Fiser Chapter 6: Antibiotics Flashcards

1
Q

Antiseptic vs. Disinfectant vs. Sterilization

A

Anti-septic: kills organisms on body
Disinfectant: kills organisms on inaminate objects
Sterilization: all organisms killed

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2
Q

Common surgical antiseptics; which one is better for fungi?

A

Iodophors: GPC, GNR, poor for fungi
Chlorhexidine: GPC, GNR, fungi

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3
Q

Bacterial classes: inhibitor of cell wall synthesis

A

PCN, CS, carbapenem, monobactams, vancomycin

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4
Q

Bacterial class: inhibitors of the 30s ribosome and protein synthesis

A

Tetra-cycline, AG (tobra, gent), Linezolid

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5
Q

Bacterial class: inhibitors of 50s ribosome and protein synthesis

A

Erythromycin, Clinda, Synercid

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6
Q

Bacterial class: Inhibitor of DNA helicase (DNA gyrase)

A

Quinolones

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7
Q

Bacterial class: Inhibitor of RNA polymerase

A

Rifampin

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8
Q

Bacterial class: Produces oxygen radicals that break up DNA

A

Flagyl

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9
Q

Bacterial class: PABA analogue, inhibits purine synthesis

A

Sulfonamides

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10
Q

Bacterial class: Inhibits dihydrofolate reductase, which inhibits purine synthesis

A

Bactrim

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11
Q

Bacteriostatis ABX

A

Tetracycline, Clinda, erythromycin, Bactrim (reversal ribosomal binding)

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12
Q

Bacterocidal ABX

A

Aminoglycocides

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13
Q

Mechanism of PCN resistance

A

Plasmids for beta-lactamase (i.e. Staph)

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14
Q

Most common method of antibiotics reistance

A

Transfer of plasmids

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15
Q

MRSA resistance caused by

A

Mutation of cell wall-binding protein

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16
Q

Mechanism of resistance for VRE

A

Mutation in cell wall binding protein

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17
Q

Gentamicin resistance due to

A

Modifying enzymes leading to decrease in active transport of gentamicin into bacteria

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18
Q

Appropriate drug levels: Vanc peak and trough

A

Peak: 20-40; trough 5-10

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19
Q

Appropriate drug levels: Gent peak and trough

A

Peak 6-10; trough < 1

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20
Q

If drug peak too high, what do you do?

A

Decrease amount of each dose

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21
Q

If drug trough too high, what do you do?

A

Decrease frequency of doses

22
Q

Organisms for PCN

A

Strep, Syphillis, N. meningitis, S. perf, GAS, anthrax

23
Q

Is PCN effective against Staph or Enterococcus?

A

No

24
Q

Oxacillin, Methicillin and Nafcillin used for treatment of

A

Staph

25
Q

Difference between Ampicillin/Amox vs. PCN

A

Picks up enterococci

26
Q

Unasyn, Augmentin

A

GPC, GNR, anaerobes; enterococci

- NOT Pseudomonas, aceinetobacter, Serratia

27
Q

Sulbactam, clavulinic acid

A

Beta-lactamase inhibitors

28
Q

Zosyn covers

A

Enterics, Pseudomonase, Acinetobacter, Serratia

29
Q

AE Zosyn

A

Inhibits platelets, high salt load

30
Q

First-generation CS

A

Cefazolin, Cephalexin; GPC

- Not effective for enterococcus; does not penetrate CNS

31
Q

Why is Ancef used for PPX?

A

Longest half-life

32
Q

Second-generation CS

A

GPC, GNR, some staph; not Enterococcus, Pseudomonas, Acinetobacter, Serratia
- Cefotetan (longest half-life)

33
Q

Third-generation CS

A

CTX, Cefepime; GNRs mostly, not Enterococcus; Yes Pseudomonas, Acinetobacter, Serratia
AE: Cholestatic jaundice, GB sludging

34
Q

Aztreonam

A

Monobactam: GNR (Pseudonomas, Acinetobacter, Serratia)

35
Q

Carbapenems (Meropenem, imipenem)

A

Given with cilastin
- BS: not effective for MEP (MRSA, Enterococcus, Proteus)
AE: Seizure

36
Q

AE carbapenems

A

Seizure

37
Q

Bactrim

A

GNR; not Enterococcus, pseudomonas, acinetobacter, serratia

AE: teratogenic, allergy, renal, SJS, hemolysis in G6PD

38
Q

ABX a/w hemolysis in G6PD

A

Bactrim

39
Q

Quinolones

A

GPC, mostly GNR
Not: Enterococcus; some Pseudomonas, Acinetobacter, Serratioa
40% MRSA
- Cipro: BID, Levaquin QD dosing

40
Q

T/F PO = IV Cipro

A

True

41
Q

AE Quinolones

A

Tendon ruptures

42
Q

Aminoglycosides

A

Gent, Tobra; good for pseudomonas, acinetobacter, serratia (not anaerobes)

43
Q

AG are synergistic with __________ for Enterococcus

A

Ampicillin

44
Q

Which ABX facilitate AG penetration?

A

Beta-lactams

45
Q

Erythromycin is a _______ ABX. Used for…

A

Macrolide

- GPC, CAP, atypical PNA

46
Q

AE erythromicin

A

Nausea (PO), cholestasis (IV)

47
Q

This ABX is a prokinetic because it binds to this receptor

A

Erythromycin; motilin

48
Q

Vancomycin

A

GPC, Enterococcus, C. diff, MRSA
- Binds cell wall proteins
Resistance: change in cell-wall binding protein
- AE: HTN, redman syndrome, nephrotoxicity, ototoxicity

49
Q

ABX effective for Pseudomonas, Acinetobacter, Serratia

A

Zosyn, Cefepime, AG (genatmcin/tobramycin), Meropenem, Fluroquinolines

50
Q

T/F You should double-cover for Pseudomonas

A

True; has alginate mucoid biolayer; can colonize tubes and lines

51
Q

Treatment for VRE

A

Linezolid; synercid

52
Q

Effective for Enterococcus

A

Ampicillin/Amoxicinllin, Vanc, Zosyn