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Review / Wrong Answers > DIT review - Micro 5 > Flashcards

DIT review - Micro 5 Flashcards

1
Q

MOA of Monobactams + Drug name

A

Aztreonam

Binds to penicillin-binding protein 3

Less susceptible to beta-lactamases

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2
Q

Uses of Aztreonam

A

Think of monobactams as aminoglycoside wannabees

Treat only gram negative aerobes (including pseudomonas)

Uses for penicillin-allergic patients with renal insufficiency who cannot tolerate aminoglycosides

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3
Q

What are the Carbapenem drugs

A
  • Imipenem, Ertapenem, Meropenem, Doripenem
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4
Q

Uses of Carbapenems

A

Are broad-spectrum and beta-lactamase resistant

Treat gram-negatives, gram-positives, anaerobes (including psuedomonas)

Used only when bugs are resistant to other drugs because of side effects

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5
Q

What drug must be co-administered with Carbapenems and why?

A

Cilastatin

Carbapenems are inactivated by dihydropeptidases in the renal tubules; Cilastin inhibits dihydropeptidase

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6
Q

Adverse effects of Carbapenems

A

Skin rash

GI distress

Lowered seizure threshold

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7
Q

MOA of Vancomycin

A

Inhibits cell wall formation by binding to D-ala D-ala peptidoglycan

Vs. Pencillins which binds to PBPs

Not susceptible to beta-lactamases

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8
Q

Describe Vancomycin resistance

A

Modificiation of D-ala D-ala to D-ala D-lac

So now Vancomycin cannot bind

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9
Q

Uses of Vancomycin

A

Gram + bugs only

Including MRSA, S. epidermidis, Vancomycin-sensitive enterococcus, Clostridium difficile

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10
Q

Adverse effects of Vancomycin

A

THINK: NOT

Nephrotoxicity, Ototoxicity, Thrombophlebitis

Red man syndrome

DRESS syndrome

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11
Q

How do you prevent red man syndrome?

A

Pre-treat with antihistamines

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12
Q

MOA of Daptomycin

A

Inserts its lipid tail into the cell membrane, leading to depolarization and cell death

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13
Q

Uses of Daptomycin

A

Vancomycin resistant bugs (VRE)

Staph: MRSA (especially MRSA bacteremia), VRSA, Endocarditis

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14
Q

What can Daptomycin NOT be used to treat and why?

A

Pneumonia

Daptomycin is inactivated by surfactant

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15
Q

Adverse effects of Daptomycin

A

Myopathy

Rhabdomyolysis

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16
Q

What drugs cause phototoxicity

A
  • THINK: I SAT for a photo
    • S – Sulfonamides
    • A – Amiodorone
    • T – Tetracyclines
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17
Q

What and at what CD4 count do you use prophylaxis for Pneumocytis jirovecii

A

TMP-SMX

CD4 < 200

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18
Q

What and at what CD4 count do you use prophylaxis for Toxoplasmosis

A

TMP-SMX

CD4 < 100

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19
Q

What and at what CD4 count do you use prophylaxis for Mycobacterium Avium

A

Azithromycin or Clarithromycin

CD4 < 50

20
Q

What drug is used for prophylaxis of endocarditis and undergoing surgical/dental procedure

A

Amoxicillin

21
Q

What drug is used for prophylaxis against pregnant women who is Group B strep +

A

Ampicillin or Penicillin G during deliver

22
Q

What are the protein synthesis inhibitors, and which work on 30S vs. 50S subunit

A
  • THINK: buy AT 30, CCEL at 50
    • 30S inhibitors = Aminoglycosides, Tetracyclines
    • 50S inhibitors = Chloramphenicol, Clindamycin, Erythromycin (macrolides), Linezolid
23
Q

Uses of Tetracycline

A
  • Broad spectrum
  • THINK: VACUUM THe BedRoom
    • Vibrio cholera, Acne, Chlamydia, Ureaplasma, Mycoplasma, Tularemia, H. Pylori, Borrelia, Rickettsia
  • Zoonotics: Yersinia, Ehrlichia, Francisella, Brucella, Coxiella
24
Q

Method of resistance to tetracyclines

A

Increased efflux out of cells via plasmid-encoded transport pumps

25
MOA of tetracycline
* Bind 30S and prevent attachment of aminoacyl-tRNA
26
What is triple therapy for H. Pylori
PPI + Amoxicillin + Clarithromycin
27
Macrolide drug names
* Azithromycin, Clarithromycin, Erythromycin
28
MOA of macrolides
* Binds to 50S. blocking translocation (THINK: macroSLIDES) * Bacteriostatic
29
Uses of macrolides
* THINK: PUS * Pneumonia (atypical – Mycoplasma, Chlamydia, Legionella) * URI (Strep pneumo, Strep pyogenes) * STD (Chlamydia, gonorrhea) * Erythromycin drops treat neonatal conjunctivitis * Bordatella pertussis * Gram + cocci in penicillin allergic patients * Prophylaxis for mycobacterium avium CD4 \< 50 (Azithromycin) * H. Pylori triple therapy (PPI + Amoxicillin + Clarithromycin)
30
Adverse effects of macrolide
* GI motility, _prolonged QT interval_, CYP450 inhibitor, acute cholestatic hepatitis
31
MOA of Clindamycin
* Binds 50S and blocks peptide transfer (translocation) * Bacteriostatic
32
Uses of clindamycin
* Anaerobic infections above the diaphragm (Clostridium, Bacteroides) * Lung abscesses (aspiration pneumonia) – Bacteroides = back of the mouth * Clostridium perfringens * Polymicrobial female genital tract infections (e.g. IUD, retained abortion) * Used Clindamycin + Gentamicin * Bacterial vaginalis * Gram (+) – Staph and strep * Strep pyogenes soft tissue infections * MRSA
33
Adverse effects of clindamycin
* Diarrhea, C. Diff, fever
34
Uses of Chloramphenicol
* Not really used in US anymore but still used in developing countries due to low cost * Meningitis (Neisseria, H. Flu, Strep pneumo) * Rocky mountain spotted fever
35
Adverse effects of Chloramphenicol
* Anemia (dose-dependent) * Aplastic anemia (dose independent) * Gray baby syndrome (infants lack UDP-glucuronyl transferase, which metabolizes Chloramphenicol)
36
MOA of Linezolid
* Binds 23S portion of 50S, preventing formation of complex
37
Uses of Linezolid
* Gram + species, including MRSA and VRE
38
Adverse effects of Linezolid
* Bone marrow suppression (especially thrombocytopenia) * Peripheral neuropathy + optic neuropathy * Serotonin syndrome (Linezolid is a weak inhibitor of MAO)
39
MOA of aminoglycosides
* Irreversible binding of 30S; can cause misreading of mRNA * Bactericidal (only one) * Coupled with beta-lactams to help get through the cell wall
40
Use of Neomycin
* **_Neomycin_** à ninja master near tunnel * When taken orally, remains active in GI tract until excreted in feces– useful in bowel prep before colorectal surgery * à colon tunnel * à scalpel weapon (surgery prep)
41
Use of Paramycin
* **_Paramycin_** à pair of mice * Luminal agent against intestinal parasites such as Entomoeba histolytica
42
Use of Streptomycin
* **_Streptomycin_** à sai master * Treat Tularemia caused by Francisella * à rabbit ears * Treats plague caused by Yersinia pestis * à squirrels with fleas
43
Use of Gentamicin
* **_Gentamicin_** à judo master * Treats resistant gram negative infections (e.g. Enterobacter, Serratia, Klebsiella) * à red shogun representing systemic gram negative infections (e.g. septicemia, nosocomial RTI, complicated UTI, intra-abdominal infection) * Pseudomonas * à Mona Lisa (treated with Gentamicin, Tobramycin, and Amikacin)
44
Use of Tobramycin
* **_Tobramycin_** à cobra ninja * Similar spectrum to Gentamicin * Both treat pseudomonas * à mona lisa
45
Use of Amikacin
* **_Amikacin_** à Katana master * Resistant to many of the enzymes that inactivate other aminoglycosides in resistant bacteria * Treatment against pseudomonas * à mona lisa
46
Adverse effects of aminoglycosides
* Adverse effects: * Nephrotoxicity, Neuromuscular blockade, Ototoxicity, Teratogen * Contraindicated in myasthenia gravis

Review / Wrong Answers (140 decks)

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