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Infectious Disease > Drugs but for realsies > Flashcards

Drugs but for realsies Flashcards

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1
Q

7 common mechanisms of antibiotics

A

1) Disrupt bacterial cell wall
2) Increase permeability of cell membrane
3) lethal inhibition of bacterial protein synthesis
4) nonlethal inhibition of protein synthesis
5) Inhibit synthesis of nucleic acids
6) Antimetabolites
7) Inhibitors of viral DNA replication

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2
Q

B lactam antibiotics mechanism of action

A

Disrupt bacterial cell wall causing them to take up water and burst through inhibiting transpeptidases that catalyze cell wall formation and activation of autolysins that cleave bonds in wall by binding Penicillin binding proteins

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3
Q

Penicilins are inactive against most….

A

…gram negative bacteria

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4
Q

B-lactamases

A

Coded for by a plasmid between bacteria to promote synthesis of proteins that release into the space around them to cleave certain PCNs

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5
Q

Narrow spectrum PCN’s that are penicillinase sensitive

A
  • PCN-G

- PCN-V

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6
Q

PCN-G treats what organisms, and is available in what form? Side effects?

A

Acts mostly on gram positive organisms, plus syphilus! Available in 4 diff salts depending on route of administration and course of action, Least toxic of all antibiotics, can have allergic reaction

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7
Q

If a patient has a PCN allergy, then how should we use cephalosporins?

A

Cautiously, probably avoid if severe PCN reaction

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8
Q

PCN drug interactions (3 to know)

A

1) probenecid - delay excretion
2) aminoglycosides - inhibed by PCNs and need to be administered separately
3) Bacteriostatic antibiotics - PCNs work best on fast dividing

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9
Q

PCN-V

A

Similar to Pen G but soluble in gastric acid so replaced pen G for oral therapy

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10
Q

Narrow spectrum PCN’s that are penicillinase resistant

A
  • oxacillin

- dicloxacillin

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11
Q

Oxacillin and dicloxacillin treats what pathogens?

A

S. aureus and S. epidermidis

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12
Q

Broad spectrum aminopenicllins

A
  • ampicillin

- amoxicillin

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13
Q

Ampicillin and amoxicillin treat what organisms? Side effects?

A
  • gram positive plus some gram negative bacilli

- amoxicillin rash (not serious) in children

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14
Q

Anti pseudomonal penicillins

A

-Piperacillin

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15
Q

Cephalosporins mechanism of action

A

Same as PCN’s, bind PBP and disrupt cell wall snthesis and activate lysins

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16
Q

1st -5th gen cephalosporins

A
  • 1st gen most susceptible to B lactamases, 5th is highly resistant
  • Increased activity against gram - bacteria
  • increased ability to reach csf
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17
Q

Cephalexin and what it treats

A

1st gen cephalospoirin, active against staphyloccoci and nonenterococcal streptococci, treat real easy shit sometimes given before surgery even

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18
Q

Cefoxitin

A

2nd gen cephalosporin, Increased activity against gram - bacteria

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19
Q

Ceftazidime and what it treats

A

3rd gen cephalosporin, broad spectrum, DOC for gram - bacilli

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20
Q

Cefipime

A

4th gen cephalosporin, highly resistant to B lactamases and broad spectrum of activity

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21
Q

Ceftaroline and what it treats

A

5th gen cephalosporin, only one active against MRSA

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22
Q

Cephalosporin absorption method, adverse side effects?

A

IM or IV required, allergic hypersensitivity, bleeding

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23
Q

Disulfuram like reaction

A

Occurs if patient is taking a cephalosporin and ingests alcohol

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24
Q

Don’t mix ceftriaxone and…

A

Ca2+, fatal precipitate

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25
Q

Carbapenems

A

B-lactam antibiotis that like penicillins and cephalosporins, inhibit bacterial cell wall synthesis, have very broad antimicrobial spectrum

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26
Q

Imipenum

A

Broad antimicrobial speectrum, can treat mixed infections

27
Q

Carbapenems method of absorption

A

Paraenterally (IV)

28
Q

Meropenum

A

Active against most gram pos and gram negative organisms

29
Q

Vancomycin usage

A

Widely used for C. difficile infections, MRSA, and patients with PCN allergies

30
Q

Vancomycin antimicrobial spectrum

A

Primarily gram + bacteria

31
Q

Vancomycin adverse effects

A
  • Renal failure (dose related)
  • Ototoxicity
  • Red man syndrome (histamine release resulting in rashes, flushing, potential to go into shock)
32
Q

Alternatives to vancomycin

A

Teicoplanin (no bad side effects really)
Fosfomycin
Telavancin

33
Q

Aminoglycosides are primarily effective against…

A

gram neg aerobes (must be aerobic for uptake)

34
Q

Aminoglycoside mechanism of action

A

Disrupt bacterial protein synthesis by byinding the 30S ribosomal subunit, rapidly bacteriocidal

35
Q

Aminoglycoside absorption, side effects

A

Paraenterally only (unless intended effect is to act in GI), sometimes topical therapy, ototoxicity nephrotoxicity, neuromuscular blockade

36
Q

Neommycin, gentamicin

A

Topical aminoglycoside therapy

37
Q

Aminoglycoside dosage must be very _____ because it has a _______

A

personalized, low therapeutic index

38
Q

These two should never share an IV bag

A

PCNs and aminoglycosides

39
Q

Gentamicin treats what organisms?

A

Treats serious infections caused by aerobic gram neg bacilli

40
Q

Amikacin characteristics

A
  • Broadest spectrum

- least vulnurable to inactivation

41
Q

Tetracyclines mechanism of action

A

Broad spectrum antibiotics that inhibit protein synthesis at the ribosome after being transported via energy dependent processes

42
Q

Tetracycline is rarely first drug of choice due to resistance in common bacterial diseases, but are still used to treat these few.

A
  • Rickettsial diseases
  • Chlamydia trachomatis
  • Brucella
  • Cholera
  • Mycoplasma pneumoniae
  • borelia burgdorferi
  • H pylori
  • antrahx
  • acne vulgaris
43
Q

Tetracycline absorption

A

Not bad absorption via GI, but form insoluble chelates with cations preventing absorption and thus require administration 1-2 hours after ingestion of a chelate

44
Q

Tetracycline side effect

A
  • GI upset
  • bones and teeth coloraion
  • suprainfection
  • hepatotoxicity
  • photosensitivity
45
Q

Longest acting tetracycline

A

Doxycycline

46
Q

Macrolides mechanism of action

A

Broad spectrum antibiotics that act by inhibiting bacterial protein synthesis, bind 50S ribosome and are bacteriostatic

47
Q

Erythromycin spectrum

A

Similar to penicillin, active against most gram positive, some gram neg

48
Q

When should erythromycin be used as DOC

A

Bordatella pertussis, corynebacterium diptheriae

49
Q

Erythromycin absorption

A

Food decreases absorption

50
Q

Erythromycin side effects

A

GI disturbances, QT prolongation and sudden cardiac death

51
Q

Clarithromycin

A

2-4x more active than erythromycin,

52
Q

Azithromycin

A

-More potent against specific organisms

53
Q

Chloramphenicol

A

Broad spectrum antibiotic with severe risk of causing aplastic anemia

54
Q

Chloramphenicol is drug of choice for…

A

Typhoid fever, bacterial meningitis

55
Q

Gray baby syndrome

A

Neonates who have been given large doses of chloramphenicol

56
Q

Dalflopristin/quinipristin, linezolid, treats

A

VRE

57
Q

Fluoroquinolones

A

Broad spectrum PO

58
Q

Fluoroquinolones side effects

A

Tendon rupture, peripheral neuropathy,

59
Q

Cirpofloxacin

A

takes care of a lot of shit

60
Q

Fluorquinolones mechanism of action

A

Passive diffusion, inhibit DNA replication, rapidly bactericidal

61
Q

Ciprofloxin warfarin interaction

A

Elevates levels

62
Q

Metronidazole

A

Useful for porotozoal infections and obligate anaerobic bacteria

63
Q

Rifampin side effects

A

Discolored body fluids

Infectious Disease (24 decks)

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