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deck_7495618 Flashcards

1
Q

Mechanism of action fluoroquinolones and quinolones?

A

inhibition of DNA gyrase

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2
Q

Name a quinolone

A

Nalidixic acid

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3
Q

Mechanism of Rifampin

A

RNA polymerase inhibitor

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4
Q

Chloramphenicol, Clindamycin, Linezolid mechanism of action

A

Inhibition of protein synthesis through 50S

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5
Q

Inhibitors of 50 S subunit

A

Chloramphenicol, clindamycin, linezolidMacrolides: Azitro, Claritro, ErithromycinStreptogramins: quinupristin, dalfopristin

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6
Q

Mechanism of action of Aminoglycosides and name them

A

Inhibition of 30 S, misreading/translation. Gentamicin, Neomycin, Amikacin, Tobramycin

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7
Q

Mechanism of action of tetracyclines and names

A

Inhibition of 30S- inhibit binding of aminoacyl-tRNA to mRNA complex.TetracyclineDoxycyclineMinocycline

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8
Q

Inhibitors of peptidoglycan synthesis

A

Glycopeptides Vancomycin Bacitracin

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9
Q

Penicillinase sensitive penicillins

A

Penicillin G (iv, im), V (oral)AmpicilinAmoxicillin

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10
Q

Penicillinase resistan penicillins

A

OxacillinNafcillinDiclOxacillin (oral)methicillin

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11
Q

Antipseudomonals

A

Piperacillin, ticarcilin

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12
Q

Piperacillin, ticarcilin are what type of ABCs

A

antipseudomonals

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13
Q

Monobactams

A

Aztreonam

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14
Q

Folic acid synthesis and reduction ( DNA methylation

A

Sulfonamides ( block PABA TO DHF)Trimpetrophin ( DHF to THF)

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15
Q

Types of penicillins

A

Penicillin G (IV, IM), Penicillin V (oral)

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16
Q

Mechanism of action of penicillins

A

D-ala D-ala structural analog, so binds to penicillin binding protein Avoids crosslinking–> leaky wallActivate autolytic enzymes

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17
Q

Use of penicillins

A

Gram +: S pneumoniae, S, pyogenes, ActinomycesGram - cocci: N. meningitidis, spirochetes ( T pallidum

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18
Q

EA penicillins

A

Hypersensitivity reactions, direct Coombs + hemolytic anemia, Thrombocytopenia

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19
Q

Penicillinase sensitive penicillins mechanism

A

Same as penicillin,Wider spectrum. Combine with clavulonate.

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20
Q

Which penicillinase sensitive penicillin has excellent oral bioavailability?

A

Amoxicillin better than ampicillin

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21
Q

Clinical use of AMPI, AMOXI, AMINOPENICILLIN?

A

HHELPSS-EH. influenza, H. pylori, E.coli , listeria, proteus, Salmonella, Shigella, enterococci

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22
Q

AE penicillinase sensitive penicillins?

A

Hypersensitivity reaction, rash (when given for mononucleosis)Pseudomembranous colitis

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23
Q

Penicillinase-Resistant penicillins mechanism

A

same as penicillinNarrow spectrumbulky R group blocks access of B lactamase to B lactam ring

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24
Q

Why methicillin is no longer used clinically?

A

interstitial nephritis It is used to determine resistant strain of staph

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25
Clinical use of penicillinase resistance penicillin
S aureus ( except MRSA, resistant because of altered penicillin-binding protein target site)
26
AE penicillinase resistance penicillin
Hypersensitivity reactioninterstitial nephritis
27
Which are the b-lactamase inhibitors?
CAST Clavulanic AcidSulbactamTazobactam
28
Syphilis treatment
Penicillin G
29
UTI treatment
Aminopenicillin( amoxi)
30
2 mechanism of resistance for penicillin
1. B lactamase2. Alteration of penicilllin binding protein
31
How is the bacterial coverage with cephalosporins?
The gram negative coverage increases as we increase the generation
32
Organisms not covered by 1st-4th generation cephalosporins?
LAME: ListeriaAtypicals( Chlamydia, Mycoplasma)MRSAEnterococci
33
1st generation cephalosporins
Cefazolin, cephalexin
34
1st generation cephalosporins coverage
PEcKProteusE.coliKlebsiella
35
1st generation cephalosporins use
UTI, URIS, Prophylaxis for viridians strep endocarditis
36
A specific use of cefazolin
surgery prophylaxis - prevent S aureus infection
37
2nd generation cephalosporins
Fake Fox FurCefaclor, cefoxitin, cefuroxime
38
2nd generation cephalosporins
HENS PEcKH. influenza, Enterobacter aerogenes, Neisseria, Serratia, Proteus, E.Coli, klebsiella
39
3rd generation cephalosporins
Ceftriaxone CefotaximeCefdimirCeftazidime
40
Clinical use of Ceftriaxone
Meningitis, gonorrhea, disseminated lyme
41
Clinical use of ceftazidime
3rd generation | antipseudomona
42
4th generation cephalosporin
Cefepime - pseudmonas and gram +
43
5th generation cephalosporin
Ceftaroline- broad gram + and gram -, including MRSA, DOESNT COVER PSEUDOMONA
44
AE of cephalosporins
``` Hypersensitivity reactions Autoimmune hemolytic anemia Disulfiram like reaction  Vitamin K deficiency Exhibit cross reactivity with penicillins Increased nephrotox of aminoglycosides   ```
45
metabolism of Ceftriaxone 
Bile, so perfect in pts with renal failure. 
46
Imipenem should always be given with ____ : an inhibitor of renal dehydropeptidase
cilastatin- decreases inactivation of the drug in the renal tubules 
47
What is the advantage of meropenem ?
decreases risk of seizures and is stable to dehydropeptidase
48
AE Carbapenems
GI distressSkin rashCNS toxictiy ( seizures)
49
Ertapenem covers pseudomona T/F
F, limited coverage 
50
Monobactam 
Aztreonam
51
Mechanism of action of Aztreonam( monobactam)
Prevents peptidoglycan cross-linking binds to penicillin binding protein 3
52
Interaction between aminoglycosides and monobactams
synergistic 
53
Monobactam use
" aminoglycoside pretender" Gram negative only  For penicillin-allergic patients and those with renal insuff who do not tolerate aminoglycoside
54
Vancomycin  mechanism
Inhibit peptidoglycan synthesis - binds to D-ala D ala Bacteriostatis again dificile 
55
Vancomycin use
Gram + only  C.difficile oral dose -
56
AE Vancomycin 
R-NOT Red man syndrome( pretreat with antihist and slow infusion rate to prevent it) NephrotoxOtototoxThrombophlebitis
57
Aminoglycosides inefective againsT anaerobes T/F
Truerequire O2 for uptake so ineffective against anaerobes. 
58
When is Neomycin used?
Bowel surgery 
59
AE Aminoglycosides
 Nephrotoxicity Neuromuscular blockade ( Miastenia gravis is an absolute contraindication of Aminoglycosides) Ototoxicity(especially when used with loop diuretics) Teratogen
60
Tetracyclines enter CNS?
LIMITED CNS PENETRATION 
61
Elimination of Doxycyclin
fecally, safe in renal failure
62
Recommendation for pts taking tetracyclines
Don't take with milk( Ca2+), antacids ( Ca or Mg) , or iron containing preparations because they divalent cations inhibit drug absorption in the gut. 
63
Tetracyclines use- mention organisms
VACCUUM THe BedRoom-  Vibrio cholera,Acne, ChlamydiaUreaplasma ureolyticumMycoplasma pneumoniaeTularemiaH.pyloriBorreliaRickettsia 
64
AE Tetracyclines
GI distressDiscoloration of teethInhibition of bone growth in childrenPhotosensitivity (SAT for Photo: sulfonamides, amiodarone, tetracyclines) Minocycline: bluish coloration of skin
65
Chloramphenicol use 
Meningitits and Rocky mountain spotted fever(Rickettsia)
66
AE Chlormaphenicol
Anemia ( dose dependent)Aplastic anemiaGray Baby syndrome( in premature infants because they lack liver UDP - glucuronyl transferase)
67
Gray baby syndrome:
In newborns or prematures. they lack liver UDP- glucuronyl transferase -- so chloramphenicol accumulates)cyanosis, abdominal distention, vasomotor collapse (often with irregular respiration), and death. Reaction appears to be associated with serum levels ≥50 mcg/mL (Powell 1982). Occurs 2-10 days TTO:STOPExchange transfusionPhenobarb- induce UDP glucuronyl transferase
68
Clindamycin use
ANAEROBIC INFECTIONS ( bacteroides spp, clostridium perfringens) Aspiration pneumoniaLung abscessOral infectionsEffective against Strep A infection 
69
AE Clindamycin
Pseudomembranous colitisFeverdiarrhea
70
Linezolid mechanism 
binds 23 S RNA and interacts with bacterial initiation complex
71
Linezolid use 
MRSA, VRSA
72
AE linezolid
BM suppression,thrombocytopeniaperipheral neuropathyserotonin syndrome
73
Gray MAN syndrome
AmiodaroneBlue color ( ceruloderma) due to deposit of melanin and lopofuscin
74
Macrolides  use 
"PUS" Pneumonia ( atypical- mycoplasma, Chlamydia, legionella)URI ( S. penumonia, S. pyogenes)STDS ( Chlamydia, Gonorrhea)
75
AE Macrolides
MACROslides GI Motility issuesArrythmia due to prolonged QTAcute Cholestatic hepatitis-- erythroRashEosinophilia  
76
Macrolides med interactions
Increases serum concentration of theophylline, oral anticoagulants
77
EA Sulfonamides
Hypersensitivity reactions hemolysis if G6PD defNephrotoxicity ( tubulointerstitial nephritis)PhotosensitivityKernicterus in infantsDisplaces other drugs from albumin( eg. warfarin)
78
Dapsone mechanism
same as sulfonamides inhibit PABA TO dhf  
79
Dapsone use
Leprosy( lepromatous and TB)Pneumocystis jirovecii prophylaxis
80
AE Dapsone
Hemolysis if G6PD def

AV_Step 3 UWORLD (8 decks)

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