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ABSITE 2019-RM > Chapter 6: Antibiotics > Flashcards

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
Q

Antibiotics for:

  • GPCs: streptococci, syphilis, Neisseria meningitides (GPR), Clostridium perfringens (GPR), beta-hemolytic Streptococcus, anthrax
  • Not effective against Staphylococcus or Enterococcus
A

Penicillin

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26
Q

Antibiotics: anti-staph penicillins (staph only)

A

Oxacillin and nafcillin

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27
Q

Antibiotics: same as penicillin but also picks up enterococci

A

Ampicillin and amoxicillin

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28
Q

Antibiotics:

  • Broad spectrum: pick up GPCs (staph/strep), GNRs +/- anaerobic coverage.
  • Effective for enterococci; not effective for Pseudomonas, Acinetobacter, or Serratia
A

Unasyn (ampicillin/sulbactam)

Augmentin (amoxicillin/clavulanic acid)

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29
Q

Ampicillin / sulbactam

A

Unasyn

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30
Q

Amoxicillin / clavulanic acid

31
Q

Beta-lactamase inhibitors

A

Sulbactam and clavulanic acid

32
Q
  • Antipseudomonal penicillins
  • GNRs: enterics, pseudomonas, acinteobacter, serratia
  • Side effects: inhibits platelets; high salt load
A

Ticarcillin and piperacillin (antipseudomonal penicillins)

33
Q
  • Broad spectrum: pick up GPCs (staph/strep), GNRs, anaerobes
  • Effective for enterococci; effective for pseudomonas, acinetobacter, serratia
  • SE: inhibits platelets, high salt load
A

Timentin (ticarcillin/clavulanic acid)

Zosyn (piperacillin/sulbactam)

34
Q

Ticarcillin / clavulanic acid

35
Q

Piperacillin / sulbactam

36
Q
  • GPCs: staph and strep

- Not effective for Enterococcus; does not penetrate CNS

A

First generation cephalosporins (cefazolin, cephalexin)

37
Q

Why is ancef (cefazolin) good for prophylaxis?

A

It has a long half life.

38
Q
  • GPCs, GNRs, +/- anaerobic coverage; lose some staph activity.
  • Not effective for enterococcus, pseudomonas, acinetobacter, serratia
  • Effective only for community-acquired GNRs
A

Second-generation cephalosporin (cefoxitin, cefotetan, cefuroxime)

39
Q

Why is cefotetan good for prophylaxis?

A

It has a long half life.

40
Q
  • GNRs mostly, +/- anaerobic coverage.
  • Not effective for enterococcus; effective for pseudomonas, acinetobacter, and serratia
  • Side effects: cholestatic jaundice, sludging in gallbladder (ceftriaxone)
A

Third-Generation cephalosporin (ceftriaxone, ceftazidime, cefepime, cefotaxime)

41
Q

Antibiotics: GNRs, picks up pseudomonas, acinetobacter, serratia

A

Monobactam (aztreonam)

42
Q

Antibiotics:

  • Given with cilastin
  • Broad spectrum: GPCs, GNRs, and anaerobes
  • Not effective for MEP: MRSA, Enterococcus, Proteus
  • Side effects: seizures.
A

Carbapenems (meropenem, imipenem)

43
Q

Why are carbapenems given with cilastin?

A

Prevents renal hydrolysis of the drug and increase half-life

44
Q

What are carbapenems not effective for?

A

MEP

- MRSA, Enterococcus, and Proteus

45
Q
  • GNRs, +/-GPCs
  • Not effective for enterococcus, pseudomonas, acinetobacter, serratia
  • Side effects: teratogenic, allergic reactions, renal damage, SJS, hemolyis in G6PD
A

Bactrim (TMP/SMX)

46
Q

Trimethoprim / sulfamethoxazole

47
Q
  • Some GPCs, mostly GNRs
  • Not effective for enterococcus, picks up Pseudomonas, acinetobacter, serratia
  • 40% of MRSA sensitive; some efficacy PO and IV.
A

Quinolones (Ciprofloxacin, levofloxacin, norfloxacin)

48
Q
  • 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
A

Aminoglycosides (gentamicin, tobramycin)

49
Q

What is amino glycoside resistance secondary to?

A

Resistance due to modifying enzymes leading to decreased active transport

50
Q
  • 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
A

Erythromycin (macrolides)

51
Q
  • GPCs, Enterococcus, Clostridium difficile (with PO intake), MRSA)
  • Binds cell wall proteins
  • Side effects: HTN, Redman syndrome (histamine release), nephrotoxicity, ototoxicity
A

Vancomycin (glycopeptides)

52
Q

What is resistance to vancomycin (glycopeptides) due to?

A

Resistance develops from a change in cell wall-binding protein

53
Q
  • GPCs, includes MRSA, VRE
A

Synercid (streptogramin - quinupristin-dalfopristin)

Linezolid (oxazolidinones)

54
Q
  • GPCs, GNRs, syphilis

- Side effects: tooth discoloration in children

A

Tetracycline

55
Q
  • Anaerobes, some GPCs
  • Good for aspiration pneumonia
  • Can be used to treat C. perfringens
  • Side effects: pseudomembraneous colitis
A

Clindamycin

56
Q
  • Anaerobes

- Side effects: disulfiram-like reaction, peripheral neuropathy (long-term use)

A

Metronidazole (Flagyl)

57
Q

Antifungal: binds sterols in wall and alters membrane permeability

  • Side effects: nephrotoxic, fever, hypokalemia, hypotension, anemia
  • Liposomal type has fewer side effects
A

Amphotericin

58
Q

Antifungal: inhibit ergosterol synthesis (needed for cell membrane)

A

Voriconazole

Itraconazole

59
Q

Antifungal: inhibits synthesis of cell wall glucan

A

Anidulafungin (Eraxis)

60
Q

Prolonged broad-spectrum antibiotics +/- fever

A

Itraconazole

61
Q

Tx: invasive aspergillosis

A

Voriconazole

62
Q

Tx: candidemia

A

Anidulafungin

63
Q

Tx: fungal sepsis other than cadida and aspergillus

A

Liposomal amphotericine

64
Q

Tuberculosis drugs

A

RIPE: rifampin, isoniazid, pyrazinamide, ethambutol

65
Q

TB: inhibits mycolic acids (give with pyridoxine

-Side effects: hepatotoxicity, B6 deficiency

66
Q

TB: inhibits RNA polymerase

-Side effects: hepatotoxicity, GI symptoms, high rate of resistance

67
Q

TB:

-Side effect: hepatotoxcity

A

Pyrazinamide

68
Q

TB:

- Side effect: retrobulbar neuritis

A

Ethambutol

69
Q

Inhibits viral DNA polymerase; used for HSV infections, EBV

70
Q

Inhibits viral DNA polymerase; used for CMV infections

- Side effects: decreased bone marrow, CNS toxicity

A

Ganciclovir

71
Q

Broad spectrum antibiotics can lead to…

A

Superinfection

72
Q

Antibiotics effective for enterococcus

A

Vancomycin
Timentin / Zosyn
Ampicillin / amoxicillin
Gentamicin w/ ampicillin

73
Q

Effective for Pseudomonas, Acinetobacter, Serratia

A 
Ticarcillin / piperacillin
Timentin / Zosyn
Third generation cephalosporins
Aminoglycosides (gentamicin and tobramycin)
Meropenem / imipenem
Fluoroquinolones
74
Q

Purpose of perioperative antibiotics

A
  • Used to prevent surgical site infections

- Need to be given within 1 hour before incision

ABSITE 2019-RM (33 decks)

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