Block 1 - Abx Review Flashcards

1
Q

Which AB affect cell wall?

A

Beta lactams

Bacitracin

Glycopeptides

Lipoglycopeptides

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2
Q

Which AB affect DNA/RNA synthesis?

A

Fluoroquinolones

Rifamycins

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3
Q

Which AB affect folate synthesis?

A

Sulfonamides

Trimethoprim

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4
Q

Which AB affect cell membrane?

A

Daptomycin

Polymyxins

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5
Q

Which AB affect 50s subunit protein synthesis?

A

Chloramphenicol

Lincosamides

Macrolides

Oxazolidinones

Pleuromutilins

Streptogramins

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6
Q

Which AB affect 30s subunit protein synthesis?

A

Aminoglycosides

Tetracyclines

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7
Q

Beta lactam target?

A

Cell wall

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8
Q

Bacitracin target?

A

Cell wall

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9
Q

Glycopeptide target?

A

Cell wall

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10
Q

Fluoroquinolone target?

A

DNA/RNA synthesis

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11
Q

Rifamycin target?

A

DNA/RNA synthesis

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12
Q

Sulfonamide target?

A

Folate synthesis

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13
Q

Trimethoprim target?

A

Folate synthesis

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14
Q

Daptomycin target?

A

Cell membrane

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15
Q

Polymyxin target?

A

Cell membrane

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16
Q

Chloramphenicol target?

A

50s subunit

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17
Q

Lincosamide target?

A

50s subunit

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18
Q

Macrolide target?

A

50s subunit

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19
Q

Beta lactam target?

A

Cell wall

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20
Q

Bacitracin target?

A

Cell wall

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21
Q

Glycopeptide target?

A

Cell wall

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22
Q

Fluoroquinolone target?

A

DNA/RNA synthesis

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23
Q

Rifamycin target?

A

DNA/RNA synthesis

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24
Q

Which AB can cause diarrhea and C. diff colitis?

A

All of them

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25
Q

Trimethoprim target?

A

Folate synthesis

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26
Q

Daptomycin target?

A

Cell membrane

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27
Q

Polymyxin target?

A

Cell membrane

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28
Q

Chloramphenicol target?

A

50s subunit

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29
Q

Lincosamide target?

A

50s subunit

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30
Q

Counseling points on natural penicillins?

A

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

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31
Q

Oxazolidinone target?

A

50s subunit

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32
Q

Pleuromutilin target?

A

50s subunit

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33
Q

Anti-staphylococcal PCN AE?

A

High salt load and hepatotoxicity

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34
Q

Anti-staphylococcal PCN counseling points?

A

Caution to those w/ HF

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35
Q

Tetracycline target?

A

30s subunit

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36
Q

What does the beta lactam ring consist of?

A

4 member ring with a nitrogen and a double bond to an oxygen

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37
Q

Beta lactams are (bactericidal/static)

A

Bactericidal

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38
Q

Which AB are found in the beta lactam group?

A

Penicillins

Cephalosporins

Carbapenems

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39
Q

Complete beta-lactam MOA?

A

Inhibits cell wall synthesis by binding to penicillin-binding proteins which inhibits final transpeptidation step

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40
Q

What are the natural penicillins?

A

Pen G and V

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41
Q

What are the anti-staphylococcal PCNs?

A

Oxacillin

Nafcillin

Dicloxacillin

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42
Q

Cefoxitin is a ___ Gen cephalosporin

A

2nd

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43
Q

Anti-staphylococcal PCN counseling points?

A

Caution to those w/ HF

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44
Q

What are the broad-spectrum PCNs?

A

Aminopenicillins

Ampicillin/Amoxicillin

Augmentin

Unasyn

Zosyn

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45
Q

What are the 3rd Gen cephalosporins?

A

Cefotaxime
Ceftriaxone
Ceftazidime

Cefixime
Cefpodoxime
Cefdinir

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46
Q

3rd Gen cephalosporin AE?

A

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

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47
Q

What are the 2nd Gen cephalosporins?

A

Cefotetan

Cefoxitin

Cefuroxime

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48
Q

2nd Gen cephalosporin AE?

A

Disulfiram-like rxn w/ cefotetan

Oral contraceptive efficacy with cefuroxime may be reduced

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49
Q

Cefazolin is a ___ Gen cephalosporin

A

1st

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50
Q

Cephalexin is a ___ Gen cephalosporin

A

1st

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51
Q

Cefotetan is a ___ Gen cephalosporin

A

2nd

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52
Q

Cefoxitin is a ___ Gen cephalosporin

A

2nd

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53
Q

Cefuroxime is a ___ Gen cephalosporin

A

2nd

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54
Q

Which 1st Gen cephalosporin is IV/PO?

A

IV: cefazolin

PO: cephalexin

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55
Q

Which 2nd Gen cephalosporin is IV/PO?

A

IV: cefotetan, cefoxitin

PO: cefuroxime

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56
Q

Cefotaxime is a ___ Gen cephalosporin

A

3rd

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57
Q

Ceftazidime/Avibactam AE?

A

High salt load, caution in HF pts

Positive direct Coombs test

Neuro issues

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58
Q

What are the carbapenems?

A

Meropenem

Imipenem/cilastatin

Doripenem

Ertapenem

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59
Q

What are the IV formulated 3rd Gen cephalosporins?

A

Cefotaxime

Ceftriaxone

Ceftazidime

60
Q

What are the PO formulated 3rd Gen cephalosporins?

A

Cefixime

Cefpodoxime

Cefdinir

61
Q

Imipenem/cilastatin/relebactam AE?

A

HTN, AST/ALT elevation, seizures, DDI w/ ganciclovir and valproic acid and divalproex

62
Q

When is aztreonam utilized?

A

Pt w/ severe penicillin allergies

If pt is allergic to ceftazidime, dont use. it shares the same side chain

63
Q

Cefdinir is a ___ Gen cephalosporin

A

3rd

64
Q

Vancomycin MOA?

A

Inhibits cell wall by blocking polymerization by binding to D-ala-D-ala portion of precursor

65
Q

4th Gen cephalosporin AE?

A

Positive direct Coombs test

ALT/AST elevation

Neuro issues

66
Q

Lipoglycopeptide MOA?

A

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
Q

Carbapenem AE?

A

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
Q

Lipoglycopeptide AE?

A

N/V

Headache for Dalbavancin and Oritavancin

Gi hemorrhage for Dalbavancin and Oritavancin

69
Q

When is aztreonam utilized?

A

Pt w/ severe penicillin allergies

70
Q

Fosfomycin AE and counseling points?

A

Diarrhea

Mix with 3-4oz in COOL water

30% absorbed w/ food

37% absorbed w/o food

DDI w/ antacids

71
Q

Which beta-lactams have highest risk of C. diff colitis?

A

Ampicillin

3rd Gen cephalosporins

72
Q

Vancomycin MOA?

A

Inhibits cell wall by blocking polymerization by binding to D-ala-D-ala portion of precursor

73
Q

Vancomycin AE?

A

Nephro and ototoxicity

Red Man Syndrome + SJS

For Red Man Syndrome, final concentration should not exceed 5mg/ml

74
Q

What are the lipoglycopeptides?

A

Telavancin

Dalbavancin

Oritavancin

75
Q

Fluoroquinolone MOA?

A

Inhibits Topoisomerase II (DNA Gyrase) and IV

76
Q

Lipoglycopeptides are bactericidal/static?

A

Bactericidal

77
Q

Fluoroquinolone DDI?

A

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
Q

Which lipoglycopeptide has a BBW? What is it?

A

Telavancin

Increased mortality in CrCl≤50 treated for HAP/VAP

79
Q

Fosfomycin MOA?

A

Phosphonic acid derivative

Inhibits cell wall synthesis by inactivating pyruvyl transferase

80
Q

Which AB causes urine to change to orange/brown?

A

Metronidazole

81
Q

Metronidazole causes urine to change to what color?

A

Orange/brown

82
Q

Metronidazole AE?

A

Abnormal taste

Peripheral neuropathy

Disulfiram-like rxn

Orange/brown urine

83
Q

Nitrofurantoin MOA?

A

Reduced by flavoproteins to reactive intermediates that alter or inactivate proteins

84
Q

Polymyxin AE?

A

Nephrotoxicity (reversible)

Neurotoxicity

Circumoral and peripheral paresthesia

85
Q

Fluoroquinolone MOA?

A

Inhibits Topoisomerase II (DNA Gyrase) and IV

86
Q

Fluoroquinolone AE?

A

Photosensitivity

Tendon rupture

Hypo/hyperglycemia

Myasthenia gravis exacerbation

87
Q

Rifamycin MOA?

A

Inhibits RNA synthesis by binding to beta subunits of RNA polymerase

88
Q

Rifampin AE?

A

Liver toxicity

Teeth, urine, sweat, tears may change to red/orange

89
Q

Which AB is a nitroimidazole AB?

A

Metrondiazole

90
Q

Which AB causes urine to change to orange/brown?

A

Metronidazole

91
Q

Metronidazole causes urine to change to what color?

A

Orange/brown

92
Q

Bactrim AE?

A

Rash

SJS

Increased SCr

Crystalluria

Hyperkalemia

Sun Sensitivity

QTc prolongation

93
Q

Bactrim counseling points?

A

Take w/o regard of food

Drink water to prevent crystalluria

94
Q

Chloramphenicol AE?

A

Blood dyscrasias

Bone marrow suppression

Fatal aplastic anemia

Gray baby syndrome

95
Q

What AB causes urine to change to brown?

A

Nitrofurantoin

96
Q

Oxazolidinones AE?

A

Bone marrow suppression

Peripheral neuropathy

Optic neuritis

Serotonin syndrome

97
Q

Oxazolidinone counseling point?

A

Report use of MAOIs within last 14 days prior to initiating therapy

Avoid consuming foods w/ lots of tyramine (>100mg)

98
Q

Sulfamethoxazole MOA?

A

Interferes with bacterial folic acid synthesis

99
Q

Trimethoprim MOA?

A

Inhibits dihydrofolic acid reduction

Inhibits enzymes of folic acid pathway

100
Q

Clindamycin AE and counseling points?

A

Colitis (BBW)

Take w/ water to avoid esophageal irritation

101
Q

What are the oxazolidinones and what is the MOA?

A

Linezolid and tedizolid

Inhibits synthesis by binding to 23S of 50S subunit

102
Q

Tetracycline AE?

A

Esophagitis

Photosensitivity

Pseudotumor cerebri

Enamel hypoplasia and mottling of teeth (<8yrs old)

Stops bone growth/development in kids

Teratogenicity

103
Q

Oxazolidinone counseling point?

A

Report use of MAOIs within last 14 days prior to initiating therapy

Avoid consuming foods w/ lots of tyramine (>100mg)

104
Q

What are the pleuromutilins?

A

Retapamulin

Lefamulin

105
Q

Tigecycline AE and counseling points?

A

N/V

Death (BBW)

Pancreas and liver issues

May decrease effectiveness of oral contraceptives

106
Q

Which AB has a BBW of mortality?

A

Tigecycline

107
Q

Which AB are teratogenic

A

Pleuromutilins, Tetracyclines, and Telavancin

108
Q

Streptogramin AE?

A

Hyperbilirubinemia

Arthralgia

Myalgia

Hepatitis

109
Q

Which AB class must you report jaundice, arthralgia, or myalgia?

A

Streptogramins

110
Q

Which AB should you not take with a high tyramine diet?

A

Oxazolidinone

111
Q

Which AB should been used in caution in HF pt due to high salt load?

A

Ceftazidime/Avibactam

Anti-staphylococcal PCN

112
Q

Tetracycline Counseling points?

A

Take with water

Avoid antacids, iron, or pepto

Take on an empty stomach

113
Q

Tigecycline AE and counseling points?

A

N/V

Death (BBW)

Pancreas and liver issues

May decrease effectiveness of oral contraceptives

114
Q

Which AB has a BBW of mortality?

A

Tigecycline

115
Q

Which AB has increased bleed risk w/ warfarin?

A

Macrolides

116
Q

Which AB have increased LFTs as their potential AE?

A

Aztreonam and Dapto

117
Q

Which AB has an IV AND inhaled formulation?

A

Aztreonam

118
Q

What AB causes sodium overload?

A

Beta-lactams

119
Q

Which AB has a BBW of mortality in pt with CrCl≤50 being treated for HAP/VAP?

A

Telavancin

120
Q

Which AB must be mixed in cool water prior to adminstration?

A

Fosfomycin

121
Q

Which AB causes circumoral and peripheral paresthia?

A

Polymyxins (for both)

Oxazolidinones (for peripheral only)

122
Q

Which AB inhibits Topoisomerase II (DNA Gyrase) and IV

A

Fluoroquinolones

123
Q

Macrolide AE?

A

Increased bleed risk w/ warfarin

Exacerbation of myasthenia gravis

Avoid use with statins

124
Q

Which AB causes crystalluria?

A

Bactrim

125
Q

Which AB causes hyperkalemia?

A

Bactrim

126
Q

What AB causes sodium overload?

A

Beta-lactams

127
Q

Which AB can cause gray baby syndrome?

A

Chloramphenicol

128
Q

Which AB causes circumoral and peripheral paresthia?

A

Polymyxins

129
Q

Which AB causes serotonin syndrome?

A

Oxazolidinones

130
Q

Which AB has a BBW for tendon rupture?

A

Fluoroquinolones

131
Q

Which AB can cause fatal aplastic anemia

A

Chloramphenicol

132
Q

Which AB has a BBW of colitis?

A

Clindamycin

133
Q

Which AB causes optic neuritis?

A

Oxazolidinones

134
Q

Which AB has bone marrow suppression?

A

Chloramphenicol and Oxazolidinone

135
Q

Which AB has AE of pseudotumor cerebri?

A

Tigecycline and Tetracycline

136
Q

Which AB class makes myasthenia gravis worse?

A

Macrolides + Fluoroquinolones

137
Q

Which AB causes sludging/kernicterus of newborns?

A

Ceftriaxone

138
Q

Statins should be avoided in which AB?

A

Macrolides and Dapto

139
Q

Which AB causes enamel hypoplasia and mottling of teeth (<8yrs old)

A

Tetracycline

140
Q

Which AB causes blood dyscrasias?

A

Chloramphenicol

141
Q

Which AB causes peripheral neuropathy?

A

Flagyl and Oxazolidinones

142
Q

Which AB causes disulfiram-like rxn?

A

Flagyl and cefotetan

143
Q

Which AB causes serum sickness?

A

3rd Gen Cephs

144
Q

Pleuromutilin AE?

A

QTc prolongation

Teratogenicity

145
Q

Which AB causes QTc prolongation?

A

Pleuromutilins + Bactrim