1. Sulfonamides

2. Dihydrofolate reductase inhibitors

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19
Q

What are the sulfonamides

A

Sulfamethoxazole
Sulfasalazine
Silver sulfadiazine
Co-trimoxazole

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20
Q

What are the DNA gyrase inhibitors

A

Ciprofloxacin

Levofloxacin

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21
Q

What are the UT antiseptics

A

Nitrofurantoin

Systemic agents

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22
Q

What are the first line anti-mycobacterial drugs

A 
Isoniazid
Ethambutol
Rifampin
Streptomycin
Pyrazinamide
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23
Q

What are the second line anti-mycobacterial drugs

A

Cycloserine
Ethionamide
Capreomycin
PAS

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24
Q

Describe penicillin toxicity

A

Ver selective, bacteriocidal in growing and proliferating cells

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25
Q

What is the MOA of penicillins

A

Covalent binding to transpeptidases/PBPs
Inhibition of cross linking of cell wall
Activation of murein hydrolases (autolysins)

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26
Q

Describe the absorption of penicillins

A

Oral even though they’re acid sensitive
IV, IM
Depot preparation of penicillin G

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27
Q

Describe the distribution of penicillins

A

Good to most tissues except eye, prostate and CNS

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28
Q

How are penicillins excreted

A

Tubular secretion

29
Q

What can block tubular secretion of penicillins

A

Probenecid

30
Q

Which penicillin isn’t excreted tubularly

A

Nafcillin its excreted by bile

31
Q

What is the half life of penicillins

A

1 hour

32
Q

Do penicillins exhibit time dependent or concentration dependent killing

A

Time dependent

33
Q

What are the clinical uses of Pen G and Pen V

A

Primarily gram + bacteria

34
Q

What which penicillin class is beta lactamase resistant

A

Anti staph - nafcillin, methicillin, oxacillin

35
Q

What are the extended spectrum penicillins used for clinically

A

Gram + and some Gram -

36
Q

What are the anti pseudomonal penicillins used for

A

Proteus sp. and pseudomonas

37
Q

What is the issue with using antipsudomonal penicillins and what do you have to combine them with

A

They develop resistance rapidly, combine with aminoglycocides or fluoroquinolones

38
Q

When should antipseudomonals be used

A

Only when absolutely indicated to protect their therapeutic value

39
Q

What are the most common adverse reactions of penicillins

A

Ampicillin rash

Hypersensitivity

40
Q

What is resistance to penicillins due to

A 
No cell wall
No activation of autopsies (murein hydrolases)
Metabolically inactive 
Inaccessible PBPs 
Beta lactamase production
41
Q

What can you do to prevent resistance due to beta lactamase

A

Give a beta lactamase inhibitor
Clavulanic acid
Sulbactam
Tazobactam

42
Q

What are issues associated with overuse of penicillins

A

Resistance
Sensitization
Superinfections be resistant organisms

43
Q

What are cephalosporins used for

A

In penicillins won’t work, less sensitive to beta lactamase

Broader spectrum of activity

44
Q

What is a negative about using cephalosporins instead of penicillins

A

Renal toxicity is more common
Poor oral absorption
Some cross reactivity with penicillins

45
Q

As the generation of cephalosporins goes up so does

A 
Greater gram - activity
Less beta lactamase activity 
Cephalosporinase resistant 
Less toxic to patient 
Better distribution especially to CNS
46
Q

What are adverse effects of cephalosporins

A

Renal toxicity, enhanced by aminoglycosides
Disulfiram effect; bleeding and platelet disorders
Hypersensitivity

47
Q

What is aztreonam used for

A

Gram - aerobes

48
Q

How do azteronam and Imipenem respond to beta lactamase

A

They are resistant

49
Q

Do aztreonam and imipenem cross the blood brain barrier?

A

Yes

50
Q

What is imipenem used for

A

Broad spectrum gram + and gram -, anaerobes

51
Q

What should imipenem be used with if treating pseudomonas

A

Aminoglycosides

52
Q

How is imipenem administered

A

IV only

53
Q

How is imipenem inactivated and how do you prevent that

A

Renal dipeptidase, co administer with cilastatin

54
Q

What is meropenem

A

Dipeptidase resistant carbapenem (as opposed to imipenem)

55
Q

How does vancomycin work

A

Inhibits transglycoslylation (step right before transpeptidation)

56
Q

What is vancomycin used for

A

Bacteriocidal for gram +

57
Q

How is vancomycin administered and for what

A

Orally for C. Diff

IV for systemic infections

58
Q

What is vancomycin synergistic with when treating MRSA

A

Aminoglycosides

59
Q

How is vancomycin cleared from IV administration

A

Through the kidneys - enhances oto and renal toxicity of aminoglycosides

60
Q

What is an adverse effect of vancomycin caused by histamine release and how is it avoided

A

Red man or red neck syndrome, administer slowly or with antihistamines

61
Q

What is something negative that developed because of vancomycin overuse

A

Vancomycin depended enterococci

62
Q

What is fosfomycin used for

A

Gram + and gram -

63
Q

What is fosfomycins MOA

A

inhibits cytoplasmic step in cell wall precursor synthesis

64
Q

How is fosfomycin taken up

A

Using G6P transporter

65
Q

How is fosfomycin taken, excreted and what type of infection is it used for

A

Oral, kidney, single dose therapy for UTI

66
Q

What is fosfomycin synergistic with

A

Beta lactamase, aminoglycosides, fluoroquinolones

67
Q

What are polymixin B and E used for

A

Active against gram - except proteus and neisseria

Limited to topical use due to renal toxicity

68
Q

When is polymixin B and E specifically used for

A

Salvage therapy

IBI Test 2 Leesy (13 decks)

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