CC1 & L1 Intro Flashcards

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1
Q

3 obligate intracellular bacteria

A

Mycobacterium Leprae
Chlamydiae spp.
Rickettsia spp.

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2
Q

3 important encapsulated bacteria

A

Niesseria meningitidis
streptococcus pneumoniae
Hemphoulis influenza

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3
Q

5 Facultative intracellular bacteria

A
salmonella spp. 
shigella spp. 
listeria monocytogenes
legionella spp.
mycobacterium tuberculosis 

also most fungi and protozoa are fac. intracellular

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4
Q

Extracellular 3 bact., 1 fungi, 1 parasite

A

Most gram+ (except listeria)
vibrio cholerae
treponema pallidum

fungi: cryptococcus spp.
parasites: giardia

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5
Q

Gram Neg LPS and antigens

A

LPS - inflammations and causes disease

- Lipid A - endotoxin 
- O-antigen - variability, complement resistance, bile resistance - enteric bacteria 
- Core - LOS - no O antigen - not usually enteric - still has the Lipid A endotoxin - gram + super antigen are similar that cause shock  - H-antigen - flagella - K- antigen - capsule
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6
Q

bacteristatic antibiotics

A

tetracyclines, macrolides (azithromycin, erythromycin) clindamycin, linezolids, tigecycline

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7
Q

bactericidal

A

penicillins, cephalosporins, aminoglycosides, vancomycin, fluoroquinolones, monobactams, daptomycin

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8
Q

B-lactam categories, mech of action, resistance

A
  • penicillin, cephalosporin, carbapenems, monobactams, vancomycin (glycopeptide), fosfomycin
  • Mechanism: resemble D-ala D-ala that is usually bound by PBP and then is crosslinked by PBP
    • Penicillin is bound by PBP isntead, inhibiting it, - cidal activity (except against enterococcus)
  • Resistance:
    • alter target: PBP - they don’t bind penicllin anymore
      • staph, strep, enterococcus (gram +)
    • increase efflux pumps
    • loss of porins
    • B-lactamases - staph
      • in periplasmic space of gram -, outside membrane gram+
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9
Q

Antibiotic cell wall inhibitor categories

A

B-lactams
vancomycin
fosfomycin

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10
Q

Vancomycin -mech, resistance, target, toxicity

A

Mech: binds D-ala to prevent cross linking, 1 step before B-lactams
Resistance: altered binding site -D-ala D-lac
- really thick cell wall so it can’t get in and do job
Target: Gram + (including MRSA, and non VRE enterococcus, ) and C.diff
Tox: red man rash
- nephrotoxicity

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11
Q

Fosfomycin - mech, target

A
  • inhibits formation of peptidoglycan precursors
  • well tolerated
  • gram + - staph, strep, entero
    gram neg - E. coli and others - no pseudomonas
  • only used for first line for uncomplicated UTI (TMP/SMX resistance
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12
Q

6 Protein synthesis inhibitor antitbiotics and mech

A

Types: aminoglycosides, macrolides (azithromycin, clarithramycin, erythramycin), tetracyclines, linezoild, clindamycin, tigecycline

Mechanism:
Block 50S - inhibit translation, block the translocation/elongation part
Block 30S: black tRNA access to ribosome, or bind rRNA

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13
Q

4 Antibiotics categories that inhibit DNA/RNA synthesis

A
  • TMP/SMX - block 2 steps in purine formation
    • 100,000x more effective against bact
    • resistance - target site mutation
  • Rifamycins (rifampin)
    • block DdRp - inhibit RNA synthesis
    • target site mutation
  • Fluoroquinolones
    • block topoisomerases
    • Resistance: abx mod enzymes, target mutation, efflux pumps
    • Ciprofloxacin
    • Levofloxacine
    • Moxifloxacine
  • Fidazomicin
    • inhibits transcription of RNA pol
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14
Q

2 DNA damaging antibiotics

A
  • Nitrofurantoin
    • reduced to form ROS damage DNA
    • resistance: mutation of reductase that makes the ROS from it
  • Metronidazole
    • pro-drug, is reduced to radiacals the damage DNA - anaerobic nitro-reduction
    • resistaance - rare, multiple
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15
Q

2 antibiotics that damage cell membranes

A
  • Daptomycin
    • bind to membrane, cause depolarization/efflux K+
    • cell death
      resistance - thick cel wall/altered binding site (still studied)
  • Polymyxin (colistin)
    • inserts into membrane than acts as a detergent that dissolves membranes
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16
Q

Non-renal elimination (unlike most that requires renal dosing

A
  • Cetriazone*
  • Moxifloxacin*
  • azithromycin
  • clindamycin
  • rifampin
  • tetracycline
  • fidaxomicin
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17
Q

Hepatic dosing required

A
Tigecycline
Rifampin
Cetriazone
Metronidazole
Clindamycin
Nafcillin/Oxacilin
18
Q

Good Oral absorption

A
Fluoroquinolones ** (di/tri cations)
Tetracyclines ** (di/tri cations)
clindamycine
linezolid
metronidazole
nitrofurantoin
rifampin
TMP/SMX
b-lactams
macrolides
19
Q

bad oral

A

aminoglycosides
vancomycin
fidaxomicin

20
Q

Excellent CSF /wide distribution

A

metronidazole
Rifampin
TMP/SMX
Linezold

21
Q

Good CSF

A
vancomycin
cetriaxone
cefuroxime
ceftazidime
cefepime
imipenen
meropenem
  • fluroquinolones
22
Q

Poor distribution

A

aminoglycosides
daptomycin
polymyxin
nitrofurantoin (only UTI)

23
Q

4 Conc. dependent antibiotics

A

aminoglycosides
fluoroquinolones
daptomycin
metronidazole

24
Q

3 Time dependent

A

B-lactams
linezolid
TMP/SMX

25
Q

Pseudomonas Coverage

A
  • Piperacilin/tazobactam
  • Doripenem, meropenem, imipenem
  • aztrenoam
  • cefepime, ceftrazidime
  • Gentamicin, trobramycin, amikacin
  • levofloxacin, ciprofloxacin
  • polymyxin

Get MICs and PD to TACCL PA

26
Q

Methicillin resistant Staph. aureus - antibiotics that fight

A
Daptomycin
Tetracyclin/tigecycline
ceftaroline
TMP/SMX
Vancomycin
Linezolid
Clindamycin

Drugs To Confidently Treat Very Lethal Commensals

27
Q

Antibiotics for VRE (vancomycin resistant enterococcus)

A

Linezolid
Daptomycin
Tigecycline (more than tetra)

Learn VRE Drugs for Test

28
Q

Bacteroides Coverage

A
  • Beta-Lactams w/Lacatamase inhibitors
  • carbapenems
  • metronidazole
  • cefoxitin
  • Clindamycin
  • Moxifloxacin
  • Tigecycline

These Many Meds Can Confidently Cover Bacteroides

29
Q

Antibiotics for Atypical Pneumonia

A
  • Tetracyclines
  • Fluoroquinolones
  • Macrolides

Chlamydiae pneumoniae
Mycoplasma pneumoniae
Legionella pneumophilia

Cough May Lesson with Three Fair Meds

30
Q

3 Meds for C. diff

A

Vancomycin
Metronidazole
Fidaomicin

31
Q

Spectrum of activity with Cephalosporins

A
  • 1st gen more G+
  • 3rd Gen more G-
  • NO cephlosporin coverage of entercoccus
  • cefoitin - good bacteroides, bad MSSA
  • Ceftaroline - Only B-Lactam with MRSA coverage

4th Gen ( cefepime) - broadest spectrum

32
Q

3 antibiotics that cause nephrotoxicity

A
  • aminoglycosides
  • polymyxins
  • vancomycin
33
Q

2 antibiotics that will lead to a C. diff infections (broad spectrum anearobe coverage except C. diff)
- C. diff is anerobic gram + unlike many in our GI tract are anaerobic but GRAM neg.

A
  • Clindamycin

- Fluoroquinolones

34
Q

Seizures/CNS toxicity (2)

A
  • Imipenem

- Fluoroquinolones

35
Q

Myopathy (1)

A

Daptomycin

36
Q

Antibtiotics that cause rash (3)

A
  • TMP/SMX
  • B-lactams
  • Vancomycin (red man)
37
Q

antibiotic that causes pulmonary fibrosis

A

nitrofurantoin

38
Q

antibiotic that causes myelosuppression (bone marrow)

A

Linezolid

39
Q

3 encapsulated bacteria

A
  • Strep pneumonia
  • neisseria meningitidis
  • haemophilus influenza
40
Q

Hospital acquired pneumonia

A

Staph aureus

  • pseudomonas
  • enteriobacter
  • acinetobacter
  • klebsiella
41
Q

Community acquired hospital pneumonia

A
  • strep pneumonia
  • h. Flu
  • atypicals