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ID Exam 2 Flashcards

1
Q

Penicillins/Cephalosporins/Carbapenems/Monobatams: MOA

A

inhibits cell wall synthesis by binding to and inhibiting PBPs

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2
Q

Penicillins/Cephalosporins/Carbapenems/Monobatams: time or conc-depedent?

A

time-dependent

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3
Q

Fluoroquinolones MOA

A

inhibits DNA synthesis by inhibiting bacterial topoisomerases

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4
Q

Macrolides MOA

A

inhibits protein synthesis by binding to 50S ribosomal subunits

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5
Q

Aminoglycosides MOA

A

inhibits protein synthesis by irreversibly binding to 30S ribosomal subunits

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6
Q

Fluoroquinolones: time or conc-dependent?

A

concentration-dependent

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7
Q

Macrolides: time or conc-dependent?

A

Time-dependent
(azithromycin can be conc-dependent against some organisms)

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8
Q

Aminoglycosides: time or conc-dependent?

A

concentration-dependent

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9
Q

vancomycin/dalbavancin MOA

A

inhibits 2nd stage of cell wall synthesis by binding to D-Ala-D-Ala cell wall precursors

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10
Q

Quinupristin-dalfopristin MOA

A

inhibits protein synthesis by binding to 50S ribosomal subunits

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11
Q

Linezolid/tedizolid MOA

A

inhibits protein synthesis by binding to 50S ribosomal subunits near 30S interface

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12
Q

Daptomycin MOA

A

causes membrane depolarization by inserting lipophilic tail in cell wall

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13
Q

Telavancin/oritavancin MOA

A

inhibits cell wall synthesis by binding to D-Ala-D-Ala call wall precursors AND causes membrane depolarization by inserting lipophilic tail in cell wall

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14
Q

Tetracyclines MOA

A

inhibits protein synthesis by binding to 30S ribosomal subunits

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15
Q

SMZ-TMP MOA

A

sequential inhibition of microbial folic acid synthesis pathway by inhibiting bacterial dihydropteroate synthetase and dihydrofolate reductase

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16
Q

Vancomycin/dalbavancin: time or conc-dependent?

A

Time-dependent

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17
Q

Quinupristin-dalfopristin: time or conc-dependent?

A

Time-dependent

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18
Q

Linezolid: time or conc-dependent?

A

Time

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19
Q

Tedizolid: time or conc-dependent?

A

Conc

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20
Q

Daptomycin: time or conc-dependent?

A

Conc

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21
Q

Telavancin/oritavancin: time or conc-dependent?

A

Conc

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22
Q

Tetracyclines: time or conc-dependent?

A

Time

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23
Q

SMZ-TMP: time or conc-dependent?

A

Time

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24
Q

Polymyxins MOA

A

Binds to phospholipids in cell membrane causing displacement of Ca and Mg, which leads to changes in cell wall permeability and leakage of cellular contents

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25
Clindamycin MOA
Inhibits protein synthesis by binding to 50S ribosomal subunits
26
Metronidazole MOA
Prodrug activated by ferredoxins whose activated metabolites damage bacterial DNA
27
Polymyxins: time or conc-dependent?
Conc
28
Clindamycin: time or conc-dependent?
Time
29
Metronidazole: time or conc-dependent?
Conc
30
MRSA Abx
Vancomycin Synercid Linezolid/tedizolid (if intolerant to vanc) Daptomycin (if intolerant to vanc) Telavanc, dalbavanc, oritavanc Ceftaroline Aminoglycosides
31
MRSA SSTIs Abx
Clindamycin TMP-SMZ Delafloxacin
32
P. aeruginosa Abx
1. Penicillins: Ticarcillin +Piperacillin and Pip-Tazo 2. Cephalosporins: Ceftazidime, Cefepime Cefiderocol 3. Carbapenems: Meropenem/doripenem (not ertapenem) 4. Aztreonam 5. FQs: Levo/cipro/dela 6. Aminoglycosides: Gentamicin, tobra, amikacin 7. Colistin, polymyxin B
33
PRSP Abx
1. Cephalosporins: Ceftriaxone, cefotaxime, cefiderocol, ceftaroline 2. FQs (levo, cipro, dela) 3. Vancomycin 4. Synercid 5. Linezolid/tedizolid 6. Daptomycin 7. Telavanc, dalbavanc, oritavanc
34
Which Abx should NOT be used with warfarin?
1. FQs (levo, cip, moxi, dela) 2. Erythromycin and clarithromycin 3. Metronidazole 4. SMZ-TMP
35
Which ABx require renal dose adjustments?
1. Aminoglycosides 2. Clarithromycin 3. Metronidazole 4. SMZ-TMP 5. Penicillins (EXCEPT nafcillin, oxacillin, piperacillin) 6. FQs: levo, cipro, dela 7. Carbapenems 8. Aztreonam 9. Vancomycin, telavancin, dalbavancin 10. Daptomycin 11. Cephalosporins (except ceftriaxone and cefoperazone)
36
ABx that should be avoided during pregnancy
1. Fluoroquinolones 2. Tetracyclines 3. Tela/dalba/oritavancin 4. SMZ-TMP
37
Aminoglycosides side effects
Nephrotoxicity Ototoxicity
38
Cephalosporins side effects
1. With 5-NMTT side chain: hypoprothrombinemia, disulfiram reaction 2. Leukopenia/neutropenia/thrombocytopenia 3. Biliary sludging - ceftriaxone 4. Pseudomembranous colitis (c. diff) 5. Nonconvulsive status epilepticus
39
Sulfonamides side effects
1. Rash (SJS rare) 2. Photosensitivity 3. Leukopenia 4. Renal insufficiency 5. Crystalluria 6. Hyperkalemia
40
Fluoroquinolones side effects
1. Peripheral neuropathy 2. Hepatotoxicity 3. QTc prolongation (caution in pts with hypokalemia or on antiarrhythmics) - risk of Torsades 4. Articular damage - don't use in pregnancy or pediatric patients 5. Tendonitis / tendon repture
41
Macrolides side effects
1. GI - pain, N/V/D 2. Thrombophlebitis and infusion site irritation 3. QTc prolongation
42
Tetracyclines side effects
1. GI - n/v 2. Photosensitivity 3. Discoloration of developing teeth - not used in children or pregnancy
43
Which penicillins should not be used in pts with CHF or renal dysfunction due to sodium load?
Pen G Nafcillin Ticarcillin Piperacillin
44
Vancomycin side effects
1. Red-man syndrome 2. Nephrotoxicity 3. Ototoxicity
45
Quinupristin/dalfopristin side effects
1. Venous irritation 2. GI - n/v/d 3. Myalgia/arthralgia 4. Rash
46
Linezolid side effects
1. GI - n/d 2. headache 3. Thrombocytopenia and anemia
47
Tela/dalba/oritavancin side effects
1. Red man syndrome 2. Nephrotoxicity 3. QTc prolongation 4. Taste disturbances
48
Which penicillins are most commonly associated with interstitial nephritis?
methicillin nafcillin
49
What unique toxicity do carbapenems have? Risk factors for this toxicity?
CNS toxicity - seizures Risk factors: preexisting CNS disorders, high doses, renal dysfunction
50
Which macrolide does NOT inhibit cyp3a4/cyp2c9?
Azithromycin
51
Drug of choice for MSSA
Nafcillin
52
Drug of choice for P. aeruginosa
Ticarcillin
53
Drug of choice for MRSA
Vancomycin
54
Why would we add an antibiotic to cover Gram-negative aerobes when using metronidazole?
Because metronidazole only covers anaerobes
55
Drug of choice for VRE
Linezolid
56
Synercid __________ CYP3a4
inhibits
57
Which drug class is rarely used as monotherapy?
aminoglycosides
58
Abx for atypical bacteria - Legionella
1. FQs 2. Macrolides 3. Tetracyclines
59
What is the drug of choice for ESBLs and AmpC-producing bacteria?
carbapenems
60
Which Abx will interact with bi- and trivalent cations so that oral absorption is impaired, potentially leading to clinical failure?
tetracyclines FQs
61
Which classes of ABx may cause QTc prolongation?
Macrolides FQs
62
If a patient has an allergic reaction to a sulfonamide, what other drugs should they avoid?
1. carbonic anhydrase inhibitors 2. thiazides 3. furosemide 4. sulfonylureas
63
Which Abx classes may cause leukopenia?
1. Penicillins 2. Cephalosporins 3. Sulfonamides
64
Metronidazole is most reliably active against what?
Bacteroides fragilis
65
What is the drug of choice for Listeria monocytogenes and Enterococcus spp.
Ampicillin and amoxicillin (aminopenicillins)
66
Beta-lactams- mechanisms of resistance
1. B-lactamase production 2. Altered PBPs 3. Decreased penetration through outer cell membrane - Gram (-) only
67
Vanc/Tela/Dalba/Oritavancin mechanism of resistance
modification of the D-ala-D-ala vancomycin binding site
68
Increases in acidity of sulfonamides ________ the incidence of crystalluria
decrease
69
SMX-TMP mechanism of resistance
mutations in dihydrofolate reductase or dihydropteroate synthetase

P3 Therapeutics (21 decks)

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