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Infectious Disease > Classifications of drugs and normal flora > Flashcards

Classifications of drugs and normal flora Flashcards

1
Q

3 primary ways to classify antimicrobial drugs

A
  • susceptible organism
  • MOA
  • drug inhibits bacterial growth (bacteriostatic), or if it is lethal to cells (bacteriocidal)
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2
Q

Narrow vs. broad spectrum

A

narrow: active only against few microorganisms
broad: active against a wide variety

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3
Q

MOAs

A

Disruption of bacterial cell wall: penicillins, cephalosporins -> act to weaken cell wall and thereby promote cell lysis

inhibition of enzyme: sulfonamide drugs suppress bacterial growth by inhibiting enzyme required to produce folic acid from PABA.

Disruption of bacterial protein synthesis: disrupt function of bacterial ribosomes

Inhibition of bacterial nucleic acid synthesis

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4
Q

Inhibitors of cell wall synthesis

A

B-lactam abx: penicilllins, cephalosporins, carbapenems, monobactams

  • clavulanic acid, sulbactam, taxobactam
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5
Q

Protein synthesis inhibitors: 30s subunit

A

Aminoglycosides: gentamicin, tobramycin, amikacin

Tetracyclines: tetracycline, doxycycline, minocycline

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6
Q

Protein synthesis inhibitors: 50s subunit

A

macrolides: erythromycin, clarithromycin, azithromycin
others: chloramphenicol, clindamycin, linezolid, streptogramins

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7
Q

DNA synthesis inhibitors

A

Fluoroquinolones: cipro, oflaxacin, norfloxacin, levofloxacin, gatiflocacin, moxifloxacin

Metronidazole

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8
Q

RNA synthesis inhibitors

A

Rifampin

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9
Q

Mycelia acid synthesis inhibitors

A

isoniazid

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10
Q

Folic acid synthesis inhibitors

A

sulfonamides, trimethoprim

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11
Q

Function of normal flora

A

GI tract: aids in digestion
mucous membranes: mucosal immunity
in general: protects host from colonization with pathogenic microbes

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12
Q

What are opportunistic pathogens?

A

cause disease when immune defenses are altered,
when they change their usual anatomic location
-the blood, brain, muscle and CSF are normally free of flora

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13
Q

Normal flora of the oral cavity

A 
streptococci viridans
Lactobacilli
Staph (aureus and epidermidis)
corynebacterium sp.
bacteroides sp.
streptococcus sanguis
streptococcus mutans 
actinomyces sp.
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14
Q

Normal flora of the nose

A 
staphylococcus epidermidis
corynebacteria
staph aureus
Neisseria sp.*
Haemphilus sp*
strep pneumoniae*
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15
Q

Normal flora of the nasopharynx

A 
non-hemolytic strep
alpha-hemolytic strep 
Neisseria sp.
strep pneumoniae
strep pyogenes
H. influenzae
Neisseria meningitidis
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16
Q

Normal flora of lower resp. tract

A

usually sterile

individual becomes infected by the pathogen descending from the nasopharynx (H. influenzae, and S. pneumoniae)

17
Q

Normal flora of external ear

A

staph epidermidis
staph aureus
corynebacterium sp.

18
Q

Normal flora of GI tract

A 
Enterobacteriaceae
enterococci 
bacteroides
staph
lactobacilli
clostridia
19
Q

Normal flora of GU tract

A 
staph epidermidis
enterococcus faeccalis
Alpha-hemolytic strep
E coli
proteus
corynebaceria sp.
acinetobacter sp.
mycoplasma sp.
candida sp
mycobacterium smegmatis
20
Q

Normal vaginal flora

A 
corynebacterium sp.
staph
nonpyogenic strep (Group B)
E coli
lactobaciluus acidophilus
flavobacterium sp.
clostridium sp.
viridans strep
other enterobacteria
21
Q

causative organisms of endocarditis and tx

A

native valve: sterp viridans -> Pen G or Amp+Nafcillin

IV drug user: MSSA, MRSA -> vanco

Prosthetic valve: S. epi, S. aureus, S. viridans -> vanco+rifampin+gentamicin

22
Q

causative organisms of intra-abdominal infections

A

Diverticulitis, perirectal abscess, peritonitis-> E. coli, p. aeruginosa, enterococci

tx: TMP-SMX-DS or cipro, or levofloxacin+ metronidazole (outpt)

23
Q

Skin and soft tissue causative agents

A

gen. cellulits: staph aureus, strep-> MSSA: cephalexin, MRSA: TMP-SMX-DS or clindamycin
strep: cephalexin

diabetic ulcer: staph, strep or pyogenes-> Doxy or TMP-SMX-DS or clindamycin

Animal bites -> cat: amox-clav (augmentin)

Necrotizing fasciitis: GABS, C. perfringens -> PCN G, cefoxitin, chloramphenicol, clindamycin, metronidazole

24
Q

Urinary tract causative agents

A

E. coli, gram - aerobic bacilli, enterococcus, staph saprophyticus -> TMP-SMX-DS

if resistance is >20% to TMP -> use cipro, levo, moxi

25
Q

Respiratory tract infections (pneumonias)

A

Aspiration pneumonia: anaerobic or aerobic -> clindamycin or ampicillin-sulbactam or A carbapenem

Lower/hosp acquired: pseudomonas aeruginosa, gram - aerobic bacilli -> imipenem -cilastatin or meropenem + cipro if suspect pseudo

Hx of HIV: pneuomocystis carinii, S. pneumoniae -> Trimethoprim-sulfamethoxazole (Bactrim, Septra)

26
Q

Respiratory tract causative agents

A

sinusitis: S. pneumo, H. influenzae, M. catarrhalis, S. auerus, Grp A strep –> peds: amox or amox-clav, pcn allergy: clinda
adult: amox-clav, pcn allergy: levo or doxy

Community acquired pneumonia: all same as sinusitis plus klebsiella, mycoplasma, chlaymdia -> azithro, clarithro, doxycycline

27
Q

meningitis in kids

A

child ampicillin + gentamicin

child 2 months - 12 years: strep pneuma, N. meningitis, H. influenza -> vanco + cerfriaxone

28
Q

Meningitis

A

1 mo -> 50 years: S. pneumoniae, meningococci: cefotaxime or ceftriaxone+ vanco

amp+cefotaxime or gentamycin

29
Q

Prophylactic antibiotics b/f surgery

A

should be admin. before surgery begins via IV

  • often used to irrigate surgical site as well
  • Cefazolon (Ancef) 30 minutes before incision

for pcn allergies: use vanco

30
Q

who is at risk at developing endocarditis?

A

prosthetic heart valves

congenital heart disease

31
Q

prophylaxis for endocarditis

A

30-60 minutes prior to dental procedures: amoxicillin 2 gm PO

if PCN allergy: clinda, azithro, clarithro

32
Q

Complications of antibiotic therapy

A 
toxicity
C. diff
alt of gut flora and change of Vit K levels leading to difficulty managing warfarin therapy
candida overgrowth
serious side effects
33
Q

C diff diarrhea

A

can be life threatening, sever inflammation of colon, may lead to colectomy, highly contagious

34
Q

Drugs most likely to cause C. diff

A 
Most frequent:
Ampicillin/amoxicillin
cephalosporins
clindamycin
quinolones

Infectious Disease (27 decks)

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