Fiser Chapter 6 ANTIBIOTICS Flashcards by Nasim Babazadeh

Betadine

An iodophor
Good for GPCs and GNRs
Not for fungi

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Chlorhexidine gluconate

e.g. Hibiclens

Good for GPCs, GNRs, and fungi

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Quinolone MoA

DNA gyrase/helicase inhibitors

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Rifampin MoA

RNA polymerase inhibitor

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PCN MoA

Cell wall synthesis inhibitor

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Vanc MoA

cell wall synthesis inhibitor

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Cephalosporin MoA

Cell wall synthesis inhibitor

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Carbapenem MoA

Cell wall synthesis inhibitor

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Monobactam (aztreonam) MoA

Cell wall synthesis inhibitor

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Tetracycline MoA

30s ribosome and protein synthesis inhibitor

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Aminoglycoside MoA

e.g. Tobramycin, Gentamicin

30s ribosome and protein synthesis inhibitor

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Linezolid MoA

30s ribosome and protein synthesis inhibitor

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Erythromycin MoA

50s ribosome and protein synthesis inhibitor

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Clindamycin MoA

50s ribosome and protein synthesis inhibitor

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Synercid MoA

50s ribosome and protein synthesis inhibitor

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Metronidzole MoA

Free radicals break DNA

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Sulfa MoA

PABA analogue, inhibits purine synthesis

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Trimethoprim MoA

DHFR inhibitor, inhibits purine synthesis

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Most common method of abx resistance

Transfer of plasmids

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PCN resistance

beta-lactamase plasmids

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MRSA resistance

cell wall binding protein mutation PBP2a

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Gentamicin resistance

Modifying enzymes cause decreased active transport of gentamicin into bacteria

PCN spectrum

Strep, syphilis, N meningitis, C perfringens, GAS, anthrax

Gap: staph and enterococcus

Oxacillin and nafcillin spectrum

Staph only: “anti-staph penicillins”

Ampicillin and amoxicillin spectrum

strep, syphilis, N meningitides, C perfringens, GAS, anthrax, +enterococcus Gap: staph

Unasyn (amp/sulbactam) and Augmentin (amox/clav) spectrum

GPCs (staph and strep), GNRs, +/- anaerobes, enterococcus | Gap: PAS pseudomonas, acinetobacter, serratia

Ticarcillin and piperacillin spectrum

GNRs (pseudomonas, enterics, acinetobacter, serratia) | Side effect: inhibits platelets, high salt load

Timentin (ticarcillin/clav) and Zosyn (pip/sulbactam) spectrum

Broad spectrum: GPCs (staph and strep), GNRs, anaerobes, enterococci, PAS pseudomonas, acinetobacter, serratioa Side effect: inhibits platelets, high salt load

Cefazolin, cephalexin (1st gen cephalo) spectrum

GPCs (staph and strep) Gap: no cephalo for an enterococcus; no CNS Cefazolin longest t1/2 so good for ppx

Cefoxitin, cefotetan, cefuroxime (2nd gen cephalo) spectrum

GPCs, GNRs, +/- anaerobe, los some staph Gap: enterococcus and CNS Cefotetan longest t1/2 so good for ppx

Ceftriaxone, ceftazidime, cefepime, cefotaxime (3rd gen cephalo)

GNRs mostly including PAS pseudomonas, acinetobacter, serratia, +/- anaerobes Gap: enterococcus Side effects: cholestasis, sludge

Aztreonam (monobactam) spectrum

GNRs; PAS pseudomonas, acinetobacter, serratia

Carbapenems with cilastatin spectrum

GPC, GNR, anaerobes Gap: MEP MRSA, enterococcus, proteus Cilastin prevents renal hydrolysis and increases t1/2 Side effect: seizures

Bactrim spectrum

GNRs, +/- GPCs Gap: enterococcus, PAS Side effects: teratogenic, allergic rxn, renal damage, SJS (EM), hemolysis in G6PD def

Cipro, levo, norflox (quinolone) spectrum

Mostly GNRs, PAS, some GPCs | Gap: enterococcus

Gentamicin, Tobramycin (aminoglycosides)

GNRs, PAS Gap: anaerobes (need O2) Amp/gen: synergy for enterococcus; beta lactams facilitate penetration Side effects: reversible nephrotoxicity, irreversible ototoxicity

Erythromycin (macrolide) spectrum

GPCs, CAP and atypical PNA Side effect: nausea and cholestasis Prokinetic: binds motilin receptor

Vancomycin (a glycopeptide) spectrum

GPCs, enterococcus, C diff if PO, MRSA | Side effects: HTN, redman (histamine), nephrotoxicity, ototoxicity

Vanc resistance mechanism

Change in cell-wall binding protein

Synercid (streptogramin) aka quinupristin-dalfopristin spectrum

GPCs, MRSA, VRE

Linezolid (oxazolidinone) spectrum

GPCs, MRSA, VRE

Tetracycline spectrum

GPCs, GNRs, syphilis | Side effects: tooth discoloration in kids

Clindamycin spectrum

anaerobes, some GPCs

Metronidazole spectrum

anaerobes | Side effects: disulfiram-like reaction, peripheral neuropathy with longterm use

Amphotericin MoA, side effects

Binds sterols in wall and alters membrane permeability Side effects: nephrotoxic Liposomal has fewer side effects Use for all fungal sepsis except candida (anidulafungin) and aspergillus (voriconazole)

Voriconazole and itraconazole MoA

Inhibit ergosterol synthesis | Invasive aspergillosis

Anidulafungin (eraxis)

Inhibits cell wall glucan synthesis | Candidemia

Isoniazid MoA and side effects

Inhibits mycolic acids (give with pyridoxine) | Side effects: Hepatotoxicity, B6 deficiency

Rifampin MoA and side effects

Inhibits RNA polymerase | Side effects: Revs up 450; hepatotoxicity, GI symptoms, high rate of resistance

Acyclovir MoA and use

Inhibits viral DNA polymerase | HSV and EBV

Ganciclovir MoA, use, side effect

inhibits viral DNA polymerase CMV Side effects: decreased bone marrow, CNS toxicity

Enterococcus treatment

Vancomyin Timentin/zosyn Ampicillin/amoxicillin Gentamycin/ampicillin

Pseudomonas, Acinetobacter, Serratia tx

``` Ticarcillin/piperacillin Timentin/zosyn Third gen cephalosporins Aminoglycosides (gentamicin and tobramycin) Meropenem/imipenem Fluoroquinolones ```