Block 1 - Abx Review Flashcards
1
Q
Which AB affect cell wall?
A
Beta lactams
Bacitracin
Glycopeptides
Lipoglycopeptides
2
Q
Which AB affect DNA/RNA synthesis?
A
Fluoroquinolones
Rifamycins
3
Q
Which AB affect folate synthesis?
A
Sulfonamides
Trimethoprim
4
Q
Which AB affect cell membrane?
A
Daptomycin
Polymyxins
5
Q
Which AB affect 50s subunit protein synthesis?
A
Chloramphenicol
Lincosamides
Macrolides
Oxazolidinones
Pleuromutilins
Streptogramins
6
Q
Which AB affect 30s subunit protein synthesis?
A
Aminoglycosides
Tetracyclines
7
Q
Beta lactam target?
A
Cell wall
8
Q
Bacitracin target?
A
Cell wall
9
Q
Glycopeptide target?
A
Cell wall
10
Q
Fluoroquinolone target?
A
DNA/RNA synthesis
11
Q
Rifamycin target?
A
DNA/RNA synthesis
12
Q
Sulfonamide target?
A
Folate synthesis
13
Q
Trimethoprim target?
A
Folate synthesis
14
Q
Daptomycin target?
A
Cell membrane
15
Q
Polymyxin target?
A
Cell membrane
16
Q
Chloramphenicol target?
A
50s subunit
17
Q
Lincosamide target?
A
50s subunit
18
Q
Macrolide target?
A
50s subunit
19
Q
Beta lactam target?
A
Cell wall
20
Q
Bacitracin target?
A
Cell wall
21
Q
Glycopeptide target?
A
Cell wall
22
Q
Fluoroquinolone target?
A
DNA/RNA synthesis
23
Q
Rifamycin target?
A
DNA/RNA synthesis
24
Q
Which AB can cause diarrhea and C. diff colitis?
A
All of them
25
Trimethoprim target?
Folate synthesis
26
Daptomycin target?
Cell membrane
27
Polymyxin target?
Cell membrane
28
Chloramphenicol target?
50s subunit
29
Lincosamide target?
50s subunit
30
Counseling points on natural penicillins?
IM formulation should not be given IV
May decrease effectiveness of oral contraceptives
Pen VK should be taken on an empty stomach 1hr before or 2hrs after meals to enhance absorption
31
Oxazolidinone target?
50s subunit
32
Pleuromutilin target?
50s subunit
33
Anti-staphylococcal PCN AE?
High salt load and hepatotoxicity
34
Anti-staphylococcal PCN counseling points?
Caution to those w/ HF
35
Tetracycline target?
30s subunit
36
What does the beta lactam ring consist of?
4 member ring with a nitrogen and a double bond to an oxygen
37
Beta lactams are (bactericidal/static)
Bactericidal
38
Which AB are found in the beta lactam group?
Penicillins
Cephalosporins
Carbapenems
39
Complete beta-lactam MOA?
Inhibits cell wall synthesis by binding to penicillin-binding proteins which inhibits final transpeptidation step
40
What are the natural penicillins?
Pen G and V
41
What are the anti-staphylococcal PCNs?
Oxacillin
Nafcillin
Dicloxacillin
42
Cefoxitin is a ___ Gen cephalosporin
2nd
43
Anti-staphylococcal PCN counseling points?
Caution to those w/ HF
44
What are the broad-spectrum PCNs?
Aminopenicillins
Ampicillin/Amoxicillin
Augmentin
Unasyn
Zosyn
45
What are the 3rd Gen cephalosporins?
Cefotaxime
Ceftriaxone
Ceftazidime
Cefixime
Cefpodoxime
Cefdinir
46
3rd Gen cephalosporin AE?
Ceftriaxone causes biliary sludging/kernicterus of newborns
Dont administer ceftriaxone w/ calcium solutions
Serum-sickness rxn
Cefdinir = liver issues
Cefpodoxime = take w/ food
Cefdinir = take at least 2hrs before/after antacids or iron
47
What are the 2nd Gen cephalosporins?
Cefotetan
Cefoxitin
Cefuroxime
48
2nd Gen cephalosporin AE?
Disulfiram-like rxn w/ cefotetan
Oral contraceptive efficacy with cefuroxime may be reduced
49
Cefazolin is a ___ Gen cephalosporin
1st
50
Cephalexin is a ___ Gen cephalosporin
1st
51
Cefotetan is a ___ Gen cephalosporin
2nd
52
Cefoxitin is a ___ Gen cephalosporin
2nd
53
Cefuroxime is a ___ Gen cephalosporin
2nd
54
Which 1st Gen cephalosporin is IV/PO?
IV: cefazolin
PO: cephalexin
55
Which 2nd Gen cephalosporin is IV/PO?
IV: cefotetan, cefoxitin
PO: cefuroxime
56
Cefotaxime is a ___ Gen cephalosporin
3rd
57
Ceftazidime/Avibactam AE?
High salt load, caution in HF pts
Positive direct Coombs test
Neuro issues
58
What are the carbapenems?
Meropenem
Imipenem/cilastatin
Doripenem
Ertapenem
59
What are the IV formulated 3rd Gen cephalosporins?
Cefotaxime
Ceftriaxone
Ceftazidime
60
What are the PO formulated 3rd Gen cephalosporins?
Cefixime
Cefpodoxime
Cefdinir
61
Imipenem/cilastatin/relebactam AE?
HTN, AST/ALT elevation, seizures, DDI w/ ganciclovir and valproic acid and divalproex
62
When is aztreonam utilized?
Pt w/ severe penicillin allergies
If pt is allergic to ceftazidime, dont use. it shares the same side chain
63
Cefdinir is a ___ Gen cephalosporin
3rd
64
Vancomycin MOA?
Inhibits cell wall by blocking polymerization by binding to D-ala-D-ala portion of precursor
65
4th Gen cephalosporin AE?
Positive direct Coombs test
ALT/AST elevation
Neuro issues
66
Lipoglycopeptide MOA?
Inhibits cell wall by blocking polymerization by binding to D-ala-D-ala portion of precursor
Telavancin additional MOA disrupts membrane potential, changes cell permeability due to lipophilic side chain moiety
67
Carbapenem AE?
Seizures (Imipenem most, doripenem least)
Neuro issues
Coordination issues w/ meropenem
Cant take imipenem/cilastatin w/ ganciclovir
SJS, necrolysis with imipenem/cilastatin dn doripenem
68
Lipoglycopeptide AE?
N/V
Headache for Dalbavancin and Oritavancin
Gi hemorrhage for Dalbavancin and Oritavancin
69
When is aztreonam utilized?
Pt w/ severe penicillin allergies
70
Fosfomycin AE and counseling points?
Diarrhea
Mix with 3-4oz in COOL water
30% absorbed w/ food
37% absorbed w/o food
DDI w/ antacids
71
Which beta-lactams have highest risk of C. diff colitis?
Ampicillin
3rd Gen cephalosporins
72
Vancomycin MOA?
Inhibits cell wall by blocking polymerization by binding to D-ala-D-ala portion of precursor
73
Vancomycin AE?
Nephro and ototoxicity
Red Man Syndrome + SJS
For Red Man Syndrome, final concentration should not exceed 5mg/ml
74
What are the lipoglycopeptides?
Telavancin
Dalbavancin
Oritavancin
75
Fluoroquinolone MOA?
Inhibits Topoisomerase II (DNA Gyrase) and IV
76
Lipoglycopeptides are bactericidal/static?
Bactericidal
77
Fluoroquinolone DDI?
Antacids
Cipro - 2hr prior and 6hrs after
Levo - 2hrs prior and after
Moxi - 4hrs prior and 8 hrs after
Dela - 2hrs prior and after
78
Which lipoglycopeptide has a BBW? What is it?
Telavancin
Increased mortality in CrCl≤50 treated for HAP/VAP
79
Fosfomycin MOA?
Phosphonic acid derivative
Inhibits cell wall synthesis by inactivating pyruvyl transferase
80
Which AB causes urine to change to orange/brown?
Metronidazole
81
Metronidazole causes urine to change to what color?
Orange/brown
82
Metronidazole AE?
Abnormal taste
Peripheral neuropathy
Disulfiram-like rxn
Orange/brown urine
83
Nitrofurantoin MOA?
Reduced by flavoproteins to reactive intermediates that alter or inactivate proteins
84
Polymyxin AE?
Nephrotoxicity (reversible)
Neurotoxicity
Circumoral and peripheral paresthesia
85
Fluoroquinolone MOA?
Inhibits Topoisomerase II (DNA Gyrase) and IV
86
Fluoroquinolone AE?
Photosensitivity
Tendon rupture
Hypo/hyperglycemia
Myasthenia gravis exacerbation
87
Rifamycin MOA?
Inhibits RNA synthesis by binding to beta subunits of RNA polymerase
88
Rifampin AE?
Liver toxicity
Teeth, urine, sweat, tears may change to red/orange
89
Which AB is a nitroimidazole AB?
Metrondiazole
90
Which AB causes urine to change to orange/brown?
Metronidazole
91
Metronidazole causes urine to change to what color?
Orange/brown
92
Bactrim AE?
Rash
SJS
Increased SCr
Crystalluria
Hyperkalemia
Sun Sensitivity
QTc prolongation
93
Bactrim counseling points?
Take w/o regard of food
Drink water to prevent crystalluria
94
Chloramphenicol AE?
Blood dyscrasias
Bone marrow suppression
Fatal aplastic anemia
Gray baby syndrome
95
What AB causes urine to change to brown?
Nitrofurantoin
96
Oxazolidinones AE?
Bone marrow suppression
Peripheral neuropathy
Optic neuritis
Serotonin syndrome
97
Oxazolidinone counseling point?
Report use of MAOIs within last 14 days prior to initiating therapy
Avoid consuming foods w/ lots of tyramine (>100mg)
98
Sulfamethoxazole MOA?
Interferes with bacterial folic acid synthesis
99
Trimethoprim MOA?
Inhibits dihydrofolic acid reduction
Inhibits enzymes of folic acid pathway
100
Clindamycin AE and counseling points?
Colitis (BBW)
Take w/ water to avoid esophageal irritation
101
What are the oxazolidinones and what is the MOA?
Linezolid and tedizolid
Inhibits synthesis by binding to 23S of 50S subunit
102
Tetracycline AE?
Esophagitis
Photosensitivity
Pseudotumor cerebri
Enamel hypoplasia and mottling of teeth (<8yrs old)
Stops bone growth/development in kids
Teratogenicity
103
Oxazolidinone counseling point?
Report use of MAOIs within last 14 days prior to initiating therapy
Avoid consuming foods w/ lots of tyramine (>100mg)
104
What are the pleuromutilins?
Retapamulin
Lefamulin
105
Tigecycline AE and counseling points?
N/V
Death (BBW)
Pancreas and liver issues
May decrease effectiveness of oral contraceptives
106
Which AB has a BBW of mortality?
Tigecycline
107
Which AB are teratogenic
Pleuromutilins, Tetracyclines, and Telavancin
108
Streptogramin AE?
Hyperbilirubinemia
Arthralgia
Myalgia
Hepatitis
109
Which AB class must you report jaundice, arthralgia, or myalgia?
Streptogramins
110
Which AB should you not take with a high tyramine diet?
Oxazolidinone
111
Which AB should been used in caution in HF pt due to high salt load?
Ceftazidime/Avibactam
Anti-staphylococcal PCN
112
Tetracycline Counseling points?
Take with water
Avoid antacids, iron, or pepto
Take on an empty stomach
113
Tigecycline AE and counseling points?
N/V
Death (BBW)
Pancreas and liver issues
May decrease effectiveness of oral contraceptives
114
Which AB has a BBW of mortality?
Tigecycline
115
Which AB has increased bleed risk w/ warfarin?
Macrolides
116
Which AB have increased LFTs as their potential AE?
Aztreonam and Dapto
117
Which AB has an IV AND inhaled formulation?
Aztreonam
118
What AB causes sodium overload?
Beta-lactams
119
Which AB has a BBW of mortality in pt with CrCl≤50 being treated for HAP/VAP?
Telavancin
120
Which AB must be mixed in cool water prior to adminstration?
Fosfomycin
121
Which AB causes circumoral and peripheral paresthia?
Polymyxins (for both)
Oxazolidinones (for peripheral only)
122
Which AB inhibits Topoisomerase II (DNA Gyrase) and IV
Fluoroquinolones
123
Macrolide AE?
Increased bleed risk w/ warfarin
Exacerbation of myasthenia gravis
Avoid use with statins
124
Which AB causes crystalluria?
Bactrim
125
Which AB causes hyperkalemia?
Bactrim
126
What AB causes sodium overload?
Beta-lactams
127
Which AB can cause gray baby syndrome?
Chloramphenicol
128
Which AB causes circumoral and peripheral paresthia?
Polymyxins
129
Which AB causes serotonin syndrome?
Oxazolidinones
130
Which AB has a BBW for tendon rupture?
Fluoroquinolones
131
Which AB can cause fatal aplastic anemia
Chloramphenicol
132
Which AB has a BBW of colitis?
Clindamycin
133
Which AB causes optic neuritis?
Oxazolidinones
134
Which AB has bone marrow suppression?
Chloramphenicol and Oxazolidinone
135
Which AB has AE of pseudotumor cerebri?
Tigecycline and Tetracycline
136
Which AB class makes myasthenia gravis worse?
Macrolides + Fluoroquinolones
137
Which AB causes sludging/kernicterus of newborns?
Ceftriaxone
138
Statins should be avoided in which AB?
Macrolides and Dapto
139
Which AB causes enamel hypoplasia and mottling of teeth (<8yrs old)
Tetracycline
140
Which AB causes blood dyscrasias?
Chloramphenicol
141
Which AB causes peripheral neuropathy?
Flagyl and Oxazolidinones
142
Which AB causes disulfiram-like rxn?
Flagyl and cefotetan
143
Which AB causes serum sickness?
3rd Gen Cephs
144
Pleuromutilin AE?
QTc prolongation
Teratogenicity
145
Which AB causes QTc prolongation?
Pleuromutilins + Bactrim
