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Chapter 6: Antibiotics Flashcards

1
Q

Kills and inhibits organisms on body

A

Antiseptic

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2
Q

Kills and inhibits organisms on inanimate objects

A

Disinfectant

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3
Q

All organisms killed

A

Sterilization

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4
Q

Antiseptic: good for GPCs and GNRs; poor for fungi

A

Iodophors (Betadine)

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5
Q

Antiseptic: good for GPCs, GNRs, and fungi

A

Chlorhexidine gluconate (Hibiclens)

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6
Q

Inhibitors of cell wall synthesis

A

Penicillins, cephalosporins, carbapenems, monobactams, vancomycin

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7
Q

Inhibitors of the 30S ribosome and protein synthesis

A

Tetracycline, aminoglycosides (tobramycin, gentamicin), linezolid

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8
Q

Inhibitors of the 50s ribosome and protein synthesis

A

Erythromycin, clindamycin, Synercid

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9
Q

Inhibitor of DNA helicase (DNA gyros)

A

Quinolones

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10
Q

Inhibitor of RNA polymerase

A

Rifampin

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11
Q

Produces oxygen radicals that breakup DNA

A

Metronidazole (Flagyl)

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12
Q
  • PABA analogue

- Inhibits purine synthesis

A

Sulfonamides

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13
Q
  • Inhibits dihydrofolate reductase which inhibits purine synthesis
A

Trimethoprim

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14
Q

Bacteriostatic antibiotics

A

Tetracycline, clindamycin, erythromycin (all have reversible ribosomal binding), Bactrim

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15
Q

Have irreversible binding to ribosome and are considered bactericidal

A

Aminoglycosides

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16
Q

Mechanism: penicillin resistance

A

Due to plasmids for beta-lactamase

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17
Q

MC method of antibiotic resistance

A

Transfer of plasmids

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18
Q

Resistance caused by a mutation of cell wall-binding protein

A

Methicillin-resistant S. aureus (MRSA)

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19
Q

Resistance caused by a mutation in cell wall-binding protein

A

Vancomycin-resistant enterococcus (VRE)

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20
Q

Resistance due to modifying enzymes leading to a decrease in active transport of this antibiotic into the bacteria

A

Gentamicin resistance

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21
Q

Vancomycin

  • Peak
  • Trough
A

Vancomycin

  • Peak: 20-40 ug/mL
  • Trough: 5-10 ug/mL
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22
Q

Gentamicin

  • Peak
  • Trough
A

Gentamicin

  • Peak: 6-10 ug/mL
  • Trough:
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23
Q

What if the peak is too high?

A

Decrease amount of each dose

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24
Q

What is the trough is too high?

A

Decrease frequency of doses (increase time interval between doses)

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25
Antibiotics for: - GPCs: streptococci, syphilis, Neisseria meningitides (GPR), Clostridium perfringens (GPR), beta-hemolytic Streptococcus, anthrax - Not effective against Staphylococcus or Enterococcus
Penicillin
26
Antibiotics: anti-staph penicillins (staph only)
Oxacillin and nafcillin
27
Antibiotics: same as penicillin but also picks up enterococci
Ampicillin and amoxicillin
28
Antibiotics: - Broad spectrum: pick up GPCs (staph/strep), GNRs +/- anaerobic coverage. - Effective for enterococci; not effective for Pseudomonas, Acinetobacter, or Serratia
Unasyn (ampicillin/sulbactam) Augmentin (amoxicillin/clavulanic acid)
29
Ampicillin / sulbactam
Unasyn
30
Amoxicillin / clavulanic acid
Augmentin
31
Beta-lactamase inhibitors
Sulbactam and clavulanic acid
32
- Antipseudomonal penicillins - GNRs: enterics, pseudomonas, acinteobacter, serratia - Side effects: inhibits platelets; high salt load
Ticarcillin and piperacillin (antipseudomonal penicillins)
33
- Broad spectrum: pick up GPCs (staph/strep), GNRs, anaerobes - Effective for enterococci; effective for pseudomonas, acinetobacter, serratia - SE: inhibits platelets, high salt load
Timentin (ticarcillin/clavulanic acid) Zosyn (piperacillin/sulbactam)
34
Ticarcillin / clavulanic acid
Timentin
35
Piperacillin / sulbactam
Zosyn
36
- GPCs: staph and strep | - Not effective for Enterococcus; does not penetrate CNS
First generation cephalosporins (cefazolin, cephalexin)
37
Why is ancef (cefazolin) good for prophylaxis?
It has a long half life.
38
- GPCs, GNRs, +/- anaerobic coverage; lose some staph activity. - Not effective for enterococcus, pseudomonas, acinetobacter, serratia - Effective only for community-acquired GNRs
Second-generation cephalosporin (cefoxitin, cefotetan, cefuroxime)
39
Why is cefotetan good for prophylaxis?
It has a long half life.
40
- GNRs mostly, +/- anaerobic coverage. - Not effective for enterococcus; effective for pseudomonas, acinetobacter, and serratia - Side effects: cholestatic jaundice, sludging in gallbladder (ceftriaxone)
Third-Generation cephalosporin (ceftriaxone, ceftazidime, cefepime, cefotaxime)
41
Antibiotics: GNRs, picks up pseudomonas, acinetobacter, serratia
Monobactam (aztreonam)
42
Antibiotics: - Given with cilastin - Broad spectrum: GPCs, GNRs, and anaerobes - Not effective for MEP: MRSA, Enterococcus, Proteus - Side effects: seizures.
Carbapenems (meropenem, imipenem)
43
Why are carbapenems given with cilastin?
Prevents renal hydrolysis of the drug and increase half-life
44
What are carbapenems not effective for?
MEP | - MRSA, Enterococcus, and Proteus
45
- GNRs, +/-GPCs - Not effective for enterococcus, pseudomonas, acinetobacter, serratia - Side effects: teratogenic, allergic reactions, renal damage, SJS, hemolyis in G6PD
Bactrim (TMP/SMX)
46
Trimethoprim / sulfamethoxazole
Bactrim
47
- Some GPCs, mostly GNRs - Not effective for enterococcus, picks up Pseudomonas, acinetobacter, serratia - 40% of MRSA sensitive; some efficacy PO and IV.
Quinolones (Ciprofloxacin, levofloxacin, norfloxacin)
48
- GNRs - Good for pseudomonas, acinetobacter, and serratia; not effective for anaerobes (need O2) - Synergistic with ampicillin for Enterococcus - Beta-lactams (ampicilin, amoxicililn) facilitate penetration - Side effects: reversible nephrotoxicity, irreversible ototoxicity
Aminoglycosides (gentamicin, tobramycin)
49
What is amino glycoside resistance secondary to?
Resistance due to modifying enzymes leading to decreased active transport
50
- GPCs, best for community-acquired pneumonia and atypical pneumonias - Side effects: nausea (PO), cholestasis (IV) - Also binds motilin receptor and is pro kinetic for bowel
Erythromycin (macrolides)
51
- GPCs, Enterococcus, Clostridium difficile (with PO intake), MRSA) - Binds cell wall proteins - Side effects: HTN, Redman syndrome (histamine release), nephrotoxicity, ototoxicity
Vancomycin (glycopeptides)
52
What is resistance to vancomycin (glycopeptides) due to?
Resistance develops from a change in cell wall-binding protein
53
- GPCs, includes MRSA, VRE
Synercid (streptogramin - quinupristin-dalfopristin) Linezolid (oxazolidinones)
54
- GPCs, GNRs, syphilis | - Side effects: tooth discoloration in children
Tetracycline
55
- Anaerobes, some GPCs - Good for aspiration pneumonia - Can be used to treat C. perfringens - Side effects: pseudomembraneous colitis
Clindamycin
56
- Anaerobes | - Side effects: disulfiram-like reaction, peripheral neuropathy (long-term use)
Metronidazole (Flagyl)
57
Antifungal: binds sterols in wall and alters membrane permeability - Side effects: nephrotoxic, fever, hypokalemia, hypotension, anemia - Liposomal type has fewer side effects
Amphotericin
58
Antifungal: inhibit ergosterol synthesis (needed for cell membrane)
Voriconazole | Itraconazole
59
Antifungal: inhibits synthesis of cell wall glucan
Anidulafungin (Eraxis)
60
Prolonged broad-spectrum antibiotics +/- fever
Itraconazole
61
Tx: invasive aspergillosis
Voriconazole
62
Tx: candidemia
Anidulafungin
63
Tx: fungal sepsis other than cadida and aspergillus
Liposomal amphotericine
64
Tuberculosis drugs
RIPE: rifampin, isoniazid, pyrazinamide, ethambutol
65
TB: inhibits mycolic acids (give with pyridoxine | -Side effects: hepatotoxicity, B6 deficiency
Isoniazid
66
TB: inhibits RNA polymerase | -Side effects: hepatotoxicity, GI symptoms, high rate of resistance
Rifampin
67
TB: | -Side effect: hepatotoxcity
Pyrazinamide
68
TB: | - Side effect: retrobulbar neuritis
Ethambutol
69
Inhibits viral DNA polymerase; used for HSV infections, EBV
Acyclovir
70
Inhibits viral DNA polymerase; used for CMV infections | - Side effects: decreased bone marrow, CNS toxicity
Ganciclovir
71
Broad spectrum antibiotics can lead to...
Superinfection
72
Antibiotics effective for enterococcus
Vancomycin Timentin / Zosyn Ampicillin / amoxicillin Gentamicin w/ ampicillin
73
Effective for Pseudomonas, Acinetobacter, Serratia
``` Ticarcillin / piperacillin Timentin / Zosyn Third generation cephalosporins Aminoglycosides (gentamicin and tobramycin) Meropenem / imipenem Fluoroquinolones ```
74
Purpose of perioperative antibiotics
- Used to prevent surgical site infections | - Need to be given within 1 hour before incision

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