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Z.Fiser > Fiser.06.Antibiotics > Flashcards

Fiser.06.Antibiotics Flashcards

1
Q

What does an antiseptic do?

A

kills and inhibits organisms in the body

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2
Q

what does a disinfectant do?

A

kills & inhibits organisms on inanimate objects

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3
Q

what does sterilization do?

A

kill all organisms

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4
Q

what does betadine (iodophor) kill and not kill?

A

good for GPCs / GNRs; bad for fungi

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5
Q

what does chlorhexidine (Hibiclens) kill?

A

good for GPCs, GNRs, and fungi

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6
Q

what is the MOA of penicillin?

A

inhibits cell wall synthesis

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7
Q

what is the MOA of cephalosporins?

A

inhibits cell wall synthesis

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8
Q

what is the MOA of carbapenems?

A

inhibits cell wall synthesis

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9
Q

what is the MOA of monobactams?

A

inhibit cell wall synthesis

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10
Q

what is the MOA of vancomycin?

A

inhibits cell wall synthesis

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11
Q

what is the MOA of tetracycline?

A

inhibits 30S ribosome and protein synthesis

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12
Q

what is the MOA of aminoglycosides? (tobramycin / gentamicin)

A

inhibits 30S ribosome and protein synthesis

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13
Q

what is the MOA of linezolid?

A

inhibits 30S ribosome and protein synthesis

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14
Q

what is the MOA of erythromycin?

A

inhibits 50S ribosome = reduced protein synthesis

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15
Q

what is the MOA of clindamycin

A

inhibits 50S ribosome = reduced protein synthesis

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16
Q

what is the MOA of Synercid (dalfopristin / quinupristin)

A

inhibits 50S ribosome = reduced protein synthesis

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17
Q

what is the MOA of quinolones?

A

inhibits DNA helicase (DNA gyrase)

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18
Q

what is the MOA of rifampin?

A

inhibits RNA polymerase

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19
Q

what is the MOA of flagyl?

A

produces O2 radicals –> DNA breaks

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20
Q

what is the MOA of sulfonamides?

A

PABA analogue (para-aminobenzoic acid) = reduced purine synthesis

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21
Q

what is the MOA of trimethoprim?

A

inhibits dihydrofolate reductase = reduced purine synthesis

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22
Q

what is the difference between bacteriostatic and bactericidal antibiotics?

A

bactericidal abx kill bacteria directly. Bacteriostatic abx stop bax from growing

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23
Q

is tetracycline bacteriostatic or bactiricidal?

A

bacteriostatic

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24
Q

is clindamycin bacteriostatic or bactericidal?

A

bacteriostatic

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25
Q

is erythromycin bacteriostatic or bactericidal? why?

A

bacteriostatic b/c it has reversible ribosomal binding

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26
Q

is Bactrim bacteriostatic or bactericidal?

A

bacteriostatic

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27
Q

are aminoglycosides bacteriostatic or bactericidal? why?

A

bacteriocidal b/c irreversible ribosomal binding

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28
Q

what enzyme is expressed in penicillin-resistant bacteria?

A

beta lactamase

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29
Q

what is the MC mechanism of abx resistance?

A

transfer of plasmids

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30
Q

what is the MOA of resistance in MRSA

A

mutation of cell wall binding protein

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31
Q

what is the mechanism of resistance of VRE?

A

mutation in a cell wall binding protein

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32
Q

what is the mechanism of resistance to gentamicin?

A

modified enzymes = reduced active transport of gentamicin into bacteria

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33
Q

what are the appropriate peak and trough levels of vancomycin?

A

peak: 20-40 ug/mL
trough: 5-10 ug/mL

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34
Q

what are the peak and trough levels for gentamicin?

A

peak: 6-10 ug/mL
trough: <1ug/mL

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35
Q

what is the dosing modification for an abx peak being too high?

A

decrease the amount of each dose

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36
Q

what is the dosing modification for an abx trough being too high?

A

reduce frequency of doses, which will increase the time between doses

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37
Q

name six bugs covered by PCN

A

strep (GPCs); syphilis; neisseria meningitides (GPRs); clostridium perfringens (GPRs); beta hemolytic strep; anthrax

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38
Q

what two GPCs are PCN ineffective against?

A

staphylococcus & enterococcus

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39
Q

what GPCs are oxacillin & nafcillin effective against?

A

anti-staph

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40
Q

what bax are ampicillin & amoxicillin effective against? (7)

A

same as PCN + enterococcus:

strep; syphilis; neisseria meningitides; clostridium perfringens; beta hemolytic strep; anthrax

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41
Q

what is covered by Unasyn (ampicillin/sublacatam) & Augmentin (amoxicillin / clavulanate)

A

Broad Spectrum - GPCs (staph/strep/enterococcus);
GNRs;
+/- anaerobic coverage

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42
Q

What are 3 bugs are Unasyn (ampicillin/sublactam)/ Augmentin(amoxicillin/clavulanate) ineffective against?

A

pseudomonas;
acinetobacter;
serratia

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43
Q

What is the MOA of sublactam

A

beta lactamase inhibitor

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44
Q

what is the MOA of clavulanic acid?

A

beta lactamase inhibitor

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45
Q

what are four bugs are ticarcillin & piperacillin effective against?

A

pseudomonas (anti-pseudomonal PCN);
enterics;
acinetobacter;
serratia

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46
Q

what are two adverse effects of ticarcillin & piperacillin

A

inhibits platelets; high salt load

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47
Q

what is the generic name of Timentin?

A

ticarcillin / clavulanic acid

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48
Q

what is the generic name for Unasyn?

A

ampicillin / sublactam

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49
Q

What is the generic name for Augmentin?

A

amoxicillin / clavulanate

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50
Q

What is the generic name for Zosyn?

A

piperacillin / tazobactam

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51
Q

what is covered by Timentin or Zosyn?

A

Broad Spectrum:
GPCs: Staph / Strep / Enterococcus;
GNRs: enterics, pseudomonas, acinetobacter, serratia;
anaerobes

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52
Q

Name two adverse effects of Timentin / Zosyn

A

inhibit platelets; high salt load

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53
Q

How frequent is Zosyn dosing?

A

qid (q6hr)

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54
Q

Name two first generation cephalosporins

A

cefazolin (Ancef); cephalexin (Keflex)

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55
Q

what do first-generation cephalosporins cover?

A

GPCs (staph and strep)

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56
Q

What bacteria is first-generation cephalosporins ineffective against?

A

enterococcus

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57
Q

what body cavity is not penetrated by first-generation cephalosporins?

A

does not penetrate CNS

58
Q

which first-generation cephalosporin has the longest T1/2 & is best for prophylaxis?

A

Ancef (cefazolin)

59
Q

Name 3 second-generations cephalosporins

A

cefoxitin (Mefoxin);
cefotetan (Apatef / Cefotan);
cefuroxime (Ceftin / Zinacef)

60
Q

Which covers staph better, first or second-generation cephalosporins?

A

first-generation cephalosporins have better staph coverage

61
Q

What do second-generation cephalosporins cover?

A

GPCs, GNR, +/- anaerobic coverage

62
Q

What are second-generation cephalosporins ineffective against? (4)

A

enterococcus; pseudomonas; acinetobacter; serratia

63
Q

are second-generation cephalosporins effective against community-acquired or nosocomial GNRs?

A

only against community-acquired GNRs

64
Q

Which second-generation cephalosporins have the longest T1/2 and are the best for prophylaxis?

A

cefotetan

65
Q

Name 4 third-generation cephalosporins

A

ceftriaxone (Rocephin); ceftazidime (Fortaz/Tazicef);

cefepime (Maxipime); cefotaxime (Claforan)

66
Q

What are third-generation cephalosporins effective against?

A

Mostly GNRs +/- anaerobic coverage; Pseudomonas, Acinetobacter, Serratia (all GNRs)

67
Q

What one bacteria are third-generation cephalosporins ineffective against?

A

Enterococcus

68
Q

Name two adverse effects of third generation cephalosporins

A

cholestatic jaundice; gallbladder sludge (CTX)

69
Q

What is covered by aztreonam (Monobactam)?

A

GNRs: pseudomonas, acinetobacter, serratia

70
Q

Name two carbapenems

A

meropenem, imipenem

71
Q

What drugs are carbapenems paired with and why?

A

cilastatin - prevents renal hydrolysis of the drug, thereby increasing T1/2 of the abx

72
Q

What do carbapenems cover?

A

Broad Spectrum: GPCs, GNRs, anaerobes

73
Q

What three bugs are carbapenems ineffective against?

A

MEP: MRSA, Enterococcus, Proteus

74
Q

Name 1 adverse effect of carbapenems

A

seizures

75
Q

What does Bactrim cover?

A

GNRs +/- GPCs

76
Q

What four bugs are Bactrim ineffective against?

A

Enterococcus; Pseudomonas; Acinetobacter; Serratia

77
Q

Name 4 adverse effects of Bactrim

A

teratogenic; allergic reactions (sulfa);

renal damage; Steven-Johnson Syndrome (erythema multiforme)

78
Q

What is the adverse effect of Bactrim in G6PD-deficient patients?

A

hemolysis

79
Q

Name three quinolones

A

ciprofloxacin; levofloxacin; norfloxacin

80
Q

What do quinolones cover?

A

Some GPCs, mostly GNRs (pseudomonas, acinetobacter, Serratia)

81
Q

What bacteria are quinolones ineffective against?

A

Enterococcus

82
Q

What percent of MRSA are sensitive to quinolones?

A

40%

83
Q

Which version of quinolones are more effective: PO or IV?

A

both are equally effective

84
Q

How frequently is ciprofloxacin dosed?

A

BID

85
Q

How frequently is levofloxacin (Levaquin) dosed?

A

qdaily

86
Q

name two aminoglycosides

A

gentamicin, tobramycin

87
Q

What do aminoglycosides cover?

A

GNRs, good for pseudomonas, acinetobacter, serratia

88
Q

What bax are aminoglycosides ineffective against and why?

A

ineffective against anaerobes because need O2 to function

89
Q

What is the mechanism of resistance of aminoglycosides?

A

resistance 2/2 modifying enzymes: cause reduced active transport of antibiotics

90
Q

What drug should you add to aminoglycosides to treat enterococcus?

A

aminoglycosides are synergistic with ampicillin

91
Q

why are beta lactams (ampicillin / amoxicillin) synergistic with aminoglycosides

A

facilitate aminoglycoside penetration

92
Q

name two adverse effects of aminoglycosides (differentiate between reversible and irreversible side effects)

A

reversible nephrotoxicity; irreversible ototoxicity

93
Q

name 1 macrolide

A

erythromycin

94
Q

what does erythromycin cover?

A

GPCs

95
Q

what two infectious diseases is erythromycin best for treating?

A

community-acquired PNA, atypical PNA

96
Q

which abx act as a prokinetic or the bowel and how?

A

erythromycin binds to the motility receptor

97
Q

name 1 adverse effect of PO erythromycin

A

nausea

98
Q

name 1 adverse effect of IV erythromycin

A

cholestasis

99
Q

name 1 glycopeptide antibiotics

A

vancomycin

100
Q

name the class of bax and three specific spp covered by vancomycin

A

GPCs:

enterococcus; C dif (PO only); MRSA

101
Q

what is the MOA of vancomycin?

A

binds cell wall proteins

102
Q

what is the mechanism of resistance of vancomycin

A

change in cell wall binding protein

103
Q

name four adverse effects of vancomycin

A

HTN; red man syndrome 2/2 histamine release;
nephrotoxicity;
ototoxicity

104
Q

what is the generic name of Synercid?

A

quinupristin/dalfopristin

105
Q

what class of bax and 2 spp does synercid cover?

A

GPCs: MRSA, VRE

106
Q

name 1 oxazolidinone abx

A

linezolid (Zyvox)

107
Q

What class of bax and 2 spp. does Linezolid cover?

A

GPCs: MRSA, VRE

108
Q

What two classes of bax are covered by clindamycin?

A

anaerobes, some GPCs

109
Q

name 1 AE of tetracycline

A

tooth discoloration in children

110
Q

what two classes of bax and two spp are covered by tetracycline?

A

GPCs, GNRs, syphilis, Clostridium perfringens

111
Q

what 1 infection is clindamycin particularly good for?

A

aspiration PNA

112
Q

name 1 AE of clindamycin

A

pseudomemranous colitis

113
Q

what class of bax is covered by Flagyl (metronidazole)

A

anaerobes

114
Q

name 2 adverse effects of Flagyl

A

disulfiram-like reaction; peripheral neuropathy with long-term use

115
Q

what is the MOA of amphotericin?

A

bind sterols in the wall; alter membrane permeability

116
Q

name 5 AEs of amphotericin

A

nephrotoxicity; fever; hypokalemia; hypotension; anemia

117
Q

does the liposomal formulation of amphotericin have more or fewer side effects?

A

liposomal type has fewer AEs

118
Q

what is the MOA for voriconazole / itraconazole?

A

inhibit ergosterol synthesis which is needed for the cell membrane

119
Q

what is the MOA of anidulafungin (Eraxis)?

A

inhibits synthesis of cell wall glucan

120
Q

what antifungal should you add for a patient with prolonged fever on BS abx

A

itraconazole

121
Q

what is the antifungal for invasive aspergillosis?

A

voriconazole

122
Q

what is the antifungal used for candidemia

A

anidulafungin (Eraxis)

123
Q

what is the tx for fungal sepsis other than candida and aspergillosis?

A

liposomal amphotericin

124
Q

name the four drugs used to tx TB

A

isoniazid, rifamipin, pyrazinamide, ethambutol

125
Q

what is the MOA of isoniazid and what drug does it need to be co-administered with?

A

inhibits mycolic acid, needs to be administered with pyridoxine

126
Q

name two AEs of isoniazid

A

B6 deficiency; hepatotoxicity

127
Q

what is the MOA of rifampin

A

inhibits RNA polymerase

128
Q

name 3 AES of rifampin

A

hepatotoxicity; GI sx; high rates of resistance

129
Q

name 1 AE of pyrazinamide

A

hepatotoxicity

130
Q

name 1 AE of ethambutol

A

retrobulbar neuritis

131
Q

what is the MOA of acyclovir?

A

inhibits viral DNA-polymerase

132
Q

what does acyclovir treat? (2)

A

HSV, EBV

133
Q

what is the MOA of ganciclovir?

A

inhibits viral DNA polymerase

134
Q

what does ganciclovir treat?

A

CMV

135
Q

name 2 AEs of ganciclovir

A

bone marrow suppression; CNS toxicity

136
Q

what abx can lead to superinfection?

A

broad spectrum abx

137
Q

name 6 abx effective against enterococcus

A

vancomycin; timentin; zosyn; ampicillin; amoxicillin; ampicillin + gentamicin

138
Q

name 6 classes of abx effective against pseudomonas, acinetobacter, and serratia

A

ticarcillin/piperacillin; timetin/zosyn; third generation cephalosporins; aminoglycosides (gentamicin/tobramycin); meropenem / imipenem; fluoroquinolones

139
Q

Which bug requires double coverage?

A

pseudomonas

140
Q

why are perioperative abx administered?

A

to prevent SSI

141
Q

when do perioperative abx need to be administered relative to the incision?

A

within 1 hour prior to incision

Z.Fiser (22 decks)

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