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Infectious Disease > Drugs one last time > Flashcards

Drugs one last time Flashcards

The Ultimate List

1
Q

B-lactam antibiotics function, categories, structure

A
  • Disrupt cell wall to allow for water to flood in and cause the cell to burst
  • PCNs, cephalosporins, carbapenums, and aztreonam
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2
Q

PCN mechanism of action

A

Bind to penicillin binding proteins and cause inhibition of transpeptidases and activation of autolysins

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3
Q

PCN is mostly affective against gram…

A

positive organisms

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4
Q

Most common ADR to PCN

A

Allergic rxn, approx 7%

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5
Q

How organisms have developed resistance to PCN

A
  • B-lactamase production
  • PCN can’t reach PBPs
  • PBP’s with low affinity
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6
Q

PenG is active against…

A
  • Gram + bacteria except for highly resistant ones

- Some gram neg including niesseria, also DOC for syphilis

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7
Q

PenG specrum

A

Narrow

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8
Q

PenG administration

A

4 diff salts, none activated PO

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9
Q

PenG elimination prolongation is caused by what?

A

Probencid

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10
Q

What 2 drug classes should never share IV?

A

PCN and aminoglycoside, inhibit each other when distributed together, synergistic when administered separately

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11
Q

PenV

A

-Identical version of PenG but has resistance to gastric acid so is the go to standard for oral therapy

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12
Q

Nafcillin, oxacillin, dicloxacillin spectrum

A

Very narrow, only penicillinase producing strains of S. aureus and S. epidermidis

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13
Q

Aminopenicillins include…

A

Ampicillin, amoxicillin

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14
Q

Ampicillin and amoxicillin antimicrobial spectrum

A

Most gram + organisms, some gram - including Haemophilus, Escherechia coli, Salmonella, Shigella, E. faecalis

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15
Q

Most commoon amoxicillin ADR

A

Amoxicillin rash, nonallrgic maculopapular rash not serious

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16
Q

Piperacillin spectrum

A

Pseudomonas aeruginosa, enterobacter, bacteroides fragilis, klebsiella, as well as most gram + and some other gram -

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17
Q

3 common B-lactamase inhibitors to be combined with penicillinase sensitive PCN

A

1) clavulanic acid
2) tazobactam
3) sulbactam

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18
Q

Cephalosporins mechanism of action

A

Same as PCN, bind PBP’s and disrupt cell wall synthesis and activate autolysins

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19
Q

How has resistance against cephilosporins developed?

A

B-lactamases, altered PBP production with lower affinity

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20
Q

Cephalexin spectrum

A

Highly active against gram + bacteria, not a lot against gram -

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21
Q

5 generations of cephalosportins

A

1) cephalexin
2) cefoxitin
3) ceftazidime
4) cefipime
5) ceftaroline

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22
Q

Cefoxitin spectrum

A

Highly active against gram +, more active against gram - as well such as klebsiella

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23
Q

Ceftazidime spectrum

A

Highly active against gram + and neg, and pseudomonas, can penetrate CSF (DOC for meningitis)

24
Q

Cefipime spectrum

A

Broad spectrum, high resistance to B-lactamases

25
Ceftaroline spectrum
MRSA mother fucker
26
Cephalosporin ADRs
- Allergic reaction - cross reactivity with penicillin - Reduction of prothrombin levels - alcohol intolerance - Ca2+ precipitate formation
27
Cephalosporins are ineffective against this type of bacteria
Enterococci
28
Carbapenems mechanism of action
-Bind PBP 1 and 2 cause weakening of bacterial cell wall with lysis and death, resistant to most B lactamases and can penetrate gram neg envelope
29
Imipenem spectrum
Very broad, many mixed infections with anaerobes, staph aureus, and gram neg bacilli, gram + and -, P. aeruginosa, B. fragilis
30
Cilistatin interacts with what drug to inhibit destruction by renal enzymes?
Imipenem
31
Imipenem ADR
- Siezures in elderly | - Cross allergy with penicillin
32
Meropenem spectrum
Active against most gram pos and gram neg, meningitis in children
33
Ertapenem spectrum
Narrower than other carbapenems, no activity against P. aeruginosa
34
Carbapenams absorption
Typically parenterally (IV)
35
Dorpipenim spectrum
Broad range, including P. aeruginosa
36
Aztreonam mechanism of action
Interferes with PBP3 to prevent synthesis of bacterial cell wall
37
Aztreonam spectrum
Narrow, only aerobic gram neg including - H. influenzae - P. aeruginosa - Enterbacteriacieae
38
Types of infeections aztreonam treats
As a sub for aminoglycosides in UTI, lower respiratory, and soft tissue infections
39
Aztreonam ADR
Pseudomembranous colitis suprainfection
40
Vancomycin mechanism of action
-Inhibiting cell wall synthesis without PBP interaction
41
Vancomycin treats what organisms
- DOC for Cdiff, MRSA - Serious infections in patients with PCN allergies - Mostly gram pos
42
Vancomycin ADRs
Renal failure, ototoxicity, red man syndrome
43
Vancomycin absorption
Parenterally, IV
44
Teicoplanin
Similar action and structure to vancomycin, but largely devoid of any ADRs
45
Fosfomycin
Similar action and structure to vancomyscin, often used in uncomplicated UTI
46
Telavancin
Similar action and structure to vancomycin, treats complex skin infections and causes taste disturbance and foamy urine
47
Aminoglycoside spectrum
Narrow, only gram - aerobic bacilli, such as the enterobacteriaciae class
48
Aminoglycoside common ADR's
Kidney and inner ear damage, neuromuscular blockage
49
Aminoglycoside mechanism of action
Dirsupt bacterial protein synthesis by binding 30 s ribosomal unit after active transport across cell membrane via Oxygen dependant process
50
Aminoglycosides, despite their status as a protein inhibitor, are fundamentally bacterio....
...cidal
51
Aminoglycoside resistance
Transfer of enzymes that inactivate them via R factors
52
Aminoglycoside absorption
Parenteral therapy or topical use
53
Gentamicin indication
Often used in combination with vanco or cephalosporin for severe gram + infection
54
Tobramycin indication
More active against P. aeruginosa, topical eye treatment
55
Amikacin 2 outstanding features
1) Broadest spectrum of all aminoglycocides | 2) Least vulnurable to inactivation by bacterial enzymes
56
Neomycin 3 outstanding features
1) most toxic of all aminoglycosides 2) topical application 3) used to suppress bowel flora prior to surgery

Infectious Disease (24 decks)

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