Drugs

Question 1

Aminoglycosides

Answer 1

Drugs: Amikacin, gentamycin, neomycin, tobramycin, streptamycin
MOA: Bactericidal. Binds 30S ribosomal subunit
Uses: GN, including pseudomonas
Side effects: Cocleotoxic (amikacin, neomycin++, tobramycin, kanamycin), vestibulotoxic (gentamycin, streptomycin)

Question 2

Carbapenems

Answer 2

Drugs: Ertapenem, imipenem, meropenem
MOA: Beta lactam cell wall synthesis inhibitor
Uses: Broad spectrum abx of last resort. Not for MRSA. Ertapenem has no efficacy against pseudomonas
Side effects: Seizures

Question 3

1st gen cephalosporins

Answer 3

Drugs: Cefazolin, cephalexin
MOA: Bactericidal. B lactic cell wall synthesis inhibitor.
Uses: Gram positives, skin flora
Side effects: Nausea

Question 4

2nd gen cephalosporins

Answer 4

Drugs: Cefoxitin, Cefprozil, Cefuroxime
MOA: Bactericidal. B lactic cell wall synthesis inhibitor.
Uses: Less GP, more GN than 1st gen, not pseudomonas or PCN resistant strep
Side effects: Diarrhea

Question 5

3rd gen cephalosporins

Answer 5

Drugs: Cefdinir, Cefixime, Ceftazidime, Ceftriaxone
MOA: Bactericidal. B lactic cell wall synthesis inhibitor.
Uses: GN except pseudomonas, has CSF penetration
Side effects: Red stool

Question 6

4th gen cephalosporins

Answer 6

Drugs: Cefepime
MOA: Bactericidal. B lactic cell wall synthesis inhibitor.
Uses: Pseudomonas
Side effects: ?increased mortality compared to other abx

Question 7

Glycopeptides

Answer 7

Drugs: Vancomycin
MOA: Bactericidal. Inhibits NAM/NAG incorporation into peptidoglycan
Uses: MRSA, C. diff, no GN efficacy
Side effects: Red man syndrome (non specific mast cell degranulation), nephrotoxic, ototoxic

Question 8

Lincosamides

Answer 8

Drugs: Clindamycin
MOA: Bacteriostatic. Binds 50S ribosomal subunit. Reduces toxin formation (DOC for toxic shock)
Uses: Anaerobes, some MRSA, some GP, most GNs are resistant
Side effects: C diff colitis

Question 9

Lipopeptides

Answer 9

Drugs: Daptomycin
MOA: Bactericidal. Binds to cell membrane causing depolarization to cell dysfunction
Uses: GP, MRSA
Side effects: Eosinophilic PNA, myalgias

Question 10

Macrolides

Answer 10

Drugs: Erythromycin, clarithromycin, azithromycin
MOA: Bacteriostatic. Binds 50S ribosomal subunit
Uses: Broad spectrum (many GP, GN, atypical infections), not MRSA and not effective in bio filming organisms
Side effects: Motilin agonist (cramping and diarrhea), inhibits P450 and causes drug drug interactions, prolonged QT

Question 11

Monobactams

Answer 11

Drugs: Aztreonam
MOA: Bactericidal. Inhibits mucopeptide synthesis of cell wall
Uses: Pseudomonas
Side effects: Eosinophilia, rare TEN

Question 12

Nitrofurans

Answer 12

Drugs: Nitrofurantoin
MOA: Damages bacterial DNA
Uses: GN, safe in pregnant women
Side effects: Hypersensitivity pneumonitis, hemolytic anemia in newborns

Question 13

Bactericidal abx

Answer 13

B lactams, metronidazole, rifampin, aminoglycosides, fluoroquinolones, vanco, daptomycin, monobactams

Question 14

Bacteriostatic abx

Answer 14

Macrolides, clindamycin, tetracycline, trimethoprim, sulfonamides

Question 15

Penicillins

Answer 15

Drugs: Amoxicillin, ampicillin, dicloxacillin, methicillin, oxacillin, PCN VK
MOA: Bactericidal. Inhibits D-alanyl-D-alanine carboxypeptidase that cross links peptidoglycan
Uses: Broad spectrum but much resistance from beta lactamases. Alterations in PCN binding proteins lead to resistance (ie MRSA).
Side effects: Rash (particularly with mono), anaphylaxis

Question 16

PCN combinations

Answer 16

Drugs: Amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin/tazobactam, ticaricillin/clavulanate
MOA: Same as PCN, but inhibits beta lactamase
Uses: Restores sensitivity to many species
Side effects: Diarrhea

Question 17

Polypeptides

Answer 17

Drugs: Bacitracin, polymyxin
MOA: Inhibits peptidoglycan transport (bacitracin), destabilizes membrane (polymyxin)
Uses: GP (bacitracin), GN (polymyxin)
Side effects: Contact dermatitis

Question 18

Quinolones

Answer 18

Drugs: Ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin
MOA: Bactericidal. Inhibits DNA gyrase.
Uses: GN, anaerobes
Side effects: Peripheral neuropathy, tendon rupture, prolonged QT, TEN, vision loss

Question 19

Sulfonamides

Answer 19

Drugs:
MOA:
Uses:
Side effects:

Question 20

Tetracyclines

Answer 20

Drugs:
MOA:
Uses:
Side effects:

Question 21

Linezolid

Answer 21

MOA:
Uses:
Side effects:

Question 22

Metronidazole

Answer 22

MOA:
Uses:
Side effects:

Question 23

Mupirocin

Answer 23

MOA:
Uses:
Side effects:

Question 24

Rifampin

Answer 24

MOA:
Uses:
Side effects:

Question 25

Cidofivir

Answer 25

DNA polymerase inhibitor